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Title: A comparison between electromyography-driven robot and passive motion device on wrist rehabilitation for chronic stroke
Authors: Hu, X
Tong, KYR
Song, R
Zheng, XJ
Leung, WFW 
Issue Date: Oct-2009
Source: Neurorehabilitation and neural repair, Oct. 2009, v. 23, no. 8, p. 837-846
Abstract: Background: The effect of using robots to improve motor recovery has received increased attention, even though the most effective protocol remains a topic of study.
Objective: The objective was to compare the training effects of treatments on the wrist joint of subjects with chronic stroke with an interactive rehabilitation robot and a robot with continuous passive motion.
Methods: This study was a single-blinded randomized controlled trial with a 3-month follow-up. Twenty-seven hemiplegic subjects with chronic stroke were randomly assigned to receive 20-session wrist training with a continuous electromyography (EMG)-driven robot (interactive group, n = 15) and a passive motion device (passive group, n = 12), completed within 7 consecutive weeks. Training effects were evaluated with clinical scores by pretraining and posttraining tests (Fugl-Meyer Assessment [FMA] and Modified Ashworth Score [MAS]) and with session-by-session EMG parameters (EMG activation level and co-contraction index).
Results: Significant improvements in FMA scores (shoulder/elbow and wrist/hand) were found in the interactive group (P < .05). Significant decreases in the MAS were observed in the wrist and elbow joints for the interactive group and in the wrist joint for the passive group (P < .05). These MAS changes were associated with the decrease in EMG activation level of the flexor carpi radialis and the biceps brachii for the interactive group (P < .05). The muscle coordination on wrist and elbow joints was improved in the interactive groups in the EMG co-contraction indexes across the training sessions (P < .05).
Conclusions: The interactive treatment improved muscle coordination and reduced spasticity after the training for both the wrist and elbow joints, which persisted for 3 months. The passive mode training mainly reduced the spasticity in the wrist flexor.
Keywords: Electromyography
Publisher: SAGE Publications
Journal: Neurorehabilitation and neural repair 
ISSN: 1545-9683
EISSN: 1552-6844
DOI: 10.1177/1545968309338191
Rights: © 2009 The Author(s)
The final, definitive version of the article is available on SAGE Journals ( is located at
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