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Robotic assisted shoulder rehabilitation therapy effectively improved post-stroke hemiplegic shoulder pain: a randomized controlled trial [with consumer summary]
Kim M-S, Kim SH, Noh S-E, Bang HJ, Lee K-M
Archives of Physical Medicine and Rehabilitation 2019 Jun;100(6):1015-1022
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: The purpose of this study was to investigate the therapeutic effects of a newly developed shoulder robot on post-stroke hemiplegic shoulder pain. DESIGN: Prospective, single-blind randomized controlled trial. SETTING: Inpatient department of a tertiary university hospital. PARTICIPANTS: Hemiplegic shoulder pain patients (n = 38) were consecutively recruited and randomly assigned to an intervention or control group. INTERVENTIONS: A newly developed robot was designed to perform joint mobilization and stretching exercises with patients lying in the supine position. Conventional physical therapy directed at both improving upper extremity mechanics and reducing neurologic injury was performed twice per day in both groups. In the intervention group, additional robotic assisted shoulder rehabilitation therapy was administered for 30 minutes per day, five times per week for 4 weeks. MAIN OUTCOME MEASURES: The visual analogue scale was the primary outcome, and the pain-free passive range of motion of the shoulder joint, the Korean version of the Shoulder Disability Questionnaire, and ultrasonographic grades were the secondary outcomes. The outcomes were evaluated at baseline (T0), post-intervention (T1), and a 4-week follow-up (T2). RESULTS: Significant time and group interaction effects were found on the visual analogue scale, in the abduction passive range of motion, and on the Shoulder Disability Questionnaire (F[2,33] = 16.384, p = 0.002; F[2,33] = 10.609, p = 0.012; F[2,33] = 32.650, p = 0.008, respectively). Significantly higher improvements in these outcome measures were observed in the intervention group than in the control group at T1 after post-hoc analysis (p < 0.05, all). These improvements were sustained at T2 when the intervention group was compared with the control group (p < 0.05, all). CONCLUSIONS: A prototype shoulder rehabilitation robot as an adjuvant therapy improves hemiplegic shoulder pain and self-reported shoulder-related disability.

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