A stroke is a common and disabling disorder, that often affects arm activities. After stroke intensive arm therapy is essential for gaining and retaining functional improvements. Because of high costs, shortage of therapists, patient burden and adherence issues, intensive arm treatment is scarcely applied, and this will become even more challenging in the future. Therefore, there is an urgent need for sustainable, technology-supported and motivating treatment in the home setting, with direct supervision of a therapist only if needed. 

The multidisciplinary ArmCoach4Stroke project aims to develop and evaluate a new and interactive therapy aid based on movement sensors to stimulate and optimize the daily use and exercise of the affected arm in the home environment by objective, personalized feedback to the patient and his/her therapist. 
 Based on objectively measured data, the system will stimulate arm use and exercise and enable personalized arm exercise outside supervised therapy sessions in the home environment. The ArmCoach4Stroke objectively measures daily behaviour and exercise performance, and provides personalized triggers and feedback on arm activity. Feedback is provided to patients as well as to therapists. The system is easy to use, patient-friendly, and part of blended care or online guided treatment. The ArmCoach4Stroke consists of two continuously worn sensor/feedback wrist units, additional sensors during exercising, and a tablet application for the patient and the therapist.

By (e.g. vibrotactile) triggers the wrist-worn system provides real-time feedback on daily arm use (based on pre-set targets), and stimulates patients to use the arm in daily life or to start exercising. During exercising, exercise performance is quantified in quantity (e.g. numbers of repetitions) and quality metrics (e.g. speed). The tablet application will contain a therapist- defined exercise library, while real-time performance feedback will be given during exercising.

Furthermore, summary data from both the daily life sensor system and the exercise module are transferred to a telemonitoring solution, allowing therapists to monitor arm use and exercise. This blended care module allows direct interaction between patient and therapist and detects changes in arm use and arm exercise performance.

The ArmCoach4Stroke will be developed in co-creation with patients and therapists and other (end)users, with focus on optimal implementation in health care. The ArmCoach4Stroke will provide the necessary intensive arm therapy that patients lack in current clinical practice, thus improving daily functioning, independence and quality of life, and making rehabilitation care more efficient and sustainable for this vulnerable and growing group.

Overview of project members

Erasmus MC
Dr. J.B.J. Bussmann (project leader)
Dr. G.R.H. Regterschot (project coordinator)
N. Langerak, MSc (PhD student)
Prof. dr. R.W. Selles
Prof. dr. G.M. Ribbers

Prof. Dr. C.G.M. Meskers
Dr. E. van Weegen
Prof. dr. G. Kwakkel

University of Twente
Dr. G.R.H. Regterschot (postdoc)
Dr. B.J.F. van Beijnum
Prof. dr. P.H. Veltink

TU Delft
Dr. P. D’Olivo (postdoc)
Dr. M.C. Roozendaal
Dr. V.T. Visch

Rijndam Rehabilitation
Drs. M. Evers
Dr. E. Grauwmeijer

Umaco (company)

2M Engineering (company)