Jebsen-Taylor Hand Function Test Research Articles

Evaluation of the FLEXotendon glove-III through a human subject case study.

Cervical spinal cord injury (SCI) can significantly impair an individual's hand functionality due to the disruption of nerve signals from the brain to the upper extremity. Robotic assistive hand exoskeletons have been proposed as a potential technology to facilitate improved patient rehabilitation outcomes, but few exoskeleton studies utilize standardized hand function tests and questionnaires to produce quantitative data regarding exoskeleton performance. This work presents the human subject case study evaluation of the FLEXotendon Glove-III, a 5 degree-of-freedom voice-controlled, tendon-driven soft robotic assistive hand exoskeleton for individuals with SCI. The exoskeleton system was evaluated in a case study with two individuals with SCI through two standardized hand function tests namely, the Jebsen-Taylor Hand Function Test and the Toronto Rehabilitation Institute Hand Function Test and three questionnaires (Capabilities of Upper Extremities Questionnaire, Orthotics Prosthetics Users Survey, Quebec User Evaluation of Satisfaction with Assistive Technology). Minor design changes were made to the exoskeleton: integrated fingertip force sensors to sense excessive grasp force, a quick connect system to expedite the exoskeleton glove swapping process between users, compact tendon tension sensors to measure tendon force for admittance control, and a redesigned smartphone app to encompass all aspects of exoskeleton use.

Myoelectric prosthesis hand grasp control following targeted muscle reinnervation in individuals with transradial amputation.

Despite the growing availability of multifunctional prosthetic hands, users' control and overall functional abilities with these hands remain limited. The combination of pattern recognition control and targeted muscle reinnervation (TMR) surgery, an innovative technique where amputated nerves are transferred to reinnervate new muscle targets in the residual limb, has been used to improve prosthesis control of individuals with more proximal upper limb amputations (i.e., shoulder disarticulation and transhumeral amputation). The goal of this study was to determine if prosthesis hand grasp control improves following transradial TMR surgery. Eight participants were trained to use a multi-articulating hand prosthesis under myoelectric pattern recognition control. All participated in home usage trials pre- and post-TMR surgery. Upper limb outcome measures were collected following each home trial. Three outcome measures (Southampton Hand Assessment Procedure, Jebsen-Taylor Hand Function Test, and Box and Blocks Test) improved 9-12 months post-TMR surgery compared with pre-surgery measures. The Assessment of Capacity for Myoelectric Control and Activities Measure for Upper Limb Amputees outcome measures had no difference pre- and post-surgery. An offline electromyography analysis showed a decrease in grip classification error post-TMR surgery compared to pre-TMR surgery. Additionally, a majority of subjects noted qualitative improvements in their residual limb and phantom limb sensations post-TMR. The potential for TMR surgery to result in more repeatable muscle contractions, possibly due to the reduction in pain levels and/or changes to phantom limb sensations, may increase functional use of many of the clinically available dexterous prosthetic hands.

Relationship between clinical outcome measurements and muscle thickness in cerebral palsy

BACKGROUND: The World Health Organization (WHO) uses the International Classification of Functioning, Disability, and Health (ICF) model to provide physical therapy diagnoses and interventions. However, the relationship between clinical assessment and imaging remains unclear. OBJECTIVE: This study aimed to determine the relationships between body function/structure, activity, and participation outcomes following neurorehabilitation in children with cerebral palsy (CP). METHODS: Nineteen children (9 girls mean age 8.8 ± 1.8 years) with CP participated in this study. Clinical motor function tests included the quality of upper extremity skills test (QUEST), Wolf motor function test (WMFT), Functional Independence Measure for Children (WeeFIM), and the Jebsen-Taylor Hand Function Test (JTHFT). Ultrasound imaging was used to measure muscle thickness, which characterizes the body structure, and activity domain variables. RESULTS: The correlations between body structure domain (muscle thickness), activity domain (QUEST, WMFT, WeeFIM) and participants variable (JTHFT) were significant, ranging from r=-0.484 to 0.893, P< 0.05. CONCLUSIONS: These novel findings suggest that muscle thickness ultrasound imaging is closely associated with WMFT, WeeFIM, and QUEST variables. This finding provides important clinical insights when using broad clinical assessment and imaging in children with CP.

