A comparison of the effects and usability of two exoskeletal robots with and without robotic actuation for upper extremity rehabilitation among patients with stroke: a single-blinded randomised controlled pilot study.
Jin Ho Park, Gyulee Park, Ha Yeon Kim and 5 others
PMID 33076952WHAT IT FOUND
Active robot assistance added to conventional therapy did not improve upper limb task performance more than a passive robot added to conventional therapy over four weeks in a small pilot.
Both groups improved, and the passive group reported better participation.
Key findings
01When both robots were added to conventional therapy, the primary upper limb task outcome improved over time in both groups, but the active and passive robots did not differ in change over time.
02The passive group showed more improvement than the active group in self-reported function and social participation, although both groups also received conventional therapy.
03In some movement quality measures, the passive group improved smoothness later, and the active group improved reaching speed earlier.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 19 participants were analysed, and no power analysis was done, so this was a small pilot. The study was done at a single rehabilitation hospital. The study was registered retrospectively. Patients had stroke duration of more than three months, MRC scale 3 or 4 proximal strength, and FMA scores of 21-50, so results may not apply to acute stroke or more severe upper limb impairment. The passive robot still provided gravity compensation, so the comparison was specifically about active assistance added to weight support. The intervention lasted four weeks, and many outcomes declined after completion, so the dose may have been too low. Kinematic data were available for only 8 active participants and 7 passive participants because of signal loss. Results apply to the specific Armeo Power and Armeo Spring robots, not to all exoskeleton robots.
Declared interests
The article is listed as non-U.S. government research support, but no detailed funding or conflict statement appears in the text.
The easy way to misread this
Do not conclude that passive robots are better for all stroke patients. The primary arm task outcome showed no difference between robots, and the participation and movement quality findings were secondary results from a small pilot in patients with some voluntary upper limb movement.