Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Córdoba, Spain.
Neurorehabilitation area, Health Division of TECNALIA, Basque Research and Technology Alliance (BRTA), San Sebastián, Spain.
J Neuroeng Rehabil. 2021 Feb 23;18(1):41. doi: 10.1186/s12984-021-00837-z.
Neuroscience and neurotechnology are transforming stroke rehabilitation. Robotic devices, in addition to telerehabilitation, are increasingly being used to train the upper limbs after stroke, and their use at home allows us to extend institutional rehabilitation by increasing and prolonging therapy. The aim of this study is to assess the usability of the MERLIN robotic system based on serious games for upper limb rehabilitation in people with stroke in the home environment.
9 participants with a stroke in three different stages of recovery (subacute, short-term chronic and long-term chronic) with impaired arm/hand function, were recruited to use the MERLIN system for 3 weeks: 1 week training at the Maimonides Biomedical Research Institute of Cordoba (IMIBIC), and 2 weeks at the patients' homes. To evaluate usability, the System Usability Scale (SUS), Adapted Intrinsic Motivation Inventory (IMI), Quebec User Evaluation of Satisfaction with assistive Technology (QUEST), and the ArmAssist Usability Assessment Questionnaire were used in the post-intervention. Clinical outcomes for upper limb motor function were assessed pre- and post-intervention.
9 patients participated in and completed the study. The usability assessment reported a high level of satisfaction: mean SUS score 71.94 % (SD = 16.38), mean QUEST scale 3.81 (SD = 0.38), and mean Adapted IMI score 6.12 (SD = 1.36). The results of the ArmAssist Questionnaire showed an average of 6 out of 7, which indicates that MERLIN is extremely intuitive, easy to learn and easy to use. Regarding clinical assessment, the Fugl-Meyer scores showed moderate improvements from pre- to post-intervention in the total score of motor function (p = 0.002). There were no significant changes in the Modified Ashworth scale outcomes (p = 0.169).
This usability study indicates that home-based rehabilitation for upper limbs with the MERLIN system is safe, useful, feasible and motivating. Telerehabilitation constitutes a major step forward in the use of intensive rehabilitation at home. Trial registration ClinicalTrials.gov, NCT04405609. Registered 06 January 2020-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04405609.
神经科学和神经技术正在改变中风康复。除了远程康复外，机器人设备也越来越多地被用于中风后的上肢训练，而且在家中使用可以通过增加和延长治疗来扩展机构康复。本研究的目的是评估基于严肃游戏的 MERLIN 机器人系统在中风患者家庭环境中上肢康复的可用性。
9 名患有中风且上肢功能受损的参与者被招募到研究中，他们分别处于恢复的三个不同阶段（亚急性期、短期慢性期和长期慢性期）：1 周在科尔多瓦的迈蒙尼德生物医学研究所（IMIBIC）进行训练，2 周在家中进行训练。为了评估可用性，在干预后使用了系统可用性量表（SUS）、适应性内在动机量表（IMI）、魁北克用户对辅助技术满意度量表（QUEST）和 ArmAssist 可用性评估问卷。在干预前后评估了上肢运动功能的临床结果。
9 名患者参与并完成了研究。可用性评估报告了高度的满意度：SUS 平均得分 71.94%（SD=16.38），QUEST 平均得分 3.81（SD=0.38），适应性 IMI 平均得分 6.12（SD=1.36）。ArmAssist 问卷的结果显示平均得分为 7 分中的 6 分，这表明 MERLIN 非常直观、易学易用。关于临床评估，Fugl-Meyer 运动功能总评分显示干预前后从中度改善（p=0.002）。改良 Ashworth 量表的结果没有显著变化（p=0.169）。
这项可用性研究表明，基于 MERLIN 系统的家庭上肢康复是安全、有用、可行和有激励性的。远程康复是家庭中强化康复的重要一步。
ClinicalTrials.gov，NCT04405609。于 2020 年 1 月 6 日注册-回顾性注册，https://clinicaltrials.gov/ct2/show/NCT04405609。
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