Wrist Rehabilitation Assisted by an Electromyography-Driven Neuromuscular Electrical Stimulation Robot After Stroke

Augmented technology is becoming increasingly present in daily life and its use for rehabilitation should not be discounted. The objective of this RCT was to compare the rehabilitation effectiveness achieved by NMES robot–assisted wrist training and that by robot-assisted training. 26 hemiplegic patients were randomly assigned to recieve 20 training sessions with a EMG driven NMES robot or with an EMG driven robot over 7 weeks.  Outcome measures were used befoe, during and 3 months after the study took place and they included the following, Fugl-Meyer Assessment (FMA), Modified Ashworth Score (MAS), and Action Research Arm Test (ARAT). The improvement in FMA (shoulder/elbow, wrist/hand) obtained in the NMES robot group was more significant than the robot group (P < .05). Significant improvement in ARAT was achieved in the NMES robot group (P < .05) but absent in the robot group. NMES robot–assisted training showed better performance in releasing muscle co-contraction than the robot-assisted across the training sessions (P < .05).

The NMES robot–assisted wrist training was more effective than the pure robot. The additional NMES application in the treatment could bring more improvements in the distal motor functions and faster rehabilitation progress.