Journal of Telemedicine and Telecare > Volume 14, Number 5 > Pp. 249-256

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RESEARCH Original articles

Feasibility of a home-based telerehabilitation system compared to usual care: arm/hand function in patients with stroke, traumatic brain injury and multiple sclerosis

Barbara CH Huijgen ^*, Miriam MR Vollenbroek-Hutten ^* , Mauro Zampolini , Eloy Opisso , Montse Bernabeu , Johan Van Nieuwenhoven , Stephan Ilsbroukx , Riccardo Magni ^**, Claudia Giacomozzi , Velio Marcellari , Sandro Scattareggia Marchese  and Hermie J Hermens ^* 

^* Roessingh Research and Development B.V., Enschede, The Netherlands; ASL 3 Umbria, Unità Organica di Riabilitazione Intensiva Neuromotoria, Trevi, Italy; Institut Universitari de Neurorehabilitació Institut Guttman, Badalona, Spain; National Multiple Sclerosis Centre, Melsbroek, Belgium; ^** Pragma Engineering, Perugia, Italy; Instituto Superiore di Sanità, Rome, Italy; Signo Motus srl Messina, Italy; Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, The Netherlands

Correspondence: MMR Vollenbroek-Hutten, Roessingh Research and Development, Roessinghbleekweg 33b, 7522 AH Enschede, The Netherlands (Fax: +31 53 434 08 49; Email: m.vollenbroek{at}rrd.nl)

We conducted a randomized controlled multicentre trial to investigate the feasibility of a telerehabilitation intervention for arm/hand function (the Home Care Activity Desk [HCAD] training) in a home setting. Usual care was compared to HCAD training. The hypothesis was that the clinical outcomes of the HCAD intervention would be at least the same as those measured after a period of usual care for patients with stroke, traumatic brain injury (TBI) and multiple sclerosis (MS) with respect to their arm/hand function. Eighty-one patients with affected arm/hand function resulting from either stroke, MS or TBI were recruited in Italy, Spain and Belgium; 11 were lost during follow-up (14%). The outcome measures were the Action Research Arm Test (ARAT) and the Nine Hole Peg Test (NHPT). There were no significant differences between the two groups on the outcome measures (ARAT and NHPT); in both groups, patients maintained or even improved their arm/hand function. The HCAD training was found to be as feasible as usual care in terms of clinical outcomes, and both therapists and patients were satisfied with the HCAD intervention. A telerehabilitation intervention using HCAD may increase the efficiency of care.

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