Stroke is a leading cause of disability worldwide, often resulting in upper limb impairments that hinder daily living activities. While conventional rehabilitation methods focus on motor recovery, recent advancements in robotic rehabilitation offer promising alternatives. This study aimed to evaluate the effects of hand robot-assisted rehabilitation on functionality, fine motor skills, and daily living activities in patients with acute stroke. A parallel-group, single-blind, randomized controlled trial was conducted with 30 stroke patients aged between 40 and 60. Participants were randomly assigned to either the Robotic Hand Rehabilitation (RHR) Group or the Neurodevelopmental Therapy (NT) Group, with both groups undergoing an 8-week rehabilitation program. Primary outcomes were hand function, assessed by the ABILHAND questionnaire, and fine motor skills, measured using the Nine Hole Peg Test (NHPT). Secondary outcomes included activities of daily living evaluated by the Barthel Index (BI), upper limb disability measured by the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, and spasticity assessed via the Modified Ashworth Scale (MAS). All assessments were performed before and after the intervention period. Both groups demonstrated significant improvements in all functional parameters except spasticity (p < 0.05). However, the RHR group showed significantly greater improvements in fine motor skills (NHPT improvement: 4.44 ± 1.18 s vs. 1.93 ± 0.90 s, p < 0.001), hand function (ABILHAND: 7.27 ± 1.39 vs. 4.87 ± 2.23, p = 0.002), and daily living activities (BI: 16.33 ± 2.97 vs. 7.67 ± 4.95, p < 0.001) compared to the NT group. There was no significant difference in spasticity outcomes between the two groups (p > 0.05). The findings suggest that hand robot-assisted rehabilitation is an effective complementary approach in acute stroke rehabilitation, particularly for enhancing fine motor control and daily living function. Given these benefits, robotic hand therapy may serve as a valuable adjunct to conventional neurodevelopmental therapy, supporting improved motor recovery in individuals with acute stroke. Further research is needed to investigate its long-term effectiveness and optimal integration within rehabilitation programs.
The study was registered retrospectively at ClinicalTrials.gov (trial number NCT06805955) on 03/02/2025.
Supplementary Information: The online version contains supplementary material available at 10.1038/s41598-025-32258-6.
Keywords: Daily living activities; Fine motor skills; Hand function; Neurodevelopmental therapy; Robotic therapy; Stroke rehabilitation.