Distal versus proximal - an investigation on different supportive strategies by robots for upper limb rehabilitation after stroke: a randomized controlled trial.
Qiuyang Qian, Chingyi Nam, Ziqi Guo and 5 others
PMID 31159822WHAT IT FOUND
On the main arm function score, EMG-driven robot, electrical stimulation, and task practice supporting fingers or wrist-elbow did not differ, though both improved upper limb function.
Finger support had lower wrist and finger spasticity scores than sleeve support.
Key findings
01No significant between-group difference was observed for FMA scores.
02Both groups showed significant improvements in FMA full scores after training.
03The hand group had lower MAS scores than the sleeve group at fingers after training and at three months, and at wrist at three months.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only thirty participants, so the between-group results are imprecise. The trial was non-blinded, and participants knew which robot they received. Both groups received the same task-oriented training, robot support, and electrical stimulation, so the study cannot show which part caused improvement. There was no usual-care control group, only two robotic support schemes. Participants had chronic stroke, moderate to severe upper limb impairment, MMSE above 21, and other exclusions, so results may not apply to more severe or more cognitively impaired patients. Training frequency varied from 3 to 5 sessions per week, which could add variation.
Declared interests
Funding came from the Innovation and Technology Commission - Hong Kong and Hong Kong Polytechnic University. The supplied text does not state authors' competing interests.
The easy way to misread this
Do not conclude that finger support gives better overall upper limb motor recovery. The primary FMA comparison showed no significant between-group difference, and the between-group differences were mainly in spasticity scores.