OBJECTIVE: To compare the effects of robot-assisted movement training with conventional techniques for the rehabilitation of upper-limb motor function after stroke. DESIGN: Randomized controlled trial, 6-month follow-up. SETTING: A Department of Veterans Affairs rehabilitation research and development center. PARTICIPANTS: Consecutive sample of 27 subjects with chronic hemiparesis (> 6 mo after cerebrovascular accident) randomly allocated to group. INTERVENTIONS: All subjects received twenty-four 1-hour sessions over 2 months. Subjects in the robot group practiced shoulder and elbow movements while assisted by a robot manipulator. Subjects in the control group received neurodevelopmental therapy (targeting proximal upper limb function) and 5 minutes of exposure to the robot in each session. MAIN OUTCOME MEASURES: Fugl-Meyer assessment of motor impairment, FIMtrade mark instrument, and biomechanic measures of strength and reaching kinematics. Clinical evaluations were performed by a therapist blinded to group assignments. RESULTS: Compared with the control group, the robot group had larger improvements in the proximal movement portion of the Fugl-Meyer test after 1 month of treatment (p < 0.05) and also after 2 months of treatment (p < 0.05). The robot group had larger gains in strength (p < 0.02) and larger increases in reach extent (p < 0.01) after 2 months of treatment. At the 6-month follow-up, the groups no longer differed in terms of the Fugl-Meyer test (p > 0.30); however, the robot group had larger improvements in the FIM (p < 0.04). CONCLUSIONS: Compared with conventional treatment, robot-assisted movements had advantages in terms of clinical and biomechanical measures. Further research into the use of robotic manipulation for motor rehabilitation is justified.

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