Robot Development and the Effect of Robot-aided Bilateral Training of Hemiplegic Upper Limbs in Subacute Stroke Patients : A Randomized Controlled Trial

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  • ARAMAKI Shinji
    Akita Prefectural Center for Rehabilitation and Psychiatric Medicine
  • SAYAMA Ichiro
    Akita Prefectural Center for Rehabilitation and Psychiatric Medicine
  • NAKAZAWA Misao
    Akita Prefectural Center for Rehabilitation and Psychiatric Medicine
  • YOKOYAMA Eriko
    Akita Prefectural Center for Rehabilitation and Psychiatric Medicine
  • SHIMOMURA Tatsuo
    Akita Prefectural Center for Rehabilitation and Psychiatric Medicine
  • HOSOKAWA Kanoko
    Akita Prefectural Center for Rehabilitation and Psychiatric Medicine

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Other Title
  • 脳卒中片麻痺上肢リハビリテーション支援ロボットの開発と亜急性期患者に対する訓練効果
  • 脳卒中片麻痺上肢リハビリテーション支援ロボットの開発と亜急性期患者に対する訓練効果--無作為化比較試験
  • ノウソッチュウ ヘンマヒ ジョウシ リハビリテーション シエン ロボット ノ カイハツ ト アキュウセイキ カンジャ ニ タイスル クンレン コウカ ムサクイカ ヒカク シケン
  • —無作為化比較試験—

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Abstract

Objective : We developed a new 4 degree of freedom robot capable of mirror-image movement of the upper limbs, including shoulders, elbows, forearms, and wrists. The objective of the present study is to assess the acceptability and clinical results of robot training. Methods : Eighteen subacute, first-ever stroke patients were randomly assigned to a robot-aided therapy group (n=9) and to a control group (n=9). The robot-aided group received additional robot-aided bilateral arm exercises, whereas the control group received bilateral repetitive arm exercises. Both exercises were conducted in the form of 20-minute sessions, for a total of 16-30 sessions, 41-104 days. Both groups also received conventional physical therapy. Motor functions were assessed using the Fugl-Meyer Upper Extremity Motor Performance Test of impairment (FM) (0-66), modified Ashworth scale sum (0-12), manual muscle strength test sum (0-35), and grip strength. Patients were also assessed using the Barthel Index (BI). Questionnaires were used to assess the patients' subjective impressions of their training sessions under the following categories : enjoyment (1-10), difficulties (1-10), and willingness for continuous training (0-2). Results : No side effects were noted. The robot-aided group showed significant improvement on FM and grip strength (p<0.05). The control group showed significant improvement on manual muscle strength test sum (p<0.05). Both groups showed significant improvement on BI (p<0.05). The robot-aided group had larger improvement in the finger movement portion of FM after treatment (p<0.05), and reported more enjoyment (p<0.05) and demonstrated greater motivation (p<0.05) than the control group. Conclusion : Use of the new 4 degree of freedom robot resulted in a larger improvement in the finger movement portion of FM and greater motivation for repetitive training of affected upper limbs in subacute, first-ever stroke patients.

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