Effectiveness of upper limb robotic-assisted therapy
in the early rehabilitation phase after stroke:
a single-blind, randomised, controlled trial

Dehem, Stéphanie [UCL] Gilliaux, Maxime Stoquart, Gaëtan [UCL] Detrembleur, Christine [UCL] Jacquemin, Géraldine Palumbo, Sara Frederick, Anne Lejeune, Thierry [UCL] et al.[show all]

Purpose: Upper limb (UL) robotic-assisted therapy (RAT) provided as partial substitution of CT, is expected to be at least as effective as CT. Its effectiveness has been less studied in the acute phase than in the chronic one. Assessments have usually been restricted to the two first domains of the International Classification of Functioning (ICF). This study aims to perform a pragmatic, multicentric, single-blind, randomized, controlled trial to evaluate the effectiveness of UL RAT, used as partial substitution to CT, in acute stroke patients, following the three ICF domains. Methods: Forty-five acute stroke patients were randomized into two groups (CT group, n=22 and RAT group, n=23). Both interventions were dose-matched regarding treatment duration and lasted nine weeks. The CT group followed a standard rehabilitation. In the RAT group, four sessions of CT (25%) were substituted by RAT each week. RAT consisted of moving the paretic UL along a reference trajectory while the robot provided an assistance as needed. A blinded assessor evaluated patients before, just after intervention and 6-month post-stroke, according to ICF. Results: Twenty-eight patients were assessed after intervention. UL motor control (Fugl Meyer +16%; p=0.05) and gross manual dexterity (Box and Block test +10 blocks; p=0.02) improved significantly more in RAT group than in CT group at 6-month post-stroke. Conclusion: RAT during acute stage of stroke is more effective than CT to improve UL motor control and gross manual dexterity, and is at least as effective as CT for activity and participation.