Robotic-Assisted Shoulder Rehabilitation Therapy Effectively Improved Poststroke Hemiplegic Shoulder Pain: A Randomized Controlled Trial

Min-Su Kim; Sung Hoon Kim; Se-Eung Noh; Heui Je Bang; Kyoung-Moo Lee

doi:10.1016/j.apmr.2019.02.003

Robotic-Assisted Shoulder Rehabilitation Therapy Effectively Improved Poststroke Hemiplegic Shoulder Pain: A Randomized Controlled Trial

Arch Phys Med Rehabil. 2019 Jun;100(6):1015-1022. doi: 10.1016/j.apmr.2019.02.003. Epub 2019 Mar 13.

Authors

Min-Su Kim¹, Sung Hoon Kim², Se-Eung Noh¹, Heui Je Bang³, Kyoung-Moo Lee⁴

Affiliations

¹ Department of Rehabilitation Medicine, Wonkwang University School of Medicine and Institute of Wonkwang Medical Science, Iksan, Republic of Korea.
² Department of Electronics Convergence Engineering, Wonkwang University School of Engineering, Iksan, Republic of Korea.
³ Department of Rehabilitation Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.
⁴ Department of Rehabilitation Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea. Electronic address: kmsgat@gmail.com.

PMID: 30878496
DOI: 10.1016/j.apmr.2019.02.003

Abstract

Objective: The purpose of this study was to investigate the therapeutic effects of a newly developed shoulder robot on poststroke hemiplegic shoulder pain.

Design: Prospective, single-blind randomized controlled trial.

Setting: Inpatient department of a tertiary university hospital.

Participants: Hemiplegic shoulder pain patients (N=38) were consecutively recruited and randomly assigned to an intervention or control group.

Interventions: A newly developed robot was designed to perform joint mobilization and stretching exercises with patients lying in the supine position. Conventional physical therapy directed at both improving upper extremity mechanics and reducing neurologic injury was performed twice per day in both groups. In the intervention group, additional robotic-assisted shoulder rehabilitation therapy was administered for 30 minutes per day, 5 times per week for 4 weeks.

Main outcome measures: The visual analog scale was the primary outcome, and the pain-free passive range of motion of the shoulder joint, the Korean version of the Shoulder Disability Questionnaire, and ultrasonographic grades were the secondary outcomes. The outcomes were evaluated at baseline (T0), postintervention (T1), and a 4-week follow-up (T2).

Results: Significant time and group interaction effects were found on the visual analog scale, in the abduction passive range of motion, and on the Shoulder Disability Questionnaire (F_2,33=16.384, P=.002; F_2,33=10.609, P=.012; F_2,33=32.650, P=.008, respectively). Significantly higher improvements in these outcome measures were observed in the intervention group than in the control group at T1 after post hoc analysis (P<0.05, all). These improvements were sustained at T2 when the intervention group was compared with the control group (P<.05, all).

Conclusions: A prototype shoulder rehabilitation robot as an adjuvant therapy improves hemiplegic shoulder pain and self-reported shoulder-related disability.

Keywords: Musculoskeletal manipulations; Pain; Rehabilitation; Robotics; Shoulder; Stroke.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Disability Evaluation
Female
Hemiplegia / etiology
Hemiplegia / rehabilitation*
Humans
Male
Middle Aged
Motion Therapy, Continuous Passive / instrumentation
Motion Therapy, Continuous Passive / methods*
Muscle Stretching Exercises / methods
Pain Measurement
Prospective Studies
Range of Motion, Articular
Robotics
Shoulder Joint / physiopathology
Shoulder Pain / etiology
Shoulder Pain / rehabilitation*
Single-Blind Method
Stroke / complications
Stroke Rehabilitation / instrumentation
Stroke Rehabilitation / methods*

Associated data

CTRI/KCT0002696