Feasibility of an Electromyography-Triggered Hand Robot for People After Chronic Stroke.

IMPORTANCE

Effective treatment of the affected hand after stroke is crucial for improved functional independence and recovery.

OBJECTIVE

To determine the feasibility and clinical utility of an electromyography-triggered hand robot.

DESIGN

Single-group repeated-measures design. Participants completed training 3×/wk for 6 wk. Feasibility data included participant feedback, adverse events, and compliance rates. Upper extremity outcomes were collected at baseline, discharge, and 6-wk follow-up.

SETTING

Outpatient clinic.

PARTICIPANTS

Twelve stroke survivors at least 6 mo poststroke living in the community.

INTERVENTION

Eighteen sessions of intensive robotic hand therapy over 6 wk. Each 60-min treatment session was personalized to match the participant's ability.

OUTCOMES AND MEASURES

Arm Motor Ability Test (AMAT), Stroke Impact Scale Hand subscale (SIS-H), Stroke Upper Limb Capacity Scale (SULCS), Fugl-Meyer Assessment, Box and Block Test, and dynamometer.

RESULTS

All participants completed the training phase. Mild skin pinching or rubbing at dorsal proximal interphalangeal joint and proximal arm fatigue were the most common adverse events. Improvements in raw scores were achieved from baseline to discharge for all outcome measures, except the SULCS. Participants significantly improved from baseline to discharge on the AMAT and the SIS-H, and improvements were maintained at 6-wk follow-up.

CONCLUSION AND RELEVANCE

Robotic hand training was feasible, safe, and well tolerated. Participants reported and demonstrated improvements in functional use of the affected arm. Thirty percent of participants achieved clinically significant improvements on the AMAT. We recommend further study of the device in a larger study using the AMAT as a primary outcome measure.

WHAT THIS ARTICLE ADDS

It is feasible and safe to implement a robotic hand training protocol for people with moderate to severe arm impairment in an outpatient setting. Robotic training may provide a viable option for this group to actively participate in intensive training of the distal hand.