Evaluation of Short-Term Clinical Effects of a Novel Repetitive Facilitation Exercise Training Program Using a Hemiplegic Elbow Extension Rehabilitation System

Abstract

Repetitive Facilitation Exercise (RFE) is known as an effective rehabilitation method that can elicit brain plasticity. In our previous study, we developed a hemiplegic upper limb rehabilitation system that can train the elbow and shoulder based on RFE theory. The system consists of a selective Arm-DoF constrainable mechanism and a multiple facilitative stimulus timing and duration control system. The selective Arm-DoF constrainable mechanism has three DoF, making it possible to selectively restrict a DoF of the shoulder or elbow. The multiple facilitative stimulation timing and duration control system only has an electrical stimulation source and a vibrator and no large actuators to perform the training exercise. In this study, we undertook an evaluation of the short-term clinical effects of a proposed elbow training program using the hemiplegic upper limb rehabilitation system. The training method consists of two sets, each involving 50 repetitions of the elbow extension exercise programmed in our system. We evaluated the short-term training effects through clinical trials for five stroke patients using the above method. In the evaluation, 10 repetitions of pre/post-tests without any facilitative stimulus were performed before and after the two sets of training. As a result, the maximum angular velocities or the average angular velocities of the elbow extensions improved significantly in most subjects. These results indicate that the quickness or the smoothness of elbow extension movements in the hemiplegic limb improved. Therefore, our clinical experiments support the short-term clinical benefits of the proposed method as well as the practicality of quantitative evaluation using our system.