Application of therapeutic exercises and robot-assisted therapy after stroke

Eremin M.V., Shmeleva S.V., Tuzov I.N., Trofimenko Yu.G., Bakulina E.D., Morozova E.V., Karpinsky A.A.

1) Russian State Social University, Moscow, Russia; 2) K.G. Razumovsky Moscow State University of Technology and Management, Moscow, Russia; 3) Burnazyan Federal Medical and Biological Center of the Federal Medical and Biological Agency of Russia, Moscow, Russia; 4) Moscow State University of Humanities and Economics, Moscow, Russia; 5) Russian University of Transport, Moscow, Russia

Background: Application of therapeutic exercises after stroke helps to restore movement of the affected limb and muscle strength, eliminate motor disorders and lost social and everyday functions, improve the psychological state, activate the patient, and reduce the risk of recurrent stroke. For rehabilitation of patients after a stroke, the use of robot-assisted devices provides verticalization of patients, elimination or reduction of paresis and paralysis of the limbs.
Objective: Assessment and restoration of the motor activity of the upper limb and social and everyday skills in people aged 55–60 years after a stroke.
Methods: All patients received standard therapy, including neuromuscular electrical myostimulation, limb massage and individual therapeutic exercise sessions to improve and restore fine motor skills. Also, training using the Armeo robotic complex was included in rehabilitation program of 6 patients of the experimental group. Before and after rehabilitation, the functions of the affected upper limb (abduction/adduction, flexion/extension of the shoulder and elbow joint, rotational and rotary movements of the hand) were assessed in both groups of post-stroke patients.
Results: The use of therapeutic exercises in passive and passive-active modes allowed to reduce muscle tone, improve abduction and adduction of the shoulder joint, flexion and extension of the shoulder and elbow joints, and stimulate more active movements due to the reflex influence of afferent impulses arising in the muscles and joints of the paralyzed limb. The use of the Armeo robotic complex allowed to increase the range of motion, compensate for movement deficiencies, the strength of the affected limb, reduce neurological deficit, and improve the psychoemotional state.
Conclusion: In order to restore impaired functions of the upper limb, robot-assisted therapy was used, which allowed to increase the effectiveness of rehabilitation through repetitive cyclic exercises, improve the activity and quality of life of patients. After rehabilitation with the use of therapeutic exercises, social and everyday skills significantly expanded in both groups of patients.

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About the Authors

M.V. Eremin, Cand. Sci. (Pedagogy), Associate Professor, Russian State Social University, Moscow, Russia; ORCID: https://orcid.org/0000-0001-9791-4615
Svetlana V. Shmeleva, Dr. Sci. (Med.), Professor, K.G. Razumovsky Moscow State University of Technologies and Management, Moscow, Russia; 89151479832@mail.ru, ORCID: https://orcid.org/0000-0003-0390-194X (corresponding author)
I.N. Tuzov, Cand. Sci. (Pedagogy), Associate Professor, Russian State Social University, Moscow, Russia; ORCID: https://orcid.org/0000-0002-5789-7838
Yu.G. Trofimenko, Cand. Sci. (Med.), Senior Researcher, Burnazyan Federal Medical and Biological Center of the Federal Medical and Biological Agency of Russia, Moscow, Russia; ORCID: https://orcid.org/0009-0000-0522-639Х
E.D. Bakulina, Cand. Sci. (Pedagogy), Associate Professor, Russian State Social University, Moscow, Russia; ORCID: https://orcid.org/0000-0003-2352-7449
E.V. Morozova, Cand. Sci. (Sociology), Associate Professor, Moscow State University of Humanities and Economics, Moscow, Russia
A.A. Karpinsky, Senior Lecturer, Russian University of Transport, Moscow, Russia; ORCID: https://orcid.org/0000-0002-2144-8248

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