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Blog Post
Robotic Support Enables More Efficient Neurological Rehabilitation
Lucille Watts • Oct 24, 2019
New study from Italy identifies Tyromotion's AMADEO, DIEGO and PABLO best at meeting the clinical, organisational and sustainability needs as well as strategic objectives of rehabilitation centres.
Dr. Irene Aprile and the team from Fondazione Don Carlo Gnocchi
(FDG), Italy conducted a research project on the effects of using robot-mediated group therapy to treat the upper limb globally. Chosen over various other devices, the Tyromotion AMADEO
, DIEGO
and PABLO
were found to be best at meeting the clinical, organisational and sustainability needs as well as strategic objectives of rehabilitation centres. The team could show that the improvements in clinical functions of the upper limb were significant when using robotic group therapy compared to the conventional (1:1) approach.
The AMADEO, DIEGO and PABLO have shown to be among the most efficient robotic devices for upper limb rehabilitation.
Background
Rehabilitation programs are mainly focused on walking recovery, with insufficient attention being paid to the upper limb. Robot-assisted therapy is gaining increasing attention from clinicians and researchers, providing promising results for upper limb recovery. However, almost all publications have focused on the effect of using a single device and the use in a research setting rather than in clinical practice. Therefore, FDG aimed first, to describe an approach for identifying a set of devices to treat the upper limb globally, and second, to verify the use of the devices in clinical practice.
Summary
Summary of the new publication from Dr. Irene Aprile and the multidisciplinary team from Fondazione Don Carlo Gnocchi (FDG), Italy
- FDG aimed to identify a set of devices, that meet their clinical, organisational, sustainability needs as well as the strategic objectives of the institution.
- The result of their systematic approach was to choose the AMADEO®, DIEGO® and PABLO® from Tyromotion
- In total 10 rehabilitation devices were evaluated:
- AMADEO® (Tyromotion)
- DIEGO® (Tyromotion)
- PABLO® (Tyromotion)
- Motore (Humanware)
- Ultra (Humanware)
- ArmeoPower (Hocoma)
- ArmeoSpring (Hocoma)
- Gloreha (Idrogent)
- ReoGo (Motore)
- Braccio die ferro
- Evaluation criteria: e.g. product maturity, body segment treated, type of assistance provided, provides assessments, maximum level of impairment, customisable exercises ,preparation time, autonomous use by the patient, possibility to use the device in group therapy, number of clinicians involved in the treatment, scientific papers, cost of purchase and maintenance.
Robotic group therapy for upper limb rehabilitation
- Robotic group therapy for upper limb rehabilitation was compared to the conventional (1:1) approach in 30 stroke patients.
- Patients in both groups performed therapy for 45 min per day for 5 days per week and a total of 30 sessions (total of 22.5 hours over 6 weeks).
- A ratio of one therapist to three (1:3) or four (1:4) patients was used, depending on the patients severity mix as well as the treating experts opinion.
- During the 30 sessions program all 4 devices were used for each patient to treat the distal and proximal upper limb. Effective therapy time was optimised by using only one or two devices per patient and session.
- All patients further received conventional treatment for balance, walking, and lower limb recovery.
- The identified devices allow to treat the upper limb globally (includingshoulder, elbow, wrist, andhand), and to arrange the rehabilitation area so that one physiotherapist can treat more than one patient at once.
- After rehabilitation, only the robotic group showed significant improvements in clinical functions of the upper limb.
- This pilot study has been followed by the introduction the devices in seven other FDG centres and a multi-centre RCT. Today, the devices are routinely used in these centres in clinical practice
A multi-centre RC from FDG in over 200 patients is in publication.
Aprile I, Germanotta M, Cruciani A et al. Upper Limb Robotic Rehabilitation after Stroke: A Multicenter, Randomized Clinical Trial. J. Neurol. Phys. Ther. (in press).
Acknowledgement
Tyromotion gratefully acknowledge Dr. Irene Aprile and the team of Fondazione Don Carlo Gnocchi for their research contributions advancing thefield. We thank EMAC for their passion in rehabilitation technology and realizing this excellent project with Tyromotion devices.
