Task-oriented Training With Electrical Stimulation Glove on Hand Function and Dexterity in Chronic Stroke Patients

Background and Rationale Stroke is a major cause of long-term disability worldwide. Many stroke survivors experience chronic upper limb impairment, including weakness, stiffness, and reduced dexterity, which limits their ability to perform daily activities. Task-oriented training is a widely used rehabilitation approach that focuses on practicing functional, goal-directed movements to restore independence. Electrical stimulation has also been shown to support neuromuscular activation and promote neuroplasticity. Integrating these two strategies into a single wearable device - an electrical stimulation glove (ESG) - may offer a novel and affordable rehabilitation option.

Study Objectives The purpose of this trial is to evaluate the effects of combining task-oriented training with an electrical stimulation glove on hand function and dexterity in chronic stroke patients, compared to task-oriented training alone.

Study Design

This is a randomized controlled trial conducted at CMH Multan, Pakistan, over nine months. A total of 36 participants are enrolled, with 18 in each group. Patients are randomly assigned to either:

Intervention Group: Task-oriented training with an electrical stimulation glove.

Control Group: Task-oriented training only.

Eligibility Participants are men and women aged 40-60 years, at least six months after their first stroke, medically stable, and with adequate cognitive ability (Mini-Mental Scale score ≥24). Patients with recurrent stroke, seizures, pacemakers, or other neurological/orthopedic impairments are excluded.

Interventions

Task-Oriented Training (Control): Sessions include warm-up exercises, functional tasks such as pegboard placement, grasp-and-release of objects, writing or drawing, and simulated daily activities, followed by cool-down stretches.

Task-Oriented Training with Electrical Stimulation Glove (Intervention): Same activities as above, but performed while wearing the ESG. The glove delivers gentle electrical impulses to wrist and finger muscles during task performance, supporting active movement and sensory feedback.

Each session lasts approximately 60 minutes, including warm-up, 40 minutes of functional activities, and cool-down. The program runs three times per week for eight weeks.

Outcome Measures

Hand function and dexterity are evaluated before and after the intervention using standardized tools:

Wolf Functional Test (WFT): assesses the quality and speed of upper limb tasks.

Fugl-Meyer Assessment - Upper Extremity (FMA-U): evaluates motor recovery of the arm and hand.

Functional Dexterity Test (FDT): measures fine motor control and coordination.

Ethical Considerations Informed consent is obtained from all participants. Confidentiality and safety are maintained throughout the study. Participation is voluntary, and individuals may withdraw at any time without penalty.

Inclusion criteria

• Patients after the six months of first stroke event (chronic stroke patient)
• Mini mental scale grade (24/above)
• Medically and neurologically stable condition
• No visual or auditory defects (Anderson & White, 2023)

Exclusion criteria

• Pre-existing arm impairment such as rheumatoid arthritis
• Cardiac pacemaker
• Patients with other neurological impairments
• Recurrent or progressive stroke
• Unconscious patients due to any other cause
• History of seizure within 2 years (Anderson & White, 2023)