Task-Oriented Training by a Personalized Electromyography-Driven Soft Robotic Hand in Chronic Stroke: A Randomized Controlled Trial

Abstract

Background Intensive task-oriented training has shown promise in enhancing distal motor function among patients with chronic stroke. A personalized electromyography (EMG)-driven soft robotic hand was developed to assist task-oriented object-manipulation training effectively. Objective. To compare the effectiveness of task-oriented training using the EMG-driven soft robotic hand. Methods A single-blinded, randomized controlled trial was conducted with 34 chronic stroke survivors. The subjects were randomly assigned to the Hand Task (HT) group (n = 17) or the control (CON) group (n = 17). The HT group received 45 minutes of task-oriented training by manipulating small objects with the robotic hand for 20 sessions, while the CON group received 45 minutes of hand-functional exercises without objects using the same robot. Fugl-Meyer assessment (FMA-UE), Action Research Arm Test (ARAT), Modified Ashworth Score (MAS), Box and Block test (BBT), Maximum Grip Strength, and active range of motion (AROM) of fingers were assessed at baseline, after intervention, and 3 months follow-up. The muscle co-contraction index (CI) was analyzed to evaluate the session-by-session variation of upper limb EMG patterns. Results The HT group showed more significant improvement in FMA-UE (wrist/hand, shoulder/elbow) compared to the CON group ( P < .05). At 3-month follow-up, the HT group demonstrated significant improvements in FMA-UE, ARAT, BBT, MAS (finger), and AROMs ( P < .05). The HT group exhibited a more significant decrease in muscle co-contractions compared to the CON group ( P < .05). Conclusions EMG-driven task-oriented training with the personalized soft robotic hand was a practical approach to improving motor function and muscle coordination. Clinical Trial Registry Name: Soft Robotic Hand System for Stroke Rehabilitation. Clinical Trial Registration-URL: https://clinicaltrials.gov/ . Unique Identifier: NCT03286309.