Reference
Aprile I, Cruciani A, Germanotta M, Gower V, Pecchioli C, Cattaneo D, Vannetti F, Padua L, GramaticaF. Upper limb robotics in rehabilitation: An approach to select the devices, based on rehabilitation aims, and their evaluation in a feasibility study. Appl. Sci. 2019 Sep, 9, 3920
https://doi.org/10.3390/app9183920
In January this year, Neurotherapy Worx in Wigan took delivery of the D-Wall by TecnoBody. Neurotherapy Worx is a specialist team of Adult and Paediatric Therapists based in a fully accessible clinic in Appley Bridge. Neurotherapy Worx offers both clinic and home-based rehabilitation. Over the last two months Neurotherapy Worx have been integrating the D-Wall into their everyday clinic. This short article shares their experiences so far. Has it been easy to integrate D-Wall within your everyday clinic practice? The D-Wall has been easy to integrate into clinic. It has been used during initial assessments, integrated into treatment plans and formal reviews. It enables us to undertake specific assessments and see change over time in patients’ abilities. How easy is the D-Wall to use with regards to patient set up? The D-Wall is very quick to set up once you have created a profile with a client’s date of birth, weight and height recorded. However, it is also possible to try different activities with an adult client without creating a profile. If you spend time in the Monitor facility so that the client understands how their foot position, their upper body and centre of gravity impacts the D-wall, this makes using the other settings, exercises, games more effective during the assessment and treatment process. How are you using D-Wall in clinic? We are using the D-Wall in many different ways! Therapy ·It is really useful for people with one sided weakness. They can visually see their alignment and work actively to try and correct this (previously we would verbally give feedback and facilitate). Good for strengthening and gaming afterwards. D-Wall is good at finding things we would not necessarily pick up on or see. It’s like an extra pair of eyes. We are working with patients and adapting things all the time. Constantly adapting and adjusting the movements. Can be used for a specific part of the session or for the whole treatment session. Trunk control. Balance – within and out of base of support. Look at specific motor control of a specific limb; or address gross motor control. Good to work on balance and trunk control whilst carrying out a more functional / meaningful activity. Engaging children and adults in repetitive movements or using the less dominant limb. Bilateral arm movements. Improve cardiovascular system in a safe supported environment. Muscle strengthening. Use neglected limb. With treadmill. With parallel bars. Using therapy ball for seated activities/games. Assessment and Reporting Standardised, repeatable fitness and health tests The data from D-Wall makes our reports a lot more accurate.
Ectron attends Masterclass in Neuro Technology (MiNT) 2024 at The Royal Society of Medicine - 15th April 2024
Ectron recently attended Tyromotion's three-day gathering in Graz, Austria with the motto: "International Meeting on the Future of Rehabilitation" Attendees, including customers and partners took the opportunity to discuss market trends, to network and to rethink the future of rehabilitation. The first day of the 3-day meeting was dedicated entirely to the international partners, with presentations by Tyromotion's In-House experts with the focus on exchanging knowledge and a presentation on new developments. There was news and educations around Tyromotion's new MTT-Line and insights into clinical applications. Highlights included new research findings and patient success stories created an exciting outlook on the future of rehabilitation. The CustomerDays, included practical demonstrations in Tyromotions s howroom . Tees Neuro Physiotherapy joined Ectron is Graz and gained valuable insights into the applications of the full Tyromotion range of devices and MTT- Line.
Ectron visit TecnoBody's Headquarters in Italy.
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ECTRON NEWS
In January this year, Neurotherapy Worx in Wigan took delivery of the D-Wall by TecnoBody. Neurotherapy Worx is a specialist team of Adult and Paediatric Therapists based in a fully accessible clinic in Appley Bridge. Neurotherapy Worx offers both clinic and home-based rehabilitation. Over the last two months Neurotherapy Worx have been integrating the D-Wall into their everyday clinic. This short article shares their experiences so far. Has it been easy to integrate D-Wall within your everyday clinic practice? The D-Wall has been easy to integrate into clinic. It has been used during initial assessments, integrated into treatment plans and formal reviews. It enables us to undertake specific assessments and see change over time in patients’ abilities. How easy is the D-Wall to use with regards to patient set up? The D-Wall is very quick to set up once you have created a profile with a client’s date of birth, weight and height recorded. However, it is also possible to try different activities with an adult client without creating a profile. If you spend time in the Monitor facility so that the client understands how their foot position, their upper body and centre of gravity impacts the D-wall, this makes using the other settings, exercises, games more effective during the assessment and treatment process. How are you using D-Wall in clinic? We are using the D-Wall in many different ways! Therapy ·It is really useful for people with one sided weakness. They can visually see their alignment and work actively to try and correct this (previously we would verbally give feedback and facilitate). Good for strengthening and gaming afterwards. D-Wall is good at finding things we would not necessarily pick up on or see. It’s like an extra pair of eyes. We are working with patients and adapting things all the time. Constantly adapting and adjusting the movements. Can be used for a specific part of the session or for the whole treatment session. Trunk control. Balance – within and out of base of support. Look at specific motor control of a specific limb; or address gross motor control. Good to work on balance and trunk control whilst carrying out a more functional / meaningful activity. Engaging children and adults in repetitive movements or using the less dominant limb. Bilateral arm movements. Improve cardiovascular system in a safe supported environment. Muscle strengthening. Use neglected limb. With treadmill. With parallel bars. Using therapy ball for seated activities/games. Assessment and Reporting Standardised, repeatable fitness and health tests The data from D-Wall makes our reports a lot more accurate.
Ectron attends Masterclass in Neuro Technology (MiNT) 2024 at The Royal Society of Medicine - 15th April 2024
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