Effects of a robot intervention on visuospatial hemineglect in postacute stroke patients: a randomized controlled trial

Abstract

Objective: To evaluate the effects of an intervention using the robot device PARO on visuospatial hemineglect and activities of daily living, and its acceptance during stroke rehabilitation. PARO is an interactive robotic toy with the appearance of a baby seal, which can move, produce sounds, and react to speech and touch.

Design: A randomized controlled trial.

Setting: Hospital for neurorehabilitation.

Subjects: Patients above 60 years old who have suffered their first stroke within the previous three months with left hemineglect (n = 39).

Interventions: The PARO group (n = 21) was exposed to PARO over a period of two weeks, three times per week. The participants of the control group (n = 18) were read to aloud.

Outcome measure: Visuospatial hemineglect was measured by a cancellation test and a Line Bisection Test, and independence in the activities of daily living was assessed by Scores of Independence Index for Neurological and Geriatric Rehabilitation (SINGER) test. The acceptance of PARO was also evaluated. Data were collected blinded at three times: baseline (T0), after two weeks of interventions (T1), and after additional two weeks as follow-up (T2).

Results: Improvement of hemineglect at T1 and T2 was significantly higher in the PARO group (T1: mean (SD) = 6.23 (3.81); T2: mean (SD) = 7.85 (3.68)) compared to the control group (T1: mean (SD) = 2.66 (4.19); T2: mean (SD) = 3.33 (4.16)) (T1: P < 0.05; T2: P < 0.05).

Conclusion: The study showed that the use of the PARO is well accepted and can help to improve neglect symptoms in patients with subacute stroke.

Keywords: Hemineglect; PARO; activities of daily living; subacute stroke.