A Usability Study in Patients With Stroke Using MERLIN, a Robotic System Based on Serious Games for Upper Limb Rehabilitation in Home Setting
Copyright policy )A Usability Study in Patients With Stroke Using MERLIN, a Robotic System Based on Serious Games for Upper Limb Rehabilitation in Home Setting
Abstract Background: Neuroscience and neurotechnology are changing stroke rehabilitation. Robotic devices as well as telerehabilitation have become of great interest and are increasingly being used to train the upper extremities after stroke. Its use in home settings allows to extend institutional rehabilitation by increasing and prolonging therapy. The aim of this study is to assess the usability of MERLIN robotic system based on serious games for the upper limb rehabilitation in stroke patients in a home environment.Methods: 12 participants with a stroke in three different stages of evolution (subacute, chronic of short evolution and long-term chronic) with impaired arm/hand function were recruited to use the MERLIN system for 3 weeks: one week of training at the Maimonides Biomedical Research Institute of Cordoba (IMIBIC), and 2 weeks at patients’ home. Evaluation of usability involved System Usability Scale (SUS), Adapted Intrinsic Motivation Inventory (IMI), Quebec User Evaluation of Satisfaction with assistive Technology (QUEST), and ArmAssist Usability Assessment Questionnaire which were evaluated post-intervention. Clinical outcomes on upper extremity motor function were assessed pre- and post-intervention.Results: Finally, 9 patients participated in the study, 3 drop-off due to the COVID-19. The usability assessment reported a high level of satisfaction: mean SUS score was 71.94 % (SD=16.38), mean QUEST scale was 3.81 (SD=0.38), and mean IMI score was 6.12 (SD=1.36). The results of the ArmAssist Questionnaire was an average of 6 out of 7, which indicates that MERLIN is easy to learn, easy to use and intuitive. Regarding clinical assessment, Fugl-Meyer scores showed moderated improvements from pre- to post-intervention in the total score of motor function (p = 0.002). There were no significative changes in Modified Ashworth scale outcomes (p = 0.169) Conclusions: This usability study indicates that home-based rehabilitation for upper limb with MERLIN system is safe, useful, feasible and motivating. The telerehabilitation suppose an important step towards an intensive rehabilitation to be bring to home.Trial registration: ClinicalTrials.gov, NCT04405609. Registered 06 January 2020 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04405609
- University of Córdoba Spain
- Hospital Universitario Reina Sofía Spain
- Sofia University Bulgaria
- FUNDACION TECNALIA RESEARCH & INNOVATION Spain
- Andalusian Health Service Spain
Male, Serious games, Medical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Delivery of Health Care::Attitude to Health::Patient Acceptance of Health Care::Patient Satisfaction, Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Physical Therapy Modalities::Exercise Therapy, Robot, Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans, User-Computer Interface, Medical Subject Headings::Phenomena and Processes::Biological Phenomena::Recovery of Function, Aged, 80 and over, Home training, Rehabilitation, Stroke Rehabilitation, Robotics, Middle Aged, Exercise Therapy, Stroke, Medical Subject Headings::Check Tags::Male, Medical Subject Headings::Anthropology, Education, Sociology and Social Phenomena::Human Activities::Leisure Activities::Recreation::Play and Playthings::Video Games, Patient Satisfaction, Extremidad superior, Medical Subject Headings::Information Science::Information Science::Computing Methodologies::Software::User-Computer Interface, Medical Subject Headings::Information Science::Information Science::Computing Methodologies::Artificial Intelligence::Robotics, Female, Medical Subject Headings::Persons::Persons::Age Groups::Adult, RC321-571, Telerrehabilitación, Adult, Upper extremity, Ejercicio en circuitos, Medical Subject Headings::Anatomy::Body Regions::Extremities::Upper Extremity, Neurosciences. Biological psychiatry. Neuropsychiatry, Health Informatics, Neurological rehabilitation, Accidente cerebrovascular, Medical Subject Headings::Diseases::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Stroke, Upper Extremity, SDG 3 - Good Health and Well-being, This research is part of a MERLIN project, which has received funding from EIT Health (Grant no. 20649). EIT Health is supported by the European Institute of Innovation and Technology (EIT), a body of the European Union which receives support from the European Union’s Horizon 2020 Research and innovation programme., Medical Subject Headings::Persons::Persons::Age Groups::Adult::Middle Aged, Humans, Medical Subject Headings::Persons::Persons::Age Groups::Adult::Aged::Aged, 80 and over, Funding Info, Aged, Telerehabilitation, Research, Medical Subject Headings::Check Tags::Female, Recovery of Function, Video Games, Medical Subject Headings::Persons::Persons::Age Groups::Adult::Aged, Neurorrehabilitación
Male, Serious games, Medical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Delivery of Health Care::Attitude to Health::Patient Acceptance of Health Care::Patient Satisfaction, Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Physical Therapy Modalities::Exercise Therapy, Robot, Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans, User-Computer Interface, Medical Subject Headings::Phenomena and Processes::Biological Phenomena::Recovery of Function, Aged, 80 and over, Home training, Rehabilitation, Stroke Rehabilitation, Robotics, Middle Aged, Exercise Therapy, Stroke, Medical Subject Headings::Check Tags::Male, Medical Subject Headings::Anthropology, Education, Sociology and Social Phenomena::Human Activities::Leisure Activities::Recreation::Play and Playthings::Video Games, Patient Satisfaction, Extremidad superior, Medical Subject Headings::Information Science::Information Science::Computing Methodologies::Software::User-Computer Interface, Medical Subject Headings::Information Science::Information Science::Computing Methodologies::Artificial Intelligence::Robotics, Female, Medical Subject Headings::Persons::Persons::Age Groups::Adult, RC321-571, Telerrehabilitación, Adult, Upper extremity, Ejercicio en circuitos, Medical Subject Headings::Anatomy::Body Regions::Extremities::Upper Extremity, Neurosciences. Biological psychiatry. Neuropsychiatry, Health Informatics, Neurological rehabilitation, Accidente cerebrovascular, Medical Subject Headings::Diseases::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Stroke, Upper Extremity, SDG 3 - Good Health and Well-being, This research is part of a MERLIN project, which has received funding from EIT Health (Grant no. 20649). EIT Health is supported by the European Institute of Innovation and Technology (EIT), a body of the European Union which receives support from the European Union’s Horizon 2020 Research and innovation programme., Medical Subject Headings::Persons::Persons::Age Groups::Adult::Middle Aged, Humans, Medical Subject Headings::Persons::Persons::Age Groups::Adult::Aged::Aged, 80 and over, Funding Info, Aged, Telerehabilitation, Research, Medical Subject Headings::Check Tags::Female, Recovery of Function, Video Games, Medical Subject Headings::Persons::Persons::Age Groups::Adult::Aged, Neurorrehabilitación
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