Comparison of upper extremity robotic rehabilitation efficacy with conventional rehabilitation in patients with hemiplegia after cerebrovascular accident

Objective: The aim of this single-blind randomized propective study is to find out whether including robotic therapy (trying to gain the previous functions of the affected side after stroke by robotic rehabilitation) in addition to conventional rehabilitation program has an effect on quality of life, motor function and activities of daily living of the hemiplegic patients. Materials and Methods: Hemiplegic patients aged 18-85, 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 were assigned to the robotic rehabilitation group and 20 were assigned to the conventional rehabilitation group. One of the groups received conventional therapy while the other group received robot-assisted rehabilitation in addition to conventional treatment. Conventional therapy included 5 days a week for 4 weeks, Range of Motion (ROM) exercises, stretching, strengthening, balance exercises and gait training. Robotic-based rehabilitation is arranged to be 30-45 minutes five days a week. All patients were assessed at the beginning of therapy and at the end of 4th week with Brunnstrom stages of motor recovery, hand grip and finger muscle strength, Modified Ashworth Scale (MAS), Stroke Specific Quality of Life Scale (SS-QOL), Motor Activity log-28, Fugl Meyer Assessment (FMA), Purdue peg test, Minnesota manual dexterity test, Montreal Cognitive Asssessment (MoCA), Nottingham Extended Activities of Daily Living (NEADL) Scale, Functional İndependance Measure (FIM), Functional Ambulation Scale (FAS), Center for Epidemiological Studies Depression Scale (CES- D). Results: In our study, improvements in motor function scores, general functioning, activities of daily living, spasticity, ambulation, cognitive assessment scale are better in robotic group when compared with control group but this difference was not statistically significant (p>0,05). We have found statistically significant improvement in CES- Depression scale in robotic group compared with control group (p=0,018). Conclusion: Results of motor function gains are significantly improved before and after the treatment in both groups and this improvements are better in robotic group however no significant differences were observed between the groups after the treatment. Robotic rehabilitation provides a favorable alternative and its addition brings slight benefits, and it is 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. By devoloping new technologies more effective and superior systems are expected in robotic rehabilitation field. More studies must be done and these studies will enable the use of new therapeutic methods in clinical practice within the framework of evidence-based medicine in the future.