Upper Extremity Rehabilitation using Robotics: Difference between revisions

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<h1> &nbsp;Description&nbsp;  </h1>
= &nbsp;Description&nbsp;  =
<p><br />
</p>
<h1> Indication&nbsp;  </h1>
<p><br />
</p>
<h1> Key Evidence&nbsp;<br />  </h1>
<h2> Stroke and Spinal Cord Injuries&nbsp;  </h2>
<p>Several robotic machines have shown to be effective in patients with stroke. For example, the Armeo Spring (Figure 1) helps to recover function in the hemiparetic arm, forearm and wrist in patients who have experienced a stroke and have consequent hemiparesis. The Armeo Spring is an adjustable suspension system for the upper limb that connects to virtual reality (VR), which has settings with several degrees of complexity <span class="fck_mw_ref">Colomer C, Baldoví A, Torromé S, Navarro MD, Moliner B, Ferri J, et al. Efficacy of Armeo® Spring during the chronic phase of stroke. Study in mild to moderate cases of hemiparesis. Neurologia [Internet]. 2013;28(5):261–7. Available from: files/160/495v28n05a90209825pdf001.pdf%5Cn http://www.ncbi.nlm.nih.gov/pubmed/22727271</span>. The system is an exoskeleton that supports the patient’s arm and magnifies any residual active movement of the hemiparetic arm in 3-dimensional space <span class="fck_mw_ref">Colomer C, Baldoví A, Torromé S, Navarro MD, Moliner B, Ferri J, et al. Efficacy of Armeo® Spring during the chronic phase of stroke. Study in mild to moderate cases of hemiparesis. Neurologia [Internet]. 2013;28(5):261–7. Available from: files/160/495v28n05a90209825pdf001.pdf%5Cnhttp://www.ncbi.nlm.nih.gov/pubmed/22727271</span>. Distally, it detects grasp pressure and the sensitivity may be adjusted depending on the patient’s condition <span class="fck_mw_ref">Colomer C, Baldoví A, Torromé S, Navarro MD, Moliner B, Ferri J, et al. Efficacy of Armeo® Spring during the chronic phase of stroke. Study in mild to moderate cases of hemiparesis. Neurologia [Internet]. 2013;28(5):261–7. Available from: files/160/495v28n05a90209825pdf001.pdf%5Cnhttp://www.ncbi.nlm.nih.gov/pubmed/22727271</span>. VR settings are designed to bring varying levels of difficulty in the velocity, direction and moving area <span class="fck_mw_ref">Colomer C, Baldoví A, Torromé S, Navarro MD, Moliner B, Ferri J, et al. Efficacy of Armeo® Spring during the chronic phase of stroke. Study in mild to moderate cases of hemiparesis. Neurologia [Internet]. 2013;28(5):261–7. Available from: files/160/495v28n05a90209825pdf001.pdf%5Cnhttp://www.ncbi.nlm.nih.gov/pubmed/22727271</span>. The system provides information about specific movement parameters (strength, range of motion, and coordination) to allow for proper adjustment of the difficulty level for the patient during the recovery process <span class="fck_mw_ref">Colomer C, Baldoví A, Torromé S, Navarro MD, Moliner B, Ferri J, et al. Efficacy of Armeo® Spring during the chronic phase of stroke. Study in mild to moderate cases of hemiparesis. Neurologia [Internet]. 2013;28(5):261–7. Available from: files/160/495v28n05a90209825pdf001.pdf%5Cnhttp://www.ncbi.nlm.nih.gov/pubmed/22727271</span>. A study of the effects of the Armeo spring system and the benefits in subacute spinal cord injury patients showed that there is significant improvement in the Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP) sensibility scores of subjects with partial hand function at baseline <span class="fck_mw_ref">Zariffa J, Kapadia N, Kramer JLK, Taylor P, Alizadeh-Meghrazi M, Zivanovic V, et al. Effect of a robotic rehabilitation device on upper limb function in a sub-acute cervical spinal cord injury population. IEEE Int Conf Rehabil Robot [Internet]. 2011;50(3):220–6. Available from: http://dx.doi.org/10.1038/sc.2011.104</span>.<br /> <br />Specific to the fingers and hand, the Amadeo is another robotic system that has shown to be useful in those recovering from stroke. A randomized control trial conducted on acute stroke patients looked at the effectiveness of robot- assisted hand therapy using the Amadeo Robotic System by Tyromotion. Amadeo Robot is an end-effector based system that has five degrees of freedom and provides the motion of one or all five fingers through a passive rotational joint placed between the fingertip and an entity that moves laterally (the thumb has two passive rotational joints) <span class="fck_mw_ref">Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, et al. Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial. Int J Rehabil Res [Internet]. 