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Kuo HJ, Yeomans M, Ruiz D, Lin CC. Video games and disability-a risk and benefit analysis. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1343057. [PMID: 38496777 PMCID: PMC10943698 DOI: 10.3389/fresc.2024.1343057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/16/2024] [Indexed: 03/19/2024]
Abstract
Purpose Over the past decades, video games have become a substantial part of the entertainment industry. While ubiquitous, video game participation remains low among people with disabilities amid potential negative effects. This article analyzes the risks and benefits that video games may present to individuals with disabilities. Methodology In this conceptual article, we explored the literature pertaining to video games and disability. To better understand the impact of video games on individuals with disabilities, we focused on the unique features of video games through the lens of the Self-Determination Theory. Findings Our findings show that individuals with disabilities are most at risk from excessive video game use, leading to increased aggression, sedentary behavior, and negative impact on academic performance. Identified benefits include promoting physical rehabilitation and psychological well-being, improving cognitive abilities and emotional regulation, and utility in promoting exercises, and managing chronic pain. Originality This article presents a number of strategies and resources to help guide individuals with disabilities, educators, practitioners, and researchers in maximizing the benefits of video games while controlling the risks.
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Affiliation(s)
- Hung Jen Kuo
- Department of Counseling, Educational Psychology and Special Education, Michigan State University, East Lansing, MI, United States
| | - Michael Yeomans
- Department of Counseling, Educational Psychology and Special Education, Michigan State University, East Lansing, MI, United States
| | - Derek Ruiz
- Rehabilitation and Disability Studies, Southern University and A&M College, Baton Rouge, LA, United States
| | - Chien-Chun Lin
- Rehabilitation and Mental Health Counseling, Western Oregon University, Monmouth, IL, United States
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2
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Pereira KU, Silva MZ, Pfeifer LI. The use of virtual reality in the stimulation of manual function in children with cerebral palsy: a systematic review. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 41:e2021283. [PMID: 36921161 PMCID: PMC10014025 DOI: 10.1590/1984-0462/2023/41/2021283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 01/30/2022] [Indexed: 03/18/2023]
Abstract
OBJECTIVE To identify in national and international literature the use of virtual reality to develop manual skills of children with cerebral palsy. METHODS This is a systematic review carried out in the PubMed database, Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), and the Online System for Search and Analysis of Medical Literature (Ovid Medline) using the keywords "cerebral palsy", "virtual reality", "occupational therapy", "child", "daily activities/activities of daily living", in English and in Portuguese. The selected articles had their methodological quality evaluated through the Physiotherapy Evidence Database (PEDro scale). RESULTS 228 studies were selected, as they included children with cerebral palsy undergoing treatment with exposure to virtual reality to improve manual function in daily activities. Studies on other themes, incomplete, and duplicated reviews were excluded. Three evaluators conducted the study selection process and included 14 articles in the analysis. CONCLUSIONS The findings suggest that virtual reality therapy has contributed to an improvement in the manual function of children with cerebral palsy, constituting a useful resource for a supporting intervention to enhance traditional therapies.
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Affiliation(s)
| | | | - Luzia Iara Pfeifer
- Universidade de São Paulo, Ribeirão Preto, SP, Brazil.,Universidade Federal de São Carlos, São Carlos, SP, Brazil
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3
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Design of a Stephenson III six-bar path generating mechanism for index finger rehabilitation device using nature-inspired algorithms. Neural Comput Appl 2021. [DOI: 10.1007/s00521-021-06320-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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4
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Gandhi DBC, Pandian JD, Szturm T, Kanitkar A, Kate MP, Bhanot K. A computer-game-based rehabilitation platform for individuals with fine and gross motor upper extremity deficits post-stroke (CARE fOR U) - Protocol for a randomized controlled trial. Eur Stroke J 2021; 6:291-301. [PMID: 34746426 PMCID: PMC8564152 DOI: 10.1177/2396987321994293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/06/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND & PURPOSE Activity-based neuroplasticity and re-organization leads to motor learning via replicating real-life movements. Increased repetition of such movements has growing evidence over last few decades. In particular, computer-game-based rehabilitation is found to be effective, feasible and acceptable for post-stroke upper limb deficits. Our study aims to evaluate the feasibility and effectiveness of 12 weeks of computer-game-based rehabilitation platform (GRP) on fine and gross motor skills post-stroke in India. METHODS Through this trial we will study the effect of adjunctive in-hospital GRP (using a motion-sensing airmouse with off-the-shelf computer games) in 80 persons with subacute stroke, for reduction of post-stroke upper limb deficits in a single-centre prospective Randomized Open, Blinded End- point trial when compared to conventional therapy alone. RESULTS We intend to evaluate between-group differences using Wolf Motor Function test, Stroke Specific Quality of Life, and GRP assessment tool. Feasibility will be assessed via recruitment rates, adherence to intervention periods, drop-out rate and qualitative findings of patient experience with the intervention. CONCLUSION The CARE FOR U trial is designed to test the feasibility and effectiveness of a computer-game based rehabilitation platform in treating upper limb deficits after stroke. In case of positive findings GRP can be widely applicable for stroke populations needing intensive and regular therapy with supervision.
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Affiliation(s)
- Dorcas BC Gandhi
- Department of Neurology, College of
Physiotherapy, Christian Medical College and Hospital, Ludhiana, India
| | | | - Tony Szturm
- College of Rehabilitation Sciences,
University of Manitoba, Winnipeg, Canada
| | | | - Mahesh P Kate
- Department of Clinical
Neurosciences, University of Alberta Hospital, Edmonton, Canada
| | - Komal Bhanot
- Department of Neurology, Christian
Medical College and Hospital, Ludhiana, India
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5
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Jovanovic LI, Popovic MR, Marquez-Chin C. Characterizing the stimulation interference in electroencephalographic signals during brain-computer interface-controlled functional electrical stimulation therapy. Artif Organs 2021; 46:398-411. [PMID: 34460942 DOI: 10.1111/aor.14059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/23/2021] [Accepted: 08/17/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The integration of brain-computer interface (BCI) and functional electrical stimulation (FES) has brought about a new rehabilitation strategy: BCI-controlled FES therapy or BCI-FEST. During BCI-FEST, the stimulation is triggered by the patient's brain activity, often monitored using electroencephalography (EEG). Several studies have demonstrated that BCI-FEST can improve voluntary arm and hand function after an injury, but few studies have investigated the FES interference in EEG signals during BCI-FEST. In this study, we evaluated the effectiveness of band-pass filters, used to extract the BCI-relevant EEG components, in simultaneously reducing stimulation interference. METHODS We used EEG data from eight participants recorded during BCI-FEST. Additionally, we separately recorded the FES signal generated by the stimulator to estimate the spectral components of the FES interference, and extract the noise in time domain. Finally, we calculated signal-to-noise ratio (SNR) values before and after band-pass filtering, for two types of movements practiced during BCI-FEST: reaching and grasping. RESULTS The SNR values were greater after filtering across all participants for both movement types. For reaching movements, mean SNR values increased between 1.31 dB and 36.3 dB. Similarly, for grasping movements, mean SNR values increased between 2.82 dB and 40.16 dB, after filtering. CONCLUSIONS Band-pass filters, used to isolate EEG frequency bands for BCI application, were also effective in reducing stimulation interference. In addition, we provide a general algorithm that can be used in future studies to estimate the frequencies of FES interference as a function of the selected stimulation pulse frequency, FSTIM , and the EEG sampling rate, FS .
