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Watanabe H, Mathis BJ, Ueno T, Taketomi M, Kubota S, Marushima A, Kawamoto H, Sankai Y, Matsumura A, Hada Y. Safety and Feasibility Study of the Medical Care Pit Walking Support System for Rehabilitation of Acute Stroke Patients. J Clin Med 2023; 12:5389. [PMID: 37629438 PMCID: PMC10455835 DOI: 10.3390/jcm12165389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/10/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Stroke rehabilitation with mechanical assistance improves outcomes by facilitating repetition and relieving the care burden of therapy staff. Here, we tested the Medical Care Pit (MCP) walking assistance training device in the rehabilitation of eight acute stroke patients (median age 60.7 ± 16.3 years) who had recently suffered ischemic (three) or hemorrhagic (five) stroke (14.1 ± 6.5 days). Patients received standard rehabilitation approximately 5 days per week (weekdays only), plus MCP therapy twice a week, totaling four MCP sessions over 2 weeks. Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Functional Ambulation Category (FAC), and other gait-associated parameters were measured. Over the 10.5 ± 1.6 days of therapy, MCP qualitatively assisted in gait analysis and real-time patient feedback while independent walking scores significantly improved (FAC 2.2 ± 0.8 to 3.1 ± 1.3, p = 0.020). FMA-LE scores also slightly improved but not to significance (p = 0.106). Objective burden on patients, as measured by modified Borg scale, was significantly improved (2.7 ± 1.6 to 2.0 ± 1.6, p = 0.014). In terms of questionnaires, anxiety scores for the physical therapist regarding gait training and falling with MCP significantly decreased (3.8 ± 2.3 to 1.0 ± 1.6; p = 0.027 and 3.1 ± 2.2 to 0.8 ± 1.3; p = 0.045) from the first to fourth sessions. Taken together, MCP, in addition to the usual rehabilitation program, was effective in gait rehabilitation for independent walking and relieved burdens on the patients. Such walking support systems may be an important part of acute stroke rehabilitation.
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Affiliation(s)
- Hiroki Watanabe
- Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan; (H.W.)
| | - Bryan J. Mathis
- International Medical Center, University of Tsukuba Hospital, Tsukuba 305-8576, Ibaraki, Japan
| | - Tomoyuki Ueno
- Department of Rehabilitation Medicine, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan
| | - Masakazu Taketomi
- Department of Rehabilitation Medicine, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan
| | - Shigeki Kubota
- Department of Occupational Therapy, Ibaraki Prefectural University of Health Sciences, Ami 300-0394, Ibaraki, Japan
| | - Aiki Marushima
- Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan; (H.W.)
| | - Hiroaki Kawamoto
- Institute of Systems and Information Engineering, University of Tsukuba, Tsukuba 305-8573, Ibaraki, Japan
| | - Yoshiyuki Sankai
- Institute of Systems and Information Engineering, University of Tsukuba, Tsukuba 305-8573, Ibaraki, Japan
| | - Akira Matsumura
- Ibaraki Prefectural University of Health Sciences, Ami 300-0394, Ibaraki, Japan
| | - Yasushi Hada
- Department of Rehabilitation Medicine, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan
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Piscicelli C, Castrioto A, Jaeger M, Fraix V, Chabardes S, Moro E, Krack P, Debû B, Pérennou D. Contribution of Basal Ganglia to the Sense of Upright: A Double-Blind Within-Person Randomized Trial of Subthalamic Stimulation in Parkinson's Disease with Pisa Syndrome. JOURNAL OF PARKINSONS DISEASE 2021; 11:1393-1408. [PMID: 33896847 DOI: 10.3233/jpd-202388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Verticality perception is frequently altered in Parkinson's disease (PD) with Pisa syndrome (PS). Is it the cause or the consequence of the PS? OBJECTIVE We tested the hypothesis that both scenarios coexist. METHODS We performed a double-blind within-person randomized trial (NCT02704910) in 18 individuals (median age 63.5 years) with PD evolving for a median of 17.5 years and PS for 2.5 years and treated with bilateral stimulation of the subthalamus nuclei (STN-DBS) for 6.5 years. We analyzed whether head and trunk orientations were congruent with the visual (VV) and postural (PV) vertical, and whether switching on one or both sides of the STN-DBS could modulate trunk orientation via verticality representation. RESULTS The tilted verticality perception could explain the PS in 6/18 (33%) patients, overall in three right-handers (17%) who showed net and congruent leftward trunk and PV tilts. Two of the 18 (11%) had an outstanding clinical picture associating leftward: predominant parkinsonian symptoms, whole-body tilt (head -11°, trunk -8°) and transmodal tilt in verticality perception (PV -10°, VV -8.9°). Trunk orientation or VV were not modulated by STN-DBS, whereas PV tilts were attenuated by unilateral or bilateral stimulations if it was applied on the opposite STN. CONCLUSION In most cases of PS, verticality perception is altered by the body deformity. In some cases, PS seems secondary to a biased internal model of verticality, and DBS on the side of the most denervated STN attenuated PV tilts with a quasi-immediate effect. This is an interesting track for further clinical studies.
