Innovative upper extremity rehabilitation methods in stroke patients: a comparison of robotic rehabilitation and action observation therapy-a randomized trial

Abstract

Introduction: After a stroke, difficulties with arm and hand movement most affect daily life. To overcome these difficulties, research is ongoing to find the most effective treatment approaches. This study investigated which of two different technology-based rehabilitation approaches improved upper extremity motor function, independence, and quality of life in stroke.

Methods: Thirty patients were randomized into two groups: robotic rehabilitation (RR) and action observation therapy (AOT). Upper extremity movements were repeated with active participation using the Houston Bionics ExoRehab X device in the RR group. On the other hand, the AOT group focused on watching and practicing functional movements through 31 first-person perspective videos. Motor functions, independence, and quality of life were assessed by the Wolf Motor Function Test (WMFT), Box-Block Test (BBT), Barthel Index (BI), and Stroke-Specific Quality of Life Questionnaire (SS-QoL). Results: The WMFT, BBT, BI, and SS-QoL scores of both groups improved from baseline. However, neither group was superior to the other in the first 4 weeks' results. At the end of 8 weeks, the RR group demonstrated significantly greater improvements in all parameters compared with the AOT group (p < 0.05 for all) except SS-QoL (p = 0.136). Discussion: While both treatment methods showed similar short-term improvements, the RR group demonstrated greater improvements in motor function and independence than the AOT group at the end of 8 weeks. The fact that AOT gains slow down after the 4th week raises the question of which week these gains will stop. Clinical trial registration: Name: Effects of the Action Observation Therapy and Robotic Rehabilitation on the Upper-Limb Motor Function in Stroke. ID: NCT05590156 (18.04.2024). URL: https://register.clinicaltrials.gov/prs/beta/studies/S000CKXO00000049/recordSummary.