Rehabilitation training robot using mirror therapy for the upper and lower limb after stroke: a prospective cohort study

Abstract Background This prospective cohort study was designed to investigate and compare the effectiveness of rehabilitation training robots versus conventional rehabilitation training on stroke survivors by monitoring alterations in brain network of stroke patients before and after robot intervent...

Full description

Saved in:
Bibliographic Details
Main Authors: Xixi Wu, Xu Qiao, Yudi Xie, Qingyan Yang, Wenting An, Lingfeng Xia, Jiatao Li, Xiao Lu
Format: Article
Language:English
Published: BMC 2025-03-01
Series:Journal of NeuroEngineering and Rehabilitation
Subjects:
Online Access:https://doi.org/10.1186/s12984-025-01590-3
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850029936680632320
author Xixi Wu
Xu Qiao
Yudi Xie
Qingyan Yang
Wenting An
Lingfeng Xia
Jiatao Li
Xiao Lu
author_facet Xixi Wu
Xu Qiao
Yudi Xie
Qingyan Yang
Wenting An
Lingfeng Xia
Jiatao Li
Xiao Lu
author_sort Xixi Wu
collection DOAJ
description Abstract Background This prospective cohort study was designed to investigate and compare the effectiveness of rehabilitation training robots versus conventional rehabilitation training on stroke survivors by monitoring alterations in brain network of stroke patients before and after robot intervention. Methods Between September 2020 and November 2021, stroke patients at four grade-A tertiary hospitals underwent limb rehabilitation training. Of the total of participants, 117 patients received conventional limb rehabilitation, 93 patients participated in upper-limb robot training, and 103 patients underwent lower-limb robot training. The measured outcomes included modified Barthel Index (MBI), Fugl-Meyer assessment subscale (FMA), and manual muscle testing (MMT). Functional magnetic resonance imaging (fMRI) was conducted on 30 patients to assess changes in the brain network. Data were mainly analyzed based on the Intention-to-Treat (ITT) principle. Results Post-interventional analysis utilizing linear mixed models in ITT analysis revealed that the robot training group had greater enhancements compared to the conventional limb rehabilitation training group. Notably, the shoulder flexor strength (P = 0.043) was significantly higher in the upper-limb group. On the other hand, hip flexor strength (P < 0.001), hip extensor strength (P < 0.001), knee extensor strength (P = 0.013), ankle dorsiflexion strength (P < 0.001) and ankle plantarflexor strength (P < 0.001) were significantly higher in the lower-limb group. In the upper-limb group, region-of-interest (ROI) -to-ROI analysis revealed enhanced functional connectivity between the left hemisphere’s motor control region and the auditory network. ROI-to-ROI analysis primarily showed enhanced interhemispheric functional connectivity in the lower-limb group, specifically between right the hemisphere’s motor control region (central opercular cortex) and left hemisphere’s primary motor area in the precentral gyrus. Conclusions According to our research findings, upper- and lower-limb rehabilitation robots demonstrated great potential in promoting motor function recovery in stroke patients. Robot-assisted training offers an alternative treatment method with comparable efficacy to traditional rehabilitation. Large-scale randomized controlled trials are needed to confirm these results. Trial registration : The study was registered on the Chinese Clinical Trial Registry (ChiCTR1800019783).
format Article
id doaj-art-3c256fcd62a7422a9e2a0ee80b8d2f2f
institution DOAJ
issn 1743-0003
language English
publishDate 2025-03-01
publisher BMC
record_format Article
series Journal of NeuroEngineering and Rehabilitation
spelling doaj-art-3c256fcd62a7422a9e2a0ee80b8d2f2f2025-08-20T02:59:23ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032025-03-0122112110.1186/s12984-025-01590-3Rehabilitation training robot using mirror therapy for the upper and lower limb after stroke: a prospective cohort studyXixi Wu0Xu Qiao1Yudi Xie2Qingyan Yang3Wenting An4Lingfeng Xia5Jiatao Li6Xiao Lu7The First Affiliated Hospital of Nanjing Medical UniversityChengdu Center for Disease Control & PreventionThe First Affiliated Hospital of Nanjing Medical UniversityThe First Affiliated Hospital of Nanjing Medical UniversityThe First Affiliated Hospital of Nanjing Medical UniversityThe First Affiliated Hospital of Nanjing Medical UniversityThe First Affiliated Hospital of Nanjing Medical UniversityThe First Affiliated Hospital of Nanjing Medical UniversityAbstract Background This prospective cohort study was designed to investigate