Densitometric evaluation might prevent failure of knee artroplasty for aseptic loosening. An 8-year observational controlled study.

OBJECTIVES: To study the correlation between quantitative ultrasound (QUS) expressed as stiffness index (SI) and the risk of aseptic loosening of knee arthroplasty.  METHODS: An observational retrospective controlled study was performed on 85 female patients (mean age: 73.3 years) divided into 2 groups from January 2007 to March 2015 and carried out at the Orthopedic Rehabilitation Unit, Casa di Cura Eremo, Arco, Trento, Italy. Group A included 42 patients who had undergone a revision of knee prosthesis for aseptic-loosening, and group B included 43 age-matched patients who underwent primary replacement of the knee without following aseptic loosening. Patients in both groups were evaluated for SI with Achilles - QUS system at the same side of the surgery. RESULTS: In group A, 20/42 patients (47.6%) had an SI T-score below -2.5. In group B, 14/43 (32.5%) patients had a SI T-score below -2.5. The difference between the 2 groups was statistically significant (p=0.015).  CONCLUSION: Stiffness index appears to be an important predictor of aseptic loosening of the knee prosthesis. Therefore, densitometric evaluation, including SI, may be recommended before surgical knee replacement.

Robotic upper limb rehabilitation after acute stroke by NeReBot: evaluation of treatment costs.

Stroke is the first cause of disability. Several robotic devices have been developed for stroke rehabilitation. Robot therapy by NeReBot is demonstrated to be an effective tool for the treatment of poststroke paretic upper limbs, able to improve the activities of daily living of stroke survivors when used both as additional treatment and in partial substitution of conventional rehabilitation therapy in the acute and subacute phases poststroke. This study presents the evaluation of the costs related to delivering such therapy, in comparison with conventional rehabilitation treatment. By comparing several NeReBot treatment protocols, made of different combinations of robotic and nonrobotic exercises, we show that robotic technology can be a valuable and economically sustainable aid in the management of poststroke patient rehabilitation.

Randomized trial of a robotic assistive device for the upper extremity during early inpatient stroke rehabilitation.

BACKGROUND: A recent Cochrane Review showed that early robotic training of the upper limb in stroke survivors can be more effective than other interventions when improving activities of daily living involving the arm function is the aim of therapy. OBJECTIVE: We tested for efficacy of the study a protocol which involved the use of the NeReBot therapy in partial substitution of standard upper limb rehabilitation in post-acute stroke patients. METHODS: In this dose-matched, randomized controlled clinical trial, 34 hemiparetic participants with movement against gravity in shoulder, elbow, and wrist muscle groups were enrolled within 15 days of the onset of stroke. All participants received a total daily rehabilitation treatment for 120 minutes, 5 days per week for 5 weeks. The control group received standard therapy for the upper limb. The experimental group received standard therapy (65% of exercise time) associated with robotic training (35% of exercise time). Muscle tone (Modified Ashworth Scale), strength (Medical Research Council), and synergism (Fugl-Meyer motor scores) were measured at impairment level, whereas dexterity (Box and Block Test and Frenchay Arm Test) and activities of daily living (Functional Independence Measure) were measured at activity level. All assessments were performed at baseline, at the end of therapy (time T1), at 3 months (time T2), and at 7 months (time T3) after entry. All between-group analyses were tested using nonparametric test with Bonferroni's adjustments for multiple testing. RESULTS: No significant between-group differences were found with respect to demographic characteristics, motor, dexterity, and ADLs at baseline, postintervention (T1) and at follow-up (T2 and T3). CONCLUSIONS: The robot therapy by NeReBot did not lead to better outcomes compared with conventional inpatient rehabilitation.