{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T02:52:37Z","timestamp":1773370357922,"version":"3.50.1"},"reference-count":33,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T00:00:00Z","timestamp":1633910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010686","name":"H2020 European Institute of Innovation and Technology","doi-asserted-by":"publisher","award":["644721"],"award-info":[{"award-number":["644721"]}],"id":[{"id":"10.13039\/100010686","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Enriched environments and tools are believed to promote grasp rehabilitation after stroke. We designed S2, an interactive grasp rehabilitation system consisting of smart objects, custom orthoses for selective grasp constraining, and an electrode array system for forearm NMES. Motor improvements and perceived usability of a new enriched upper limb training system for sub-acute stroke patients was assessed in this interim analysis. Inclusion criteria: sub-acute stroke patients with MMSE&gt;20, ipsilesional MI&gt;80%, and contralesional MI&lt;80%. Effects of 30-min therapy supplements, conventional vs. S2 prototype, are compared through a parallel two-arms dose-matched open-label trial, lasting 27 sessions. Clinical centres: Asklepios Neurologische Klinik Falkenstein, K\u00f6nigstein im Taunus, Germany, and Clinica Villa Beretta, Costa Masnaga, Italy. Assessment scales: ARAT, System Usability, and Technology Acceptance. Methodology: 26 participants were block randomized, allocated to the study (control N=12, experimental N=14) and underwent the training protocol. Among them, 11 participants with ARAT score at inclusion below 35, n = 6 in the experimental group, and n = 5 in the control group were analysed. Results: participants in the enriched treatment group displayed a larger improvement in the ARAT scale (+14.9 pts, pval=0.0494). Perceived usability differed between clinics. No adverse effect was observed in relation to the treatments. Trial status: closed. Conclusions: The S2 system, developed according to shared clinical directives, was tested in a clinical proof of concept. Variations of ARAT scores confirm the feasibility of clinical investigation for hand rehabilitation after stroke.<\/jats:p>","DOI":"10.3390\/s21206739","type":"journal-article","created":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T21:45:32Z","timestamp":1633988732000},"page":"6739","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Reactive Exercises with Interactive Objects: Interim Analysis of a Randomized Trial on Task-Driven NMES Grasp Rehabilitation for Subacute and Early Chronic Stroke Patients"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4451-1817","authenticated-orcid":false,"given":"Andrea","family":"Crema","sequence":"first","affiliation":[{"name":"Translational Neural Engineering Laboratory, Center for Neuroprosthetics, Campus Biotech, EPFL, 1202 Geneva, Switzerland"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6077-3257","authenticated-orcid":false,"given":"Ivan","family":"Furfaro","sequence":"additional","affiliation":[{"name":"Translational Neural Engineering Laboratory, Center for Neuroprosthetics, Campus Biotech, EPFL, 1202 Geneva, Switzerland"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7228-0791","authenticated-orcid":false,"given":"Flavio","family":"Raschell\u00e0","sequence":"additional","affiliation":[{"name":"Translational Neural Engineering Laboratory, Center for Neuroprosthetics, Campus Biotech, EPFL, 1202 Geneva, Switzerland"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7670-5758","authenticated-orcid":false,"given":"Mauro","family":"Rossini","sequence":"additional","affiliation":[{"name":"Centro di Riabilitazione \u201cVilla Beretta\u201d, Unit\u00e0 Complessa di Medicina Riabilitativa Ospedale Valduce, 23845 Costa Masnaga, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7724-1502","authenticated-orcid":false,"given":"Johannes","family":"Zajc","sequence":"additional","affiliation":[{"name":"Ottobock HealthCare Products GmbH, 1110 Vienna, Austria"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0795-2306","authenticated-orcid":false,"given":"Constantin","family":"Wiesener","sequence":"additional","affiliation":[{"name":"Technische Universit\u00e4t Berlin, Fachgebiet Regelungssysteme, 10587 Berlin, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8888-4792","authenticated-orcid":false,"given":"Walter","family":"Baccinelli","sequence":"additional","affiliation":[{"name":"ABACUS s.r.l., 20155 Milan, Italy"}]},{"given":"Davide","family":"Proserpio","sequence":"additional","affiliation":[{"name":"Centro di Riabilitazione \u201cVilla Beretta\u201d, Unit\u00e0 Complessa di Medicina Riabilitativa Ospedale Valduce, 23845 Costa Masnaga, Italy"}]},{"given":"Andreas","family":"Augsten","sequence":"additional","affiliation":[{"name":"Asklepios Neurological Clinic Falkenstein, 61462 K\u00f6nigstein-Falkenstein, Germany"}]},{"given":"Nancy","family":"Immick","sequence":"additional","affiliation":[{"name":"Asklepios Neurological Clinic Falkenstein, 61462 K\u00f6nigstein-Falkenstein, Germany"}]},{"given":"Sebastian","family":"Becker","sequence":"additional","affiliation":[{"name":"HASOMED GmbH, 39114 Magdeburg, Germany"}]},{"given":"Matthias","family":"Weber","sequence":"additional","affiliation":[{"name":"HASOMED GmbH, 39114 Magdeburg, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0865-4418","authenticated-orcid":false,"given":"Thomas","family":"Schauer","sequence":"additional","affiliation":[{"name":"Technische Universit\u00e4t Berlin, Fachgebiet Regelungssysteme, 10587 Berlin, Germany"}]},{"given":"Karsten","family":"Krakow","sequence":"additional","affiliation":[{"name":"Asklepios Neurological Clinic Falkenstein, 61462 K\u00f6nigstein-Falkenstein, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3992-3246","authenticated-orcid":false,"given":"Giulio","family":"Gasperini","sequence":"additional","affiliation":[{"name":"Centro di Riabilitazione \u201cVilla Beretta\u201d, Unit\u00e0 Complessa di Medicina Riabilitativa Ospedale Valduce, 23845 Costa Masnaga, Italy"}]},{"given":"Franco","family":"Molteni","sequence":"additional","affiliation":[{"name":"Centro di Riabilitazione \u201cVilla Beretta\u201d, Unit\u00e0 Complessa di Medicina Riabilitativa Ospedale Valduce, 23845 Costa Masnaga, Italy"}]},{"given":"Michael Friedrich","family":"Russold","sequence":"additional","affiliation":[{"name":"Ottobock HealthCare Products GmbH, 1110 Vienna, Austria"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8484-9834","authenticated-orcid":false,"given":"Maria","family":"Bulgheroni","sequence":"additional","affiliation":[{"name":"ABACUS s.r.l., 20155 Milan, Italy"}]},{"given":"Silvestro","family":"Micera","sequence":"additional","affiliation":[{"name":"Translational Neural Engineering Laboratory, Center for Neuroprosthetics, Campus Biotech, EPFL, 1202 Geneva, Switzerland"},{"name":"The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant\u2019Anna, 56025 Pontedera, Italy"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,11]]},"reference":[{"key":"ref_1","first-page":"241","article-title":"The learned nonuse phenomenon: Implications for rehabilitation","volume":"42","author":"Taub","year":"2006","journal-title":"Eur. 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