Telerehabilitation using a 2-D planar arm rehabilitation robot for hemiparetic stroke: a feasibility study of clinic-to-home exergaming therapy.

The study had no control group, so it is impossible to determine if the observed improvements were due to the robot, the natural course of recovery, or the concomitant conventional OT that 8 of the 12 participants received. The sample size was very small (n=12), and the study was not powered to detect differences in clinical or economic outcomes. The exact intensity and content of the concomitant conventional OT received by participants were not documented, making it difficult to isolate the effect of the home robot. The home training phase was limited to 30 days, which may not reflect long-term adherence or the durability of effects beyond that period. Participants were mostly male, younger than the average stroke population, and had a high proportion of hemorrhagic strokes, which may limit generalizability to older or more diverse patient groups.

The study was supported by the National Health Innovation Centre, Singapore, and the Temasek Foundation. The device used (H-Man) is a commercial product from Articares Pte Ltd, and the software platform was developed by the same company. The authors note that the vendor delivered and set up the devices, and the software developers added exergames during the study period.

Do not interpret the statistically significant group-level FMA improvements as proof that the robot caused clinically meaningful recovery. Only 3 of the 12 participants achieved a minimal clinically important difference, and 8 participants received concurrent conventional therapy, so the specific contribution of the home robot cannot be separated from other treatments.