Hand Function In Stroke Patients Research Articles

Relationship between Hand grip strength and Hand function in patients with Stroke: A Cross-Sectional Study

BackgroundHands are vital and inevitable organs. It's essential to evaluate hand function post-stroke as it is a major source of impairment. Grip strength gives a guide to hand function as a measure of impairment. The modified Sphygmomanometer Test (MST) offers an intriguing alternative method for assessing hand grip strength as compared to using hand-held dynamometers. ObjectivesThe study aimed to investigate the correlation between hand grip strength and hand function in stroke patients. MethodsA cross-sectional research was carried out on a group of 45 stroke patients, ranging in age from 40 to 70 years. The assessment included the measurement of hand grip strength through the Modified Sphygmomanometer Test (MST), as well as the evaluation of hand function using the Box and Block Test (BBT) and the Jebsen Taylor Hand Function Test (JTHFT). Correlation analysis was performed using the Pearson correlation coefficient test. ResultsThe outcomes showed a strong to excellent between MST and BBT (r = 0.909, p = 0.000); and between MST and JTHFT Non Dominant Hand (JTHFTNDH, r = −0.669 and p = 0.000). However, there was a weak correlation between MST and JTHFT Dominant Hand, and this correlation was not statistically significant (r = −0.243 and p = 0.108). ConclusionThe findings indicated a relationship between hand grip strength and hand function among stroke patients. MST holds potential as a convenient, objective and cost-effective alternative in clinical settings for evaluating hand grip strength and predicting hand function.

Effect of Soft Rehabilitation Robot Gloves on Upper Limb and Hand Function of Stroke Patients：A Meta-Analysis

Effect of Soft Rehabilitation Robot Gloves on Upper Limb and Hand Function of Stroke Patients：A Meta-Analysis

A Newly-Designed Wearable Robotic Hand Exoskeleton Controlled by EMG Signals and ROS Embedded Systems

One of the most difficult parts of stroke therapy is hand mobility recovery. Indeed, stroke is a serious medical disorder that can seriously impair hand and locomotor movement. To improve hand function in stroke patients, new medical technologies, such as various wearable devices and rehabilitation therapies, are being developed. In this study, a new design of electromyography (EMG)-controlled 3D-printed hand exoskeleton is presented. The exoskeleton was created to help stroke victims with their gripping abilities. Computer-aided design software was used to create the device’s 3D architecture, which was then printed using a polylactic acid filament. For online classifications, the performance of two classifiers—the support vector machine (SVM) and the K-near neighbor (KNN)—was compared. The Robot Operating System (ROS) connects all the various system nodes and generates the decision for the hand exoskeleton. The selected classifiers had high accuracy, reaching up to 98% for online classification performed with healthy subjects. These findings imply that the new wearable exoskeleton, which could be controlled in accordance with the subjects’ motion intentions, could aid in hand rehabilitation for a wider motion range and greater dexterity.

Correlation between the ERD in grasp/open tasks of BCIs and hand function of stroke patients: a cross-sectional study

Background and aimsBrain-computer interfaces (BCIs) are emerging as a promising tool for upper limb recovery after stroke, and motor tasks are an essential part of BCIs for patient training and control of rehabilitative/assistive BCIs. However, the correlation between brain activation with different levels of motor impairment and motor tasks in BCIs is still not so clear. Thus, we aim to compare the brain activation of different levels of motor impairment in performing the hand grasping and opening tasks in BCIs.MethodsWe instructed stroke patients to perform motor attempts (MA) to grasp and open the affected hand for 30 trials, respectively. During this period, they underwent EEG acquisition and BCIs accuracy recordings. They also received detailed history records and behavioral scale assessments (the Fugl-Meyer assessment of upper limb, FMA-UE).ResultsThe FMA-UE was negatively correlated with the event-related desynchronization (ERD) of the affected hemisphere during open MA (R = − 0.423, P = 0.009) but not with grasp MA (R = − 0.058, P = 0.733). Then we divided the stroke patients into group 1 (Brunnstrom recovery stages between I to II, n = 19) and group 2 (Brunnstrom recovery stages between III to VI, n = 23). No difference during the grasping task (t = 0.091, P = 0.928), but a significant difference during the open task (t = 2.156, P = 0.037) was found between the two groups on the affected hemisphere. No significant difference was found in the unaffected hemisphere.ConclusionsThe study indicated that brain activation is positively correlated with the hand function of stroke in open-hand tasks. In the grasping task, the patients in the different groups have a similar brain response, while in the open task, mildly injured patients have more brain activation in open the hand than the poor hand function patients.

