A Novel Wearable Device for Motor Recovery of Hand Function in Chronic Stroke Survivors.
Supriyo Choudhury, Ravi Singh, A Shobhana and 7 others
PMID 32452275WHAT IT FOUND
Home use of a device pairing electrical shocks with loud clicks improved hand grasp in chronic stroke survivors.
The average gain was small, but responders showed clinically meaningful improvement. Other hand functions and strength did not change.
Key findings
01The paired stimulation group showed significant improvement in total Action Research Arm Test scores and the Grasp subscore, while the random stimulation and standard treatment groups did not.
02There was no significant change in modified Ashworth scores, grip or wrist strength, or wrist range of movement in any group.
03Twenty-nine percent of patients in the paired stimulation group were responders, defined as having at least a 6-point increase in total ARAT score.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study did not standardize physical therapy across patients, and many received little or no therapy, though there were no group differences in therapy hours. The sample size was determined by convenience over 1 year and 7 months, not by power calculation. The average improvement in ARAT score was 5 points, which is below the estimated minimal clinically important difference of 5.7 points, though individual responders exceeded this. The device had technical issues, with micro-USB charge points breaking in 4 devices. Two patients withdrew due to dislike of the repeated click sound. The study was conducted in a single center in India, limiting generalizability.
Declared interests
The authors declared no potential conflicts of interest. Initial work on the device was funded by the Medical Research Council and the Wellcome Trust.
The easy way to misread this
Do not expect this device to improve hand strength, reduce spasticity, or enhance fine pinch or gross motor skills. The benefit was limited to grasp function and was modest on average. Only a subset of patients showed clinically meaningful improvement.