2014;37(3):236–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769557</span>. All five translational degrees of freedom are independent and provide an almost entire coverage of the fingers’ workspace <span class="fck_mw_ref">Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, et al. Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial. Int J Rehabil Res [Internet]. 2014;37(3):236–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769557</span>. The interface between the human hand and the machine is achieved thanks to elastic bands or plasters and the wrist is restrained from movement by a Velcro strap <span class="fck_mw_ref">Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, et al. Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial. Int J Rehabil Res [Internet]. 2014;37(3):236–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769557</span>. The Amadeo treatment composed of:<br />1) Continuous passive therapy<br />2) Assisted movement therapy<br />3) Balloon training (active training in a virtual environment by carrying out target oriented tasks) <span class="fck_mw_ref">Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, et al. Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial. Int J Rehabil Res [Internet]. 2014;37(3):236–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769557</span>.<br />Comparable to traditional Occupational Therapy methods, patients within the robotic therapy group made significant improvements in Fugl-Meyer Scale (FM), and Box and Block Test (BB) at the end of treatment (4/5 weeks) and maintained improvements after a 3-month follow-up <span class="fck_mw_ref">Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, et al. Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial. Int J Rehabil Res [Internet]. 2014;37(3):236–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769557</span>. This result is very important because the gain achieved is not exercise or time dependent, but could be secondary to reorganization of brain structures <span class="fck_mw_ref">Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, et al. Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial. Int J Rehabil Res [Internet]. 2014;37(3):236–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769557</span>.
</p><p>More evidence demonstrated the clinical feasibility of using other types of robotics than the Armeo or Amadeo. MIT-MANUS, MIME, ARM-Guide, T-WREX and NeReBot <span class="fck_mw_ref">Norouzi-Gheidari N, Archambault PS, Fung J. Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature. J Rehabil Res Dev. 2012;49(4):479–96.</span>. The results are just as expected, when conventional therapy is matched with robotic therapy in terms of duration/intensity, there is no statistically significant difference in the Fugl Meyer assessment scores <span class="fck_mw_ref">Norouzi-Gheidari N, Archambault PS, Fung J. Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature. J Rehabil Res Dev. 2012;49(4):479–96.</span>. However, when robotic therapy was added on top of conventional therapy, there was a significant improvement in Fugal Meyer scores <span class="fck_mw_ref">Norouzi-Gheidari N, Archambault PS, Fung J. Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature. J Rehabil Res Dev. 2012;49(4):479–96.</span>. The same results were seen in motor control measured by the Motor Status Scale. The presiding theme that more is better exists whether it is therapy is conventional or robotic<span class="fck_mw_ref">Norouzi-Gheidari N, Archambault PS, Fung J. Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature. J Rehabil Res Dev. 2012;49(4):479–96.</span>. However, functional abilities (measured by the FIM) did not see the same improvements with additional robotic therapy <span class="fck_mw_ref">Norouzi-Gheidari N, Archambault PS, Fung J. Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature. J Rehabil Res Dev. 2012;49(4):479–96.</span>. This difference can be attributed to the fact that robotic therapy programs focus mainly on motor recovery rather than functional abilities of the upper limb <span class="fck_mw_ref">Norouzi-Gheidari N, Archambault PS, Fung J. Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature. J Rehabil Res Dev. 2012;49(4):479–96.</span>. This can have a negative impact on treatment as patients participate in rehabilitation to try to regain functional abilities and they want to see better results in that regard.
</p>
<table width="100%" cellspacing="1" cellpadding="1">