Finding Effective Adjustment Levels for Upper Limb Exergames: Focus Group Study With Children With Physical Disabilities

We developed the Blexer system consisting of a database and a web interface for therapists that can host different types of adaptive and personally configurable virtual reality exergames based on Kinect (Microsoft Corp) motion capture to provide entertaining exercises for children with motor disabilities. It allows for parameter adjustment and the monitoring of results remotely, thereby providing a useful tool to complement traditional physical therapy sessions with home exercises. The aim of this study was to observe the motor benefits achieved through the use of a video exergame and the importance and implications of correctly setting the game's difficulty parameters. This was an observational case study of 6 children with different physical disabilities receiving physical therapy at school combined with the use of a fully configurable exergame under research that forms a part of the Blexer environment. The game integrates 4 repeatedly appearing upper limb exercises with individually adjustable difficulties (intermittent arm rising, arm forward and backward movement, rising and holding of one arm, and trunk control in all directions). The outcomes were 3 assessments of 2 efficacy measures: Box and Block Test and Jebsen Taylor Hand Function Test. A total of 5 children with cerebral palsy (mean 8.4, SD 2.7 years; Gross Motor Function Classification II-2/5, 40%; III-2/5, 40%; and IV-1/5, 20%) and 1 child with obstetric brachial plexus palsy (aged 8 years; Mallet Classification III) received between 8 and 11 sessions of training (10-20 minutes per session), depending on age, motivation, and fatigue. Significant associations were observed between game parameter settings and improvements in motor function, on the one hand, and between the type of improvement and disability severity, on the other: with adjusted game parameters goal and time in the range of 70% to 100%, only less affected children improved in the Box and Block Test (+11 blocks vs -1 block), and more affected children improved more in the Jebsen Taylor Hand Function Test (+90 seconds vs +27 seconds). When defining the difficulty parameters for an exergame, we suggest a classification in levels ranging from very easy to very hard. For practical use, we suggest setting the difficulty for the player to an easy or medium level rather than high-commitment goals, as this leads to a longer playtime with more fun and, therefore, seems to improve the results of the game and, consequently, mobility.

Effects of a single session action observation training on hand function in healthy young adults: a randomised controlled assessor and participants-blinded trial

Purpose The aim was to investigate the effects of a single session action observation training (AOT) on hand function and evaluate whether observing self-actions would be more effective than observing someone else. Materials and Methods A total of 60 right-handed healthy young adults, (32 female, 28 males and the mean age was 21.32 ± 1.07 years) were included in the study. The participants were randomly divided into five groups, self-action observation (sAO), observation of a third person (AO), action practice (AP), non-action observation (nAO), and control. A single session was performed for all participants. The primary outcome was the Jebsen Taylor Hand Function Test (JTHFT) assessed by a masked assessor. Results Significant differences were observed between the sAO and control group in total left side JTHFT performance (p < 0.001). Additionally, there were significant differences between the AO and control group (p < 0.001), and AP and nAO group (p = 0.003) and AP and control group (p < 0.001) in total JTHFT performance change of the left side. Significant differences were found between the sAO and nAO (p = 0.001) and control groups (p < 0.001) in dominant side total JTHFT performance change. No difference between sAO and AP groups were observed (p > 0.05). Conclusion It was observed that a single session of action observation training improved hand function in healthy adults. The better performance achieved in the group watching the self-video may suggest that watching the self-image activates more mirror neurons.

Hand injuries in Children: A retrospective multicentric study

Aim: This retrospective multicentric study aims to determine the characteristics of childhood hand injuries and identify the clinical changes in hand dominance in different pediatric age groups. Methods: Between June 2008 and June 2018, 697 cases of hand injuries in preschool children that resulted in sequelae in Central Anatolia were evaluated retrospectively. The demographic data of patients who came in for a checkup, the mechanism of occurrence of the injury that caused sequelae, and if accompanied by a fracture were analyzed using questionnaires that investigated the conditions of the patients and caregivers during the hospital and recovery periods. In addition, 12-year-olds or older who came in for their last check-up were evaluated using four parameters of the Jebsen–Taylor hand function test. Results: One hundred thirteen of the 697 successfully contacted patients attended the last clinical check-up. The hand that had suffered trauma was nondominant in 63 (70.8%) of the 89 patients who were of school age and able to write when they attended the last check-up. Two or more fingers, except the thumb, were amputated at different levels in 49 patients. Two or more fingers, including the isolated thumb or thumb, were amputated at different levels in 17 patients. Conclusion: This study focuses on the evolving pattern of hand dominance and the various types of hand injuries in pediatric age groups.

