Task-oriented arm training for stroke patients based on remote handling technology concepts: A feasibility study

Abstract

Background: Improving arm-hand skill performance is a major therapeutic target in stroke rehabilitation. Arm-hand rehabilitation may be enriched in content and variation by using technology-assisted training. Especially for people with a severely affected arm, technology-assisted training offers more challenging training possibilities.

Objective: The aim of this study was to explore the feasibility of ReHab-TOAT, a "Remote Handling Based Task-Oriented Arm Training" approach featuring enriched haptic feedback aimed at improving daily activities and participation.

Methods: Five subacute or chronic stroke patients suffering moderate to severe arm-hand impairments and five rehabilitation therapists participated. All participants received 2 ReHab-TOAT sessions. Outcome measure was a bespoke feasibility questionnaire on user experiences and satisfaction regarding 'motivation', 'individualization of training', 'potential training effects', and 'implementation in rehabilitation' of patients and therapists.

Results: Both patients and therapists experienced ReHab-TOAT as being feasible. They found ReHab-TOAT very motivating and challenging. All patients perceived an added value of ReHab-TOAT and would continue the training. Small improvements regarding exercise variability were suggested.

Conclusion: ReHab-TOAT seems to be a feasible and very promising training approach for arm-hand rehabilitation of stroke patients with a moderately or severely affected arm. Further research is necessary to investigate potential training effects of ReHab-TOAT.

Keywords: ReHab-TOAT; arm-hand skill performance; rehabilitation; stroke; technology-assisted.

Figure 1.

(1a) Dexter${}^{\text{TM}}$ training set-up and (1b) therapist interface & example of force directions. (1a) The left picture shows the training set-up with a patient. The right picture shows the Dexter${}^{\text{TM}}$ device itself, and the technical expert with the necessary computers in the background. (1b) The left picture shows the interface through which the therapist can set and change training settings of the Dexter${}^{\text{TM}}$ device. The right picture illustrates the different forces that can be defined in a game and can be personalized for each patient.

Figure 2.

ReHab-TOAT training session timing.