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Wodu CO, Sweeney G, Slachetka M, Kerr A. Stroke Survivors' Interaction With Hand Rehabilitation Devices: Observational Study. JMIR BIOMEDICAL ENGINEERING 2024; 9:e54159. [PMID: 38922668 DOI: 10.2196/54159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 04/10/2024] [Accepted: 06/01/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND The hand is crucial for carrying out activities of daily living as well as social interaction. Functional use of the upper limb is affected in up to 55% to 75% of stroke survivors 3 to 6 months after stroke. Rehabilitation can help restore function, and several rehabilitation devices have been designed to improve hand function. However, access to these devices is compromised in people with more severe loss of function. OBJECTIVE In this study, we aimed to observe stroke survivors with poor hand function interacting with a range of commonly used hand rehabilitation devices. METHODS Participants were engaged in an 8-week rehabilitation intervention at a technology-enriched rehabilitation gym. The participants spent 50-60 minutes of the 2-hour session in the upper limb section at least twice a week. Each participant communicated their rehabilitation goals, and an Action Research Arm Test (ARAT) was used to measure and categorize hand function as poor (scores of 0-9), moderate (scores of 10-56), or good (score of 57). Participants were observed during their interactions with 3 hand-based rehabilitation devices that focused on hand rehabilitation: the GripAble, NeuroBall, and Semi-Circular Peg Board. Observations of device interactions were recorded for each session. RESULTS A total of 29 participants were included in this study, of whom 10 (34%) had poor hand function, 17 (59%) had moderate hand function, and 2 (7%) had good hand function. There were no differences in the age and years after stroke among participants with poor hand function and those with moderate (P=.06 and P=.09, respectively) and good (P=.37 and P=.99, respectively) hand function. Regarding the ability of the 10 participants with poor hand function to interact with the 3 hand-based rehabilitation devices, 2 (20%) participants with an ARAT score greater than 0 were able to interact with the devices, whereas the other 8 (80%) who had an ARAT score of 0 could not. Their inability to interact with these devices was clinically examined, and the reason was determined to be a result of either the presence of (1) muscle tone or stiffness or (2) muscle weakness. CONCLUSIONS Not all stroke survivors with impairments in their hands can make use of currently available rehabilitation technologies. Those with an ARAT score of 0 cannot actively interact with hand rehabilitation devices, as they cannot carry out the hand movement necessary for such interaction. The design of devices for hand rehabilitation should consider the accessibility needs of those with poor hand function.
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Affiliation(s)
- Chioma Obinuchi Wodu
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, United Kingdom
- Department of Biomedical Technology, University of Port Harcourt, Port Harcourt, Nigeria
| | - Gillian Sweeney
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, United Kingdom
| | - Milena Slachetka
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, United Kingdom
| | - Andrew Kerr
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, United Kingdom
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Pfledderer CD, von Klinggraeff L, Burkart S, da Silva Bandeira A, Lubans DR, Jago R, Okely AD, van Sluijs EMF, Ioannidis JPA, Thrasher JF, Li X, Beets MW. Consolidated guidance for behavioral intervention pilot and feasibility studies. Pilot Feasibility Stud 2024; 10:57. [PMID: 38582840 PMCID: PMC10998328 DOI: 10.1186/s40814-024-01485-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/26/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND In the behavioral sciences, conducting pilot and/or feasibility studies (PFS) is a key step that provides essential information used to inform the design, conduct, and implementation of a larger-scale trial. There are more than 160 published guidelines, reporting checklists, frameworks, and recommendations related to PFS. All of these publications offer some form of guidance on PFS, but many focus on one or a few topics. This makes it difficult for researchers wanting to gain a broader understanding of all the relevant and important aspects of PFS and requires them to seek out multiple sources of information, which increases the risk of missing key considerations to incorporate into their PFS. The purpose of this study was to develop a consolidated set of considerations for the design, conduct, implementation, and reporting of PFS for interventions conducted in the behavioral sciences. METHODS To develop this consolidation, we undertook a review of the published guidance on PFS in combination with expert consensus (via a Delphi study) from the authors who wrote such guidance to inform the identified considerations. A total of 161 PFS-related guidelines, checklists, frameworks, and recommendations were identified via a review of recently published behavioral intervention PFS and backward/forward citation tracking of a well-known PFS literature (e.g., CONSORT Ext. for PFS). Authors of all 161 PFS publications were invited to complete a