Research Article
Issue Date: January/February 2021
Published Online: December 11, 2020
Updated: December 14, 2020
Effects of Robot-Assisted Rehabilitation on Hand Function of People With Stroke: A Randomized, Crossover-Controlled, Assessor-Blinded Study
Author Affiliations
  • Hsin-Chieh Lee, MS, is Occupational Therapist, Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
  • Fen-Ling Kuo, MS, is Occupational Therapist, Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
  • Yen-Nung Lin, MD, MS, is Physiatrist, Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, and Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei City, Taiwan.
  • Tsan-Hon Liou, MD, PhD, is Physiatrist, Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, and Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
  • Jui-Chi Lin, MS, is Occupational Therapist, Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; 08175@s.tmu.edu.tw
  • Shih-Wei Huang, MD, is Physiatrist, Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, and Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Article Information
Research Articles
Research Article   |   December 11, 2020
Effects of Robot-Assisted Rehabilitation on Hand Function of People With Stroke: A Randomized, Crossover-Controlled, Assessor-Blinded Study
American Journal of Occupational Therapy, December 2020, Vol. 75, 7501205020. https://doi.org/10.5014/ajot.2021.038232
American Journal of Occupational Therapy, December 2020, Vol. 75, 7501205020. https://doi.org/10.5014/ajot.2021.038232
Abstract

Importance: The effects of robot-assisted task-oriented training with tangible objects among patients with stroke remain unknown.

Objective: To investigate the effects of robot-assisted therapy (RT) with a Gloreha device on sensorimotor and hand function and ability to perform activities of daily living (ADLs) among patients with stroke.

Design: Randomized, crossover-controlled, assessor-blinded study.

Setting: Rehabilitation clinic.

Participants: Patients (N = 24) with moderate motor and sensory deficits.

Intervention: Patients participated in 12 RT sessions and 12 conventional therapy (CT) sessions, with order counterbalanced, for 6 wk, with a 1-mo washout period.

Outcomes and Measures: Performance was assessed four times: before and after RT and before and after CT. Outcomes were measured using the Fugl-Meyer Assessment–Upper Extremity (FMA–UE), Box and Block Test, electromyography of the extensor digitorum communis (EDC) and brachioradialis, and a grip dynamometer for motor function; Semmes–Weinstein hand monofilament and the Revised Nottingham Sensory Assessment for sensory function; and the Modified Barthel Index (MBI) for ADL ability.

Results: RT resulted in significantly improved FMA–UE proximal (p = .038) and total (p = .046) and MBI (p = .030) scores. Participants’ EDC muscles exhibited higher efficacy during the small-block grasping task of the Box and Block Test after RT than after CT (p = .050).

Conclusions and Relevance: RT with the Gloreha device can facilitate whole-limb function, leading to beneficial effects on arm motor function, EDC muscle recruitment efficacy, and ADL ability for people with subacute and chronic stroke.

What This Article Adds: The evidence suggests that a task-oriented approach combined with the Gloreha device can facilitate engagement in whole-limb active movement and efficiently promote functional recovery.