모야모야병 아동의 로봇 보조 상지 훈련에 대한 효과: 사례 연구

The purpose of this study was to investigate the effect of robot-assisted upper limb rehabilitation training on hand and upper limb function in children with Moya-Moya disease.&#x0D; The intervention method used InMotion®RM, an upper limb-assisted rehabilitation robot, and the evaluation was conducted once each pre- and post-assessment, and the treatment was conducted 10 times for 30 minutes, a total of 12 sessions. The functional movement of the upper limb and hand was evaluated using the Jebsen-Taylor Hand Function Test and the program inherent in the InMotion®RM. The results were compared through a visual analysis using tables and graphs.&#x0D; After the training, the Jepson-Taylor Hand Function Test score improved in all areas, compared to the baseline. Evaluation using the program inherent in InMotion®RM showed improvement in the smoothness, accuracy, efficiency, and stability of upper limb movement.&#x0D; The results of this case study suggest that robot-assisted upper limb training is applicable to children with Moya-Moya disease and that it has a positive effect on improving the function and stability of the upper limb. In the future, more research subjects will be needed to study the method and effectiveness of robot-assisted upper limb training through group research.

A Study On The Application Of Mobile Arm Support In Individuals With Cervical Cord Injuries

<h3>Research Objectives</h3> To investigate the change in the active range of motion (AROM) of the shoulder and elbow joints by applying the mobile arm support (MAS) in cervical injury patients with limitations in the proximal part of the upper extremities. Additionally, the user satisfaction with MAS was assessed. <h3>Design</h3> One group before-after trial. <h3>Setting</h3> Inpatients at the National Rehabilitation Center. <h3>Participants</h3> This study included five tetraplegic patients with at least one year since the onset and neurological level of injury at C3–C4 level. <h3>Interventions</h3> Participants were trained by applying the Wilmington Robotic Exoskeleton (WREX). Training was conducted based on the Jebsen–Taylor hand function test. Six sessions of the intervention were conducted for 30 minutes each, thrice a week for 2 weeks. <h3>Main Outcome Measures</h3> The AROM of the shoulder and elbow joints was measured. Additionally, Korean-Quebec User Evaluation of Satisfaction with Assistive Technology (K-QUEST) was used to evaluate the satisfaction. <h3>Results</h3> The AROM of the shoulder joint increased from 38.040±35.710° to 49.960±36.884° for flexion, 26.380±19.367° to 31.800±14.249° for extension, 18.980±12.765° to 21.340±14.570° for adduction, 44.180±24.547° to 53.620±24.253° for internal rotation, and 28.020±17.071° to 34.900±20.793° for external rotation, but without significant differences. The elbow joint showed no AROM change. K-QUEST assessed the satisfaction with the equipment, with a 5-point scoring system from 1 (not satisfied) to 5 (very satisfied). Most items showed a satisfaction level ≥4, confirming positive results with WREX. <h3>Conclusions</h3> MAS training in patients with chronic cervical injury demonstrated an increase in the AROM of the shoulder. Thus, MAS training can improve the upper extremity functions in cervical injury patients. Additionally, the K-QUEST results confirmed positive satisfaction with the WREX equipment in these patients. <h3>Author(s) Disclosures</h3> Jung-Eun Lim(1), Woo Yeung Kim(2), Onyoo Kim(2) (1)National Rehabilitation Research Institute, National Rehabilitation Center and Hospital, Seoul, South Korea (2)Department of Rehabilitation Medicine, National Rehabilitation Center and Hospital, Seoul, South Korea

Upper limb function of individuals hospitalized in intensive care: A 6-month cohort study

