Authors (including presenting author) :
Chung RKF, Tsui AYY, Kwan YYF, Chan BSC, Leung DCK, Cheung BWL, Chan CMY, Leung KKL
Affiliation :
Physiotherapy Department, Kowloon Hospital
Introduction :
Loss of upper limb function is a common problem after stroke. Computer-assisted interactive training combines upper limb function and cognitive training for stroke survivors. The interactive training involves repeated assisted-active functional movement of the hemiplegic arm and the computer provides visual feedback on the quality of movement which enhances patient’s motivation and promotes exercise adherence.
Objectives :
To investigate the usefulness of computer-assisted interactive upper limb functional training for acute and sub-acute stroke patients.
Methodology :
Between 1st June and 30th November 2024, stroke patients were recruited from the rehabilitation and medical wards. Patients with a diagnosis of stroke(ICD-10: I60-I69) which involve one hemiplegic side, able to understand simple instructions and follow commands were included. Exclusion criteria were stroke patients with severe deficits in visual acuity or fixed contracture in the affected limb. In addition to daily physiotherapy training, 10 sessions of 15 minutes of computer-assisted interactive upper limb functional training were provided. Training effect was evaluated by the Hong Kong version of the Functional Test for the Hemiplegic Upper Extremity(FTHUE-HK), upper limb muscle power, hand grip strength and rated satisfaction of treatment. Assessments were conducted before and after the implementation of computer-assisted interactive upper limb functional training. Considering the ordinal nature of the variables and the small sample size, non-parametric tests were used. The data obtained were compared by medians of Wilcoxon signed rank tests.
Result & Outcome :
6 males and 4 females stroke patients, aged between 61 to 92 years old, completed the program and assessment. The results showed statistically significant improvement in FTHUE-HK(Median=1.0, Z=2.83, p=0.005), muscle power(Shoulder: Median=0.50, Z=2.45, p=0.014; Elbow: Median=0.50, Z=2.0, p=0.046; Wrist: Median=0.50, p=0.011; Fingers: Median=0.50, Z=2.83, p=0.011) and hand grip(Median=3.0kgf, Z=2.82, p=0.005). Patients showed high satisfaction(79%) and good adherence to physiotherapy training. In this small-scale study, combining the computer-assisted upper limb functional training into daily physiotherapy practice produced significant improvement in upper limb function as well as arousing interest for patients to actively participate in rehabilitation. Besides, visual feedback on the quality of upper limb movement enhances neuroplasticity in stroke rehabilitation. The findings of this preliminary study warrant a more comprehensive study, including long-term effect of the additional benefit of computer-assisted interactive upper limb functional training, and with comparison to a control group.
