Robotic-assisted Upper Extremity Training in Spinal Cord Injury Patients

Objective: To evaluate the effectiveness of robotic-assisted training of forearm and hand functions in spinal cord injury patients Methods: Forty patients were randomized into robotic and control groups. Both groups received conventional rehabilitation program for four weeks. Moreover, robotic group received robotic rehabilitation program tailored to the patient five times a week (each session of 30 min). Results: There were 20 patients (17 M, 3 F) in the robotic group (mean age of 28,20 ± 9 years) and 20 patients (16 M, 4 F) in the control group (mean age of 31,1 ± 10,2 years). Compared with baseline; although both groups showed improvement with respect to the upper extremity motor score and non-key muscle functions, difference of change was prominent in favor of the robotic group (p=0.002 and p=0.051, respectively). Grip strength (p=0.045) and palmar pinch (p=0.010) values improved only in the robotic group. Improvements in SCIM-III total, SCIM III self care, FIM total and FIM self-care sub scores were statistically significant in the robotic group compared to the control group (Δ) (p=0.010, p=0.002, p=0.040, p=0.008, respectively). SF-36 scores showed significant changes in general health perception (p=0.012), physical functioning (p=0.042), mental health (p=0.029), and vitality subscales p=0.008) only in the robotic group. Conclusion: Robotic rehabilitation applied in addition to the conventional rehabilitation program seems to be effective in improving muscle strength, gripping, SCIM III, FIM, and SF-36 scores. Keywords: Spinal cord injury; robotic rehabilitation; upper extremity; activities of daily living; hand functions