Does hand robotic rehabilitation improve motor function by rebalancing interhemispheric connectivity after chronic stroke? Encouraging data from a randomised-clinical-trial. Issue 5 (May 2019)

• Record Type: Journal Article
• Authors: Calabrò, Rocco Salvatore; Accorinti, Maria; Porcari, Bruno; Carioti, Luigi; Ciatto, Laura; Billeri, Luana; Andronaco, Veronica Agata; Galletti, Franco; Filoni, Serena; Naro, Antonino
• Is Part Of: Clinical neurophysiology. Volume 130:Issue 5(2019:May)
• Page Start: 767
• Page End: 780
• Publication Date: 2019-05
• Subjects: Amadeo™ -- Hand rehabilitation -- Frontoparietal connectivity -- Sensorimotor plasticity; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2019.02.013
• Languages: English
• ISSNs: 1388-2457

Abstract

Highlights: Robotic hand training can be helpful in improving hand motor recovery. Amadeo™ induces large modulations of sensorimotor rhythms and connectivity. Robotic training yields improvement of hand motor performance by restoring hand motor control. Abstract: Objective: The objective of this study was the evaluation of the clinical and neurophysiological effects of intensive robot-assisted hand therapy compared to intensive occupational therapy in the chronic recovery phase after stroke. Methods: 50 patients with a first-ever stroke occurred at least six months before, were enrolled and randomised into two groups. The experimental group was provided with the Amadeo™ hand training (AHT), whereas the control group underwent occupational therapist-guided conventional hand training (CHT). Both of the groups received 40 hand training sessions (robotic and conventional, respectively) of 45 min each, 5 times a week, for 8 consecutive weeks. All of the participants underwent a clinical and electrophysiological assessment (task-related coherence, TRCoh, and short-latency afferent inhibition, SAI) at baseline and after the completion of the training. Results: The AHT group presented improvements in both of the primary outcomes (Fugl-Meyer Assessment for of Upper Extremity and the Nine-Hole Peg Test) greater than CHT (both p < 0.001). These results were paralleled by a larger increase in the frontoparietal TRCoh in the AHT than in the CHT group (p < 0.001) and a greater rebalance between the SAI of both the hemispheres (p < 0.001). Conclusions: These data suggest a wider remodelling of sensorimotor plasticity and interhemispheric inhibition between sensorimotor cortices in the AHT compared to the CHT group. Significance: These results provide neurophysiological support for the therapeutic impact of intensive robot-assisted treatment on hand function recovery in individuals with chronic stroke.