Robotics-Enhanced Physiotherapeutic Interventions to Improve Circulatory Efficiency after Endovascular Surgery

Abstract

Background: Peripheral Arterial Disease (PAD) often makes it hard to move your lower limbs and does not allow you to do certain things. Endovascular Revascularisation (EVR) is a good way to open up blocked arteries, but for long-term success, early and organised physiotherapy is needed to get the blood flow back to normal. Conventional rehabilitation methods don't always have standardisation, intensity control, or obedience, which means they don't always produce the best results.

Objective: This study looks into whether Robotics-Enhanced Physiotherapy (REP), which includes robotic ankle-pump training, exoskeleton-assisted ambulation, and intermittent pneumatic compression (IPC), can help post-EVR patients' circulation and functional performance more than regular physiotherapy.

Methods: One hundred and eighty-two patients who had successful infra-inguinal EVR were randomly assigned to either normal physiotherapy or REP. The Circulatory Efficiency Index (CEI) was the main result. It was made up of the Ankle-Brachial Index (ABI), the Near-Infrared Spectroscopy (NIRS) recovery slope, and the Calf Venous Ejection Fraction (VEF). The 6-Minute Walk Distance (6MWD), pain (VAS), and oedema grading were secondary results. At the start, on Day 7, and in Week 4, assessments were done.

Results: It was much better in the REP group (+0.48 ± 0.12 vs. +0.21 ± 0.09, p < 0.01), and the NIRS re-oxygenation happened faster (+23% vs. +12%, p = 0.01). The gains in ABI and VEF were also bigger, and the 6MWD was longer, and pain scores went down.

Conclusion: Robotics-Enhanced Physiotherapy is a structured, safe, and successful way to improve physical and circulatory health after EVR. REP can help standardise vascular rehabilitation and speed up patient healing by combining programmable exercise dosing with real-time feedback