Greater recovery of upper-limb function in stroke patients with repetitive functional proprioceptive stimulation compared to robotic mechanotherapy: a quasi-randomized controlled trial

Motor impairments and spastic paresis cause important functional limitations into daily life activities of stroke patients. The application of functional proprioceptive stimulations (FPS), i.e. focal vibration that induce complex kinesthetic sensation of movement, emerges as a promising therapeutic tool inside the neurorehabilitation process. The aim of the current study was to assess the efficacy of multi-segmental FPS in upper-limb function recovery among stroke patients with a Modified Rankin scale score of 3, compared to a standard robotic mechanotherapy rehabilitation protocols, over a three-week rehabilitation period. The design of the study was parallel-group assessor-blinded quasi-RCT. Sixty stroke patients aged 32–76, 1–6 months post-stroke, were divided into an experimental group (EG) and a control group (CG), each with 30 participants. The CG received 12 daily sessions of conventional physical therapy and 12 sessions of robotic mechanotherapy, the EG underwent 12 sessions of FPS in addition to the same conventional therapy. To assess the upper-limb recovery functional scales MRC, MAS, FMA-UE, FAT, ARAT, NPRS were used before and after the intervention. The EG showed a significant improvement in FMA-UE, with a change of 19 points compared to 3 points in the CG (23% vs. 4.5%), exceeding the MCID threshold, primarily due to changes in distal musculature (no changes in CG). MRC distal, MAS, and FMA-UE scores demonstrated significantly higher MCID in the EG. A multiple linear regression identified significant predictors of changes primarily in the EG, mainly time since stroke and initial scores on the respective scale. FPS combined with conventional therapy significantly enhances upper-limb recovery in stroke patients, particularly by improving distal musculature, with time since stroke and initial scores being key predictors of success. Such rehabilitation allows patients to use the upper limb more effectively when performing household activities such as eating, dressing, personal hygiene, etc. The trial was registered on 16.11.2023 at ClinicalTrials.gov, under the registration number NCT06143475.