<tr>
<br>  
<td><span class="fck_mw_template"><span class="fck_mw_template">{{#ev:youtube|zE-NmOw-uY4|300}}</span></span><span class="fck_mw_ref">Hocoma. ArmeoSpring Movie (English). Available from: https://www.youtube.com/watch?v=zE-NmOw-uY4</span>
 
</td><td><span class="fck_mw_template"><span class="fck_mw_template">{{#ev:youtube|KA37ws_6-XM|300}}</span></span><span class="fck_mw_ref">Tyromotion. AMADEO Finger-Hand Rehabilitation (English). Available from: https://www.youtube.com/watch?v=KA37ws_6-XM&amp;t=13sfckLR|}fckLRfckLR== Multiple Sclerosis  ==fckLRfckLR= References  =</span>
= Indication&nbsp;  =
</td>
 
</tr>
<br>  
</table>
 
= Key Evidence&nbsp;<br>  =
 
== Stroke and Spinal Cord Injuries&nbsp;  ==
 
Several robotic machines have shown to be effective in patients with stroke. For example, the Armeo Spring (Figure 1) helps to recover function in the hemiparetic arm, forearm and wrist in patients who have experienced a stroke and have consequent hemiparesis. The Armeo Spring is an adjustable suspension system for the upper limb that connects to virtual reality (VR), which has settings with several degrees of complexity <ref>Colomer C, Baldoví A, Torromé S, Navarro MD, Moliner B, Ferri J, et al. Efficacy of Armeo® Spring during the chronic phase of stroke. Study in mild to moderate cases of hemiparesis. Neurologia [Internet]. 2013;28(5):261–7. Available from: files/160/495v28n05a90209825pdf001.pdf%5Cn http://www.ncbi.nlm.nih.gov/pubmed/22727271</ref>. The system is an exoskeleton that supports the patient’s arm and magnifies any residual active movement of the hemiparetic arm in 3-dimensional space <ref>Colomer C, Baldoví A, Torromé S, Navarro MD, Moliner B, Ferri J, et al. Efficacy of Armeo® Spring during the chronic phase of stroke. Study in mild to moderate cases of hemiparesis. Neurologia [Internet]. 2013;28(5):261–7. Available from: files/160/495v28n05a90209825pdf001.pdf%5Cnhttp://www.ncbi.nlm.nih.gov/pubmed/22727271</ref>. Distally, it detects grasp pressure and the sensitivity may be adjusted depending on the patient’s condition <ref>Colomer C, Baldoví A, Torromé S, Navarro MD, Moliner B, Ferri J, et al. Efficacy of Armeo® Spring during the chronic phase of stroke. Study in mild to moderate cases of hemiparesis. Neurologia [Internet]. 2013;28(5):261–7. Available from: files/160/495v28n05a90209825pdf001.pdf%5Cnhttp://www.ncbi.nlm.nih.gov/pubmed/22727271</ref>. VR settings are designed to bring varying levels of difficulty in the velocity, direction and moving area <ref>Colomer C, Baldoví A, Torromé S, Navarro MD, Moliner B, Ferri J, et al. Efficacy of Armeo® Spring during the chronic phase of stroke. Study in mild to moderate cases of hemiparesis. Neurologia [Internet]. 2013;28(5):261–7. Available from: files/160/495v28n05a90209825pdf001.pdf%5Cnhttp://www.ncbi.nlm.nih.gov/pubmed/22727271</ref>. The system provides information about specific movement parameters (strength, range of motion, and coordination) to allow for proper adjustment of the difficulty level for the patient during the recovery process <ref>Colomer C, Baldoví A, Torromé S, Navarro MD, Moliner B, Ferri J, et al. Efficacy of Armeo® Spring during the chronic phase of stroke. Study in mild to moderate cases of hemiparesis. Neurologia [Internet]. 2013;28(5):261–7. Available from: files/160/495v28n05a90209825pdf001.pdf%5Cnhttp://www.ncbi.nlm.nih.gov/pubmed/22727271</ref>. A study of the effects of the Armeo spring system and the benefits in subacute spinal cord injury patients showed that there is significant improvement in the Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP) sensibility scores of subjects with partial hand function at baseline <ref>Zariffa J, Kapadia N, Kramer JLK, Taylor P, Alizadeh-Meghrazi M, Zivanovic V, et al. Effect of a robotic rehabilitation device on upper limb function in a sub-acute cervical spinal cord injury population. IEEE Int Conf Rehabil Robot [Internet]. 2011;50(3):220–6. Available from: http://dx.doi.org/10.1038/sc.2011.104</ref>.<br> <br>Specific to the fingers and hand, the Amadeo is another robotic system that has shown to be useful in those recovering from stroke. A randomized control trial conducted on acute stroke patients looked at the effectiveness of robot- assisted hand therapy using the Amadeo Robotic System by Tyromotion. Amadeo Robot is an end-effector based system that has five degrees of freedom and provides the motion of one or all five fingers through a passive rotational joint placed between the fingertip and an entity that moves laterally (the thumb has two passive rotational joints) <ref>Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, et al. Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial. Int J Rehabil Res [Internet]. 2014;37(3):236–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769557</ref>. All five translational degrees of freedom are independent and provide an almost entire coverage of the fingers’ workspace <ref>Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, et al. Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial. Int J Rehabil Res [Internet]. 2014;37(3):236–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769557</ref>. The interface between the human hand and the machine is achieved thanks to elastic bands or plasters and the wrist is restrained from movement by a Velcro strap <ref>Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, et al. Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial. Int J Rehabil Res [Internet]. 2014;37(3):236–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769557</ref>. The Amadeo treatment composed of:<br>1) Continuous passive therapy<br>2) Assisted movement therapy<br>3) Balloon training (active training in a virtual environment by carrying out target oriented tasks) <ref>Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, et al. Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial. Int J Rehabil Res [Internet]. 2014;37(3):236–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769557</ref>.<br>Comparable to traditional Occupational Therapy methods, patients within the robotic therapy group made significant improvements in Fugl-Meyer Scale (FM), and Box and Block Test (BB) at the end of treatment (4/5 weeks) and maintained improvements after a 3-month follow-up <ref>Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, et al. Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial. Int J Rehabil Res [Internet]. 2014;37(3):236–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769557</ref>. This result is very important because the gain achieved is not exercise or time dependent, but could be secondary to reorganization of brain structures <ref>Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, et al. Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial. Int J Rehabil Res [Internet]. 2014;37(3):236–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769557</ref>.
 
