OBJECTIVE: To compare the outcome of robot-assisted therapy with dose-matched active control therapy by using accelerometers to study functional recovery in chronic stroke patients. DESIGN: Prospective, randomized, controlled trial. SETTING: Stroke units in three medical centres. SUBJECTS: Twenty patients post stroke for a mean of 22 months. INTERVENTION: Robot-assisted therapy (n = 10) or dose-matched active control therapy (n = 10). All patients received either of these two therapies for 90 to 105 minutes each day, 5 days per week, for four weeks. MAIN MEASURES: Outcome measures included arm activity ratio (the ratio of mean activity between the impaired and unimpaired arm) and scores on the Fugl-Meyer Assessment Scale, Functional Independence Measure, Motor Activity Log and ABILHAND questionnaire. RESULTS: The robot-assisted therapy group significantly increased motor function, hemiplegic arm activity and bilateral arm coordination (Fugl-Meyer Assessment Scale 51.20 +/- 8.82, p = 0.002; mean arm activity ratio 0.76 +/- 0.10, p = 0.026; ABILHAND questionnaire 1.24 +/- 0.28, p = 0.043) compared with the dose-matched active control group (Fugl-Meyer Assessment Scale 40.90 +/- 13.14; mean arm movement ratio 0.69 +/- 0.11; ABILHAND questionnaire 0.95 +/- 0.43). CONCLUSIONS: Symmetrical and bilateral robotic practice, combined with functional task training, can significantly improve motor function, arm activity, and self-perceived bilateral arm ability in patients late after stroke.

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