Quantitative analysis of voluntary movement and anticipatory postural adjustments: a functional approach.

Daily living activities and tasks like standing forward reaching present complex Anticipatory Postural Adjustments (APAs), and an objective, repeatable, subject- and task-dependent procedure to detect Voluntary Movements (VM) and APAs onsets is still missing. This paper proposes a new approach to the VMs study, based on a functional mechanical interpretation of the movement performing, which allows defining kinematic and dynamic APAs. A protocol for the identification of VMs and APAs onsets in the reaching movement is presented. Acquired data on 9 healthy young subjects enable a preliminary validation of this method suitability as support for an objective quantification of APAs.

Robot-Assisted Rehabilitation of Hand Paralysis After Stroke Reduces Wrist Edema and Pain: A Prospective Clinical Trial.

OBJECTIVE: The purpose of this study was to determine whether passive robotic-assisted hand motion, in addition to standard rehabilitation, would reduce hand pain, edema, or spasticity in all patients following acute stroke, in patients with and without hand paralysis. METHODS: Thirty-five participants, aged 45 to 80 years, with functional impairments of their upper extremities after a stroke were recruited for the study from September 2013 to October 2013. One group consisted of 16 patients (mean age ± SD, 68 ± 9 years) with full paralysis and the other groups included 14 patients (mean age ± SD, 67 ± 8 years) with partial paralysis. Patients in the both groups used the Gloreha device for passive mobilization of the hand twice a day for 2 consecutive weeks. The primary outcome measure was hand edema. Secondary outcome measures included pain intensity and spasticity. All outcome measures were collected at baseline and immediately after the intervention (2 weeks). RESULTS: Analysis of variance revealed that the partial paralysis group experienced a significantly greater reduction of edema at the wrist (P = .005) and pain (P = .04) when compared with the full paralysis group. Other outcomes were similar for the groups. CONCLUSION: The results of the current study suggest that the partial paralysis group experienced a significantly greater reduction of edema at the wrist and pain when compared with the full paralysis group. The reduction in pain did not meet the threshold of a minimal clinically important difference.