Testing of a Hybrid FES-Robot Assisted Hand Motor Training Program in Sub-Acute Stroke Survivors

Abstract

While hands-on therapy is the most commonly used technique for upper limb rehabilitation after stroke, it requires a therapist and residual activity and is best suited for active-assisted exercises. Robotic therapy on the other hand, can provide intention driven training in a motivating environment. We compared a robotic and standard therapy group, allowing intention driven finger flexion/extention respectively active-assisted exercises and a standard therapy only group. A total of 25 patients, 2 to 6 months post–stroke, with moderate motor deficit (Fugl-Meyer Assessment or FMA between 15 and 50), were randomly assigned in one of the groups. Patients practiced 30 minutes of hands-on therapy each day for 2 weeks with a supplementary 30 minutes of robotic therapy each day for patients in the experimental group. Subjects were evaluated using the FMA, Box and Blocks test (BBT) and Stroke Impact Scale (SIS) before and after the treatment. Patients in the experimental group showed higher average gain in all tests than those in the control group but only the SIS average gain was on the limit of statistical significance. This study shows the potential efficacy of robotic therapy for hand rehabilitation in subacute stroke patients.

Keywords

• electrical stimulation
• mechatronic hand
• neuromuscular stimulation
• rehabilitation robotics
• robot control