Using robot-assisted therapy to improve upper limb function in stroke patients

This study compared proximal robotic rehabilitation to distal robotic rehabilitation at improving upper limb function in stroke patients. The authors concluded that distal robotic rehabilitation may be more effective, particularly at improving distal upper limb function and strength.

It is common among stroke patients to have upper limb motor deficits. This can affect independence, recovery and the ability to carry out daily tasks. Robot-assisted therapy is a new rehabilitation approach to improve upper limb function and recovery. There are limited studies however that directly compare the effectiveness of different robotic devices. It is unknown whether proximal (near the area limb attachment to the body) or distal (located further from the area of attachment to the body) would be better at improving upper limb function.

This study aimed to compare the effect of proximal robot-assisted therapy and distal robot-assisted therapy at improving upper limb function in stroke patients.

The study used a robot-assisted therapy called InMotion ARM (ARM) which focuses on training proximal shoulder and elbow movements. They compared this to InMotion WRIST (WRIST) which targets distal wrist and forearm movements. A control therapy group involving conventional rehabilitation was also included. 

40 stroke patients were included. 15 patients were treated with ARM. 13 patients that were treated with WRIST. 12 patients were in the control group.

WRIST patients saw significant improvements in overall arm muscle strength, distal muscle strength, and quality of movement compared to the ARM group. The WRIST group also had better distal reflexes, movement, and strength compared to the control group. There was no significant differences between the ARM group and the control group.

The authors concluded that distal robot-assisted therapy using the InMotion WRIST system was more effective at improving distal muscle function and strength.