The upper limb indices of motion in children
Children with neurological disorders such as acquired brain injury (ABI) or cerebral palsy (CP) often experience impairment of the upper limb, which impacts on their ability to act in the activities of daily living and on the development of skills required to participate in social and school contexts.
The use of robot-aided therapy can support traditional physiotherapy, also through the use of virtual reality, which can stimulate the child’s interest during the training of specific tasks, without requiring full antigravity control of the limb.
Although indices of upper limb movement have been studied in the adult neurological patient, as in our 2016 study, we still have no indications for the use of robotic movement assessment in the paediatric patient.
Virtual reality and ladybirds
In collaboration with the Eugenio Medea IRCCS di Lecco, we conducted a retrospective study to evaluate the ability of the Armeo®Spring device combined with a customised software created by MBE, to record functional changes in the upper limb. In addition, we investigated whether a robotic rehabilitation programme together with a traditional physiotherapy could improve upper limb function in children with ABI or CP.
A set of indices computed form the handle trajectory (see our previous study) were assessed in 43 children at the beginning, at two weeks and at four weeks, through a task consisting of reaching ladybirds on a screen using the Armeo®Spring. The children underwent robotic-aided therapy with virtual reality five days a week for a month, combined with the same amount of physiotherapy.
All motion parameters involving accuracy, velocity and smoothness improved from the first follow-up and continued to improve at one month, in line with the changes recorded by two clinical scales used as a standard comparison.
The correlation between clinical and instrumental evaluation found certified the validity of the latter in assessing a motor outcome even in a paediatric population, also thanks to the additional software specifically created by MBE.
Moreover, the improvements obtained suggested the effectiveness of rehabilitation with Armeo®Spring, when combined with classical physiotherapy, that has to be demonstrated in a clinical trial.
The integral text is available at the link.
