A home-based hand rehabilitation platform for hemiplegic patients after stroke: a feasibility study

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Banihani, Jasem
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Background: Patients with stroke often experience weakened upper limbs, making daily tasks difficult. Although rehabilitation devices are available, patients often relapse after discharge due to insufficient practice. We present a home-based hand telerehabilitation intervention using the iManus platform comprising a sensorized glove that captures hand movement range of motion values and a mobile app for the patients, alongside a therapist portal for monitoring patient progress. Objective: This research aimed to examine the feasibility, safety, and effectiveness of a home-based telerehabilitation intervention, in improving hand function for individuals with mild stroke. Additionally, a qualitative approach was used to explore users' experiences, perceived benefits, and challenges associated with using the platform in a home setting. Methods: In this single-case study, we delivered a hand telerehabilitation intervention to a chronic stroke patient with impaired hand function using the iManus platform. The intervention consisted of 40 home sessions over eight weeks. We assessed feasibility through user adherence and feedback obtained using a System Usability Scale (SUS) and a semi-structured interview with the participant and an informal caregiver. Safety was evaluated by monitoring pain levels using the Visual Analog Scale (VAS), while efficacy was determined through observing the changes in range of motion using the iManus platform and clinical outcomes measures, namely the Fugl Meyer Assessment (FMA) and Jebsen Taylor Hand Function Test (JTHFT). Results: The participant completed all 40 assigned sessions, with each averaging 20 minutes. Usability scored 77.5 out of 100 on the SUS. User feedback from the interviews revealed improved mobility and control over therapy as benefits, while also indicating room for improvement in the intervention's adaptability and functionality. During the intervention, the participant noted no pain increase, and the telerehabilitation platform recorded range of motion improvements for all finger and wrist joints, excluding wrist extension. The FMA scores were 43 at T0, 53 at T1, and 56 at T2, while the JTHFT scores were 223 at T0, 188 at T1, and 240 at T2. Conclusion: This single case study demonstrated the feasibility, safety, and efficacy of a home-based hand intervention for stroke survivors. The participant demonstrated improved hand functions, adherence to the program, and reported satisfaction with the intervention. However, these results are preliminary and require further validation in a larger-scale study.
telerehabilitation, e-Health, at-home hand rehabilitation, remote physical therapy, telemonitoring, non-supervised therapy, hand exoskeleton