More evidence demonstrated the clinical feasibility of using other types of robotics than the Armeo or Amadeo. MIT-MANUS, MIME, ARM-Guide, T-WREX and NeReBot <ref>Norouzi-Gheidari N, Archambault PS, Fung J. Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature. J Rehabil Res Dev. 2012;49(4):479–96.</ref>. The results are just as expected, when conventional therapy is matched with robotic therapy in terms of duration/intensity, there is no statistically significant difference in the Fugl Meyer assessment scores <ref>Norouzi-Gheidari N, Archambault PS, Fung J. Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature. J Rehabil Res Dev. 2012;49(4):479–96.</ref>. However, when robotic therapy was added on top of conventional therapy, there was a significant improvement in Fugal Meyer scores <ref>Norouzi-Gheidari N, Archambault PS, Fung J. Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature. J Rehabil Res Dev. 2012;49(4):479–96.</ref>. The same results were seen in motor control measured by the Motor Status Scale. The presiding theme that more is better exists whether it is therapy is conventional or robotic<ref>Norouzi-Gheidari N, Archambault PS, Fung J. Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature. J Rehabil Res Dev. 2012;49(4):479–96.</ref>. However, functional abilities (measured by the FIM) did not see the same improvements with additional robotic therapy <ref>Norouzi-Gheidari N, Archambault PS, Fung J. Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature. J Rehabil Res Dev. 2012;49(4):479–96.</ref>. This difference can be attributed to the fact that robotic therapy programs focus mainly on motor recovery rather than functional abilities of the upper limb <ref>Norouzi-Gheidari N, Archambault PS, Fung J. Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature. J Rehabil Res Dev. 2012;49(4):479–96.</ref>. This can have a negative impact on treatment as patients participate in rehabilitation to try to regain functional abilities and they want to see better results in that regard.
 
{| width="100%" cellspacing="1" cellpadding="1"
|-
| <img class="FCK__MWTemplate" src="http://www.physio-pedia.com/extensions/FCKeditor/fckeditor/editor/images/spacer.gif" _fckfakelement="true" _fckrealelement="6" _fck_mw_template="true"><ref>Hocoma. ArmeoSpring Movie (English). Available from: https://www.youtube.com/watch?v=zE-NmOw-uY4</ref>  
| <img class="FCK__MWTemplate" src="http://www.physio-pedia.com/extensions/FCKeditor/fckeditor/editor/images/spacer.gif" _fckfakelement="true" _fckrealelement="2" _fck_mw_template="true"><ref>Tyromotion. AMADEO Finger-Hand Rehabilitation (English). Available from: https://www.youtube.com/watch?v=KA37ws_6-XM&amp;t=13sfckLR|}fckLRfckLR== Multiple Sclerosis  ==fckLRfckLR= References  =</ref>  
|}

