Post-stroke arm/hand training at home.

Rationale:

After experiencing a stroke, the majority of people have to cope with impaired arm and hand function. Post-stroke rehabilitation training aims to regain arm and hand motor function, which is essential to perform most activities of daily living (ADL) independently. To stimulate restoration of arm function after stroke, intensive, task-specific training with active contribution of the patient is essential. The application of robotics in rehabilitation to promote this repetitive training is promising. Most research involving robotics so far has demonstrated significant improvement in upper limb motor function by participants, but limited studies have showed improvements in ADL. In the SCRIPT project we are developing robotic technologies for home rehabilitation to enable self-administration of more intense and more frequent exercises, specifically of the hand and wrist with the goal of contributing to the personal independence of stroke patients.



Objective:

The primary objective of this study is to examine user acceptance and assess changes in arm function by people with chronic stroke following technology-supported arm/hand training at home. Secondary objectives are to examine whether stroke patients increase their total amount of practice when provided with the opportunity, examine if this additional training enhances changes in arm/hand function and explore which factors contribute to this. We also intend to examine whether technology-supported arm/hand training at home results in comparable improvements to that observed after conventional training.



Study design:

This explorative feasibility study has a longitudinal design with an experimental group and a control group. Evaluation is based on one baseline measurement pre-training and two evaluation measurements post-training (within one week and follow-up after two months).



Study population:

Twenty chronic stroke patients will participate in the study (10 experimental, 10 control). Subjects should have reasonable ability to control the proximal arm, and have some extent of hand function.



Intervention:

During six weeks, the chronic stroke patients will receive either 18 one hour sessions, plus additional training when desired, of technology assisted arm and hand home training (experimental group), or conventional home training (control group). For the experimental group, training consists of arm and hand exercises conducted while undertaking computerised games, wearing the SCRIPT hand device to support hand opening, and wearing the SaeboMAS for gravity compensation of the proximal arm. The training for the control group consists of standard arm and hand exercises.



Main study parameters/endpoints:

Main study parameters are outcomes related to user acceptance, including usability, satisfaction, motivation and compliance.

Patients who will train with the SCRIPT-system will have similar or improved arm and hand function in comparison with the patients who receive conventional arm and hand exercises.

Evaluation is based on one baseline measurement pre-training and two evaluation measurements post-training (within one week and follow-up after two months).

During six weeks, the chronic stroke patients will receive either 18 one hour sessions, plus additional training when desired, of technology assisted arm and hand home training (experimental group), or conventional home training (control group). For the experimental group, training consists of arm and hand exercises conducted while undertaking computerised games, wearing the SCRIPT hand device to support hand opening, and wearing the SaeboMAS for gravity compensation of the proximal arm. The training for the control group consists of standard arm and hand exercises.