Comparative Effectiveness of Robot-Assisted Training Versus Enhanced Upper Extremity Therapy on Upper and Lower Extremity for Stroke Survivors: A Multicentre Randomized Controlled Trial

Lin, Yingnan; Li, Qinying; Qu, Qingming; Li, Ding; Chen, Zhe; Huang, Fubiao; Hu, Shihong; Deng, Wei; Guo, Fengxian; Deng, Panmo; Li, Li; Hao, Jian; Cong, Gao; Shu, Beibei; Jia, Jie

doi:10.2340/jrm.v54.882

Cited by 7 publications

(7 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A significant improvement in the Barthel Index and ADLs was observed after the intervention, reflecting a higher level of independence after being released from hospital. Other studies analyzing the effect of RAT on stroke demonstrated improvement in the Barthel index or the Fugh-Meyer Scale [ 30 , 36 , 37 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

The Efficacity of the NeuroAssist Robotic System for Motor Rehabilitation of the Upper Limb—Promising Results from a Pilot Study

Tohănean

Tucan

Vanta

et al. 2023

JCM

View full text Add to dashboard Cite

The research aimed to evaluate the efficacy of the NeuroAssist, a parallel robotic system comprised of three robotic modules equipped with human–robot interaction capabilities, an internal sensor system for torque monitoring, and an external sensor system for real-time patient monitoring for the motor rehabilitation of the shoulder, elbow, and wrist. The study enrolled 10 consecutive patients with right upper limb paresis caused by stroke, traumatic spinal cord disease, or multiple sclerosis admitted to the Neurology I Department of Cluj-Napoca Emergency County Hospital. The patients were evaluated clinically and electrophysiologically before (T1) and after the intervention (T2). The intervention consisted of five consecutive daily sessions of 30–45 minutes each of 30 passive repetitive movements performed with the robot. There were significant differences (Wilcoxon signed-rank test) between baseline and end-point clinical parameters, specifically for the Barthel Index (53.00 ± 37.72 vs. 60.50 ± 36.39, p = 0.016) and Activities of Daily Living Index (4.70 ± 3.43 vs. 5.50 ± 3.80, p = 0.038). The goniometric parameters improved: shoulder flexion (70.00 ± 56.61 vs. 80.00 ± 63.59, p = 0.026); wrist flexion/extension (34.00 ± 28.75 vs. 42.50 ± 33.7, p = 0.042)/(30.00 ± 22.97 vs. 41.00 ± 30.62, p = 0.042); ulnar deviation (23.50 ± 19.44 vs. 33.50 ± 24.15, p = 0.027); and radial deviation (17.50 ± 18.14 vs. 27.00 ± 24.85, p = 0.027). There was a difference in muscle activation of the extensor digitorum communis muscle (1.00 ± 0.94 vs. 1.40 ± 1.17, p = 0.046). The optimized and dependable NeuroAssist Robotic System improved shoulder and wrist range of motion and functional scores, regardless of the cause of the motor deficit. However, further investigations are necessary to establish its definite role in motor recovery.

show abstract

Section: Discussionmentioning

confidence: 99%

The Efficacity of the NeuroAssist Robotic System for Motor Rehabilitation of the Upper Limb—Promising Results from a Pilot Study

Tohănean

Tucan

Vanta

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…First, it is a novel integrated treatment method for combining synergy-based FES and RAT interventions, based on integrated rehabilitation technologies and synergistic enhancement effects for improving the upper limb function after stroke. Previous studies examined individual components (e.g., CRP, FES, RAT) but have not combined them in an integrated method [ 4 , 20 , 29 ]. Second, the comprehensive intervention protocol will be evidence-based and rigorously developed based on the evidence, recommendations, theories and practice standards of the systematic review [ 4 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

Synergy-based functional electrical stimulation and robotic-assisted for retraining reach-to-grasp in stroke: a study protocol for a randomized controlled trial

