Telerehabilitation using the Rutgers Master II glove following carpal tunnel release surgery: proof-of-concept

Abstract

Carpal tunnel syndrome is caused by the compression of the median nerve as it transits the carpal tunnel, with an incidence of about 1% of the population. If surgery is needed, the treatment involves decompression of the median nerve followed sometimes by musculoskeletal outpatient rehabilitation. This paper presents a proof-of-concept pilot clinical trial in which the Rutgers Masters II haptic glove was tested on five subjects, who were two weeks post-hand surgery. Subjects trained for 13 sessions, 30 min per session, three sessions per week, and had no conventional outpatient therapy. Computerized measures of performance showed group effects in hand mechanical energy (1200% for the virtual ball squeezing and DigiKey exercises and 600% for the power putty exercise). Improvement in their hand function was also observed (a 38% reduction in virtual pegboard errors, and 70% fewer virtual hand ball errors). Clinical strength measures showed increases in grip (by up to 150%) and key pinch (up to 46%) strength in three of the subjects, while two subjects had decreased strength following the study. However, all five subjects improved in their tip pinch strength of their affected hand (between 20%-267%). When asked whether they would recommend the virtual reality exercises to others, four subjects very strongly agreed and one strongly agreed that they would.