This study compared the differential efficiency among RMT and RBAT. The result indicated that both two intervention were promising interventions and lead to positive change on patients’ sensorimotor function, daily function, self-efficacy, quality of life, and motor function and retain to 3 months.
On the primary outcomes, the RMT group significantly gained greater benefit on motor ability than the RBAT and a positive trend on sensorimotor function. On the secondary outcomes, the RMT group showed positive trends on IADL and quality of life. On the order hand, RBAT group show a positive trend on the achievement of self-expectation.
Due to the preliminary nature of the study, the findings should be interpreted with caution. Further research may be implemented based on a well-designed randomized controlled trial with a larger sample.
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Figure 1. Flow Chart of the Study Procedure
Figure 2A. Figure 2B.
Figure 2C. Figure 2D.
Figure 2A-D. Experimental Materials and Setting (2A) Bi-Manu-Track – Reha-Stim;
(2B) Mirror Box; (2C) Manu-Track in forearm pronation/supination mode; (2D) Bi-Manu-Track in elbow flexion/extension mode
Figure 2E. Figure 2F.
Figure 2G
Figure 2E-G. (2E) Functional task in mirror therapy; (2F) Functional task in Bilateral arm training; (2G) Transfer Package checklist
Figure 3. Treatment Procedures for two groups
Figure 4. Box-and-whisker plot showing the score changes of FMA-UE in the two study groups.
Figure 5. Box-and-whisker plot showing the score changes of rNSA in the two study groups.
Figure 6. Box-and-whisker plot showing the score changes of MRC in the two study groups.
Figure 7. Box-and-whisker plot showing the score changes of ABILHAND in the two study groups.
Figure 8. Box-and-whisker plot showing the score changes of WMFT-Time in the two study groups.
Figure 9. Box-and-whisker plot showing the score changes of WMFT-Quality in the two study groups.
Figure 10. Box-and-whisker plot showing the score changes of CAHAI in the two study groups.
Figure 11. Box-and-whisker plot showing the score changes of MAL in the two study groups.
Figure 12. Box-and-whisker plot showing the score changes of NEADL in the two study groups.
Figure 13. Box-and-whisker plot showing the score changes of FIM in the two study groups.
Figure 14. Box-and-whisker plot showing the score changes of GAS and FIM in the two study groups.
Figure 15. Box-and-whisker plot showing the score changes of SIS in the two study groups.
Figure 16. Box-and-whisker plot showing the score changes of the ratio of affect arm activity counts in the two study groups.
Table 1. Descriptive and Inferential Statistics of clinical characteristics
Table 2. Descriptive and Inferential Statistics of FMA-UE by group
Pretreatment 30.00(26.50-38.00) .008* 31.67(30.25-35.25) .011* .044^ .487 Posttreatment 42.00(33.50-47.00) 36.50(34.50-41.25)
Proximal
Pretreatment 26.00(23.00-28.50) .007* 27.00(24.25-31.50) .011* .198 .311 Posttreatment 31.00(28.00-33.00) 30.50(27.25-34.50)
Distal
Pretreatment 6.00(3.00-10.50) .011* 6.00(2.00-7.00) .011* .222 .295 Posttreatment 11.00(6.00-16.00) 7.50(4.25-9.00)
Within-group comparison: *p<0.05, when compared with pretreatment
Between-group comparison: ^p<0.05, when RMT group greater than RBAT group
Table 3. Descriptive and Inferential Statistics of FMA-UE from posttreatment to follow-up by group
Posttreatment 40.00 (33.75-50.00) .109 36.00(32.50-49.50) .197 Follow up 38.00 (31.25-48.50) 34.00(27.50-47.50)
Proximal
Posttreatment 32.00 (29.50-33.75) .197 28.00(25.50-37.00) .99 Follow up 30.00 (27.50-33.50) 30.00(25.50-36.50) Distal
Posttreatment 9.00 (3.25-16.25) .414 8.00(6.00-13.50) .273 Follow up 6.50(3.00-16.00) 7.50(3.50-11.00)
Within-group comparison: *p<0.05, when compared with pretreatment
Between-group comparison: ^p<0.05, when RMT group greater than RBAT group
Table 4. Descriptive and Inferential Statistics of rNSA by group
Pretreatment 140.00 (90.00-146.00) .012* 142.00(70.50-146.00) .012* .815 .070 Posttreatment 144.00 (105.00-148.50) 143.50(92.75-150.50)
