Upper Extremity Robotic Rehabilitation in Patients With Hemiplegia
Upper Extremity Robotic Rehabilitation in Patients With Hemiplegia
Comparison of Upper Extremity Robotic Rehabilitation Efficiency with Conventional
 Rehabilitation in Patients with Hemiplegia after Cerebrovascular Event
The aim of this single-blind randomized prospective study is to find out whether including
 robotic therapy in addition to conventional rehabilitation program has an effect on quality
 of life, motor function and activities of daily living of the hemiplegic patients. Hemiplegic
 patients diagnosed by anamnesis, physical examination and radiological analysis, which have
 been referred to the outpatient clinic of Ege University Faculty of Medicine Department of
 Physical Therapy and Rehabilitation between April 2016 and April 2019 have been taken to the
 study. The demographic and clinical data of the patients were recorded and they were
 randomized into 2 groups. 17 patients assigned to the robotic rehabilitation group (Study
 group) receiving robot-assisted rehabilitation in addition to conventional treatment and 20
 assigned to the conventional rehabilitation group (control group) receiving only conventional
 therapy completed the study. Robotic-based rehabilitation given additionally was arranged to
 be 30-45 minutes, 5 days per week for 4 weeks. All patients were assessed at the beginning of
 therapy and at the end of 4th week with Brunnstrom stages of motor recovery, Fugl Meyer
 Assessment (FMA), hand grip strength, Purdue peg test, Minnesota manual dexterity test,
 Modified Ashworth Scale (MAS) , Functional Independance Measure (FIM), Stroke Specific
 Quality of Life Scale (SS-QOL), Nottingham Extended Activities of Daily Living (NEADL) Scale,
 Montreal Cognitive Assessment (MoCA), Center for Epidemiological Studies Depression Scale
 (CES- D). In the study, improvements in motor function scores, spasticity, general
 functioning, activities of daily living, cognitive assessment scale are better in robotic
 group when compared with control group but this difference was not statistically significant
 (p>0,05). The investigators have found statistically significant improvement in CES-
 Depression scale in robotic group compared with control group (p=0,018). Significantly
 improved motor function gains are observed before and after the treatment in both groups
 being better in the robotic group however no significant differences were observed between
 the groups after the treatment. Robotic rehabilitation provides a favorable alternative
 bringing slight benefits, and also advantageous in terms of work power and psychological
 recovery so robotic rehabilitation addition to conventional neurological rehabilitation is
 effective and useful in patient management after stroke or cerebrovascular events.
Inclusion Criteria:

 -  Having a single stroke

 -  Being an adult

 -  Having a duration of 4 to 30 months after stroke

 -  A score greater than 16 in mini-mental test

 -  Upper extremity Brunnstrom stage 2 or higher

 -  Being a fluent speaker in Turkish.

 Exclusion Criteria:

 -  Severe apraxia

 -  Skin ulcers

 -  Multiple cerebrovascular events

 -  Severe decompensated diseases (cardiopulmonary, neurological, orthopedic and
 psychiatric etc), cardiac pacemakers, severe neuropsychological impairment,

 -  Neglect syndrome

 -  Spasticity greater than 3 in Modified Ashworth Scale

 -  Severe joint contractures

 -  Botulinum toxin-A injection in their upper extremity and dose change in drugs for
 spasticity in the last 3 months.