Effectiveness of combining robotic therapy and modified constraint-induced movement therapy for moderate to severe upper limb paresis after stroke in subacute phase: Case–control study by propensity score analysis

Abstract

Introduction: Robotic assisted therapy and modified constraint-induced movement therapy are used evidence-based approach in stroke rehabilitation. However, there is no study showing a combination of robotic assisted therapy and modified constraint-induced movement therapy (combined therapy) in the subacute phase. This study investigated the effectiveness of combined therapy in stroke patients with moderate to severe upper limb paresis compared with conventional occupational therapy at subacute setting. Methods: This research used a case–control study. The intervention group ( n = 15) consisting of patients with moderate to severe upper limb paresis (Brunnstrom recovery stage upper extremity III or IV and above hand III) 4–8 weeks since stroke onset received a combined therapy for 3 weeks (total intervention time: 1440 minutes). The control group ( n = 15) extracted by propensity score matching received a conventional occupational therapy for 4 weeks (total intervention time: 1680–2240 minutes). The primary outcome was the Fugl-Meyer assessment upper limb score change before and after the intervention. Results: The intervention group exhibited significantly greater improvement on Fugl-Meyer assessment upper lim change ( p = 0.005). Conclusion: In the subacute phase, the combined therapy of robotic assisted therapy and modified constraint-induced movement therapy helped improve upper limb motor function more effectively and efficiently than conventional occupational therapy.

Combined repetitive facilitative exercise under continuous neuromuscular electrical stimulation and task-oriented training for hemiplegic upper extremity during convalescent phase after stroke: before-and-after feasibility trial

“…Recently, robotic therapy has been introduced and its efficacy has been reported in cases where patients presented with moderate to severe paralysis with FMA <30 during the convalescent period ( 49 ). Furthermore, case–control studies have reported favorable results with TOT with robotic therapy combined ( 50 ).…”

Relationship between changes in real-world arm use behavior and structural remodeling of white matter after ischemic stroke

“…Patients received interventions for upper extremity hemiplegia based on guidelines (Winstein et al, 2016). Robotic-assisted therapy and modi ed Constraintinduced movement therapy were mainly provided for UE functional training following the protocol from the developer and promoted real-world arm use in the affected hands (Morris et al, 2006;Anmoto et al, 2023). DTI acquisition DTI was performed using a 3.0-T magnetic resonance scanner (Trio; Siemens AG, Erlangen, Germany) with a 16-channel head coil.…”