The impact of robot-mediated adaptive I-TRAVLE training on impaired upper limb function in chronic stroke and multiple sclerosis

Purpose: The current study aimed to investigate proof-of-concept efficacy of an individualized, robotmediated training regime for people with MS (pwMS) and stroke patients. Method: Thirteen pwMS and 14 chronic stroke patients performed 36 (stroke) or 40 (pwMS) training sessions with the I-TRAVLE system. Evaluation of upper limb function was performed at baseline, after training and at 3 months follow-up. Clinical outcome measures consisted of active range of motion (ROM), Motricity Index, Jamar handgrip strength, perceived fatigue and strength, Wolf Motor Function Test (WFMT) and ABILHAND. Robot-generated outcome measures consisted of movement velocity, ROM and actual covered distance compared to straight-line distance. Results: In pwMS, significant improvements were found after training in active shoulder ROM, handgrip strength, perceived strength and WMFT activities. No significant change in clinical outcome was found in stroke patients, except for perceived strength. Significant improvement in speed and movement duration was found after training in both groups. At follow-up, clinical outcome deteriorated in pwMS and was maintained in stroke patients. Conclusions: Robot-mediated training resulted in improved movement coordination in both groups, as well as clinical improvement in pwMS. Absence of functional improvements in stroke patients may relate to severe upper limb dysfunction at baseline. The authors would like to thank the Rehabilitation Centre Blixembosch for their cooperation regarding the development of the I-TRAVLE system (2009–2012), master students Wouter Dielkens and Sander Geurts for their help with the training and data collection and Prof. Dr. Bert Op‘t Einde for project management (2008–12). This research project is supported by Interreg (INTERREG IVA-VLANED-1.58: “I-TRAVLE” project).