Effects of an assist-as-needed equipped Tenodesis-Induced-Grip Exoskeleton Robot (TIGER) on upper limb function in patients with chronic stroke.
Hsiu-Yun Hsu, Chia-Lin Koh, Kang-Chin Yang and 4 others
PMID 38173006WHAT IT FOUND
Assist-as-needed TIGER robot training plus task-specific motor training improved Fugl-Meyer scores from baseline in 16 chronic stroke patients, but the original constant-assistance TIGER showed greater gains, so the new mode was not superior.
Key findings
01Participants trained with the AAN-equipped TIGER and given task-specific motor training showed significant Fugl-Meyer improvements from baseline.
02The original constant-assistance TIGER improved total, wrist and hand, and coordination Fugl-Meyer scores more than the AAN-equipped TIGER over time.
03Baseline wrist and hand Fugl-Meyer score was the best predictor of later hand function improvement, and a model with gender, Box and Blocks score, and sensory status explained 57.2% of post-treatment variance.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This was a single-group feasibility study, not a randomised trial, so the results do not show that the robot training itself caused the improvement. The robot training and task-specific motor training were given together, so the contribution of the assist-as-needed mode cannot be separated from the rest of the programme. Sixteen participants were analysed, and one withdrew, so the study is small and exploratory. The Box and Blocks Test improved statistically, but the change did not reach the minimal detectable change, so the functional dexterity gain may not be meaningful. The authors noted that 5 of 16 participants could not move the affected wrist at baseline, and four of those reported no change. The 10-minute assist-as-needed setting and the 3-second waiting time may not be optimal.
The easy way to misread this
Do not conclude that the assist-as-needed TIGER alone caused improvement. Participants also received 20 minutes of task-specific motor training each session, and the original constant-assistance TIGER showed greater Fugl-Meyer gains.