Integrating hand exoskeletons into goal-oriented clinic and home stroke and spinal cord injury rehabilitation
File(s)
Published version
Author(s)
Yurkewich, Aaron
Ortega, Sara
Sanchez, Jose
Wang, Rosalie H
Burdet, Etienne
Type
Journal Article
Abstract
Introduction
Robotic exoskeletons are emerging as rehabilitation and assistive technologies that simultaneously restore function and enable independence for people with disabilities.
Aim
We investigated the feasibility and orthotic and restorative effects of an exoskeleton-supported goal-directed rehabilitation program for people with hand impairments after stroke or Spinal Cord Injury (SCI).
Method
A single-arm case-series feasibility study was conducted using a wearable untethered hand exoskeleton during goal-directed therapy programs with in-clinic and at-home components. Therapists trained stroke and SCI patients to use a hand exoskeleton during rehabilitation exercises, activities of daily living and patient-selected goals. Each patient received a 1-hour in-clinic training session on five consecutive days, then took the exoskeleton home for two consecutive days to perform therapist-recommended tasks. Goal Attainment Scaling (GAS) and the Box and Block Test (BBT) were administered at baseline, after in-clinic therapy and after home use, with and again without wearing the exoskeleton. The System Usability Scale (SUS), Motor Activity Log, and Fugl-Meyer Assessment were also administered to assess the intervention’s acceptability, adherence, usability and effectiveness.
Results
Four stroke patients (Chedoke McMaster Stage of Hand 2–4) and one SCI patient (ASIA C8 Motor Stage 1) 23 ± 19 months post-injury wore the hand exoskeleton to perform 280 ± 23 exercise repetitions in the clinic and additional goal-oriented tasks at home. The patients performed their own goals and the dexterity task with higher performance following the 7-days therapy program in comparison to baseline for both exoskeleton-assisted (ΔGAS: 18 ± 10, ΔBBT: 1 ± 5) and unassisted (ΔGAS: 14 ± 14, ΔBBT: 3 ± 4) assessments. Therapists and patients provided ‘good’ SUS ratings of 78 ± 6 and no harmful events were reported.
Conclusions
The exoskeleton-supported stroke and SCI therapy program with in-clinic and at-home training components was feasible.
Robotic exoskeletons are emerging as rehabilitation and assistive technologies that simultaneously restore function and enable independence for people with disabilities.
Aim
We investigated the feasibility and orthotic and restorative effects of an exoskeleton-supported goal-directed rehabilitation program for people with hand impairments after stroke or Spinal Cord Injury (SCI).
Method
A single-arm case-series feasibility study was conducted using a wearable untethered hand exoskeleton during goal-directed therapy programs with in-clinic and at-home components. Therapists trained stroke and SCI patients to use a hand exoskeleton during rehabilitation exercises, activities of daily living and patient-selected goals. Each patient received a 1-hour in-clinic training session on five consecutive days, then took the exoskeleton home for two consecutive days to perform therapist-recommended tasks. Goal Attainment Scaling (GAS) and the Box and Block Test (BBT) were administered at baseline, after in-clinic therapy and after home use, with and again without wearing the exoskeleton. The System Usability Scale (SUS), Motor Activity Log, and Fugl-Meyer Assessment were also administered to assess the intervention’s acceptability, adherence, usability and effectiveness.
Results
Four stroke patients (Chedoke McMaster Stage of Hand 2–4) and one SCI patient (ASIA C8 Motor Stage 1) 23 ± 19 months post-injury wore the hand exoskeleton to perform 280 ± 23 exercise repetitions in the clinic and additional goal-oriented tasks at home. The patients performed their own goals and the dexterity task with higher performance following the 7-days therapy program in comparison to baseline for both exoskeleton-assisted (ΔGAS: 18 ± 10, ΔBBT: 1 ± 5) and unassisted (ΔGAS: 14 ± 14, ΔBBT: 3 ± 4) assessments. Therapists and patients provided ‘good’ SUS ratings of 78 ± 6 and no harmful events were reported.
Conclusions
The exoskeleton-supported stroke and SCI therapy program with in-clinic and at-home training components was feasible.
Date Issued
2022-10-02
Date Acceptance
2022-10-01
Citation
Journal of Rehabilitation and Assistive Technologies Engineering, 2022, 9, pp.1-11
ISSN
2055-6683
Publisher
SAGE Publications
Start Page
1
End Page
11
Journal / Book Title
Journal of Rehabilitation and Assistive Technologies Engineering
Volume
9
Copyright Statement
© The Author(s) 2022, Article Reuse Guidelines. This work is published under a CC BY licence.
License URL
Sponsor
Commission of the European Communities
Identifier
https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000864139900001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
871767
Subjects
Science & Technology
Technology
Engineering, Biomedical
Engineering
robotic exoskeletons
upper extremity
assistive technology
home rehabilitation
stroke
spinal cord injury
INDUCED MOVEMENT THERAPY
INDIVIDUALS
PROGRAM
Publication Status
Published
Date Publish Online
2022-10-02