Hand rehabilitation designs should consider people with poor hand function due to spasticity: An observational study (Preprint)

Abstract

The human hand is crucial for carrying out activities of daily living as well as interacting with the environment. The functional use of the hand is affected in 75% of those who suffer a stroke as a result of lingering mobility impairment in their hand and upper limbs after a stroke. Rehabilitation can help stroke survivors regain function and there are several rehabilitation technologies and devices that aim to improve the functions of the hand in stroke survivors.

In this study, we observed how stroke survivors with poor hand function interacted with some of these hand technologies/ devices.

Twenty-nine (29) participants included in this study engaged in an eight-week rehabilitation intervention at a technology-enriched rehabilitation gym. The participants spent 50 to 60 minutes of the two-hour session in the upper limb gym at least twice a week. Each participant communicated their rehabilitation goals and an action research arm test (ARAT) was used to measure and categorize their levels of hand impairment (poor, moderate, and good) prior to the intervention. Participants with poor hand function were observed interacting with three rehabilitation devices that focused on improving hand function; Gripable™, Neuroball™, and Peg board. Observations of technology interactions were recorded for each session.

Of the twenty-nine ((n=29) participants, 10/29 (34%) had poor hand function, 17/29 (59%) had moderate hand function, and 2/29 (7%) had good hand function. Of the 10 with poor hand function, 8/10 (80%) could not interact with any of the hand-based technologies. This was observed to be a result of either the presence of high muscle tone/stiffness or muscle weakness.

Not all stroke survivors with impairments in their hands can make use of the available hand rehabilitation technologies. With a good number of persons limited from actively benefitting from hand rehabilitation using technologies, there is a need for rehabilitation designs intended to improve hand functions to take into cognizance the needs of people with poor hand function as a result of spasticity.