Lower limb trauma can cause kinetic chains impairments that compromise quality of movement and postural stability A pilot study is now being conducted in INAIL Rehabilitation Center of Volterra using Hunova, a robotic system for lower limbs and core stability training and evaluation, to examine whether robot-assisted therapy is effective in motor control and gait performance recovery when compared to conventional rehabilitation programs.

Hunova consists of two mobile platforms for exercising in both seated and upright mono and bipodalic conditions The device can operate in passive, active and assistive mode, detecting compensatory trunk movements with an inertial sensor and giving sensory feedback during exercise. The ongoing open randomized controlled trial foresees the enrolment of fifty-six patients with functional locomotor impairments following work-related injuries of the lower limbs Patients are randomly allocated to experimental or control group and receive a 3 weeks rehabilitation program and a pre- and post-treatment assessment including robotic, clinical and instrumental non-robotic evaluations. All participants undergo an individualized rehabilitation protocol, tailored to specific patient needs and injury characteristics; the experimental group perform instability and resistive training with Hunova; control subjects follow a training program using traditional non-robotic equipment Results Robotic therapy was well tolerated and easy to manage An interim analysis on 37 patients shows that both groups benefited the proposed training protocol and robotic therapy was not inferior to conventional rehabilitation; moreover, patients with distal lower extremity injury show a significantly greater improvement in statistic stability than patients with proximal lower extremity injury.

Hunova allows to measure significant parameters of static and dynamic stability and can centralize a complex progression of exercises to recover trunk control and reactive balance after traumatic injuries Final results of the study will contribute to explore the rule of robotic therapy in orthopedic conditions.