Abstract
Stroke
is a leading cause of permanent disability worldwide, with 60% of
survivors experiencing upper limb impairment six months post-stroke.
While spontaneous recovery plateaus within six months, targeted motor
rehabilitation can improve function beyond this period. However,
resource constraints limit access to outpatient therapy, highlighting
the need for cost-efficient and accessible treatments. We developed a
novel, wearable myoelectric interface for neurorehabilitation (MINT),
providing affordable, gamified, at-home rehabilitation for moderate to
severe stroke patients. MINT conditioning reduces abnormal arm muscle
co-activation and enhances movement. In a transdisciplinary, randomized,
sham-controlled trial with 59 stroke survivors, the experimental group
experienced significantly reduced abnormal muscle co-activation and
significantly improved arm function after six weeks of at-home MINT use,
while the sham control group did not improve. Our approach addresses
key challenges in at-home stroke rehabilitation: 1) Patient motivation:
collaborating with software engineers, we created engaging game
environments to maximize patient motivation and adherence to at-home
rehabilitation.(With 100% recovery protocols you would have no problems motivating patients! When the fuck will you deliver 100% recovery protocols?) 2) Patient progress monitoring: We developed an
automated pipeline that tracks patient progress, including training
repetition counts, game success rates, and muscle activities. We faced
multiple challenges in implementing this at-home trial, including a high
drop-out rate, mostly due to external factors unrelated to the
intervention, insufficient communication, and computer illiteracy.
Addressing these challenges will involve enhancing patient support and
improving usability, and is critical to future home-based therapies.
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