Upper Limb Treatment With "Gloreha Aria" in the Hemiplegic Patients
Upper Limb Treatment With "Gloreha Aria" in the Hemiplegic Patients
Stroke is one of the leading causes of death and disability and has been described as a
 worldwide epidemic (1). Stroke survivors are affected by impairments and limitations of
 cognitive, language, perceptual, sensory, and motor functions. After a stroke, patients can
 improve spontaneously within the first 3 months (2) and then more slowly in the following
 year. The first day, decreased oedema and partial reperfusion of the ischemic penumbra may
 possibly explain these phenomena, but the improvement of neurological deficit in the
 following weeks suggests plasticity phenomena and brain cortical reorganization (3). While
 most recovery is thought to be made in the first few weeks after stroke, patients may make
 improvements on functional tasks many months after having a stroke (4). Restoring arm and
 hand skill after a stroke remains challenging, even though stroke rehabilitation programs
 have proven partial efficacy Repetitive task training has been shown to be effective in some
 aspects of rehabilitation, such as improving walking distance and speed and improving upper
 limb function (5).

 In this project, the investigators will use "Gloreha ARIA" (7) a new sensor-based therapy
 device designed for motor recovery of impaired upper limb Gloreha Aria offers specific
 programs that help patients to move arm, wrist and fingers. Therapists can customize therapy
 by focusing on a specific motor task.
The hypothesis was that rehabilitation with this device could be not inferior in comparison
 with hands-on physiotherapy, in the reeducation of upper arm in the patient affected by
 stroke from cerebral ischemia or hemorrhage that had occurred ≤ 30 days before.

 The principle purpose of this study will be to evaluate:

 1. The feasibility of this new device

 2. Efficacy in improving arm function abilities in the rehabilitation of patients with
 stroke in the sub-acute phase.

 Post-stroke patients admitted for inpatient rehabilitation to the Neurological Rehabilitation
 will be screened for enrolment and randomized in a controlled trial.

 All the patients will be informed about the aim and experimental procedures before enrolment,
 thus written informed consent will be obtained from all of them. Patients included in the
 study will be randomly assigned to intervention or control group according to simple
 randomization technique (computerized random numbers).
Inclusion Criteria:

 -  to exhibit first cerebral vascular disease with unilateral hemispherical lesion
 confirmed by CT scan or MRI;

 -  to be sub-acute patients (less than 30 days from the cerebral vascular event);

 -  being affected by upper limb paresis;

 Exclusion Criteria:

 1. unable to understand verbal instruction or motor commands;

 2. unilateral neglect;

 3. apraxia;

 4. significant visual impairment;

 5. unstable medical condition;

 6. significant orthopedic limitation to the shoulder, elbow; wrist and hand;

 7. upper arm peripherical nerve lesion;

 8. neuromuscular or neurodegenerative diseases;

 9. spasticity > 3 in according to the Modifies Ashworth Scale (3);