Evidence map›Paper›PMID 37109287›Full record

ArticleJournal of clinical medicine2023

Effects of Uni- vs. Bilateral Upper Limb Robot-Assisted Rehabilitation on Motor Function, Activities of Daily Living, and Electromyography in Hemiplegic Stroke: A Single-Blinded Three-Arm Randomized Controlled Trial.

Runping Yuan, Xu Qiao, Congzhi Tang, Ting Zhou, Wenli Chen, Ruyan Song, Yong Jiang, Jan D Reinhardt, Hongxing Wang

Open access · goldAbstract read
In one paragraph

Article in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 4 pooled it
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 4 syntheses or guidelines pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
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  5. Trial
  6. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 3 countries.

Runping YuanGraduate School of Bengbu Medical College, Bengbu 233030, China.
Xu QiaoInstitute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Sichuan University, Chengdu 610041, China.ORCID 0000-0001-7417-7034
Congzhi TangSoutheast University Zhongda Hospital, Nanjing 210003, China.
Ting ZhouSoutheast University Zhongda Hospital, Nanjing 210003, China.
Wenli ChenSoutheast University Zhongda Hospital, Nanjing 210003, China.
Ruyan SongSoutheast University Zhongda Hospital, Nanjing 210003, China.
Yong JiangThe First Affiliated Hospital of Bengbu Medical College, Bengbu 233099, China.
Jan D ReinhardtInstitute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Sichuan University, Chengdu 610041, China.
Hongxing WangSoutheast University Zhongda Hospital, Nanjing 210003, China.
Zhongda Hospital Southeast University · CNHong Kong Polytechnic University · HKBengbu Medical College · CNFirst Affiliated Hospital of Bengbu Medical College · CN

Funding

This work was supported by grants from the National Key Research and Development Program of China, Jiangsu Key Research and Development Program ( and Horizontal Project of Nanjing Estun Co., LTD fund (Grant No.:2022YFC2009700)(BE2020718) (H202120503).
6 · The paper itself

Abstract

objectiveTo evaluate if bilateral or unilateral upper limb robot-assisted rehabilitation training using a new three-dimensional end-effector robot that targets shoulder and elbow flexion and abduction is superior to conventional therapy with regard to upper extremity motor function recovery and neuromuscular improvement in stroke patients.

designRandomized, controlled, parallel, assessor-blinded, three-arm clinical trial.

settingSoutheast University Zhongda Hospital Nanjing, Jiangsu, China.

methodsSeventy patients with hemiplegic stroke were randomly assigned to conventional training (Control, n = 23) or unilateral (URT, n = 23), or bilateral robotic training (BRT, n = 24). The conventional group received routine rehabilitation, 60 min/day, 6 days/week, for 3 weeks. For URT and BRT upper limb robot-assisted rehabilitation training was added. This was 60 min/day, 6 days/week, for 3 weeks. The primary outcome was upper limb motor function assessed with Fugl-Meyer-Upper Extremity Scale (FMA-UE). Secondary outcomes were activities of daily living (ADL) assessed with the Modified Barthel Index (MBI), Motor Evoked Potential (MEP) to assess corticospinal tract connectivity, Root Mean Square (RMS) value, and integrate Electromyography (iEMG) value recorded by surface electromyography to evaluate muscle contraction function.

resultsThe primary outcome indicator FMA-UE (least square mean (LSMEAN): 31.40, 95% confidence interval (95% CI): 27.74-35.07) and the secondary outcome indicator MBI (LSMEAN: 69.95, 95% CI: 66.69-73.21) were significantly improved in BRT as opposed to control (FMA-UE, LSMEAN: 24.79, 95% CI: 22.23-27.35; MBI, LSMEAN: 62.75, 95% CI: 59.42-66.09); and unilateral (FMA-UE, LSMEAN: 25.97, 95% CI: 23.57-28.36; MBI, LSMEAN: 64.34, 95% CI: 61.01-67.68). BRT also showed greater improvement in the anterior deltoid bundle with regard to muscle contraction function indicated by RMS (LSMEAN: 257.79, 95% CI: 211.45-304.12) and iEMG (LSMEAN: 202.01, 95% CI: 167.09-236.94), as compared to the controls (RMS, LSMEAN: 170.77, 95% CI: 148.97-192.58; iEMG, LSMEAN: 132.09, 95% CI: 114.51-149.68), and URT (RMS, LSMEAN: 179.05, 95% CI: 156.03-202.07; iEMG, LSMEAN: 130.38, 95% CI: 107.50-153.26). There was no statistically significant difference between URT and conventional training for any outcome. There was no significant difference in MEP extraction rate after treatment between groups (

conclusionsA 60 min daily training for upper extremities using a three-dimensional end-effector targeting elbow and shoulder adding conventional rehabilitation appears to promote upper limb function and ADL in stroke patients only if delivered bilaterally. URT does not seem to result in better outcomes than conventional rehabilitation. Electrophysiological results suggest that training using a bilateral upper limb robot increases the recruitment of motor neurons rather than improving the conduction function of the corticospinal tract.

Indexed as

motor evoked potentialmotor functionstrokesurface electromyographyupper limb robot-assisted rehabilitation

Identifiers

PMID37109287
PMCPMC10143606
OpenAlexW4366420854

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.