and compare the effectiveness of rehabilitation training robots versus conventional rehabilitation training on stroke survivors by monitoring alterations in brain network of stroke patients before and after robot intervention. Methods Between September 2020 and November 2021, stroke patients at four grade-A tertiary hospitals underwent limb rehabilitation training. Of the total of participants, 117 patients received conventional limb rehabilitation, 93 patients participated in upper-limb robot training, and 103 patients underwent lower-limb robot training. The measured outcomes included modified Barthel Index (MBI), Fugl-Meyer assessment subscale (FMA), and manual muscle testing (MMT). Functional magnetic resonance imaging (fMRI) was conducted on 30 patients to assess changes in the brain network. Data were mainly analyzed based on the Intention-to-Treat (ITT) principle. Results Post-interventional analysis utilizing linear mixed models in ITT analysis revealed that the robot training group had greater enhancements compared to the conventional limb rehabilitation training group. Notably, the shoulder flexor strength (P = 0.043) was significantly higher in the upper-limb group. On the other hand, hip flexor strength (P < 0.001), hip extensor strength (P < 0.001), knee extensor strength (P = 0.013), ankle dorsiflexion strength (P < 0.001) and ankle plantarflexor strength (P < 0.001) were significantly higher in the lower-limb group. In the upper-limb group, region-of-interest (ROI) -to-ROI analysis revealed enhanced functional connectivity between the left hemisphere’s motor control region and the auditory network. ROI-to-ROI analysis primarily showed enhanced interhemispheric functional connectivity in the lower-limb group, specifically between right the hemisphere’s motor control region (central opercular cortex) and left hemisphere’s primary motor area in the precentral gyrus. Conclusions According to our research findings, upper- and lower-limb rehabilitation robots demonstrated great potential in promoting motor function recovery in stroke patients. Robot-assisted training offers an alternative treatment method with comparable efficacy to traditional rehabilitation. Large-scale randomized controlled trials are needed to confirm these results. Trial registration : The study was registered on the Chinese Clinical Trial Registry (ChiCTR1800019783).https://doi.org/10.1186/s12984-025-01590-3StrokeRehabilitation robotCohort studyMotor recovery
spellingShingle Xixi Wu
Xu Qiao
Yudi Xie
Qingyan Yang
Wenting An
Lingfeng Xia
Jiatao Li
Xiao Lu
Rehabilitation training robot using mirror therapy for the upper and lower limb after stroke: a prospective cohort study
Journal of NeuroEngineering and Rehabilitation
Stroke
Rehabilitation robot
Cohort study
Motor recovery
title Rehabilitation training robot using mirror therapy for the upper and lower limb after stroke: a prospective cohort study
title_full Rehabilitation training robot using mirror therapy for the upper and lower limb after stroke: a prospective cohort study
title_fullStr Rehabilitation training robot using mirror therapy for the upper and lower limb after stroke: a prospective cohort study
title_full_unstemmed Rehabilitation training robot using mirror therapy for the upper and lower limb after stroke: a prospective cohort study
title_short Rehabilitation training robot using mirror therapy for the upper and lower limb after stroke: a prospective cohort study
title_sort rehabilitation training robot using mirror therapy for the upper and lower limb after stroke a prospective cohort study
topic Stroke
Rehabilitation robot
Cohort study
Motor recovery
url https://doi.org/10.1186/s12984-025-01590-3
work_keys_str_mv AT xixiwu rehabilitationtrainingrobotusingmirrortherapyfortheupperandlowerlimbafterstrokeaprospectivecohortstudy
AT xuqiao rehabilitationtrainingrobotusingmirrortherapyfortheupperandlowerlimbafterstrokeaprospectivecohortstudy
AT yudixie rehabilitationtrainingrobotusingmirrortherapyfortheupperandlowerlimbafterstrokeaprospectivecohortstudy
AT qingyanyang rehabilitationtrainingrobotusingmirrortherapyfortheupperandlowerlimbafterstrokeaprospectivecohortstudy
AT wentingan rehabilitationtrainingrobotusingmirrortherapyfortheupperandlowerlimbafterstrokeaprospectivecohortstudy
AT lingfengxia rehabilitationtrainingrobotusingmirrortherapyfortheupperandlowerlimbafterstrokeaprospectivecohortstudy
AT jiataoli rehabilitationtrainingrobotusingmirrortherapyfortheupperandlowerlimbafterstrokeaprospectivecohortstudy
AT xiaolu rehabilitationtrainingrobotusingmirrortherapyfortheupperandlowerlimbafterstrokeaprospectivecohortstudy