Temperature
Pretreatment 17.00 (10.00-18.00) .026* 17.00 (2.5-18.00) .141 .321 .304 Posttreatment 18.00 (13.50-18.00) 18.00 (4.5-18.00)
Tactile Sensation
Pretreatment 97.00(63.50-106.00) .012* 101.00(53.00-105.75) .028* .370 .240 Posttreatment 104.00(75.00-107.00) 104.00(74.75-105.75)
Proprioception
Pretreatment 20.00(17.50-21.00) .012* 19.50(12.50-21.00) .317 .815 .070 Posttreatment 21.00(19.50-21.00) 21.00(12.50-21.00)
Stereognosis
Pretreatment 21.00(9.00-22.00) <.99 21.00(3.25-22.00) .257 .423 .233 Posttreatment 22.00(8.50-22.00) 21.50(3.75-22.00)
Within-group comparison: *p<0.05, when compared with pretreatment
Between-group comparison: ^p<0.05, when RMT group greater than RBAT group
Table 5. Descriptive and Inferential Statistics of MRC by group Posttreatment 3.50 (2.37-4.13) 3.5 (2.94-3.72)
Proximal
Pretreatment 3.28 (2.37-4.25) .018* 3.65 (2.63-4.69) .027* .883 .031 Posttreatment 3.77 (2.75-4.75) 4.13 (3.56-4.94)
Distal
Pretreatment 2.44 (1.63-2.63) .105 2.59 (2.06-2.88) .66 .433 .19 Posttreatment 2.75 (2.00-3.63) 2.65 (2.06-3.38)
continued from previous page
Within-group comparison: *p<0.05, when compared with pretreatment
Between-group comparison: ^p<0.05, when RMT group greater than RBAT group
Table 6. Descriptive and Inferential Statistics of ABILHAND by group ABILHAND RMT, Median (Q1–Q3)
n=9
p RBAT, Median (Q1–Q3) n=8
p
Mann-Whitney U p
Effect size r Overall
Pretreatment 24.00(21.00-47.50) .011* 28.50(16.75-39.75) .012* .499 .164 Posttreatment 47.00 (33.00-55.00) 42.00(28.50-48.50)
Within-group comparison: *p<0.05, when compared with pretreatment
Between-group comparison: ^p<0.05, when RMT group greater than RBAT group
Table 7. Descriptive and Inferential Statistics of WMFT by group
WMFT RMT, Median (Q1–Q3)
n=9
p RBAT, Median (Q1–
Q3) n=8
p
Mann-Whitney U p
Effect size r
Time
Pretreatment 169.84(104.55-236.00) .008* 183.78(62.76-109.86) .007* .773 .070 Posttreatment 86.96(62.76-109.86) 79.87(50.49-119.96)
Quality
Pretreatment 33.50(27.50-45.50) .012* 34.00(26.75-45.00) .012* .593 .129 Posttreatment 42.00 (31.50-51.00) 39.00(35.25-49.00)
Within-group comparison: *p<0.05, when compared with pretreatment
Between-group comparison: ^p<0.05, when RMT group greater than RBAT group
Table 8. Descriptive and Inferential Statistics of CAHAI by group
CAHAI RMT, Median (Q1–
Q3) n=9
p RBAT, Median (Q1–
Q3) n=8
p
Mann-Whitney U p
Effect size r
Pretreatment 42.00(27.00-43.00) .007* 34.50(25.75-38.50) .012* .562 .035 Posttreatment 52.00(34.00-55.00) 44.50(35.50-48.00)
Within-group comparison: *p<0.05, when compared with pretreatment
Between-group comparison: ^p<0.05, when RMT group greater than RBAT group
Table 9. Descriptive and Inferential Statistics of MAL by group
Pretreatment 26.00(21.50-46.50) .008* 16.00(11.00-42.00) .008* .700 .097 Posttreatment 47.00 (35.00-80.00) 49.00(33.00-67.00)
QOM
Pretreatment 21.50(13.75-35.75) .012* 17.50(5.50-28.75) .012* .665 .107 Posttreatment 46.00 (25.00-68.00) 41.00(23.25-73.25)
Within-group comparison: *p<0.05, when compared with pretreatment
Between-group comparison: ^p<0.05, when RMT group greater than RBAT group
Table 10. Descriptive and Inferential Statistics of MAL from posttreatment to follow-up by group
MAL RMT, Median (Q1–
Q3) n=5
p RBAT, Median (Q1–
Q3) n=4
p
AOU
Posttreatment 47.00 (35.00-69.00) .665 62.00(33.50-87.75) .180 Follow up 48.00 (28.00-79.00) 52.00(31.75-74.00)
QOM
Posttreatment 37.00(32.00-67.00) .665 66.50(29.75-82.25) .180 Follow up 46.00(20.50-63.50) 60.00(28.75-74.75)
Within-group comparison: *p<0.05, when compared with pretreatment
Between-group comparison: ^p<0.05, when RMT group greater than RBAT group
Table 11. Descriptive and Inferential Statistics of NEADL by group
NEADL RMT, Median (Q1–Q3)
n=9
p RBAT, Median (Q1–
Q3) n=8
p
Mann-Whitney U p
Effect size r
Pretreatment 39.00 (26.00-42.00) .012* 42.50 (19.50-51.00) .017* .066 .443 Posttreatment 40.00 (37.50-50.50) 51.00 (20.75-53.75)
Within-group comparison: *p<0.05, when compared with pretreatment
