Error Enhancement for Upper Limb Rehabilitation in the Chronic Phase after Stroke: A 5-Day Pre-Post Intervention Study

Marjan Coremans, Eli Carmeli, Ineke De Bauw, Bea Essers, Robin Lemmens, Geert Verheyden

Research output: Contribution to journalArticlepeer-review


A large proportion of chronic stroke survivors still struggle with upper limb (UL) problems in daily activities, typically reaching tasks. During three-dimensional reaching movements, the deXtreme robot offers error enhancement forces. Error enhancement aims to improve the quality of movement. We investigated clinical and patient-reported outcomes and assessed the quality of movement before and after a 5 h error enhancement training with the deXtreme robot. This pilot study had a pre-post intervention design, recruiting 22 patients (mean age: 57 years, mean days post-stroke: 1571, male/female: 12/10) in the chronic phase post-stroke with UL motor impairments. Patients received 1 h robot treatment for five days and were assessed at baseline and after training, collecting (1) clinical, (2) patient-reported, and (3) kinematic (KINARM, BKIN Technologies Ltd., Kingston, ON, Canada) outcome measures. Our analysis revealed significant improvements (median improvement (Q1–Q3)) in (1) UL Fugl–Meyer assessment (1.0 (0.8–3.0), p < 0.001) and action research arm test (2.0 (0.8–2.0), p < 0.001); (2) motor activity log, amount of use (0.1 (0.0–0.3), p < 0.001) and quality of use (0.1 (0.1–0.5), p < 0.001) subscale; (3) KINARM-evaluated position sense (−0.45 (−0.81–0.09), p = 0.030) after training. These findings provide insight into clinical self-reported and kinematic improvements in UL functioning after five hours of error enhancement UL training.

Original languageEnglish
Article number471
Issue number2
StatePublished - 12 Jan 2024

Bibliographical note

Publisher Copyright:
© 2024 by the authors.


  • error enhancement
  • stroke
  • upper limb rehabilitation

ASJC Scopus subject areas

  • Analytical Chemistry
  • Information Systems
  • Atomic and Molecular Physics, and Optics
  • Biochemistry
  • Instrumentation
  • Electrical and Electronic Engineering


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