Robotic Assistance for Training Finger Movement Using a Hebbian Model: A Randomized Controlled Trial.
Justin B Rowe, Vicky Chan, Morgan L Ingemanson and 3 others
PMID 28803535WHAT IT FOUND
High robotic assistance did not improve the primary hand function outcome more than low assistance, but both groups improved.
Higher assistance was more motivating and was linked to more benefit for more severely impaired patients with intact proprioception.
Key findings
01The primary Box and Blocks score improved over time, but high and low assistance groups did not differ.
02The high and low assistance groups attempted 7994 and 7930 movements on average, with success rates of 81.6% and 55.1%.
03High assistance was associated with higher motivation, and more severely impaired participants benefited more from it.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Only 30 participants completed the study, and it was conducted at one site. There was no unassisted control group because it could not match the movement dose. Baseline stability was checked only one week apart. The trial included a relatively high percentage of hemorrhagic stroke survivors. Higher assistance benefits were small, about two Fugl-Meyer points, and only on secondary endpoints. The protocol was not designed to maximize transfer to hand function. Motivation and attention were not separated. No correction was made for multiple comparisons across outcomes.
The easy way to misread this
Do not conclude that high robotic assistance improves hand function more than low assistance. The primary Box and Blocks outcome showed no group difference, and the secondary benefit was limited to Fugl-Meyer and pinch tests.