Authors (including presenting author) :
Lee JKY, Ho ETH, Chow ESL, Woo CW, Leung KKL
Affiliation :
Physiotherapy Department, Kowloon Hospital
Keyword 2: :
Subacute stroke
Keyword 3: :
Integrated rehabilitation
Introduction :
Upper limb impairment affects approximately 75% of stroke survivors, leading to significant functional limitations[1]. This impairment is also associated with impaired balance and mobility[2-3]. Achieving optimal recovery requires high-intensity personalized training, necessitating integrated rehabilitation strategies that target both upper limb function and ambulation beyond conventional standard care.
Objectives :
This study explored the effects of integrated training using a wireless, EMG-driven robotic glove system (which enables self-initiated, active-assisted hand movements) on upper limb motor function, balance and ambulation in subacute stroke patients.
Methodology :
Thirteen in-patients of Kowloon Hospital (mean age 63.31±7.42 years)completed integrated, personalized training (30 minutes, 3-5 days per week, average 13.62±3.67 sessions) since March 2025. The program included task-specific hand training with robotic gloves, along with reaching and lifting activities, while progressively challenging the stability in standing positions. Outcome measurements included grip strength, Fugl-Meyer Assessment - Upper Extremity(FMA-UE), Box and Block Test(BBT), Berg Balance Scale(BBS) and Modified Functional Ambulatory Classification(MFAC). Wilcoxon signed-rank tests were used for statistical analysis.
Result & Outcome :
Results demonstrated significant improvements across all measures post-training. Balance improved with BBS showing median gain of 13 points(p=0.001), exceeding the minimal clinically important difference(MCID) for stroke[4]. Walking independence improved with MFAC showing median gain of 1 category(p=0.002). Upper limb function showed substantial recovery with FMA-UE Total Score showing median gain of 9 points(p=0.001), achieving MCID for stroke[5]. Dexterity(BBT) and grip strength showed median gain of 4 blocks(p=0.001) and 4kgF(p=0.003) respectively. No adverse events occurred. High patient satisfaction was reported(Global Rate of Change scale 8.85±0.90), with patients showing greater engagement due to unique EMG-driven self-initiation and visual feedback features. The mobile, wearable glove facilitated high-intensity, repetitive, task-specific hand training, while enabling physiotherapists to safely integrate advanced balance and gait training by using the improved hand function for stability and support. The improved MFAC might be contributed by enhanced upper limb function which help promote functional independence. Integrated, personalized training with wearable robotic gloves in subacute phase of stroke is safe and effective, demonstrating substantial gains across motor function, balance, and functional mobility. This integrated rehabilitation approach should be considered as an adjunct in in-patient stroke rehabilitation, given its potential to maximize recovery across multiple functional domains on both upper limb function and mobility.
