Effectiveness of intelligent robotic-assisted training system combined with repetitive facilitative exercise on upper limb motor function after stroke: a randomized controlled trial

Abstract Background Intelligent robotic-assisted training (IRAT) has been proven to improve upper limb motor function after stroke, but it needs to be combined with other treatment methods to achieve better results. Neuromuscular facilitation manipulation is a common series of therapies for stroke c...

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Main Authors: Jing-Zhi Zhang, Jun Chen, Xiao-Long Liu, Lin-Bo Yan, Si-Mao Xu
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Sports Science, Medicine and Rehabilitation
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Online Access:https://doi.org/10.1186/s13102-025-01234-y
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author Jing-Zhi Zhang
Jun Chen
Xiao-Long Liu
Lin-Bo Yan
Si-Mao Xu
author_facet Jing-Zhi Zhang
Jun Chen
Xiao-Long Liu
Lin-Bo Yan
Si-Mao Xu
author_sort Jing-Zhi Zhang
collection DOAJ
description Abstract Background Intelligent robotic-assisted training (IRAT) has been proven to improve upper limb motor function after stroke, but it needs to be combined with other treatment methods to achieve better results. Neuromuscular facilitation manipulation is a common series of therapies for stroke clinical practice, and the Repetitive facilitative exercise (RFE) developed based on it has been widely applied. This study aims to investigate the effectiveness of IRAT combined with RFE on upper limb motor function in stroke patients. Methods In this three-arm, single-blind randomized controlled trial, 76 patients with stroke were randomly assigned to the IRAT group (n = 25), the RFE group (n = 26) and the conventional therapy (CT) group (n = 25). The IRAT group received IRAT combined with RFE. The RFE group received only RFE. The CT group received conventional therapy. Interventions were administered five times weekly for four weeks. The primary outcome measure was upper limb motor function, assessed using the Fugl-Meyer assessment for upper extremity (FMA-UE) scale. Assessment instruments included with IRAT system provided additional measures, including kinematic reach range (KRR), active participation proportion (APP), trajectory deviation (TD), and trajectory tracking error (TTE). Results Demographic properties differences among the three groups were not significant (p > 0.05). At baseline, the groups did not differ significantly (p > 0.05). FMA-UE, KRR and APP increased significantly (p < 0.05) in all groups. TD and TTE decreased significantly (p < 0.05) in all groups. Post-intervention, the IRAT group showed significantly higher FMA-UE, KRR and APP scores compared to the RFE and CT groups. Additionally, TD and TTE were significantly lower in the IRAT group than in the RFE and CT groups. Conclusion IRAT combined with RFE was more effective in improving the upper limb motor function than RFE or CT after stroke. Trial registration This study was registered at https://www.clinicaltrials.gov/ (NCT06435624; May 24, 2024).
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spelling doaj-art-3e9c3f8be0a84c458c6b843bf4cb5e2a2025-08-20T03:03:29ZengBMCBMC Sports Science, Medicine and Rehabilitation2052-18472025-07-0117111510.1186/s13102-025-01234-yEffectiveness of intelligent robotic-assisted training system combined with repetitive facilitative exercise on upper limb motor function after stroke: a randomized controlled trialJing-Zhi Zhang0Jun Chen1Xiao-Long Liu2Lin-Bo Yan3Si-Mao Xu4Department of Rehabilitation Therapy, Nanjing Mingzhou Rehabilitation HospitalDepartment of Rehabilitation Therapy, Nanjing Mingzhou Rehabilitation HospitalSchool of Electronic Engineering and Automation, Guilin University of Electronic TechnologyNanjing University School of Life SciencesChengdu Sport University School of Sports Medicine and HealthAbstract Background Intelligent robotic-assisted training (IRAT) has been proven to improve upper limb motor function after stroke, but it needs to be combined with other treatment methods to achieve better results. Neuromuscular facilitation manipulation is a common series of therapies for stroke clinical practice, and the Repetitive facilitative exercise (RFE) developed based on it has been widely applied. This study aims to investigate the effectiveness of IRAT combined with RFE on upper limb motor function in stroke patients. Methods In this three-arm, single-blind randomized controlled trial, 76 patients with stroke were randomly assigned to the IRAT group (n = 25), the RFE group (n = 26) and the conventional therapy (CT) group (n = 25). The IRAT group received IRAT combined with RFE. The RFE group received only RFE. The CT group received conventional therapy. Interventions were administered five times weekly for four weeks. The primary outcome measure was upper limb motor function, assessed using the Fugl-Meyer assessment for upper extremity (FMA-UE) scale. Assessment instruments included with IRAT system provided additional measures, including kinematic reach range (KRR), active participation proportion (APP), trajectory deviation (TD), and trajectory tracking error (TTE). Results Demographic properties differences among the three groups were not significant (p > 0.05). At baseline, the groups did not differ significantly (p > 0.05). FMA-UE, KRR and APP increased significantly (p < 0.05) in all groups. TD and TTE decreased significantly (p < 0.05) in all groups. Post-intervention, the IRAT group showed significantly higher FMA-UE, KRR and APP scores compared to the RFE and CT groups. Additionally, TD and TTE were significantly lower in the IRAT group than in the RFE and CT groups. Conclusion IRAT combined with RFE was more effective in improving the upper limb motor function than RFE or CT after stroke. Trial registration This study was registered at https://www.clinicaltrials.gov/ (NCT06435624; May 24, 2024).https://doi.org/10.1186/s13102-025-01234-yIntelligent robotic-assisted trainingRehabilitationRepetitive facilitative exerciseStrokeUpper limb motor function
spellingShingle Jing-Zhi Zhang
Jun Chen
Xiao-Long Liu
Lin-Bo Yan
Si-Mao Xu
Effectiveness of intelligent robotic-assisted training system combined with repetitive facilitative exercise on upper limb motor function after stroke: a randomized controlled trial
BMC Sports Science, Medicine and Rehabilitation
Intelligent robotic-assisted training
Rehabilitation
Repetitive facilitative exercise
Stroke
Upper limb motor function
title Effectiveness of intelligent robotic-assisted training system combined with repetitive facilitative exercise on upper limb motor function after stroke: a randomized controlled trial
title_full Effectiveness of intelligent robotic-assisted training system combined with repetitive facilitative exercise on upper limb motor function after stroke: a randomized controlled trial
title_fullStr Effectiveness of intelligent robotic-assisted training system combined with repetitive facilitative exercise on upper limb motor function after stroke: a randomized controlled trial
title_full_unstemmed Effectiveness of intelligent robotic-assisted training system combined with repetitive facilitative exercise on upper limb motor function after stroke: a randomized controlled trial
title_short Effectiveness of intelligent robotic-assisted training system combined with repetitive facilitative exercise on upper limb motor function after stroke: a randomized controlled trial
title_sort effectiveness of intelligent robotic assisted training system combined with repetitive facilitative exercise on upper limb motor function after stroke a randomized controlled trial
topic Intelligent robotic-assisted training
Rehabilitation
Repetitive facilitative exercise
Stroke
Upper limb motor function
url https://doi.org/10.1186/s13102-025-01234-y
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