Cerebral Palsy Clinical Trial
Official title:
Movement Velocity and Fluidity Improve After Armeo®Spring Rehabilitation in Children Affected by Acquired and Congenital Brain Diseases: an Observational Study
Children with acquired and congenital brain lesions (namely, cerebral palsy, CP, and acquired
brain injury, ABI) may exhibit upper limb impairment, with consequent limitations in their
daily living activities.
In recent years, robotic rehabilitation has become an important tool to promote functional
recovery in patients with CP and ABI, thanks to its ability to promote high intensity,
repetitive, engaging training. Moreover, it has additional advantages that can contribute to
the understanding of the effectiveness of these devices in motor learning and recovery. It
has indeed higher resolution and inter -rater and intra-rater reliability with respect to
standard assessment methods (i.e. clinical scales). Furthermore, it is able to provide a
quantitative evaluation of patients' movement during treatments instead of relying
exclusively on qualitative observation. Recently, Merlo and co-workers (Sol et Salus, Rimini,
Italy) developed and validated a tool to extract indices of accuracy, velocity and smoothness
from the analysis of 3D trajectories of the end point of the robotic exoskeleton Armeo®Spring
(Hocoma, CH).
The primary aim of the study is to retrospectively investigate the effectiveness of
robot-assisted upper limb rehabilitation in children affected by congenital and acquired
brain damages by means of funcional scales and quantitative assessment of movement
performance (accuracy, velocity and smoothness).
Patients affected by acquired or congenital brain disease are enrolled. The inclusion
criteria are: age between 5 and 18; the ability to handle objects in daily life within levels
I, II, and III, according to the Manual Ability Classification System (MACS); the ability to
understand and follow test instructions. Conversely, the exclusion criteria are: severe
muscle contracture and/or spasticity, a diagnosis of severe learning disabilities or
behavioral problems and visual or hearing difficulties that would impact on function and
participation.
Participants undergo the standard intervention protocol followed at the IRCCS E. Medea. It is
composed by 20 sessions with Armeo®Spring and 20 sessions of physiotherapy, within 1 month.
Patients are evaluated before (T0) and after (T1) the intervention with the Quality of Upper
Extremities Skills Test (QUEST) and the Melbourne Assessment of Unilateral Upper Limb
Function. During the first, tenth and last training session, patients executed the "Vertical
Capture" exergame, which assess patient's functional level during a task that involves elbow
flex-extension and shoulder flex- extension and abd-adduction. From these evaluation
sessions, quantitative indices of movement performance (precision, velocity and smoothness)
are extracted.
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