Effects of Robot-assisted Upper Limb Training on Hemiplegic Patients

Abstract

Chungnam National University HospitalObjective: To investigate the effects of short-term robot-assisted upper limb training on hemiplegic patients compared to conventional physical therapy.Method: This study was a prospective, single-blinded, randomized controlled trial. Eighteen hemiplegic patients due to brain lesions were randomly assigned to: (1) robot-assisted upper limb training and conventional upper limb physical therapy for 30 min a day, respectively (Robot group); or (2) conventional upper limb physical therapy for 30 min twice a day (Conventional group). All interventions were provided for 2 weeks, 5 times a week. Each patient was evaluated at pre- and post-treatment by the Fugl-Meyer assessment-upper extremity (FMA-UE), Jebsen hand function test (JHFT), grip power, modified Barthel index-upper extremity (MBI-UE), line bisection test, and Albert test.Results: The Robot group showed significant improvement in FMA-UE (pre: 13.22 ± 14.20, post: 21.67 ± 15.84; p = 0.018), MBI-UE (pre: 14.33 ± 7.42, post: 16.56 ± 6.95; p = 0.041), and line bisection test (pre: 25.15 ± 34.48, post: 14.93 ± 28.38; p = 0.043). The Conventional group showed significant improvement only in MBI-UE (pre: 9.22 ± 6.06, post: 15.56 ± 6.19; p = 0.008). The improvement in MBI-UE was larger in the Conventional group than Robot group (6.33 ± 3.28 vs. 2.22 ± 2.49; p = 0.014).Conclusion: This study suggests that short-term robot-assisted upper limb training may improve upper limb function in hemiplegic patients. However, proper physical therapy may be needed to transfer improved upper limb function to activity of daily living. In addition, goal-directed reaching tasks using a robot are expected to be a treatment option for hemineglect. (Brain & NeuroRehabilitation 2014; 7: 39-47)Key Words: hemiplegia, hemispatial neglect, rehabilitation, robotics, upper extremity