Comparative effects of EMG-driven robot-assisted therapy versus task-oriented training on motor and daily function in patients with stroke: a randomized cross-over trial

Abstract

Background Robot-assisted hand training has shown positive effects on promoting neuromuscular control. Since both robot-assisted therapy and task-oriented training are often used in post-stroke rehabilitation, we raised the question of whether two interventions engender differential effects in different domains. Methods The study was conducted using a randomized, two-period crossover design. Twenty-four chronic stroke survivors received a 12-session robot-assisted intervention followed by a 12-session task-oriented intervention or vice versa. A 1-month washout period between each intervention was implemented. Outcome measures were evaluated before the intervention, after the first 12-session intervention, and after the second 12-session intervention. Clinical assessments included Fugl-Meyer Assessment for Upper Extremity, Wolf Motor Function Test, Action Research Arm Test and Motor Activity Log. Results Our findings suggested that EMG-driven robot-assisted therapy was as effective as task-oriented training in terms of improving upper limbs functional performance in activity domain, and robot-assisted therapy was more effective in improving movement duration during functional tasks. Task-oriented training showed better improvement in body function domain and activity and participation domain, especially in improving spontaneous use of affected arm during daily activities. Conclusions Both intervention protocol had their own advantages in different domains, and robot-assisted therapy may save manpower and be considered as an alternative intervention to task-oriented training. Combining the two approaches could yield results greater than either alone, which awaits further study. Trial registration: ClinicalTrials.gov Identifier: NCT03624153. Registered on 9th August 2018, https://clinicaltrials.gov/ct2/show/NCT03624153.

Effects of EMG-based robot for upper extremity rehabilitation on post-stroke patients: a systematic review and meta-analysis

“…One study was extracted two experimental groups ( Page et al, 2020 ). For randomized cross-over trial ( Chen et al, 2022 ), data before crossover were extracted. The study with fewest number of participants was carried out by Hayward ( n = 8, EG:4, CG:4) ( Hayward et al, 2013 ).…”

“…Studies have found that the EMG-based robot improved the Fugl-Meyer assessment (FMA) score and spasticity of the upper extremity in post-stroke patients when compared with conventional therapy, ( Stein et al, 2007 ; Song et al, 2008 ; Hu et al, 2015 ; Nam et al, 2017 ). However, Chen et al, ( Chen et al, 2022 ), and Page et al, ( Stein et al, 2007 ; Page et al, 2013 ; Page et al, 2020 ), respectively found the efficacy of the EMG-based robot was not superior to task-oriented training and conventional hands-on manual therapy. Therefore, it remains unclear whether the effect of the EMG-based robot is superior to conventional therapies on upper limb function of stroke survivors.…”

“…The EMG-based robot is one of the novel techniques designed for maximizing the involvement of voluntary efforts during post-stroke training. Unlike traditional robot-assisted training, the EMG-based robot can detect residual EMG signals of the affected limb in real time and integrate the participants’ voluntary motor intention represented by the EMG signal from the residual muscles into training ( Song et al, 2008 ; Rong et al, 2015 ; Chen et al, 2022 ). Once the EMG signals reach a specific threshold, the robot-assisted training will be activated, assisting the patients to complete a desired movement.…”

The Use of Sports Rehabilitation Robotics to Assist in the Recovery of Physical Abilities in Elderly Patients with Degenerative Diseases: A Literature Review

“…Furthermore, it can also provide corresponding training for patients with limb dysfunction to help restore the working ability of their limbs [62]. At present, robotic exoskeletons can be divided into the following four types, according to where they are worn: upper limb robotic exoskeletons [20][21][22][23][24], lower limb robotic exoskeletons [25][26][27][28][29][30], whole body robotic exoskeletons [15], and ground robotic exoskeletons [31,32].…”

Efficacy and safety of using a unilateral lower limb exoskeleton in neurorehabilitation: a randomized controlled trial

“…The increasing number of clinical trials has shown that robot-assisted therapy is effective in rehabilitation [15][16][17][18][19]. The conventional bilateral lower limb exoskeleton (BLLE) comprises powered dual robotic legs, facilitating rehabilitation training by driving both unaffected and affected lower limbs to perform a pre-programmed interactive gait control [20].…”