After stroke, it is common for individuals to experience hand impairment. This deficit can severely restrict functional ability and independence. Recovery of hand function following stroke is highly variable. In this study, we will use brain imaging to predict individual response to treatment after only one therapy session. Survivors of stroke will receive upper extremity therapy with a novel intervention using a smart watch. The device applies imperceptible vibration to the wrist and has been shown to immediately improve chronic stroke survivors' touch sensation and hand dexterity in preliminary studies.
Post-stroke hand impairment is highly prevalent and severely restricts functional ability and independence. Yet, there is no assistive device to help hand function at home, every day, during activities of daily living. This study addresses this gap by providing an innovative technology. The "TheraBracelet" is a wristband applying imperceptible white-noise vibration to skin. TheraBracelet is efficacious, as it has been shown to immediately improve chronic stroke survivors' touch sensation and hand dexterity in preliminary studies. TheraBracelet is affordable by using only a low-cost vibrator. TheraBracelet is also translational, because a vibrator strategically placed at the wrist does not interfere with dexterous finger motions, and it is low-risk by involving only imperceptible vibration on skin. These practicalities assure easy adoption in home environment for large impact on sensorimotor impairment. This study is to determine the feasibility and safety of using this assistive device all day every day for a month during daily activity, and to determine if TheraBracelet's instant effects are sustained during prolonged use. This objective will be accomplished in a double-blinded, randomized, controlled, crossover design study. Feasibility (compliance of using the device everyday) and safety will be assessed for the treatment condition compared to the control condition (wearing the device without vibration) through weekly evaluations. In addition, TheraBracelet's instant benefits in improving hand function will be assessed weekly. Persistence of TheraBracelet's instant benefits across all weekly evaluations will support durability (i.e. desensitization to vibration does not occur during extended daily use over a one-month period). This project is expected to lead to an assistive wristband that increases hand function during activities of daily living, thus increasing independence and quality of life and reducing caregiver burden for a large number of stroke survivors with hand impairment.