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Robot-based training integrated into usual care might optimize therapy productivity and increase treatment dose. This retrospective study compared two doses of an upper limb rehabilitation program combining robot-assisted therapy and occupational therapy on motor recovery and costs after stroke.    Methods  Thirty-six subacute stroke patients [Fugl-Meyer Assessment (FMA) score 32 ± 12 points; mean ± SD] underwent a combined program of 29 ± 3 sessions of robot-assisted therapy and occupational therapy. Scheduled session time for the higher dose group (HG) was 90 min (two 45-min sessions;  n  = 14) and for the lower dose group (LG) was 60 min (two 30-min sessions;  n  = 22). Pre-/post-treatment change in FMA score (ΔFMA, %), actual active time (min), number of movements and number of movements per minute per robot-assisted therapy session were compared between groups. The costs of the combined programs were also analyzed.    Results  ΔFMA did not differ significantly between groups; the HG improved by 16 ± 13 % and the LG by 11 ± 8%. A between-group difference was found for actual active time ( p  = 1.06E −13 ) and number of movements ( p  = 4.42E −2 ) but not for number of movements per minute during robot-assisted therapy: the HG performed 1,023 ± 344 movements over 36 ± 3 min and the LG performed 796 ± 301 movements over 29 ± 1 min. Both groups performed 28 movements per minute. The combined program cost was €2017 and €1162 for HG and LG, respectively.    Conclusions  Similar motor improvements were observed following two doses of movement-based training. The reduction in scheduled session time did not affect the intensity of the practice and met economic constraints.

frontiers in neurology

Impact of Dose of Combined Conventional and Robotic Therapy on Upper Limb Motor Impairments and Costs in Subacute Stroke Patients: A Retrospective Study