Exoskeleton-Assisted Anthropomorphic Movement Training for the Upper Limb After Stroke: The EAMT Randomized Trial

Area of Science:

• Rehabilitation Medicine
• Robotics in Healthcare
• Neuroscience

Background:

• Current robot-assisted arm training often uses rigid, mechanical movements.
• The effectiveness of integrating natural, coordinated upper extremity (UE) movement patterns into robotic exoskeletons is not well understood.
• This study investigates a novel approach using exoskeletal assistance for human-like gross movements in post-stroke patients.

Purpose of the Study:

• To compare the efficacy of exoskeleton-assisted anthropomorphic movement training with conventional therapist-mediated training.
• To evaluate outcomes in patients with subacute stroke and moderate-to-severe upper extremity motor impairment.

Main Methods:

• A randomized, single-blind, noninferiority trial involving 80 subacute stroke inpatients.
• Participants received 20 sessions of 45-minute exoskeleton-assisted anthropomorphic movement training or conventional therapy.
• The primary outcome measure was the change in the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) at 4 weeks.

Main Results:

• Exoskeleton-assisted anthropomorphic movement training resulted in a significantly greater improvement in FMA-UE scores (14.73 points) compared to conventional therapy (9.90 points).
• The adjusted difference favored the exoskeleton group by 4.51 points, demonstrating noninferiority and potential superiority.
• Post hoc analysis indicated greater benefits for patients with moderate-to-severe motor impairment (FMA-UE score 23-38).

Conclusions:

• Exoskeleton-assisted anthropomorphic movement training is effective for improving UE function in patients with subacute stroke.
• The repetitive practice of human-like movements facilitated by exoskeletons shows positive rehabilitation outcomes.
• Further research is needed to explore long-term effects and optimize this training paradigm.