Robotic-Assisted Therapy for Hand and Fingers

Amadeo is the most advanced sensory robotic device used in all phases of rehabilitation for individuals with motor and sensory impairments in the hand and fingers. Due to its adaptability (interchangeable attachments, adjustable table height, hand unit positioning, magnets), it is used in therapy for both children and adults.

Amadeo is the only device in the world that mimics the natural grasping motion of the hand during therapy.

Repetitive movements in the area of the hand and finger joints during therapy create internal and external stimuli for the patient, which stimulate neuronal reorganization within the brain and thus restore lost movement and function.

Therapy with the Amadeo device is used in cases where the patient has reduced or limited movements in the hand and fingers, in case of weakened motor function and weakened muscle strength in the area of the hand and fingers, in case of reduced muscle tone and reduced coordinated movements of the fingers, and in case of fine motor disorders.

Through its specific program of work, the Amadeo device in therapy gives positive results in reducing spasms and increased muscle tone of the hand and fingers.

It also offers the possibility of conducting sensory therapy, so it is used in therapy for the lack of sensation in the hand and fingers.

Amadeo device components:

• Hand unit: Features an electric mechanism for finger movement.
• Supports: For the hand and arm (suitable for children and adults).
• Magnet attachments: For fingers with adjustable sizes.
• Device frame: Height adjustable.
• Control panel: For configuring therapy parameters and monitoring the treatment.

Performing movements in therapy on the Amadeo device is one-dimensional (extend-flex), while the range of movements depends on the anatomical and physiological limitation of movement in the area of the fingers and is individual for each patient.

Depending on the degree of damage, the therapy is carried out in the form of active, passive or active-assisted movement.

In the active form of therapy, the patient performs the movement independently up to the maximum limit of mobility, while in the case of passive movement, the Amadeo device supports the performance of the movement itself. Actively assisted movement is performed by the patient in such a way that he actively performs the movement as much as he can, and the rest of the performance of the maximum movement is taken over by the device itself.

Therapy on the Amadeo device can be performed individually for each finger or simultaneously for all fingers. Alternating and/or random finger movement sequences are also possible. The movements of individual fingers can be deactivated or limited if necessary.

During the therapy, the therapist designs the work program himself, controls the speed and extent of movement, and regulates the limit of force individually according to the patient’s own needs.

Procedure overview

After we place the patient in the appropriate physiological position in front of the device, we fix the appropriate extensions with magnets on the cheekbones of his fingers with the help of a patch. The elbow and hand are then placed and fixed in the support, and the pads of the fingers together with magnets on the finger slides.

We configure the appropriate final movement position in the direction of stretching and bending the fingers and enter the therapy. The Amadeo device moves the fingers in accordance with the movement parameters that we configured at the beginning of each therapy.

By entering the therapy, the Amadeo device with the help of “Measurement applications” allows us to perform an initial, initial measurement/test for each patient, which we then store in the database of the device itself. Subsequent assessments are compared to the initial state to monitor progress and therapy outcomes.

With the help of “Measuring applications” we evaluate/test:

1. Assess finger and hand strength.
2. Measure finger movement range.
3. Evaluate muscle tone and spasticity.
4. Spasticity

After the assessment of the initial condition, the patient starts therapy by choosing the appropriate therapeutic program, depending on the individual needs of the patient. The Amadeo device offers the option of choosing three therapeutic programs:

1. Continuous Passive Motion (CPM): Device stimulates passive movement.
2. Assisted therapy: Patient actively participates up to their maximum range.
3. Interactive therapy: Includes virtual therapeutic games.

During the therapy, the integrated sensor system enables continuous recording and assessment of the strength and range of movements in the fingers. In this way, they provide the therapist and the patient with real-time feedback on the course of the therapy.

In case of excessive force or increased range of motion, the fingers are automatically separated from the movement mechanism.

Therapy on the Amadeo device is carried out in our institution within 55 minutes.

Recovery

The main goal of therapy on the Amadeo device is to increase the range of motion in the fingers, to improve and better the fine and gross motility of the fingers, to increase the strength of the fingers and hand, to improve the control of the mobility of the fingers, to increase the selective movements and agility of the fingers, and to develop the movement of grasping and relaxation.

After each therapy performed on the Amadeo device, the patient receives a pair of related exercises to do at home, depending on what he did in therapy that day. This practice helps improve recovery by increasing repetition of the same actions.

Candidates

Target groups include neurological, orthopedic, and pediatric patients.

Absolute indications:

• Stroke
• Traumatic brain injury
• Brain tumor
• Spinal cord injury
• Parkinson’s disease
• Multiple sclerosis
• Cerebral palsy
• Motor neuron diseases, e.g., ALS
• Muscular dystrophies
• Paralysis due to cervical disc herniation
• Fractures and injuries of the hand and fingers

Absolute contraindications:

• Acute hand and finger pain
• Pain persisting after conventional therapy
• Joint contractures
• Severe spasm causing finger joint fixation
• Psychotic or neurotic disorders
• High-grade ataxia
• Advanced osteoporosis (risk of fractures)
• Unstable fractures
• Children under 3 years old
• Inability to position the patient correctly relative to the device

Relative contraindications:

• Apraxia
• Arthritis in the small joints of the hand
• Cognitive impairments
• Hand and finger fractures with callus formation
• Epilepsy
• Cardiac pacemakers (device distance < 15 cm)
• Infections
• Joint problems
• Osteoporosis
• Circulatory problems
• Pain
• Sensory disorders
• Skin issues (wounds, burns)
• Shoulder subluxation
• Swelling/ulcerations on the skin
• Material intolerance (adhesive pads)

Preparation

Each patient must undergo an evaluation by a physician or therapist to determine if Amadeo therapy is appropriate and will yield positive results.

If recommended, the patient will have the opportunity to test the therapy to understand its nature.

Therapy on the Amadeo device is individual, fun and motivating, and adapted to the patient’s needs. The therapist is always present during therapy.

Service location