Rehab device enables stroke patients with arm disabilities to do more physical training

To use it, patients squeeze, turn, or lift the handgrip, and it vibrates in response to their performance whilst playing. The device uses a novel mechanism, which can detect the tiny flicker movements of severely paralysed patients and channel them into controlling a computer game.

In a clinical trial of 30 patients,researchers from Imperial College London, the University of Southampton and Imperial College Healthcare NHS Trust found that thedevice enabled on average 104 upper limbs (UL) repetitions per day whereas conventional therapy achieved 15 UL repetitions per day.The study is published in Neurorehabilitation & Neural Repair.

Michelle Broderick,lead author of the study and Clinical Research Therapist in Stroke at Imperial College Healthcare NHS Trust, said: "This study is the first to show that a rehabilitation device – GripAble – can achieve significant increases in the amount of exercise patients do compared to supervised therapy. Our findings suggest that a significant proportion of stroke survivors may potentially benefit from GripAble alongside conventional therapy. This could improve patient outcomes as well as easing pressure for the NHS in terms of infrastructure and resources."

UL impairment is the most common physical side effect of stroke, with 60 per cent of stroke survivors experiencing persistent UL weakness. Repetitive task- directed exercise improves long-term UL recovery, making this a key component of occupational therapy and physiotherapy following a stroke. However, this is limited by cost and availability oftherapists. The researchers wanted to see whether the GripAble device could be used to increase exercise dose of inpatient stroke survivors. The study was funded by NIHR Imperial Biomedical Research Centre (BRC).

The team recruited 30 patients with UL weakness as a result of stroke from Charing Cross Hospital, part of Imperial College Healthcare NHS Trust, between September – December 2019. All participants were provided with the GripAble device and taught to use it in a single training session. The participants were then left to use the device without any supervision over eight days.

The researchers then compared the number of UL repetitions patients did as a result of the device with conventional therapy at the hospital.They found that 26 patients were able to use the device meaningfully with their affected UL. The device enabled 104 UL repetitions per day, whereas conventional therapy achieved 15 UL repetitions per day.They also found that on average patients used the device for 26 minutes per day to do their UL exercises, in addition to 25 minutes daily conventional UL therapy, therefore doubling total exercise duration to 51 minutes, which is significantly greater than standard care. After surveying the participants, they also found that 57 per cent found the device easy to use and understand and 63 per cent felt that the device promoted UL recovery.The team will now conduct a further study to access the impact of GripAble on clinical outcomes.

MEDICA-tradefair.com; Source: Imperial College London