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The paper is aimed at summarizing the article titled “Predicting functional recovery in chronic stroke rehabilitation using event-related desynchronization-synchronization during robot-assisted movement”. The work was published in 2016, but the period when the study took place is not specified. However, judging from the date of receipt and the researchers’ affiliated institutions, the study had commenced in Italy before 2015 (Caimmi et al., 2016). The article presents the results of a preliminary prospective study that focuses on potential cortical activity changes following robot-assisted rehabilitation interventions.
In the article being analyzed, there is no information pointing at the presence of blinded experiments since it was a preliminary study with an unequal number of healthy and post-stroke patients. The information about the groups of participants was available to clinicians and study personnel since the only post-stroke individual in the sample needed special procedures to participate. Therefore, ethical issues related to blinded experiments were absent.
There were more than four data collection points and follow-up assessments were conducted one year after the experiment. However, the number of participants was the same during all research steps, and all nine subjects were able to attend all assessments.
The researchers did not use the principles of random sampling in the study, so the assignment of patients was not randomized. Instead, sampling was selective since the experimentation included or excluded participants based on their health status. At the same time, it can be supposed that the researchers relied on one more characteristic of individuals to include or exclude new participants – handedness (Caimmi et al., 2016).
In general, the article does not present a thorough discussion of practices for the recruitment of participants or an extensive list of inclusion and exclusion criteria. To some extent, it can be related to its being a preliminary study to be replicated in the future with larger samples and stricter methodological principles. The presence of non-compliant participants is not mentioned because all robotic-assisted exercises were performed under medical surveillance. Also, the potential impact of lifestyle-related factors on follow-up assessment results was not discussed, which can be a potential problem.
The study does not seem to be biased since both groups received treatment based on the presence or absence of specific rehabilitation needs. The group that consisted of participants with no disorders had no special needs, and the exercises and evaluation sessions were structured accordingly. As for the only patient with rehabilitation needs after stroke, before the actual experiment, she needed to perform some exercises using her unaffected limb, and the data were used to ensure the effectiveness of the exercises. Therefore, the treatment that the groups received was different in detail, but such dissimilarities were fair and based on objective information related to medical conditions. Importantly, no participants were required to spend financial resources to use expensive devices for rehabilitation.
In the end, the results of the study do not seem to apply to my professional practice with clients who have rehabilitation needs. The first factor that limits the ability to implement the findings into practice is the prevalence of healthy subjects in the sample, which causes some concerns related to the clinical validity of findings. The results are research-based, but it is clear from the formulation of the research question that the study focused on the effects of fully robotic assistance on healthy individuals’ cortical activity.
At the same time, people with actual neurorehabilitation needs are underrepresented in the sample, and one woman with hemiparesis was included only for comparison. Due to the focus of the study and the sample’s characteristics, the results are unlikely to impact the working practices that I use with post-stroke clients.
Reference
Caimmi, M., Visani, E., Digiacomo, F., Scano, A., Chiavenna, A., Gramigna, C.,… Panzica, F. (2016). Predicting functional recovery in chronic stroke rehabilitation using event-related desynchronization-synchronization during robot-assisted movement. BioMed Research International, 2016, 1‑11. Web.
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