Effect of 3-Dimensional Robotic Therapy Combined with Electromyography-Triggered Neuromuscular Electrical Stimulation on Upper Limb Function and Cerebral Cortex Activation in Stroke Patients: A Randomized Controlled Trial.

(1) Background: This study investigated the effect of 3-dimensional robotic therapy (RT) combined with electromyography-triggered neuromuscular electrical stimulation (RT-ENMES) on stroke patients' upper-limb function and cerebral cortex activation. (2) Methods: Sixty-one stroke patients were assigned randomly to one of three groups. The stroke patients were in the subacute stage between 2 and 6 months after onset. The three groups received 20 min of RT and 20 min of electromyography-triggered neuromuscular electrical stimulation (ENMES) in the RT-ENMES group (n = 21), 40 min of RT in the RT group (n = 20), and 40 min of ENMES in the ENMES group (n = 20). The treatments were for 40 min, 5 days per week, and for 8 weeks. Upper-extremity function was evaluated using the Fugl-Meyer assessment for upper extremity (FMA-UE), Wolf motor function test, and action research arm test (ARAT); cerebral cortex activation and motor-evoked potential (MEP) amplitude were evaluated before and after the study. (3) Results: The analysis showed significant changes in all evaluation items for all three groups in the before-and-after comparisons. Significant changes were observed in the FMA-UE, ARAT, and MEP; in the posttest, the RT-ENMES group showed more significant changes in the FMA-UE, ARAT, and MEP than the other two groups. (4) Conclusions: The study analysis suggests that RT-ENMES effectively improves upper-limb function and cerebral cortex activation in patients with stroke.