Unsupervised Robot-Assisted Therapy at Home After Stroke: a Pilot Feasibility Study.

Unsupervised robot-assisted therapy could allow increasing upper limb therapy dose for stroke survivors with minimal additional burden on the healthcare system. Thanks to the ability to actively assist movement and dynamically adapt the assistance level, actuated devices can support individuals with a wide range of deficits. However, these devices are often complex to use, and their application in a fully unsupervised setting has rarely been explored. Here, we present a pilot study investigating the feasibility of unsupervised therapy with ReHandyBot, an actuated device for upper limb rehabilitation. The increase in therapy dose achieved during unsupervised training, device usability and user experience were evaluated. Stroke inpatients of a rehabilitation clinic learned how to use the device for two weeks with progressively decreasing levels of supervision. After discharge, they could take it home for two weeks of unsupervised therapy. Four of the five recruited participants learned how to use the device without supervision, and three completed the protocol. During the two weeks at home, on average they performed 518.3 minutes of therapy with ReHandyBot. Usability and user experience ratings show that the device was well accepted. These positive results support larger studies investigating unsupervised home therapy with ReHandyBot and suggest that active devices can be used by patients with no to mild cognitive impairments at home without the supervision of external persons.