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Forearm, wrist, and hand impairments affect many individuals and impose a significant economic burden on health care systems. The FEPSim (flexion, extension, pronation, and supination) is designed for hand and wrist rehabilitation. It could become part of the standard care for upper extremity rehabilitation, aiming to improve range of motion, dexterity, and strength during therapeutic activities. However, the FEPSim has not yet been tested in a health care setting, highlighting the need for a trial to assess its effectiveness in upper extremity rehabilitation. We aim to assess the feasibility of conducting a definitive trial investigating the effectiveness of adding a new device for hand therapy exercises, the FEPSim, to standard care for patients with impairments of the hand, wrist, and forearm. Thirty-eight patients with impairments of distal upper extremities were randomly assigned either to the intervention group (FEPSim and standard care, n=19) or to the control group (standard care, n=19). Therapeutic activities to increase strength, range of motion, resistance, and dexterity were delivered by treating hand therapists using the FEPSim device for the intervention group. Outcome measures included wrist passive and active range of motion, grip strength, pinch grip force, and the Patient-Rated Wrist Evaluation. The trial retention rate (36/38, 95%) and compliance (control group: 100%; intervention group: 89%) were high. The comparisons of the change-from-baseline between groups revealed that in 63.2% (12/19) of the outcome variables, the change was in favor of the FEPSim, with statistically significant improvements in passive wrist flexion (t34=-0.335, P=.008) and grip strength (t34=-1.841, P=.04). The FEPSim was accepted as part of standard care by therapists and patients at 2 hospitals. The trial design was feasible for hand intervention using the FEPSim device. The FEPSim positively affected grip strength, an objective measure of hand functioning.

Abstract Background Frailty, a condition often affecting older adults, increases vulnerability and diminishes physical abilities across bodily systems. Current non-routine frailty screening in primary care or clinical settings fails to detect “hidden health vulnerabilities” in a timely manner. Smart home technologies offer an affordable and effective solution for continuous frailty tracking and prevention. However, existing home monitoring technologies typically require users to acquire new skills or are invasive, such as camera-based systems. Objective: Our goal is to create a high-accuracy home monitoring system coupled with Internet of Things devices to identify potential frailty indicators. Methods This qualitative description study involves 4 to 8 participants, including older adults with and without Mild Cognitive Impairments/frailty, caregivers, and clinicians, in a group interview. Using card sorting and task mapping, the interview seeks to identify and define the features and challenges of a smart home system to monitor frailty in older adults. Results The study is registered in clinical trials, with data collection commencing soon. At the conference, we will present the research protocol and the findings from the analysis of the interviews. Conclusion Through the early engagement of older adults and caregivers, we strive to design a valuable and meaningful system that (1) uses zero-effort technologies so frail older adults do not need to develop new skills in order to use the system; (2) is a non-camera-based tracking technology preserving autonomy and privacy; (3) generates the frailty data meaningful for older adults, caregivers and the health system.

Abstract Background Every 21 seconds an American experiences a Traumatic Brain Injury (TBI), and every 40 seconds, another endures a stroke. These events fall under Acquired Brain Injuries (ABI) with prevalence rates impacted by an aging population. ABI can lead to various physical, cognitive, and mental impairments, emphasizing the need for innovative rehabilitation strategies, including those specific to older adults. Mixed Reality (MR) technologies offer potential in enhancing ABI rehabilitation, yet face challenges such as methodological inconsistencies, differing clinical populations, and exaggerated efficacy claims. Objectives 1) Review MR’s role in ABI rehabilitation among older adults, assessing the implications of aging, clinical, and technological considerations. 2) Present ongoing MR research at the Glenrose Rehabilitation Hospital (GRH, Edmonton, Canada). Methods 1) A systematic review following PRISMA guidelines was performed across seven databases, with two independent reviewers analyzing the data. The analysis emphasized clinical objectives, MR systems, levels of evidence, and technology readiness levels. 2) QR codes that link to videos will highlight the ongoing research and development of MR-delivered ABI rehabilitation at the GRH. Results Twenty-six studies met the inclusion criteria, totalling 453 subjects with ABI (mean age: 60 ± 5.34 years). MR applications mainly targeted upper limb motor rehabilitation, revealing an overall low level of evidence and a median technology readiness level of 6 (prototypes tested in relevant environments). Conclusion Despite existing variability and technological challenges, the promising results stress the importance of ongoing research and innovation in MR rehabilitation. The GRH stands as a key research hub, actively advancing this field.