IMPACT OF ROBOT – ASSISTED GLOVE HAND TRAINING ON FINE AND GROSS MOTOR FUNCTION. RECOVERY AND DAY-TO-DAY FUNCTIONAL TASKS IN POST-MEDIAN NERVE REDIRECTION INDIVIDUALS: A NOVEL RECOVERY THERAPY APPROACH

Abstract

BACKGROUND: Selective nerve transfers involve rerouting healthy nerves to restore lost motor function, whereas robot-assisted upper-limb therapy provides structured rehabilitation for patients recovering from neurological damage. Robotic systems deliver controlled, accurate movement assistance and interaction, and over the past twenty years have demonstrated rehabilitation results comparable to those achieved through conventional therapy.

OBJECTIVE: To evaluate the impact of robotic-glove–assisted hand training on fine and gross motor skills and daily functional performance in patients post median nerve transfer using a quasi-experimental approach.

METHODOLOGY: A quasi-experimental study was conducted at Ghurki Trust Teaching Hospital, Lahore, over six months with 36 patients post median nerve transfer. Participants were divided into Group A (Robot Group, n = 18) receiving soft robotic glove therapy and Group B (Control Group, n = 18) undergoing conventional hand exercises. Functional outcomes were assessed using the Soller man Hand Function Test, Jebsen–Taylor Hand Function Test, Pegboard Dexterity Test, and Barthel Index. Propensity Score Matching (PSM) minimized baseline differences, and statistical analyses were performed in SPSS v25, including normality checks via the Shapiro–Wilk test.

RESULTS: Both groups showed improvements in hand function and dexterity. The Robot Group improved in the Jebsen–Taylor Test from 85.60±17.02 to 74.53±17.01 (p = 0.000) and in the Sollerman Test from 34.20±7.66 to 45.33±7.73 (p = 0.000). The Control Group also improved, albeit to a lesser extent. Pegboard Dexterity scores increased in the Robot Group from 29.53±4.48 to 40.60±4.34 (p = 0.000) and in the Control Group from 29.20±4.82 to 33.26±4.81 (p = 0.000).

CONCLUSION: Combining conventional hand therapy with robotic-glove rehabilitation significantly enhances fine motor performance, hand function, and daily living activities in patients following median nerve transfer. While random assignment was not employed, statistical matching strengthens the validity of results, supporting robot-assisted therapy as an effective post-surgical intervention.

KEY WORDS:  Hand Rehabilitation, Nerve Transfer Rehabilitation, Robotic Glove, Quasi-Experimental Study.