# Haptic-Enabled Hand Rehabilitation in Stroke Patients: A Scoping Review
###### Abstract  
There is a plethora of technology-assisted interventions for hand therapy, however, less is known about the effectiveness of these interventions. This scoping review aims to explore studies about technology-assisted interventions targeting hand rehabilitation to identify the most effective interventions. It is expected that multifaceted interventions targeting hand rehabilitation are more efficient therapeutic approaches than mono-interventions. The scoping review will aim to map the existing haptic-enabled interventions for upper limb rehabilitation and investigates their effects on motor and functional recovery in patients with stroke. The methodology used in this review is based on the Arksey and O'Malley framework, which includes the following stages: identifying the research question, identifying relevant studies, study selection, charting the data, and collating, summarizing, and reporting the results. Results show that using three or four different technologies was more positive than using two technologies (one technology + haptics). In particular, when standardized as a percentage of outcomes, the combination of three technologies showed better results than the combination of haptics with one technology or with three other technologies. To conclude, this study portrayed haptic-enabled rehabilitation approaches that could help therapists decide which technology-enabled hand therapy approach is best suited to their needs. Those seeking to undertake research and development anticipate further opportunities to develop haptic-enabled hand telerehabilitation platforms. hand; neurologic; rehabilitation; sensory integration; haptic; tactile; robotic; virtual reality; augmented reality +
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Patients who have had a stroke are often faced with permanent movement impairments that limit their ability to engage in meaningful occupations such as self-care, leisure activities, or work. Impaired hand function is among the most common effects of stroke [5]. Hand or upper limb weakness happens severely in up to 87% of patients with stroke [6; 7]. The hand rehabilitation process aims to reduce spasticity, increase neuoplasticity enhance functional outcomes. Spasticity was defined by [PERSON] et al. as \"a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex\" [8] (p. 485). Neuoplasticity, also known as neural plasticity, or brain plasticity, is the \"capacity of neurons and neural networks in the brain to change their connections and behaviour in response to new information, sensory stimulation, development, damage, or dysfunction\" [9]. While clinicians tend to profit from a substantial amount of time spent in treating spasticity and neuroplasticity after the stroke [10; 11], studies show that they may not be having enough care. Compared with other patient populations, patients who have had a stroke spend more time inactive and alone or less active on rehabilitation units, more likely because of reduced sensorimotor capacity [12; 13]. Hence, there seems to be a difference in practice between how much training stroke patients need and how much they receive. Therefore, it is beneficial to investigate ways to increase both the efficacy of training upper limb and hand movement. Robotic-assisted therapies are increasingly becoming available for stroke rehabilitation. The basic components of robotic-assisted therapy are (1) motorized mechanical component; (2) performance-related visual feedback; and (3) an interactive computer program that monitors progress. The ability to provide high-dosage and high-intensity interventions is a significant advantage of robotic-assisted devices [4]. A lack of devices targeting hand rehabilitation exists as most current devices target elbow and shoulder movements. Evidence shows that robotic-assisted therapy combined with virtual reality appears to be a valuable intervention for stroke rehabilitation [4].