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Robotic Rehabilitation of the Hand Spasticity


Authors: P. Konečný 1,2,3,4,5;  M. Tarasová 3;  J. Kubíková 1;  M. Vernerová 1
Authors‘ workplace: CLR SMN Agel Prostějov primář MUDr. P. Konečný, Ph. D., MBA 1;  Fyzioterapie FZV UP, Olomouc přednosta doc. MUDr. A. Krobot, Ph. D. 2;  KFRL LF MU, Brno prof. MUDr. P. Dobšák, CSc. 3;  ICRC FNUSA, Brno ředitel Gorazd B. Stokin, M. D., MSc., Ph. D. 4;  Neurologická klinika LF UP, Olomouc přednosta prof. MUDr. P. Kaňovský, CSc. 5
Published in: Rehabil. fyz. Lék., 24, 2017, No. 1, pp. 19-22.
Category: Original Papers

Overview

Introduction:
Spasticity is an integral part of spastic syndrome with high incidence in diseases of central nervous system. The principal problems of the spastic syndrome include paresis, muscle shortening and dystonia. The muscle shortening and muscular hypertonia can be influenced pharmacologically, by neurorehabilitation techniques and progressive stretching techniques. Robotic technologies, providing optimal repeated rehabilitation stretching of spastic muscles can be used as supplement or substitution of the stretching techniques. One such robot fulfilling the requirements for therapy of the hand finger spasticity is the robotic glove Gloreha Professional II.

Methods:
The study aimed at verification of the effects of robotic therapy in patients after brain vascular event (6 to 60 months after the origin) wit spastic hand paresis in a degree according to modified Ashworth scale (MAS) 1 – 3. The prospective randomized study of 20 cases and 18 controls evaluates the changes in the grip by the SVH test (score of visual evaluation of hand grip strength test) and changes in finger spasticity after eight weeks of treatment. The experimental group underwent a complex antispastic therapy (administration of botulinum toxin, 300 Speywood units Dysport botox – fractionated into the surface and deep flexor of fingers, physiotherapy for 5 hours weekly and ergotherapy 2.5 hour weekly). The control group was treated by the conventional complex therapy.

Results:
In the experimental group there were statistically significant changes in diminution of spasticity (MAS median form 2 to 1 in the experimental group versus 2 to 1+ in the control group) and an improvement in the hand grip functions (SVH from median of 10 entry to 15 on the output in the experimental group against SVH in median 11 to 13). However, the results were not significant at the P=0.05 level.

Conclusion:
The robotic rehabilitation has an important influence in antispastic treatment of fingers with perspective therapeutic results, as our study has shown.

Keywords:
spasticity, hand, robotic-assisted rehabilitation


Sources

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