Rehabilitation of Upper Limbs After Stroke

Evaluation of the Effects of Upper Limb Rehabilitation Using the Pablo Tyromotion Device in People After Stroke

The aim of the research will be to evaluate the effects of upper limb rehabilitation using modern Pablo Tyromotion technologies in people after stroke in the late period.

Prior to the study, an assessment of the reliability, reproducibility and validity of the devices among stroke individuals will be carried out.

The research will be conducted among people who have suffered a stroke in the late period.

The subjects will be allocated, by random selection, to two groups:

The study group will complete a conventional rehabilitation program supplemented with biofeedback exercises using the Pablo Tyromotion device.

The control group will participate in conventional rehabilitation without biofeedback exercises.

Patients will undergo ongoing rehabilitation at the Donum Corde Rehabilitation and Medical Care Center (four weeks). The first examination will be performed on the day of admission, the second on the day of discharge, and the third (control) one month after discharge, during a follow-up visit.

Measurements will be performed three times for all participants:

• assessment of hand and finger muscle strength
• calculated body mass index (BMI)
• proprioceptive testing (mirror test, Thumb Location Test)
• rehabilitation outcome assessment
• functional capacity - Barthel Index, ADL
• Ashworth muscle tone (spasticity)
• hand dexterity using the Box and Blocks test
• hand grip function according to the Frenchay scale
• motor function of the hand and upper limb according to the Fugl-Meyer Motor Assessment Scale for Upper Extremity

Inclusion Criteria:

• informed, voluntary consent of the patient
• age 45-80 years
• elementary (basic) gripping ability
• degree of paresis of the upper limb and hand 4 -5 on the Brunnström scale
• degree of disability on the Rankin scale 3
• spastic tension of the upper limb, paresis hand not more than 3 on the modified Ashworth scale
• current health condition confirmed by a medical examination, allowing participation in tests and exercises

Exclusion Criteria:

• lack of informed, voluntary consent of the patient
• second or subsequent stroke, hemorrhagic stroke, stroke of the brainstem and cerebellum
• disorders of higher mental functions limiting comprehension and carrying out tasks during exercises
• visual field disturbances
• mechanical and thermal injuries that may limit the grasping function of the hand
• concomitant neurological, rheumatological and orthopedic diseases, including permanent - contractures that may affect the grasping ability and locomotion
• unstable medical condition
• failure to complete a 3-week rehabilitation stay