Case Report| Volume 36, ISSUE 1, P234-240, January 2023

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The effect of Electromyography (EMG)-driven Robotic Treatment on the recovery of the hand Nine years after stroke

Published:April 27, 2021DOI:


      • There is a need for new studies in stroke cases that are quite chronic.
      • It may be beneficial to support subjective evaluations used in stroke rehabilitation with objective evaluations such as electrophysiological measurements.
      • The robotic rehabilitation system has some advantages, such as providing high repetitive activities, compared to the traditional rehabilitation approaches.
      • In stroke rehabilitation, it should be aimed to transfer the gains obtained after the treatment to daily life.


      To investigate the effect of electromyography (EMG)-driven robotic therapy on the recovery of the hand in a stroke case lasting 9 years.


      An 18-year-old patient with hemiparesis due to the ischemic lesion was admitted to our clinic with hand impairment. Fifteen sessions (5 weeks x 3 times) of robotic rehabilitation were applied with the Hand of Hope. Average EMG (mV) of flexor digitorum superficialis (FDS) muscle, average force (N) and the rate of force development (RFD)(N/s) were also assessed before and after the treatment following the 5th and 10th sessions and at the end of treatment. Also, Fugl-Meyer Assessment of Upper Extremity Scale (FMU-UE), Motor Activity Log (MAL), Canadian Occupational Performance Score (COPM) and Visual Analog Scale (VAS) were used for assessment before and after the treatment.


      The average EMG measured from FDS increased from 0.093-0.133 mV. The average force and average RFD increased from 45.6-97.7 and from 135.6-172.6 respectively. While affected and/or unaffected side force ratio increased dramatically from 54%-82%, the FMA-UE score increased from 56-59. The MAL quality of use score increased from 3.93-4.13. Performance and satisfaction scores of COPM changed from 5.25-7.25 and 4.5-8.25 respectively. VAS score for fatigue changed from 6 to 4.


      The improvement achieved 9 years later with 15 sessions of rehabilitation suggests that improvement may be possible for chronic stroke patients.


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      JHT Read for Credit

      Quiz: # 926

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to There is only one best answer for each question.
      • # 1.
        The study design is
        • a.
        • b.
        • c.
          case series
        • d.
          case study
      • # 2.
        Outcome measures included
        • a.
          NCV of both median and ulnar nerves
        • b.
          Semmes Weinstein monofilaments for sensibility
        • c.
          RFD (N/s) & EMG (mV)
        • d.
          JAMAR dynamometry
      • # 3.
        The intervention consisted of _________ sessions
        • a.
        • b.
        • c.
        • d.
      • # 4.
        The patient's chief complaint prior to use of the robotic device was
        • a.
          limited ROM
        • b.
          limited function
        • c.
          limited sensibility
        • d.
      • # 5.
        While the results of the robotic intervention were positive and encouraging, the device is not being presented as “ready for routine clinical use”
        • a.
          not true
        • b.
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.