Abstract
Background: Approximately 80% of patients with stroke develop upper limb dysfunction. Although the greatest recovery of hand function is seen in the acute phase, only 14% achieve complete recovery. Beginning upper extremity functional training and repetitive movements from the early stage of stroke onset is considered important; however, in the acute stage of stroke, during which getting out of the bedside and self-care training are prioritized, patients often use the unaffected upper extremity. The newly developed EsoGLOVE robot hand training module is expected to assist with bedside hand function training. In this retrospective study, we aimed to evaluate the feasibility of training using this novel hand training support robot and assess its effectiveness.
Methods: The pneumatic robot provided auxiliary movements, such as flexion and extension of the fingers and passive movements. Of 24 eligible patients with similar Brunnström hand recovery stage, 12 who received treatment with EsoGLOVE were assigned to the robot-assisted training group, and 12 who did not were assigned to the usual training group. Some durability issues were encountered, and improvements were made to the robot at the therapists’ requests to make it easier to use. The primary outcome was the Brunnström hand recovery stage. Baseline comparisons between men and women were performed using the chi-square test for categorical variables (ischemic or hemorrhagic stroke) and the Mann–Whitney test for continuous variables. Within-group comparisons were performed using the Wilcoxon test for the primary outcome. Owing to the non-normal distribution of the data, between-group comparisons were performed using the Mann–Whitney U test.
Results: No adverse events were associated with robot use (20–40 min a day, five times a week) in addition to conventional training during the early subacute phase. Compared with patients who underwent conventional training alone, hand and finger functions improved significantly (p=0.018) in those who used the robot after approximately 2 months.
Conclusions: The EsoGLOVE robot is safe to use and has high clinical practicality. Nevertheless, we plan to conduct a prospective comparative study to verify its effectiveness.