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Affiliation(s)
- Lazar I Jovanovic
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.,The KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.,CRANIA, University Health Network, Toronto, Ontario, Canada
| | - Milos R Popovic
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.,The KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.,CRANIA, University Health Network, Toronto, Ontario, Canada
| | - Cesar Marquez-Chin
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.,The KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.,CRANIA, University Health Network, Toronto, Ontario, Canada
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6
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Parmar ST, Kanitkar A, Sepehri N, Bhairannawar S, Szturm T. Computer Game-Based Telerehabilitation Platform Targeting Manual Dexterity: Exercise Is Fun. "You Are Kidding-Right?". SENSORS (BASEL, SWITZERLAND) 2021; 21:5766. [PMID: 34502656 PMCID: PMC8434447 DOI: 10.3390/s21175766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/12/2021] [Accepted: 08/20/2021] [Indexed: 11/24/2022]
Abstract
There is a need for innovation to improve the engagement and accessibility of rehabilitation programs for children and adults with upper extremity motor impairments due to neurodevelopmental disorders, acquired brain injuries, or spinal cord injuries. For this purpose, a computer game-based telerehabilitation platform (GTP) was developed to address this need. Through the application of a miniature inertial-based computer mouse and the wide variety of commercial computer games, the developed GTP can provide engaging task-specific exercises for the rehabilitation of manual dexterity (object handling and manipulation). A purpose-built repetitive task practice software (RTP) was also developed to gather event data and synchronize it with patient movements during gameplays. This provides automated monitoring and quantification of patients' motor skills, while they practice a range of game-based exercises with their hand and/or arm. The GTP would initially be used in a supervised clinical setting followed by a transition to function at home and be monitored by clinician specialists. Clinical support for home and rural communities, with protocols that can be easily updated, will help increase accessibility to targeted and personalized solutions for patients and achieve the desired training effect.
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Affiliation(s)
| | - Anuprita Kanitkar
- College of Rehabilitation Science, University of Manitoba, Winnipeg, MB R3T 5V6, Canada;
| | - Nariman Sepehri
- Department of Mechanical Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, MB R3T 5V6, Canada;
| | - Satish Bhairannawar
- Department of Electronics and Communication Engineering, SDM College of Engineering and Technology, Dharwad 580009, Karnataka, India;
| | - Tony Szturm
- College of Rehabilitation Science, University of Manitoba, Winnipeg, MB R3T 5V6, Canada;
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7
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Grampurohit N, Bell A, Duff SV, Mulcahey MJ, Thielen CC, Kaplan G, Marino RJ. Highlighting gaps in spinal cord injury research in activity-based interventions for the upper extremity: A scoping review. NeuroRehabilitation 2021; 49:23-38. [PMID: 33967071 DOI: 10.3233/nre-210042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Upper extremity activity-based therapy for neurologic disorders employs high-intensity, high repetition functional training to exploit neuroplasticity and improve function. Research focused on high-intensity upper extremity activity-based therapy for persons with spinal cord injury (SCI) is limited. OBJECTIVE To summarize high-intensity activity-based interventions used in neurological disorders for their current or potential application to SCI. METHODS The scoping review included articles from MEDLINE, CINAHL, Cochrane CENTRAL, and OTSeeker with the criteria: non-invasive activity-based interventions delivered at least three times/week for two weeks, upper extremity functional outcomes, age 13 years or older, English language, and neurological disorders three months post onset/injury. RESULTS The search yielded 172 studies. There were seven studies with SCI, all in adults. Activity-based interventions in SCI included task-specific training and gaming, with and without electrical stimulation, and a robotic exoskeleton. The other populations found in the review included studies in stroke, cerebral palsy, and multiple sclerosis. Thirty-four different interventions were reported in other populations. In comparison to the extensive stroke research, work in SCI was not found for high-intensity interventions using virtual reality, brain stimulation, rehabilitation devices, and applications to the home and telerehab settings. CONCLUSION The results highlight critical gaps within upper extremity high-intensity activity-based research in SCI.
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Affiliation(s)
- Namrata Grampurohit
- Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Alison Bell
- Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Susan V Duff
- Crean College of Health and Behavioral Sciences, Chapman University, Irvine, CA, USA
| | - M J Mulcahey
- Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Gary Kaplan
- Scott Memorial Library, Academic Commons, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ralph J Marino
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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Kanitkar A, Parmar ST, Szturm TJ, Restall G, Rempel G, Naik N, Gaonkar N, Sepehri N, Ankolekar B. Reliability and validity of a computer game-based tool of upper extremity assessment for object manipulation tasks in children with cerebral palsy. J Rehabil Assist Technol Eng 2021; 8:20556683211014023. [PMID: 34123406 PMCID: PMC8175827 DOI: 10.1177/20556683211014023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 04/13/2021] [Indexed: 11/15/2022] Open
Abstract
Introduction A computer game-based upper extremity (CUE) assessment tool is developed to quantify manual dexterity of children with Cerebral Palsy (CP). The purpose of this study was to determine test-retest reliability of the CUE performance measures (success rate, movement onset time, movement error, and movement variation) and convergent validity with the Peabody Developmental Motor Scale version 2 (PDMS-2) and the Quality of Upper Extremity Skills Test (QUEST). Methods Thirty-five children with CP aged four to ten years were tested on two occasions two weeks apart. Results CUE performance measures of five chosen object manipulation tasks exhibited high to moderate intra-class correlation coefficient (ICC) values. There was no significant difference in the CUE performance measures between test periods. With few exceptions, there was no significant correlation between the CUE performance measures and the PDMS-2 or the QUEST test scores. Conclusions The high to moderate ICC values and lack of systematic errors indicate that the CUE assessment tool has the ability to repeatedly record reliable performance measures of different object manipulation tasks. The lack of a correlation between the CUE and the PDMS-2 or QUEST scores indicates that performance measures of these assessment tools represent distinct attributes of manual dexterity.
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Affiliation(s)
- Anuprita Kanitkar
- Department of Applied Health Sciences, University of Manitoba, Winnipeg, Canada
- Anuprita Kanitkar, University of Manitoba 771 McDermot Avenue, Winnipeg, MB Manitoba R3E 0T6 Canada 204 789-3897.
| | - Sanjay T Parmar
- SDM College of Physiotherapy, Shri Dharamshala Manjunatheshwara University, Dharwad, India
| | - Tony J Szturm
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Gayle Restall
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Gina Rempel
- Pediatrics & Child Health, University of Manitoba, Winnipeg, Canada
| | - Nilashri Naik
- Department of Physiotherapy, Ushas School for Exceptional Children, Hubli, India
| | | | - Nariman Sepehri
- Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada
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Langan J, Bhattacharjya S, Subryan H, Xu W, Chen B, Li Z, Cavuoto L. In-Home Rehabilitation Using a Smartphone App Coupled With 3D Printed Functional Objects: Single-Subject Design Study. JMIR Mhealth Uhealth 2020; 8:e19582. [PMID: 32706702 PMCID: PMC7407249 DOI: 10.2196/19582] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/04/2020] [Accepted: 06/25/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Stroke is a major cause of long-term disability. While there is potential for improvements long after stroke onset, there is little to support functional recovery across the lifespan. mHealth solutions can help fill this gap. mRehab was designed to guide individuals with stroke through a home program and provide performance feedback. OBJECTIVE To examine if individuals with chronic stroke can use mRehab at home to improve upper limb mobility. The secondary objective was to examine if changes in limb mobility transferred to standardized clinical assessments. METHODS mRehab consists of a smartphone coupled with 3D printed household items: mug, bowl, key, and doorknob. The smartphone custom app guides task-oriented activities and measures both time to complete an activity and quality of movement (smoothness/accuracy). It also provides performance-based feedback to aid the user in self-monitoring their performance. Task-oriented activities were categorized as (1) object transportation, (2) prehensile grip with supination/pronation, (3) fractionated finger movement, and (4) walking with object. A total of 18 individuals with stroke enrolled in the single-subject experimental design study consisting of pretesting, a 6-week mRehab home program, and posttesting. Pre- and posttesting included both in-laboratory clinical assessments and in-home mRehab recorded samples of task performance. During the home program, mRehab recorded performance data. A System Usability Scale assessed user's perception of mRehab. RESULTS A total of 16 participants completed the study and their data are presented in the results. The average days of exercise for each mRehab activity ranged from 15.93 to 21.19 days. This level of adherence was sufficient for improvements in time (t15=2.555, P=.02) and smoothness (t15=3.483, P=.003) in object transportation. Clinical assessments indicated improvements in functional performance (t15=2.675, P=.02) and hand dexterity (t15=2.629, P=.02). Participant's perception of mRehab was positive. CONCLUSIONS Despite heterogeneity in participants' use of mRehab, there were improvements in upper limb mobility. Smartphone-based portable technology can support home rehabilitation programs in chronic conditions such as stroke. The ability to record performance data from home rehabilitation offers new insights into the impact of home programs on outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT04363944; https://clinicaltrials.gov/ct2/show/NCT04363944.
