Original research| Volume 100, ISSUE 6, P1015-1022, June 2019

Robotic-Assisted Shoulder Rehabilitation Therapy Effectively Improved Poststroke Hemiplegic Shoulder Pain: A Randomized Controlled Trial

Published:March 13, 2019DOI:


      • We developed a novel shoulder pain rehabilitation robot with 1 arm that was capable of performing abduction range of motion exercises within the limits of pain tolerance.
      • After a 4-week rehabilitation therapy using this robot, visual analog scale scores were significantly lower, and the abduction passive range of motion and disability caused by shoulder pain were improved.
      • Robotic-assisted shoulder pain rehabilitation therapy was beneficial for the treatment of hemiplegic shoulder pain.



      The purpose of this study was to investigate the therapeutic effects of a newly developed shoulder robot on poststroke hemiplegic shoulder pain.


      Prospective, single-blind randomized controlled trial.


      Inpatient department of a tertiary university hospital.


      Hemiplegic shoulder pain patients (N=38) were consecutively recruited and randomly assigned to an intervention or control group.


      A newly developed robot was designed to perform joint mobilization and stretching exercises with patients lying in the supine position. Conventional physical therapy directed at both improving upper extremity mechanics and reducing neurologic injury was performed twice per day in both groups. In the intervention group, additional robotic-assisted shoulder rehabilitation therapy was administered for 30 minutes per day, 5 times per week for 4 weeks.

      Main Outcome Measures

      The visual analog scale was the primary outcome, and the pain-free passive range of motion of the shoulder joint, the Korean version of the Shoulder Disability Questionnaire, and ultrasonographic grades were the secondary outcomes. The outcomes were evaluated at baseline (T0), postintervention (T1), and a 4-week follow-up (T2).


      Significant time and group interaction effects were found on the visual analog scale, in the abduction passive range of motion, and on the Shoulder Disability Questionnaire (F2,33=16.384, P=.002; F2,33=10.609, P=.012; F2,33=32.650, P=.008, respectively). Significantly higher improvements in these outcome measures were observed in the intervention group than in the control group at T1 after post hoc analysis (P<0.05, all). These improvements were sustained at T2 when the intervention group was compared with the control group (P<.05, all).


      A prototype shoulder rehabilitation robot as an adjuvant therapy improves hemiplegic shoulder pain and self-reported shoulder-related disability.


      List of abbreviations:

      CPM (continuous passive motion), HSP (hemiplegic shoulder pain), K-SDQ (Korean version of the Shoulder Disability Questionnaire), PROM (passive range of motion of the shoulder), RSRT (robotic-assisted shoulder rehabilitation therapy), VAS (visual analog scale)
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