Robot-assisted training after proximal humeral fracture: A randomised controlled multicentre intervention trial. (February 2021)

• Record Type: Journal Article
• Authors: Kröger, Inga; Nerz, Corinna; Schwickert, Lars; Schölch, Sabine; Müßig, Janina Anna; Studier-Fischer, Stefan; Nolte, Philip-Christian; Becker, Clemens; Augat, Peter
• Is Part Of: Clinical rehabilitation. Volume 35:Number 2(2021)
• Page Start: 242
• Page End: 252
• Publication Date: 2021-02
• Subjects: Robot-assisted rehabilitation -- humeral fracture -- occupational and physiotherapy -- robotics -- patient reported outcomes; Medical rehabilitation -- Periodicals; 617.03
• DOI: 10.1177/0269215520961654
• Languages: English
• ISSNs: 0269-2155

Abstract

Objective: To examine whether robotic-assisted training as a supplement to usual therapy is safe, acceptable and improves function and patient reported outcome after proximal humeral fractures (PHF). Design: Multicentre, assessor-blinded, randomised controlled prospective trial. Setting: Three different rehabilitation hospitals in Germany. Subjects: In total 928 PHF patients between 35 and 70 years were screened. Forty-eight participants were included in the study (intervention group n = 23; control group n = 25). Intervention: The control group received usual occupational and physiotherapy over three weeks, and the intervention group received additional 12 robot-assisted training sessions at the ARMEO ® -Spring. Main measures: Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), the Wolf Motor Function Test-Orthopaedic, active range of motion and grip strength were determined before and after intervention period. The DASH was additionally obtained postal 6 and 13 months following surgery. Results: The mean age of participants was 55 ± 10 years and was similar in both groups ( p > 0.05). The change in DASH as the primary endpoint in the intervention group after intervention was −15 (CI = 8–22), at follow-up six month −7 (CI = −2 to 16) at follow up 13 month −9 (CI = 1–16); in control group −14 (CI = 11–18), at follow-up six month −13 (CI = 7–19) at follow up 13 month −6 (CI = −3 to 14). No difference in the change was found between groups ( p > 0.05). None of the follow-up time points demonstrated an additional benefit of the robotic therapy. Conclusion: The additional robot-assisted therapy was safe, acceptable but showed no improvement in functional shoulder outcome compared to usual therapy only.