Mechanical design and feasibility of a finger exoskeleton to support finger extension of severely affected stroke patients.

In this paper we presented the mechanical design and evaluation of a low-profile and lightweight exoskeleton that supports the finger extension of stroke patients during daily activities without applying axial forces to the finger. The exoskeleton consists of a flexible structure that is secured to the index finger of the user while the thumb is fixed in an opposed position. Pulling on a cable will extend the flexed index finger joint such that objects can be grasped. The device can achieve a grasp size of at least 7 cm. Technical tests confirmed that the exoskeleton was able to counteract the passive flexion moments corresponding to the index finger of a severely affected stroke patient (with an MCP joint stiffness of k = 0.63Nm/rad), requiring a maximum cable activation force of 58.8N. A feasibility study with stroke patients (n=4) revealed that the body-powered operation of the exoskeleton with the contralateral hand caused a mean increase of 46° in the range of motion of the index finger MCP joint. The patients (n=2) who performed the Box & Block Test were able to grasp and transfer maximally 6 blocks in 60 sec. with exoskeleton, compared to 0 blocks without exoskeleton. Our results showed that the developed exoskeleton has the potential to partially restore hand function of stroke patients with impaired finger extension capabilities. An actuation strategy that does not involve the contralateral hand should be implemented during further development to make the exoskeleton suitable for bimanual daily activities.

Effect of Rhythmic Auditory Stimulation against Mirror Therapy on Hand Function in Stroke Patients

Objective: Stroke affects the upper limb function keeping the patient dependent for daily activities. Rhythmic auditory stimulation is proved to be beneficial in upper limb functions, although Mirror therapy and Conventional therapy has their own beneficial effects in stroke. The study aimed at comparing the effect of rhythmic auditory stimulation against mirror therapy and conventional therapy. Method: Sixty participants were taken for the study divided into three groups, 20 in each. Interventions were planned with Group A for Conventional therapy, Group B for Rhythmic Auditory Stimulation and Group C as Mirror therapy. Hand grip was measured by Hand held Dynamometer and Hand function by using Action Research Arm Test. Treatment was given for 20 minutes in a day, for 5 sessions a week extending for 4 weeks. Findings: The results obtained after the analysis showed a significant difference in ARAT scores among three groups: Control (34.808.27), RAS (40.607.12) and Mirror therapy (33.507.86) with mean post-test scores (F=4.7400, p=0.0120) and change from pre-test to post-test (F=67.2790, p=0.0001). A significant difference was observed among three groups: Control (21.286.82), RAS (27.616.94) and Mirror therapy (23.39 5.47) with mean post-test scores (F=5.0040, P=0.0100) and pretest posttest score for hand grip (F=59.6750, P=0.0001). Novelty: Mirror therapy and rhythmic auditory stimulation influences the visual and the auditory system respectively. The novelty of this study is being exhibited in identifying the effective intervention that can influence the neuroplasticity of the brain in the learning process. Conclusion: Both RAS and mirror therapy programme have been found to improve hand functions and grip in paretic arms; hence they can be used as an add-on intervention alongside convention therapy to help hemi paretic patients regain upper extremity function. Keywords: Rhythmic Auditory stimulation; Mirror box; Paretic arm; Hand function and Hand grip

Application of Multi-Dimensional Intelligent Visual Quantitative Assessment System to Evaluate Hand Function Rehabilitation in Stroke Patients.

Hand dysfunction is one of the main symptoms of stroke patients, but there is still a lack of accurate hand function assessment systems. This study focused on the application of the multi-dimensional intelligent visual quantitative assessment system (MDIVQAS) in the rehabilitation assessment of hand function in stroke patients and evaluate hand function rehabilitation in stroke patients. Eighty-two patients with stroke and unilateral hand dysfunction were evaluated by MDIVQAS. Cronbach's Alpha coefficient was used to assess the internal consistency of MDIVQAS; the F-test is used to assess the differences in MDIVQAS for multiple repeated measures. Spearman's analysis was used to identify correlations of MDIVQAS with other assessment systems. t-tests were used to identify differences in outcomes assessed with MDIVQAS in patients before and after treatment. p < 0.05 were considered significant. (1) Cronbach's Alpha coefficient of MDIVQAS in evaluating hand's function > 0.9. (2) There was no significant difference between the other repeated measurements, except for thumb rotation in MDIVQAS. (3) MDIVQAS had a significant correlation with other assessment systems (r > 0.5, p < 0.01). (4) There were significant differences in the evaluation of hand function in patients before and after treatment using MDIVQAS. The MDIVQAS system has good reliability and validity in the evaluation of stroke hand function, and it can also better evaluate the treatment effect.

