The WeReha Project for an Innovative Home-Based Exercise Training in Chronic Stroke Patients: A Clinical Study

Abstract

Background: Telerehabilitation (TR) in chronic stroke patients has emerged as a promising modality to deliver rehabilitative treatment-at-home. The primary objective of our methodical clinical study was to determine the efficacy of a novel rehabilitative device in terms of recovery of function in daily activities and patient satisfaction and acceptance of the medical device provided. Methods: A 12-week physiotherapy program (balance exercises, upper and lower limb exercises with specific motor tasks using a biofeedback system and exergaming) was administered using the WeReha device. Twenty-five ( N = 25) chronic stroke outpatients were enrolled, and the data of 22 patients was analyzed. Clinical data and functional parameters were collected by Berg Balance scale (BBS), Barthel Index (BI), Fugl-Meyer scale (FM), Modified Rankin scale (mRS), and Technology Acceptance Model (TAM) questionnaire at baseline (T0), after treatment (T1), and at the 12-week follow-up (T2). Statistical tests were used to detect significant differences ( P < .05), and Cohen’s (Co) value was calculated. Results: BI scores improved significantly after treatment ( P = .036; Co 0.776, medium), as well as BBS scores ( P = .008; Co 1.260, high). The results in FM scale ( P = .003) and mRS scores ( P = .047) were significant post treatment. Follow-up scores remained stable across all scales, except the BI. The A and C sub-scales of the TAM correlated significantly to only a T2 to T1 difference for BI scores with P = .021 and P = .042. Conclusion: Currently, the WeReha program is not the conventional therapy for stroke patients, but it could be an integrative telerehabilitative resource for such patients as a conventional exercise program-at-home. ClinicalTrials.gov identifier: NCT03964662.

Application of Home-Based Wearable Technologies in Physical Rehabilitation for Stroke: A Scoping Review

“…Therefore, the overall evidence in this area was considered "very limited". Similarly, "very limited" evidence from three studies [56,57,58] was available to support the effectiveness of wearable technology interventions in improving the physical function of stroke participants. Two studies [57,58], a case study and a nonrandomized controlled trial, used activity trackers to improve participants' physical function.…”

“…60 Therefore, the self-management paradigm has been adopted to The PRISMA diagram [26] in Figure 1 Table I provides an overview of the 27 chosen studies, which 23 consist of 13 randomized controlled trials (RCTs), 3 non-24 randomized controlled trials, 9 "before-after" studies, and 2 25 case studies. Most of the studies (n = 22) [33-54] applied 26 wearable devices to the UL region, while one [55] focused on 27 the LL region, and three others [56][57][58] focused on overall 28 physical function. One study [59] applied wearable devices to 29 upper and lower limb regions.…”

Robotic Home-Based Rehabilitation Systems Design: From a Literature Review to a Conceptual Framework for Community-Based Remote Therapy During COVID-19 Pandemic

“…Another home rehabilitation device for post-stroke patients is WeReha, which is intended to be used for hand impairments with the possible remote supervision of physiotherapists ( Bellomo et al, 2020 ). The primary purpose of this device’s invention is to train the fine movements of the hand and simultaneously stimulate the cognitive aspect, exploiting the biofeedback technology.…”

Ethical, Legal, Organisational and Social Issues of Teleneurology: A Scoping Review

“…While, once diagnosed, most neurological patients can be cared for on an outpatient basis, those requiring immediate diagnostic tests and treatment must be managed in a hospital setting [ 9 ]. The greatest evidence for the use of TN has been in neurocritical care and emergency stroke, where rapid assessment by a neurologist or other cerebrovascular pathology specialist is required, especially in remote underserved communities, such as rural areas, where direct access to neurology services are lacking [ 10 , 11 , 12 , 13 , 14 ].…”