Robot-assisted therapy with the use of MOTOmed letto 2 in complex early rehabilitation of patients with stroke admitted to the intensive care unit

Objective: to assess the effect of early robot-assisted rehabilitation (MOTOmed Letto 2) on neurological recovery, severity of the disease, the rate and severity of multiple organ dysfunction syndrome and the rate of venous thromboembolism in acute stroke patients during intensive care unit (ICU) stay, including patients who require mechanical ventilation. This case-control study included 66 patients (49 males and 17 females, median age 59) with acute ischemic stroke and cerebral hemorrhage admitted to ICU. Patients were distributed into two comparable groups, intervention (n=33) and control group (n=33), and monitored from admission to day 21. Both groups received standard rehabilitation from admission, and patients in the intervention group also received robot-assisted arm and leg therapy. Groups had similar median GCS, NIHSS, APACHE II, MODS scores on admission. There was no significant difference in neurological and medical outcome on day 21 (median GCS: 15 vs. 15, p=0.32; median NIHSS 11 vs. 15, p>0.05; median APACHE II 6 vs. 9, p >0.05; median MODS 0 vs. 1, p >0.05 in the intervention and control group, respectively). The rate of multiple organ dysfunction syndrome and deep venous thrombosis (DVT) on day 21 was also similar in the intervention and control groups (60% vs. 67%, p>0.05, and 57.6% vs. 45.4%, p>0.05, respectively). The rate of severe multiple organ dysfunction syndrome, incidence of pulmonic embolism (PE) and mortality rate were lower in the intervention group vs. control group (14%, vs. 41%, p<0.05; 12% vs. 33%; p<0.05; 12% vs. 39%, p<0.05, respectively). Early robotassisted therapy in patients with severe stroke admitted to the ICU was associated with significant reduction of PE rate, incidence of severe multiple organ dysfunction syndrome and mortality on day 21, but did not influence neurological outcome and DVT rate.