Abstract
BackgroundNew developments, based on the concept of wearable soft-robotic devices, make it possible to support impaired hand function during the performance of daily activities and intensive task-specific training. The wearable soft-robotic ironHand glove is such a system that supports grip strength during the performance of daily activities and hand training exercises at home.DesignThis pilot randomized controlled clinical study explored the effect of prolonged use of the assistive ironHand glove during daily activities at home, in comparison to its use as a trainings tool at home, on functional performance of the hand.MethodsIn total, 91 older adults with self-perceived decline of hand function participated in this study. They were randomly assigned to a 4-weeks intervention of either assistive or therapeutic ironHand use, or control group (received no additional exercise or treatment). All participants performed a maximal pinch grip test, Box and Blocks test (BBT), Jebsen-Taylor Hand Function Test (JTHFT) at baseline and after 4-weeks of intervention. Only participants of the assistive and therapeutic group completed the System Usability Scale (SUS) after the intervention period.ResultsParticipants of the assistive and therapeutic group reported high scores on the SUS (mean = 73, SEM = 2). The therapeutic group showed improvements in unsupported handgrip strength (mean Δ = 3) and pinch strength (mean Δ = 0.5) after 4 weeks of ironHand use (p≤0.039). Scores on the BBT and JTHFT improved not only after 4 weeks of ironHand use (assistive and therapeutic), but also in the control group. Only handgrip strength improved more in the therapeutic group compared to the assistive and control group. No significant correlations were found between changes in performance and assistive or therapeutic ironHand use (p≥0.062).ConclusionThis study showed that support of the wearable soft-robotic ironHand system either as assistive device or as training tool may be a promising way to counter functional hand function decline associated with ageing.
Highlights
Hand function predominantly determines the quality of performance in activities of daily living (ADL) and work-related functioning
This study showed that support of the wearable soft-robotic ironHand system either as assistive device or as training tool may be a promising way to counter functional hand function decline associated with ageing
Four sites (1) Roessingh Research and Development (RRD), Enschede, (2) National Foundation for the Elderly (NFE), Bunnik in the Netherlands, (3) Eskilstuna Kommun Vård- och omsorgsforvaltningen (ESK), Eskilstuna in Sweden and (4) terzStiftung (TERZ), Berlingen in Switzerland were involved in the recruitment of the participants
Summary
Hand function predominantly determines the quality of performance in activities of daily living (ADL) and work-related functioning. Older adults with age-related loss of muscle mass (i.e. sarcopenia) [1] and/or age-related diseases (e.g. stroke, arthritis) [2, 3] suffer from loss of hand function As a consequence, they experience functional limitations, which affects independence in performing ADL [3,4,5]. In a traditional rehabilitation setting, those kinds of interventions are performed with one-on-one attention from the healthcare professional for each patient This might become problematic in the near future when the population of older adults with age-related diseases (e.g. stroke, rheumatoid arthritis) with hand function decline will rise, resulting in an increased need for healthcare professionals and a rise of healthcare costs [8]. The wearable soft-robotic ironHand glove is such a system that supports grip strength during the performance of daily activities and hand training exercises at home
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