Author(s): SAKAI, H., MURAKI, D., ISHIGURO, K., Institution: TOKYO UNIVERSITY OF TECHNOLOGY, Country: JAPAN, Abstract-ID: 1011

INTRODUCTION:
In recent years, upper limb training robots have been used in rehabilitation for upper limb dysfunction due to stroke, and their usefulness has been reported. However, robot devices used for rehabilitation intervention are often large and expensive, and availability is limited. Therefore, there is a need for equipment that can be used in day care facilities and homes. In this study, we developed an inexpensive, compact and easy-to-operate upper limb training device, and tested it on several patients with chronic hemiplegia.
METHODS:
Five people with chronic hemiplegia (3 men, 2 women) participated in this study. Their age ranged from 42 to 67 years (average 58.2 years, 7 to 93 months after onset), and there were 3 cases of right hemiplegia and 2 cases of left hemiplegia. Training was carried out, using our unique system, in an outpatient setting for 40 minutes a day, 2 to 3 times a week for 4 weeks after the study was explained in full and subjects gave their informed consent. The system we have developed consists of an operating stick (similar to a joy stick) and a stick-type computer (similar to a television streaming dongle). The lower part of the operating stick uses a special ball joint technology to reduce the weight of the upper limbs while allowing smooth movement in space. A sensor is embedded under the ball joint at the bottom of the operating stick allowing for movements in any direction (360 degrees) to be displayed on a monitor. Evaluation consisted of the Fugl-Meyer Assessment (FMA) for upper limbs (total 66 points) before and after training, Motor Activity Log (MAL), and a questionnaire after training. The Wilcoxon signed rank test was used for before and after comparisons.
RESULTS:
FMA-U score was 45.2±10.3 before training and 57.2±12.7 after training, a statistically significant improvement, (p<0.05). Furthermore, FMA was divided into four categories: shoulder, elbow, and forearm (total 36 points), wrist joint (total 10 points), hand finger (total 14 points), and speed/coordination (total 6 points). Elbow and forearm scores increased significantly from 22.8±7.2 before training to 28.3±4.1 after training, (p<0.05). There was a tendency for improvement in speed/coordination. MAL-A showed a significant improvement in AOU from an average of 1.4 ± 2.6 points to 2.3 ± 2.8 points after completion, (p<0.05). In the usability questionnaire, there was a lot of positive feedback.
CONCLUSION:
We have developed a unique portable stick-type training device for upper limb dysfunction and when it was tested on patients with chronic hemiplegia, significant results were obtained. This system enables exercise in space as a training method for upper limb dysfunction, and can provide a certain volume of training while receiving visual feedback. This system is inexpensive, compact and portable, making it possible for it to be widely used in general hospitals, rehabilitation facilities, and in homes.