hoMEcare aRm rehabiLItatioN (MERLIN) improves the upper limb function in stroke patients

Introduction. In 80% of stroke patients the upper arm has limited function 6 months post-stroke. Robotic therapy can provide arm therapy for stroke patients and might be suitable for home use.
Objective. To improve the arm function of chronic stroke patients during 6 weeks of home training using MERLIN (robotic device with telerehabilitation platform).
Patients. Patients with unilateral paresis in the chronic phase of stroke with at least some upper limb function.
Methods. Patients trained 6 weeks at home with MERLIN, at least 3 hours per week. A pretest-posttest within subject design was used with measurements at 6 weeks pre-intervention (T0), at the start (T1), at the end (T2) and at 6 weeks post-intervention (T3). Primary outcome was the Wolf Motor Function Test (WMFT).
Results. Twelve patients were included, two patients dropped out due to problems with the device handling (hand too small) and personal reasons. A repeated measures ANOVA was performed based on intention to treat (Bonferroni corrected alfa = 0.008). Preliminary results showed that patients improved significantly on the WMFT between T0-T2 (p=0.006) with 5.3 points and between T1-T3 (p=0.004) with 4.6 points due to training with MERLIN. The patients who completed the training period trained on average 17.4 hours.
Discussion and conclusion. No serious adverse events related to MERLIN-treatment were reported. MERLIN was effective in improving arm function with lasting results up to 6 weeks after training.
Clinical message. Chronic stroke patients are able to improve arm function with intensive home-based robotic-assisted training, requiring minimal therapist supervision.