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Affiliation(s)
- Jeanne Langan
- Department of Rehabilitation Science, University at Buffalo, Buffalo, NY, United States
| | - Sutanuka Bhattacharjya
- Department of Occupational Therapy, Georgia State University, Atlanta, GA, United States
| | - Heamchand Subryan
- Center for Inclusive Design and Environmental Access, University at Buffalo, Buffalo, NY, United States
| | - Wenyao Xu
- Computer Science and Engineering Department, University at Buffalo, Buffalo, NY, United States
| | - Baicheng Chen
- Computer Science and Engineering Department, University at Buffalo, Buffalo, NY, United States
| | - Zhengxiong Li
- Computer Science and Engineering Department, University at Buffalo, Buffalo, NY, United States
| | - Lora Cavuoto
- Department of Industrial and Systems Engineering, University at Buffalo, Buffalo, NY, United States
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Yang Z, van Beijnum BJF, Li B, Yan S, Veltink PH. Estimation of Relative Hand-Finger Orientation Using a Small IMU Configuration. SENSORS (BASEL, SWITZERLAND) 2020; 20:s20144008. [PMID: 32707635 PMCID: PMC7412023 DOI: 10.3390/s20144008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/14/2020] [Accepted: 07/17/2020] [Indexed: 06/11/2023]
Abstract
Relative orientation estimation between the hand and its fingers is important in many applications, such as virtual reality (VR), augmented reality (AR) and rehabilitation. It is still quite a big challenge to do the estimation by only exploiting inertial measurement units (IMUs) because of the integration drift that occurs in most approaches. When the hand is functionally used, there are many instances in which hand and finger tips move together, experiencing almost the same angular velocities, and in some of these cases, almost the same accelerations are measured in different 3D coordinate systems. Therefore, we hypothesize that relative orientations between the hand and the finger tips can be adequately estimated using 3D IMUs during such designated events (DEs) and in between these events. We fused this extra information from the DEs and IMU data with an extended Kalman filter (EKF). Our results show that errors in relative orientation can be smaller than five degrees if DEs are constantly present and the linear and angular movements of the whole hand are adequately rich. When the DEs are partially available in a functional water-drinking task, the orientation error is smaller than 10 degrees.
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Affiliation(s)
- Zhicheng Yang
- Department of Biomedical Signals Systems, Technical Medical Centre, University of Twente, 7500 AE Enschede, The Netherlands; (B.-J.F.v.B.); (P.H.V.)
- School of Marine Science and Technology, Northwestern Polytechnical University, Xi’an 710072, China; (B.L.); (S.Y.)
| | - Bert-Jan F. van Beijnum
- Department of Biomedical Signals Systems, Technical Medical Centre, University of Twente, 7500 AE Enschede, The Netherlands; (B.-J.F.v.B.); (P.H.V.)
| | - Bin Li
- School of Marine Science and Technology, Northwestern Polytechnical University, Xi’an 710072, China; (B.L.); (S.Y.)
| | - Shenggang Yan
- School of Marine Science and Technology, Northwestern Polytechnical University, Xi’an 710072, China; (B.L.); (S.Y.)
| | - Peter H. Veltink
- Department of Biomedical Signals Systems, Technical Medical Centre, University of Twente, 7500 AE Enschede, The Netherlands; (B.-J.F.v.B.); (P.H.V.)
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Bhattacharjya S, Stafford MC, Cavuoto LA, Yang Z, Song C, Subryan H, Xu W, Langan J. Harnessing smartphone technology and three dimensional printing to create a mobile rehabilitation system, mRehab: assessment of usability and consistency in measurement. J Neuroeng Rehabil 2019; 16:127. [PMID: 31665036 PMCID: PMC6820925 DOI: 10.1186/s12984-019-0592-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 09/10/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Residual sensorimotor deficits are common following stroke. While it has been demonstrated that targeted practice can result in improvements in functional mobility years post stroke, there is little to support rehabilitation across the lifespan. The use of technology in home rehabilitation provides an avenue to better support self-management of recovery across the lifespan. We developed a novel mobile technology, capable of quantifying quality of movement with the purpose of providing feedback to augment rehabilitation and improve functional mobility. This mobile rehabilitation system, mRehab, consists of a smartphone embedded in three dimensional printed items representing functional objects found in the home. mRehab allows individuals with motor deficits to practice activities of daily living (ADLs) and receive feedback on their performance. The aim of this study was to assess the usability and consistency of measurement of the mRehab system. METHODS To assess usability of the mRehab system, four older adults and four individuals with stroke were recruited to use the system, and complete surveys to discuss their opinions on the user interface of the smartphone app and the design of the 3D printed items. To assess the consistency of measurement by the mRehab system, 12 young adults were recruited and performed mRehab ADLs in three lab sessions within 1 week. Young adults were chosen for their expected high level of consistency in motor performance. RESULTS Usability ratings from older adults and individuals with stroke led us to modify the design of the 3D printed items and improve the clarity of the mRehab app. The modified mRehab system was assessed for consistency of measurement and six ADLs resulted in coefficient of variation (CV) below 10%. This is a commonly used CV goal for consistency. Two ADLs ranged between 10 and 15% CV. Only two ADLs demonstrated high CV. CONCLUSIONS mRehab is a client-centered technology designed for home rehabilitation that consistently measures performance. Development of the mRehab system provides a support for individuals working on recovering functional upper limb mobility that they can use across their lifespan.
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Affiliation(s)
| | | | - Lora Anne Cavuoto
- Industrial and Systems Engineering, University at Buffalo, Buffalo, NY USA
| | - Zhuolin Yang
- Computer Science and Engineering, University at Buffalo, Buffalo, NY USA
| | - Chen Song
- Computer Science and Engineering, University at Buffalo, Buffalo, NY USA
| | - Heamchand Subryan
- Center for Inclusive Design and Environmental Access, University at Buffalo, Buffalo, NY USA
| | - Wenyao Xu
- Computer Science and Engineering, University at Buffalo, Buffalo, NY USA
| | - Jeanne Langan
- Rehabilitation Science, University at Buffalo, Buffalo, NY USA
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12
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Rohrbach N, Chicklis E, Levac DE. What is the impact of user affect on motor learning in virtual environments after stroke? A scoping review. J Neuroeng Rehabil 2019; 16:79. [PMID: 31248439 PMCID: PMC6598261 DOI: 10.1186/s12984-019-0546-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 06/05/2019] [Indexed: 01/08/2023] Open
Abstract
PURPOSE The purported affective impact of virtual reality (VR) and active video gaming (AVG) systems is a key marketing strategy underlying their use in stroke rehabilitation, yet little is known as to how affective constructs are measured or linked to intervention outcomes. The purpose of this scoping review is to 1) explore how motivation, enjoyment, engagement, immersion and presence are measured or described in VR/AVG interventions for patients with stroke; 2) identify directional relationships between these constructs; and 3) evaluate their impact on motor learning outcomes. METHODS A literature search was undertaken of VR/AVG interventional studies for adults post-stroke published in Medline, PEDro and CINAHL databases between 2007 and 2017. Following screening, reviewers used an iterative charting framework to extract data about construct measurement and description. A numerical and thematic analytical approach adhered to established scoping review guidelines. RESULTS One hundred fifty-five studies were included in the review. Although the majority (89%; N = 138) of studies described at least one of the five constructs within their text, construct measurement took place in only 32% (N = 50) of studies. The most frequently described construct was motivation (79%, N = 123) while the most frequently measured construct was enjoyment (27%, N = 42). A summative content analysis of the 50 studies in which a construct was measured revealed that constructs were described either as a rationale for the use of VR/AVGs in rehabilitation (76%, N = 38) or as an explanation for intervention results (56%, N = 29). 38 (76%) of the studies proposed relational links between two or more constructs and/or between any construct and motor learning. No study used statistical analyses to examine these links. CONCLUSIONS Results indicate a clear discrepancy between the theoretical importance of affective constructs within VR/AVG interventions and actual construct measurement. Standardized terminology and outcome measures are required to better understand how enjoyment, engagement, motivation, immersion and presence contribute individually or in interaction to VR/AVG intervention effectiveness.
