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Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici

Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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European Journal of Physical and Rehabilitation Medicine 2017 Sep 04

DOI: 10.23736/S1973-9087.17.04815-8


lingua: Inglese

Technologically-advanced assessment of upper-limb spasticity: a pilot study

Federico POSTERARO 1, 2 , Simona CREA 3, Stefano MAZZOLENI 2, 3, Mihai BERTEANU 4, Ileana CIOBANU 5, Nicola VITIELLO 3, 6, Marco CEMPINI 3, 8, Sabata GERVASIO 7, Natalie MRACHACZ-KERSTING 7

1 Rehabilitation Department Versilia Hospital, AUSL Toscana Nord Ovest, Pisa, Italy; 2 Bioengineering Rehabilitation Laboratory, Auxilium Vitae Rehabilitation Centre, Volterra, Pisa, Italy; 3 The BioRobotics Institute, Scuola Superiore Sant’Anna, Pontedera, Pisa, Italy; 4 University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania; 5 University Hospital Elias, Rehabilitation Research, Bucharest, Romania; 6 Fondazione Don Carlo Gnocchi, Florence, Italy; 7 Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark; 8 Shirley Ryan AbilityLab, Chicago, IL, USA


BACKGROUND: Spasticity is a muscle disorder associated with upper motor neuron syndrome occurring in neurological disorders, such as stroke, multiple sclerosis, spinal cord injury and others. It influences the patient’s rehabilitation, interfering with function, limiting independence, causing pain and producing secondary impairments, such as contractures or other complications. Due to the heterogeneity of clinical signs of spasticity, there is no agreement on the most appropriate assessment and measurement modality for the evaluation of treatment outcomes.
DESIGN: Observational pilot study involving five post stroke patients.
METHODS: A new robotic device able to automatically assess upper-limb spasticity during passive and active mobilization has been developed. The elbow spasticity of five post stroke patients has been assessed by using the new device and by means of the Modified Ashworth Scale (MAS). After the first assessment, subjects were treated with botulin toxin injections, and then underwent 10 sessions of robotic treatments. After the treatment, subjects spasticity was assessed by using the robotic device and the MAS score.
RESULTS: In four out of five patients, the botulin toxin injection and robotic treatment resulted in the improvement of the MAS score; in three patients the robotic measures were able to detect the MAS changes. In one subject botulin toxin was not effective and the robotic device was able to detect the lack of effectiveness.
CONCLUSIONS: By using the robotic device some spasticity parameters can be continuously recorded during the rehabilitation treatment in order to objectively measure the effectiveness of the interventions provided.
CLINICAL REHABILITATION IMPACT: The standardized evaluation parameters recorded using robotic devices may provide several advantages: 1) the measures for spasticity assessment can be monitored during every rehabilitation session (even during each movement), 2) these measurements are able to highlight even small changes, 3) the recovery plateau can be detected early thus avoiding further rehabilitation sessions, and 4) these measurements can reduce the assessment bias in multicenter studies.

KEY WORDS: Rehabilitation - Robotics - Upper limb - Spasticity - Assessment

inizio pagina

Publication History

Article first published online: September 4, 2017
Manuscript accepted: September 4, 2017
Manuscript revised: August 28, 2017
Manuscript received: May 13, 2017

Per citare questo articolo

Posteraro F, Crea S, Mazzoleni S, Berteanu M, Ciobanu I, Vitiello N, et al. Technologically-advanced assessment of upper-limb spasticity: a pilot study. Eur J Phys Rehabil Med 2017 Sep 04. DOI: 10.23736/S1973-9087.17.04815-8

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