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Affiliation(s)
- Céline Piscicelli
- Department of NeuroRehabilitation, Grenoble-Alpes University Hospital, Grenoble, France.,Lab Cognitive Neurosciences CNRS-UMR5105 (LPNC), University Grenoble-Alpes, Grenoble, France
| | - Anna Castrioto
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Marie Jaeger
- Department of NeuroRehabilitation, Grenoble-Alpes University Hospital, Grenoble, France
| | - Valerie Fraix
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Stephan Chabardes
- Department of Neurosurgery, Grenoble-Alpes University Hospital, Grenoble, France
| | - Elena Moro
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Paul Krack
- Movement Disorders Center, Department of Neurology, University Hospital (Inselspital) and University of Bern, Bern, Switzerland
| | - Bettina Debû
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Dominic Pérennou
- Department of NeuroRehabilitation, Grenoble-Alpes University Hospital, Grenoble, France.,Lab Cognitive Neurosciences CNRS-UMR5105 (LPNC), University Grenoble-Alpes, Grenoble, France
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Sasaki S, Nagano Y, Ichikawa H. Loading differences in single-leg landing in the forehand- and backhand-side courts after an overhead stroke in badminton: A novel tri-axial accelerometer research. J Sports Sci 2018; 36:2794-2801. [PMID: 29745786 DOI: 10.1080/02640414.2018.1474535] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Anterior cruciate ligament (ACL) injuries in badminton commonly occur during single-leg landing after an overhead stroke in the backhand-side court. This study compared differences in trunk acceleration and kinematic variables during single-leg landing in the forehand- and backhand-side courts after an overhead stroke. Eighteen female junior badminton players performed two singles games while wearing a tri-axial accelerometer. The moment that over 4g of resultant acceleration was generated was determined using synchronised video cameras. Trunk lateral inclination and hip abduction angles at the point of landing with over 4g of resultant acceleration were analysed. Mediolateral acceleration in the backhand-side court was greater than that in the opposite-side court (p < 0.001, ES = 0.840). Both trunk lateral angles were larger than those previously reported in injured participants and the hip abduction angle in the backhand-side court was larger than that in the forehand-side court (p < 0.001, ES = 2.357). The lateral and vertical acceleration in the backhand-side court showed moderate-to-strong correlations with the trunk and hip angles. The mediolateral physical demand and high-risk posture in the backhand-side court may be associated with a higher incidence of knee injuries during badminton games.
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Affiliation(s)
- Shogo Sasaki
- a Faculty of Health Sciences , Tokyo Ariake University of Medical and Health Sciences , Tokyo , Japan
| | - Yasuharu Nagano
- b Department of Sports Wellness Sciences , Japan Women's College of Physical Education , Tokyo , Japan
| | - Hiroshi Ichikawa
- c Department of Health and Sports , Niigata University of Health and Welfare , Niigata , Japan
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Jaeger M, Admirat A, Marquer A, Chrispin A, Davoine P, Piscicelli C, Pérennou D. A clinimetric study of lateroplusion measure by Verticam for patients recovering from a stroke. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jaeger M, Admirat A, Marquer A, Chrispin A, Davoine P, Piscicelli C, Pérennou D. Étude clinimétrique de la mesure de latéropulsion post-AVC par Verticam. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chen CH, Chang H, Yang LY, Liu HC, Tsung TT, Hung TT. A preliminary report of a disposable electrical non-fiberoptic endoscope in thoracoscopic surgery. Int J Surg 2011; 10:20-4. [PMID: 22155380 DOI: 10.1016/j.ijsu.2011.11.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 11/21/2011] [Accepted: 11/23/2011] [Indexed: 11/27/2022]
Abstract
PURPOSE Conventional thoracoscopic surgery requires a camera connected to optic fibers and rigid rod lens to ensure the provision of adequate light and quality of real-time images in the operative field. However, the camera, the connected optic fibers and rigid rod lens are not disposable due to cost, which is a concern as regards potential contamination of patients. To decrease such contamination, we designed a disposable device of extremely low cost which we tested in thoracoscopic surgery in animals. DESCRIPTION A complementary metal-oxide-semiconductor is used for obtaining real-time image at a refresh rate of 30 frames per second. A circumferential light was added by a light emitting diode. We connected wires to a universal serial bus adapter, with which the device can negotiate with a computer so as to control signal retrieval and adjustment of the light as well as focus. The device was designed to be as compact as possible. The contour resembled a conventional thoracoscope, but with no optic fibers and rigid rod lens included. EVALUATION We used the devices to perform routine thoracoscopic surgical procedures, including wedge resection of the lung, lobectomy, esophagectomy, pericardiotomy and pleural biopsy in two 40-kg pigs under general anesthesia. The operating techniques were not altered while using this device. CONCLUSION This disposable, electrical non-fiberoptic endoscope has the potential to be easily and safely used in routine thoracoscopic surgery at a minimal cost. Further clinical evaluation will be required to demonstrate the utility in human patients.
