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Many stroke patients have an impaired arm and hand function, which limits them in the performance of activities of daily living independently. To enable intensive rehabilitation for the upper limb after stroke, many technological devices have been developed. A next step would be to provide such technologies at home, to support self-administered motivational training, without requiring continuous therapist involvement. In the Supervised Care and Rehabilitation Involving Personal Telerobotics project (SCRIPT) we combined both the technology and telemedicine aspects. The thesis aims to evaluate the global impact (in terms of feasibility and potential clinical effects) of technology-supported, functional training of the arm and hand at home in chronic stroke patients, in two consecutive phases during the iterative design process. Through the evaluation phases, it became more clear that when developing technology-supported devices, it is important to develop a robust, reliable and safe device, which patients can easily use independently. Besides, patients should be kept motivated and challenged to training, because training duration is a major contributor to clinical changes. And finally, the contents of the training should address both reaching and hand function, since they are indicated as valuable targets for treatment applications to stimulate functional improvements after stroke.

Technology-supported arm and hand training at home after stroke