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Affiliation(s)
- Nina Rohrbach
- Chair of Human Movement Science, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Emily Chicklis
- Department of Physical Therapy, Movement & Rehabilitation Science, Northeastern University, Boston, MA USA
| | - Danielle Elaine Levac
- Department of Physical Therapy, Movement & Rehabilitation Science, Northeastern University, Boston, MA USA
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Valkenborghs SR, Callister R, Visser MM, Nilsson M, van Vliet P. Interventions combined with task-specific training to improve upper limb motor recovery following stroke: a systematic review with meta-analyses. PHYSICAL THERAPY REVIEWS 2019. [DOI: 10.1080/10833196.2019.1597439] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Sarah R. Valkenborghs
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW, Australia
- Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia
- Centre for Research Excellence in Stroke Rehabilitation and Recovery, Hunter Medical Research Institute, Newcastle, NSW, Australia
- School of Biomedical Science and Pharmacy, Faculty of Health, University of Newcastle, Newcastle, NSW, Australia
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW, Australia
- Centre for Research Excellence in Stroke Rehabilitation and Recovery, Hunter Medical Research Institute, Newcastle, NSW, Australia
- School of Biomedical Science and Pharmacy, Faculty of Health, University of Newcastle, Newcastle, NSW, Australia
| | - Milanka M. Visser
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Michael Nilsson
- Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia
- Centre for Research Excellence in Stroke Rehabilitation and Recovery, Hunter Medical Research Institute, Newcastle, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Paulette van Vliet
- Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia
- Centre for Research Excellence in Stroke Rehabilitation and Recovery, Hunter Medical Research Institute, Newcastle, NSW, Australia
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Thielen CC, Marino RJ, Duff S, Kaplan G, Mulcahey MJ. Activity-based Rehabilitation Interventions of the Neurologically Impaired Upper Extremity: Description of a Scoping Review Protocol. Top Spinal Cord Inj Rehabil 2018; 24:288-294. [PMID: 29997431 DOI: 10.1310/sci2403-288] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction: A scoping review provides a means to synthesize and present a large body of literature on a broad topic, such as methods for various upper extremity activity-based therapy (ABT) interventions. Objectives: To describe our scoping review protocol to evaluate peer-reviewed articles focused on ABT interventions for individuals with neurologically impaired upper extremities. Methods: At Jefferson College of Health Professions and Sidney Kimmel Medical College at Jefferson, Philadelphia, the authors will follow this protocol to conduct a scoping review by establishing a research question and conducting a search of bibliographic databases to identify relevant studies. Using specific inclusion and exclusion criteria, abstracts will be screened and full-text articles will be reviewed for inclusion in charting, summarizing, and reporting results of appropriate studies. Conclusion: This protocol will guide the scoping review process to develop a framework for establishing a noninvasive ABT intervention informed by evidence for individuals with neurologically impaired upper extremities.
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Affiliation(s)
- Christina Calhoun Thielen
- Jefferson College of Health Professions, Jefferson (Philadelphia University + Thomas Jefferson University), Philadelphia, Pennsylvania
| | - Ralph J Marino
- Sidney Kimmel Medical College at Jefferson (Philadelphia University + Thomas Jefferson University), Philadelphia, Pennsylvania
| | - Susan Duff
- Crean College of Health and Behavioral Sciences, Chapman University, Irvine, California
| | - Gary Kaplan
- Center for Teaching and Learning, Jefferson (Philadelphia University + Thomas Jefferson University), Philadelphia, Pennsylvania
| | - M J Mulcahey
- Jefferson College of Health Professions, Jefferson (Philadelphia University + Thomas Jefferson University), Philadelphia, Pennsylvania
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Abstract
There is a long history of using videogames in a therapeutic capacity including rehabilitation for stroke patients, people with traumatic brain injuries, burns victims, wheelchair users, Erb's palsy sufferers, children undergoing chemotherapy, children with muscular dystrophy, autistic children and individuals looking to overcome real-life challenges (including symptoms of depression) and boost their wellbeing (including boosting life satisfaction, self-efficacy and social support). This paper briefly and selectively examines a number of areas including: (1) videogames as physiotherapy and occupational therapy, (2) videogames as distractors in the role of pain management, (3) videogames and cognitive rehabilitation, (4) videogames and the development of social and communication skills among the learning disabled, (5) videogames and impulsivity/attention deficit disorders, (6) videogames and therapeutic benefits in the elderly, (7) videogames in psychotherapeutic settings, (8) videogames and health care, (9) videogames and anxiety disorders, and (10) videogames and psychological wellbeing. It is concluded that there has been considerable success when games are specifically designed to address a specific problem or to teach a certain skill. However, generalizability outside the game-playing situation remains an important consideration.
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Affiliation(s)
- Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Daria J. Kuss
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Angelica B. Ortiz de Gortari
- International Gaming Research Unit, Psychology Division, Nottingham Trent University, Nottingham, UK & Psychology and Neuroscience of Cognition Research Unit, University of Liège, Belgium
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Kanitkar A, Szturm T, Parmar S, Gandhi DB, Rempel GR, Restall G, Sharma M, Narayan A, Pandian J, Naik N, Savadatti RR, Kamate MA. The Effectiveness of a Computer Game-Based Rehabilitation Platform for Children With Cerebral Palsy: Protocol for a Randomized Clinical Trial. JMIR Res Protoc 2017; 6:e93. [PMID: 28526673 PMCID: PMC5454217 DOI: 10.2196/resprot.6846] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 02/03/2017] [Accepted: 02/03/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It is difficult to engage young children with cerebral palsy (CP) in repetitive, tedious therapy. As such, there is a need for innovative approaches and tools to motivate these children. We developed the low-cost, computer game-based rehabilitation platform CGR that combines fine manipulation and gross movement exercises with attention and planning game activities appropriate for young children with CP. OBJECTIVE The objective of this study is to provide evidence of the therapeutic value of CGR to improve upper extremity (UE) motor function for children with CP. METHODS This randomized controlled, single-blind, clinical trial with an active control arm will be conducted at 4 sites. Children diagnosed with CP between the ages of 4 and 10 years old with moderate UE impairments and fine motor control abnormalities will be recruited. RESULTS We will test the difference between experimental and control groups using the Quality of Upper Extremity Skills Test (QUEST) and Peabody Developmental Motor Scales, Second Edition (PDMS-2) outcome measures. The parents of the children and the therapist experiences with the interventions and tools will be explored using semi-structured interviews using the qualitative description approach. CONCLUSIONS This research protocol, if effective, will provide evidence for the therapeutic value and feasibility of CGR in the pediatric rehabilitation of UE function. TRIAL REGISTRATION Clinicaltrials.gov NCT02728375; http:https://clinicaltrials.gov/ct2/show/NCT02728375 (Archived by WebCite at http://www.webcitation.org/6qDjvszvh).