Zhou,

Hu,

Yun

et al. 2023

BMC Neurol

View full text Add to dashboard Cite

Background Stroke survivors have long-term upper limb impairment, which impacts the quality of life (QOL) and social reintegration, but there is lack of effective therapeutic strategies and novel technologies. Customized multi-muscle functional electrical stimulation (FES) based on the muscle synergy of healthy adults and robotic-assisted therapy (RAT) have been proved efficacy respectively. Synergy-based FES combined with RAT can be a novel and more effective therapy for upper limb recovery of stroke survivors from the perspective of synergistic enhancement. However, few studies have examined the effectiveness of combined synergy-based FES and RAT, especially for motor control evaluated by reach-to-grasp (RTG) movements. The main objective of the following research protocol is to evaluate the effectiveness and efficacy, as well as adoptability, of FES-RAT and FES or RAT rehabilitation program for upper limb function improvement after stroke. Methods This will be an assessor-blinded randomized controlled trial involving a 12-week intervention and a 6-month follow-up. Stratified randomization will be used to equally and randomly assign 162 stroke patients into the FES + conventional rehabilitation program (CRP) group, RAT + CRP group and FES-RAT + CRP group. Interventions will be provided in 5 sessions per week, with a total of 60 sessions. The primary outcome measurements will include the Fugl-Meyer Assessment and Biomechanical Assessment of RTG movements. The secondary outcome measurements will include quality of life and brain neuroplasticity assessments by MRI. Evaluations will be performed at five time points, including at baseline, 6 weeks and 12 weeks from the start of treatment, and 3 months and 6 months following the end of treatment. A two-way analysis of variance with repeated measures will be applied to examine the main effects of the group, the time factor and group-time interaction effects. Discussion The results of the study protocol will provide high quality evidence for integrated synergy-based FES and RAT, and synergy-based FES alone and guide the design of more effective treatment methods for stroke rehabilitation. Trial registration ChiCTR2300071588.

show abstract

“…Unlike synergy-based FES that activates weak muscles, robotic-assisted therapy (RAT) is another upper limb rehabilitation approach, which allows an intensive, high frequency repeat training in accordance with principles of motor learning[6, [19][20][21]. More importantly, so far, the RAT training system could design accurate movement trajectory that ts ADL as training target for drive optimal control strategies in real environments, such as reach-to-grasp (RTG).…”

Section: Introductionmentioning

confidence: 99%

Synergy-based functional electrical stimulation and robotic-assisted for retraining reach-to-grasp in stroke: a study protocol for randomised controlled trial

Zhou

Yun

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Customized multi-muscle Functional Electrical Stimulation (FES) based on muscle synergy of the healthy adults, may provide opportunity for improve the upper limb motor function of the stroke survivors. Additionally, synergy-based FES combined with Robotic-assisted Therapy (RAT) can be a novel and more effective therapy for improving upper limb function of the stroke survivors from the perspective of synergistic enhancement. However, few studies examined the effectiveness of combined synergy-based FES and RAT for stroke upper limb function improvement, especially for the motor control evaluated by the Reach-To-Grasp (RTG) behavior. Methods This study will be an assessor-blind randomized controlled trial involving 12-week intervention and 6-month follow-up. The stratified randomization will be used to randomly assign the 120 stroke patients into FES + conventional rehabilitation programs (CRP) group, RAT + CRP group and FES-RAT + CRP group equally. Intervention will be 3 sessions a week, with a total of 36 sessions. The primary outcome measurements will include Fugl-Meyer Assessment and Biomechanical Assessment of RTG behavior. The secondary outcome measurements will include Quality of life and Brain Neuroplasticity assessment by MRI. There are five time points for the evaluation, including baseline, 6 weeks and 12 weeks from the start of treatment, and 3 months, 6 months following the end of treatment. Two-way of variance with repeated measures will be applied to examine the main effects of the group, the time factor and group-time interaction effects. Discussion The results of the study protocol will provide evidence with high quality for integrated synergy-based FES and RAT, and synergy-based FES alone, and guide significance for design more effective treatment methods in stroke rehabilitation. Trial registration number ChiCTR2300071588.

show abstract

Comparative Effectiveness of Robot-Assisted Training Versus Enhanced Upper Extremity Therapy on Upper and Lower Extremity for Stroke Survivors: A Multicentre Randomized Controlled Trial

Cited by 7 publications

References 35 publications

The Efficacity of the NeuroAssist Robotic System for Motor Rehabilitation of the Upper Limb—Promising Results from a Pilot Study

The Efficacity of the NeuroAssist Robotic System for Motor Rehabilitation of the Upper Limb—Promising Results from a Pilot Study

Synergy-based functional electrical stimulation and robotic-assisted for retraining reach-to-grasp in stroke: a study protocol for a randomized controlled trial

Synergy-based functional electrical stimulation and robotic-assisted for retraining reach-to-grasp in stroke: a study protocol for randomised controlled trial

Contact Info

Product

Resources

About