Hybrid robot & FES rehabilitation after stroke: short-term performance, fatigue, and patient experience
Author(s)
Type
Journal Article
Abstract
Combining functional electrical stimulation (FES) and robotics may enhance post-stroke motor recovery, particularly in the subacute phase, yet evidence on usability and user experience remains limited. This study
evaluated the feasibility and short-term effects of robotic, FES, and hybrid assistance during a wrist flexion–extension tracking task in 32 subacute stroke patients, most with severe upper-limb impairments. Participants received one of the three assistance modalities across three training sessions. Quantitative measures of tracking performance, effort, and fatigue, along with patient-reported outcomes, were analysed. Tracking performance improved during assisted trials across all groups, confirming the immediate efficacy of each modality, with no significant differences between them. The benefit of assistance was greater in more impaired patients, particularly in the Robot and Hybrid groups. Cocontraction increased in the FES and Hybrid groups during assistance, suggesting enhanced muscular engagement, while no change was observed in the Robot group. No significant increases in muscular fatigue were detected. All modalities were well tolerated, enjoyable and perceived as useful, with hybrid assistance receiving consistently positive feedback. Although the short intervention limited conclusions on unassisted performance over time, these findings demonstrate the feasibility and acceptability of hybrid robot–FES training across a broad range of impairment levels.
evaluated the feasibility and short-term effects of robotic, FES, and hybrid assistance during a wrist flexion–extension tracking task in 32 subacute stroke patients, most with severe upper-limb impairments. Participants received one of the three assistance modalities across three training sessions. Quantitative measures of tracking performance, effort, and fatigue, along with patient-reported outcomes, were analysed. Tracking performance improved during assisted trials across all groups, confirming the immediate efficacy of each modality, with no significant differences between them. The benefit of assistance was greater in more impaired patients, particularly in the Robot and Hybrid groups. Cocontraction increased in the FES and Hybrid groups during assistance, suggesting enhanced muscular engagement, while no change was observed in the Robot group. No significant increases in muscular fatigue were detected. All modalities were well tolerated, enjoyable and perceived as useful, with hybrid assistance receiving consistently positive feedback. Although the short intervention limited conclusions on unassisted performance over time, these findings demonstrate the feasibility and acceptability of hybrid robot–FES training across a broad range of impairment levels.
Date Issued
2026-09-23
Date Acceptance
2026-09-01
Citation
Journal of Rehabilitation and Assistive Technologies Engineering, 2026, 13
ISSN
2055-6683
Publisher
SAGE Publishing
Journal / Book Title
Journal of Rehabilitation and Assistive Technologies Engineering
Volume
13
Copyright Statement
© The Author(s) 2026. Creative Commons License (CC BY 4.0) This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
License URL
Publication Status
Published
Article Number
20556683261488467
Date Publish Online
2026-09-23