Revision as of 03:15, 9 May 2017

 Description [edit | edit source]


Indication [edit | edit source]


Key Evidence 
[edit | edit source]

Stroke and Spinal Cord Injuries [edit | edit source]

Several robotic machines have shown to be effective in patients with stroke. For example, the Armeo Spring (Figure 1) helps to recover function in the hemiparetic arm, forearm and wrist in patients who have experienced a stroke and have consequent hemiparesis. The Armeo Spring is an adjustable suspension system for the upper limb that connects to virtual reality (VR), which has settings with several degrees of complexity [1]. The system is an exoskeleton that supports the patient’s arm and magnifies any residual active movement of the hemiparetic arm in 3-dimensional space [2]. Distally, it detects grasp pressure and the sensitivity may be adjusted depending on the patient’s condition [3]. VR settings are designed to bring varying levels of difficulty in the velocity, direction and moving area [4]. The system provides information about specific movement parameters (strength, range of motion, and coordination) to allow for proper adjustment of the difficulty level for the patient during the recovery process [5]. A study of the effects of the Armeo spring system and the benefits in subacute spinal cord injury patients showed that there is significant improvement in the Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP) sensibility scores of subjects with partial hand function at baseline [6].

Specific to the fingers and hand, the Amadeo is another robotic system that has shown to be useful in those recovering from stroke. A randomized control trial conducted on acute stroke patients looked at the effectiveness of robot- assisted hand therapy using the Amadeo Robotic System by Tyromotion. Amadeo Robot is an end-effector based system that has five degrees of freedom and provides the motion of one or all five fingers through a passive rotational joint placed between the fingertip and an entity that moves laterally (the thumb has two passive rotational joints) [7]. All five translational degrees of freedom are independent and provide an almost entire coverage of the fingers’ workspace [8]. The interface between the human hand and the machine is achieved thanks to elastic bands or plasters and the wrist is restrained from movement by a Velcro strap [9]. The Amadeo treatment composed of:
1) Continuous passive therapy
2) Assisted movement therapy
3) Balloon training (active training in a virtual environment by carrying out target oriented tasks) [10].
Comparable to traditional Occupational Therapy methods, patients within the robotic therapy group made significant improvements in Fugl-Meyer Scale (FM), and Box and Block Test (BB) at the end of treatment (4/5 weeks) and maintained improvements after a 3-month follow-up [11]. This result is very important because the gain achieved is not exercise or time dependent, but could be secondary to reorganization of brain structures [12].

More evidence demonstrated the clinical feasibility of using other types of robotics than the Armeo or Amadeo. MIT-MANUS, MIME, ARM-Guide, T-WREX and NeReBot [13]. The results are just as expected, when conventional therapy is matched with robotic therapy in terms of duration/intensity, there is no statistically significant difference in the Fugl Meyer assessment scores [14]. However, when robotic therapy was added on top of conventional therapy, there was a significant improvement in Fugal Meyer scores [15]. The same results were seen in motor control measured by the Motor Status Scale. The presiding theme that more is better exists whether it is therapy is conventional or robotic[16]. However, functional abilities (measured by the FIM) did not see the same improvements with additional robotic therapy [17]. This difference can be attributed to the fact that robotic therapy programs focus mainly on motor recovery rather than functional abilities of the upper limb [18]. This can have a negative impact on treatment as patients participate in rehabilitation to try to regain functional abilities and they want to see better results in that regard.

