- Among patients having upper limb functional limitation after stroke, robot-assisted training was not superior to either enhanced upper limb therapy or usual care for improving function.
Why this matters
- Upper limb motor impairment is common and often persistent, and affects activities of daily living.
- 3-month rate of upper limb function success:
- 42% with usual care,
- 44% with robot-assisted training, and
- 50% with enhanced upper limb therapy.
- Vs usual care, no significant benefit of:
- Robot-assisted training (aOR, 1.17; 98.3% CI, 0.70-1.96).
- Enhanced upper limb therapy (aOR, 1.51; 98.3% CI, 0.90-2.51).
- Rate of serious adverse events:
- 8% with usual care,
- 15% with robot-assisted training (P=.013), and
- 13% with enhanced upper limb therapy (P=.08).
- However, none attributable to interventions.
- UK multicenter randomized controlled trial: 770 adults with stroke having moderate or severe upper limb functional limitation (RATULS trial).
- Robot-assisted training (MIT-Manus robotic gym; 45 minutes, 3 times weekly, 12 weeks),
- Enhanced upper limb therapy program (repetitive functional task practice; 45 minutes, 3 times weekly, 12 weeks), and
- Usual care.
- Main outcome: 3-month upper limb function success (Action Research Arm Test).
- Funding: National Institute for Health Research.
- Outcome tool used needs further validation
- Higher dropout is usual care group.
- Usual care likely varied.