In-home tele-rehabilitation improves tetraplegic hand function

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Spinal cord injury (SCI) survivors with tetraplegia face significant challenges in performing activities of daily living (ADLs).
• Functional electrical stimulation (FES) combined with exercise therapy (ET) offers potential for improving hand function, but treatment delivery remains a challenge.

Purpose of the Study:

• To compare the efficacy of two different in-home tele-therapy (IHT) delivered exercise therapy (ET) programs for individuals with tetraplegia.

Main Methods:

• A 6-week study involving 13 participants with tetraplegia, comparing conventional ET (strength training, computer games, therapeutic electrical stimulation) with ReJoyce ET (FES-ET on a workstation with specialized software).
• Participants underwent both treatments in a randomized crossover design with a 1-month washout period.
• Hand function was assessed using the Action Research Arm Test (ARAT), grasp and pinch forces, and the ReJoyce automated hand function test (RAHFT).

Main Results:

• The ReJoyce ET group showed significantly greater improvements in ARAT scores (13.0% ± 9.8%) compared to conventional ET (4.0% ± 9.6%).
• ReJoyce ET also led to greater improvements in RAHFT scores (16.9% ± 8.6%) versus conventional ET (3.3% ± 10.2%).

Conclusions:

• In-home tele-supervised FES-ET delivered via a workstation is a feasible and potentially effective treatment for SCI survivors with residual motor function.
• The ReJoyce system demonstrates superior outcomes in improving hand function for ADLs compared to conventional ET in this population.