Background: Impaired physical function is a common complication in intensive care unit (ICU) patients. However, specific upper limb (UL) function is still poorly studied in this population. Objective: To evaluate UL function at discharge and after a 6-month follow-up of individuals hospitalized in the ICU. Methods: This was a longitudinal prospective 6-month multicentre cohort study with forty-six individuals hospitalized in the ICU undergoing mechanical ventilation for ≥ 48 h (ICU Group) and forty-six healthy individuals matched by sex, age, and socioeconomic status (control Group). The primary outcomes were measurements of UL disability using the Jebsen-Taylor Hand Function Test (JTT) and the Nine Hole Peg Test (NHPT). Secondary outcomes were physical function (Barthel index), muscle strength (Medical Research Council scale and hand grip strength), and quality of life (EuroQol-5 Dimension). All measurements were assessed after ICU discharge and at a 6-month follow-up. Results: The JTT performance time in the ICU group after discharge was worse than that in the control group [121 s (86–165) vs. 54 s (49–61), median (IQR), p<0,001] and was reduced after 6 months [62 s (54–81), p<0,01]. The NHPT performance time at discharge in the ICU group was worse than that in the controls [39 s (33–59) vs. 21 s (20–23), p<0,001] and was reduced after 6 months of follow-up [24 s (21–27), p<0,01]. Physical function, muscle strength and quality of life were reduced after ICU discharge. Conclusion: Individuals hospitalized in the ICU presented with reduced UL function at discharge and at the 6-month follow-up.

Comparison of Constrained Induced Movement Therapy and Bimanual Training on Functional Outcome of Hemiplegic Cerebral Palsy

OBJECTIVES The aim of this study was to compare the effects of constrained induced movement therapy (CIMT) and BimanualIntensive Training (BIT) on functional outcomes of hemiplegic cerebral palsy children. METHODOLOGY Cerebral palsy children with age groups of 5 to 12 years were included with a total sample size of 38. Simplerandom sampling was done, and data was collected from Islamabad. Two groups were formed and named groupA: constrained induced movement therapy with 19% and group B: bimanual training with 19% respectively. Thefunctional outcome for the CIMPT and for the BIT group was assessed on the pretest and post-test scoreevaluation of QUEST and JTHF tests. RESULTS Statistically significant (p &lt;0.05) improvement was found in The Quality of Upper Extremity Skills Test (QUEST)and Jebsen-Taylor Test of Hand Function (JTHF) in the between -group analysis. For within the group analysisthe p-value &lt;0.05 suggests that there was a significant diffe rence in within-group analysis too. The values forgrasp and dissociated movements suggest that QUEST post-test values are impactful in the CMIT group whereasin the BIT group simultaneous and spontaneous movement was increased but JTHF post -test values were moresignificant in CMIT. CONCLUSION BIT is more beneficial for both hand’s simultaneous and spontaneous movement, whereas CMIT is morebeneficial for grip and overcoming the “learned-nonuse” phenomena in cerebral palsy children.

Somatosensation and motor performance in the less-affected and more-affected hand of unilateral cerebral palsy children: a cross-sectional study

Purpose This study aimed to examine motor performance and somatosensory processing of unilateral cerebral palsy (UCP) children in both the less-affected hand and the more-affected hand. This study is also aimed at analysing the somatosensory proccessing in the more-affected hand in relation to age and damaged hemisphere. Materials and methods Forty-seven children aged from 6 to 15 years (UCP = 23; TD = 24) were recruited. Grip strength, pinch strength, Box and Block Test and Jebsen Taylor Hand Function Test were used to analyse motor performance. A comprehensive somatosensory assessment battery was included: tactile registration, unilateral, bilateral and spatio-temporal perception, haptic recognition, texture perception, proprioception, pressure pain threshold and functional sensitivity. Results UCP children exhibited lower performance in all aspects of motor performance measured in both the less-affected hand and the more-affected hand, except grip strength in the less-affected hand. Significant differences were found for all tests included in the somatosensory assessment in both the less-affected hand and the more-affected hand, except unilateral perception tests in the less-affected hand. Conclusions UCP children present difficulties in motor performance and somatosensory processing not only in the more-affected hand, but also in the less-affected hand. Somatosensation may be a critical driver of functional performance. Implications for rehabilitation The less-affected hand of children with unilateral cerebral palsy should be included in both assessment and intervention programmes. Somatosensory processing should be assessed through a comprehensive battery, both in the less-affected hand and in the more-affected hand of unilateral cerebral palsy children. Somatosensory treatment must be taken into account if functional performance in the activities of daily living of unilateral cerebral palsy children is to be improved.

