Background: We evaluated the effectiveness of robot-assisted motion and activity in additional to physiotherapy (PT) and occupational therapy (OT) on stroke patients with hand paralysis.
Methods:A randomized controlled trial was conducted. Thirty-two patients, 34.4% female (mean ± SD age: 68.9 ± 11.6 years), with hand paralysis after stroke participated. The experimental group received 30 minutes of passive mobilization of the hand through the robotic device Gloreha (Brescia, Italy), and the control group received an additional 30 minutes of PT and OT for 3 consecutive weeks (3 d/wk) in addition to traditional rehabilitation. Outcomes included the National Institutes of Health Stroke Scale (NIHSS), Modified Ashworth Scale, Barthel Index (BI), Motricity Index (MI), short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH), and the visual analog scale (VAS) measurements. All measures were collected at baseline and end of the intervention (3 weeks).
Results: A significant effect of time interaction existed for NIHSS, BI, MI, and QuickDASH, after stroke immediately after the interventions (all, P < .001). The experimental group had a greater reduction in pain compared with the control group at the end of the intervention, a reduction of 11.3 mm compared with 3.7 mm, using the 100-mm VAS scale.
Conclusions: In the treatment of pain and spasticity in hand paralysis after stroke, robot-assisted mobilization performed in conjunction with traditional PT and OT is as effective as traditional rehabilitation.
Bilateral training for neuromotor rehabilitation of the upper limb. Thanks to Gloreha Sinfonia, healthy hand movement can be replied on affected hand. Even a hemiplegic patient with total motor deficit can become an active player during treatment:
– patient voluntarily moves healthy hand
– Gloreha robotic glove replies the same movement on the affected hand
[Purpose] The purpose of this case series was to determine the effects of robot-assisted hand rehabilitation with a Gloreha device on skeletal muscle perfusion, spasticity, and motor function in subjects with poststroke hemiparesis.
[Subjects and Methods] Seven patients, 2 women and 5 men (mean ± SD age: 60.5 ±6.3 years), with hemiparesis (>6 months poststroke), received passive mobilization of the hand with a Gloreha (Idrogenet, Italy), device (30 min per day; 3 sessions a week for 3 weeks). The outcome measures were the total hemoglobin profiles and tissue oxygenation index (TOI) in the muscle tissue evaluated through near-infrared spectroscopy. The Motricity Index and modified Ashworth Scale for upper limb muscles were used to assess mobility of the upper extremity.
[Results] Robotic assistance reduced spasticity after the intervention by 68.6% in the upper limb. The Motricity Index was unchanged in these patients after treatment. Regarding changes in muscle perfusion, significant improvements were found in total hemoglobin. There were significant differences between the pre- and posttreatment modified Ashworth scale.
[Conclusion] The present work provides novel evidence that robotic assistance of the hand induced changes in local muscle blood flow and oxygen supply, diminished spasticity, and decreased subject-reported symptoms of heaviness and stiffness in subjects with post-stroke hemiparesis.
Objective: The purpose of the study was to evaluate the feasibility and efficacy of robot-assisted hand rehabilitation in improving arm function abilities in sub-acute hemiplegic patients.
Design: Randomized controlled pilot study.
Setting: Inpatient rehabilitation centers.
Participants: Thirty hemiplegic stroke patients (Ashworth spasticity index <3) were recruited and randomly divided into a Treatment group (TG) and Control group (CG).
Interventions: Patients in the TG received intensive hand training with Gloreha, a hand rehabilitation glove that provides computer-controlled, repetitive, passive mobilization of the fingers, with multisensory feedback. Patients in the CG received the same amount of time in terms of conventional hand rehabilitation.
Main outcome measures: Hand motor function (Motricity Index, MI), fine manual dexterity (Nine Hole Peg Test, NHPT) and strength (Grip and Pinch test) were measured at baseline and after rehabilitation, and the differences, (Δ) mean(standard deviation), compared between groups.
Results Twenty-seven patients concluded the program: 14 in the TG and 13 in the CG. None of the patients refused the device and only one adverse event of rheumatoid arthritis reactivation was reported. Baseline data did not differ significantly between the two groups. In TG, ΔMI 23(16.4), ΔNHPT 0.16(0.16), ΔGRIP 0.27(0.23) and ΔPINCH 0.07(0.07) were significantly greater than in CG, ΔMI 5.2(9.2), ΔNHPT 0.02(0.07), ΔGRIP 0.03(0.06) and ΔPINCH 0.02(0.03)] (p=0.002, p=0.009, p=0.003and p=0.038, respectively).
Conclusions: Gloreha Professional is feasible and effective in recovering fine manual dexterity and strength and reducing arm disability in sub-acute hemiplegic patients.
MUM-OF-TWO Karen experienced sudden paralysis caused by undiscovered arthritis.
MOST women apply their make-up without giving it a second thought. But for Karen Watts, touching up her lipstick and putting on eye-liner is something she feared she’d never do again.
Five years ago, the mum-of-two’s life was shattered when she awoke one morning to find herself lying on the floor paralysed from the chest down.
