HoMEcare aRm rehabiLItatioN (MERLIN): telerehabilitation using an unactuated device based on serious games improves the upper limb function in chronic stroke.
Samantha G Rozevink, Corry K van der Sluis, Ainara Garzo and 2 others
PMID 33726801WHAT IT FOUND
Chronic stroke patients improved arm function after six weeks of home training with the MERLIN device and serious games.
Gains lasted six weeks after stopping, but quality of life did not change. Only ten of twelve participants completed the training.
Key findings
01Primary outcome (WMFT Functional Ability Scale) showed significant improvement, with a 5.0-point gain from baseline to post-training.
02Secondary outcomes (FMA-UE and ARAT) improved significantly, and gains were retained six weeks after training ended.
03Quality of life scores did not change significantly despite the improvements in arm function.
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 underpowered with only 12 participants, and two dropped out, leaving a very small sample for analysis. It was a within-subject design without a separate control group, so natural recovery or placebo effects cannot be entirely ruled out, although the control period showed no change. More than half of the participants did not meet the prescribed training intensity, which complicates the interpretation of the dose-response relationship. The device fit was problematic for some patients, with small hands finding the grip too large and large hands finding it too small, leading to discomfort and dropouts. The study was conducted in a single region in the Netherlands, which may limit generalizability to other populations or healthcare systems.
Declared interests
The study was funded by EIT Health. The authors declared no competing interests, but the device components were provided by specific companies (TECNALIA R&I and GMV, Spain).
The easy way to misread this
Do not assume this device works for all chronic stroke patients. The study had a high dropout rate due to poor fit and discomfort, and many participants failed to complete the required training hours. It is most likely to succeed in highly motivated patients who can troubleshoot technical issues independently.