Alterations in dexterity and manual function in patients with focal hand dystonia

IntroductionFocal hand dystonia is a movement disorder whose symptoms cause alterations in the performance of tasks requiring a high level of dexterity. Currently, there is no model for interpreting the disease and few studies have identified the difficulties of patients with dystonia in carrying out activities of daily living (ADL). This study aims to describe manipulative dexterity and its influence on ADLs in patients with focal hand dystonia. Materials and methodsWe performed an observational, cross-sectional, case-control study including 24 participants (12 patients with focal hand dystonia and 12 controls). The patients were referred by the neurology department of Hospital Ramón y Cajal. We gathered sociodemographic data, as well as retrospective clinical data for patients. We subsequently administered evaluation tests, in the following order: Nine-Hole Peg Test (NHPT), Box and Blocks Test (BBT), Purdue Pegboard Test (PPT), and Jebsen-Taylor Test of Hand Function (JTTHF). ResultsThe study sample included a total of 24 participants, 7 women and 17 men, with a mean age (standard deviation) of 50.79 (14.40) years. In the patient group, neuromuscular involvement or psycho-emotional problems were not detected in half of cases; smaller numbers of patients presented difficulties associated with the right shoulder (25%) and anxious state (33.3%). ConclusionsOur results indicate that focal hand dystonia affects manipulative dexterity in these patients, who showed poorer performance and required more time to complete the tasks.

Brazilian version of the Jebsen Taylor Hand Function test: An observational cross-sectional study on standardization, reliability and normative data

Study DesignThis is an observational cross-sectional study. BackgroundTo assess dexterity and hand function, it is important to use validated performance-based outcome measures, such as the Jebsen Taylor Hand Function test (JTHFT). There is no previous study that has used this test in asymptomatic individuals to establish normal values for the Brazilian population, or to assess its reliability. PurposeThe first aim of the study was to provide a standardized illustrated manual of the Brazilian version of the JTHFT. The second aim was to evaluate JTHFT test-retest reliability in asymptomatic adults, and the third aim was to determine normative values. MethodsThis study consists of 236 individuals aged 18-60 years, of both sexes, asymptomatic for pain or injury in the upper limbs. An illustrated manual of instructions was developed in Portuguese, test-retest reliability was assessed by determining the intraclass correlation coefficient (ICC), and to evaluate the average of the correlations between the items, the Cronbach Alpha coefficient was used. The standard error of measurements of the test and retest of the JTHFT subtasks was also performed. ResultsThe Cronbach Alpha coefficient, resulted in acceptable average values 0.75 for the dominant hand and 0.76 for the nondominant hand. JTHFT subtests reveal moderate to excellent test-retest reliability, varying from 0.53, 95% CI: 0.39-0.64; to 0.93, 95% CI: 0.91-0.95 for the dominant hand, and for the nondominant hand 0.66, 95%: 0.57-0.74; to 0.92, 95% CI: 0.90-0.94. ConclusionJTHFT is reliable for a Brazilian sample in terms of test-retest measures and can be used both in research and in clinical practice. A standardized illustrated manual of application was provided.

High-Definition Transcranial Direct Current with Electrical Theta Burst on Post-Stroke Motor Rehabilitation: A Pilot Randomized Controlled Trial

Background: High-definition transcranial electrical theta burst superimposing direct current stimulation (HD-tDCS-eTBS) not only incorporates the therapeutic advantages of tDCS and TBS but enhances stimulation focality and practicality. However, the applicability of this innovative neuromodulatory device in post-stroke rehabilitation remains uncertain. Objective: This study aimed to assess the efficacy and safety of the HD-tDCS-eTBS on upper extremity (UE) motor function in patients with chronic stroke. Methods: A patient-blinded, randomized controlled study was conducted. Twenty-four participants were randomly assigned into either the active HD-tDCS-eTBS group or sham HD-tDCS-eTBS group. Both groups received 20 minutes of active/sham HD-tDCS-eTBS combined with 30 minutes of conventional UE rehabilitation each time, 3 times a week for 4 weeks. Outcome measures including the Fugl-Meyer Assessment of Upper Extremity, Wolf Motor Function Test, Jebsen-Taylor Hand Function Test, Finger-Nose Test, and Modified Ashworth Scale were assessed before and immediately after the intervention period. Results: Spasticity of shoulder adductor (P = .05), elbow extensor (P = .04), and thumb flexor (P < .01) were significantly reduced in the active HD-tDCS-eTBS group versus the sham group. Nonsignificant trends in the improvements of most other outcome measures were in favor of the active HD-tDCS-eTBS group with moderate to large effect sizes (P = .06–.26, ηp2 = 0.06–0.16). No severe adverse events except for slight skin redness under the stimulus electrode was detected after the HD-tDCS-eTBS. Conclusions: Our findings support that HD-tDCS-eTBS is safe and has therapeutic potential for post-stroke UE motor rehabilitation. Trial registration: ClinicalTrials.gov (ID: NCT04278105).

