Authors (including presenting author) :
Chung RKF, Chan JSP, Leung KKL, Kwan YYF, Chan BSC, Leung DCK, Lee JWK, Yue RPY
Affiliation :
Physiotherapy Department, Kowloon Hospital
Keyword 1: :
Computer-assisted interactive training
Keyword 2: :
Stroke upper limb rehabilitation
Introduction :
Impairment of upper limb function remains a major problem after stroke, significantly impairing independence and quality of life. Computer assisted interactive training (CAIT) represents an emerging rehabilitation approach that integrates physical and cognitive components with real time visual feedback, aiming to enhance motor relearning, motivation, and adherence.
Objectives :
To evaluate the effectiveness of adjunct computer-assisted interactive upper limb training compared to conventional physiotherapy alone in patients with subacute stroke. The primary outcomes included upper limb functional performance, hand grip strength, and patient satisfaction; secondary analyses explored muscle power.
Methodology :
A cross-sectional study was conducted in Physiotherapy Department of Kowloon Hospital between June 2024 and November 2025. Patients with a confirmed stroke diagnosis (ICD-9: 430-436) involving unilateral hemiplegia were included if they could comprehend and follow simple instructions. Exclusion criteria encompassed stroke patients with severe visual acuity deficits or fixed contractures in the affected limb. Thirty stroke participants at the medical wards were recruited and assigned to either the CAIT group (n=15; 60%male), who received ten sessions of additional 15 minute computer assisted training in addition to conventional physiotherapy, or the control group (n=15; 66.7%male), who received conventional physiotherapy. Outcome measures included the Hong Kong Version of the Functional Test for the Hemiplegic Upper Extremity (FTHUE HK), hand grip strength, post training satisfaction scores and muscle power grading. Between group comparisons were analyzed using independent samples t tests of IBM SPSS 30.0, with significance set at p ≤ 0.05 and effect size estimated by Cohen’s d.
Result & Outcome :
Groups were comparable in baseline characteristics (mean age:CAIT 76.13±10.11 years; control 75.73±5.57 years, p=0.894). The CAIT group demonstrated significantly greater improvements in FTHUE HK scores (mean ± SD change:1.1±0.64 vs. 0.60±0.51; p = 0.017, Cohen’s d=0.92) and hand grip strength (3.47±3.36 kgf vs. 1.07±1.16 kgf; p = 0.014, Cohen’s d=0.96). Large effect sizes (Cohen’s d>0.8) were observed for these key variables including FTHUE-HK and hand grip strength. These underscore substantial and clinically meaningful differences between groups. Satisfaction scores were also higher in the CAIT group (8.13±1.19 vs. 7.07±0.80 out of 10; p = 0.007) and better adherence to physiotherapy training. No significant between group differences were detected in shoulder, elbow, or wrist muscle power. Computer-assisted interactive upper limb functional training proved an effective adjunct to conventional therapy in subacute stroke rehabilitation. These findings demonstrate that integrating CAIT into daily physiotherapy significantly enhances upper limb function while boosting patient engagement and active participation in rehabilitation.
