Previously submitted to: JMIR Rehabilitation and Assistive Technologies (no longer under consideration since Mar 31, 2026)
Date Submitted: Oct 8, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Intensive, Multi-Technology Rehabilitation programme for Chronic Stroke Survivors: A Phase I single-arm repeated-measures study
ABSTRACT
Background:
The need to meet minimum guideline recommendations for rehabilitation after stroke motivated the cocreation of a multi-technology enriched rehabilitation gym (TERG). Previous research has established the feasibility and acceptability of this approach in chronic and sub-acute stroke populations.
Objective:
This study aimed to gather preliminary evidence, and effect sizes, on the effectiveness of a multi-technology intervention for motor recovery in a chronic stroke population and identify factors that explain variation in response.
Methods:
This was a Pre-Post, single arm study design located in a rehabilitation research centre. Participants had a diagnosis of stroke, at least 12 months previously, with consequent motor disability. Following baseline measures, an 8-week exercise program using the TERG (e.g., virtual reality treadmills, power-assisted equipment, balance trainers, and upper limb training systems) was individually tailored by a physiotherapist in partnership with participants. Standard measures of activity and participation were recorded two weeks before (baseline), immediately before and immediately post (outcome) intervention.
Results:
Sixty-seven individuals participated, mean age 60.49 (SD 14.44) years, 41.87 (41.31) months since stroke, 51 were male, 26 had aphasia, mean MoCa score of 25.56 (6 to 30). Eight individuals (11.94%) did not complete the programme (transport difficulties n=5, illness n=1, unknown n=2), five withdrawing before baseline. The remaining 59 participants (88.06%) completed an average of 18.12 (SD 6.49,10-38) two-hour sessions. There were statistically significant (p <.05) improvements from baseline to outcome on every variable, with varying effect sizes. Cluster analysis distinguished two sub-groups. Group 1 (n = 20) had poorer balance, arm function and global disability scores at baseline but showed greater improvement than group 1 (n=47) who were younger with higher functioning at baseline.
Conclusions:
This study assessed the impact of a novel cocreated, multi-technology, rehabilitation intervention on mobility and global function of people in the chronic phase of stroke recover. The results show overall improvement with the greatest improvement observed among participants with greater initial levels of disability. Clinical Trial: NCT06787768
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