AN EXOSKELETON ROBOTIC DEVICE FOR UPPER LIMB TRAINING AFTER STROKE: PILOT CASE SERIES.

Purpose: Stroke is a leading cause of long-term disability in adult population and more than half of the survivors are left with significant impairment. Rehabilitation options are still limited to address the need for effective recovery from motor impairment, especially for upper limb functions. In the last decade, roboticassisted arm training has been an emerging research topic. However, there is still fundamental need to study safety, feasibility and effectiveness of each device before implementing them into standard rehabilitation protocols. In this case series we demonstrate results from a pilot clinical trial aiming to evaluate an robotic exoskeleton specifically designed for rehabilitation of arm motor functions. Methods: Two chronic left hemiplegic patients (Case1: male, 66 yo, 48 months since stroke ; Case 2: female, 58 yo, 12 months since stroke onset) participated in the study. Modified Ashworth Scale (MAS), Fugl Meyer (FM), isokinetic system (Biodex), Barthel Index (BI) were used before and after treatment to assess spasticity, motor recovery, proprioception and muscle strength, and ADL, respectively. Participants underwent a total of 12 sessions (60 min/session, 3 sessions/week, during 4 weeks) robotic-assisted arm training by using a robotic exoskeleton device, HoustonBionics ExoRehabUE1 (Istanbul, Turkey). Results: Both participants have demonstrated improvement in all outcome measures, with a higher improvement in proprioception. None of the training sessions were missed due to excessive fatigue or lack of motivation. Moreoever, they reported high motivation to participate in the treatment and demonstrated considerable increase in virtual game scores. Conclusions: Robotic-assisted arm training with the HoustonBionis ExoRehabUE1 device is well tolerated, and found to be feasible in rehabilitation of arm impairment after stroke. Improvement in movement and sensory functions were observed. Preliminary results from this pilot trial will be used for a randomized clinical trial with a larger sample size. [ABSTRACT FROM AUTHOR]