Haptic Perception Training Programs on Fine Motor Control in Adolescents with Developmental Coordination Disorder: A Preliminary Study.

Somatosensory and haptic perception deficit was commonly found in developmental coordination disorder (DCD) and was closely related to fine motor functions, and the intervention strategies should thus emphasize improving the underlying haptic functions. This study was intended to investigate the effects of haptic perception training programs on fine motor functions in adolescents with DCD. A total of 82 DCD participants were assigned to either the haptic perception training program (HTP; n = 42, 16 females, mean age = 13.32 ± 2.85 years) or standard occupational therapy (SOT; n = 40, 16 females, mean age = 13.41 ± 3.8 years) group. Both groups were given 12-week training, twice a week, 30 min per session. Outcome measures were: Jebsen-Taylor Hand Function Test (JTFHT), Bruininks–Oseretsky Test of Motor Proficiency-Second Edition (BOT-2), Test of Visual-Perceptual Skills- Fourth Edition (TVPS-4), and Vineland Adaptive Behavior Scale -Chinese Version (VABS-C). After the intervention, the HTP group outscored the SOT group on most fine motor control (JTFHT and BOT-2) tasks and all TVPS-4 and VABS-C items. The HTP group had greater pre–post changes on fine motor integration, fine motor precision, manual dexterity, and writing. TVPS-4 reached significant intervention gains on visual spatial relations, visual memory, and visual sequential memory. The haptic perception training programs demonstrated benefits in enhancing fine motor control in adolescents with DCD. It could be used as an easy and effective alternative to hospital or school-based therapy during the pandemic.

Towards Instant Calibration in Myoelectric Prosthetic Hands: A Highly Data-Efficient Controller Based on the Wasserstein Distance.

Prosthetic hand control research typically focuses on developing increasingly complex controllers to achieve diminishing returns in pattern recognition of muscle activity signals, making models less suitable for user calibration. Some works have investigated transfer learning to alleviate this, but such approaches increase model size dramatically-thus reducing their suitability for implementation on real prostheses. In this work, we propose a novel, non-parametric controller that uses the Wasserstein distance to compare the distribution of incoming signals to those of a set of reference distributions, with the intended action classified as the closest distribution. This controller requires only a single capture of data per reference distribution, making calibration almost instantaneous. Preliminary experiments building a reference library show that, in theory, users are able to produce up to 9 distinguishable muscle activity patterns. However, in practice, variation when repeating actions reduces this. Controller accuracy results show that 10 non-disabled and 1 disabled participant were able to use the controller with a maximum of two recalibrations to perform 6 actions at an average accuracy of 89.9% and 86.7% respectively. Practical experiments show that the controller allows users to complete all tasks of the Jebsen-Taylor Hand Function Test, although the task of picking and placing small common objects required on average more time than the protocol's maximum time.

The acute effects of action observation training on upper extremity functions, cognitive processes and reaction times: a randomized controlled trial

Aim: To investigate the acute effects of action observation training on upper extremity functions, cognitive functions and response time in healthy, young adults. Materials & methods: A total of 60 participants were randomly divided into five groups: the self-action observation group, action observation group, action practice group, non-action observation group and control group. The Jebsen-Taylor hand function test (JTHFT), nine-hole peg test, serial reaction time task and d2 test of attention were applied to the participants before and after the interventions. Results: JTHFT performance with both non-dominant and dominant hands improved significantly compared with baseline in all groups (p<0.001). JTHFT performance with non-dominant and dominant hands differed between the groups (p<0.001). Conclusion: Action observation training seems to enhance the performance of upper extremity-related functions. Observing self-actions resulted in statistically significant positive changes in more variables compared with other methods. However, its clinical effectiveness over the other methods should be investigated in future long-term studies. Clinical Trial Registration: NCT04932057 (ClinicalTrials.gov).

