Robot-assisted Versus Conventional Physical Therapy for Hand in Sub-acute Stroke (ROCHAS)

May 22, 2026 updated by: Montiha Azeem

This randomized controlled trial aims to compare the effectiveness of robotic-assisted physiotherapy and conventional physiotherapy in improving hand function among patients with sub-acute stroke. Stroke often results in weakness, reduced hand strength, impaired dexterity, and difficulty performing daily activities due to upper-limb motor dysfunction. Early rehabilitation targeting hand recovery is essential to improve independence and quality of life.

A total of 30 participants with sub-acute post-stroke spastic hemiplegia will be recruited from the University of Lahore Hospital and randomly assigned into two groups. The intervention group will receive robotic-assisted physiotherapy focused on repetitive, task-specific wrist and finger extension training using a robotic hand/wrist device, while the control group will receive conventional therapist-led upper-limb rehabilitation exercises. Both groups will undergo treatment sessions lasting 30-45 minutes, five days per week for four weeks.

Outcome measures will include hand muscle strength assessed using a hand-held dynamometer, hand dexterity evaluated through the Action Research Arm Test (ARAT), and functional improvement measured using the Fugl-Meyer Assessment for Upper Extremity (FMA-UE). Additional measures such as spasticity, activities of daily living, and quality of life will also be recorded. Assessments will be conducted at baseline, during treatment, and after completion of the intervention period by a blinded assessor.

The study is expected to determine whether robotic-assisted physiotherapy provides greater improvements in hand strength, dexterity, and upper-limb functional recovery compared to conventional physiotherapy in individuals recovering from stroke. Findings from this research may contribute to evidence-based rehabilitation strategies for improving upper-limb outcomes after stroke.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Stroke is one of the leading causes of long-term disability worldwide and frequently results in upper-limb impairments that significantly affect independence and quality of life. Hand dysfunction, including reduced grip strength, poor dexterity, impaired coordination, and difficulty performing functional tasks, is common during the sub-acute phase following stroke. Recovery of hand and upper-limb function is considered a major goal of neurorehabilitation because deficits in grasping, object manipulation, and coordinated movement restrict performance of activities of daily living and social participation.

Conventional physiotherapy remains a widely used rehabilitation approach for upper-limb recovery after stroke. It typically involves therapist-guided range-of-motion exercises, strengthening, task-oriented training, neuromuscular facilitation, and functional retraining techniques. Although beneficial, conventional therapy may be limited by therapist fatigue, reduced intensity of repetitions, and variability in treatment delivery. Emerging rehabilitation technologies such as robotic-assisted physiotherapy have been introduced to overcome these limitations by providing high-intensity, repetitive, task-specific, and feedback-driven training that may enhance neuroplasticity and motor relearning.

Robotic-assisted physiotherapy allows patients to perform repeated wrist and finger movements with adjustable assistance or resistance while receiving visual or sensory feedback. These systems can increase the number of movement repetitions, promote active participation, and objectively monitor patient performance. Previous studies have suggested that robotic rehabilitation may improve motor control, muscle strength, and functional outcomes in stroke survivors; however, evidence comparing robotic-assisted therapy with conventional physiotherapy specifically for hand recovery in sub-acute stroke patients remains limited.

This randomized controlled trial will compare robotic-assisted physiotherapy with conventional physiotherapy for improving hand function in individuals with sub-acute stroke. Thirty participants meeting the eligibility criteria will be recruited from the University of Lahore Hospital and randomly allocated into two equal groups using the sealed-envelope randomization method. Group A will receive robotic-assisted physiotherapy targeting wrist and finger extension through repetitive, task-specific robotic training combined with visual feedback and progressive assistance or resistance. Group B will receive conventional physiotherapy consisting of active-assisted and resistive exercises, task-oriented training, neuromuscular facilitation, mirror therapy, and activities of daily living training. Both groups will receive treatment five days per week for four weeks, with each session lasting approximately 30-45 minutes.

Primary outcomes will include hand muscle strength measured by a hand-held dynamometer, hand dexterity assessed using the Action Research Arm Test (ARAT), and upper-limb functional recovery measured through the Fugl-Meyer Assessment for Upper Extremity (FMA-UE). Secondary outcomes will include spasticity using the Modified Ashworth Scale, activities of daily living using the Modified Barthel Index, and quality of life using the EQ-5D questionnaire. Outcome assessments will be performed at baseline, midpoint, and post-intervention by a blinded assessor using standardized protocols.

