K. Y. L. Wong

School of Medical and Health Sciences, Tung Wah College, Hong Kong SAR, China

Abstract Title: The Effectiveness of Robotic Hand Assisted Exercise in Chronic Stroke Patients: A pilot study

Biography: Background Stroke is one of the leading causes of long-term disability in Hong Kong, with the prevalence rate expected to reach 110 thousand by 2036. Current research on robotic hand therapy has shown to be effective for rehabilitation in chronic stroke patients. However, robotic devices for fine upper-limb movements and research on unsupervised home-based robotic hand assisted exercise were limited. Therefore, this study aimed to explore the effectiveness of a 4-week home-based exercise program using a portable robotic hand and the sustainability of effects after the exercise program. Methods Eleven chronic stroke participants with mild to moderate hand dysfunction were recruited. Participants underwent a four-week home-based exercise program after a structured training, and completing 20 sessions (5 days per week) in total. The Action Research Arm Test (ARAT), Fugl-Meyer Assessment (FMA), Box and Block Test (BBT) and Michigan Hand Questionnaire (MHQ) were used as outcome measures. Assessments were performed in pre-, post- and follow-up (4-week post-exercise) periods. Descriptive analysis and parametric tests were performed using two-way repeated measures analysis of variance (ANOVA). Results All participants attended and completed all assessments with no adverse events. The average self-reported exercise compliance rate was 95.5%. Motor function, passive joint motion in FMA, FMA total score, and BBT showed significant improvements from pre- to post- exercise (p<0.05). Sensation in FMA showed significant improvement between pre- and follow-up (p<0.05). However, the MHQ total score between pre- and post-exercise was decreased. Conclusion The study demonstrated the effectiveness of home-based robotic hand training, producing promising gains in motor function with improvements in sensation shown in short-term follow-up. The high adherence rate indicated that portable robotic hands were acceptable to patients. To explain the discrepancy in subjective marker, follow up individual interviews reflected the choice of assessment tool had limitation in its design in terms of length and specificity in reflecting the respective outcome. Keywords: Home-based Robotic hand exercise, Neurological Rehabilitation, Chronic Stroke Survivors, portable exoskeleton, exercise compliance

Research Interest: Background Stroke is one of the leading causes of long-term disability in Hong Kong, with the prevalence rate expected to reach 110 thousand by 2036. Current research on robotic hand therapy has shown to be effective for rehabilitation in chronic stroke patients. However, robotic devices for fine upper-limb movements and research on unsupervised home-based robotic hand assisted exercise were limited. Therefore, this study aimed to explore the effectiveness of a 4-week home-based exercise program using a portable robotic hand and the sustainability of effects after the exercise program. Methods Eleven chronic stroke participants with mild to moderate hand dysfunction were recruited. Participants underwent a four-week home-based exercise program after a structured training, and completing 20 sessions (5 days per week) in total. The Action Research Arm Test (ARAT), Fugl-Meyer Assessment (FMA), Box and Block Test (BBT) and Michigan Hand Questionnaire (MHQ) were used as outcome measures. Assessments were performed in pre-, post- and follow-up (4-week post-exercise) periods. Descriptive analysis and parametric tests were performed using two-way repeated measures analysis of variance (ANOVA). Results All participants attended and completed all assessments with no adverse events. The average self-reported exercise compliance rate was 95.5%. Motor function, passive joint motion in FMA, FMA total score, and BBT showed significant improvements from pre- to post- exercise (p<0.05). Sensation in FMA showed significant improvement between pre- and follow-up (p<0.05). However, the MHQ total score between pre- and post-exercise was decreased. Conclusion The study demonstrated the effectiveness of home-based robotic hand training, producing promising gains in motor function with improvements in sensation shown in short-term follow-up. The high adherence rate indicated that portable robotic hands were acceptable to patients. To explain the discrepancy in subjective marker, follow up individual interviews reflected the choice of assessment tool had limitation in its design in terms of length and specificity in reflecting the respective outcome. Keywords: Home-based Robotic hand exercise, Neurological Rehabilitation, Chronic Stroke Survivors, portable exoskeleton, exercise compliance