Efficacy of interactive manual dexterity training after stroke: a pilot single-blinded randomized controlled trial.
Maxime Térémetz, Sonia Hamdoun, Florence Colle and 12 others
PMID 37464404WHAT IT FOUND
Dextrain training did not improve gross hand dexterity more than conventional therapy immediately after treatment.
However, Dextrain showed greater gains in specific finger control tasks and a non-significant trend for better dexterity at 3-month follow-up.
Key findings
01The primary outcome, change in Box and Block Test score immediately after training, showed no significant difference between the Dextrain and conventional therapy groups.
02Dextrain therapy resulted in significantly greater improvements in specific dexterity components, including force tracking precision and independent finger movement reaction times, compared to conventional therapy.
03At 3-month follow-up, the Dextrain group showed a greater median difference in self-reported amount of paretic arm use in daily life compared to the conventional therapy group.
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 was a pilot trial with a small sample size (42 patients), limiting the power to detect significant differences. High dropout rates at the 3-month follow-up, largely due to COVID-19 restrictions, affected the analysis of long-term outcomes. The Dextrain group was significantly younger than the conventional therapy group at baseline, which may have influenced results despite adjustments. The training dose was relatively low (12 sessions), which may have underestimated the potential benefits of Dextrain. Several secondary outcomes and subgroup analyses were exploratory and not corrected for multiple comparisons, increasing the risk of false-positive findings. The primary outcome (BBT) measures gross dexterity and may not capture specific improvements in finger individuation that Dextrain targets.
Declared interests
The authors declared no conflicts of interest. The study was supported by non-U.S. government grants.
The easy way to misread this
Do not interpret the significant improvements in specific Dextrain device tasks (like force tracking) as evidence that Dextrain is superior to conventional therapy for general hand function. The primary outcome for gross dexterity was null immediately after treatment, and the 3-month trend was not statistically significant. The benefits observed were in specific, trained components, not necessarily in broader functional hand use.