{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:21:56Z","timestamp":1791332516510,"version":"4.3.1"},"reference-count":61,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,5,1]],"date-time":"2022-05-01T00:00:00Z","timestamp":1651363200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Hand movements are particularly impaired in patients with Parkinson\u2019s Disease (PD), contributing to functional disability and difficulties in activities of daily living. Growing evidence has shown that robot-assisted therapy may be considered an effective and reliable method for the delivery of the highly repetitive training that is needed to trigger neuroplasticity, as intensive, repetitive and task-oriented training could be an ideal strategy to facilitate the relearning of motor function and to minimize motor deficit. The purpose of this study is to evaluate the improvement of hand function with semi-autonomous exercises using an upper extremity exoskeleton in patients with PD. A multicenter, parallel-group, randomized clinical trial was then carried out at the IRCCS Centro Neurolesi Bonino-Pulejo (Messina, Italy). Thirty subjects with a diagnosis of PD and a Hoehn\u2013Yahr score between 2 and 3 were enrolled in the study. Patients were 1:1 randomized into either the experimental group (ERT), receiving 45 min training daily, 6 days weekly, for 8 weeks with Armeo\u00aeSpring (Volketswil, Switzerland) (a gravity-supporting device), or the control group (CPT), which was subjected to the same amount of conventional physical therapy. Motor abilities were assessed before and after the end of the training. The main outcomes measures were the Nine-hole peg test and the motor section of the UPDRS. All patients belonging to ERT and 9 out of 15 patients belonging to the CPT completed the trial. ERT showed a greater improvement in the primary outcome measure (nine-hole peg test) than CPT. Moreover, a statistically significant improvement was found in ERT concerning upper limb mobility, and disease burden as compared to CPT. Using an upper extremity exoskeleton (i.e., the Armeo\u00aeSpring) for semi-autonomous training in an inpatient setting is a new perspective to train patients with PD to improve their dexterity, executive function and, potentially, quality of life.<\/jats:p>","DOI":"10.3390\/jcm11092543","type":"journal-article","created":{"date-parts":[[2022,5,1]],"date-time":"2022-05-01T06:23:08Z","timestamp":1651386188000},"page":"2543","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Improving Upper Extremity Bradykinesia in Parkinson\u2019s Disease: A Randomized Clinical Trial on the Use of Gravity-Supporting Exoskeletons"],"prefix":"10.3390","volume":"11","author":[{"given":"Loredana","family":"Raciti","sequence":"first","affiliation":[{"name":"GCA-Centro Spoke AO Cannizzaro, Catania, IRCCS Centro Neurolesi Bonino-Pulejo, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loris","family":"Pignolo","sequence":"additional","affiliation":[{"name":"S. Anna Institute, Research in Advanced Neurorehabilitation, 88900 Crotone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Perini","sequence":"additional","affiliation":[{"name":"Spoke Centre of Palermo, IRCCS Centro Neurolesi Bonino-Pulejo, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Pullia","sequence":"additional","affiliation":[{"name":"Behavioral and Robotic Neurorehabilitation Unit, IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Porcari","sequence":"additional","affiliation":[{"name":"Behavioral and Robotic Neurorehabilitation Unit, IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desiree","family":"Latella","sequence":"additional","affiliation":[{"name":"Behavioral and Robotic Neurorehabilitation Unit, IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Isgr\u00f2","sequence":"additional","affiliation":[{"name":"Behavioral and Robotic Neurorehabilitation Unit, IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonino","family":"Naro","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8566-3166","authenticated-orcid":false,"given":"Rocco Salvatore","family":"Calabr\u00f2","sequence":"additional","affiliation":[{"name":"Behavioral and Robotic Neurorehabilitation Unit, IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.parkreldis.2007.07.019","article-title":"Impairment of complex upper limb motor function in de novo Parkinson\u2019s disease","volume":"14","author":"Ponsen","year":"2008","journal-title":"Parkinsonism Relat. 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