Banihani Jasem, Choukou Mohamed-Amine
College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada.
Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada.
Heliyon. 2024 Aug 3;10(16):e35565. doi: 10.1016/j.heliyon.2024.e35565. eCollection 2024 Aug 30.
Patients with stroke often experience weakened upper limbs, making daily tasks difficult to perform. Although rehabilitation devices are available, patients often relapse post-discharge due to insufficient practice. We present a home-based hand telerehabilitation intervention using the iManus™ platform comprising a sensorized glove, a mobile app for the patients, and a therapist portal for monitoring patient progress.
This research aimed to examine the feasibility, safety, and effectiveness of a home-based telerehabilitation intervention in improving hand function for individuals with mild stroke. A qualitative approach was also used to explore users' experiences, perceived benefits, and challenges associated with using the platform in a home setting.
In this single-case study, we delivered a hand telerehabilitation intervention to a chronic stroke patient with impaired hand function using the iManus™ platform. The intervention consisted of 40 home sessions over eight weeks. We assessed feasibility through user adherence and feedback obtained using a System Usability Scale (SUS) and a semi-structured interview with the participant and their informal caregiver. Safety was evaluated by monitoring pain levels using the Visual Analog Scale (VAS), and efficacy was determined by observing the changes in the fingers' range of motion using the iManus™ platform and clinical outcomes measures, namely the Fugl-Meyer Assessment (FMA) and Jebsen Taylor Hand Function Test (JTHFT).
Our participant completed all the assigned sessions, with each averaging 20 min. Usability scored 77.5 out of 100 on the SUS. User feedback from the interviews revealed improved mobility and control over therapy as benefits, indicating room for improvement in the intervention's adaptability and functionality. During the intervention, the participant noted no pain increase, and the telerehabilitation platform recorded range of motion improvements for all finger and wrist joints, excluding wrist extension. The FMA scores were 43 at T0, 53 at T1, and 56 at T2, while the JTHFT scores were 223 at T0, 188 at T1, and 240 at T2.
This single case study demonstrated the preliminary feasibility, safety, and efficacy of a novel home-based hand intervention for stroke survivors. The participant showed improved hand functions, good adherence to the program, and reported satisfaction with the intervention. However, these results are based on a single-case study, and further large-scale studies are needed before any generalization is recommended.
中风患者常出现上肢功能减弱，导致日常活动难以进行。尽管有康复设备，但患者出院后常因练习不足而复发。我们介绍一种基于家庭的手部远程康复干预，使用iManus™平台，该平台包括一个传感手套、一个供患者使用的移动应用程序以及一个供治疗师监测患者进展的门户。
本研究旨在检验基于家庭的远程康复干预对轻度中风患者改善手部功能的可行性、安全性和有效性。还采用定性方法探索用户在家庭环境中使用该平台的体验、感知到的益处和挑战。
在这个单病例研究中，我们使用iManus™平台对一名手部功能受损的慢性中风患者进行手部远程康复干预。干预包括在八周内进行40次家庭治疗。我们通过使用系统可用性量表（SUS）以及对参与者及其非正式照料者进行半结构化访谈获得的用户依从性和反馈来评估可行性。通过使用视觉模拟量表（VAS）监测疼痛水平来评估安全性，并通过使用iManus™平台观察手指活动范围的变化以及临床结果指标，即Fugl-Meyer评估（FMA）和Jebsen Taylor手部功能测试（JTHFT）来确定疗效。
我们的参与者完成了所有指定的治疗，每次平均20分钟。SUS可用性评分为77.5分（满分100分）。访谈中的用户反馈显示，活动能力改善和对治疗的控制增强是益处，这表明干预的适应性和功能仍有改进空间。在干预期间，参与者表示疼痛没有增加，远程康复平台记录了所有手指和腕关节（不包括腕关节伸展）的活动范围有所改善。FMA评分在T0时为43分，T1时为53分，T2时为56分，而JTHFT评分在T0时为223分，T1时为188分，T2时为240分。
这个单病例研究证明了一种新型的基于家庭的手部干预对中风幸存者的初步可行性、安全性和有效性。参与者手部功能得到改善，对该方案依从性良好，并对干预表示满意。然而，这些结果基于单病例研究，在建议进行任何推广之前，还需要进一步的大规模研究。
