Evidence of neuroplasticity with robotic hand exoskeleton for post-stroke rehabilitation: a randomized controlled trial

Abstract Background A novel electromechanical robotic-exoskeleton was designed in-house for the rehabilitation of wrist joint and Metacarpophalangeal (MCP) joint. Objective The objective to compare effectiveness (clinical-scales neurophysiological-measures) robotic-therapy training sessions with dose-matched conventional therapy in patients stroke. Methods pilot prospective parallel randomized controlled study at clinical settings stroke within 2 years chronicity. Patients were randomly assigned receive an intervention 20 45 min each, five days a week four weeks, Robotic-therapy Group (RG) (n = 12) upper-limb Control-Group (CG) 11). We intended evaluate effects exoskeleton based on functional outcomes cortical-excitability as compared conventional-rehabilitation. Clinical-scales– Modified Ashworth Scale, Active Range Motion, Barthel-Index, Brunnstrom-stage Fugl-Meyer (FM) scale neurophysiological measures (using Transcranial Magnetic Stimulation) –Motor Evoked Potential Resting Motor threshold, acquired pre- post-therapy. Results No side noticed any patients. Both RG CG showed significant ( p < 0.05) improvement all motor-outcomes except Scale CG. significantly higher over Motion FM Wrist-/Hand component. An increase ipsilesional-hemisphere found be statistically CG, indexed by decrease Threshold amplitude Potential. changes shown contralesional-hemisphere. Interhemispheric RMT-asymmetry evidenced indicating increased along interhemispheric changes. Conclusion Robotic-exoskeleton motor Neurophysiological could most likely consequence plastic reorganization use-dependent plasticity. Trial registry number : ISRCTN95291802