Consideration-of-concept of EvolvRehab Body for upper limb virtual rehabilitation at home for people late after stroke

Objective: EvolvRehab-Body is a non-immersive virtual rehabilitation system that could provide high-dose, exercise-based upper limb therapy after stroke. This consideration-of-concept study investigated: adherence rate to prescribed repetitions; viability of repeated measures in preparation for a dose-articulation study; and preliminary signal of potential benefit.

Methods: pre-post and repeated measures with people at least six months after stroke. Twelve-week intervention: exercise-based therapy via EvolvRehab-Body. Pre-post-intervention measures: Wolf Motor Function Test (WMFT); hand grip force. Repeated-during-intervention measures: Motricity Index (MI) and Action Research Arm Test (ARAT). Analysis: adherence rate (%) to set repetitions; percentage of total possible measures collected; pre-to-post-intervention change estimated in relation to published minimally detectable changes of WMFT and hand grip force; and slope of plotted data for MI and ARAT (linear regression).

Results: Eight of twelve participants completed the 12-week intervention phase. Adherence: 87.5% (1710 to 9377 repetitions performed). Viability repeated measures: 88 of 96 (91.7%) ARAT and MI scores collected. Preliminary signal of potential benefit was observed in five participants but not always for the same measures. Three participants improved WMFT-time (-7.9 to -27.2 seconds/item), four improved WMFT-function (0.2 to 1.1 points/item), and nobody changed grip force. Slope of plotted data over the 12-week intervention ranged from: -1.42 (p=0.26) to 1.36 (p=0.24) points-per-week for MI and -0.30 (p=0.40) to 1.71 (p<0.001) points-per-week for ARAT.

Conclusion: Findings of good adherence rate in home settings and preliminary signal of benefit for some participants gives support to proceed to a dose-articulation study. These findings cannot inform clinical practice.