The Efficacy of a Programmable Keyboard on Upper Limb Function and the Ability to Perform Activities of Daily Living in a Person with Hemiplegia: Case Report
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Updated: Sep 14, 2025

Brain-Computer Interface-controlled Upper Limb Robotic System for Enhancing Daily Activities in Stroke Patients
Published on: April 18, 2025
Anna Berardi1, Marika Zaccagnino2, Giovanni Galeoto3
1IRCCS Neuromed, Via Atinense, 18, 86077 Pozzilli IS Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
Introduction:
Studies on rehabilitation devices in individuals with hemiplegia have shown that robotic rehabilitation tends to be more effective in individuals with mild rather than moderate or severe hemiplegia. The aim of this study was to demonstrate the rehabilitative effectiveness of a programmable keyboard (Click4all®) in improving the performance of daily life activities (PC, tablet, and smartphone) in a 30-year-old man with hemiplegia.
Methods:
A 31-year-old man underwent surgery in 2017 to remove prefrontal cortical dysplasia responsible for epileptic seizures. Following the operation, he developed left hemiplegia. Following this intervention, he developed left hemiplegia. The upper limb showed shoulder asymmetry in the frontal plane, with the arm extended along the trunk and the thumb slightly adducted. The patient was assessed three times using the following tools: Matching Person and Technology (MPT), Survey of Technology Use (SOTU), Assistive Technology Device Predisposition Assessment (ATD PA), and Quebec User Assessment of Satisfaction with Assistive Technology (QUEST 2.0). Following the initial assessment, the patient was trained to use Click4all® at home, applying it for 30 minutes per day over a period of two months.
Results:
According to the MPT (ATD PA) rating scale, the patient reported satisfaction with the improvements achieved across various functional domains. The average score on the QUEST ranged from 4.62 to 4.25, showing that the patient was very satisfied with the aid. Finally, the patient's evaluation of adherence and performance indicated improvements in both the usability of the device and the residual function of the plegic limb over time.
Conclusion:
In this study, the Click4all® programmable keyboard was used to create a system comprising of both a rehabilitation and autonomy aid. The results highlighted not only an increased level of independence in the patient, but also a significant improvement in psychosocial well-being.
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