Training finger individuation with a mechatronic-virtual reality system leads to improved fine motor control post-stroke

I have no finger individuation so I'll have to look at this more closely.
http://search.naric.com/research/rehab/redesign_record.cfm?search=2&type=all&criteria=J70148&phrase=no&rec=126485
NARIC Accession Number: J70148.  What's this?
ISSN: 1743-0003.
Author(s): Thielbar, Kelly O.; Lord, Thomas J.; Fischer, Heidi C.; Lazzaro, Emily C.; Barth, Kristin C.; Stoykov, Mary E.; Triandafilou, Kristen M.; Kamper, Derek.
Project Number: H133E070013.
Publication Year: 2014.
Number of Pages: 24.
Abstract: Study investigated the impact of finger individuation training using a novel mechatronic-virtual reality system on fine motor control after stroke. An actuated virtual keypad (AVK) system was developed in which the impaired hand controls a virtual hand playing a set of keys. Creation of individuated digit movements is assisted by a pneumatically actuated glove. Fourteen subjects with chronic hand impairment resulting from a single stroke incurred at least 6 months prior underwent 18 hour-long sessions of extensive therapy (3 times per week for 6 weeks) targeted at finger individuation. Subjects were randomly divided into two groups: one group utilized the AVK system (AVK group) while the other group received a similarly intensive dose of occupational therapy (OT group). Outcome measures including the Jebsen-Taylor Hand Function Test, Action research Arm Test, Fugl-Meyer Upper Extremity Motor Assessment/Hand subcomponent, grip and pinch strengths were collected at baseline, post-treatment and one-month post-treatment. While both groups exhibited some signs of change after the training sessions, only the AVK group displayed statistically significant improvement both for measures of impairment and measures of task performance. Additionally, the finger individuation index (a measure of finger independence) improved only for the AVK group after training in the subset of these participants for which it was measured. Actively assisted individuation therapy comprised of non-task-specific modalities, such as can be achieved with virtual platforms like the AVK described here, may prove to be valuable clinical tools for increasing the effectiveness and efficiency of therapy following stroke.