The use of commercial arm robots in supporting stroke patients during their recovery is on the rise. Nearly 80% of patients face challenges with their arm function, making these robots an increasingly appealing solution for addressing healthcare sector resource limitations.
However, research conducted by Amsterdam UMC has revealed that these robots do not yield clinically meaningful benefits for patients.
“In particular countries such as China, Japan, and South Korea, but also in North America and Europe, UL-Robots is seen more and more as the solution for the lack of intensive upper limb training. But our research shows that they really need to be rethought if they are ever to meaningfully contribute to the care package that we can offer,” says Gert Kwakkel, Professor of Neurorehabilitation at Amsterdam UMC and the leader of the study that started in May 2020.
The data from over 4,000 stroke patients participating in 90 studies was analyzed by the researchers to determine the impact of arm robots on stroke rehabilitation. Findings indicate that although there was a slight 3% increase in muscle and arm function, there was no corresponding improvement in arm-hand dexterity.
Additionally, it seems that the costs of healthcare are higher when using a robot compared to traditional treatment with a physiotherapist or occupational therapist.
“Our findings provide robust evidence. This evidence is independent of the type of robot used, the number of weights the robot checks, the cost, and additional features – such as virtual game displays – that have been added to the robot arm,” says Kwakkel, who is also head of research at Amsterdam Rehabilitation Centre Reade.
“With the data of more than 4,000 patients and thousands of treatments, we would have been able to demonstrate the presence of a positive effect of the arm robots. The fact that this did not happen suggests that the arm robots are more of a hype than an actual solution.”
“We saw that arm robots have evolved tremendously over time, but that despite improvements in technology, they have not delivered any improvement for patients over the past two decades. Despite the fact that robots are being used more and more, there is still little evidence to support this. Robots that can completely take over arm and hand functions by using an interface that is directly or indirectly controlled by the brain seem to be more promising when it comes to regaining important functions such as grasping and reaching. However, this development is still in its infancy. For the time being, future research in the field of rehabilitation robotics will have to focus more on better understanding how stroke patients learn to regain their skills,” concludes Kwakkel.
Journal reference:
- Luca De Iaco, Janne M. Veerbeek, Johannes C.F. Ket, and Gert Kwakkel. Upper Limb Robots for Recovery of Motor Arm Function in Patients With Stroke. Neurology, 2024; DOI: 10.1212/WNL.000000000020949