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Affiliation(s)
- Anuprita Kanitkar
- Applied Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Tony Szturm
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Sanjay Parmar
- SDM College of Medical Sciences and Hospital, Rajiv Gandhi University of Health Sciences, Dharwad, India
| | - Dorcas Bc Gandhi
- Christian Medical College and Hospital, Department of Neurology, Baba Farid University of Health Sciences, Ludhiana, India
| | - Gina Ruth Rempel
- Max Rady College of Medicine, Rady Faculty of Health Sciences, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Gayle Restall
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Monika Sharma
- Christian Medical College and Hospital, Department of Pediatrics, Baba Farid University of Health Sciences, Ludhiana, India
| | - Amitesh Narayan
- Kasturba Medical College, Department of Physiotherapy, Manipal University, Mangalore, India
| | - Jeyaraj Pandian
- Christian Medical College and Hospital, Department of Neurology, Baba Farid University of Health Sciences, Ludhiana, India
| | - Nilashri Naik
- Department of Physiotherapy, Ushas School for Exceptional Children, Hubli, India
| | - Ravi R Savadatti
- SDM College of Physiotherapy, Rajiv Gandhi University of Health Sciences, Dharwad, India
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Chen CC, Liu CY, Ciou SH, Chen SC, Chen YL. Digitized Hand Skateboard Based on IR-Camera for Upper Limb Rehabilitation. J Med Syst 2017; 41:36. [PMID: 28084601 DOI: 10.1007/s10916-016-0682-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 12/28/2016] [Indexed: 11/29/2022]
Abstract
Abnormal upper limb function seriously impacts a patient's daily life. After receiving emergency treatment patient should receive function-rebuilding and recovery training. The objective of this study is to integrate IR-camera, an infrared emitter, with a conventional passive hand skateboard training device for conventional upper limb training and the training process is comprehensively recorded and analyzed. Patients participating in the occupational therapy have a binding band attached to hand skateboard on the table to guide the patient in moving the hand skateboard along the designated path to train the patient's upper limbs. Six people with normal upper limb function participated in the stability test. The device repeatability and test results were verified acceptable. Eight patients with abnormal upper limb function (their upper limb function was damaged due to stroke, MMSE > =27) were trained for 4 weeks. The patient scores in finishing rate and finishing time showed significant improvement. The paired T test results (satisfy p < 0.05 or p < 0.01) between wk-1 and wk-2 are significant. The paired T test results (satisfy p < 0.01) between wk-1 and wk-4 are extremely significant. The new IR-Camera system focuses continuously on the "Figure of eight" curve. The system is light weight and convenient for stroke in home use. The study applies IR-camera technology to the conventional hand skateboard for upper limb training. The experiments show that the hardware of the proposed device no longer delays in response and can result in obvious clinical advances. The proposed device is verified worthy of promotion.
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Affiliation(s)
- Chih-Chen Chen
- Department of Management Information Systems, Hwa Hsia University of Technology, New Taipei City, Taiwan, Republic of China
| | - Chun-Yen Liu
- Department of Computer Science, National Taipei University of Education, Taipei, Taiwan, Republic of China
| | - Shih-Hsiang Ciou
- Department of Electronic Engineering, National Taipei University of Technology, Taipei, Taiwan, Republic of China
| | - Shih-Ching Chen
- Department of Physical Medicine & Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan, Republic of China
| | - Yu-Luen Chen
- Department of Digital Technology Design, National Taipei University of Education, No. 134, Sec. 2, Heping E. Rd., Da-an District, Taipei City 106, Taiwan, Republic of China.
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Srikesavan CS, Shay B, Szturm T. Task-Oriented Training with Computer Games for People with Rheumatoid Arthritis or Hand Osteoarthritis: A Feasibility Randomized Controlled Trial. Games Health J 2016; 5:295-303. [DOI: 10.1089/g4h.2016.0005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Cynthia Swarnalatha Srikesavan
- Centre for Rehabilitation Research in Oxford (RRIO), Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Barbara Shay
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Tony Szturm
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
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NOH NORAZMIRAMD, KADRI NAHRIZULADIB, USMAN JULIANA. DEVELOPMENT OF ARDUINO-BASED HAND DYNAMOMETER ASSISTIVE DEVICE. J MECH MED BIOL 2016. [DOI: 10.1142/s0219519416500330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of this study is to develop a hand dynamometer that can act as a rehabilitation device by acquiring quantified data to enhance the power of hand grip strength. On the whole, patient that suffers from the hand injury is directly exposed to intricacy when performing daily task. Therefore, many hand aids have been developed to overcome the problem. A typical hand assistive device is able to measure the hand grip strength, which eventually increases its functionality. Like hand dynamometer, it is used for regular screening of hand grip strength and also for the preliminary and ongoing assessment of patients with hand dysfunction or trauma. Strain gauge-based system transducer acts as the measurement system together with Arduino microcontroller for the instrumentation, communication and controlling applications. The integration of strain gauges with a transducer is called a load cell which also made up the overall of force sensor to obtain readings from the hand grip movement. Microcontroller will further use this information to store and analyze data in the SD card. The percentage difference observed between hands across the sample of 25 subjects support the 10% rule. An overall 10.74% difference was found when combined dominant and non-dominant hand strength scores for all subjects were observed.
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Affiliation(s)
- NORAZMIRA MD NOH
- Department of Biomedical Engineering, University of Malaya, Kuala Lumpur, Wilayah Persekutuan 50603, Malaysia
| | - NAHRIZUL ADIB KADRI
- Department of Biomedical Engineering, University of Malaya, Kuala Lumpur, Wilayah Persekutuan 50603, Malaysia
| | - JULIANA USMAN
- Department of Biomedical Engineering, University of Malaya, Kuala Lumpur, Wilayah Persekutuan 50603, Malaysia
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20
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Chen CC. Multimedia virtualized environment for shoulder pain rehabilitation. J Phys Ther Sci 2016; 28:1349-54. [PMID: 27190481 PMCID: PMC4868241 DOI: 10.1589/jpts.28.1349] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 01/16/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Researchers imported games and virtual reality training to help participants
train their shoulders in a relaxed environment. [Subjects and Methods] This study included
the use of Kinect somatosensory device with Unity software to develop 3-dimensional
situational games. The data collected from this training process can be uploaded via the
Internet to a cloud or server for participants to perform self-inspection. The data can be
a reference for the medical staff to assess training effectiveness for those with
impairments and plan patient rehabilitation courses. [Results] In the training activities,
8 subjects with normal shoulder function demonstrated that the system has good stability
and reproducibility. Six subjects with impaired shoulder underwent 6 weeks of training.
During the third week of training, average performance stabilized. The t-test comparing
1–2 weeks to 3–4 weeks and 5–6 weeks showed significant differences. [Conclusion] Using
games as training methods improved patient concentration, interest in participation and
allowed patients to forget about their body discomfort. The equipment utilized in this
study is inexpensive, easy to obtain, and the system is easy to install. People can
perform simple self-training both at home or in the office.
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Affiliation(s)
- Chih-Chen Chen
- Department of Management Information Systems, Hwa Hsia University of Technology, Taiwan
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21
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Chen CC, Chen YL, Chen SC. Application of RFID technology-upper extremity rehabilitation training. J Phys Ther Sci 2016; 28:519-24. [PMID: 27065539 PMCID: PMC4793003 DOI: 10.1589/jpts.28.519] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 11/06/2015] [Indexed: 12/01/2022] Open
Abstract
[Purpose] Upper extremity rehabilitation after an injury is very important. This study
proposes radio frequency identification (RFID) technology to improve and enhance the
effectiveness of the upper extremity rehabilitation. [Subjects and Methods] People use
their upper extremities to conduct daily activities. When recovering from injuries, many
patients neglect the importance of rehabilitation, which results in degraded function.
This study recorded the training process using the traditional rehabilitation hand gliding
cart with a RFID reader, RFID tags in the panel, and a servo host computer. [Results]
Clinical evidence, time taken to achieve a full score, counts of missing the specified
spots, and Brunnstrom stage of aided recovery, the proximal part of the upper extremity
show that the RFID-based upper extremity training significantly and reduce negative
impacts of the disability in daily life and activities. [Conclusion] This study combined a
hand-gliding cart with an RFID reader, and when patients moved the cart, the movement
could be observed via the activated RFID tags. The training data was collected and
quantified for a better understanding of the recovery status of the patients. Each of the
participating patients made progress as expected.
