Authors (including presenting author) :
Fan MK(1), Lau M(1), Yue SY(1), Ip WM(1), Choy PC(1), Chen PW(1), Cheung KY(1), Ho HH(1), Ip CS(1), Tse KY(1), Yip CH(1)
Affiliation :
(1) Occupational Therapy Department, Shatin Hospital
Introduction :
Post-stroke upper limb rehabilitation presented significant challenges, with upper limb disability rate ranging from 33% to 78% after stroke (Allison, Shenton, Bamforth, Kilbride, & Richards, 2016). Occupational therapists play a crucial role in restoring arm function and facilitating daily activities for stroke patients (Kristensen, Persson, Nygren, Boll & Matzen, 2011). However, conventional stroke rehabilitation requires therapist to perform manual therapy, which is time-consuming and labor-intensive. Robotic-assistive technologies have emerged as an effective alternative, providing intensive, task-specific and repetitive upper limb interventions while alleviating the workload demand of occupational therapists, with comparable outcomes in rehabilitation (Budhota et. al., 2021).
Effective utilization of robotic-assistive technologies during various rehabilitation stages is critical. Variation in clinical practice among occupational therapists may affect the implementation of these technologies (Kristensen, Borg, & Hounsgaard, 2012). Therefore, standardization in the application of robotic-assistive technologies regarding different hand function levels is essential.
Objectives :
In July 2023, a protocol-driven robotic-assistive upper limb rehabilitation program was developed in Shatin hospital, enabling the assignment of patients to robotic-assistive training based on their assessment results of Functional Test of Hemiplegic Upper Extremities. Prior to evaluating rehabilitation outcomes, feedback from occupational therapists and patients was collected to assess the feasibility and acceptance of this program.
Methodology :
A survey involving 14 occupational therapists working in stroke units revealed significant findings.
Result & Outcome :
All respondents (100%) reported enhanced standardization, efficiency and confidence in utilizing robotic-assistive technologies after the implementation of protocol-driven rehabilitation program. Specifically, 92.9% indicated that the program optimized workload management without compromising the quantity of care. Additionally, 85.7% affirmed that the quality of care remained intact. Moreover, 92.9% reported that the integration of robotic-assistive technologies allowed for increased time dedicated to functional skill training.
All respondents (100%) agreed that robotic-assistive technologies facilitated standardized, intensive and repetitive training. On average, 80% of patients were prescribed robotic-assistive rehabilitation programs. However, some therapists expressed concerns regarding the application of these technologies, including citing patients’ medical contraindication to robotic-assistive technologies, and the insufficient availability of robotic equipment.
Furthermore, a satisfaction survey for patients receiving the protocol-driven robotic-assistive upper limb rehabilitation program indicated significant improvements in post-stroke upper limb complications, including such as hypertonicity and shoulder pain. The training effectively enhanced arm function, with patients expressing a preference for robotic-assistive technologies over conventional training methods. Overall, patient feedback was very positive.
In conclusion, the protocol-driven robotic-assistive upper limb rehabilitation program has reduced workload demand on occupational therapists during the post-stroke rehabilitation. Positive feedback from both occupational therapists and patients indicates the program’s effectiveness and potential for future applications.
