A Multiparameter Approach to Evaluate Post-Stroke Patients: An Application on Robotic Rehabilitation
Multidomain instrumental evaluation of post-stroke chronic patients, coupled with standard clinical assessments, has rarely been exploited in the literature. Such an approach may be valuable to provide comprehensive insight regarding patients’ status, as well as orienting the rehabilitatio...
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doaj-369a4c7fc8464ae8986218dc91da9c092020-11-25T01:56:30ZengMDPI AGApplied Sciences2076-34172018-11-01811224810.3390/app8112248app8112248A Multiparameter Approach to Evaluate Post-Stroke Patients: An Application on Robotic RehabilitationAntonella Belfatto0Alessandro Scano1Andrea Chiavenna2Alfonso Mastropietro3Simona Mrakic-Sposta4Simone Pittaccio5Lorenzo Molinari Tosatti6Franco Molteni7Giovanna Rizzo8Institute of Bioimaging and Molecular Physiology (IBFM), National Research Council of Italy (CNR), Via Fratelli Cervi, 93, 20090 Segrate, ItalyInstitute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing (STIIMA), National Research Council of Italy (CNR), Via Alfonso Corti 12, 20133 Milan, ItalyInstitute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing (STIIMA), National Research Council of Italy (CNR), Via Alfonso Corti 12, 20133 Milan, ItalyInstitute of Bioimaging and Molecular Physiology (IBFM), National Research Council of Italy (CNR), Via Fratelli Cervi, 93, 20090 Segrate, ItalyInstitute of Bioimaging and Molecular Physiology (IBFM), National Research Council of Italy (CNR), Via Fratelli Cervi, 93, 20090 Segrate, ItalyInstitute of Condensed Matter Chemistry and Technologies for Energy, (ICMATE), National Research Council of Italy (CNR), Via Previati 1/E, 23900 Lecco, ItalyInstitute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing (STIIMA), National Research Council of Italy (CNR), Via Alfonso Corti 12, 20133 Milan, ItalyRehabilitation Presidium of Valduce Ospedale Villa Beretta, Via Nazario Sauro 17, 23845 Costa Masnaga, ItalyInstitute of Bioimaging and Molecular Physiology (IBFM), National Research Council of Italy (CNR), Via Fratelli Cervi, 93, 20090 Segrate, ItalyMultidomain instrumental evaluation of post-stroke chronic patients, coupled with standard clinical assessments, has rarely been exploited in the literature. Such an approach may be valuable to provide comprehensive insight regarding patients’ status, as well as orienting the rehabilitation therapies. Therefore, we propose a multidomain analysis including clinically compliant methods as electroencephalography (EEG), electromyography (EMG), kinematics, and clinical scales. The framework of upper-limb robot-assisted rehabilitation is selected as a challenging and promising scenario to test the multi-parameter evaluation, with the aim to assess whether and in which domains modifications may take place. Instrumental recordings and clinical scales were administered before and after a month of intensive robotic therapy of the impaired upper limb, on five post-stroke chronic hemiparetic patients. After therapy, all patients showed clinical improvement and presented pre/post modifications in one or several of the other domains as well. All patients performed the motor task in a smoother way; two of them appeared to change their muscle synergies activation strategies, and most subjects showed variations in their brain activity, both in the ipsi- and contralateral hemispheres. Changes highlighted by the new multiparametric instrumental approach suggest a recovery trend in agreement with clinical scales. In addition, by jointly demonstrating lateralization of brain activations, changes in muscle recruitment and the execution of smoother trajectories, the new approach may help distinguish between true functional recovery and the adoption of suboptimal compensatory strategies. In the light of these premises, the multi-domain approach may allow a finer patient characterization, providing a deeper insight into the mechanisms underlying the relearning procedure and the level (neuro/muscular) at which it occurred, at a relatively low expenditure. The role of this quantitative description in defining a personalized treatment strategy is of great interest and should be addressed in future studies.https://www.mdpi.com/2076-3417/8/11/2248chronic strokerobotic assistanceEEGERD mapsmuscle synergiessynergies clusteringkinematicsFugl-Meyer Assessment |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Antonella Belfatto Alessandro Scano Andrea Chiavenna Alfonso Mastropietro Simona Mrakic-Sposta Simone Pittaccio Lorenzo Molinari Tosatti Franco Molteni Giovanna Rizzo |
