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Updated: Jan 24, 2026

Brain-Computer Interface-controlled Upper Limb Robotic System for Enhancing Daily Activities in Stroke Patients
Published on: April 18, 2025
Robot assisted training for the upper limb after stroke (RATULS): a multicentre randomised controlled trial
Helen Rodgers1, Helen Bosomworth2, Hermano I Krebs3
1Stroke Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK; Stroke Northumbria, Northumbria Healthcare NHS Foundation Trust, North Tyneside, UK; Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Robot-assisted training and enhanced upper limb therapy (EULT) did not improve arm function after stroke compared to usual care. These findings do not support using robot-assisted training in routine clinical practice for stroke survivors.
Area of Science:
- Neurorehabilitation
- Robotics in Medicine
- Stroke Recovery
Background:
- Loss of arm function is a significant post-stroke challenge.
- Robot-assisted training and enhanced upper limb therapy (EULT) are potential interventions.
- Clinical effectiveness of these therapies compared to usual care requires evaluation.
Purpose of the Study:
- To compare the clinical effectiveness of robot-assisted training (MIT-Manus) versus EULT and usual care.
- To assess the impact on upper limb function and activities of daily living post-stroke.
Main Methods:
- Pragmatic, multicentre, randomised controlled trial (RATULS) involving 770 stroke patients.
- Patients with moderate to severe upper limb limitation were assigned to robot-assisted training, EULT, or usual care.
- Primary outcome was upper limb function success (Action Research Arm Test [ARAT]) at 3 months.
Main Results:
- Robot-assisted training (44%) and EULT (50%) did not significantly improve ARAT success compared to usual care (42%).
- No significant difference in upper limb function was observed between robot-assisted training and EULT.
- Serious adverse events were slightly higher in intervention groups but not intervention-attributable.
Conclusions:
- Robot-assisted training and EULT did not demonstrate superior efficacy over usual care for improving upper limb function in stroke patients.
- Current evidence does not support the routine clinical implementation of robot-assisted training as utilized in this trial.
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