Sensor-Based Arm Skill Training in Chronic Stroke Patients: Results on Treatment Outcome, Patient Motivation, and System Usability

Abstract

As stroke incidence increases, therapists' time is under pressure. Technology-supported rehabilitation may offer new opportunities. The objective of this study was to evaluate patient motivation for and the feasibility and effects of a new technology-supported task-oriented arm training regime (T-TOAT). Nine chronic stroke patients performed T-TOAT (2 x 30 min/day, four days/week) during eight weeks. A system including movement tracking sensors, exercise board, and software-based toolkit was used for skill training. Measures were recorded at baseline, after four and eight weeks of training, and six months posttraining. T-TOAT improved arm-hand performance significantly on Fugl-Meyer, Action Research Arm Test, and Motor Activity Log. Training effects lasted at least six months posttraining. Health-related-quality-of-life had improved significantly after eight weeks of T-TOAT with regard to perceived physical health, but not to perceived mental health (SF-36). None of the EuroQol-5D components showed significant differences before and after training. Participants were intrinsically motivated and felt competent to use the system. Furthermore, system usability was rated very good. However, exercise challenge as perceived by participants decreased significantly over eight weeks of training. The results of this study indicate that T-TOAT is feasible. Despite the small number of stroke patients tested, significant and clinically relevant improvements in skilled arm-hand performance were found.