Outcomes of Robot-Assisted Stroke Rehabilitation in Motor, Daily Functions, Pain and Fatigue

Background: Stroke survivors are limited in their daily functions due to restrictedmotor function. None Robot-assisted Therapies (RTs), providing intensive sensorimotor approaches, has been established as effective on both upper extremity(UE) motor function and performance of daily livings for patients with chronic stroke.

Objective: To determine whether the Intensive Robot-assisted Therapy (IRT) is safe, tolerable and effective on both UE motor recovery and functional performance of chronic stroke survivors.

Methods: Multi-centered randomized controlled trial involved 20 chronic stroke participants with mild to moderate hemiparesis between July 1, 2010, and June 19,2011. Patients were randomly assigned to IRT and dose-matched (i.e.,matched on therapy hours) control intervention (CI) to receive 18-20 sessions (105-120 mins/day,4-6 days/wk, 3-4 weeks). Based on the ICF model, we choose Fugl-Meyer Assessment (FMA) as primary outcome measure to assess the body function domain;
ABILHAND and Functional Independent Measure (FIM) as the secondary outcomes to measure the activities and participation domain; Visual Analogue Scale as the contextual domain to assess adverse effects.

Results: 20 participants completed our intervention protocols, no significant between-group differences were found in baseline characteristics. Significant between-group difference and large effect were shown on the FMA total score(F(1,19)= 7.66, P= .013, η2= .31) after treatment. The IRT group, as compared to CI, showed greater improvements in both proximal shoulder-elbow level and distal forearm-wrist-hand level on FMA scale; however, non-significant differences were reported on both ABILHAND scale (F(1,19)= .374, P= .549, η2= .022) and FIM(F(1,19)= 3.025, P= .097,
η2= .131) after treatment. IRT did not show excessive
adverse effects in comparison to CI.

Conclusions: It may be feasible to deliver the IRT for chronic stroke patients with mild to moderate hemiparesis. The current results suggest that IRT is beneficial to
improve UE motor function at both proximal and distal level without causing excessive adverse effects; however, this new intervention regimen may not adequate to drive significant differences on functional performance in comparison to CI.