A Comparative Efficacy Study of Robotic Priming of Bilateral Approach in Stroke Rehabilitation

Yi-Chun Li, Keh-Chung Lin, Chia-Ling Chen, Grace Yao, Ya-Ju Chang, Ya-Yun Lee, Chien-Ting Liu, Yi-Chun Li, Keh-Chung Lin, Chia-Ling Chen, Grace Yao, Ya-Ju Chang, Ya-Yun Lee, Chien-Ting Liu

Abstract

Background: Stroke survivors can remain impaired in body functions, activity, and participation. A novel rehabilitation regimen is required to obtain scientific evidence and to help clinicians determine effective interventions for stroke. Mirror therapy (MT) and bilateral upper limb training (BULT) are based on the tenet of bilateral movement practice; however, the additional effect of bilateral robotic priming combined with these two therapies is unclear. Objectives: This study examined the effects of two hybrid therapies, robotic priming combined with MT and robotic priming combined with BULT, in stroke survivors. Methodology: The study randomized 31 participants to groups that received robotic priming combined with MT (n = 15) or robotic priming combined with BULT (n = 16). Outcome measures included the Fugl-Meyer Assessment (FMA), the revised Nottingham Sensory Assessment (rNSA), the Chedoke Arm and Hand Activity Inventory (CAHAI), and accelerometer data. Results: Both groups showed statistically significant within-group improvements in most outcome measures. Significant between-group differences and medium-to-large effect sizes were found in favor of the group that received robotic priming combined with MT based on the FMA distal part subscale scores, FMA total scores, and accelerometer data. Conclusion: Robotic priming combined with MT may have beneficial effects for patients in the improvements of overall and distal arm motor impairment as well as affected arm use in real life. Additional follow-up, a larger sample size, and consideration of the effect of lesion location or different levels of cognitive impairment are warranted to validate our findings in future studies. Clinical trial registration: www.ClinicalTrials.gov, identifier NCT03773653.

Keywords: bilateral upper limb training; mirror therapy; mirror visual feedback; motor learning; priming; stroke.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Li, Lin, Chen, Yao, Chang, Lee and Liu.

Figures

Figure 1
Figure 1
Intervention setup for Bi-Manu-Track robot (A), mirror therapy (B), and bilateral upper limb training (C).
Figure 2
Figure 2
Consolidated standards of reporting trials flowchart of the study.
Figure 3
Figure 3
Diagram of the study design.

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