Factors Related to Functional Outcome in Patients with Moderate or Higher Upper Limb Paralysis using ReoGo^®-J – A Retrospective Observational Study –

Abstract

Background: Several guidelines recommend robotic therapy for upper extremity motor paralysis after stroke, but the number of eligible patients is unknown. This study aimed to examine predictors of functional outcomes after robotic therapy in patients with moderate or severe upper extremity paralysis.

Methods: This retrospective observational study included 53 patients with subacute stroke. Patients received daily occupational therapy (OT) for 4 weeks and robotic therapy 3 to 4 times per week for 20 min per session. Binomial logistic regression analysis was performed to estimate predictors of participants with a minimal clinically important difference (MCID) of 9 points or greater in the Fugl-Meyer Assessment of Upper Extremity (FMA-UE) after 4 weeks based on FMA-UE shoulder and elbow forearm scores, days since onset, and amount of OT training. Cutoff values were calculated using receiver operating characteristic curves.

Results: Only the FMA-UE shoulder and elbow forearm score (odds ratio = 0.913, p = 0.014) was a predictor of FMA-UE improvement in MCID after 4 weeks. The cutoff value was calculated to be 12.5 points.

Conclusion: The FMA-UE shoulder and elbow forearm score at the start of interventions may be a useful predictor of functional outcomes after robotic therapy in patients with moderate or severe upper limb motor paralysis after stroke. Furthermore, an FMA shoulder and elbow forearm score of 12.5 might be necessary to show improvement over MCID in the short term.