Robotic Therapy Provides a Stimulus for Upper Limb Motor Recovery After Stroke That Is Complementary to and Distinct From Conventional Therapy

People suffering from chronic stroke frequently have long-lasting upper extremity impairments that hinder function during activities of daily living. Rehabilitation robotics have shown potential in improving arm function, but current systems do not allow realistic training of activities of daily living. This study incorporated the ARMin III and HandSOME device into a novel robotic therapy modality that provides functional training of reach and grasp tasks. The aim of the study was to compare the effects of equal doses of robotic and conventional therapy in patients with chronic stroke. Subjects were randomized to 12 hours of robotic or conventional therapy and then crossed over to the other therapy type after a 1-month washout period. Twelve moderate to severely impaired individuals with chronic stroke were enrolled, and 10 completed the study. Over the 3-month study period, subjects displayed significant improvements in the Fugl-Meyer (P = .013) and Box and Blocks tests (P = .028). The robotic intervention yielded significantly greater improvements in the Action Research Arm Test than conventional therapy (P = .033). Gains in the Box and Blocks test from conventional therapy were larger than from robotic therapy in subjects who received conventional therapy after robotic therapy (P = .044).

Data from this study indicate that robotic therapy can elicit improvements in arm function that are distinct from conventional therapy and supplements conventional methods to improve outcomes. Findings from this pilot study should be confirmed in a larger study.

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