ROBOT-assisted stroke rehabilitation significantly improved upper limb motor recovery compared with conventional cognitive rehabilitation in patients with chronic stroke, according to a randomised controlled trial.
The single-centre exploratory trial included 30 patients with stroke, who were randomly assigned to either an intervention group or a control group. Each group included 15 participants.
The intervention involved robot-assisted integrated cognitive-motor training using an end-effector system. Sessions combined goal-directed reaching exercises with tasks designed to engage attention, memory, and executive function. Participants completed 10 sessions of 30 minutes over 3 weeks.
The control group received conventional paper-based cognitive rehabilitation matched for treatment time and dose.
The study assessed global cognitive function using the Korean Mini-Mental State Examination (MMSE) and the Korean Montreal Cognitive Assessment (MoCA). Secondary measures included cognitive subdomains, upper limb motor function, and functional independence.
Both groups demonstrated significant improvements in MMSE and MoCA scores. However, the researchers found no statistically significant differences between the groups for either measure.
Similar patterns were observed across the secondary cognitive assessments. Although improvements were seen within both groups in several Cognitive Assessment Screening Test (CERAD) subdomains, these differences were no longer statistically significant between groups after adjustment using the False Discovery Rate method.
The clearest difference between the groups was observed in upper limb motor recovery. Scores on the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) increased from 33.6 to 37.5 in the robot-assisted group. In comparison, scores changed from 25.7 to 25.9 in the control group.
The between-group difference was statistically significant (p=0.012; Cohen’s d=0.98).
The researchers concluded that robot-assisted integrated cognitive-motor rehabilitation was feasible and safe for patients with chronic stroke. While the approach produced cognitive improvements comparable to conventional rehabilitation, it was associated with superior upper limb motor recovery.
The findings suggest that combining cognitive tasks with goal-directed motor training could support motor rehabilitation after stroke. However, the study’s small sample size and exploratory design mean that larger trials are needed to establish whether the approach provides additional cognitive benefits over conventional rehabilitation.
Cha S et al. Robot-assisted integrated cognitive-motor rehabilitation in patients with chronic stroke: a randomized controlled trial. Front Neurol. 2026;17:1866135.
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