430
Views
6
CrossRef citations to date
0
Altmetric
Research Article

Impact of initial flexor synergy pattern scores on improving upper extremity function in stroke patients treated with adjunct robotic rehabilitation: A randomized clinical trial

, , &
Pages 516-524 | Received 26 Oct 2019, Accepted 01 Mar 2020, Published online: 10 Mar 2020
 

ABSTRACT

Background: Robot-assisted rehabilitation is an appealing strategy for patients after stroke, as it generates repetitive movements in a consistent, precise, and automated manner.

Objective: To identify patients who will benefit most from robotic rehabilitation for upper extremity (UE) hemiparesis.

Methods:We used data from our previous randomized clinical trial comparing 6 weeks of robotic therapy (ReoGeo system) plus standard therapy (n=30) with self-guided therapy plus standard therapy (n=26) for sub-acute phase rehabilitation in adults with mild to moderate UE hemiparesis. The outcome measures were three Fugl-Meyer (FMA) motor scores: total UE score, proximal UE score, and UE flexor synergy score. Based on pre-therapy UE flexor synergy scores, participants were categorized into mild (10–12 points), moderate (6–9 points), and severe (0–5 points) impairment classes.

Results: In the robotic group, all outcome measures improved after therapy in patients with moderate or severe impairment. In the self-guided therapy, most outcomes did not improve, regardless of the impairment class. When changes from pre- to post-therapy were compared between robotic and self-guided groups, most outcomes were similar in all impairment classes. However, robotic therapy was associated with greater improvement in UE flexor synergy than self-guided therapy in patients with moderate impairment (2.3±1.3 vs. -0.1±2.8, P=0.027).

Conclusions: Post-strokerobot-assisted rehabilitation, as an adjunct to standard rehabilitation therapy, improved UE function in patients with moderate or severe pre-therapy UE flexor synergy impairment. Adjunct robotic therapy produced greater improvement in UE flexor synergy motor function than adjunct self-guided rehabilitation in patients with moderate pre-therapy impairment.

Acknowledgments

We would like to thank all of the clinicians and researchers involved in this study. We would also like to thank BioScience Writers for their professional writing assistance.

Author contribution statements

TT and KT contributed equally in designing the study, as well as writing and reviewing the manuscript. KH and KD contributed to reviewing the manuscript.

Additional information

Funding

This work was supported by Teijin Pharma Ltd, Tokyo, Japan.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.