Development of an Untethered Adaptive Thumb Exoskeleton for Delicate Rehabilitation Assistance

Robot-assisted thumb rehabilitation can improve the hand function of stroke patients because the thumb accounts for 40% of hand function. However, existing thumb rehabilitation robots are limited in terms of portability, comfort, adaptability, and independent joint actuation. This article proposes an untethered adaptive thumb exoskeleton that actively assists the 3-degree-of-freedom movements of the thumb. The exoskeleton is composed of an adaptive thumb mechanism and a spherical mechanism. The kinematics, statics, and performances of the adaptive thumb mechanism and the spherical mechanism are analyzed. Experimental validation is performed to test the workspace, self-alignment, interaction forces, admittance controller, and grasping assistance performance of the exoskeleton. The workspace and self-aligning experiments prove that the proposed exoskeleton can achieve a large workspace of the thumb joints and realize self-alignment. The interaction force experimental results show that the exoskeleton can reduce the tangential interaction forces by 76.8% and improve comfort. Finally, the control and delicate grasping assistance experiments validate the exoskeleton’s ability to realize the delicate grasping of the thumb. These characteristics show that the thumb exoskeleton has the potential to assist delicate thumb rehabilitation.

Investigation of therapeutic effects of wearable robotic gloves on improving hand function in stroke patients: A systematic review.

Background: Over the past decades, wearable robotic gloves due to their positive features are used by clinicians to improve motor function in the upper extremity. This systematic review aims to evaluate the studies that investigated the therapeutic effects of wearable robotic gloves to improve hand function in stroke patients. Methods: The most related databases including MEDLINE (PubMed), ISI Web of Knowledge, Scopus, IEEE, and Google Scholar were systematically searched and studies were collected up to September 2021. The methodological quality assessment was done using an adapted version of the Downs and Black checklist. Results: Of the 2674 articles searched, 5 studies were recognized as being relevant in this systematic review. The methodological quality of all included studies was between 7 to 10 points of adapted 12-point score of Downs and Black checklist. All studies concluded that the introduced robotic device had a good therapeutic effect on investigated patients' hand function. The studies had limitations in terms of the level of evidence, sample size, stroke patient groups, and therapeutic process. Conclusion: There is no standard approach with definite intervention timing to evaluate the effect of such devices. Therefore, more comprehensive studies are needed to confirm the therapeutic effects of wearable robotic gloves on improving hand function after a stroke.

Effect of motor relearning program on the upper limb function in stroke survivors: A systematic review

Background
 Problems with upper limb impairments are very common after a stroke. Improving arm function is a core element of rehabilitation. Many physiotherapy interventions have been developed some of which has have found to be beneficial.
 
 Objective
 To analyze the effect of motor relearning program (MRP) on the upper limb function in stroke survivors.
 
 Data sources
 This systematic review included Randomized Controlled Trials (RCTs) and quasi-experimental studies for patients suffering from stroke. The articles were retrieved from
 Google Scholar, Cochrane and Pub Med. Articles were also accessed from Journals.
 
 Study selection
 Data belonging from 2012 to 2021 were included. RCTs and quasi experimental studies that focused on motor relearning program for upper limb/hand for stroke patients were included in this review.
 
 Results
 Total 10 studies were included in this review with 339 patients. Among them, 217 had received MRP whereas, 122 had received other physiotherapy treatment technique for stroke rehabilitation.
 
 Conclusion
 MRP given alone or in conjunction with other physiotherapeutic treatment is likely to yield beneficial results for improving the upper limb /hand function in stroke patients.

Non-motorised Rehabilitation Device for Performance Assessment in Upper Limb Stroke Rehabilitation: A Pilot Study

