Poster 234: Effects of Robotic Therapy on Motor Impairment and Recovery in Stroke Patients

Objective: To test in stroke patients whether additional sensorimotor training of the paralyzed or paretic upper limb delivered by a robotic device enhanced motor recovery and functional outcome. Design: Randomized controlled trial. Setting: Hospitalized care. Participants:20 patients with poststroke hemiparesis or hemiplegia within the first week after stroke. Intervention: Patients were randomly assigned either to early robotic training (robotic therapy group for 25 sessions of ≈40min/d) or exposed to the robotic device without training (control group for 3 times weekly for 15 sessions of ≈10min/d). Robot therapy by a new robot, designed and built at Padova University, provides sensorimotor stimulation for hemiplegic patients, through active and passive mobilization of the upper limb, with visual and acoustic feedback. Main Outcome Measures: Outcomes were assessed by the same masked raters, before treatment began and at 60 and 240 days, with the upper-extremity component of the Fugl-Meyer Assessment (FMA), the Motor Status Scale (MSS) score, FIM instrument, and FIM motor score. Results: The robotic therapy and control groups had comparable demography, clinical characteristics, lesion size, and pretreatment impairment scores. The robotic group demonstrated significant improvement in motor (FMA, P=.01; MSS shoulder and elbow, P=.05; wrist and hand, P=.05), and functional outcome (FIM, P=.03; FIM motor, P=.01) at 60±8 days compared with the control group. The significant improvement in the robotic group persisted at follow-up after 240±24 days. All treated patients had favorable impressions of robotic treatment. There were no side effects. Conclusions: This study revealed statistically significant benefits of robotic therapy in persons with stroke-related paralyzed or paretic upper limb. In these patients, an early robotic approach may usefully complement other treatments by reducing motor impairment during both acute and chronic phases of stroke recovery.