Ann Rehabil Med.  2016 Dec;40(6):961-971. 10.5535/arm.2016.40.6.961.

Effect of Upper Extremity Robot-Assisted Exercise on Spasticity in Stroke Patients

• Lee KW
• Kim SB
• Lee JH
• Lee SJ
• Yoo SW

• KMID: 2371327
• DOI: http://doi.org/10.5535/arm.2016.40.6.961

Abstract

OBJECTIVE
To determine the efficacy of a stretching and strengthening exercise program using an upper extremity robot, as compared with a conventional occupational therapy program for upper extremity spasticity in stroke patients.
METHODS
Subjects were randomly divided into a robot-assisted therapy (RT) group and a conventional rehabilitation therapy (CT) group. RT group patients received RT and CT once daily for 30 minutes each, 5 days a week, for 2 weeks. RT was performed using an upper-extremity robot (Neuro-X; Apsun Inc., Seoul, Korea), and CT was administered by occupational therapists. CT group patients received CT alone twice daily for 30 minutes, 5 days a week, for 2 weeks. Modified Ashworth Scale (MAS) was used to measure the spasticity of upper extremity. Manual muscle tests (MMT), Manual Function Tests (MFT), Brunnstrom stage, and the Korean version of Modified Barthel Index (K-MBI) were used to measure the strength and function of upper extremity. All measurements were obtained before and after 2-week treatment.
RESULTS
The RT and CT groups included 22 subjects each. After treatment, both groups showed significantly lower MAS scores and significant improvement in the MMT, MFT, Brunnstrom stage, and K-MBI scores. Treatment effects showed no significant differences between the two groups.
CONCLUSION
RT showed similar treatment benefits on spasticity, as compared to CT. The study results suggested that RT could be a useful method for continuous, repeatable, and relatively accurate range of motion exercise in stroke patients with spasticity.

Keyword

Stroke; Robot; Spasticity; Upper extremity

MeSH Terms

Humans
Methods
Muscle Spasticity*
Occupational Therapy
Range of Motion, Articular
Rehabilitation
Seoul
Stroke*
Upper Extremity*

Figure

• 

  Fig. 1 Schematic of a Neuro-X (Apsun Inc., Seoul, Korea) working method.

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  Fig. 2 Four game programs on the Neuro-X system (Apsun Inc., Seoul, Korea). (A) Basic continuous passive motion exercise (CPM) mode. (B) Basic controlled assisted movement exercise (CAM) mode. (C) Grinding millstone. (D) Jumping rope.

• 

  Fig. 3 Neuro-X system, an upper limb rehabilitation robot, consisted of a monitor and upper limb exercise equipment. (A) Paretic arm is placed in a custom-made arm support fixed to the robot. (B) Robot system affording horizontal rotational movement training of upper extremity. (C) Robot system delivering elbow extension. (D) Robot system delivering shoulder abduction. (E) Robot system delivering elbow flexion. (F) Robot system delivering shoulder adduction.

• 

  Fig. 4 The algorithm for subject enrollment.

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