<img class="FCK__MWTemplate" src="http://www.physio-pedia.com/extensions/FCKeditor/fckeditor/editor/images/spacer.gif" _fckfakelement="true" _fckrealelement="6" _fck_mw_template="true">[19] <img class="FCK__MWTemplate" src="http://www.physio-pedia.com/extensions/FCKeditor/fckeditor/editor/images/spacer.gif" _fckfakelement="true" _fckrealelement="2" _fck_mw_template="true">[20]
  1. ↑ Colomer C, Baldoví A, Torromé S, Navarro MD, Moliner B, Ferri J, et al. Efficacy of Armeo® Spring during the chronic phase of stroke. Study in mild to moderate cases of hemiparesis. Neurologia [Internet]. 2013;28(5):261–7. Available from: files/160/495v28n05a90209825pdf001.pdf%5Cn http://www.ncbi.nlm.nih.gov/pubmed/22727271
  2. ↑ Colomer C, Baldoví A, Torromé S, Navarro MD, Moliner B, Ferri J, et al. Efficacy of Armeo® Spring during the chronic phase of stroke. Study in mild to moderate cases of hemiparesis. Neurologia [Internet]. 2013;28(5):261–7. Available from: files/160/495v28n05a90209825pdf001.pdf%5Cnhttp://www.ncbi.nlm.nih.gov/pubmed/22727271
  3. ↑ Colomer C, Baldoví A, Torromé S, Navarro MD, Moliner B, Ferri J, et al. Efficacy of Armeo® Spring during the chronic phase of stroke. Study in mild to moderate cases of hemiparesis. Neurologia [Internet]. 2013;28(5):261–7. Available from: files/160/495v28n05a90209825pdf001.pdf%5Cnhttp://www.ncbi.nlm.nih.gov/pubmed/22727271
  4. ↑ Colomer C, Baldoví A, Torromé S, Navarro MD, Moliner B, Ferri J, et al. Efficacy of Armeo® Spring during the chronic phase of stroke. Study in mild to moderate cases of hemiparesis. Neurologia [Internet]. 2013;28(5):261–7. Available from: files/160/495v28n05a90209825pdf001.pdf%5Cnhttp://www.ncbi.nlm.nih.gov/pubmed/22727271
  5. ↑ Colomer C, Baldoví A, Torromé S, Navarro MD, Moliner B, Ferri J, et al. Efficacy of Armeo® Spring during the chronic phase of stroke. Study in mild to moderate cases of hemiparesis. Neurologia [Internet]. 2013;28(5):261–7. Available from: files/160/495v28n05a90209825pdf001.pdf%5Cnhttp://www.ncbi.nlm.nih.gov/pubmed/22727271
  6. ↑ Zariffa J, Kapadia N, Kramer JLK, Taylor P, Alizadeh-Meghrazi M, Zivanovic V, et al. Effect of a robotic rehabilitation device on upper limb function in a sub-acute cervical spinal cord injury population. IEEE Int Conf Rehabil Robot [Internet]. 2011;50(3):220–6. Available from: http://dx.doi.org/10.1038/sc.2011.104
  7. ↑ Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, et al. Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial. Int J Rehabil Res [Internet]. 2014;37(3):236–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769557
  8. ↑ Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, et al. Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial. Int J Rehabil Res [Internet]. 2014;37(3):236–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769557
  9. ↑ Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, et al. Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial. Int J Rehabil Res [Internet]. 2014;37(3):236–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769557
  10. ↑ Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, et al. Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial. Int J Rehabil Res [Internet]. 2014;37(3):236–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769557
  11. ↑ Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, et al. Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial. Int J Rehabil Res [Internet]. 2014;37(3):236–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769557
  12. ↑ Sale P, Mazzoleni S, Lombardi V, Galafate D, Massimiani MP, Posteraro F, et al. Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial. Int J Rehabil Res [Internet]. 2014;37(3):236–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769557
  13. ↑ Norouzi-Gheidari N, Archambault PS, Fung J. Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature. J Rehabil Res Dev. 2012;49(4):479–96.
  14. ↑ Norouzi-Gheidari N, Archambault PS, Fung J. Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature. J Rehabil Res Dev. 2012;49(4):479–96.
  15. ↑ Norouzi-Gheidari N, Archambault PS, Fung J. Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature. J Rehabil Res Dev. 2012;49(4):479–96.
  16. ↑ Norouzi-Gheidari N, Archambault PS, Fung J. Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature. J Rehabil Res Dev. 2012;49(4):479–96.
  17. ↑ Norouzi-Gheidari N, Archambault PS, Fung J. Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature. J Rehabil Res Dev. 2012;49(4):479–96.
  18. ↑ Norouzi-Gheidari N, Archambault PS, Fung J. Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: systematic review and meta-analysis of the literature. J Rehabil Res Dev. 2012;49(4):479–96.
  19. ↑ Hocoma. ArmeoSpring Movie (English). Available from: https://www.youtube.com/watch?v=zE-NmOw-uY4
  20. ↑ Tyromotion. AMADEO Finger-Hand Rehabilitation (English). Available from: https://www.youtube.com/watch?v=KA37ws_6-XM&t=13sfckLR%7C}fckLRfckLR== Multiple Sclerosis ==fckLRfckLR= References =
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