JMIR Publications

ABSTRACT

Background:

The hand is crucial for carrying out activities of daily living as well as social interaction. The functional use of the hand is affected in 75% of stroke survivors. Rehabilitation can help restore function and several rehabilitation devices have been designed to improve hand function, however, access to these devices is compromised in people with more severe loss of function.

Objective:

In this study, we aimed to observe stroke survivors with poor hand function interacting with a range of commonly used hand rehabilitation devices.

Methods:

Participants were engaged in an eight-week rehabilitation intervention at a technology-enriched rehabilitation gym. The participants spent 50 to 60 minutes of the two-hour session in the upper limb section at least twice a week. Each participant communicated their rehabilitation goals and an action research arm test (ARAT) was used to measure and categorise hand function;poor (0 – 9), moderate (10 – 56), and good (57). Participants were observed during their interactions with three handbased rehabilitation devices that focussed on hand rehabilitation; Gripable™, Neuroball™, and Pegboard. Observations of device interactions were recorded for each session.

Results:

Twenty-nine (n=29) participants were included in this study. Out of whom, 10/29 (34%) had poor hand function, 17/29 (59%) had moderate hand function, and 2/29 (7%) had good hand function. There was no difference in the age and years after stroke of participants with poor hand function and those with moderate (p = .06 and p=.09) and good (p=.37 and p=.99) hand function. On the ability of the 10 participants with poor hand function to interact with the three hand-based rehabilitation devices used, 2/10 (20%) with an ARAT score greater than 0 were able to interact while the other 8/10 (80%) who had a score of 0 on ARAT could not interact. The reason for their inability to interact with these devices was clinically examined to be a result of either the presence of muscle tone/stiffness or muscle weakness.

Conclusions:

Not all stroke survivors with impairments in their hands can make use of currently available rehabilitation technologies. Those with an ARAT Score of zero (0) cannot actively interact with hand rehabilitation devices as they cannot carry out the hand movement necessary for such interaction. The design of devices for hand rehabilitation should consider the accessibility needs of those with poor hand function.