Discussion
chronic stroke, stroke, motor dysfunction
STROKE, DISEASE, CORTEX
Our study compared the effects of CT and BRT on upper limb function and activities of daily living in stroke patients. The results show BRT better improves patients' upper limb motor function and ADL performance than CT. In addition, this study examined the EEG cortical activity and network of the two groups of patients in an attempt to reveal potential neural mechanism differences between the different intervention methods. The results showed that there was a significant difference in the functional brain connectivity between the two groups of patients, both in terms of brain activity regions, as well as regions of interest (ROI), with the bilateral group showing better results than the CT group.FMA-UE was the main outcome indicator in this study, and the results of the study showing no significant difference between the BRT and CT groups after treatment. However, the BRT group showed significantly greater improvement in FMA-UE difference before and after treatment compared to the CT group. Wu et al.'s meta-analysis showed no significant difference in the BRT group compared to the CT for the improvement of upper limb function in patients [A meta-analysis study in Cochrane also showed that upper limb robotics improved the ability to perform activities of daily living in patients with acute and subacute stroke, but not in patients with chronic stroke [Regarding the comparison of quantitative EEG, we found the power spectrum energy of the alpha rhythm was not reduced in the BRT group compared to the conventional group. By retrospective analysis, the functional brain connections in the region of interest (ROI) were significantly different between the two groups at the frontal, limbic, and parietal connections on both sides. Previous studies have also shown that changes in the coupling strength between hemispheres in homologous regions are associated with the degree of recovery of motor function, and this correlation mainly exists between primary motor regions [In the normal resting state, the brain shows an active network of interactions between the two hemispheres, and changes in resting-state activity in the cortex after stroke are associated with motor dysfunction during movement [This trial has several limitations. First, the study included patients with a disease duration of less than three months, and observed the effect of BRT on upper limb function. Further studies are needed to investigate the effect of BRT on stroke patients with a disease duration of three months or longer. Second, because of the epidemic, this study included a small sample size and did not observe the effects of unilateral upper extremity robotic therapy, and a larger sample is still needed for further studies in the future. Third, the observation period of this study was short and quantitative EEG evaluation before treatment was missing.