Action observation treatment-based exoskeleton (AOT-EXO) for upper extremity after stroke: study protocol for a...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Robotics

Background:

• Stroke commonly causes motor deficits, leading to long-term disability.
• Robot-assisted training and action observation treatment show promise in improving motor recovery.
• Combining these approaches may enhance neural activation and functional outcomes.

Purpose of the Study:

• To evaluate the efficacy of action observation treatment combined with exoskeleton therapy (AOT-EXO) for post-stroke upper extremity rehabilitation.
• To investigate the impact of AOT-EXO on motor circuit activation and motor outcomes.
• To explore the kinematic and neurological mechanisms underlying AOT-EXO therapy.

Main Methods:

• A multicentre, prospective, three-group randomized controlled trial (RCT) involving 132 stroke patients.
• Patients will be randomized into conventional therapy (CT), exoskeleton therapy (EXO), or AOT-EXO groups.
• Assessments include Fugl-Meyer Assessment for Upper Extremity (FMA-UE), kinematic metrics, and neuroimaging over 12 weeks.

Main Results:

• Primary outcome: Fugl-Meyer Assessment for Upper Extremity (FMA-UE) changes.
• Secondary outcomes: Action Research Arm Test (ARAT), modified Barthel Index (MBI), kinematic data, and neurophysiological measures (rMT, MEP, fMRI).
• Safety outcomes will also be monitored throughout the trial.

Conclusions:

• The AOT-EXO trial will provide evidence on the feasibility and efficacy of this combined therapy for stroke survivors.
• It aims to elucidate the kinematic and neurological mechanisms driving improvements in upper extremity motor function.
• Findings could inform novel rehabilitation strategies for post-stroke motor recovery.