Feasibility of post-stroke hand rehabilitation supported by a soft robotic hand orthosis in-clinic and at-home
Abstract Background Stroke is a leading cause of adult disability in the world. Upper limb impairments are common post-stroke, with nearly half of those initially affected continuing to live with long-term functional limitations, impacting their independence and quality of life. Task-specific, inten...
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BMC
2025-08-01
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| Series: | Journal of NeuroEngineering and Rehabilitation |
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| Online Access: | https://doi.org/10.1186/s12984-025-01717-6 |
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| author | Natalie Tanczak Tegan Kate Plunkett Sijie Lin Lorena Kuenzler Megan Lau Wee Keong Christopher Kuah Chwee Yin Ng Roger Gassert Karen Chua Olivier Lambercy |
| author_facet | Natalie Tanczak Tegan Kate Plunkett Sijie Lin Lorena Kuenzler Megan Lau Wee Keong Christopher Kuah Chwee Yin Ng Roger Gassert Karen Chua Olivier Lambercy |
| author_sort | Natalie Tanczak |
| collection | DOAJ |
| description | Abstract Background Stroke is a leading cause of adult disability in the world. Upper limb impairments are common post-stroke, with nearly half of those initially affected continuing to live with long-term functional limitations, impacting their independence and quality of life. Task-specific, intensive therapy has been shown to promote recovery; however, achieving this dose is resource-intensive and logistically challenging. Robotic hand orthoses (RHOs) are a promising approach to support functional rehabilitation regardless of location, thus providing high-dose therapy with minimal additional burden on the clinics. Methods We evaluated the use of the RELab tenoexo 2.0, a soft RHO, in a two-phase feasibility study supporting functional hand training in persons after chronic stroke. Participants (n = 8) first used the device to complete nine training sessions supervised by occupational therapists over 3 weeks in-clinic, then brought the device home to continue the training to complete 2 weeks of unsupervised training. Feasibility was assessed with therapy dose (repetitions and time) and adherence to the suggested at-home rehabilitation program. Functional improvements were tracked using clinical assessments across time points. Finally, usability evaluations provided insights into users’ perceptions of the device. Results During the in-clinic phase, participants completed an average of 809 ± 317 RHO supported repetitions over 521 ± 130 min. At home, this increased to 1293 ± 948 repetitions over 486 ± 125 min across an average of 11.75 ± 5.4 sessions. Across the whole intervention, participant’s mean Action Research Arm Test score increased by 5.0 ± 4.4, whereas the Fugl-Meyer Assessment Upper Extremity score increased by 6.0 ± 2.5. These improvements were retained after one month. The usability was rated as good, with a mean System Usability Scale rating of 72.5, and a mean Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 score of 3.94/5.0. Conclusion This study shows that the RHO can serve as a viable rehabilitation tool for functional hand training after chronic stroke across the continuum of care. High-dose training, both in-clinic and at home, demonstrated the feasibility of the device and intervention, with meaningful clinical improvements highlighting its therapeutic potential as a training strategy. High adherence rates and positive usability indicate strong user acceptance. Trial registration NCT06412237 |
| format | Article |
| id | doaj-art-4aeecdc9f87d4c3092376a580e5e7d46 |
| institution | Kabale University |
| issn | 1743-0003 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of NeuroEngineering and Rehabilitation |
