Preliminary Evaluation of an Adaptive Robotic Training Program of the Wrist for Persons with Multiple Sclerosis
2. Materials and Methods
2.2. Experimental Set-Up and Protocol
2.3. Assessment Sessions
- Active and passive wrist ROM in flexion/extension and radial/ulnar deviation. Participants moved actively or were passively moved by the WristBot towards each direction until they reached maximal excursion. The outcome measure was maximal wrist rotation in degrees recorded by encoders along each direction.
- The ability to track a target moving in the space identified by flexion/extension and radial/ulnar deviation. Without any assistive force, participants actively moved the handle of the robot to follow a target over a Lissajous figure (figure-eight shape) for 3 min. The pronation/supination plane was locked during the task. For each participant, the size of the figure never exceeded the 80% of the active ROM previously assessed. The trajectory was described by the following law of motion Equation (1):
- Maximum grip force to measure overall grip strength. This was performed twice on each limb and the highest force in kg was recorded (Jamar Smart Digital Hand Dynamometer, Performance Health, Warrenville, IL, USA).
- Grip force endurance test to measure muscular endurance on each limb. Participants gripped the dynamometer at 50% of their maximum grip force and the time to fatigue in seconds (defined as when the participant could no longer hold 50% of their maximum for 2 consecutive seconds) was recorded.
- Maximum isometric wrist force measured in kg was determined for flexion/extension and radial/ulnar deviation using a stationary load cell (Model: BG 500, Mark-10 Corporation, New York, NY, USA).
- 19-Hole Peg Test (9-HPT) was performed twice on each limb. 9HPT is used in clinics to evaluate finger dexterity  accordingly to the time taken to accomplish the required tasks. One participant was physically unable to complete the test with the trained limb at T0 due to a disabling tremor and was eliminated from the mean values.
- The Patient Rated Wrist Evaluation (PRWE) was administered, and participants had to answer 15 questions that pertained to pain, ADLs in the affected limb and activities that require the use of both limbs . Higher final scores point out higher levels of wrist disability.
2.4. Training Sessions
3. Data and Statistical Analysis
4.2. Assessment: Wrist Kinematics
4.3. Assessment: Wrist Strength
4.4. Assessment: Clinical Outcome Measures
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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|Age||MS Phenotype||Dominant Limb||Trained Limb||Years since Diagnosis||EDSS Score||Sex|
|Radial Deviation||0.04 *||0.59|
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Mannella, K.; Albanese, G.A.; Ditor, D.; Zenzeri, J.; Holmes, M.W.R. Preliminary Evaluation of an Adaptive Robotic Training Program of the Wrist for Persons with Multiple Sclerosis. Appl. Sci. 2021, 11, 9239. https://doi.org/10.3390/app11199239
Mannella K, Albanese GA, Ditor D, Zenzeri J, Holmes MWR. Preliminary Evaluation of an Adaptive Robotic Training Program of the Wrist for Persons with Multiple Sclerosis. Applied Sciences. 2021; 11(19):9239. https://doi.org/10.3390/app11199239Chicago/Turabian Style
Mannella, Kailynn, Giulia A. Albanese, David Ditor, Jacopo Zenzeri, and Michael W. R. Holmes. 2021. "Preliminary Evaluation of an Adaptive Robotic Training Program of the Wrist for Persons with Multiple Sclerosis" Applied Sciences 11, no. 19: 9239. https://doi.org/10.3390/app11199239