Since then, Karen, 57, has had to rely on others for a helping hand. But now, thanks to a bionic glove and intensive therapy, she is able to feed herself, brush her teeth and do her own make-up.
Before using the innovative hand therapy device – which is controlled via a computer – the former office administrator had limited movement in her left hand and hardly any in her right.
Now Karen, who lives in Glasgow’s west end , can straighten her fingers, grasp objects and raise her hands to her face.
The grandmother-of-two admits the special glove made by Gloreha, which looks like a prop from a Hollywood sci-fi movie, has given her a new lease of life.
She said: “It’s like my hands have come alive again. I can’t even begin to put into words what it feels like to be able to do my own make-up, brush my teeth and, best of all, hold a wine glass.
“It’s been incredible. There are motorised metallic rods on the glove, which are controlled by a computer and allow me to painlessly straighten my fingers and grip.
“When I take the glove off, my hands can move more freely and, over time, I have been able to do more and more for myself. Regaining this bit of independence is a dream come true.”
Karen, who is mum to Chris, 34, and Gemma, 32, will never forget the morning in February 2010 when she lost use of her legs and lower body.
She said: “My life changed overnight. One day I was hill climbing with my family, the next I was paralysed, confined to a wheelchair and having to resign myself to the
fact I would never walk again.
“All I remember is waking up and not being able to move.
“I spent six months in the spinal unit at Glasgow’s Southern General where doctors discovered I had been suffering from arthritis in my neck and shoulders, which had caused the bones around the spinal chord in my neck to harden.”
Karen, who is married to refrigeration boss Bobby, added: “It was a really difficult time for my family. Nothing can prepare you for something like that.
“I decided early on that I had two choices – I could give in and lead a miserable life or get on with it and make the best of the situation.
“With the support of my family and friends, I have done just that.”
During her time in hospital, Karen – who has two-year-old twin grandsons – received intense hand therapy from Leslie Wallace, who specialises in upper limb rehabilitation.
She added: “Leslie brought me on leaps and bounds. At first, my right hand and arm were stuck motionless against my body but it wasn’t long before she got the movement going.
“When I left the hospital, I continued to work with Leslie privately and, when she was
asked to try out the new glove on a patient, I was happy to volunteer.
“The results were immediate and every time I slip on the glove, I feel myself getting a little bit stronger. If I had £4000 to spare, I would buy my own portable version.
“It would be great if more of the machines could be made available.
“I’ve accepted my life will never be the same again and at times I find it really tough, like when I cannot hold my grandsons. But I’m a positive person and have learned to live with the blow I have been dealt.
“Thanks to the glove and my amazing therapist, I can go out for a family meal and feed myself. The little things mean a lot.”
Therapist Leslie said: “When I saw the machine, I knew instantly who to try it on. We had been stretching the fingers manually, which was slowly helping, but the glove speeded everything up. The difference is incredible. I really hope it will be made available in hospitals across Scotland.”
Derek Jones, director of Anatomical Concepts (UK), the company who supply the glove, said: “We discovered the glove in Italy and are trying to make it more widely available throughout the UK. Karen is proof of how much difference it can make to people’s lives.”
Lack of arm movement can be very debilitating following a stroke. Shoulder pain and an arm that feels incredibly heavy is obviously a real barrier to recovery.
GLOREHA DYNAMIC ARM SUPPORT
The Gloreha Dynamic Arm support is a nicely engineered device that provides an adjustable amount of lift to the users affected arm.
Clamping to a table or wheelchair the amount of support can be varied very easily and precisely over 12 steps – giving support between 900 and 4800 grammes.
The whole unit allows the arm to move effortlessly to ease the performance of functional tasks or exercises. After use, the DAS can be “parked” in a convenient position.
Although designed as a companion to the Gloreha Hand Rehabilitation Device, the Dynamic Arm Support System is proving a big hit – with a nicer appearance than competitor products and an attractive price. Contact us for price information or to see one For details of the whole Gloreha Range see http://www.gloreha.co.uk.
It is well established that recovery of motor function of the upper limb, regardless the aetiology of the impairment, is essential for gaining independence in daily living activities. In fact this happens after a cerebrovascular disease as well as after brain surgery or other pathologies. [1-2]
The complexity of the recovery course requires an intensive approach: mechanical devices for passive motion of the limb can help to add some intensity to treatment. [3-6] Recent studies have confirmed how the sensory-sensory stimulation has a crucial role in motor re-learning in neurological patients, even when it is only passively administered. [7-9]
Moreover, virtual reality combined to robotics is able to stimulate patient with an interactive environment. It is also postulated that virtual reality, among other actions, can involve the mirror brain cells by means of visual stimuli with a positive influence on functional recovery. 
In this perspective, a few years ago, Gloreha was developed: a robotic, glove shaped device, for hand rehabilitation. The device provides passive mechanical motion and, while moving the fingers, allows patient to observe on a screen, his own action going on.  (Fig. 1) Aim of this study is to evaluate the short-term effects of the use of Gloreha device in neurooncological patients affected by upper limb impairment during rehabilitation course, after tumour removal.