Abstract
End-effector (EE) and exoskeleton (Exo) robots have not been directly compared previously. The present study aimed to directly compare EE and Exo robots in chronic stroke patients with moderate-to-severe upper limb impairment. This single-blinded, randomised controlled trial included 38 patients with stroke who were admitted to the rehabilitation hospital. The patients were equally divided into EE and Exo groups. Baseline characteristics, including sex, age, stroke type, brain lesion side (left/right), stroke duration, Fugl–Meyer Assessment (FMA)–Upper Extremity score, and Wolf Motor Function Test (WMFT) score, were assessed. Additionally, impairment level (FMA, motor status score), activity (WMFT), and participation (stroke impact scale [SIS]) were evaluated. There were no significant differences in baseline characteristics between the groups. After the intervention, improvements were significantly better in the EE group with regard to activity and participation (WMFT–Functional ability rating scale, WMFT–Time, and SIS–Participation). There was no intervention-related adverse event. The EE robot intervention is better than the Exo robot intervention with regard to activity and participation among chronic stroke patients with moderate-to-severe upper limb impairment. Further research is needed to confirm this novel finding.
Highlights
End-effector (EE) and exoskeleton (Exo) robots have not been directly compared previously
EE robots are connected to patients at one distal point, and their joints do not match with human joints
There were no significant differences in baseline characteristics, including baseline primary outcome measures, between the EE and Exo groups (Table 1)
Summary
End-effector (EE) and exoskeleton (Exo) robots have not been directly compared previously. A recent multicentre randomised controlled trial showed better improvements in FMA scores with robot-assisted training on comparing robot-assisted training with usual care, but showed no significant difference in scores on comparing robot-assisted training with enhanced upper limb therapy These findings indicate that robot-assisted training can reduce the burden for therapists but is not a definite superior option[5]. Bertani et al reported significant favourable results with regard to arm function for Exo robots but not for EE robots; the risk of bias should be considered owing to the smaller sample size of Exo robots when compared with that of EE robots[10] These indirect comparisons are helpful, they are limited by the heterogeneity in clinical studies, including design, population, outcomes, and intervention protocols
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