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Affiliation(s)
- Chih-Chen Chen
- Department of Management Information Systems, Hwa Hsia University of Technology: 111 Gongzhuan Rd., Zhonghe Dist., New Taipei City 235, Taiwan
| | - Yu-Luen Chen
- Department of Digital Technology Design, National Taipei University of Education, Taiwan
| | - Shih-Ching Chen
- Department of Physical Medicine and Rehabilitation, Taipei Medical University and Hospital, Taiwan
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22
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Dimbwadyo-Terrer I, Gil-Agudo A, Segura-Fragoso A, de los Reyes-Guzmán A, Trincado-Alonso F, Piazza S, Polonio-López B. Effectiveness of the Virtual Reality System Toyra on Upper Limb Function in People with Tetraplegia: A Pilot Randomized Clinical Trial. BIOMED RESEARCH INTERNATIONAL 2016; 2016:6397828. [PMID: 26885511 PMCID: PMC4739467 DOI: 10.1155/2016/6397828] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 12/20/2015] [Accepted: 12/21/2015] [Indexed: 12/04/2022]
Abstract
The aim of this study was to investigate the effects of a virtual reality program combined with conventional therapy in upper limb function in people with tetraplegia and to provide data about patients' satisfaction with the virtual reality system. Thirty-one people with subacute complete cervical tetraplegia participated in the study. Experimental group received 15 sessions with Toyra(®) virtual reality system for 5 weeks, 30 minutes/day, 3 days/week in addition to conventional therapy, while control group only received conventional therapy. All patients were assessed at baseline, after intervention, and at three-month follow-up with a battery of clinical, functional, and satisfaction scales. Control group showed significant improvements in the manual muscle test (p = 0,043, partial η (2) = 0,22) in the follow-up evaluation. Both groups demonstrated clinical, but nonsignificant, changes to their arm function in 4 of the 5 scales used. All patients showed a high level of satisfaction with the virtual reality system. This study showed that virtual reality added to conventional therapy produces similar results in upper limb function compared to only conventional therapy. Moreover, the gaming aspects incorporated in conventional rehabilitation appear to produce high motivation during execution of the assigned tasks. This trial is registered with EudraCT number 2015-002157-35.
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Affiliation(s)
- I. Dimbwadyo-Terrer
- Occupational Thinks Research Group, Centro Superior de Estudios Universitarios La Salle (UAM), C/La Salle 10, 28023 Madrid, Spain
| | - A. Gil-Agudo
- Biomechanics and Technical Aids Department, National Hospital for Spinal Cord Injury, Finca la Peraleda s/n, 45071 Toledo, Spain
| | - A. Segura-Fragoso
- Health Sciences Institute, Avenida de Madrid s/n, Talavera de la Reina, 45600 Toledo, Spain
| | - A. de los Reyes-Guzmán
- Biomechanics and Technical Aids Department, National Hospital for Spinal Cord Injury, Finca la Peraleda s/n, 45071 Toledo, Spain
| | - F. Trincado-Alonso
- Biomechanics and Technical Aids Department, National Hospital for Spinal Cord Injury, Finca la Peraleda s/n, 45071 Toledo, Spain
| | - S. Piazza
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Avenida Doctor Arce 37, 28002 Madrid, Spain
| | - B. Polonio-López
- Nursing, Physiotherapy and Occupational Therapy Department, University of Castilla La Mancha, Avenida Real Fábrica de Sedas s/n, Talavera de la Reina, 45600 Toledo, Spain
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Burns MK, Andeway K, Eppenstein P, Ruroede K. Use of the Wii Gaming System for Balance Rehabilitation: Establishing Parameters for Healthy Individuals. Games Health J 2015. [PMID: 26196177 DOI: 10.1089/g4h.2013.0067] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study was designed to establish balance parameters for the Nintendo(®) (Redmond, WA) "Wii Fit™" Balance Board system with three common games, in a sample of healthy adults, and to evaluate the balance measurement reproducibility with separation by age. SUBJECTS AND METHODS This was a prospective, multivariate analysis of variance, cohort study design. Seventy-five participants who satisfied all inclusion criteria and completed an informed consent were enrolled. Participants were grouped into age ranges: 21-35 years (n=24), 36-50 years (n=24), and 51-65 years (n=27). Each participant completed the following games three consecutive times, in a randomized order, during one session: "Balance Bubble" (BB) for distance and duration, "Tight Rope" (TR) for distance and duration, and "Center of Balance" (COB) on the left and right sides. RESULTS COB distributed weight was fairly symmetrical across all subjects and trials; therefore, no influence was assumed on or interaction with other "Wii Fit" measurements. Homogeneity of variance statistics indicated the assumption of distribution normality of the dependent variables (rates) were tenable. The multivariate analysis of variance included dependent variables BB and TR rates (distance divided by duration to complete) with age group and trials as the independent variables. The BB rate was statistically significant (F=4.725, P<0.005), but not the TR rate. The youngest group's BB rate was significantly larger than those of the other two groups. CONCLUSIONS "Wii Fit" can discriminate among age groups across trials. The results show promise as a viable tool to measure balance and distance across time (speed) and center of balance distribution.
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Affiliation(s)
- Melissa K Burns
- Department of Physical Therapy, Marianjoy Rehabilitation Hospital , Wheaton, Illinois
| | - Kathleen Andeway
- Department of Physical Therapy, Marianjoy Rehabilitation Hospital , Wheaton, Illinois
| | - Paula Eppenstein
- Department of Physical Therapy, Marianjoy Rehabilitation Hospital , Wheaton, Illinois
| | - Kathleen Ruroede
- Department of Physical Therapy, Marianjoy Rehabilitation Hospital , Wheaton, Illinois
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Kapadia NM, Bagher S, Popovic MR. Influence of different rehabilitation therapy models on patient outcomes: hand function therapy in individuals with incomplete SCI. J Spinal Cord Med 2014; 37:734-43. [PMID: 24968955 PMCID: PMC4231961 DOI: 10.1179/2045772314y.0000000203] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVES The primary objective was to compare the benefits of single (COT1) versus double (COT2) dose of conventional occupational therapy (COT) in improving voluntary hand function in individuals with incomplete, sub-acute C3-C7 spinal cord injury (SCI). The secondary objective was to compare these two interventions versus functional electrical stimulation therapy plus COT (FES + COT). DESIGN Retrospective analysis. Setting Inpatient spinal cord rehabilitation center, Toronto. PARTICIPANTS Individuals with traumatic incomplete sub-acute SCI. INTERVENTIONS Data from Phases I and II (ClinicalTrials.gov ID NCT00221117) randomized control trials were pooled together for the purpose of this study. Participants in the COT1 group received 45 hours of therapy, the COT2 group received 80 hours of therapy, and the FES + COT group received 40 hours of COT therapy +40 hours of FES therapy. OUTCOME MEASURES We analyzed the functional independence measure (FIM) and the spinal cord independence measure (SCIM) self-care sub-scores. Results The mean change scores on the FIM self-care sub-score for the COT1, COT2, and FES + COT groups were 12.8, 10, and 20.1 points, respectively. Similarly, the mean change scores on the SCIM self-care sub-score for the COT1, COT2, and FES + COT groups were, 2.6, 3.16, and 10.2 points, respectively. CONCLUSION Increased rehabilitation intensity alone may not always be beneficial. The type of intervention plays a significant role in determining functional changes. In this instance, receiving one (COT1) or two (COT2) doses of COT resulted in similar outcomes, however, FES + COT therapy yielded much better outcomes compared to COT1 and COT2 interventions.
