[ARTICLE] The Efficacy of a Haptic-enhanced Virtual Reality System for Precision Grasp Acquisition in Stroke Rehabilitation – Full Text PDF

ABSTRACT
Stroke is a leading cause of long-term disability, and virtual reality (VR)-based stroke rehabilitation is effective in increasing motivation and the functional performance in people with stroke. Although much of the functional reach and grasp capabilities of the upper extremities is regained, the pinch
movement remains impaired following stroke. In this study, we developed a haptic-enhanced VR system to simulate haptic pinch tasks to assist in long-term post-stroke recovery of upper-extremity fine motor function. We recruited 16 adults with stroke to verify the efficacy of this new VR system.
Each patient received 30-min VR training sessions 3 times per week for 8 weeks; all participants attended all 24 training sessions. Outcome measures, Fugl Meyer Assessment (FMA), Test Evaluant les Membres superieurs des Personnes Agees (TEMPA), Wolf Motor Function Test (WMFT), Box and
Block Test (BBT), and Jamar Grip Dynamometer, showed statistically significant progress from pretest to posttest and follow-up, indicating that the proposed system effectively promoted fine motor recovery of function. Additionally, our evidence suggests that this system was also effective under certain challenging conditions such as being in the chronic stroke phase or a co-side of lesion and dominant hand (non- dominant hand impaired). System usability assessment indicated the participants strongly intended to continue using this VR-based system in rehabilitation.

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[ARTICLE] Task-specific reach-to-grasp training after stroke: Development and description of a home-based intervention – UWE Research Repository

Abstract

Objective: To describe and justify the development of a home-based, task-specific upper limb training intervention to improve reach-to-grasp after stroke and pilot it for feasibility and acceptability prior to a randomised controlled trial.

Intervention description: The intervention is based on intensive practice of whole reach-to-grasp tasks and part-practice of essential reach-to-grasp components. A ‘pilot’ manual of activities covering the domains of self-care, leisure and productivity was developed for the feasibility study. The intervention comprises 14 hours of therapist-delivered sessions over 6 weeks, with additional self-practice recommended for 42 hours (i.e. 1 hour every day). As part of a feasibility randomised controlled trial, 24 people with a wide range of upper limb impairment after stroke experienced the intervention to test adherence and acceptability. The median number of repetitions in 1-hour therapist-delivered sessions was 157 (IQR: 96-211). The amount of self-practice was poorly documented. Where recorded, median amount of practice was 30 minutes (IQR: 22-45) per day. Findings demonstrated that the majority of participants found the intensity, content and level of difficulty of the intervention acceptable, and the programme to be beneficial. Comments on the content and presentation of the self-practice material were incorporated in a revised ‘final’ intervention manual.

Discussion: A comprehensive training intervention to improve reach-to-grasp for people living at home after stroke has been described in accordance with the TIDieR reporting guidelines. The intervention has been piloted, found to be acceptable and feasible in the home setting.

Source: Task-specific reach-to-grasp training after stroke: Development and description of a home-based intervention – UWE Research Repository

[ARTICLE] Abstract – Passive reach and grasp with functional electrical stimulation and robotic arm support

…Here, we investigate the technical feasibility of an integrated training system combining robotics and functional electrical stimulation (FES) to support reach and grasp during functional manipulation of objects. To support grasp and release, FES controlled the thumb and fingers using Model Predictive Control (MPC), while a novel 3D robotic manipulator provided reach support…

via IEEE Xplore Abstract (Abstract) – Passive reach and grasp with functional electrical stimulation and robotic arm support.