The Electronic Grip Gauge (EGG): Automated Assessment of Sensorimotor Hand Function Using an Instrumented Fragile Object

IEEE Transactions on Neural Systems and Rehabilitation Engineering · 2026-01-01

Hand dexterity assessments play a crucial role in informing the rehabilitative care of individuals with upper-limb hemiparesis. However, current assessments often struggle to evaluate the hand's ability to precisely control grip force, a skill vital for daily activities like handling fragile objects. Here we describe the design of the Electronic Grip Gauge (EGG), an adjustable-weight, instrumented "fragile" object that measures grip force, load force, acceleration, orientation, and relative position. Embedded sensors enable automatic segmentation and analysis of EGG transfers in various modes. In "Non-Fragile" mode, there is no break threshold; the EGG serves as an automated variant of the Box-and-Blocks test. In "Fragile" mode, the EGG simulates fragility by playing a "break" noise if grip force exceeds a set threshold, requiring grip control to prevent breaks. In "Fragile-Feedback" mode, audio-visual feedback is provided proportional to applied grip force to supplement potentially impaired tactile feedback. Demonstrating functionality, we evaluated sensorimotor differences between 26 hemiparetic and 26 age-matched healthy participants. In "Fragile" mode, paretic hands were significantly slower, applied excessive force, and broke the EGG more frequently than contralateral and healthy control hands. In "Fragile-Feedback" mode, a subset of paretic hands improved, transferring the EGG faster and/or with less force. This work demonstrates the EGG's utility in automatically quantifying sensorimotor deficits and that, for a subset of hemiparetic patients, audiovisual feedback could potentially coach and rehabilitate hand function. Collectively, this work showcases the EGG's potential as both an assessment and rehabilitation device for grip force control-a critical skill in hand therapy.

Resilience in Stroke survivor-care-partner Dyads (ReStoreD): a study protocol for a randomized-control trial

Trials · 2025-06-04 · 3 citations

BACKGROUND: The impact of stroke is shared between the stroke survivor and their care-partner. An estimated 30-50% of stroke survivors and their care-partners experience depression or anxiety that negatively affects rehabilitation outcomes and quality of life. Yet, interventions to support couples post-stroke are largely insufficient or inaccessible. A novel remotely delivered dyadic intervention to promote Resilience in Stroke survivor-care-partner Dyads (ReStoreD) was developed to address this need. The intervention includes psychoeducation and weekly modules that help couples learn and practice goal-setting, communication strategies, and positive psychology activities like expressing gratitude, finding meaning, and fostering connections. The purpose of this study is to conduct an efficacy trial of the 8-week ReStoreD intervention with a sample of 200 dyads (n = 400) consisting of one individual who has sustained an ischemic or hemorrhagic stroke between 3 months and 3 years prior to enrollment and a cohabitating partner. METHODS: Using a fully powered, randomized waitlist-control design, the efficacy of ReStoreD to reduce emotional distress in both dyad members will be determined (Aim 1). In addition, the effects of ReStoreD on secondary outcomes (resilience, relationship quality, stress-related stroke, meaningful activity engagement) as potential mediators (Aim 2) and moderators to determine whether certain subgroups respond better to the intervention (Aim 3) will be examined. All participants will complete standardized, validated assessments at baseline, 8 weeks, 16 weeks, and 6-month follow-up. All aspects of the study, including intervention activities and assessments, are conducted remotely, online. DISCUSSION: This is the first rigorously designed efficacy trial to test a positive psychology intervention for stroke survivors and their care-partners. When the aims of this study are realized, there will be (1) a remotely delivered, dyadic intervention to support couples post-stroke; (2) a better understanding of the mechanisms involved in the intervention's effect on emotional distress, which can inform future interventions; and (3) the ability to identify a more specific target population for whom the intervention works best. Ultimately, if found efficacious, this intervention will offer sustainable and accessible support for couples who are coping with stroke to improve rehabilitation outcomes and quality of life. TRIAL REGISTRATION: This trial is registered at ClinicalTrials.gov at NCT#04845542. Registered on April 13, 2021.

Stories About Ken

Cognitive and Behavioral Neurology · 2025-07-17

Comparing the sensitivity and specificity of novel motor assessments for traumatic brain injury

PM&R · 2025-06-06

BACKGROUND: Portable technology that records movements with high accuracy provides potential for sensitive clinical movement tests for individuals who experienced a traumatic brain injury (TBI). OBJECTIVE: (1)To present impairments assessed using markerless motion capture (MMC) and (2) to compare the sensitivity and specificity of the MMC-mediated tests to each other and to common clinical tests. DESIGN: Screening study, using as criterion standard the ability to classify participant with TBI versus control participant. SETTING: Research laboratory. PARTICIPANTS: The study included 30 individuals with TBI and 101 control participants. Entry criteria included most recent head injury <5 years old, no history of movement issues prior to injury, no movement-affecting medications, and sufficient cognitive ability to follow instructions. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Performance on MMC-mediated tests and existing clinical analogs. MMC-mediated tests included finger oscillation, simple reaction time, and visually guided movement tasks. For comparison, participants also completed the following clinical tests: Halstead-Reitan finger tapping, simple reaction time test, and Beery Visuomotor Integration test. Impairments were identified as test scores of participants with TBI that fell outside of the 95% interval of control participants' test scores. Random forest analysis was used to calculate the sensitivity and specificity of MMC and clinical tests according to their ability to correctly classify participants with TBI and control participants. RESULTS: MMC-mediated tests revealed impairments in more participants with TBI than clinical tests in all three TBI groups (mild, repeated, and moderate to severe). Similarly, MMC-mediated tests revealed a higher percentage of scores as impairments than clinical tests in all three groups with TBI. Furthermore, MMC-mediated tests proved more sensitive and more specific than clinical tests (70% versus 50% and 98% versus 93%, respectively). CONCLUSION: MMC-mediated tests are sensitive and specific (compared to traditional clinical tests) and have potential to fill a gap in clinical care of TBI.