The effect of adding robot-assisted hand rehabilitation to conventional rehabilitation program following stroke: A randomized-controlled study.

Objectives This study aimed to investigate the effectiveness of adding robot-assisted hand therapy (HandTutor) to conventional rehabilitation program compared to a conventional rehabilitation program alone in stroke survivors. Patients and methods Between March 2012 and December 2012, a total of 33 stroke patients (21 males, 12 females; median age: 56 years; range, 38 to 73 years) were included in this prospective, randomized-controlled study. The patients were randomly divided into two groups as experimental (n=16) and control (n=17). Both groups received conventional rehabilitation for 3 h/day, for two days/week, totally for five weeks, while the experimental group received additional 1-hour robot-assisted hand therapy during each session. Outcome measures were the Fugl-Meyer Assessment, Box and Block Test, Nine-Hole Peg Test, Jebsen-Taylor Hand Function Test, grip strength, and pinch strength. All patients were assessed at baseline, at the end of the treatment, and three months after the treatment. Results Both groups showed statistically significant improvements in all the parameters (p<0.05). No significant differences were observed between the groups at any time points (p>0.05). The changes between baseline and three-month follow-up after the treatment revealed that adding robot-aided hand therapy led to greater changes in all the parameters related to functional activities and muscle strength, except for the Fugl-Meyer Assessment. Conclusion Adding robot-assisted therapy to conventional rehabilitation may provide greater changes in upper extremity rehabilitation of subacute stroke patients compared to conventional rehabilitation program alone.

Comparisons of Children with and without Type I Diabetes on Hand and Visual Motor Integration Skills and on Participation in Daily Activities.

Our aim in this study was to compare hand skills, visual-motor integration skills, and participation in daily living activities of children with and without Type 1 diabetes (T1DM). In this prospective cross-sectional study, we included 44 children with T1DM (17 males, 27 females; aged 8-12years) and a control group of 45 healthy age-matched children without T1DM (22 males, 23 females). We compared group scores on the Jebsen-Taylor Hand Function Test (JTHFT), the Beery-Buktenica Developmental Visual Motor Integration Test (Beery VMI), and the Participation and Environment Measure - Children and Youth (PEM-CY). JTHFT and Beery VMI scores of children with T1DM were significantly lower than those of the control group (p ≤ 0.005). On the PEM-CY, children with T1DM were found to have more participation barriers in the community than controls. Relative deficits in hand skills and visual motor integration of children with T1DM should be managed with greater attention and assistance.

Effect of activity-based training versus strengthening exercises on upper extremity functions in Parkinson's patients; A randomized controlled, single blind, superiority trial

BackgroundIdiopathic Parkinson's disease is a neurodegenerative disease which is appeared by symptoms such as resting tremor, bradykinesia, rigidity, and postural instability. Such symptoms as tremor, bradykinesia, and rigidity significantly affect patients' upper extremity function. Rehabilitation programs should be implemented to improve the upper extremity functions of patients. ObjectiveActivity-based training would improve dexterity and functional activities to a larger extent than strengthening exercises. This study aimed at evaluating the effect of activity-based training and strengthening exercises on upper extremity functions in Parkinson's disease and to compare the two methods. Method40 Parkinson's patients with mean of 64.45 ± 9.13 age were randomized and divided into two groups as activity-based training and strengthening exercise group. Patients were evaluated at the beginning and after 6 weeks of treatment with Unified Parkinson's Disease Rating Scale, Parkinson's Disease Questionnaire-39, Duruöz Hand Index, Jebsen Taylor Hand Function Test, Nine-Hole Peg Test, Jamar dynamometer, Jamar pinch meter, Semmes Weinstein Monofilament Test and two-point discrimination. ResultIn both groups, upper extremity functions, handgrip strengths and quality of life of patients improved significantly. Tactile sense improved only in the activity-based training group. ConclusionActivity-based training is not superior to strengthening exercise programs at improving upper extremity functions and dexterity of Parkinson's patients.