title: Effects of training with a passive hand orthosis and games at home in chronic stroke: a pilot randomised controlled trial.
abstract: OBJECTIVE
  To compare user acceptance and arm and hand function changes after technology-supported training at home with conventional exercises in chronic stroke. Secondly, to investigate the relation between training duration and clinical changes.
  
  
  METHODS
  A randomised controlled trial.
  
  
  METHODS
  Training at home, evaluation at research institute.
  
  
  METHODS
  Twenty chronic stroke patients with severely to mildly impaired arm and hand function.
  
  
  METHODS
  Participants were randomly assigned to six weeks (30 minutes per day, six days a week) of self-administered home-based arm and hand training using either a passive dynamic wrist and hand orthosis combined with computerised gaming exercises (experimental group) or prescribed conventional exercises from an exercise book (control group).
  
  
  METHODS
  Main outcome measures are the training duration for user acceptance and the Action Research Arm Test for arm and hand function. Secondary outcomes are the Intrinsic Motivation Inventory, Fugl-Meyer assessment, Motor Activity Log, Stroke Impact Scale and grip strength.
  
  
  RESULTS
  The control group reported a higher training duration (189 versus 118 minutes per week, P = 0.025). Perceived motivation was positive and equal between groups ( P = 0.935). No differences in clinical outcomes over training between groups were found (P ⩾ 0.165). Changes in Box and Block Test correlated positively with training duration ( P = 0.001).
  
  
  CONCLUSIONS
  Both interventions were accepted. An additional benefit of technology-supported arm and hand training over conventional arm and hand exercises at home was not demonstrated. Training duration in itself is a major contributor to arm and hand function improvements.
authors: 1 Roessingh Research and Development, Enschede, the Netherlands.|2 Department of Biomechanical Engineering, University of Twente, Enschede, the Netherlands.
authors: Sharon M
authors: SM
authors: Nijenhuis
authors: 1 Roessingh Research and Development, Enschede, the Netherlands.|2 Department of Biomechanical Engineering, University of Twente, Enschede, the Netherlands.
authors: Gerdienke B
authors: GB
authors: Prange-Lasonder
authors: 1 Roessingh Research and Development, Enschede, the Netherlands.|2 Department of Biomechanical Engineering, University of Twente, Enschede, the Netherlands.|3 Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA.
authors: Arno Ha
authors: AH
authors: Stienen
authors: 1 Roessingh Research and Development, Enschede, the Netherlands.|2 Department of Biomechanical Engineering, University of Twente, Enschede, the Netherlands.|3 Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA.
authors: Johan S
authors: JS
authors: Rietman
authors: 1 Roessingh Research and Development, Enschede, the Netherlands.|3 Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA.|4 Department of Biomedical Signals and Systems, University of Twente, Enschede, the Netherlands.
authors: Jaap H
authors: JH
authors: Buurke
mesh_terms: D000368:Aged; D002908:Chronic Disease; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006225:Hand / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods; D009989:Orthotic Devices; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation*; D010865:Pilot Projects; D011379:Prognosis; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000503:physiopathology*; D013997:Time Factors; D016896:Treatment Outcome; D018910:Video Games
keywords: Stroke; dynamic orthotic device; home training; rehabilitation games; upper extremity