Long-term usability and feasibility of home-based hand therapy with the Plug-and-train hand rehabilitation robot(PLUTO)

Research Objectives: To evaluate the long-term usability and feasibility of robot-assisted home-based rehabilitation with PLUTO

Design: Feasibility trial

Setting: Independent at-home rehabilitation

Participants: Five chronic stroke patients (> 6 months post first stroke)

Interventions: PLUTO is a single-degree-of-freedom robot for training wrist flexion-extension, wrist ulnar-radial deviation, forearm pronation-supination, hand opening-closing, and functional grasps. All training is gamified with games that adapt to the patient’s performance, with the robot assisting minimally.

Patients and their caregivers were trained to use PLUTO for the first three days in the clinic, following which the device was set up at their homes for independent use for four weeks. They could contact the engineering team for any technical support. Patients were recommended to train for at least an hour every.

Main Outcome Measures: The primary outcome was long-term usability which was quantified at the end of 4 weeks with: System Usability Scale(SUS), User Experience Questionnaire(UEQ), and the Intrinsic Motion Inventory(IMI). The total duration of training and duration per day were quantified using the data collected from the robot. Clinical outcomes were also measured pre- and post-training using Fugl-Meyer Assessment(FMA), Box-and-blocks test(BBT), ABIL hand and Barthel scale.

Results: All five patients completed four weeks of training and trained for about 93±19.78 minutes daily, 5.6±0.78 days per week. Patients rated PLUTO with a SUS score of 76.5±7.84, and the caregivers gave a score of 76.5±12. All patients rated both the IMI and the UEQ positively on all subscales. Technical assistance was provided 5.8±3.8 times over the four weeks.
On the clinical scales, patients improved by 8.4±3.92 points in FMA, 2±4.91 blocks on BBT, 8.25±5.8 points on ABIL-hand and 9.6±6.43 points on Barthel index.

Conclusions: This study provides preliminary evidence about the long-term usability and feasibility of home-based robot-assisted hand neurorehabilitation with PLUTO. All patients rated the system to have good usability and preferred at-home training more than outpatient training. This pilot study warrants a more extensive, systematic, and blinded study to evaluate the efficacy of robot-assisted home neurorehabilitation of hand function.

Author(s) Disclosures: No author disclosures.