three-round Delphi survey, which was used to guide the creation of a consolidated list of considerations to guide the design, conduct, and reporting of PFS conducted by researchers in the behavioral sciences. RESULTS A total of 496 authors were invited to take part in the three-round Delphi survey (round 1, N = 46; round 2, N = 24; round 3, N = 22). A set of twenty considerations, broadly categorized into six themes (intervention design, study design, conduct of trial, implementation of intervention, statistical analysis, and reporting) were generated from a review of the 161 PFS-related publications as well as a synthesis of feedback from the three-round Delphi process. These 20 considerations are presented alongside a supporting narrative for each consideration as well as a crosswalk of all 161 publications aligned with each consideration for further reading. CONCLUSION We leveraged expert opinion from researchers who have published PFS-related guidelines, checklists, frameworks, and recommendations on a wide range of topics and distilled this knowledge into a valuable and universal resource for researchers conducting PFS. Researchers may use these considerations alongside the previously published literature to guide decisions about all aspects of PFS, with the hope of creating and disseminating interventions with broad public health impact.
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Affiliation(s)
- Christopher D Pfledderer
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health in Austin, Austin, TX, 78701, USA.
- Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, School of Public Health in Austin, Austin, TX, 78701, USA.
| | | | - Sarah Burkart
- Arnold School of Public Health, University of South Carolina, Columbia, SC, 29205, USA
| | | | - David R Lubans
- College of Human and Social Futures, The University of Newcastle Australia, Callaghan, NSW, 2308, Australia
| | - Russell Jago
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 1QU, UK
| | - Anthony D Okely
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | | | - John P A Ioannidis
- Department of Medicine, Stanford University, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University, Stanford, CA, USA
- Department of Statistics, Stanford University, Stanford, CA, USA
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
| | - James F Thrasher
- Arnold School of Public Health, University of South Carolina, Columbia, SC, 29205, USA
| | - Xiaoming Li
- Arnold School of Public Health, University of South Carolina, Columbia, SC, 29205, USA
| | - Michael W Beets
- Arnold School of Public Health, University of South Carolina, Columbia, SC, 29205, USA
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McCormick S, Jarvis JM, Terhorst L, Richardson A, Kaseman L, Kesbhat A, Yepuri Y, Beyene E, VonVille H, Bendixen R, Treble-Barna A. Patient-report and caregiver-report measures of rehabilitation service use following acquired brain injury: a systematic review. BMJ Open 2024; 14:e076537. [PMID: 38382949 PMCID: PMC10882343 DOI: 10.1136/bmjopen-2023-076537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVE To review patient-report/caregiver-report measures of rehabilitation service use following acquired brain injury (ABI). DATA SOURCES Medline, APA PsycINFO, Embase and CINAHL were searched on November 2021 and November 2022. Authors were contacted if measures were not included in manuscripts/appendices. STUDY SELECTION Included articles were empirical research or a research protocol, available in English and described measures of patient report/caregiver report of rehabilitation service use post-ABI via quantitative or qualitative methods. Two reviewers independently screened 5290 records using DistillerSR. Discrepancies were resolved by team adjudication. DATA EXTRACTION Data extraction was piloted with high levels of agreement (k=.94). Data were extracted by a single member with team meetings to seek guidance as needed. Data included administration characteristics (reporter, mode of administration, recall period), psychometric evidence and dimensions assessed (types of services, setting, frequency, duration, intensity, qualitative aspects). DATA SYNTHESIS One hundred and fifty-two measures were identified from 85 quantitative, 56 qualitative and 3 psychometric studies. Psychometric properties were reported for four measures, all of which focused on satisfaction. Most measures inquired about the type of rehabilitation services used, with more than half assessing functional (eg, physical therapy) and behavioural health rehabilitation services, but fewer than half assessing community and academic reintegration (eg, special education, vocational rehabilitation) or cognitive (eg, neuropsychology) services. Fewer than half assessed qualitative aspects (eg, satisfaction). Recall periods ranged from 1 month to 'since the ABI event' or focused on current use. Of measures that could be accessed (n=71), many included a limited checklist of types of services used. Very few measures assessed setting, frequency, intensity or duration. CONCLUSIONS Despite widespread interest, the vast majority of measures have not been validated and are limited in scope. Use of gold-standard psychometric methods to develop and validate a comprehensive patient-report/caregiver-report measure of rehabilitation service use would have wide-ranging implications for improving rehabilitation research in ABI.
