Efficacy of wrist robot-aided orthopedic rehabilitation: a randomized controlled trial

• Published in: Journal of neuroengineering and rehabilitation 2021-08, Vol.18 (1), p.1-130, Article 130
• Main Authors: Albanese, Giulia Aurora, Taglione, Elisa, Gasparini, Cecilia, Grandi, Sara, Pettinelli, Foebe, Sardelli, Claudio, Catitti, Paolo, Sandini, Giulio, Masia, Lorenzo, Zenzeri, Jacopo
• Format: Article
• Language: English
• Subjects: Clinical trials; Devices; Edema; Fractures; Health aspects; Injuries; Neurological diseases; Orthopedic; Orthopedics; Pain; Patients; Physical therapists; Physical therapy; Range of motion; Rehabilitation; Robotic assessment; Robotic rehabilitation; Robotics; Robots; Spinal cord injuries; Technology application; Therapeutics, Physiological; Therapy; Virtual reality; Wrist; Wrist injury
• ISSN: 1743-0003; 1743-0003
• DOI: 10.1186/s12984-021-00925-0

Background In recent years, many studies focused on the use of robotic devices for both the assessment and the neuro-motor reeducation of upper limb in subjects after stroke, spinal cord injuries or affected by neurological disorders. Contrarily, it is still hard to find examples of robot-aided assessment and rehabilitation after traumatic injuries in the orthopedic field. However, those benefits related to the use of robotic devices are expected also in orthopedic functional reeducation. Methods After a wrist injury occurred at their workplace, wrist functionality of twenty-three subjects was evaluated through a robot-based assessment and clinical measures (Patient Rated Wrist Evaluation, Jebsen-Taylor and Jamar Test), before and after a 3-week long rehabilitative treatment. Subjects were randomized in two groups: while the control group (n = 13) underwent a traditional rehabilitative protocol, the experimental group (n = 10) was treated replacing traditional exercises with robot-aided ones. Results Functionality, assessed through the function subscale of PRWE scale, improved in both groups (experimental p = 0.016; control p < 0.001) and was comparable between groups, both pre (U = 45.5, p = 0.355) and post (U = 47, p = 0.597) treatment. Additionally, even though groups' performance during the robotic assessment was comparable before the treatment (U = 36, p = 0.077), after rehabilitation the experimental group presented better results than the control one (U = 26, p = 0.015). Conclusions This work can be considered a starting point for introducing the use of robotic devices in the orthopedic field. The robot-aided rehabilitative treatment was effective and comparable to the traditional one. Preserving efficacy and safety conditions, a systematic use of these devices could lead to decrease human therapists' effort, increase repeatability and accuracy of assessments, and promote subject's engagement and voluntary participation. Trial Registration ClinicalTrial.gov ID: NCT04739644. Registered on February 4, 2021--Retrospectively registered, Keywords: Robotic rehabilitation, Robotic assessment, Wrist injury, Orthopedic