The WeReha Project for an Innovative Home-Based Exercise Training in Chronic Stroke Patients: A Clinical Study

Rosa Grazia Bellomo, Teresa Paolucci, Aristide Saggino, Letizia Pezzi, Alessia Bramanti, Vincenzo Cimino, Marco Tommasi, Raoul Saggini, Rosa Grazia Bellomo, Teresa Paolucci, Aristide Saggino, Letizia Pezzi, Alessia Bramanti, Vincenzo Cimino, Marco Tommasi, Raoul Saggini

Abstract

Background: Telerehabilitation (TR) in chronic stroke patients has emerged as a promising modality to deliver rehabilitative treatment-at-home. The primary objective of our methodical clinical study was to determine the efficacy of a novel rehabilitative device in terms of recovery of function in daily activities and patient satisfaction and acceptance of the medical device provided.

Methods: A 12-week physiotherapy program (balance exercises, upper and lower limb exercises with specific motor tasks using a biofeedback system and exergaming) was administered using the WeReha device. Twenty-five (N = 25) chronic stroke outpatients were enrolled, and the data of 22 patients was analyzed. Clinical data and functional parameters were collected by Berg Balance scale (BBS), Barthel Index (BI), Fugl-Meyer scale (FM), Modified Rankin scale (mRS), and Technology Acceptance Model (TAM) questionnaire at baseline (T0), after treatment (T1), and at the 12-week follow-up (T2). Statistical tests were used to detect significant differences (P < .05), and Cohen's (Co) value was calculated.

Results: BI scores improved significantly after treatment (P = .036; Co 0.776, medium), as well as BBS scores (P = .008; Co 1.260, high). The results in FM scale (P = .003) and mRS scores (P = .047) were significant post treatment. Follow-up scores remained stable across all scales, except the BI. The A and C sub-scales of the TAM correlated significantly to only a T2 to T1 difference for BI scores with P = .021 and P = .042.

Conclusion: Currently, the WeReha program is not the conventional therapy for stroke patients, but it could be an integrative telerehabilitative resource for such patients as a conventional exercise program-at-home.ClinicalTrials.gov identifier: NCT03964662.

Keywords: Neurology; physical therapy; rehabilitation; stroke; telerehabilitation; virtual reality.

Conflict of interest statement

Declaration of conflicting interests:The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: All authors state that no financial or personal interests have influenced this work. This study is part of the Magic-PCP Project [NCT03964662], with a grant from the European Union, which concerns the clinical experience of the “G. D’Annunzio” University and IRCSS “Bonino Pulejo”.

© The Author(s) 2020.

Figures

Figure 1.
Figure 1.
Smart object, three-dimensional objects printed in plastic material: (a) the disc is used to perform coordinated and specular movements of prono-supination of the wrists, (b) the joystick is used to perform shoulder flexion, elbow flexion-extension and ipsilateral prone-supination movements, (c) the remote control is used to perform elbow flexion-extension, and (d) the spinning top is used to perform a correct grip of the hemiparetic hand and allow the movement of the ipsilateral upper limb.
Figure 2.
Figure 2.
Mean ratings of BBS, BI, FM, and mRS assessment scales in relation to time series (T0 = baseline; T1 = training session; T2 = follow-up).

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