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Affiliation(s)
- Chih-Hao Chen
- Department of Thoracic Surgery, Mackay Memorial Hospital, Taipei City, Taiwan.
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Grunt S, van Kampen PJ, van der Krogt MM, Brehm MA, Doorenbosch CAM, Becher JG. Reproducibility and validity of video screen measurements of gait in children with spastic cerebral palsy. Gait Posture 2010; 31:489-94. [PMID: 20304653 DOI: 10.1016/j.gaitpost.2010.02.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Revised: 02/04/2010] [Accepted: 02/14/2010] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine the reproducibility and validity of video screen measurement (VSM) of sagittal plane joint angles during gait. METHODS 17 children with spastic cerebral palsy walked on a 10m walkway. Videos were recorded and 3d-instrumented gait analysis was performed. Two investigators measured six sagittal joint/segment angles (shank, ankle, knee, hip, pelvis, and trunk) using a custom-made software package. The intra- and interrater reproducibility were expressed by the intraclass correlation coefficient (ICC), standard error of measurements (SEM) and smallest detectable difference (SDD). The agreement between VSM and 3d joint angles was illustrated by Bland-Altman plots and limits of agreement (LoA). RESULTS Regarding the intrarater reproducibility of VSM, the ICC ranged from 0.99 (shank) to 0.58 (trunk), the SEM from 0.81 degrees (shank) to 5.97 degrees (trunk) and the SDD from 1.80 degrees (shank) to 16.55 degrees (trunk). Regarding the interrater reproducibility, the ICC ranged from 0.99 (shank) to 0.48 (trunk), the SEM from 0.70 degrees (shank) to 6.78 degrees (trunk) and the SDD from 1.95 degrees (shank) to 18.8 degrees (trunk). The LoA between VSM and 3d data ranged from 0.4+/-13.4 degrees (knee extension stance) to 12.0+/-14.6 degrees (ankle dorsiflexion swing). CONCLUSION When performed by the same observer, VSM mostly allows the detection of relevant changes after an intervention. However, VSM angles differ from 3d-IGA and do not reflect the real sagittal joint position, probably due to the additional movements in the other planes.
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Affiliation(s)
- Sebastian Grunt
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The
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Babyar SR, Peterson MGE, Bohannon R, Pérennou D, Reding M. Clinical examination tools for lateropulsion or pusher syndrome following stroke: a systematic review of the literature. Clin Rehabil 2009; 23:639-50. [DOI: 10.1177/0269215509104172] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To examine the clinimetric properties and clinical applicability of published tools for `quantifying' the degree of lateropulsion or pusher syndrome following stroke. Data sources: Search through electronic databases (MEDLINE, EMBASE, CINAHL, Science Citation Index) with the terms lateropulsion, pushing, pusher syndrome, validity, reliability, internal consistency, responsiveness, sensitivity, specificity, posture and stroke. Databases were searched from their inception to October 2008. Review methods: Abstracts were selected by one author. A panel of experts then determined which should be included in this review. Five abstracts were reviewed and the panel agreed to omit one abstract because those authors did not write a full manuscript. The panel critiqued manuscripts according to predetermined criteria about clinical and clinimetric properties. Results: Four manuscripts referencing three tools for examining lateropulsion were found. Validity and reliability data support the clinical use of the Scale for Contraversive Pushing, the Modified Scale for Contraversive Pushing and the Burke Lateropulsion Scale. The Scale for Contraversive Pushing has the most extensive testing of clinimetric properties. The other tools show promising preliminary evidence of clinical and research utility. More testing is needed with larger, more diverse samples. Reviewers' conclusions: The Scale for Contraversive Pushing, the Modified Scale for Contraversive Pushing and the Burke Lateropulsion Scale are reliable and valid measures with good clinical applicability. Larger, more varied samples should be used to better delineate responsiveness and other clinimetric properties of these examination tools.
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Affiliation(s)
- Suzanne R Babyar
- Physical Therapy Program, Hunter College and Graduate Center of the City University of New York and Burke Rehabilitation Hospital, White Plains,
| | | | - Richard Bohannon
- Department of Physical Therapy, Naeg School of Education, University of Connecticut, Storrs, USA
| | - Dominic Pérennou
- Hôpital Nord - CHU, Clinique de Médecine Physique et Réadapatation, Pôle Réeducation et Physiologie, Université Grenoble, Grenoble, France
| | - Michael Reding
- Neurology Department, Stroke Unit, Burke Rehabilitation Hospital, White Plains, New York, USA
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Pérennou DA, Mazibrada G, Chauvineau V, Greenwood R, Rothwell J, Gresty MA, Bronstein AM. Lateropulsion, pushing and verticality perception in hemisphere stroke: a causal relationship? Brain 2008; 131:2401-13. [PMID: 18678565 DOI: 10.1093/brain/awn170] [Citation(s) in RCA: 235] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- D A Pérennou
- Clinique de Médecine Physique et Réadaptation, Hôpital Nord-CHU Grenoble, Université Grenoble 1 degrees, Unité de Rééducation Neurologique du Grau du Roi, CHU Nîmes, France.
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