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|Robot-assisted reach training with an active assistant protocol for long-term upper extremity impairment poststroke: a randomized controlled trial|
|Cho KH, Song W-K|
|Archives of Physical Medicine and Rehabilitation 2019 Feb;100(2):213-219|
|8/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*|
OBJECTIVE: To assess whether robot-assisted reach training (RART) with an active assistant protocol can improve upper extremity function and kinematic performance in chronic stroke survivors. DESIGN: This study was conducted as a randomized controlled trial. SETTING: National rehabilitation center. PARTICIPANTS: Chronic stroke survivors (N = 38) were randomized into 2 groups: A robot-assisted reach training with assist-as-needed (RT-AAN) group and a robot-assisted reach training with guidance force (RT-G) group. INTERVENTION: The RT-AAN group received robot-assisted reach training with an assist-as-needed mode for 40 minutes per day, 3 times per week over a 6-week period, and the RT-G group participated in the RART with a guidance mode for 40 minutes per day, 3 times per week over a 6-week period. MAIN OUTCOME MEASURES: Upper extremity functions were measured with Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT), and Box and Block Test. In addition, movement velocities were measured as an index for upper extremity kinematic performances in 6 directions. RESULTS: Both groups showed significant improvements in FMA, ARAT, and kinematics (movement velocity) in all directions (targets 1 to 6, p < 0.05). However, the RT-AAN group showed significantly more improvement than the RT-G group in FMA and ARAT (p < 0.05). CONCLUSIONS: RART with an active assistant protocol showed improvements of upper extremity function and kinematic performance in chronic stroke survivors. In particular, assist-as-needed robot control was effective for upper extremity rehabilitation. Therefore robot-assisted training may be suggested as an effective intervention to improve upper extremity function in chronic stroke survivors.