The findings of this study may help determine whether robotic-assisted physiotherapy offers superior benefits over conventional physiotherapy for hand rehabilitation in sub-acute stroke patients. The results may contribute to the development of evidence-based rehabilitation protocols and support the integration of advanced robotic technologies into stroke rehabilitation programs to optimize upper-limb recovery and functional independence.

Study Type

Interventional

Enrollment (Estimated)

30

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • Recruiting
        • University of Lahore Teaching Hospital, Lahore
        • Contact:
        • Contact:
        • Principal Investigator:
          • Muhammad Uzair, MSPTN

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

Both male and female adults aged 30-50 years diagnosed with post-stroke spastic hemiplegia confirmed by a neurologist.

Stroke duration 2 weeks to 6 months (sub acute stage) with medically stable condition.

Presence of mild to moderate upper-limb spasticity using screening test(Modified Ashworth Scale score 1-3).

Ability to comprehend and follow simple verbal instructions using screening test (MMSE ≥ 24).

Exclusion Criteria:

No history of upper-limb orthopedic surgery or botulinum toxin injections in the last 6 months.

History of recurrent or uncontrolled seizure disorders, progressive neurological diseases, or unstable cardiovascular conditions.

Participation in any intensive upper-limb rehabilitation program (CIMT, bimanual training, task-specific training, robotic therapy, FES therapy) within the past 6 months.

Comorbid conditions affecting upper-limb function (fractures, severe arthritis, peripheral nerve injuries).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: group A Robotic-Assisted Physiotherapy Group
Participants in this group will receive robotic-assisted physiotherapy focused on wrist and finger extension training using a robotic hand/wrist rehabilitation device. Treatment will include repetitive task-specific movements, active-assist and active-resist exercises, visual feedback tasks, and functional grasp-release training. Sessions will be conducted for 30-45 minutes per session, 5 days per week for 4 weeks under therapist supervision.
Device: Robotic-Assisted Hand Rehabilitation Therapy
Participants will receive robotic-assisted hand rehabilitation using a robotic hand/wrist training device designed to improve wrist and finger extension, hand coordination, and functional upper-limb recovery after stroke. The intervention will include repetitive task-specific movements, active-assist and active-resist training, grasp-release exercises, visual feedback activities, and functional motor practice supervised by a physiotherapist. Treatment intensity and robotic assistance will be progressively adjusted according to patient performance and recovery level. Sessions will last 30-45 minutes, 5 days per week for 4 weeks.
Active Comparator: group B Conventional Physiotherapy Group
Participants in this group will receive conventional therapist-led upper-limb rehabilitation consisting of active-assisted and active range-of-motion exercises, strengthening exercises for wrist and finger extensors, task-oriented functional training, neuromuscular facilitation, mirror therapy, and activities of daily living training. Sessions will be conducted for 30-45 minutes per session, 5 days per week for 4 weeks.
Procedure: Conventional Physiotherapy
Participants will receive conventional physiotherapy focused on upper-limb rehabilitation after stroke. The treatment program will include active-assisted and active range-of-motion exercises, strengthening exercises for wrist and finger extensors, task-specific functional training, neuromuscular facilitation techniques, mirror therapy, and activities of daily living practice. Exercise intensity and task difficulty will be progressively increased according to patient ability and motor recovery. Sessions will last 30-45 minutes, 5 days per week for 4 weeks under physiotherapist supervision.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Upper Limb Motor Function Using Fugl-Meyer Assessment for Upper Extremity (FMA-UE)
Time Frame: Baseline and after 4 weeks of intervention
The Fugl-Meyer Assessment for Upper Extremity (FMA-UE) will be used to evaluate motor recovery and functional improvement of the affected upper limb in participants with sub-acute stroke. The assessment includes evaluation of reflexes, movement synergy, wrist control, hand function, and coordination. Higher scores indicate better upper-limb motor performance and recovery.
Baseline and after 4 weeks of intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Montiha Azeem

Investigators

  • Principal Investigator: Muhammad Uzair, MSPTN, The University of Lahore, Lahore

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

May 22, 2026

Primary Completion (Estimated)

June 22, 2026

Study Completion (Estimated)

June 23, 2026

Study Registration Dates

First Submitted

May 22, 2026

First Submitted That Met QC Criteria

May 22, 2026

First Posted (Actual)

May 29, 2026

Study Record Updates

Last Update Posted (Actual)

May 29, 2026

Last Update Submitted That Met QC Criteria

May 22, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • UOL/IREB/25/15/03/50

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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