The robot assisted upper-limb rehabilitation program on functional recovery in persons with stroke: results from a randomized clinical trial

Research Objectives: To compare the functional recovery of impaired upper limb (UL) between a robot-assisted rehabilitation program (RARP) and with therapist-assisted conventional rehabilitation program (TACRP) following stroke.

Design: A randomized clinical trial

Setting: A tertiary care teaching hospital, India

Participants: Persons who had first episode of stroke within last 6-months

Interventions: Persons in group-A received unsupervised RARP for the impaired upper limb for 1 hour, whereas persons in group-B received supervised TACRP for 1 hour. Both groups received 15 treatment sessions over the period of one month (3 days/ week).

Main Outcome Measures: The primary outcome was functional recovery, assessed by the Fugl-Meyer Assessment scale for upper extremity (FMA-UE). The secondary outcome was the reduction of spasticity at the wrist and improvement in quality of life (QoL), which were assessed with modified Ashworth Scale (MAS) and WHO-QoL questionnaires, respectively.
All persons were followed up for three months. Persons were assessed at baseline, at six weeks, and at 12 weeks.

Results: The mean age of the persons (n=40) was 59 years with a male-female ratio of 3:2. The duration of UL-impairment was 1 to 5.8 months after stroke onset. Twenty-one (52.5%) persons had right UL impairment. Both groups were comparable at baseline demographic and clinical parameters. Both groups demonstrated significant improvement (p < 0.001) in motor function (FMA-UE), reduction of spasticity of the wrist, and QoL over a period of time. Compared to TACRP, persons who received RARP reported significant improvement in UE-motor function and QoL at three months. The functional improvements in both groups were not related to the severity of the stroke. There were no significant differences in changes in spasticity between the two groups.

Conclusions: Both groups reported significant improvement in functional recovery and reduction of spasticity. However, compared to TACRP, the RARP reported better functional recovery in the upper limb following a stroke at three months.

Author(s) Disclosures: Nil