Rehabilitation of hand function is challenging, and only few studies have investigated robotassisted rehabilitation focusing on distal joints of the upper limb. This paper investigates the feasibility of using the HapticKnob, a table-top end-effector device, for robot-assisted rehabilitation of grasping and forearm pronation/supination, two important functions for activities of daily li-ving involving the hand, and which are often impaired in chronic stroke patients. It evaluates the effectiveness of this device for improving hand function and the transfer of improvement to arm function. Methods A single group of fifteen chronic stroke patients with impaired arm and hand functions (Fugl-Meyer motor assessment scale (FM) 10-45/66) participated in a 6-week 3-hours/week reha-bilitation program with the HapticKnob. Outcome measures consisted primarily of the FM and Motricity Index (MI) and their respecti-ve subsections related to distal and proximal arm function, and were assessed at the beginning, end of treatment and in a 6-weeks followup. Results Thirteen subjects successfully completed robot-assisted therapy, with significantly improved hand and arm motor functions, demonstrated by an average 3.00 points increase on the FM and 4.55 on the MI at the completion of the therapy (4.85 FM and 6.84 MI six weeks posttherapy). Improvements were observed both in distal and proximal components of the clinical scales at the completion of the study (2.00 FM wrist/hand, 2.55 FM shoulder/elbow, 2.23 MI hand and 4.23 MI shoulder/elbow). In addition, impro-vements in hand function were observed, as measured by the Motor Assessment Scale, grip force, and a decrease in arm muscle spa-sticity. These results were confirmed by motion data collected by the robot.Conclusions The results of this study show the feasi-bility of this robot-assisted therapy with patients presenting a large range of impairment levels. A significant homogeneous impro-vement in both hand and arm function was observed, which was maintained 6 weeks after end of the therapy.

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