Improving the Efficiency of Robot-Mediated Rehabilitation by Using a New Organizational Model: An Observational Feasibility Study in an Italian Rehabilitation Center

Robotic rehabilitation is a promising way to restore upper limb function, but new organizational models are crucial in order to improve its sustainability. We aimed to analyze the feasibility of a robot-Assisted REhabilitation Area (robotAREA) equipped with four devices, using a new organizational model in which one physiotherapist supervises up to four patients. In 33 days, 60 patients were treated in the robotAREA. Two hundred fifty-five rehabilitation sessions were analyzed, each including two, three, or four patients supervised by one physiotherapist (the R2, R3, and R4 group, respectively). For each session, the duration of (a) setup, (b) training, (c) supervision, (d) session closure, and participant satisfaction were measured. For each patient, upper limb impairment, disability, mobility, and comorbidity were recorded. The time of training in the R4 group was lower by only 2 and 3 min compared to the R2 and R3 groups, respectively, while the supervision significantly changed between the R2, R3, and R4 groups. No differences were observed in satisfaction. Moreover, according to the logistic regression analysis, when the mean disability of the group is moderate, four patients can be supervised by one physiotherapist. These results suggest that the proposed model is feasible, and the mean disability of the group could influence the proper physiotherapist/patient ratio.