Stroke patients with upper limb disability restricted to carry out their activities of daily living. The patient needs a motivation to recover from a stroke and the patient also needs to go through a rehabilitation process at the same time. The conventional rehabilitation process scoring systems are always subjective, lack reliability and relies heavily on the ability of the trained physiotherapist that providing only rough estimates on motor function. On the other hand, robot-based assessments are objective, repeatable, and could potentially reduce the assessment time. Therefore, a simple non-motorized device was developed as a tool to objectively assess hand function of stroke patients. This study was carried out to investigate the suitability of using thedeveloped device with stroke patient populations and to evaluate the performance of clinical scores prediction of the stroke patients. A total of five patients with upper limb disability following stroke consented to take part in this study. Twelve predictive variables were investigated, relating to the total movement time, velocity, strategy, accuracy, and smoothness from three robotic assessment modules which are Draw I, Draw Diamond and Draw Circle. The hardware for measuring elbow angle hasbeen developed to measurethe shoulder movement performedby patient during the assessment process. In addition to that, the shoulder movement calculation method has been proposed and validated.The findings indicatethat the performance of prediction for all assessment modules hasbeen increased after implementing the shoulder movement calculation. It is recommended this calculation method to be used in conjunction with kinematic variables to carry out the data acquisition process in the future for improvement of effectiveness and accuracy of the robotic assessment.

Effectiveness of a Soft Robotic Glove to Assist Hand Function in Stroke Patients: A Cross-Sectional Pilot Study.

Purpose Stroke patients have difficulty performing tasks using their paretic hands. There are limited data on the effects of using a soft robotic glove to assist with hand function. The objective of this study was to investigate the effectiveness of a soft robotic glove in assisting hand function in stroke patients. Methods This study was a cross-sectional pilot study. Twenty stroke patients with partial or complete hand weakness were recruited from a rehabilitation centre. The Box and Block Test (BBT) and the Action Research Arm Test (ARAT) were performed under two conditions: with and without use of the soft robotic glove. The order of the conditions was randomly assigned by a computer-generated program. Results BBT scores increased 6.4 blocks when using the soft robotic glove (p < 0.001). ARAT grasp, grip, pinch, and overall scores increased by 27.08% (p < 0.01), 28.75% (p < 0.001), 15.89% (p < 0.01), and 21.15% (p < 0.001), respectively, using the glove versus not using the glove. Conclusions The findings of this study suggest that using a soft robotic glove can assist a poststroke paretic hand in executing grasp, grip, and pinch.

A Study on the Effect of Functional Electrical Stimulation on Hand Function in Stroke Patients with Flexor Synergy in Upper Limb

Background and Purpose: To determine whether Functional Electrical Stimulation can improve motor function of hand in spastic hemiplegics and whether any improvements are maintainedMethods: 30 subjects of stroke with spastic hemiplegia with flexor synergy upper limb. 15 patients in each group, Group A (Functional Electrical Stimulation group) &amp; Group B (Control group). GroupA received Functional Electrical Stimulation plus standard inpatient/outpatient stroke rehabilitation program. Group-B received only standard inpatient/outpatient stroke rehabilitation program. Assessment data were recorded before treatment, at 4, 8, 12 and 24 weeks. Outcome Measures were Action Research Arm Test Score, Range Of Motion of Active Wrist extension, Functional independence measure, Modified Ashworth Scale.Results: Use of Functional Electrical Stimulation resulted in improvement of hand functions in patients. There was decrease in wrist flexors muscle tone and subsequent improvement in activities of daily livings observed. There was no significant improvement observed in Active Wrist extension.Conclusion: Functional Electrical Stimulation is an important intervention in the treatment of stroke with spastic hemiplegia. It can help in the improvement of hand functions when prescribed along with exercises.

Effect of Transcranial Direct Current Stimulation Combined with Rehabilitation on Arm and Hand Function in Stroke Patients: A Systematic Review and Meta-Analysis.

Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that may enhance motor recovery after stroke. We performed a systematic review and meta-analysis to assess the efficacy of tDCS combined with rehabilitation on arm and hand function after stroke. Electronic databases were searched from their inception to September 2021. We performed a systematic review of selected randomized controlled trials, and methodological qualities were measured using the PEDro (Physiotherapy Evidence Database) scale. We calculated the standardized mean difference for effect size using the Comprehensive Meta-Analysis 3.0 software. We selected 28 studies for the systematic review and 20 studies for the meta-analysis. The overall effect size was 0.480 (95% CI [0.307; 0.653], p < 0.05), indicating a moderate effect size of tDCS combined with rehabilitation for upper extremity function in stroke survivors. The tDCS with occupational therapy/physical therapy (0.696; 95% CI [0.390; 1.003], p < 0.05) or virtual reality therapy (0.510; 95% CI [0.111; 0.909], p < 0.05) was also significantly more effective than other treatments. This meta-analysis of 20 randomized controlled trials provides further evidence that tDCS combined with rehabilitation, especially occupational therapy/physical therapy and virtual reality therapy, may benefit upper extremity function of the paretic upper limb in stroke patients.

