Home-based (virtual) rehabilitation improves motor and cognitive function for stroke patients: a randomized controlled trial of the Elements (EDNA-22) system.
Peter H Wilson, Jeffrey M Rogers, Karin Vogel and 3 others
PMID 34823545WHAT IT FOUND
Home EDNA tablet training plus usual rehab improved more affected-hand Box and Block scores and cognitive screening scores more than home GRASP plus usual rehab in a small stroke trial.
Key findings
01In the group receiving EDNA plus usual therapy, Box and Block scores for the more affected hand improved from 23.5 to 34.7 blocks (p = 0.006), while the group receiving GRASP plus usual therapy showed negligible change.
02In the group receiving EDNA plus usual therapy, MoCA scores improved from 18.5 to 21.9 (p = 0.006), while the group receiving GRASP plus usual therapy did not.
03Between-group change scores favoured EDNA plus usual therapy over GRASP plus usual therapy on more affected-hand Box and Block (t = 2.25, p = 0.040) and MoCA (t = 2.31, p = 0.036).
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 trial stopped early because of COVID-19 disruptions, so only ten EDNA and seven GRASP participants were analysed. Participants had mild-to-moderate deficits and had to sit without assistance and have some upper-limb movement, so results do not apply to more severely affected stroke patients. The therapist who contacted patients was not blinded, although outcome assessors were. Both groups also received usual therapy, so the study cannot show that EDNA alone, without usual therapy, produced the gains. Caregiver NFI data were missing for most GRASP participants, and follow-up testing was limited by COVID-19 restrictions.
Declared interests
The supplied article text does not include a conflicts of interest or funding declaration; the publication metadata lists research support from a non-U.S. government source.
The easy way to misread this
Do not conclude that EDNA alone caused the improvements. Both groups also received usual rehabilitation, and the trial was small, so the result is a signal for further testing rather than proof for routine use.