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Background: Upper extremity (UE) stroke rehabilitation requires patients to perform exercises at home, yet patients show limited benefit from paper-based home exercise programs.

Objective: To compare the effectiveness of 2 home exercise programs for reducing UE impairment: a paper-based approach and a sensorized exercise system that incorporates recommended design features for home rehabilitation technology.

Methods: In this single-blind, randomized controlled trial, 27 participants in the subacute phase of stroke were assigned to the sensorized exercise (n = 14) or conventional therapy group (n = 13), though 2 participants in the conventional therapy group were lost to follow-up. Participants were instructed to perform self-guided movement training at home for at least 3 hours/week for 3 consecutive weeks. The sensorized exercise group used FitMi, a computer game with 2 puck-like sensors that encourages movement intensity and auto-progresses users through 40 exercises. The conventional group used a paper book of exercises. The primary outcome measure was the change in Upper Extremity Fugl-Meyer (UEFM) score from baseline to follow-up. Secondary measures included the Modified Ashworth Scale for spasticity (MAS) and the Visual Analog Pain (VAP) scale.

Results: Participants who used FitMi improved by an average of 8.0 ± 4.6 points on the UEFM scale compared to 3.0 ± 6.1 points for the conventional participants, a significant difference ( t -test, P = .029). FitMi participants exhibited no significant changes in UE MAS or VAP scores.

Conclusions: A sensor-based exercise system incorporating a suite of recommended design features significantly and safely reduced UE impairment compared to a paper-based, home exercise program.

Trial Registration: ClinicalTrials.gov Identifier: NCT03503617.

