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Table 2 Clinical observations and adverse events

From: Home-based Computer Assisted Arm Rehabilitation (hCAAR) robotic device for upper limb exercise after stroke: results of a feasibility study in home setting

Number of participants Clinical observations/Clinical adverse events Actions taken Result
One Wrist pain when uses joystick for more than 10 min particularly while playing higher-level games Advised to play lower level games, reduce duration of session, use a wrist splint and do wrist stabilising and strengthening exercises. Reduction in wrist pain
Three Shoulder pain. Two participants reported an increase in shoulder pain with device usage. One of them was noted to be sitting with back unsupported in the chair and had excessive wrist flexion while holding the joystick. The third participant had long-standing shoulder pain unrelated to device usage. All three participants had shoulder impingement syndrome on clinical examination. They were advised on shoulder strengthening and range of motion exercises. One participant was advised on sitting back against the chair and holding joystick handle with the wrist in a neutral position during game play. Shoulder pain improved with exercises
One Injured finger with bruising while trying to stretch fingers to hold the handle of the joystick Advised on slow stretching of fingers prior to holding handle. Also received botulinum toxin injection to finger flexors as routine planned treatment unrelated to this study. No further injury while gripping joystick
One Reported scapula becoming more prominent in affected upper limb (has had the prominence since stroke) Reassured and advised on scapular stabilisation exercises. No further worsening of prominence
Four Could not use device as expected due to personal problems or medical problems (such as chest infections) unrelated to device usage None. Research team not made aware of personal problems by the participants during the study period. Usage improved once medical problems were resolved
Two Low mood. One participant due to chronic ill health and other participant due to family member being unwell. Reassurance. n/a
One Painful thumb and index finger in the affected hand, reported to be not related to device usage. Found to have osteoarthritis of small joints in these fingers. Advised to use topical analgesia. Good relief of symptoms with topical analgesia
One Episodes of dizziness during study period, reported to be unrelated to device use. Lacked motivation to use device. Dizziness symptoms resolved with adjustment of his regular medications. Needed lot of encouragement from participant’s wife to use the device. Needed encouragement from wife throughout study period