A Qualitative and Usability Evaluation of Advanced Technologies for Home Upper Limb Neurorehabilitation Post-stroke
Home RehabGym: a Qualitative and Usability Evaluation of Advanced Technologies for Home Upper Limb Neurorehabilitation Post-stroke
Tan Tock Seng Hospital
30 participants
Jul 31, 2024
INTERVENTIONAL
Conditions
Summary
Due to limited resources such as the low therapist to patient ratio or high costs associated to rehabilitation therapy, providing higher therapy dose to patients after discharge is highly challenging. This often results in non-use of the impaired limb as a result of the decreased therapy dose, causing partial loss of the functional improvements previously gained during early rehabilitation. In this study, the investigators plan to pilot the HomeRehab Gym concept via the deployment of three rehabilitation devices at patients' homes: MyoPanda, H-Man and ReHandyBot.
Eligibility
Inclusion Criteria8
- Clinical stroke (ischaemic or haemorrhagic) confirmed by admitting doctors and CT, CT angiography or MRI brain imaging
- Age 21 to 80 years, both males and females
- At least 28 days post-stroke
- Upper limb motor impairment of Fugl-Meyer Assessment (FMA) scale 20 to 50
- Montreal Cognitive Assessment (MoCA) > 21/30
- Ability to sit supported and continuously for 60 minutes
- Stable home abode with enough space to place technologies
- Has a carer/next of kin to supervise home-based exercises
Exclusion Criteria13
- Functional impairment of the upper limb due to other pathologies
- Medical conditions incompatible with research participation: uncontrolled medical illnesses (hypertension or diabetes, ischaemic heart disease, congestive heart failure, bronchial asthma, severe /untreated depression, agitation, end stage renal/liver/heart/lung failure, unresolved cancers)
- Anticipated life expectancy of less than 6 months
- Pacemakers and other active implants
- Active seizures within 3 months
- Local factors potentially worsened by intensive technology-aided upper-limb therapy and computer-based training:
- Spasticity - modified Ashworth Scale MAS > 2 of any upper limb muscle groups
- Severe pain in affected arm - Visual Analogue Scale for pain VAS > 5/10
- Skin wounds
- Cognitive impairment precluding study participation
- Severe visual impairment or visual neglect affecting ability to use technologies
- History of dementia, depression or behavioural problems
- Pregnant or lactating females will not be allowed to participate
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Interventions
The HMAN is certified as a CE class 2A upper limb rehabilitation robot suitable for hospital, clinic and home-based use in 2020 by Health Sciences Authority, Singapore. It has since been employed in post-stroke neurorehabilitation therapy and assessment of sensorimotor functions in stroke patients.
ReHandyBot is the portable version of ReHapticKnob a robot developed at ETH Zurich that provides neurocognitive therapy, focusing on hand opening and closing movements as well as prono-supination of the forearm.
MyoPanda is a passive wrist/hand device which patients use to train the hand and wrist function by controlling a virtual avatar with EMG activity measures.
Locations(1)
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NCT06406569