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Effect of a Soft Robotic Sock Device on Lower Extremity Rehabilitation Following Stroke: A Preliminary Clinical Study With Focus on Deep Vein Thrombosis Prevention

Published on Jan 1, 2019in IEEE Journal of Translational Engineering in Health and Medicine
· DOI :10.1109/jtehm.2019.2894753
Fan-Zhe Low3
Estimated H-index: 3
(NUS: National University of Singapore),
Jeong Hoon Lim7
Estimated H-index: 7
(NUS: National University of Singapore)
+ 1 AuthorsRaye Chen Hua Yeow4
Estimated H-index: 4
(NUS: National University of Singapore)
Background and objective: Immobility of the lower extremity due to medical conditions such as stroke can lead to medical complications such as deep vein thrombosis or ankle contracture, and thereafter prolonged recovery process of the patients. In this preliminary clinical study, we aimed to examine the effect of a novel soft robotic sock device, capable of providing assisted ankle exercise, in improving blood flow in the lower limb to prevent the complication of strokes such as deep vein thrombosis and joint contracture. Methods: Stroke patients were recruited ( n = 17) to compare patients using the conventional pneumatic compression device with our robotic sock device on separate days. The primary outcome was to compare the venous flow profile of the superficial femoral vein in terms of the time average mean velocity and volumetric flow. The secondary outcome was to identify the ankle joint range of motion with the assistance of the device. Results: We noted improvements in the venous profile at the early phase of the device use, though its efficacy seemed to drop with time, as compared to the IPC device, where there was a significant improvement in the venous profile. The ankle joint dorsiflexion-plantarflexion range of motion assisted by the device was 11.5±6.3°. Conclusion and clinical impact: The current version of our sock device appears to be capable of improving venous blood flow in the early phase of device use and assisting with ankle joint exercise. The insights from this preliminary clinical study will serve as the basis for further improvement of the device and subsequent conduct of a longitudinal clinical trial. Funding: National Health Innovation Centre Singapore (NHIC) grant, R-172-000-391-511, MOE AcRF Tier 1 R-397-000-301-114.
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Published on Mar 1, 2017in Stroke 6.05
Maiko Yagi4
Estimated H-index: 4
Hideo Yasunaga31
Estimated H-index: 31
+ 5 AuthorsJunko Fujitani3
Estimated H-index: 3
Background and Purpose— We aimed to examine the concurrent effects of timing and intensity of rehabilitation on improving activities of daily living (ADL) among patients with ischemic stroke. Methods— Using the Japanese Diagnosis Procedure Combination inpatient database, we retrospectively analyzed consecutive patients with ischemic stroke at admission who received rehabilitation (n=100 719) from April 2012 to March 2014. Early rehabilitation was defined as that starting within 3 days after admi...
9 Citations Source Cite
Published on Mar 1, 2017in Stroke 6.05
Steven C. Cramer62
Estimated H-index: 62
(UCI: University of California, Irvine),
Steven L. Wolf67
Estimated H-index: 67
(Emory University)
+ 15 AuthorsMaarten G. Lansberg44
Estimated H-index: 44
(Stanford University)
Stroke is the second leading cause of death and the third leading cause of disability-adjusted life years worldwide. Although numerous therapies have been developed over the past 10 years to treat acute ischemic stroke, the stark reality remains that only 5% of these patients are so treated in the United States,1 in part, because of treatment window times <3 to 6 hours post-onset, and many of these 5% nonetheless have significant long-term disability. Acute treatment options after hemorrhagic st...
21 Citations Source Cite
Published on Jun 1, 2016
Fan-Zhe Low3
Estimated H-index: 3
(NUS: National University of Singapore),
Melati Dewi Ali + 2 AuthorsChen-Hua Yeow15
Estimated H-index: 15
(NUS: National University of Singapore)
We present a soft robotic sock device developed to provide robotic assistance in ankle dorsiflexion and plantarflexion of stroke patients who are at high risk of developing deep vein thrombosis. The actuators extend when infused with pressurized air, so as to guide the ankle into plantarflexion motion. On the other hand, the actuators contract back to their initial length when deflated to pull the ankle into dorsiflexion. In this work, the actuators were characterized in terms of their linear di...
Source Cite
Fan-Zhe Low3
Estimated H-index: 3
(NUS: National University of Singapore),
Hong Han Tan1
Estimated H-index: 1
(NUS: National University of Singapore)
+ 1 AuthorsChen-Hua Yeow15
Estimated H-index: 15
(NUS: National University of Singapore)
Deep vein thrombosis (DVT) is a severe medical condition that affects many patients around the world, where one of the main causes is commonly associated with prolonged immobilization. Current mechanical prophylaxis systems, such as the compression stockings and intermittent pneumatic compression devices, have yet to show strong efficacy in preventing DVT. The current study aimed to develop a soft pneumatic sock prototype that uses soft extension pneumatic actuators to provide assisted ankle dor...
