Finger Exoskeleton in Simple Motor Rehabilitation Therapy on Arm and Hand Muscle Ability of Post-Stroke Sufferers

Post-stroke sufferers will generally experience weakness on one side of the body, balance, vision, sensory, motor, and cognitive. In West Kalimantan, the estimated stroke sufferer in 2013 was 25,195 people. Based on data from the Public Hospital of  Dr. Soedarso Pontianak shows a significant increase from January 2018 to December 2018 totaling 722 people. The research objective was to assess the effectiveness of the finger exoskeleton tool in simple motor therapy on the ability of the client's arm and hand muscles after a stroke. This study used a quantitative approach with a quasi-experimental design. Pre-test and Post-test Nonequivalent Control Group with two groups, which were the control group of 12 people and the intervention group of 12 people with finger exoskeleton tools. The statistical test used was the independent t test and paired t test. Measurement of muscle ability with the Action Research Arm Test. Analysis of the difference in total scores between before and after treatment in the intervention group using Paired T-Test obtained a p-value of 0.000 (p value <0.05) and in the control group using the Wilcoxon test a p-value of  0.016 (p value <0.05). It shows that there is a significant difference in the total score between before and after finger exoskeleton therapy and range of motion. Intervention of finger exoskeleton assistive devices in simple motor rehabilitation therapy is effective in increasing the ability of the client's arm and hand muscles after stroke. It is recommended to make another finger rehabilitation tool with a more optimal design according to the parameters, which are the severity of the client after stroke, subject kinematics, control of movement torque and adaptation between the subject and the robotic device used.

Rehabilitation Interventions for Upper Limb Function in the First Four Weeks Following Stroke: A Systematic Review and Meta-Analysis of the Evidence

OBJECTIVE

To investigate the therapeutic interventions reported in the research literature and synthesize their effectiveness in improving upper limb (UL) function in the first 4 weeks poststroke.

DATA SOURCES

Electronic databases and trial registries were searched from inception until June 2016, in addition to searching systematic reviews by hand.

STUDY SELECTION

Randomized controlled trials (RCTs), controlled trials, and interventional studies with pre/posttest design were included for adults within 4 weeks of any type of stroke with UL impairment. Participants all received an intervention of any physiotherapeutic or occupational therapeutic technique designed to address impairment or activity of the affected UL, which could be compared with usual care, sham, or another technique.

DATA EXTRACTION

Two reviewers independently assessed eligibility of full texts, and methodological quality of included studies was assessed using the Cochrane Risk of Bias Tool.

DATA SYNTHESIS

A total of 104 trials (83 RCTs, 21 nonrandomized studies) were included (N=5225 participants). Meta-analyses of RCTs only (20 comparisons) and narrative syntheses were completed. Key findings included significant positive effects for modified constraint-induced movement therapy (mCIMT) (standardized mean difference [SMD]=1.09; 95% confidence interval [CI], .21-1.97) and task-specific training (SMD=.37; 95% CI, .05-.68). Evidence was found to support supplementary use of biofeedback and electrical stimulation. Use of Bobath therapy was not supported.

CONCLUSIONS

Use of mCIMT and task-specific training was supported, as was supplementary use of biofeedback and electrical simulation, within the acute phase poststroke. Further high-quality studies into the initial 4 weeks poststroke are needed to determine therapies for targeted functional UL outcomes.