This document discusses a study on the effects of glove rehabilitation therapy (Gloreha) for post-stroke patients. The study assessed effects on motor skills, visual-spatial exploration, attention, and spasticity. Ten rehabilitation sessions over two weeks were administered. Results showed improvements in visual-spatial tests for one patient, attention for all patients, manual dexterity and functional capacity for some, and reduced spasticity for one patient. The study concluded that Gloreha integration of motor and cognitive rehabilitation showed benefits.

1. Glove rehabilitation therapy for
post-stroke patients:
rational, application examples,
effects on motor and visual-
spatial exploration capacities
Valentina Varalta
Neuropsychologist
Neuromotor and Cognitive Rehabilitation Research Center
Neurological Rehabilitation Department
Hospital University of Verona

2. Right brain lesion
SENSORIMOTOR IMPAIRMENTS COGNITIVE IMPAIRMENTS
Unilateral spatial Heminattentive
neglect deficit

3. Unilateral Spatial Neglect:
Neglect:
SPATIAL-MOTOR-
SPATIAL-MOTOR-CUEING PARADIGM
Limb activation contralateral to a cerebral lesion
seems to reduce visual neglect

4. EXPERIMENTAL TRIAL
Purpose of the study
EFFECTS OF PASSIVE REHABILITATION OF THE CONTRALESIONAL UPPER LIMB:
Spatial Unilateral Heminattentive deficit (sustained attention,
1) Neglect selective attention, reaction time)
2) Sensorimotor impairments (manual dexterity, motricity), spasticity
Patients
Inclusion criteria Exclusion criteria
• Cerebral stroke on the right • Other vascular cerebral events in anamnesis and/or
hemisphere neurological deseases
• Aged from 18 and 85 • Dementia
• Low level spasticity of the upper • Psychiatric disaeses
limb (pt<3 Modified Ashworth Scale) • Aphasia of medium-high level
• Abuse of alcohol and/or drugs
• Important spasticity (pt≥3 Modified Ashworth Scale)

5. EXPERIMENTAL TRIAL
EVALUATION 1
General clinical evaluation EVALUATION 2
+
Outcome measures Outcome measures
evaluation evaluation
14 days (10 rehabilitation sessions)
T0 T1
(pre-treatment) (post-treatment)
General clinical evaluation: Outcome measures evaluation:
• MMSE
• European Stroke Scale Cognitive Tests: Motor Tests:
• Modified Ashworth Scale Line Crossing Test Modified Ashworth Scale
Bells Test Fugl Meyer Assessment
Line Bisection Test Motricity Index
Saccadic Training Nine Hole Peg Test
Computerized Test for the Purdue PegBoard Test
assessment of unilateral stimuli
Sustained Attention of
Response Task (SART)

6. EXPERIMENTAL TRIAL
Treatment
• 10 rehabilitation sessions of 25 minutes
• 5 sessions per week (for 2 weeks)

7. RESULTS
PATIENTS: Demographic and clinical data
Patient Gender Age (years) Education (years) Time from onset (months) Type of lesion MMSE
B.A. F 69 5 13 Ischemic 23,9
B. M. F 66 8 35 Ischemic 25
F. M. F 64 5 4 Hemorrhagyc 24,9
M. S. F 85 7 9 Ischemic 23,8
PRE-TREATMENT ASSESSMENT: Neuropsychological tests
Line Bisection Saccadic Training
Line Crossing Test Bells Test Test SART (Rehacom)
left right left right FA O RT left right
B.A. 12/18 18/18 11/17 17/17 3/9 11/24 17 511 7252 2575
B. M. 18/18 18/18 12/17 13/17 9/9 8/24 31 557 1375 1213
F. M. 6/18 13/18 4/17 15/17 0/9 14/24 34 452 2411 1062
M. S. 10/18 10/18 9/17 11/17 8/9 4/24 140 612 5726 3330
PRE-TREATMENT ASSESSMENT: Motor tests
Nine Hole Peg Motricity FUGL MEYER - Motor
Purdue Peg Board Test Test Index Modified Ashworth Scale capacity assessment
left right bimanual assembl. left right shoulder elbow wrist Fingers
B. A. 2 1 0 1 0,08 0,13 73/99 0 0 0 0 99/115
B. M. - 0 2 1 2 43/115
F. M. 4 12 6 4 0,14 0,58 85/99 0 0 0 0 101/115
M. S. - 0 0 1 0 31/115

8. RESULTS
NEGLECT TEST: Comparison pre/post treatment
20
18
16
14
12
10
8 T0
B.A. 6 T1
4
2
0
left
sx (18 item) right left
dx (18 item) sx (17 item) right
dx (17 item) Line
Test di Albert (BIT) Test delle Campanelle Bisection
Bisezione di
Line Crossing Test Bells Test Test
linee (BIT)
20
18
16
14
12
10
F.M. 8 T0
6 T1
4
2
0
left
sx (18 item) right left
dx (18 item) sx (17 item) light
dx (17 item) Line
Line Crossing(BIT)
Test di Albert Test Test delle Campanelle
Bells Test Bisection
Bisezione di
Test
linee (BIT)

9. RESULTS
HEMINATTENTIVE TEST: Comparison pre/post treatment
8000 700
Reaction Time Contralesonal stimuli 7000 600
6000 500
Reaction Time
5000
400
4000
T0 300 T0
3000
T1 200 T1
2000
1000 100
0 0
B.A. B. M. F. M. M. S. B.A. B. M. F. M. M. S.
Saccadic Training SART
MANUAL DEXTERITY TEST: Comparison pre/post treatment
10 0,8 125
8 0,7 115
0,6 105
6
95
4 0,5
85
2 0,4 75
0,3 65
0 T0
0,2 55
bimanuale
bimanuale
rightdx
assembl.
dx
assembl.
left sn
left sn
bimanual
bimanual
right
0,1 45 T1
0 35
left right left right 25
sn dx sn dx
B. A. B. M. F. M. M. S.
B.A. F.M. B.A. F.M.
Nine Hole Peg Test Fugl-Meyer
Purdue PegBoard Test

10. CONCLUSIONS
AFTER PASSIVE MOBILIZATION OF CONTRALESIONAL UPPER LIMB WITH GLOREHA:
1. Effects on visual-spacial and exploration capacities:
1 patient shows an improvement about the performance in all the performed test
1 patient shows unhomogeneous performance
2. Effects on attentive capacities:
All the patients show an improvement about the speed of relevation of contralesional
stimuli (Saccadic Training) and a reduction of the reaction time about supported
attention (SART)
3. Effects on motor capacities:
We have registered an increase of the capacities of manual dexterity (NHPT; PPBT) and
a slight improvement of functional capacities (Fugl-Meyer)
4. Effects on spasticity level:
The patient with spasticity (B.M.) has reduced this affliction (fingers)
INTEGRATION BETWEEN MOTOR REHABILITATION AND COGNITIVE
REHABILITATION THANKS TO ROBOTIC DEVICES LIKE GLOREHA

11. Giulia Montemezzi Elisabetta La Marchina
NICOLA SMANIA
Marialuisa Gandolfi Alessandro Picelli Daniele Munari
Patrizia Ianes Christian Geroin Cristina Fonte
Thank you
for your attention