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25.08.2020 | Original Communication

Age is negatively associated with upper limb recovery after conventional but not robotic rehabilitation in patients with stroke: a secondary analysis of a randomized-controlled trial

verfasst von: Francesca Cecchi, Marco Germanotta, Claudio Macchi, Angelo Montesano, Silvia Galeri, Manuela Diverio, Catiuscia Falsini, Monica Martini, Rita Mosca, Emanuele Langone, Dionysia Papadopoulou, Maria Chiara Carrozza, Irene Aprile

Erschienen in: Journal of Neurology | Ausgabe 2/2021

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Abstract

Background

There is consistent evidence that robotic rehabilitation is at least as effective as conventional physiotherapy for upper extremity (UE) recovery after stroke, suggesting to focus research on which subgroups of patients may better respond to either intervention. In this study, we evaluated which baseline variables are associated with the response after the two approaches.

Methods

This is a secondary analysis of a randomized-controlled trial comparing robotic and conventional treatment for the UE. After the assigned intervention, changes of the Fugl-Meyer Assessment UE score by ≥ 5 points classified patients as responders to treatment. Variables associated with the response were identified in a univariate analysis. Then, variables independently associated with recovery were investigated, in the whole group, and the two groups separately.

Results

A sample of 190 patients was evaluated after the treatment; 121 were responders. Age, baseline impairment, and neglect were significantly associated with worse response to the treatment. Age was the only independently associated variable (OR 0.967, p = 0.023). Considering separately the two interventions, age remained negatively associated with recovery (OR 0.948, p = 0.013) in the conventional group, while none of the variables previously identified were significantly associated with the response to treatment in the robotic group.

Conclusions

We found that, in our sample, age is significantly associated with the outcome after conventional but not robotic UE rehabilitation. Possible explanations may include an enhanced positive attitude of the older patients towards technological training and reduced age-associated fatigue provided by robotic-assisted exercise. The possibly higher challenge proposed by robotic training, unbiased by the negative stereotypes concerning very old patients’ expectations and chances to recover, may also explain our findings.

Trial registration number

NCT02879279.

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Titel: Age is negatively associated with upper limb recovery after conventional but not robotic rehabilitation in patients with stroke: a secondary analysis of a randomized-controlled trial
verfasst von: Francesca Cecchi
Marco Germanotta
Claudio Macchi
Angelo Montesano
Silvia Galeri
Manuela Diverio
Catiuscia Falsini
Monica Martini
Rita Mosca
Emanuele Langone
Dionysia Papadopoulou
Maria Chiara Carrozza
Irene Aprile
Publikationsdatum: 25.08.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology / Ausgabe 2/2021
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-10143-8

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Age is negatively associated with upper limb recovery after conventional but not robotic rehabilitation in patients with stroke: a secondary analysis of a randomized-controlled trial

Abstract

Background

Methods

Results

Conclusions

Trial registration number

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Abstract

Background

Methods

Results

Conclusions

Trial registration number

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