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Affiliation(s)
- Sophie McCormick
- Department of Physical Medicine & Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jessica M Jarvis
- Department of Physical Medicine & Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lauren Terhorst
- Department of Occupational Therapy, SHRS Data Center, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Amanda Richardson
- Department of Physical Medicine & Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lauren Kaseman
- Department of Physical Medicine & Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Aboli Kesbhat
- College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA
| | - Yamini Yepuri
- Department of Physical Medicine & Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Elizabeth Beyene
- Department of Physical Medicine & Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Helena VonVille
- Health Sciences Library System, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Roxanna Bendixen
- Division of Occupational Therapy, College of Health Professions, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Amery Treble-Barna
- Department of Physical Medicine & Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Parry M, Owadally T, O’Hara A, Nickerson N, Hart D. Community- and Patient-Partner Engagement in Women's Cardiovascular Disease Research: A Rapid Review of the Evidence. CJC Open 2024; 6:485-502. [PMID: 38487065 PMCID: PMC10935688 DOI: 10.1016/j.cjco.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/13/2023] [Indexed: 03/17/2024] Open
Abstract
The primary objective of this rapid review is to describe community-partner and patient-partner engagement in women's cardiovascular disease (CVD) research. Secondary objectives are to: (i) describe the phase of the research in which community and patient partners were engaged; (ii) define the level of engagement at each research phase; and (iii) make recommendations for future engagement of community and/or patient partners in women's CVD research. Rapid review guidelines recommended by the Cochrane Rapid Reviews Methods Group and Tricco et al. were used to search 5 databases using medical subject headings (MeSH) and/or keywords. Participants included women (cis and trans) aged > 18 years who had ischemic heart disease, heart failure, or stroke. A risk of bias assessment was not undertaken. Findings are summarized and/or clustered as community-based participatory research, or patient-oriented and/or patient-partner research. Our search yielded 39,998 titles and abstracts. Of these, 35 were included in a final narrative synthesis, comprising data from 474 community and/or patient partners, including 417 (88%) women. Over 85% of community partners collaborated in the design and/or planning and implementation of women's CVD research; most originated in the US; only one originated in Canada. Most patient-oriented and patient-partner research originated in Canada. However, less than 50% of patient partners collaborated in any phase of research. Sex, gender, race, and ethnicity were rarely reported. Results suggest negligible community and inadequate patient-oriented and/or patient-partner engagement in women's CVD research in Canada. Improved CVD outcomes for women may be achieved with better community- and patient-partner collaboration across all phases of research, genders, race, and ethnicities.
