Brief Report  |   May 2019
Feasibility of an Electromyography-Triggered Hand Robot for People After Chronic Stroke
Grace J. Kim; Michael Taub; Carly Creelman; Christine Cahalan; Michael W. O’Dell; Joel Stein
Author Affiliations
  • Grace J. Kim, PhD, OTR/L, is Assistant Professor, Department of Occupational Therapy, New York University, New York. At the time of this study, she was Senior Occupational Therapist, Department of Rehabilitation Medicine, New York Presbyterian Hospital–Weill Cornell Medical Center, New York; gjk207@nyu.edu
  • Michael Taub, MS, was Research Assistant, Department of Physical Medicine and Rehabilitation, Weill Cornell Medicine, New York, at the time of this study.
  • Carly Creelman, MS, is Care Coordinator, COAC/Brooklyn Hospital, Brooklyn, New York. At the time of the study, she was Research Assistant, Department of Physical Medicine and Rehabilitation, Weill Cornell Medicine, New York.
  • Christine Cahalan, MS, OTR/L, is Occupational Therapy Supervisor, Inpatient Rehabilitation Unit, Department of Rehabilitation Medicine, New York Presbyterian Hospital–Weill Cornell Medical Center, New York.
  • Michael W. O’Dell, MD, is Vice Chairman, Department of Rehabilitation Medicine, New York Presbyterian Hospital–Weill Cornell Medical Center, New York, and Professor, Department of Physical Medicine and Rehabilitation, Weill Cornell Medicine, New York.
  • Joel Stein, MD, is Professor, Department of Rehabilitation and Regenerative Medicine, Columbia University College of Physicians and Surgeons, New York, and Chairman, Department of Rehabilitation and Regenerative Medicine, New York Presbyterian Hospital–Columbia Presbyterian Medical Center, New York.
Article Information
Neurologic Conditions / Stroke / Columns: Brief Report
Brief Report   |   May 2019
Feasibility of an Electromyography-Triggered Hand Robot for People After Chronic Stroke
American Journal of Occupational Therapy, 05 2019, Vol. 73, 7304345040p1-7304345040p9. doi:10.5014/ajot.2019.030908
American Journal of Occupational Therapy, 05 2019, Vol. 73, 7304345040p1-7304345040p9. doi:10.5014/ajot.2019.030908
Abstract

Importance: Effective treatment of the affected hand after stroke is crucial for improved functional independence and recovery.

Objective: To determine the feasibility and clinical utility of an electromyography-triggered hand robot.

Design: Single-group repeated-measures design. Participants completed training 3×/wk for 6 wk. Feasibility data included participant feedback, adverse events, and compliance rates. Upper extremity outcomes were collected at baseline, discharge, and 6-wk follow-up.

Setting: Outpatient clinic.

Participants: Twelve stroke survivors at least 6 mo poststroke living in the community.

Intervention: Eighteen sessions of intensive robotic hand therapy over 6 wk. Each 60-min treatment session was personalized to match the participant’s ability.

Outcomes and Measures: Arm Motor Ability Test (AMAT), Stroke Impact Scale Hand subscale (SIS–H), Stroke Upper Limb Capacity Scale (SULCS), Fugl-Meyer Assessment, Box and Block Test, and dynamometer.

Results: All participants completed the training phase. Mild skin pinching or rubbing at dorsal proximal interphalangeal joint and proximal arm fatigue were the most common adverse events. Improvements in raw scores were achieved from baseline to discharge for all outcome measures, except the SULCS. Participants significantly improved from baseline to discharge on the AMAT and the SIS–H, and improvements were maintained at 6-wk follow-up.

Conclusion and Relevance: Robotic hand training was feasible, safe, and well tolerated. Participants reported and demonstrated improvements in functional use of the affected arm. Thirty percent of participants achieved clinically significant improvements on the AMAT. We recommend further study of the device in a larger study using the AMAT as a primary outcome measure.

What This Article Adds: It is feasible and safe to implement a robotic hand training protocol for people with moderate to severe arm impairment in an outpatient setting. Robotic training may provide a viable option for this group to actively participate in intensive training of the distal hand.