Titel:	Optimized Home Rehabilitation Technology Reduces Upper Extremity Impairment Compared to a Conventional Home Exercise Program: A Randomized, Controlled, Single-Blind Trial in Subacute Stroke.
Autor/in / Beteiligte Person:	Swanson, VA ; Johnson, C ; Zondervan, DK ; Bayus, N ; McCoy, P ; Ng, YFJ ; Schindele Bs, J ; Reinkensmeyer, DJ ; Shaw, S
Zeitschrift:	Neurorehabilitation and neural repair, Jg. 37 (2023), Heft 1, S. 53-65
Veröffentlichung:	2002- : Thousand Oaks, CA : Sage Publications ; <i>Original Publication</i>: New York, NY : Demos Medical Pub., c1999-, 2023
Medientyp:	academicJournal
ISSN:	1552-6844 (electronic)
DOI:	10.1177/15459683221146995
Schlagwort:	Humans Single-Blind Method Recovery of Function Treatment Outcome Upper Extremity Muscle Spasticity Stroke complications Stroke Rehabilitation
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Randomized Controlled Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Language: English [Neurorehabil Neural Repair] 2023 Jan; Vol. 37 (1), pp. 53-65. <i>Date of Electronic Publication: </i>2023 Jan 12. MeSH Terms: Stroke* / complications ; Stroke Rehabilitation* ; Humans ; Single-Blind Method ; Recovery of Function ; Treatment Outcome ; Upper Extremity ; Muscle Spasticity References: Aust J Physiother. 2006;52(4):241-8. (PMID: 17132118) ; Stat Med. 1994 Jul 15-30;13(13-14):1341-52; discussion 1353-6. (PMID: 7973215) ; Phys Ther. 1987 Feb;67(2):206-7. (PMID: 3809245) ; Cochrane Database Syst Rev. 2007 Oct 17;(4):CD006073. (PMID: 17943883) ; Neurorehabil Neural Repair. 2015 Jun;29(5):395-406. (PMID: 25273359) ; Bioinformatics. 2012 Jan 1;28(1):112-8. (PMID: 22039212) ; Disabil Rehabil Assist Technol. 2016 Nov;11(8):653-60. (PMID: 25879304) ; Lancet Neurol. 2017 Oct;16(10):826-836. (PMID: 28920888) ; Curr Opin Neurol. 2010 Dec;23(6):683-7. (PMID: 20852420) ; Curr Opin Neurol. 2010 Dec;23(6):671-7. (PMID: 20962639) ; Int J Stroke. 2017 Jul;12(5):480-493. (PMID: 28697711) ; Neurorehabil Neural Repair. 2018 Jan;32(1):73-83. (PMID: 29334831) ; IEEE Eng Med Biol Mag. 2005 Jan-Feb;24(1):36-9. (PMID: 15709534) ; Stroke. 2007 Feb;38(2 Suppl):840-5. (PMID: 17261749) ; Arch Phys Med Rehabil. 2009 Oct;90(10):1692-8. (PMID: 19801058) ; Stroke. 2004 Jun;35(6):1410-4. (PMID: 15087552) ; Proc Hum Factors Ergon Soc Annu Meet. 2018 Sep;62(1):1037-1041. (PMID: 35465216) ; Cochrane Database Syst Rev. 2003;(1):CD002925. (PMID: 12535444) ; Clin Rehabil. 2001 Feb;15(1):20-31. (PMID: 11237158) ; Cochrane Database Syst Rev. 2013 Dec 16;(12):CD010255. (PMID: 24338496) ; IEEE J Biomed Health Inform. 2014 Nov;18(6):1804-12. (PMID: 25014974) ; Neurorehabil Neural Repair. 2013 Oct;27(8):732-41. (PMID: 23774125) ; Conf Proc IEEE Eng Med Biol Soc. 2004;2004:4787-90. (PMID: 17271381) ; Clin Rehabil. 2005 Jun;19(4):404-11. (PMID: 15929509) ; Stroke. 1998 Apr;29(4):785-92. (PMID: 9550512) ; Neurorehabil Neural Repair. 2010 Sep;24(7):620-35. (PMID: 20424192) ; Int J Med Inform. 2019 Mar;123:11-22. (PMID: 30654899) ; Top Stroke Rehabil. 2011 Oct;18 Suppl 1:599-610. (PMID: 22120029) ; Prev Med. 2003 Jan;36(1):17-29. (PMID: 12473421) ; Int J Environ Res Public Health. 2021 Sep 28;18(19):. (PMID: 34639494) ; Top Stroke Rehabil. 2011 May-Jun;18(3):277-84. (PMID: 21642065) ; Stroke. 2020 Sep;51(9):2639-2648. (PMID: 32811378) ; Med Sci Sports Exerc. 1997 Aug;29(8):977-85. (PMID: 9268953) ; Disabil Rehabil. 2017 May;39(9):934-939. (PMID: 27062881) ; Phys Ther. 1993 Nov;73(11):771-82; discussion 783-6. (PMID: 8234458) ; Circulation. 2019 Mar 5;139(10):e56-e528. (PMID: 30700139) ; IEEE Int Conf Rehabil Robot. 2013 Jun;2013:6650400. (PMID: 24187219) ; Muscle Nerve. 2001 Aug;24(8):1000-19. (PMID: 11439375) ; Phys Ther. 2012 Jun;92(6):791-8. (PMID: 22282773) ; Spinal Cord. 2009 Mar;47(3):196-203. (PMID: 18825160) ; Med Care. 2005 Mar;43(3):203-20. (PMID: 15725977) ; Lancet Neurol. 2004 Sep;3(9):528-36. (PMID: 15324721) ; Front Neurol. 2022 Jun 20;13:896298. (PMID: 35795800) ; Stroke. 2019 Jul;50(7):1831-1837. (PMID: 31164067) ; Proc Natl Acad Sci U S A. 2021 Sep 28;118(39):. (PMID: 34544853) ; Am J Occup Ther. 2016 May-Jun;70(3):7003290020p1-8. (PMID: 27089296) ; Int Disabil Stud. 1990 Jan-Mar;12(1):6-9. (PMID: 2211468) ; Top Stroke Rehabil. 2022 Sep;29(6):449-463. (PMID: 34281494) ; Arch Phys Med Rehabil. 2021 Jan;102(1):115-131. (PMID: 32339483) ; J Rehabil Res Dev. 2006 Aug-Sep;43(5):671-8. (PMID: 17123207) ; Int J Med Inform. 2018 Jun;114:66-75. (PMID: 29673606) ; Stroke. 2014 Jul;45(7):2053-8. (PMID: 24867924) Grant Information: R44 AG059256 United States AG NIA NIH HHS Contributed Indexing: Keywords: FitMi; exercise therapy; home exercise program; mRehab; rehabilitation; sensors; stroke Molecular Sequence: ClinicalTrials.gov NCT03503617 Entry Date(s): Date Created: 20230113 Date Completed: 20230202 Latest Revision: 20230301 Update Code: 20231215 PubMed Central ID: PMC9896541

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Optimized Home Rehabilitation Technology Reduces Upper Extremity Impairment Compared to a Conventional Home Exercise Program: A Randomized, Controlled, Single-Blind Trial in Subacute Stroke.