Cardiovascular

Technology-Assisted Rehabilitation Gym for at-home Training (TARGeT) for stroke survivors: A study protocol for evaluating feasibility, safety, usability, clinical benefit, and costs.

TL;DR

The TARGeT trial protocol presents a single-centre pilot feasibility study evaluating whether unsupervised, home-based multi-technology upper limb stroke rehabilitation is feasible, safe, usable, clinically beneficial, and cost-effective compared to conventional therapy.

Key Findings

More than half of stroke survivors experience persistent upper limb impairments, yet many do not receive a sufficiently high therapy dose, particularly in the outpatient phase.

  • Stroke is described as 'a leading cause of long-term disability'
  • High-dose, repetitive, task-specific training is identified as essential for motor recovery based on 'clear evidence'
  • Key barriers include limited therapist availability, high care costs, and travel burdens
  • The gap in therapy access is described as 'critical'

Most existing technology-assisted rehabilitation studies are limited to single-device interventions, conducted in clinical settings, and/or require constant supervision, restricting scalability and impact.

  • This limitation is identified as a gap that the TARGeT trial is designed to address
  • The TARGeT program integrates 'multiple complementary technologies' rather than a single device
  • The program is designed to be 'unsupervised' and 'home-based'
  • The goal is to deliver 'scalable, high-dose rehabilitation directly into patients' homes'

The TARGeT trial is designed as a single-centre pilot feasibility trial enrolling up to 30 subacute and chronic stroke survivors.

  • Sample size is 'up to 30' participants
  • Participants are described as 'subacute and chronic stroke survivors'
  • The trial is registered on ClinicalTrials.gov under NCT06406569
  • The trial is published in PloS One (2026)

Participants will complete six weeks of daily home-based therapy using three complementary rehabilitation technologies enabling self-administered training without therapist supervision.

  • Duration of the intervention is six weeks
  • Training is designed to be 'daily'
  • Three complementary rehabilitation technologies are used together
  • Training is described as 'self-administered without therapist supervision'
  • Clinicians will remotely monitor training via 'an online platform that reports data on the training progress'

Assessments will be conducted at five timepoints measuring clinical outcomes, quality of life, healthcare utilization, and technology usability.

  • Clinical outcome measures include the Fugl-Meyer Assessment (FMA) and Action Research Arm Test (ARAT)
  • Technology usability will be measured using the System Usability Scale (SUS) and Raw Task Load Index (RawTLX)
  • Quality of life and healthcare utilization are also included as outcomes
  • Five assessment timepoints are specified

The study will assess whether clinical outcomes are comparable to conventional therapy based on data from previous studies including the authors' own data and literature data.

  • Comparisons will be made against 'own data and literature data' rather than a concurrent control group
  • The study aims to determine 'associated costs relative to conventional therapy'
  • Primary feasibility endpoints include feasibility, safety, usability, and satisfying user experience
  • The study is characterized as a pilot feasibility trial, with results intended to 'inform future trials'

The TARGeT program is intended to support broader adoption of decentralized, technology-enabled stroke rehabilitation by addressing therapy access and intensity gaps.

  • The program is described as delivering 'scalable, high-dose rehabilitation directly into patients' homes'
  • Results are intended to 'support broader adoption of decentralized, technology-enabled stroke rehabilitation'
  • The study addresses both clinical benefit and economic potential, including cost assessment relative to conventional therapy
  • Remote monitoring by clinicians via an online platform is a key feature enabling decentralized delivery

What This Means

This paper describes the design and protocol for a clinical study called TARGeT (Technology-Assisted Rehabilitation Gym for at-home Training), which aims to test a new approach to stroke rehabilitation. The study will enroll up to 30 stroke survivors who will use three different rehabilitation technologies at home every day for six weeks, without needing a therapist physically present. Instead, clinicians will monitor their progress remotely through an online platform. The study will look at whether this approach is practical and safe, whether patients find it easy and satisfying to use, whether it produces improvements in arm and hand function similar to what conventional therapy achieves, and what it costs compared to traditional rehabilitation. This research addresses a significant problem in stroke care: many survivors do not get enough rehabilitation therapy, especially after they leave the hospital, because of limited therapist availability, high costs, and the difficulty of traveling to clinics. Most technology-based rehabilitation research has tested only one device at a time, in clinical settings, with a therapist always present — limiting how widely such approaches can be used. TARGeT attempts to combine multiple complementary technologies into a home-based, largely unsupervised program to increase the amount of therapy patients can access. This research suggests that if the TARGeT approach proves feasible, safe, and effective in this pilot study, it could pave the way for larger trials and potentially offer a more accessible and scalable way to deliver high-intensity stroke rehabilitation to people in their own homes. The results will help researchers understand whether this multi-technology, remote-monitored model is ready for broader testing and, eventually, wider clinical adoption.

Have a question about this study?

Citation

Kager S, Cheng H, Kuah C, Samkharadze T, Lin H, Ng C, et al.. (2026). Technology-Assisted Rehabilitation Gym for at-home Training (TARGeT) for stroke survivors: A study protocol for evaluating feasibility, safety, usability, clinical benefit, and costs.. PloS one. https://doi.org/10.1371/journal.pone.0355160