To examine the effects of bilateral robotic priming combined with mirror therapy (R-mirr) versus bilateral robotic priming combined with bilateral arm training (R-bilat), relative to the control approach of bilateral robotic priming combined with movement-oriented training (R-mov) in patients with stroke.
A single-blind, preliminary, randomized controlled trial.
Four outpatient rehabilitation settings.
Outpatients with stroke and mild to moderate motor impairment (N = 63).
Patients received 6 weeks of clinic-based R-mirr, R-bilat, or R-mov for 90 minutes/day, 3 days/week, plus a transfer package at home for 5 days/week.
Main Outcome Measures
Fugl-Meyer Assessment upper extremity subscale (FMA-UE), ABILHAND, and Stroke Impact Scale (SIS) version 3.0 scores before, immediately after, and 3 months after treatment as well as the lateral pinch strength and the accelerometry before and immediately after treatment.
The posttest results favored R-mirr over R-bilat and R-mov on the FMA-UE score (P<.05). Follow-up analysis revealed that significant improvement in FMA-UE score was retained at the 3-month follow-up in the R-mirr over R-bilat or R-mov (P<.05). Significant improvements were not observed in the R-mirr over R-bilat and R-mov on other outcomes.
Between-groups differences were only detected for the primary outcome – FMA-UE. That was R-mirr was more effective at enhancing upper-limb motor improvement, and the effect has the potential to be maintained at 3 months of follow-up.
List of abbreviations:ANCOVA (Analysis of Covariance), FMA-UE (Fugl-Meyer Assessment upper extremity subscale), LMM (linear mixed model), NIHSS (National Institutes of Health Stroke Scale), R-bilat (bilateral robotic primed bilateral arm training), R-mov (bilateral robotic primed movement-oriented training), R-mirr (bilateral robotic primed mirror therapy), SIS (Stroke Impact Scale version 3.0), UE (upper extremity)
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Accepted: February 14, 2023
Received in revised form: February 11, 2023
Received: June 16, 2022
Publication stageIn Press Journal Pre-Proof
© 2023 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine