Tanczak Natalie, Plunkett Tegan Kate, Lin Sijie, Kuenzler Lorena, Lau Megan, Kuah Wee Keong Christopher, Ng Chwee Yin, Gassert Roger, Chua Karen, Lambercy Olivier
Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore.
Rehabilitation Engineering Laboratory (RELab), Department of Health Sciences and Technology (D-HEST), ETH Zurich, Zurich, Switzerland.
J Neuroeng Rehabil. 2025 Aug 21;22(1):183. doi: 10.1186/s12984-025-01717-6.
Stroke is a leading cause of adult disability in the world. Upper limb impairments are common post-stroke, with nearly half of those initially affected continuing to live with long-term functional limitations, impacting their independence and quality of life. Task-specific, intensive therapy has been shown to promote recovery; however, achieving this dose is resource-intensive and logistically challenging. Robotic hand orthoses (RHOs) are a promising approach to support functional rehabilitation regardless of location, thus providing high-dose therapy with minimal additional burden on the clinics.
We evaluated the use of the RELab tenoexo 2.0, a soft RHO, in a two-phase feasibility study supporting functional hand training in persons after chronic stroke. Participants (n = 8) first used the device to complete nine training sessions supervised by occupational therapists over 3 weeks in-clinic, then brought the device home to continue the training to complete 2 weeks of unsupervised training. Feasibility was assessed with therapy dose (repetitions and time) and adherence to the suggested at-home rehabilitation program. Functional improvements were tracked using clinical assessments across time points. Finally, usability evaluations provided insights into users' perceptions of the device.
During the in-clinic phase, participants completed an average of 809 ± 317 RHO supported repetitions over 521 ± 130 min. At home, this increased to 1293 ± 948 repetitions over 486 ± 125 min across an average of 11.75 ± 5.4 sessions. Across the whole intervention, participant's mean Action Research Arm Test score increased by 5.0 ± 4.4, whereas the Fugl-Meyer Assessment Upper Extremity score increased by 6.0 ± 2.5. These improvements were retained after one month. The usability was rated as good, with a mean System Usability Scale rating of 72.5, and a mean Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 score of 3.94/5.0.
This study shows that the RHO can serve as a viable rehabilitation tool for functional hand training after chronic stroke across the continuum of care. High-dose training, both in-clinic and at home, demonstrated the feasibility of the device and intervention, with meaningful clinical improvements highlighting its therapeutic potential as a training strategy. High adherence rates and positive usability indicate strong user acceptance.
NCT06412237.
中风是全球成年人残疾的主要原因。中风后上肢功能障碍很常见，近一半最初受影响的人长期存在功能受限问题，影响他们的独立性和生活质量。特定任务的强化治疗已被证明可促进恢复；然而，达到这种治疗剂量资源消耗大且在后勤方面具有挑战性。机器人手部矫形器（RHO）是一种很有前景的方法，无论在何处都能支持功能康复，从而以最小的额外负担为诊所提供高剂量治疗。
我们在一项两阶段可行性研究中评估了软质RHO RELab tenoexo 2.0在支持慢性中风患者手部功能训练中的应用。参与者（n = 8）首先在诊所使用该设备，在职业治疗师的监督下，于3周内完成9次训练课程，然后将设备带回家继续训练，以完成2周的无监督训练。通过治疗剂量（重复次数和时间）以及对建议的家庭康复计划的依从性来评估可行性。在不同时间点使用临床评估来跟踪功能改善情况。最后，通过可用性评估了解用户对该设备的看法。
在诊所阶段，参与者在521±130分钟内平均完成了809±317次由RHO辅助的重复动作。在家中，平均11.75±5.4次训练课程中，在486±125分钟内重复次数增加到1293±948次。在整个干预过程中，参与者的平均动作研究臂测试得分提高了5.0±4.4，而Fugl-Meyer上肢评估得分提高了6.0±2.5。这些改善在一个月后得以保持。可用性被评为良好，系统可用性量表平均评分为72.5，魁北克辅助技术用户满意度评估2.0平均得分为3.94/5.0。
本研究表明，RHO可作为慢性中风后手部功能训练的一种可行康复工具，贯穿整个护理过程。在诊所和家中进行的高剂量训练证明了该设备和干预措施的可行性，有意义的临床改善突出了其作为一种训练策略的治疗潜力。高依从率和积极的可用性表明用户接受度高。
NCT06412237。