"Rehabbing the Couple:" Supporting Couples Coping with Stroke through a Novel Dyadic Intervention

Archives of Physical Medicine and Rehabilitation · 2025-04-30

Use of myoelectric orthosis after stroke or traumatic brain injury: a systematic review

Topics in Stroke Rehabilitation · 2025-09-22

BACKGROUND: Upper extremity (UE) paralysis and weakness due to stroke or traumatic brain injury (TBI) can limit independent functioning. Myoelectrically controlled orthoses can be used for compensatory support for activities of daily living (ADL), and for restorative rehabilitation to reduce disability. OBJECTIVE: We investigate the use of UE myoelectric orthoses (UE-MEO) for compensatory and/or restorative use after stroke or TBI. METHODS: We conducted a systematic review (PROSPERO CRD42024577225) from 15 databases including MEDLINE®, Embase®, and APA PsycInfo®. Peer-reviewed reports from 2014 onwards with patient use of UE-MEO after stroke or TBI were included. RESULTS: Ten studies (11 reports) met the criteria; all included individuals post-stroke and one included a post-TBI subset. The majority were Oxford level of evidence 3b and rated as low risk of bias. All compensatory use studies showed participants could complete more activities or more parts of activities while wearing the UE-MEO. Studies in which the UE-MEO was studied as a restorative therapy took place in outpatient clinics and in the home setting, with mixed results across studies. CONCLUSION: The results suggest that use of a UE-MEO is a viable option as a compensatory tool to improve UE function in individuals with partial paralysis or weakness due to stroke or TBI. Additional evidence is needed to test the utility of a UE-MEO for restorative use and to identify the patient population most likely to derive benefits.

Virtually assisted home rehabilitation after acute stroke (VAST-rehab): A descriptive pilot study for young and underserved stroke survivors

Digital Health · 2025-01-01

Introduction: was to offer a fully remote telerehabilitation intervention to stroke survivors during the COVID-19 pandemic. Methods: Participants were recruited from acute care, inpatient rehab, or provider/self-referral if they had a stroke within the previous year, prestroke modified Rankin Scale < 3, were recommended to participate in rehab, and had internet access. Exclusions were: prior injury/diagnoses that impacted functional level, life expectancy of less than six months, or safety concerns. Outcomes were within one week prior to initiation and within one week after completion of telerehabilitation sessions. Video call sessions were completed 1-2 times a week for 12 weeks. Occupational therapy, physical therapy, and/or speech therapy were provided. Analyses involved descriptive statistics; qualitative comments were aggregated and analyzed for broader themes. Twenty participants were consented. Results: Of the 20 participants (39-71 years old, 35% White, 50% female), 12 completed study activities, five completed exit interview; 10 demonstrated improvement on National Institute of Health Stroke Scale from a mean of 5.6 at baseline to 2.7 at end of study, six demonstrated improvement in modified Rankin Score and EuroQol (EQ-5D-5L) scores from a mean of 2.8 to 1.9 and 13.3 to 9.3, respectively, and five demonstrated an increase above the minimally clinically important difference (mean change = 5) on Montreal Cognitive Assessment. On the Stroke Impact Scale rating of total recovery, six of the 12 scored themselves with improvement (mean change = 18.2). Exit interview data revealed an emerging theme: while in-person therapy was preferred, telerehabilitation was an important resource for those without access to in-person therapy. Conclusion: Our study adds to the growing data on the practice of telerehabilitation for survivors of stroke. Future studies are underway to address telerehabilitation serving the uninsured, underinsured, and populations in rural areas. Clinicaltrialsgov ID: NCT05659784.

The Neuroscience of Everyday Life

2024-11-21 · 1 citations

Introduction

2024-11-21

The purpose of this chapter is to explore how Alex, a 17-year-old, non-binary high-school senior who wants to put on make-up might be affected by Bell’s palsy, a condition that impacts the functioning of cranial nerve VII (facial nerve). People with Bell’s palsy have full lives with their daily routines, relationships and learning, but may require modifications for function. The key neuroscience concepts that will be explored in this chapter include structure and function of cranial nerve VII (facial nerve), principles of peripheral nervous system regeneration, and the neuromuscular junction, acetylcholine transmission, and reflex arcs.

Feasibility, Acceptability, and Preliminary Effects of Res-ET in Young Stroke Survivors: A Pilot Study

Archives of Physical Medicine and Rehabilitation · 2024-04-01