A Novel, Digital, and Interactive Multi-Mode Stroke Rehabilitation System of Arm and Hand: Development and Validation of Clinical Efficacy

Stroke is the leading cause of long-term adult disability, and its incidence is increasing due to the population ageing worldwide. One of the most crippling impairments in stroke survivors is upper-limb motor dysfunction, which consequently impacts on their premorbid activities and daily life. Action observation therapy (AOT) and mirror therapy (MT) have recently gained increasing attention in stroke rehabilitation for improving patients’ motor and daily function. During AOT, patients learn motor movements or tasks by observing videos of actions performed by healthy individuals. MT provides a visual illusion of the patient’s non-affected hand movements as if it were the affected one via a mirror. However, the usual administration procedures of AOT and MT present several challenges: the inability to perform various and individualized movements and tasks, unbalanced head and trunk control during MT, and a weak sense of body ownership. Thus, further research to overcome these constraints and to optimize AOT and MT with recent imaging technology is warranted.With the advancement of digital imaging technology, we aim to develop a novel, digital, and interactive multi-mode stroke rehabilitation (MSR) system of arm and hand to integrate both AOT and MT into one system. This new MSR system will be designed to operate in multiple training modes of digital AOT and MT. For digital AOT, there will be 2 training modes, in which the users can either select pre-recorded videos in the computer or record their own movements. For digital MT, there will be 2 modes: unilateral and bilateral MT. These features will make this MSR system achieve an interactive, multi-functional, and individualized stroke rehabilitation system.We propose a 3-year study project with two phases. In the phase I study, we aim to develop and set up the hardware and software of this new MSR system. Moreover, 10 stroke patients and 4 certified therapists will be recruited for pilot testing of the usability and feasibility of this new MSR system. In the phase II study, we will conduct a randomized controlled trial to examine and compare the treatment effects of the digital AOT, digital MT, and a control intervention in patients with stroke. During the phase II study, an estimated total of 60 patients with stroke will also be recruited. Each participant will be randomly allocated to 1 of 3 intervention groups for a total of 15 therapy sessions. Outcome measures will be administrated at pre-treatment, immediately after the treatment, and at 1-month follow-up after treatment.This proposed study will develop a novel upper-limb stroke rehabilitation system and will provide information regarding the clinical treatment efficacy of this new system. This MSR system will integrate and translate recent advances in video-based therapy and image processing into rehabilitation practice to enhance patients’ function. The core study results and outcomes will contribute to the development and validation of an innovative upper-limb stroke rehabilitation system for optimizing the motor recovery of stroke patients, and also further advance stroke research and clinical practice.

Project ID:PC10907-0874
External Project ID:MOST109-2314-B182-031