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Affiliation(s)
- Monica Parry
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Tasneem Owadally
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Arland O’Hara
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | | | - Donna Hart
- Patient Partner, Milton, Ontario, Canada
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Ali AS, Kumaran DS, Unni A, Sardesai S, Prabhu V, Nirmal P, Pai AR, Guddattu V, Arumugam A. Effectiveness of an Intensive, Functional, and Gamified Rehabilitation Program on Upper Limb Function in People With Stroke (EnteRtain): A Multicenter Randomized Clinical Trial. Neurorehabil Neural Repair 2024:15459683231222921. [PMID: 38284559 DOI: 10.1177/15459683231222921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
BACKGROUND1 Despite a growing interest in gaming rehabilitation for upper limb (UL) recovery post-stroke, studies investigating the effects of game-based rehabilitation incorporating functional games are lacking. OBJECTIVE To investigate the efficacy of an intensive, functional, gamified rehabilitation program compared to task-based training on UL motor function in acute/sub-acute stroke survivors. METHODS This randomized, multicenter, single-blind, clinical trial comprises 120 participants with unilateral stroke who were randomized to receive either gamified training (n = 64) using the ArmAble™ [experimental group (EG)] or task-based training (n = 56) in conjunction with conventional therapy for 2 hours per day, 6 days per week for 2 weeks, followed by UL rehabilitation for another 4 weeks at home. Primary outcomes evaluated by a blinded assessor included the Fugl-Meyer Assessment-Upper Extremity (FM-UE), and Action Research Arm Test (ARAT). Data were analyzed using a linear mixed-effect regression model. RESULTS The mean (standard deviation) age of the participants was 54.4 ± 11.7 years (78.1% men) in the EG and 57.7 ± 10.9 years (73.2% men) in the comparator group (CG). The median (interquartile range) time since stroke was 30.0 (54.0) days in the EG and 22.5 (45.0) days in the CG. Following the 2-week intervention, a statistically significant improvement was observed in the EG for the FM-UE [between-group mean differences (95% confidence interval): -3.9 (-6.5, -1.3); P = .003]; but not for the ARAT [-2.9 (-5.8, 0.0); P = .051]. Gains at 6 weeks were significantly greater in the EG for both FM-UE [-3.9 (-6.5, -1.3); P = .003]; and ARAT [-3.0 (-5.9, -0.0); P = .046]. CONCLUSION Gamified rehabilitation using the ArmAble™ device has shown immediate and short-term improvement in UL function after acute/sub-acute stroke. CLINICAL TRIALS REGISTRY NUMBER CTRI/2020/09/027651.
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Affiliation(s)
- A Sulfikar Ali
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - D Senthil Kumaran
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Amritha Unni
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sanjukta Sardesai
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vasudeva Prabhu
- Department of Physiotherapy, SDM Ayurveda Hospital, Udupi, Karnataka, India
| | - Punitha Nirmal
- Department of Physiotherapy, Poovanthi Institute of Rehabilitation and Elder care, Poovanthi, Tamil Nadu, India
| | - Aparna R Pai
- Department of Neurology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vasudeva Guddattu
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ashokan Arumugam
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, UAE
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS-Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, UAE
- Sustainable Engineering Asset Management Research Group, RISE-Research Institute of Sciences and Engineering, University of Sharjah, Sharjah, UAE
- Adjunct Faculty, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Kilbride C, Butcher T, Warland A, Ryan J, Scott DJM, Cassidy E, Athanasiou DA, Singla-Buxarrais G, Baker K, Norris M. Rehabilitation via HOMe-Based gaming exercise for the Upper limb post Stroke (RHOMBUS): a qualitative analysis of participants' experience. BMJ Open 2024; 14:e075821. [PMID: 38245009 PMCID: PMC10806457 DOI: 10.1136/bmjopen-2023-075821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 11/08/2023] [Indexed: 01/22/2024] Open
Abstract
OBJECTIVE To report participants' experiences of trial processes and use of the Neurofenix platform for home-based rehabilitation following stroke. The platform, consisting of the NeuroBall device and Neurofenix app, is a non-immersive virtual reality tool to facilitate upper limb rehabilitation following stroke. The platform has recently been evaluated and demonstrated to be safe and effective through a non-randomised feasibility trial (RHOMBUS). DESIGN Qualitative approach using semistructured interviews. Interviews were audio recorded, transcribed verbatim and analysed using the framework method. SETTING Participants' homes, South-East England. PARTICIPANTS Purposeful sample of 18 adults (≥18 years), minimum 12 weeks following stroke, not receiving upper limb rehabilitation prior to the RHOMBUS trial, scoring 9-25 on the Motricity Index (elbow and shoulder), with sufficient cognitive and communicative abilities to participate. RESULTS Five themes were developed which explored both trial processes and experiences of using the platform. Factors that influenced participant's decision to take part in the trial, their perceptions of support provided during the trial and communication with the research team were found to be important contextual factors effecting participants' overall experience. Specific themes around usability and comfort of the NeuroBall device, factors motivating persistence and perceived effectiveness of the intervention were highlighted as being central to the usability and acceptability of the platform. CONCLUSION This study demonstrated the overall acceptability of the platform and identified areas for enhancement which have since been implemented by Neurofenix. The findings add to the developing literature on the interface between virtual reality systems and user experience. TRIAL REGISTRATION NUMBER ISRCTN60291412.