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Affiliation(s)
- Naaz M. Kapadia
- Correspondence to: Naaz M. Kapadia, Spinal Cord Injury Research Program, Toronto Rehabilitation Institute, University Hospital Network, 520 Sutherland Drive, Toronto, Canada ON M4G 3V9.
| | - Shaghayegh Bagher
- Toronto Rehabilitation Institute, University Hospital Network, Toronto, Canada
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25
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Adie K, Schofield C, Berrow M, Wingham J, Freeman J, Humfryes J, Pritchard C. Does the use of Nintendo Wii Sports™ improve arm function and is it acceptable to patients after stroke? Publication of the Protocol of the Trial of Wii™ in Stroke - TWIST. Int J Gen Med 2014; 7:475-81. [PMID: 25336985 PMCID: PMC4199966 DOI: 10.2147/ijgm.s65379] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Many stroke patients experience loss of arm function requiring rehabilitation, which is expensive, repetitive, and does not always translate into "real life." Nintendo Wii Sports™ (Wii™) may offer task-specific training that is repetitive and motivating. The Trial of Wii™ in Stroke (TWIST) is designed to investigate feasibility, efficacy, and acceptability using Wii™ to improve affected arm function for patients after stroke. METHOD This is a randomized controlled trial (RCT), incorporating a qualitative study and health economics analysis that compares playing Wii™ versus arm exercises in patients receiving standard rehabilitation in a home setting within 6 months of stroke with a motor deficit of less than 5 on the MRC (Medical Research Council) scale (arm). In this study, we expect to randomize 240 participants. OUTCOME MEASURES Primary outcome is change in affected arm function at 6 weeks follow-up in intervention and control group using the Action Research Arm Test. Secondary outcomes include occupational performance using the Canadian Occupational Performance Measure, quality of life using the Stroke Impact Scale, cost effectiveness analysis, and a qualitative study investigating factors that influence use of Wii™ for patients and carers. CONCLUSION TWIST is the first UK RCT assessing the feasibility, cost effectiveness, and acceptability of Wii™ in stroke rehabilitation. The trial has been registered with ISRCTN 06807619 and UK CRN 11030. Results of the study will be published after completion of study in August 2014.
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Affiliation(s)
- Katja Adie
- Royal Cornwall Hospital Trust, Cornwall, UK
| | | | - Margie Berrow
- Peninsula Clinical Trials Unit, Plymouth University Schools of Medicine and Dentistry, Plymouth, Devon, UK
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Szturm T, Polyzoi E, Marotta J, Srikesavan CS. An In-School-Based Program of Combined Fine Motor Exercise and Educational Activities for Children with Neurodevelopmental Disorders. Games Health J 2014; 3:326-32. [PMID: 26192639 DOI: 10.1089/g4h.2014.0051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This article introduces a game-based rehabilitation platform designed to integrate training of fine motor skills and cognitive functions. A novel computer interface device was developed that can effectively replace a standard computer mouse when doing exercises to rehabilitate hand function. This smart device converts signals from miniature motion sensors to signals equivalent to that of a computer mouse. In this way, nearly any object or utensil can be changed to function exactly as a computer mouse, simply by attaching the motion sensor. Multiple objects with varied sizes, shapes, weights, and functional demands for precision can be used for exercise and to practice a variety of gross or fine motor skills, and, importantly, while playing fun computer games. The platform was designed to work with modern and common computer games, which have a broad range of movement speeds and accuracy levels, cognitive activities (puzzles, choices, distractors), and educational content. The platform includes a designed assessment game with advanced data logging for electronic monitoring. Data analysis methods have been developed to quantify performance metrics that provide insights into the quality, efficiency, and skill of a child and thus mean to conduct trend analyses that indicate how the child is performing over time.
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Affiliation(s)
- Tony Szturm
- 1 Department of Physical Therapy, College of Rehabilitation Sciences, Faculty of Health Sciences, University of Manitoba , Winnipeg, Manitoba, Canada
| | - Eleoussa Polyzoi
- 2 Faculty of Education (Developmental Studies & Special Needs Education), University of Winnipeg , Winnipeg, Manitoba, Canada
| | - Jonathan Marotta
- 3 Department of Psychology, University of Manitoba , Winnipeg, Manitoba, Canada
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Zhou J, Sebastian E, Mangona V, Yan D. Real-time catheter tracking for high-dose-rate prostate brachytherapy using an electromagnetic 3D-guidance device: a preliminary performance study. Med Phys 2013; 40:021716. [PMID: 23387739 DOI: 10.1118/1.4788641] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE In order to increase the accuracy and speed of catheter reconstruction in a high-dose-rate (HDR) prostate implant procedure, an automatic tracking system has been developed using an electromagnetic (EM) device (trakSTAR, Ascension Technology, VT). The performance of the system, including the accuracy and noise level with various tracking parameters and conditions, were investigated. METHODS A direct current (dc) EM transmitter (midrange model) and a sensor with diameter of 1.3 mm (Model 130) were used in the trakSTAR system for tracking catheter position during HDR prostate brachytherapy. Localization accuracy was assessed under both static and dynamic analyses conditions. For the static analysis, a calibration phantom was used to investigate error dependency on operating room (OR) table height (bottom vs midposition vs top), sensor position (distal tip of catheter vs connector end of catheter), direction [left-right (LR) vs anterior-posterior (AP) vs superior-inferior (SI)], sampling frequency (40 vs 80 vs 120 Hz), and interference from OR equipment (present vs absent). The mean and standard deviation of the localization offset in each direction and the corresponding error vectors were calculated. For dynamic analysis, the paths of five straight catheters were tracked to study the effects of directions, sampling frequency, and interference of EM field. Statistical analysis was conducted to compare the results in different configurations. RESULTS When interference was present in the static analysis, the error vectors were significantly higher at the top table position (3.3 ± 1.3 vs 1.8 ± 0.9 mm at bottom and 1.7 ± 1.0 mm at middle, p < 0.001), at catheter end position (3.1 ± 1.1 vs 1.4 ± 0.7 mm at the tip position, p < 0.001), and at 40 Hz sampling frequency (2.6 ± 1.1 vs 2.4 ± 1.5 mm at 80 Hz and 1.8 ± 1.1 at 160 Hz, p < 0.001). So did the mean offset errors in the LR direction (-1.7 ± 1.4 vs 0.4 ± 0.5 mm in AP and 0.8 ± 0.8 mm in SI directions, p < 0.001). The error vectors were significantly higher with surrounding interference (2.2 ± 1.3 mm) vs without interference (1.0 ± 0.7 mm, p < 0.001). An accuracy of 1.6 ± 0.2 mm can be reached when using optimum configuration (160 Hz at middle table position). When interference was present in the dynamic tracking, the mean tracking errors in LR direction (1.4 ± 0.5 mm) was significantly higher than that in AP direction (0.3 ± 0.2 mm, p < 0.001). So did the mean vector errors at 40 Hz (2.1 ± 0.2 mm vs 1.3 ± 0.2 mm at 80 Hz and 0.9 ± 0.2 mm at 160 Hz, p < 0.05). However, when interference was absent, they were comparable in the both directions and at all sampling frequencies. An accuracy of 0.9 ± 0.2 mm was obtained for the dynamic tracking when using optimum configuration. CONCLUSIONS The performance of an EM tracking system depends highly on the system configuration and surrounding environment. The accuracy of EM tracking for catheter reconstruction in a prostate HDR brachytherapy procedure can be improved by reducing interference from surrounding equipment, decreasing distance from transmitter to tracking area, and choosing appropriated sampling frequency. A calibration scheme is needed to further reduce the tracking error when the interference is high.
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Affiliation(s)
- Jun Zhou
- Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI 48073, USA.
