Objective: In patients with stroke, the authors tested whether additional s
ensorimotor training of the paralyzed or paretic upper limb delivered by a
robotic device enhanced motor outcome. Methods: Fifty-six patients with str
oke and hemiparesis or hemiplegia received standard poststroke multidiscipl
inary rehabilitation, and were randomly assigned either to receive robotic
training (at least 25 hours) or exposure to the robotic device without trai
ning. Outcomes were assessed by the same masked raters, before treatment be
gan and at the end of treatment, with the upper extremity component of the
Fugl-Meyer Motor Assessment, the Motor Status score, the Motor Power score,
and Functional Independence Measurement. Result: The robot treatment and c
ontrol group had comparable clinical characteristics, lesion size, and pret
reatment impairment scores. By the end of treatment, the robot-trained grou
p demonstrated improvement in motor outcome for the trained shoulder and el
bow (Motor Power score, p < 0.001; Motor Status score, p < 0.01) that did n
ot generalize to untrained wrist and hand. The robot-treated group also dem
onstrated significantly improved functional outcome (Functional Independenc
e Measurement-Motor, p < 0.01). Conclusion: Robot-delivered quantitative an
d reproducible sensorimotor training enhanced the motor performance of the
exercised shoulder and elbow. The robot-treated group also demonstrated imp
roved functional outcome. When added to standard multidisciplinary rehabili
tation, robotics provides novel therapeutic strategies that focus on impair
ment reduction and improved motor performance.