Serafino Francesca (Montecatone Rehabilitation Institute, Imola (BO), Italy)
Ricci Lucia (Montecatone Rehabilitation Institute, Imola (BO), Italy)
Sabatelli Simona (Montecatone Rehabilitation Institute, Imola (BO), Italy)
Materazzi Francesco Giuseppe (Montecatone Rehabilitation Institute, Imola (BO), Italy)
Baldarelli Fabio Alessandro (Montecatone Rehabilitation Institute, Imola (BO), Italy)
Menna Laura (Montecatone Rehabilitation Institute, Imola (BO), Italy)
Ciardulli Francesca (Montecatone Rehabilitation Institute, Imola (BO), Italy)
Cinotti Maria Giulia (Montecatone Rehabilitation Institute, Imola (BO), Italy)
Rucci Paola (Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy); Di Staso Rossana (Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy)
Baroncini Ilaria (Montecatone Rehabilitation Institute, Imola (BO), Italy); Simoncini Laura (Montecatone Rehabilitation Institute, Imola (BO), Italy)
Patients with spinal cord injury (SCI) have impaired trunk and postural control (both static and dynamic), often with a major impact on activities of daily living (ADL) 1. Therefore, improving trunk mobility and strengthening trunk control are primary rehabilitation goals. Nowadays, robotic therapy can be added to conventional rehabilitation to improve trunk control, balance and proprioception in the seated position2.
The aim of this preliminary study is to evaluate the effects of intensive robotic therapy with the Hunova® device (Movendo Technology, Italy) on trunk control and ability to perform ADL in individuals with acute SCI. Specifically, we analysed the changes after robotic training with Hunova® on the following outcomes: Trunk Control Test for SCI (TCT-SCI), Self-care and Overall mobility subscales of the Spinal Cord Independence Measure-III (SCIM-III) and measurements from the Hunova evaluation tests.
21 SCI patients hospitalised at the Montecatone Rehabilitation Institute from March 2023 to May 2024 with acute (<6 months post-injury) motor complete (n=9) or incomplete (n=12) lesions (NLI level between C4 and L2) underwent robotic training for 1 hour a day, 5 days a week, for 2 weeks, in addition to conventional rehabilitation treatment. The robotic rehabilitation training included static and dynamic trunk control exercises and dual-task exercises. The following parameters were measured before (T0) and after (T1) robotic treatment and analysed retrospectively: TCT-SCI and SCIM-III for clinical assessment, centre of pressure (COP) related parameters and trunk range of motion (ROM) as recorded by Hunova®.
Analysis of variance for repeated measures (ANOVA) was performed to assess the overall change of parameters over time and differences in the trend of the scores according to the level of completeness. Statistical analyses were performed using JASP v.0.18.3 software with a significance level of p=0.05.
The clinical scales scores TCT for SCI, SCIM III Self-care and SCIM III Overall mobility and the measurements recorded by Hunova® regarding the right and left ROM of the trunk improved significantly after the robotic rehabilitation sessions (p<0.05 from the ANOVA analysis at T0 and T1 of all considered outcomes).
Furthermore, when scores were analysed according to the level of completeness of the lesion, the TCT for SCI scale and the measurements of right and left ROM were significantly lower at T0 and T1 in the complete subjects than in the incomplete subjects (p<0.05 for TCT and ROM outcomes).
The results of this study provide preliminary evidence of patients’ improvement in trunk control and mobility based on clinical evaluation scales and quantitative measurements recorded by the robotic device These improvements indicate that the robotic training has a beneficial effect in acute spinal cord injury patients.
