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Background <p>Impaired upper extremity (UE) function is a major contributor to disability after stroke. Combining robotic devices with functional electrical stimulation (FES) has emerged as a promising hybrid approach to enhance post stroke UE function.</p> Objective <p>To assess the preliminary efficacy of robotic training with the REACH+multi-muscle FES device compared to the REACH device alone on UE function in individuals with chronic stroke.</p> Methods <p>This was a pilot non-blinded randomized control trial. Twenty individuals with chronic stroke were randomized to hybrid REACH + FES (<i>n</i> = 10) or REACH alone training (<i>n</i> = 10). All participants utilized the REACH device for training, which consisted of point-to-point reaching movements in response to a visually evoked task. The REACH + FES group additionally received multi-muscle FES during the REACH device training. Training consisted of 60&#xa0;min sessions, 3 times/week for six weeks, totaling 18 sessions. The primary outcomes were the kinematic outcomes from the Kinereach/TrakStar virtual reality system. Secondary outcomes included Upper Extremity Fugl Meyer Assessment (UE-FMA), Action Research Arm Test (ARAT), Reaching Performance Scale for Stroke (RPSS), and Modified Ashworth Scale (MAS).</p> Results <p>Both groups demonstrated improvements in kinematic and clinical outcomes post-training; but the REACH + FES group showed superior improvements in unconstrained reaching, including distance (midline, contralateral and ipsilateral directions; <i>p</i> &lt; 0.05) and contralateral linearity(<i>p</i> &lt; 0.05). Additionally, REACH + FES also exhibited improvements in UE impairments (UE-FMA: <i>p</i> &lt; 0.025, Far component of RPSS: <i>p</i> &lt; 0.05, MAS: <i>p</i> &lt; 0.05) and function (ARAT: <i>p</i> &lt; 0.025).</p> Conclusion <p>There is preliminary support for the use of an end-effector, uniaxial robotic device integrated with multi-muscle FES to maximize UE functional improvement in individuals with chronic stroke in a clinically meaningful way.</p> <p><i>Clinical Trial Registration</i> NCT05854485.</p>

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Extending reach: hybrid robotic-functional electrical stimulation training for post-stroke upper extremity rehabilitation

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月16日

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  • Sanjana Rao,
  • Bryson Boettger,
  • Gad Alon,
  • Jill Whitall,
  • Brad Hennessie,
  • Anindo Roy,
  • Kelly P. Westlake

摘要

Background

Impaired upper extremity (UE) function is a major contributor to disability after stroke. Combining robotic devices with functional electrical stimulation (FES) has emerged as a promising hybrid approach to enhance post stroke UE function.

Objective

To assess the preliminary efficacy of robotic training with the REACH+multi-muscle FES device compared to the REACH device alone on UE function in individuals with chronic stroke.

Methods

This was a pilot non-blinded randomized control trial. Twenty individuals with chronic stroke were randomized to hybrid REACH + FES (n = 10) or REACH alone training (n = 10). All participants utilized the REACH device for training, which consisted of point-to-point reaching movements in response to a visually evoked task. The REACH + FES group additionally received multi-muscle FES during the REACH device training. Training consisted of 60 min sessions, 3 times/week for six weeks, totaling 18 sessions. The primary outcomes were the kinematic outcomes from the Kinereach/TrakStar virtual reality system. Secondary outcomes included Upper Extremity Fugl Meyer Assessment (UE-FMA), Action Research Arm Test (ARAT), Reaching Performance Scale for Stroke (RPSS), and Modified Ashworth Scale (MAS).

Results

Both groups demonstrated improvements in kinematic and clinical outcomes post-training; but the REACH + FES group showed superior improvements in unconstrained reaching, including distance (midline, contralateral and ipsilateral directions; p < 0.05) and contralateral linearity(p < 0.05). Additionally, REACH + FES also exhibited improvements in UE impairments (UE-FMA: p < 0.025, Far component of RPSS: p < 0.05, MAS: p < 0.05) and function (ARAT: p < 0.025).

Conclusion

There is preliminary support for the use of an end-effector, uniaxial robotic device integrated with multi-muscle FES to maximize UE functional improvement in individuals with chronic stroke in a clinically meaningful way.

Clinical Trial Registration NCT05854485.