End-effector (EE) and exoskeleton (Exo) robots have not been directly compared previously. The present study aimed to directly compare EE and Exo robots in chronic stroke patients with moderate-to-severe upper limb impairment. This single-blinded, randomised controlled trial included 38 patients with stroke who were admitted to the rehabilitation hospital. The patients were equally divided into EE and Exo groups. Baseline characteristics, including sex, age, stroke type, brain lesion side (left/right), stroke duration, Fugl–Meyer Assessment (FMA)–Upper Extremity score, and Wolf Motor Function Test (WMFT) score, were assessed. Additionally, impairment level (FMA, motor status score), activity (WMFT), and participation (stroke impact scale [SIS]) were evaluated. There were no significant differences in baseline characteristics between the groups. After the intervention, improvements were significantly better in the EE group with regard to activity and participation (WMFT–Functional ability rating scale, WMFT–Time, and SIS–Participation). There was no intervention-related adverse event. The EE robot intervention is better than the Exo robot intervention with regard to activity and participation among chronic stroke patients with moderate-to-severe upper limb impairment. Further research is needed to confirm this novel finding.

The aim of this study was to evaluate the relationship between the fear of falling, physical performance, and physical characteristics in an elderly population. This study is a cross-sectional study with 883 community dwellers 60 yrs or older from a rural area. They completed surveys and evaluations including demographics, the Korean version of the Falls Efficacy Scale-International, the Short Physical Performance Battery, the timed up and go (TUG) test, grip strength, and bone mineral density. The subjects who had experienced a fall showed lower physical performance than those who had not experienced a fall. Regardless of a previous experience of a fall, the score on the Korean version of the Falls Efficacy Scale-International had a positive correlation with TUG time and negative correlations with the score on the Short Physical Performance Battery, grip strength, and bone mineral density. Compared with the group without the fear of falling, the group with the fear of falling showed a lower score on the Short Physical Performance Battery, longer TUG time, weaker grip strength, and lower bone mineral density. The subjects with osteoporosis showed significantly higher scores on the Korean version of the Falls Efficacy Scale-International. The experience of falls had a significant relationship with the fear of falling and physical performance, and greater fear of falling was related to poorer physical performance, independent of the experience of falls. This result implies that more attention should be paid to seniors with the fear of falling and the experience of falls, and screening and consequent intervention for fall prevention should be warranted in this population. For this purpose, the TUG test may be recommended as a screening tool because TUG time reflects the fear of falling and the experience of falls as well as physical performance.

Kang B, et al. Ann Rehabil Med. 2015 Dec;39(6):957-963. http://dx.doi.org/10.5535/arm.2015.39.6.957

Kim HS, et al. J Korean Med Sci. 2021 Mar;36(12):e80. https://doi.org/10.3346/jkms.2021.36.e80

Kwon JW, et al. Ann Rehabil Med. 2013 Dec;37(6):832-838. http://dx.doi.org/10.5535/arm.2013.37.6.832