6 Citations Source Cite
Published on Jul 4, 2015in The Lancet 59.10
Julie Bernhardt37
Estimated H-index: 37
(Florey Institute of Neuroscience and Mental Health),
Peter Langhorne65
Estimated H-index: 65
(Glas.: University of Glasgow)
+ 7 AuthorsGeoffrey A. Donnan96
Estimated H-index: 96
(University of Melbourne)
Abstract Early mobilisation after stroke is thought to contribute to the effects of stroke-unit care; however, the intervention is poorly defined and not underpinned by strong evidence. We aimed to compare the effectiveness of frequent, higher dose, very early mobilisation with usual care after stroke. We did this parallel-group, single-blind, randomised controlled trial at 56 acute stroke units in five countries. Patients (aged ≥18 years) with ischaemic or haemorrhagic stroke, first or recurren...
199 Citations Source Cite
Published on Jan 1, 2015
Csilla Vér2
Estimated H-index: 2
Gergely Hofgárt3
Estimated H-index: 3
+ 2 AuthorsLászló Csiba36
Estimated H-index: 36
Purpose: To develop a continuous passive motion (CPM) device for the passive motion of the paretic ankle-foot and investigate the effect of continuous passive motion of bedridden, hemiparetic acute stroke patients. Methods: 49 patients with stroke were investigated. Results in stroke patients (device group) were compared with those of 15 control subjects (manual group) also with stroke but not treated by device. The period of the treatment was 7 days; the duration was 30 minutes per day by CPM d...
3 Citations Source Cite
Published on Sep 1, 2013in Brain Injury 1.67
Aurore Thibaut19
Estimated H-index: 19
Camille Chatelle25
Estimated H-index: 25
+ 3 AuthorsOlivia Gosseries34
Estimated H-index: 34
AbstractBackground: Spasticity following a stroke occurs in about 30% of patients. The mechanisms underlying this disorder, however, are not well understood.Method: This review aims to define spasticity, describe hypotheses explaining its development after a stroke, give an overview of related neuroimaging studies as well as a description of the most common scales used to quantify the degree of spasticity and finally explore which treatments are currently being used to treat this disorder.Result...
101 Citations Source Cite
Published on Aug 10, 2013in The Lancet 59.10
Martin Dennis72
Estimated H-index: 72
(Edin.: University of Edinburgh)
CLOTS (Clots in Legs Or sTockings after Stroke) Trials Collaboration* Summary Background Venous thromboembolism is a common, potentially avoidable cause of death and morbidity in patients in hospital, including those with stroke. In surgical patients, intermittent pneumatic compression (IPC) reduces the risk of deep vein thrombosis (DVT), but no reliable evidence exists about its eff ectiveness in patients who have had a stroke. W e assessed the eff ectiveness of IPC to reduce the risk of DVT in...
135 Citations Source Cite
Published on Jan 1, 2013in International Journal of Stroke 4.47
Toby B. Cumming23
Estimated H-index: 23
Randolph S. Marshall36
Estimated H-index: 36
(CUMC: Columbia University Medical Center),
Ronald M. Lazar39
Estimated H-index: 39
(CUMC: Columbia University Medical Center)
Cognitive impairment after stroke is common and can cause disability with major impacts on quality of life and independence. There are also indirect effects of cognitive impairment on functional recovery after stroke through reduced participation in rehabilitation and poor adherence to treatment guidelines. In this article, we attempt to establish the following: • whether there is a distinct profile of cognitive impairment after stroke; • whether the type of cognitive deficit can be associated w...
133 Citations Source Cite
Published on Jul 1, 2012in Archives of Physical Medicine and Rehabilitation 2.70
Li Khim Kwah8
Estimated H-index: 8
Robert D. Herbert69
Estimated H-index: 69
+ 7 AuthorsSimon C. Gandevia102
Estimated H-index: 102
(UNSW: University of New South Wales)
Abstract Kwah LK, Herbert RD, Harvey LA, Diong J, Clarke JL, Martin JH, Clarke EC, Hoang PD, Bilston LE, Gandevia SC. Passive mechanical properties of gastrocnemius muscles of people with ankle contracture after stroke. Objective To investigate the mechanisms of contracture after stroke by comparing passive mechanical properties of gastrocnemius muscle-tendon units, muscle fascicles, and tendons in people with ankle contracture after stroke with control participants. Design Cross-sectional study...
42 Citations Source Cite
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