Upper-limb robot-assisted therapy in rehabilitation of acute stroke patients: Focused review and results of new randomized controlled trial

摘要

The successful motor rehabilitation of stroke patients requires early intensive and taskspecific therapy. A recent Cochrane Review, although based on a limited number of randomized controlled trials (RCTs), showed that early robotic training of the upper limb (i.e., during acute or subacute phase) can enhance motor learning and improve functional abilities more than chronicphase training. In this article, a new subacutephase RCT with the NeuroRehabilitationroBot (NeReBot) is presented. While in our first study we used the NeReBot in addition to conventional therapy, in this new trial we used the same device in substitution of standard proximal upperlimb rehabilitation. With this protocol, robot patients achieved similar reductions in motor impairment and enhancements in paretic upperlimb function to those gained by patients in a control group. By analyzing these results and those of previous studies, we hypothesize a new robotic protocol for acute and subacute stroke patients based on both treatment modalities (in addition and in substitution).