Measuring changes of movement dynamics during robot-aided neurorehabilitation of stroke patients

The aim of this study was to describe in detail a new method, called normalized force control parameter (nFCP), to measure changes in movement dynamics obtained during robot-aided neurorehabilitation, and to evaluate its ability to estimate the clinical scales. The study was conducted in a group of 18 subjects after chronic stroke who underwent robot therapy of the upper limb. We used two different measures of movement dynamics to assess patients' performance during each session of training: the nFCP and force directional error (FDE), both measuring the directional error of the patient-exerted force applied to the end-effector of the robot device. Both metrics exhibited significant changes over the three-week course of treatment. The comparison between nFCP and FDE slopes showed a significant and high correlation ( r = 0.79; p < 0.001), indicating that the two parameters are closely correlated. The FDE informed on the direction of the force error, while the nFCP showed a better performance in predicting the clinical scale values. Assessment of the time course of recovery showed that nFCP, FDE and the movement smoothness improved quickly at first and then plateaued, while steady gains in mean velocity of movement took place over a longer time course. These data may be helpful to the therapist in developing more effective robot-based therapy protocols.