Effects of Upper Extremity Coordination Exercises Based on Fatigue Prediction on Upper Extremity Sensory-motor Functions in Chronic Stroke Survivors

Objectives: This study aimed to investigate the effect of upper extremity coordination exercises based on fatigue prediction on fine and gross manual dexterity, upper limb motor function, shoulder and elbow proprioception, occupational performance, and activities of daily living in chronic stroke survivors. Methods: In this pilot double-blind randomized clinical trial, 24 chronic strokes were enrolled using the non-probability sampling method. Participants were randomly allocated to the control (received routine occupational therapy) and intervention (received upper extremity coordination exercises based on fatigue prediction using the Kinect) groups. Before and after the interventions (six weeks, three sessions/week, 45 min/session), as well as six weeks after completion of interventions, participants were assessed using the following tools: Box-Block Test, Purdue-Pegboard Test, Wolf-Motor Function Test, Action Research Arm Test, Manual Ability Measure-16, Grip Dynamometer, Shoulder Position Sense Test (SPST), Elbow Position Sense Test (EPST), Canadian Occupational Performance Measure, Shah-Barthel Index (SH-BI), and Multi-dimensional Fatigue Inventory. This project was carried out in the rehabilitation department of Shafa-Yahyaeian Hospital from May 2019 to June 2020. Results: The results showed a significant improvement in all assessments of both control and intervention groups (P≤0.05), except for SH-BI. Further, the improvement of EPST and SPST scores in the intervention group was significantly greater than the control group (P≤0.05). Also, a significant decrease in fatigue severity was observed in both control and intervention groups (P≤0.05).  Conclusion: These results suggest that upper extremity coordination exercises based on fatigue prediction in combination with routine occupational therapy could lead to improvement of upper extremity sensory-motor functions and power grip and caused a decrease in fatigue severity in chronic stroke.