Task-oriented mirrored upper-limb robotic training in subacute patients after stroke: a case control study

Abstract

Abstract Objective People with stroke often have upper limb motor impairment, which has an impact on their activities of daily living and quality of life. Robotic-assisted training devices are used for upper limb rehabilitation, but their effectiveness in enhancing activities of daily living is not satisfactory yet. In this study, we combined task-oriented training and mirror training to an upper limb robot, created a task-oriented mirrored upper limb robot (Wisebot X5), and investigated the feasibility and safety of task-oriented mirror robot training for subacute stroke patients and observed its effects on upper limb motor function and activities of daily living. Methods Based on case-control principles, 32 patients with subacute stroke were assigned to receive task-oriented mirrored upper limb rehabilitation robot training for 30 minutes each time, 5 times per week for 4 weeks, or to receive the equivalent duration of conventional occupational therapy training. The primary outcome was the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), and secondary outcomes were the Modified Barthel Index (MBI), the Stroke Self-Efficacy Scale (SSEQ), the System Usability Scale (SUS), and the Chinese version of the Quebec User Evaluation With Assistive Technology(C-QUEST). Statistical analysis was performed with paired-samples t-test. Results Thirty-two patients participated and completed the study. After the 4-week intervention, for FMA-UE, the experimental group was better than the control group in terms of the change score from the baseline to post intervention (P༜0.05). For MBI and SSEQ, both the experimental and control groups showed significant increases after the intervention(P༜0.05). However, there was no statistical difference between the groups in terms of the change score from the baseline to post intervention(P༞0.05). The usability assessment reported a high level of satisfaction: mean SUS score is 74.84% (SD = 11.64), mean QUEST scale is 4.42 (SD = 0.31). Conclusions Task-oriented mirrored upper-limb robotic training is feasible and safe for patients with subacute stroke. It is beneficial in promoting the recovery of upper limb function and activities of daily living.