Between-group comparison: ^p<0.05, when RMT group greater than RBAT group
Table 12. Descriptive and Inferential Statistics of FIM by group
FIM RMT, Median (Q1–Q3)
n=9
p RBAT, Median (Q1–
Q3) n=8
p
Mann-Whitney U p
Effect size r Pretreatment 111.00(108.50-116.00) .058 112.50(95.00-114.75) .027* .963 .011 Posttreatment 113.00 (111.00-123.00) 114.00(98.25-115.00)
Within-group comparison: *p<0.05, when compared with pretreatment
Between-group comparison: ^p<0.05, when RMT group greater than RBAT group
Table 13. Descriptive and Inferential Statistics of GAS by group Within-group comparison: *p<0.05, when compared with pretreatment
Between-group comparison: ^p<0.05, when RMT group greater than RBAT group
Table 14. Descriptive and Inferential Statistics of SIS by group
Pretreatment 58.20(52.93-66.79) .008* 61.26(49.33-81.77) .025* .149 .344 Posttreatment 67.52 (65.67-73.59) 72.89(52.81-84.71)
Strength
Pretreatment 31.25 (28.13-43.75) .034* 43.75 (37.50-54.68) .268 .436 .188 Posttreatment 50.00 (37.50-53.13) 50.00 (34.38-60.94)
ADL
Pretreatment 62.50 (52.50-80.00) .012* 67.50 (55.00-91.88) .144 .079 .426 Posttreatment 75.00 (67.50-86.25) 85.00 (57.50-94.38)
Mobility
Pretreatment 80.56 (75.00-94.44) .017* 93.06 (65.97-99.31) .223 .065 .477 Posttreatment 91.67 (81.94-97.22) 95.83 (66.67-100.00)
Hand function
Pretreatment 25.00 (7.50-60.00) .007* 30.00 (2.50-53.75) .042* .882 .036 Posttreatment 35.00 (22.50-72.50) 55.00 (13.75-68.75)
Recovery
Pretreatment 50.00 (30.00-65.00) .017* 50.00 (35.00-58.75) .059 .273 .266 Posttreatment 50.00 (47.50-77.50) 60.00 (42.50-60.00)
Physical Function
Pretreatment 54.16(42.06-65.12) .008* 55.79(44.44-74.59) .050 .149 .349 Posttreatment 65.55(52.01-73.64) 72.44(44.39-77.05)
Within-group comparison: *p<0.05, when compared with pretreatment, Between-group comparison: ^p<0.05, when RMT group greater than RBAT group
Table 15. Descriptive and Inferential Statistics of SIS by group
Posttreatment 66.41(60.84-80.64) .780 72.89(53.74-82.75) .680 Follow up 67.52 (65.67-73.59) 72.89(52.81-84.71)
Strength
Posttreatment 50.00 (25.00-53.12) .357 46.87 (34.75-54.68) .257 Follow up 43.75 (37.50-56.25) 46.87 (43.75-59.37)
ADL
Posttreatment 75.00 (58.75-83.75) .068 85.00 (61.25-91.88) .317 Follow up 82.50 (68.75-93.75) 84.72 (68.50-89.38)
Mobility
Posttreatment 83.33 (79.16-95.83) .141 90.27 (54.16-99.31) .655 Follow up 83.33 (80.55-98.61) 84.75 (68.05-99.30)
Hand function
Posttreatment 30.00 (20.00-62.50) .257 62.50 (15.50-68.75) .461 Follow up 35.00 (17.50-70.00) 37.50 (20.00-66.75)
Recovery
Posttreatment 53.33 (48.85-73.80) .345 72.44 (42.23-76.32) .995 Follow up 50.00 (37.50-61.25) 65.00 (45.50-73.75)
Physical Function
Posttreatment 50.00(37.50-60.00) .500 60.00(45.00-71.25) .068 Follow up 48.46(45.13-65.78) 53.74(38.60-63.58)
Within-group comparison: *p<0.05, when compared with pretreatment, Between-group comparison: ^p<0.05, when RMT group greater than RBAT group
Table 16. Descriptive and Inferential Statistics of the ratio of affect arm activity counts Affect arm activity
counts/ nonaffect arm activity counts
RMT, Median (Q1–
Q3) n=7
p RBAT, Median (Q1–
Q3) n=6
p
Mann-Whitney U p
Effect size r
Pretreatment 0.22 (0.18-0.25) .008* 0.25 (0.21-0.35) .017* .773 .070
Posttreatment 0.29 (0.21-0.31) 0.30 (0.28-0.37) Within-group comparison: *p<0.05, when compared with pretreatment
Between-group comparison: ^p<0.05, when RMT group greater than RBAT group
Table 17. The summary table of results
RMT RBAT
FMA (Overall^, proximal*) GAS*
rNSA (Temperature*, Overall*) NEADL*
SIS (Overall*, ADL*, Mobility*)
*not significantly with a moderate effect size at between-group comparison
^significantly at between-group comparison
Table 18. Descriptive and Inferential Statistics of MAS by group
MAS RMT, Median (Q1–
Q3) n=9
p RBAT, Median (Q1–
Q3) n=8
p
Mann-Whitney U p
Effect size r
Pretreatment 1.00 (0.89-1.50) .008* 1.19(0.95-1.38) .012* .562 .140
Posttreatment 0.86 (0.64-1.28) 1.02(0.53-1.15) Within-group comparison: *p<0.05, when compared with pretreatment
Between-group comparison: ^p<0.05, when RMT group greater than RB