(Research Hub Theater) Changes in Hand Function and Resting Motor Threshold Following a 3-week Intervention Using a Novel Passive Hand Function Therapy Device in Chronic Stroke

Background and/or Objectives: This study explored the effects of training with a novel passive hand function therapy (HFT) device on motor function and cortical excitability in chronic persons with stroke (PWS).

Design: Experimental design

Setting: Private Treatment room

Participants: 9 chronic PWS

Interventions: Participants participated in 15 1-hour sessions using a passive hand function training device. The device provided gamified feedback and progressed in a granular progressive approach.

Main Outcome Measures: Action Research Arm Test (ARAT) broken into subgroups: Grasp, Grip, Pinch and Gross, and Resting Motor Threshold (RMT) of the unaffected hemisphere using Transcranial Magnetic Stimulation (TMS).

Results: Significant motor improvements of the hand were observed in the mean scores for the ARAT (PRE: 17.44±2.94, POST: 25.33±2.94, p< 0.006). Participants consistently showed increased cortical excitability in the unaffected hemisphere following treatment, reflected as a reduced RMT (PRE: 57.11 ± 13.1, POST: 52.22 ± 14.8, p = 0.016, ES = -1.01). In the unaffected hemisphere, post-intervention decreases in RMT are significantly correlated with post-intervention increases in ARAT scores (rrm(8) = -0.73, 95% CI [-0.931, -0.184], p = 0.017).

Conclusions: Passive hand function training can increase contralesional cortical excitability, increase hand motor function, and may be an effective option for HFT in chronic PWS. Future studies that investigate passive options for HFT and cortical excitability in PWS should investigate with larger sample sizes, include more assessments and control groups.