Effects of semi-independent bedside rehabilitation of the upper limb assisted with a mobile wrist-hand exoneuromusculoskeleton (ENMS) for inpatients with subacute stroke: a randomized controlled trial (RCT).

The trial analysed 52 participants who completed the assigned training at one hospital. Participants and therapists were not blinded, although the outcome assessor was a physical therapist blinded to group allocation. The comparison was not a clean robot-versus-no-robot test: all groups received 30 minutes of Bobath occupational therapy daily, and the ENMS group also had a different supervision model from the fully supervised cycling robot and conventional groups. The ENMS group started with higher finger spasticity than the conventional group, so the finger spasticity result may be influenced by baseline imbalance. The study included only people who could sit for 30 minutes, had enough cognition to follow simple instructions as assessed by MMSE >23, could passively extend finger joints to 180 degrees, and had low spasticity, so it may not apply to more impaired patients. Fixed OT checkpoints at sessions 1, 6, 11, 16, and 21 may not have been enough to answer all questions during independent training.

Funding was provided by the Shenzhen Research and Development Program, the Innovation and technology fund of Hong Kong, and the University Grants Committee. The supplied text does not state author conflicts of interest.

Do not conclude that the wrist-hand robot alone caused the better upper-limb scores. Every group received 30 minutes of Bobath occupational therapy each day, and the robot group also trained semi-independently while the other groups had continuous therapist supervision, so the robot's separate contribution cannot be isolated.