Supplemental Digital Content is Available in the Text. Background and Purpose: After stroke, only 12% of survivors obtain complete upper limb (UL) functional recovery, while in 30% to 60% UL deficits persist. Despite the complexity of the UL, prior robot-mediated therapy research has used only one robot in comparisons to conventional therapy. We evaluated the efficacy of robotic UL treatment using a set of 4 devices, compared with conventional therapy. Methods: In a multicenter, randomized controlled trial, 247 subjects with subacute stroke were assigned either to robotic (using a set of 4 devices) or to conventional treatment, each consisting of 30 sessions. Subjects were evaluated before and after treatment, with follow-up assessment after 3 months. The primary outcome measure was change from baseline in the Fugl-Meyer Assessment (FMA) score. Secondary outcome measures were selected to assess motor function, activities, and participation. Results: One hundred ninety subjects completed the posttreatment assessment, with a subset (n = 122) returning for follow-up evaluation. Mean FMA score improvement in the robotic group was 8.50 (confidence interval: 6.82 to 10.17), versus 8.57 (confidence interval: 6.97 to 10.18) in the conventional group, with no significant between-groups difference (adjusted mean difference −0.08, P = 0.948). Both groups also had similar change in secondary measures, except for the Motricity Index, with better results for the robotic group (adjusted mean difference 4.42, P = 0.037). At follow-up, subjects continued to improve with no between-groups differences. Discussion and Conclusions: Robotic treatment using a set of 4 devices significantly improved UL motor function, activities, and participation in subjects with subacute stroke to the same extent as a similar amount of conventional therapy. Video Abstract is available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A291).

中文翻译：

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中风后上肢机器人康复

补充数字内容在文本中可用。背景和目的：中风后，只有 12% 的幸存者获得完全上肢 (UL) 功能恢复，而 30% 至 60% 的 UL 缺陷持续存在。尽管 UL 很复杂，但与传统治疗相比，先前的机器人介导治疗研究仅使用了一个机器人。与常规治疗相比，我们使用一组 4 台设备评估了机器人 UL 治疗的功效。方法：在一项多中心、随机对照试验中，247 名亚急性卒中受试者被分配到机器人（使用一组 4 台设备）或常规治疗组，每组包括 30 个疗程。治疗前后对受试者进行评估，3个月后进行随访评估。主要结果指标是 Fugl-Meyer 评估 (FMA) 评分相对于基线的变化。选择次要结果测量来评估运动功能、活动和参与。结果：190 名受试者完成了治疗后评估，其中一个子集 (n = 122) 返回进行后续评估。机器人组的平均 FMA 评分改善为 8.50（置信区间：6.82 至 10.17），而常规组为 8.57（置信区间：6.97 至 10.18），组间差异不显着（调整后的平均差异 -0.08，P = 0.948）。除了运动指数外，两组在次要测量方面也有类似的变化，机器人组的结果更好（调整后的平均差为 4.42，P = 0.037）。在随访中，受试者继续改善，没有组间差异。讨论和结论：使用一组 4 个设备的机器人治疗显着改善了亚急性中风受试者的 UL 运动功能、活动和参与，其程度与常规治疗的量相同。视频摘要可从作者那里获得更多见解（参见视频，补充数字内容 1，可在：http://links.lww.com/JNPT/A291 上获得）。