Effect of Upper Extremity Robot-Assisted Exercise on Spasticity in Stroke Patients

Abstract

ObjectiveTo determine the efficacy of a stretching and strengthening exercise program using an upper extremity robot, as compared with a conventional occupational therapy program for upper extremity spasticity in stroke patients.MethodsSubjects were randomly divided into a robot-assisted therapy (RT) group and a conventional rehabilitation therapy (CT) group. RT group patients received RT and CT once daily for 30 minutes each, 5 days a week, for 2 weeks. RT was performed using an upper-extremity robot (Neuro-X; Apsun Inc., Seoul, Korea), and CT was administered by occupational therapists. CT group patients received CT alone twice daily for 30 minutes, 5 days a week, for 2 weeks. Modified Ashworth Scale (MAS) was used to measure the spasticity of upper extremity. Manual muscle tests (MMT), Manual Function Tests (MFT), Brunnstrom stage, and the Korean version of Modified Barthel Index (K-MBI) were used to measure the strength and function of upper extremity. All measurements were obtained before and after 2-week treatment.ResultsThe RT and CT groups included 22 subjects each. After treatment, both groups showed significantly lower MAS scores and significant improvement in the MMT, MFT, Brunnstrom stage, and K-MBI scores. Treatment effects showed no significant differences between the two groups.ConclusionRT showed similar treatment benefits on spasticity, as compared to CT. The study results suggested that RT could be a useful method for continuous, repeatable, and relatively accurate range of motion exercise in stroke patients with spasticity.

Robotic Assisted Upper Limb Training Post Stroke: A Randomized Control Trial Using Combinatory Approach Toward Reducing Workforce Demands

“…Different approaches were developed to compare the effects of upper limb robotic therapy in contrast to conventional interventions for motor function recovery in stroke patients [for reviews, e.g., (11)(12)(13)]. The three main approaches available in literature are: (i) the addition of robotic therapy to conventional therapy (14)(15)(16)(17)(18), (ii) the full substitution of regular therapy with robotic therapy (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), and (iii) the use of combinatory training schemes that integrate conventional and robotic therapy (31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41).…”

“…The last approach uses a dose matched combinatory training scheme (iii) to share the workload between the robot and therapists. For instance, Lee et al ( 37 ) compared conventional therapy with a dose matched combination of conventional and robotic assisted therapy. Participants of the robotic group trained half of the total training time with the robot and the other half with therapists.…”

“…Moreover, additional robotic therapy has benefits of extra training ( 14 , 16 ) but this comes at a greater financial cost. In contrast to the other approaches, the use of combinatory therapy showed promising results, allowing therapists to share the work with the robots ( 31 , 34 , 37 , 39 ) while maintaining similar outcomes compared to conventional therapy alone. This approach offers the advantages of decreasing the therapists' workload, which can lead to reduced cost ( 34 ) and enhancement of their productivity.…”

“…We aim to validate the clinical efficacy and the safety of a time matched combinatory training approach that integrates robotic assisted training using H-Man and 1:1 conventional therapy. Previous studies investigated combinatory training schemes where the time spent on 1:1 therapy was reduced to half of the total therapy time ( 31 , 34 , 37 ). In this study, the proportion of time spent on 1:1 conventional therapy was one third of the total therapy time and we examine if this combinatory approach, with two thirds substitution using an arm robot, compares with conventional therapy alone.…”

Factors influencing return to work after stroke: the Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) Study

“…Functional evaluations were performed using previously validated instruments, including the National Institutes of Health Stroke Scale (NIHSS, 0–42 points; a lower score is better),20 modified Rankin Scale (mRS, score range of 0–6; a lower score is better),21 Fugl-Meyer Assessment (FMA),22 Functional Ambulatory Category (FAC),23 Korean Mini-Mental State Examination (K-MMSE),24 Korean version of the Frenchay Aphasia Screening Test (K-FAST),25 American Speech-Language-Hearing Association National Outcomes Measurement System (ASHA-NOMS),26 Korean-Modified Barthel Index (K-MBI),27 Geriatric Depression Scale-Short Form (GDS-SF)28 and EuroQol-5 dimensions (EQ-5D) 29…”