HoMEcare aRm rehabiLItatioN (MERLIN): preliminary evidence of long term effects of telerehabilitation using an unactuated training device on upper limb function after stroke

Juha M Hijmans,Corry K Van Der Sluis,Samantha G Rozevink

doi:10.1186/s12984-021-00934-z

Juha M Hijmans, Corry K Van Der Sluis + Show 1 more

Open Access

https://doi.org/10.1186/s12984-021-00934-z

Copy DOI

Abstract

BackgroundWhile short term effects on upper limb function of stroke patients after training with robotic devices have been studied extensively, long term effects are often not addressed. HoMEcare aRm rehabiLItatioN (MERLIN) is a combination of an unactuated training device using serious games and a telerehabilitation platform in the patient’s home situation. Short term effects showed that upper limb function improved after training with MERLIN. The aim was to determine long term effects on upper limb function and quality of life.MethodsSix months after cessation of the 6 week MERLIN training program, the upper limb function and quality of life of 11 chronic stroke patients were assessed. Upper limb function was measured using the Wolf Motor Function Test (WMFT), Action Research Arm Test (ARAT) and Fugl-Meyer Assessment-Upper Extremity (FMA-UE). EuroQoL-5D (EQ-5D) was used to measure quality of life.ResultsThe WMFT, ARAT and EQ-5D did not show significant differences 6 months after the training period compared to directly after training. At 6 months follow-up, FMA-UE results were significantly better than at baseline. Time plots showed a decreasing trend in all tests.ConclusionTraining effects were still present at 6 months follow-up, since arm function seemed similar to directly after training and FMA-UE results were better than at baseline. However, because of the decreasing trend shown in all tests, it is questionable if improvements will be maintained longer than 6 months. Due to the sample size and study design, results should be interpreted with caution.Trial registration This study is registered at the Netherlands Trial Register (NL7535). Registered 18-02-2019, https://www.trialregister.nl/trial/7535

Highlights

The majority of people who suffered a stroke have persistent problems with using the arm or hand in daily life, with estimates between 62 and 88% [1, 2]
We investigated the long term effect of hoMEcare aRm rehabiLItatioN (MERLIN), an unactuated training device combined with a telecare platform to train the arm and hand at home
A lot of variation in arm function scores could be observed between the patients. In this short report we present the results of a followup study 6 months after cessation of a home rehabilitation program using an unactuated training device

Summary

Introduction

The majority of people who suffered a stroke have persistent problems with using the arm or hand in daily life, with estimates between 62 and 88% [1, 2]. The latest insights show that improvement of the upper limb function is possible even 1 year after stroke onset [4, 5]. Patients with a better upper limb function may be more independent and less reliant on their caregivers, which is important for a stroke survivor [6]. Independence of the patient may unburden the health care system due to a lower need for care and adaptations at home or a reduction in the need for long term therapy. While short term effects on upper limb function of stroke patients after training with robotic devices have been studied extensively, long term effects are often not addressed. Short term effects showed that upper limb function improved after training with MERLIN. The aim was to determine long term effects on upper limb function and quality of life

Objectives

Methods

Results

Discussion

Conclusion