Remote Assessment of Post-Stroke Elbow Function Using Internet-Based Telerobotics: A Proof-of-Concept Study.

Area of Science:

• Rehabilitation Medicine
• Robotics
• Telehealth

Background:

• Upper limb hemiparesis is a common stroke impairment, necessitating regular assessment for effective rehabilitation.
• Limited clinic accessibility hinders timely and adequate assessments for stroke survivors.
• Remote assessment solutions are needed to overcome geographical and logistical barriers.

Purpose of the Study:

• To investigate the feasibility of teleassessments for motor impairments of the spastic elbow in stroke survivors.
• To evaluate the accuracy of remote assessment for passive range of motion (PROM), muscle strength, and spasticity.
• To determine the viability of a telerobotic system for remote physical interaction and assessment.

Main Methods:

• A telerobotic system was developed with a master robot for the doctor and a slave robot for the patient's elbow.
• Torque and speed data were transferred over the Internet for real-time remote interaction.
• An intercontinental remote assessment between the US and South Korea was conducted to test feasibility under challenging conditions.

Main Results:

• Twelve stroke patients' elbows were assessed remotely.
• Remote PROM assessment showed an average absolute difference of 5.98 ± 3.51° compared to in-person assessments.
• Substantial agreement (k=0.643) was found for elbow flexor strength, and fair agreement (k=0.308) for spasticity.
• No adverse events were reported during or after the telerobotic assessments.

Conclusions:

• Internet-based telerobotic remote assessment for spastic elbow motor impairment in stroke survivors is feasible.
• The system demonstrates effectiveness even across long distances with delayed networks.
• This technology offers a promising solution for accessible and accurate remote rehabilitation monitoring.