Background: Gravity confounds arm movement ability in post-stroke hemiparesis. Reducing its influence allows effective practice leading to recovery. Yet, there is a scarcity of wearable devices suitable for personalized use across diverse therapeutic activities in the clinic. Objective: In this study, we investigated the safety, feasibility, and efficacy of anti-gravity therapy using the ExoNET device in post-stroke participants. Methods: Twenty chronic stroke survivors underwent six, 45-minute occupational therapy sessions while wearing the ExoNET, randomized into either the treatment (ExoNET tuned to gravity-support) or control group (ExoNET tuned to slack condition). Clinical outcomes were evaluated by a blinded-rater at baseline, post, and six-week follow-up sessions. Kinetic, kinematic, and patient experience outcomes were also assessed. Results: Mixed-effect models showed a significant improvement in Box and Blocks scores in the post-intervention session for the treatment group (effect size: 2.1, p = .04). No significant effects were found between the treatment and control groups for ARAT scores and other clinical metrics. Direct kinetic effects revealed a significant reduction in muscle activity during free exploration with an effect size of (-7.12%, p< 005). There were no significant longitudinal kinetic or kinematic trends. Subject feedback suggested a generally positive perception of the anti-gravity therapy. Conclusions: Anti-gravity therapy with the ExoNET is a safe and feasible treatment for post-stroke rehabilitation. The device provided anti-gravity forces, did not encumber range of motion, and clinical metrics of anti-gravity therapy demonstrated improvements in gross manual dexterity. Further research is required to explore potential benefits in broader clinical metrics.

翻译：背景：重力干扰了中风后偏瘫患者的手臂运动能力。降低其影响可促进有效的练习，进而实现康复。然而，目前缺乏适合在临床多样化治疗活动中个性化使用的可穿戴设备。目的：在本研究中，我们探讨了使用ExoNET装置进行抗重力治疗在中风后参与者中的安全性、可行性和有效性。方法：20名慢性中风幸存者在穿戴ExoNET时接受了六次每次45分钟的职业治疗，随机分为治疗组（ExoNET调至重力支撑状态）或对照组（ExoNET调至松弛状态）。临床结果由盲法评估者在基线、治疗后和六周随访时进行评估。同时评估了动力学、运动学及患者体验结果。结果：混合效应模型显示，治疗组在干预后阶段Box and Blocks评分显著改善（效应量：2.1，p = 0.04）。治疗组与对照组之间在ARAT评分及其他临床指标上未发现显著差异。直接的动力学效应显示，在自由探索期间肌肉活动显著减少，效应量为-7.12%（p < 0.005）。未观察到显著的纵向动力学或运动学趋势。受试者反馈表明对抗重力治疗总体持积极态度。结论：使用ExoNET进行抗重力治疗是中风后康复的一种安全且可行的方案。该设备提供抗重力力，不限制活动范围，且抗重力治疗的临床指标显示粗大手动灵活性有所改善。需要进一步研究以探索其在更广泛临床指标中的潜在益处。