Correlation Between Age of Stroke Patients and Mental Imagery to Improve Hand Function

Mental imagery is the rehearsal of a physical task mentally, without execution of any physical task. The technique triggers the similar neurons (mirror neurons) of brain as are triggered by physical performance of the task. &#x0D; Objective: To find correlation between age of stroke patients and mental imagery to improve hand function.Methodology: A sample of 50 patients was selected from DHQ hospital Jhelum. The inclusion criteria were as follows; age 55-75, gender (male and female), and stroke duration more than 12 months. Patients of age below 55 and above 75, patients with parietal stroke were excluded from study. Patients were treated with mental imagery technique for 10 weeks, P&lt;0.05.Results: Both male and females were included in study. Sample consisted of 67% females and 33% male. Mean age of participants was 56.42 + 1.36. WMFT was used as outcome measure. Post treatment mean WMFT score was 57.9. Pearson Correlation was used to find out correlation between age and mental imagery outcome.&#x0D; Conclusions: It was concluded that no correlation is present between age and mental imagery ability of older adult stroke patients. Older adults were benefited with mental imagery technique and a significant improvement in hand function ofstroke patients was found.

Study on the intelligent evaluation model after stoke based on random forest

According to the summary of “China cardiovascular report 2018”, in recent years, there are 2 million new stroke patients in China every year, and nearly 70% of them have lost hand function due to stroke. Therefore, the rehabilitation evaluation of postoperative hand function of stroke patients is complicated with low intelligence. In this paper, data collection methods are introduced firstly, and the original data are artificially classified. Then, starting from the decision tree method, the motion data of stroke patients are intelligently evaluated by establishing a random forest, and the evaluation results are returned to the patients for review in the form of floating point number based on their probability proportion. Finally, the results of the model experiment and its advantages and disadvantages are analyzed, and the future development direction and prospect are put forward.

A Novel Soft Robotic Supernumerary Hand for Severely Affected Stroke Patients.

Upper limb functions are severely affected in 23% of the chronic stroke patients, compromising their life quality. To re-enable hand use, providing a degree of functionality and motivating against learned non-use, we propose a robotic supernumerary limb, the SoftHand X (SHX), consisting of a robotic hand, a gravity support system, and different sensors to detect the patient's intent for controlling the robotic hand. In this paper, this novel compensational approach is introduced and experimentally evaluated in stroke patients, assessing its efficacy, usability and safety. Ten patients were asked to perform tasks of a modified Action Research Arm Test with the SHX, by using three input methods. The mARAT scores rated the potentiality of the system. Usability was evaluated with the System Usability Scale, while spasticity before and after use was measured by the modified Ashworth Scale (mAS). Nine patients, not able to perform any tasks without external support, completed the whole experimental procedure using the proposed system with a median score greater than 12/30. Among the three input methods tested, the usability of one was rated as "good" while the other two were rated as "ok". Seven patients exhibited a reduction of the mAS. All nine patients stated that they would use the system frequently. Results obtained suggest that the SHX has the potential to partially compensate severely impaired hand function in stroke patients.

Low cost hand orthotic device to improve hand function of stroke patients

Low cost hand orthotic device to improve hand function of stroke patients

Effect of constraint induced movement therapy versus bimanual task training for improvement of motor hand function in stroke patients

Effect of constraint induced movement therapy versus bimanual task training for improvement of motor hand function in stroke patients

Feasibility of a wearable soft-robotic glove to support impaired hand function in stroke patients.

To investigate the feasibility of a wear-able, soft-robotic glove system developed to combine assistive support in daily life with performing therapeutic exercises on a computer at home (the HandinMind system). Feasibility study. Five chronic stroke patients with limitations in activities of daily living due to impaired hand function. Participants performed a usability test and several functional tasks with the HandinMind system across 2 sessions. Feasibility was measured using the System Usability Scale (SUS), Intrinsic Motivation Inventory (IMI) and performance times of the functional tasks. User acceptance measured by the SUS and IMI was scored high. The median SUS scores of sessions 1 and 2 were 80.0 (interquartile range (IQR) 70.0-88.8) and 77.5 (IQR 75.0-87.5), respectively, and the median IMI score was 6.3 points out of 7 points (IQR 6.2-6.3). Functional task performance was initially slower with the HandinMind glove compared with performance without the glove, but improved up to the level of performance without the glove across no more than 3 repetitions. Chronic stroke patients with impaired hand function were positive about the feasibility of the first prototype of the HandinMind system. How-ever, performance and ease of use of the system should be improved further in future development phases.