spellingShingle |
Antonella Belfatto Alessandro Scano Andrea Chiavenna Alfonso Mastropietro Simona Mrakic-Sposta Simone Pittaccio Lorenzo Molinari Tosatti Franco Molteni Giovanna Rizzo A Multiparameter Approach to Evaluate Post-Stroke Patients: An Application on Robotic Rehabilitation Applied Sciences chronic stroke robotic assistance EEG ERD maps muscle synergies synergies clustering kinematics Fugl-Meyer Assessment |
author_facet |
Antonella Belfatto Alessandro Scano Andrea Chiavenna Alfonso Mastropietro Simona Mrakic-Sposta Simone Pittaccio Lorenzo Molinari Tosatti Franco Molteni Giovanna Rizzo |
author_sort |
Antonella Belfatto |
title |
A Multiparameter Approach to Evaluate Post-Stroke Patients: An Application on Robotic Rehabilitation |
title_short |
A Multiparameter Approach to Evaluate Post-Stroke Patients: An Application on Robotic Rehabilitation |
title_full |
A Multiparameter Approach to Evaluate Post-Stroke Patients: An Application on Robotic Rehabilitation |
title_fullStr |
A Multiparameter Approach to Evaluate Post-Stroke Patients: An Application on Robotic Rehabilitation |
title_full_unstemmed |
A Multiparameter Approach to Evaluate Post-Stroke Patients: An Application on Robotic Rehabilitation |
title_sort |
multiparameter approach to evaluate post-stroke patients: an application on robotic rehabilitation |
publisher |
MDPI AG |
series |
Applied Sciences |
issn |
2076-3417 |
publishDate |
2018-11-01 |
description |
Multidomain instrumental evaluation of post-stroke chronic patients, coupled with standard clinical assessments, has rarely been exploited in the literature. Such an approach may be valuable to provide comprehensive insight regarding patients’ status, as well as orienting the rehabilitation therapies. Therefore, we propose a multidomain analysis including clinically compliant methods as electroencephalography (EEG), electromyography (EMG), kinematics, and clinical scales. The framework of upper-limb robot-assisted rehabilitation is selected as a challenging and promising scenario to test the multi-parameter evaluation, with the aim to assess whether and in which domains modifications may take place. Instrumental recordings and clinical scales were administered before and after a month of intensive robotic therapy of the impaired upper limb, on five post-stroke chronic hemiparetic patients. After therapy, all patients showed clinical improvement and presented pre/post modifications in one or several of the other domains as well. All patients performed the motor task in a smoother way; two of them appeared to change their muscle synergies activation strategies, and most subjects showed variations in their brain activity, both in the ipsi- and contralateral hemispheres. Changes highlighted by the new multiparametric instrumental approach suggest a recovery trend in agreement with clinical scales. In addition, by jointly demonstrating lateralization of brain activations, changes in muscle recruitment and the execution of smoother trajectories, the new approach may help distinguish between true functional recovery and the adoption of suboptimal compensatory strategies. In the light of these premises, the multi-domain approach may allow a finer patient characterization, providing a deeper insight into the mechanisms underlying the relearning procedure and the level (neuro/muscular) at which it occurred, at a relatively low expenditure. The role of this quantitative description in defining a personalized treatment strategy is of great interest and should be addressed in future studies. |
topic |
chronic stroke robotic assistance EEG ERD maps muscle synergies synergies clustering kinematics Fugl-Meyer Assessment |
url |
https://www.mdpi.com/2076-3417/8/11/2248 |
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