Technology-Enabled Upper Limb Rehabilitation for Neurological Impairment: A Feasibility Randomized-Controlled Trial Protocol

Background. Technology-enabled upper limb (UL) rehabilitation improves therapy intensity and impairment outcomes, however clinical usage remains low and evidence for functional outcomes is limited. While benefits of single-mode technologies have been demonstrated, a combination of technology modes or "hybrid" approach is an emerging option with shoulder to fingertip capability. Investigation of this approach within a hospital setting is warranted to inform occupational therapy practice with neurological patients. Purpose. This study examines feasibility of hybrid technology-enabled UL rehabilitation for in-patients with neurological impairments. Method and Analyses. A Phase II feasibility randomized controlled trial (RCT) will compare usual care versus hybrid technology intervention using three technology modes (robotics, virtual reality, sensor-based therapy) plus usual care. Pre-post outcomes for UL impairment, activity, participation and self-reported function will be analyzed using 2 x 2 repeated measures ANOVA. Effect sizes will inform a power analysis for a full-scale RCT. Field observations and participant surveys will capture feasibility factors. It is anticipated hybrid technology for UL neurorehabilitation will be feasible in a hospital setting and show preliminary effectiveness for improving UL use in daily activities. Ethics and Dissemination. Ethics granted from RBWH Human Research Ethics Committee (HREC/2020/QRBW/67076) and The University of Queensland (2021/HE002211).