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

• Published in: Physiotherapy 2022-09, Vol.116, p.97-107
• Main Authors: Ellis, F., Hancock, N., Kennedy, N., Clark, A., Wells, J., Chandler, E., Payne, D., Pomeroy, VM
• Format: Article
• Language: English
• Subjects: Stroke; User-led design; Virtual Reality; Virtual Rehabilitation
• ISSN: 0031-9406; 1873-1465
• DOI: 10.1016/j.physio.2022.03.004

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. 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). Eight of twelve participants completed the 12-week intervention phase. Adherence: 88% (1710–9377 repetitions performed). Viability repeated measures: 88 of 96 (92%) 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 s/item), four improved WMFT-function (0.2–1.1 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