title: A comparison between electromyography-driven robot and passive motion device on wrist rehabilitation for chronic stroke.
abstract: BACKGROUND
  The effect of using robots to improve motor recovery has received increased attention, even though the most effective protocol remains a topic of study.
  
  
  OBJECTIVE
  . The objective was to compare the training effects of treatments on the wrist joint of subjects with chronic stroke with an interactive rehabilitation robot and a robot with continuous passive motion.
  
  
  METHODS
  . This study was a single-blinded randomized controlled trial with a 3-month follow-up. Twenty-seven hemiplegic subjects with chronic stroke were randomly assigned to receive 20-session wrist training with a continuous electromyography (EMG)-driven robot (interactive group, n = 15) and a passive motion device (passive group, n = 12), completed within 7 consecutive weeks. Training effects were evaluated with clinical scores by pretraining and posttraining tests (Fugl-Meyer Assessment [FMA] and Modified Ashworth Score [MAS]) and with session-by-session EMG parameters (EMG activation level and co-contraction index).
  
  
  RESULTS
  . Significant improvements in FMA scores (shoulder/elbow and wrist/hand) were found in the interactive group (P < .05). Significant decreases in the MAS were observed in the wrist and elbow joints for the interactive group and in the wrist joint for the passive group (P < .05). These MAS changes were associated with the decrease in EMG activation level of the flexor carpi radialis and the biceps brachii for the interactive group (P < .05). The muscle coordination on wrist and elbow joints was improved in the interactive groups in the EMG co-contraction indexes across the training sessions (P < .05).
  
  
  CONCLUSIONS
  . The interactive treatment improved muscle coordination and reduced spasticity after the training for both the wrist and elbow joints, which persisted for 3 months. The passive mode training mainly reduced the spasticity in the wrist flexor.
authors.affiliation: Department of Health Technology and Informatics, Hong Kong Polytechnic University, Hong Kong.
authors.forename: Xiao Ling
authors.initials: XL
authors.lastname: Hu
authors.forename: Kai-Yu
authors.initials: KY
authors.lastname: Tong
authors.forename: Rong
authors.initials: R
authors.lastname: Song
authors.forename: Xiu Juan
authors.initials: XJ
authors.lastname: Zheng
authors.forename: Wallace W F
authors.initials: WW
authors.lastname: Leung
mesh_terms: D000465:Algorithms; D002908:Chronic Disease; D004551:Elbow Joint / Q000502:physiology; D004576:Electromyography / Q000379:methods*; D006801:Humans; D008954:Models, Biological; D026741:Physical Therapy Modalities / Q000295:instrumentation*; D016059:Range of Motion, Articular; D020127:Recovery of Function / Q000502:physiology; D012371:Robotics / Q000295:instrumentation*; D012785:Shoulder Joint / Q000502:physiology; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D014955:Wrist Joint / Q000502:physiology*