Abstract
BackgroundImpaired dexterity of the weaker upper extremity is common post stroke and it is recommended that these individuals practice many repetitions of movement to regain function. However, stroke rehabilitation methods do not achieve the required intensity to be effective. Touchscreen tablet technology may be used as a motivating tool for self-training impaired dexterity of the weaker upper extremity post stroke.Methods/DesignRehab-let is a self-training protocol utilizing game apps on a touchscreen for practicing movement of the weaker upper extremity. We will conduct a pilot randomized controlled trial to assess Rehab-let compared to traditional self-training to improve dexterity of the weaker hand, and to increase self-training time and satisfaction in individuals with subacute stroke. Forty individuals with stroke undergoing subacute rehabilitation will be randomly allocated to Rehab-let or a traditional self-training program using therapeutic aids such as balls, blocks and pegs. All participants will be requested to perform self-training for 60 minutes a day, 5 times a week for 4 weeks. Dexterity assessed by The Nine Hole Peg Test is the main outcome measure. Assessments will be administered pre and post the self-training intervention by assessors blind to the group allocation.DiscussionThe outcomes of this study will inform the design of a fully powered randomized controlled trial to evaluate the effectiveness of Rehab-let. If found to be effective, Rehab-let can be used during subacute rehabilitation to increase treatment intensity and improve dexterity. Potentially, Rehab-let can also be used after discharge and might be ideal for individuals with mild stroke who are often not referred to formal rehabilitation.Trial RegistrationCurrent Controlled Trials NCT02136433 registered on 17 September 2014.
Highlights
Impaired dexterity of the weaker upper extremity is common post stroke and it is recommended that these individuals practice many repetitions of movement to regain function
The outcomes of this study will inform the design of a fully powered randomized controlled trial to evaluate the effectiveness of Rehab-let
If found to be effective, Rehab-let can be used during subacute rehabilitation to increase treatment intensity and improve dexterity
Summary
Self-training is a time-efficient and cost-effective way [8] to increase treatment time for the weaker upper extremity. Tablets may be used to train other impairments, such as cognitive or language deficits, which are common post stroke [32] Such a self-training protocol may help transfer some of the responsibility of rehabilitation to the clients themselves: i.e., self-management, possibly increasing their selfefficacy as well as improvement of the weaker upper extremity. Mild stroke accounts for 60 % of all cases of stroke [33] and, despite the fact that these individuals are considered not to have disabling functional deficits [34], they might experience motor, sensory, visual, speech or cognitive deficits [34, 35] These individuals are usually discharged home [36] without further rehabilitation since they are expected to return to their premorbid status [37].
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