Self-Administered Gaming and Exercise at Home (SAGEH)
This study aims at comparing manual function outcomes between the standard of care and additional self-administered hand therapy after stroke. Strokes are common neurological injuries, and although rates of survival have increased in recent decades, survivors often continue to experience deficiencies in hand dexterity and bimanual function. Most motor recovery takes place within the first 3 months after a stroke. This initial period is necessary for stabilizing the patient but also provides different opportunities to foster motor recovery. Functional gains, including instances after the post-acute period, have been observed after regular and frequent (high dosage) therapy, suggesting that recovery is likely influenced by practice-driven sensorimotor learning. These findings motivate the implementation of daily therapeutic regimes beyond post-stroke hospitalization and basic motor function, aiming instead at addressing overlooked deficiencies in manipulation and bimanual coordination. While some hand therapy is often provided during outpatient therapy visits (the standard of care), self-administered sessions play a large role in implementing additional daily therapy. As a result, the investigators are interested in both the implementation of self-administered regimes and measuring clinical outcomes with and without self-administered therapy.
• Age 21 years and over
• Stroke confirmed by CT or MRI within the previous 6 weeks.
• Arm and/or hand impairment induced by the stroke.
• Meet JSTTEP criteria and are enrolled in JSTTEP.
• Admitted to the Johns Hopkins Hospital (JHH) inpatient stroke service.
• Proficient in speaking and reading English.
• Willing and capable to contacted remotely for all necessary telemedicine contacts.
• No history of prior ischemic or hemorrhagic stroke with associated motor deficits (prior stroke with no upper limb motor symptoms is allowed)
• Ability to give informed consent.