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J Neurol Phys Ther. 2016 Jan;40(1):31-9. doi: 10.1097/NPT.0000000000000110.

Tablet Apps and Dexterity: Comparison Between 3 Age Groups and Proof of Concept for Stroke Rehabilitation.

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Department of Occupational Therapy, Center of Advanced Technologies in Rehabilitation, Rehabilitation Hospital, Sheba Medical Center, Tel Hashomer, Israel (R.K.), Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel; Department of Neurological Rehabilitation (G.Z.), The Chaim Sheba Medical Center at Tel-HaShomer, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; The Tel Aviv Sourasky Medical Center (I.D., T.S.M.), Tel Aviv, Israel; and Department of Occupational Therapy Sagol School of Neuroscience, Department of Occupational Therapy, School of Health Professions & Sagol school of Neuroscience, Sackler Faculty of Medicine, Tel Aviv University, Israel (D.R.), School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.



Touch screen tablet technology might be suitable for self-training of impaired dexterity poststroke. We compared performance of app-based hand activities in individuals without a disability from 3-age groups, and assessed the feasibility of using tablet apps in individuals with stroke.


Experiment I included 172 Individuals without a disability: 79 young adults (26.2 [3.9] years old), 61 middle-aged adults (55.9 [5.1] years old), and 32 older adults (68.7 [3.0] years old). Experiment II included 20 individuals with stroke, aged 59.3 ± 13.7 years with impairment of the upper extremity. All participants performed the app-based "Tap-it" (tapping) task twice and the Nine Hole Peg Test. The stroke group practiced with additional apps and underwent clinical assessments.


Significant differences in the tapping task performance were found between the 3 age groups (dominant hand time: F(2,169) = 30.57; P = 0.0001; and accuracy F(2,169) = 25.20; P = 0.0001; nondominant hand time: F(2,169) = 35.09; P = 0.0001; and accuracy F(2,169) = 19.62; P = 0.0001). Of the 20 individuals with stroke, 15 were able to complete the 2 trials of the tapping task, but all participants reported enjoying the experience and thought the apps may have potential for stroke rehabilitation to improve performance of the stroke-affected hand.


Performance of tablet app-based hand activities was affected by impaired hand dexterity in older participants without a disability and in participants with stroke. Tablet apps may potentially provide a way to facilitate self-training of repetitive, task-oriented, isolated finger and hand movements to improve hand dexterity and function after stroke.Video abstract available for additional insights from the authors (see Supplemental Digital Content 1,

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