The impact of robotic hand rehabilitation on hand function and fatigue in patients with stroke (RoHa-S)

Objective: Considering the wide use of technology and robotics in rehabilitation, this study investigates the potential impact of robotic rehabilitation with the robot end-effector Amadeo® on hand function and its possible effects on fatigue in patients with stroke outcomes. Methods: This is a single blind, randomized-controlled pilot study. Twenty-four patients were randomly assigned to the experimental group (G-AMA) for robotic rehabilitation with Amadeo® and conventional rehabilitation, or the control group (G-CON) for conventional rehabilitation. All patients received 45-minute rehabilitation thrice a week for four weeks. Clinical measures for motor function, spasticity, autonomy, quality of life, and fatigue were used to assess all patients at baseline and end of treatment. Instrumental assessment included Amadeo® force and range of motion (ROM) measurements. Results: Considering clinical evaluations, all patients indifferent to the group showed statistically significant improvement at the end of treatment. Comparison between groups showed a statistically significant difference in motor function (p < 0.001), autonomy (p < 0.001) and fatigue (p < 0.001). Regarding instrumental assessment, only G-AMA patients showed statistically significant differences in several parameters, especially considering the percent ROM of individual fingers and hand; inter-group comparison showed a significant difference in hand extension strength (p = 0.042) and percent ROM of individual fingers (p < 0.001) and hand (p < 0.001). Conclusions: This study suggests that robotic hand treatment with Amadeo®, combined with traditional methods, reduces fatigue in stroke patients with hand impairments. Therapeutic combinations of new technologies and conventional approaches can improve rehabilitation outcomes and patients’ quality of life, transforming post-stroke rehabilitation and other disorders.