Effects of a robot-aided somatosensory training on proprioception and motor function in stroke survivors.
I-Ling Yeh, Jessica Holst-Wolf, Naveen Elangovan and 5 others
PMID 33971912WHAT IT FOUND
Wrist position sense thresholds lowered over testing days in both stroke survivors and controls.
The study did not show the robot training produced a larger change in stroke survivors than in controls. Motor tracing changes were not established.
Key findings
01Wrist position sense thresholds fell across the measurement times in both the stroke group and the control group, and the change did not differ significantly between groups.
02Eight of eleven stroke participants lowered their threshold at posttest; responders reduced thresholds by 9.3 to 47.0 percent, with a mean reduction of 30.2 percent, and the stroke group mean was 1.3 degrees at retention.
03The stroke group averaged a 22 percent reduction in tracing error and a 40 percent increase in median SEP amplitude, but neither change was statistically significant.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample was small, with 12 stroke survivors and 10 controls. The study was a pre-post design with a control group, but no randomisation or blinding is reported, so it cannot establish that the training caused the changes. Both stroke participants and controls improved over time, and the analysis did not show a greater change in the stroke group, so practice, time or testing cannot be separated from the intervention. Participants needed at least 20 degrees of active wrist movement, adequate cognition and limited muscle tone, and they were living at home and independent in self-care, so results may not apply to more impaired stroke survivors. The training was only 48 minutes over two days, and the untrained motor outcome did not change significantly. One stroke participant could not complete the threshold test, and fewer participants completed the brain response test because of time and fatigue. The paper reports several outcomes without a clearly labelled primary outcome.
Declared interests
Funding came from the National Center for Advancing Translational Sciences, Istituto Italiano di Tecnologia, and Ruprecht-Karls-Universität Heidelberg. The supplied text does not report author conflicts of interest.
The easy way to misread this
Do not read the lower thresholds as proof that the robot training caused recovery. Both stroke participants and controls improved across testing days, and the analysis did not show a greater change in the stroke group. The paper does not report randomisation or blinding, and the sample was small, so time, practice and attention cannot be separated from the training.