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Srikesavan CS, Shay B, Robinson DB, Szturm T. Task-oriented training with computer gaming in people with rheumatoid arthritisor osteoarthritis of the hand: study protocol of a randomized controlled pilot trial. Trials 2013; 14:69. [PMID: 23497529 PMCID: PMC3599819 DOI: 10.1186/1745-6215-14-69] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 02/18/2013] [Indexed: 11/17/2022] Open
Abstract
Background Significant restriction in the ability to participate in home, work and community life results from pain, fatigue, joint damage, stiffness and reduced joint range of motion and muscle strength in people with rheumatoid arthritis or osteoarthritis of the hand. With modest evidence on the therapeutic effectiveness of conventional hand exercises, a task-oriented training program via real life object manipulations has been developed for people with arthritis. An innovative, computer-based gaming platform that allows a broad range of common objects to be seamlessly transformed into therapeutic input devices through instrumentation with a motion-sense mouse has also been designed. Personalized objects are selected to target specific training goals such as graded finger mobility, strength, endurance or fine/gross dexterous functions. The movements and object manipulation tasks that replicate common situations in everyday living will then be used to control and play any computer game, making practice challenging and engaging. Methods/Design The ongoing study is a 6-week, single-center, parallel-group, equally allocated and assessor-blinded pilot randomized controlled trial. Thirty people with rheumatoid arthritis or osteoarthritis affecting the hand will be randomized to receive either conventional hand exercises or the task-oriented training. The purpose is to determine a preliminary estimation of therapeutic effectiveness and feasibility of the task-oriented training program. Performance based and self-reported hand function, and exercise compliance are the study outcomes. Changes in outcomes (pre to post intervention) within each group will be assessed by paired Student t test or Wilcoxon signed-rank test and between groups (control versus experimental) post intervention using unpaired Student t test or Mann–Whitney U test. Discussion The study findings will inform decisions on the feasibility, safety and completion rate and will also provide preliminary data on the treatment effects of the task-oriented training compared with conventional hand exercises in people with rheumatoid arthritis or osteoarthritis of the hand. Trial registration ClinicalTrials.gov: NCT01635582
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Affiliation(s)
- Cynthia Swarnalatha Srikesavan
- Department of Physical Therapy, School of Medical Rehabilitation, Faculty of Medicine, University of Manitoba, R106 - 771 Mc Dermot Avenue, Winnipeg, Manitoba R3E 0T6, Canada
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Combs SA, Finley MA, Henss M, Himmler S, Lapota K, Stillwell D. Effects of a repetitive gaming intervention on upper extremity impairments and function in persons with chronic stroke: a preliminary study. Disabil Rehabil 2012; 34:1291-8. [DOI: 10.3109/09638288.2011.641660] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Arthritic hand-finger movement similarity measurements: tolerance near set approach. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2011; 2011:569898. [PMID: 21559241 PMCID: PMC3087412 DOI: 10.1155/2011/569898] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Accepted: 02/09/2011] [Indexed: 11/17/2022]
Abstract
The problem considered in this paper is how to measure the degree of resemblance between nonarthritic and arthritic hand movements during rehabilitation exercise. The solution to this problem stems from recent work on a tolerance space view of digital images and the introduction of image resemblance measures. The motivation for this work is both to quantify and to visualize differences between hand-finger movements in an effort to provide clinicians and physicians with indications of the efficacy of the prescribed rehabilitation exercise. The more recent introduction of tolerance near sets has led to a useful approach for measuring the similarity of sets of objects and their application to the problem of classifying image sequences extracted from videos showing finger-hand movement during rehabilitation exercise. The approach to measuring the resemblance between hand movement images introduced in this paper is based on an application of the well-known Hausdorff distance measure and a tolerance nearness measure. The contribution of this paper is an approach to measuring as well as visualizing the degree of separation between images in arthritic and nonarthritic hand-finger motion videos captured during rehabilitation exercise.
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Kapadia NM, Zivanovic V, Furlan J, Craven BC, McGillivray C, Popovic MR. Functional Electrical Stimulation Therapy for Grasping in Traumatic Incomplete Spinal Cord Injury: Randomized Control Trial. Artif Organs 2011; 35:212-6. [DOI: 10.1111/j.1525-1594.2011.01216.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Manipulation of objects with and without the use of the index finger: implications for digital amputations. J Hand Ther 2011; 23:352-59; quiz 360. [PMID: 20609561 DOI: 10.1016/j.jht.2010.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Revised: 02/11/2010] [Accepted: 04/30/2010] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Clinical Measurement. PURPOSE To evaluate changes in temporal and amplitude movement accuracy with tasks requiring fine motor manipulation with and without the use of the index finger (WIF). PARTICIPANTS Twenty right-handed participants (10 males, 10 females, aged 24-47 years) were recruited. METHODS Three objects, ranging in weight and size, that required the use of 2 or 3 fingers were selected for this study. Motor performance was quantified during manipulation of a pen, cork, and wine glass using a computerized visual guided tracking task. The miniBird (Ascension Technology, Burlington, VT, USA) miniature motion tracking sensor was attached to each object to measure and record the 3D linear and angular motion. RESULTS Task performance and temporal accuracy of the pen task in the normal condition was more accurate (P=.033). During the WIF condition there was significantly more motion performing the wine task (P<.001). CONCLUSIONS The protocol directly measures the ability of the hand to coordinate movement in response to a visual tracking target. Both temporal accuracy and amplitude consistency can be objectively evaluated. The current study evaluates the ability of the hand to manipulate 3 objects used in fine motor manipulation, using motion analysis and visual tracking. LEVEL OF EVIDENCE 3b.
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Brown SH, Lewis CA, McCarthy JM, Doyle ST, Hurvitz EA. The effects of Internet-based home training on upper limb function in adults with cerebral palsy. Neurorehabil Neural Repair 2011; 24:575-83. [PMID: 20581338 DOI: 10.1177/1545968310361956] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND While adults with hemiplegic cerebral palsy (CP) can have significant upper limb dysfunction, the effects of movement-based training has not been investigated. OBJECTIVE This uncontrolled trial assessed the effects of a home and internet-based upper limb intervention program targeting motor and sensory function. METHODS Twelve adults, aged 21 to 57 yrs, GMFCS levels I-III with asymmetric upper limb involvement participated in the Upper Limb Training and Assessment (ULTrA) program. Clinical and functional measures included the Motor Activity Log (MAL), the Nine-Hole Peg test, and grip strength. An upper limb training system consisting of a laptop, webcam, target light board, and hand manipulation/ discrimination devices was installed in each participant's home. Training occurred 40 min/day, 5 days/wk for 8 wks and included both unilateral and bilateral reach movements as well as a series of hand sensorimotor tasks such as card turning, stereognosis, and tactile discrimination. Data generated during each session were transmitted to the laboratory via the Internet. MAIN OUTCOME MEASURES were movement time, interlimb delay time, and performance on hand sensorimotor tasks. RESULTS Following training, affected limb reach movement time decreased significantly for unilateral and bilateral tasks. Interlimb delay during sequential reaching also decreased. Significant improvement in hand manipulation tasks was also seen. Compliance was excellent and there were no adverse effects. CONCLUSION The ULTrA program had beneficial effects for adults with CP and is safe and convenient to use. This system contrasts sharply with programs with similar intent that require participant travel and hours of therapist-based intervention.
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Affiliation(s)
- Susan H Brown
- School of Kinesiology, University of Michigan, Ann Arbor, MI 48109-2013, USA.
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Lange BS, Requejo P, Flynn SM, Rizzo AA, Valero-Cuevas FJ, Baker L, Winstein C. The potential of virtual reality and gaming to assist successful aging with disability. Phys Med Rehabil Clin N Am 2010; 21:339-56. [PMID: 20494281 DOI: 10.1016/j.pmr.2009.12.007] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Using the advances in computing power, software and hardware technologies, virtual reality (VR), and gaming applications have the potential to address clinical challenges for a range of disabilities. VR-based games can potentially provide the ability to assess and augment cognitive and motor rehabilitation under a range of stimulus conditions that are not easily controllable and quantifiable in the real world. This article discusses an approach for maximizing function and participation for those aging with and into a disability by combining task-specific training with advances in VR and gaming technologies to enable positive behavioral modifications for independence in the home and community. There is potential for the use of VR and game applications for rehabilitating, maintaining, and enhancing those processes that are affected by aging with and into disability, particularly the need to attain a balance in the interplay between sensorimotor function and cognitive demands and to reap the benefits of task-specific training and regular physical activity and exercise.
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Affiliation(s)
- B S Lange
- VRPSYCH Laboratory, Institute for Creative Technologies, University of Southern California, 13274 Fiji Way, Marina Del Rey, CA 90292, USA
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