A home-based, self-administered stimulation program to improve selected hand functions of chronic stroke

Area of Science:

• Neurorehabilitation
• Physical Therapy
• Stroke Recovery

Background:

• Chronic stroke survivors often experience persistent upper limb paresis, impacting hand function.
• Limited effective interventions exist for improving hand function in this population.

Purpose of the Study:

• To evaluate the efficacy of a combined stimulation-training program for enhancing hand functions in chronic stroke survivors.
• To assess improvements in upper limb impairments, including spasticity and pain.

Main Methods:

• A 5-week, multi-site, pretest-posttest home-based training program.
• Participants (N=77) with chronic upper limb paresis engaged in daily stimulation and functional grasp/hold/release training.
• Standardized tests measured hand function (Jebsen-Taylor, Box and Blocks, Nine-Hole Peg), spasticity (Ashworth Scale), and pain (VAS).

Main Results:

• Significant improvements were observed in simulated feeding time (34.8%), light object lift (44.9%), heavy object lift (40.9%), Box and Blocks test (26.3%), and Nine-Hole Peg test (58.7%).
• A mean reduction in spasticity of 0.87 points at the elbow and 0.78 points at the wrist was noted.
• Patients with persistent pain reported a significant reduction in pain levels.

Conclusions:

• A 5-week daily home-based, task-specific stimulation and training program effectively improved hand function.
• The intervention successfully addressed upper limb impairments, including spasticity and pain, in chronic stroke survivors.