Authors: (including presenting author): :
Fan MK (1), Lau M (1), Yue SY (1), Leung YS (1), Ip WM (1), Chan WC (1), Choy PC (1), Cheung KY (1), Ip CS (1), Tam SH (1), Wan KC (1), Yuen WS (1)
Affiliation: :
(1) Occupational Therapy, Shatin Hospital
Keyword 1: :
Technology-integrated Upper Limb Rehabilitation Protocol
Keyword 2: :
Optimize advanced technologies utilization
Keyword 3: :
Guide clinical decision-making on advanced technologies
Keyword 4: :
Maximize functional recovery of stroke survivors
Introduction: :
Stroke often cause motor impairments in the upper extremities, limiting patients’ functional abilities. Various advanced technologies—including exoskeletons, end-effectors, hand robotics, and virtual reality—are increasingly adopted in upper limb rehabilitation. Nonetheless, the lack of a standardized approach to their application, patient selection, and training objectives poses a significant challenge in clinical practice. Developing a systematic, evidence-based rehabilitation protocol that integrates these advanced technologies is crucial for ensuring consistent, effective, and personalized patient care.
Objectives: :
This study aims to establish a standardized upper limb rehabilitation protocol incorporating advanced technologies and to evaluate its effectiveness on patients’ upper limb function. The implementation of this protocol has the potential to optimize technology utilization, guide clinical decision-making, and ultimately enhance recovery for patients with upper limb impairments.
Methodology: :
This standardized upper limb rehabilitation protocol was developed based on the Functional Test for the Hemiplegic Upper Extremity (FTHUE). Advanced technologies were categorized according to their training characteristics and objectives, and recommended for use at corresponding FTHUE levels. The clinical application commenced between January and August 2025. A one-group pretest-posttest design was employed, with subacute stroke patients recruited from Shatin Hospital. Inclusion criteria were as follows: (1) initial FTHUE score between 1 and 5, (2) ability to tolerate a one-hour gym session with adequate sitting tolerance and good cognition. Exclusion criteria was as follows: (1) Severe additional neurological or orthopedic impairments prior to stroke. Patients completed 10 sessions of one-hour upper limb trainings incorporating advanced technologies under the guidance of the standardized protocol. Assessments were conducted at baseline (T0) and prior to discharge (T1). Outcome measures included the FTHUE, Fugl-Meyer Assessment – Upper Extremity (FMA-UE) and the Modified Barthel Index (MBI).
Result & Outcome: :
A total of 59 subacute stroke patients with a mean age of 67 years were recruited, including 25 females and 34 males. An average increase of 1.4 points was observed in FTHUE levels, along with an average improvement of 13.6 points in the FMA-UE (Motor Function) score. Both results were statistically significant, indicating notable enhancements in upper limb function following the protocol-driven rehabilitation. Additionally, there was an average increase of 18.1 in MBI scores, which was also statistically significant, reflecting substantial improvement in ADL performance. The implementation of this standardized, protocol-driven upper limb rehabilitation program that integrates advanced technologies demonstrated significant improvements in both upper limb function and ADL performance among subacute stroke patients. The positive outcomes highlight the critical role of a systematic, evidence-based approach in optimizing technology utilization and ensuring personalized, effective rehabilitation. This protocol not only facilitates consistent clinical decision-making but also bridges the gap between technological innovation and patient-centered care. Ultimately, such a technology-enhanced, protocol-driven rehabilitation program is essential for maximizing functional recovery and enhancing functional independence in stroke survivors.
