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

Authors

  • Yingnan Lin Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
  • Qin-ying Li Department of Rehabilitation Medicine, Jing’an District Centre Hospital of Shanghai, Fudan University, Shanghai, China
  • Qingming Qu Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
  • Li Ding Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
  • Zhen Chen Neurorehabilitation Centre, First Rehabilitation Hospital of Shanghai/Affiliated Hospital of Tongji University (preparation), Shanghai, China
  • Fubiao Huang Department of Occupational Therapy, China Rehabilitation Research Center, Beijing, China
  • Shihong Hu Department of Rehabilitation Medicine, Shanghai Fifth People’s Hospital, Shanghai, China
  • Wei Deng Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
  • Fengxian Guo Shanghai Electric GeniKIT Medical Science and Technology Co. Ltd, Shanghai, China
  • Chuankai Wang Department of Rehabilitation Medicine, South China Hospital, Health Science Center, Shenzhen, China
  • Panmo Deng Department of Rehabilitation Medicine, Jing’an District Centre Hospital of Shanghai, Fudan University, Shanghai, China
  • Li Li Department of Rehabilitation Medicine, Jing’an District Centre Hospital of Shanghai, Fudan University, Shanghai, China
  • Hao Jin Department of Rehabilitation Medicine, Jing’an District Centre Hospital of Shanghai, Fudan University, Shanghai, China
  • Cong Gao Department of Rehabilitation Medicine, Jing’an District Centre Hospital of Shanghai, Fudan University, Shanghai, China
  • Beibei Shu Department of Rehabilitation Medicine, Jing’an District Centre Hospital of Shanghai, Fudan University, Shanghai, China
  • Jie Jia Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; National Center for Neurological Disorders, Shanghai, China

DOI:

https://doi.org/10.2340/jrm.v54.882

Keywords:

stroke, rehabilitation, robotic training, upper extremity, lower extremity

Abstract

Objective: Robot-assisted neuro-rehabilitation therapy plays a central role in upper extremity recovery of stroke. However, the efficacy of robotic training on the upper extremity is not yet well defined, and little attention has been devoted to its potential effect on the lower extremity. The aim of this study was to compare the efficacy of robot-assisted training and therapist-mediated enhanced upper extremity therapy on the upper and lower extremities.
Methods: A randomized clinical trial involving 172 stroke survivors was conducted in China. All participants received either robot-assisted training or enhanced upper extremity therapy for 3 weeks. Fugl-Meyer assessment upper extremity subscale (FMA-UE), Fugl-Meyer assessment lower extremity subscale (FMA-LE), and Modified Barthel Index were administered at baseline, mid-treatment (1 week after treatment start), and post-treatment.
Results: Participants in the robot-assisted training group showed a significant improvement in the hemiplegia extremity, which was non-inferior to the enhanced upper extremity therapy group in FMA-UE (p < 0.05), while suggesting greater motor recovery of lower extremity in FMA-LE (p < 0.05) compared with the enhanced upper extremity therapy group. A marked increase in Modified Barthel Index was observed within groups; however, no significant difference was found between groups.
Conclusion: Robot-assisted training is non-inferior but not better in reducing impairment of the upper extremity and appears to be superior in reducing impairment of the lower extremity compared with enhanced upper extremity therapy for stroke survivors.

LAY ABSTRACT
Although post-stroke robot-assisted training of the upper extremity has been widely studied, its efficacy is not yet well defined, and its effects on the lower extremity are unknown. This study aimed to evaluate the effects of upper extremity robot-assisted training on the upper and lower extremities in stroke survivors. Robot-assisted training is non-inferior in improving the function of the upper extremity and superior in improving the function of the lower extremity compared with enhanced upper extremity therapy. Robot-assisted training can be used for functional recovery of the upper and lower extremities in stroke survivors.

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Published

2022-08-26

How to Cite

Lin, Y., Li, Q.- ying, Qu, Q., Ding, L., Chen, Z., Huang, F., … Jia, J. (2022). Comparative Effectiveness of Robot-Assisted Training Versus Enhanced Upper Extremity Therapy on Upper and Lower Extremity for Stroke Survivors: A Multicentre Randomized Controlled Trial. Journal of Rehabilitation Medicine, 54, jrm00314. https://doi.org/10.2340/jrm.v54.882

Issue

Vol. 54 (2022)

Section

Original Report

Categories

License

Copyright (c) 2022 Yingnan Lin, Qinying Li, Qingming Qu, Li Ding, Zhen Chen, Fubiao Huang, Shihong Hu, Wei Deng, Fengxian Guo, Panmo Deng, Li Li, Hao Jin, Cong Gao, Beibei Shu, Jie Jia

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

All digitalized JRM contents is available freely online. The Foundation for Rehabilitation Medicine owns the copyright for all material published until volume 40 (2008), as from volume 41 (2009) authors retain copyright to their work and as from volume 49 (2017) the journal has been published Open Access, under CC-BY-NC licences (unless otherwise specified). The CC-BY-NC licenses allow third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.
From 2024, articles are published under the CC-BY licence. This license permits sharing, adapting, and using the material for any purpose, including commercial use, with the condition of providing full attribution to the original publication.

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