| spelling | doaj-art-4aeecdc9f87d4c3092376a580e5e7d462025-08-24T11:11:36ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032025-08-0122111110.1186/s12984-025-01717-6Feasibility of post-stroke hand rehabilitation supported by a soft robotic hand orthosis in-clinic and at-homeNatalie Tanczak0Tegan Kate Plunkett1Sijie Lin2Lorena Kuenzler3Megan Lau4Wee Keong Christopher Kuah5Chwee Yin Ng6Roger Gassert7Karen Chua8Olivier Lambercy9Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE)Institute of Rehabilitation Excellence (IREx), Tan Tock Seng Hospital Rehabilitation CentreInstitute of Rehabilitation Excellence (IREx), Tan Tock Seng Hospital Rehabilitation CentreFuture Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE)Institute of Rehabilitation Excellence (IREx), Tan Tock Seng Hospital Rehabilitation CentreFuture Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE)Institute of Rehabilitation Excellence (IREx), Tan Tock Seng Hospital Rehabilitation CentreFuture Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE)Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE)Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE)Abstract Background Stroke is a leading cause of adult disability in the world. Upper limb impairments are common post-stroke, with nearly half of those initially affected continuing to live with long-term functional limitations, impacting their independence and quality of life. Task-specific, intensive therapy has been shown to promote recovery; however, achieving this dose is resource-intensive and logistically challenging. Robotic hand orthoses (RHOs) are a promising approach to support functional rehabilitation regardless of location, thus providing high-dose therapy with minimal additional burden on the clinics. Methods We evaluated the use of the RELab tenoexo 2.0, a soft RHO, in a two-phase feasibility study supporting functional hand training in persons after chronic stroke. Participants (n = 8) first used the device to complete nine training sessions supervised by occupational therapists over 3 weeks in-clinic, then brought the device home to continue the training to complete 2 weeks of unsupervised training. Feasibility was assessed with therapy dose (repetitions and time) and adherence to the suggested at-home rehabilitation program. Functional improvements were tracked using clinical assessments across time points. Finally, usability evaluations provided insights into users’ perceptions of the device. Results During the in-clinic phase, participants completed an average of 809 ± 317 RHO supported repetitions over 521 ± 130 min. At home, this increased to 1293 ± 948 repetitions over 486 ± 125 min across an average of 11.75 ± 5.4 sessions. Across the whole intervention, participant’s mean Action Research Arm Test score increased by 5.0 ± 4.4, whereas the Fugl-Meyer Assessment Upper Extremity score increased by 6.0 ± 2.5. These improvements were retained after one month. The usability was rated as good, with a mean System Usability Scale rating of 72.5, and a mean Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 score of 3.94/5.0. Conclusion This study shows that the RHO can serve as a viable rehabilitation tool for functional hand training after chronic stroke across the continuum of care. High-dose training, both in-clinic and at home, demonstrated the feasibility of the device and intervention, with meaningful clinical improvements highlighting its therapeutic potential as a training strategy. High adherence rates and positive usability indicate strong user acceptance. Trial registration NCT06412237https://doi.org/10.1186/s12984-025-01717-6Robotic hand orthosisWearable robotsStroke rehabilitationFeasibilityFunctional trainingNeurorehabilitation |
| spellingShingle | Natalie Tanczak Tegan Kate Plunkett Sijie Lin Lorena Kuenzler Megan Lau Wee Keong Christopher Kuah Chwee Yin Ng Roger Gassert Karen Chua Olivier Lambercy Feasibility of post-stroke hand rehabilitation supported by a soft robotic hand orthosis in-clinic and at-home Journal of NeuroEngineering and Rehabilitation Robotic hand orthosis Wearable robots Stroke rehabilitation Feasibility Functional training Neurorehabilitation |
| title | Feasibility of post-stroke hand rehabilitation supported by a soft robotic hand orthosis in-clinic and at-home |
| title_full | Feasibility of post-stroke hand rehabilitation supported by a soft robotic hand orthosis in-clinic and at-home |
| title_fullStr | Feasibility of post-stroke hand rehabilitation supported by a soft robotic hand orthosis in-clinic and at-home |
| title_full_unstemmed | Feasibility of post-stroke hand rehabilitation supported by a soft robotic hand orthosis in-clinic and at-home |
| title_short | Feasibility of post-stroke hand rehabilitation supported by a soft robotic hand orthosis in-clinic and at-home |
| title_sort | feasibility of post stroke hand rehabilitation supported by a soft robotic hand orthosis in clinic and at home |
| topic | Robotic hand orthosis Wearable robots Stroke rehabilitation Feasibility Functional training Neurorehabilitation |
| url | https://doi.org/10.1186/s12984-025-01717-6 |
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