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Affiliation(s)
- Cherry Kilbride
- Department of Health Sciences, Brunel University London, Uxbridge, UK
| | - Tom Butcher
- Department of Health Sciences, Brunel University London, Uxbridge, UK
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Alyson Warland
- Department of Health Sciences, Brunel University London, Uxbridge, UK
| | - Jennifer Ryan
- Department of Health Sciences, Brunel University London, Uxbridge, UK
- Public Health and Epidemiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Daniel J M Scott
- Department of Health Sciences, Brunel University London, Uxbridge, UK
- Neurofenix, London, UK
| | | | | | | | - Karen Baker
- Department of Health Sciences, Brunel University London, Uxbridge, UK
- Neurofenix, London, UK
| | - Meriel Norris
- Department of Health Sciences, Brunel University London, Uxbridge, UK
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Pfledderer CD, von Klinggraeff L, Burkart S, da Silva Bandeira A, Lubans DR, Jago R, Okely AD, van Sluijs EM, Ioannidis JP, Thrasher JF, Li X, Beets MW. Expert Perspectives on Pilot and Feasibility Studies: A Delphi Study and Consolidation of Considerations for Behavioral Interventions. RESEARCH SQUARE 2023:rs.3.rs-3370077. [PMID: 38168263 PMCID: PMC10760234 DOI: 10.21203/rs.3.rs-3370077/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Background In the behavioral sciences, conducting pilot and/or feasibility studies (PFS) is a key step that provides essential information used to inform the design, conduct, and implementation of a larger-scale trial. There are more than 160 published guidelines, reporting checklists, frameworks, and recommendations related to PFS. All of these publications offer some form of guidance on PFS, but many focus on one or a few topics. This makes it difficult for researchers wanting to gain a broader understanding of all the relevant and important aspects of PFS and requires them to seek out multiple sources of information, which increases the risk of missing key considerations to incorporate into their PFS. The purpose of this study was to develop a consolidated set of considerations for the design, conduct, implementation, and reporting of PFS for interventions conducted in the behavioral sciences. Methods To develop this consolidation, we undertook a review of the published guidance on PFS in combination with expert consensus (via a Delphi study) from the authors who wrote such guidance to inform the identified considerations. A total of 161 PFS-related guidelines, checklists, frameworks, and recommendations were identified via a review of recently published behavioral intervention PFS and backward/forward citation tracking of well-know PFS literature (e.g., CONSORT Ext. for PFS). Authors of all 161 PFS publications were invited to complete a three-round Delphi survey, which was used to guide the creation of a consolidated list of considerations to guide the design, conduct, and reporting of PFS conducted by researchers in the behavioral sciences. Results A total of 496 authors were invited to take part in the Delphi survey, 50 (10.1%) of which completed all three rounds, representing 60 (37.3%) of the 161 identified PFS-related guidelines, checklists, frameworks, and recommendations. A set of twenty considerations, broadly categorized into six themes (Intervention Design, Study Design, Conduct of Trial, Implementation of Intervention, Statistical Analysis and Reporting) were generated from a review of the 161 PFS-related publications as well as a synthesis of feedback from the three-round Delphi process. These 20 considerations are presented alongside a supporting narrative for each consideration as well as a crosswalk of all 161 publications aligned with each consideration for further reading. Conclusion We leveraged expert opinion from researchers who have published PFS-related guidelines, checklists, frameworks, and recommendations on a wide range of topics and distilled this knowledge into a valuable and universal resource for researchers conducting PFS. Researchers may use these considerations alongside the previously published literature to guide decisions about all aspects of PFS, with the hope of creating and disseminating interventions with broad public health impact.
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Affiliation(s)
| | | | - Sarah Burkart
- University of South Carolina Arnold School of Public Health
| | | | | | - Russ Jago
- University of Bristol Population Health Sciences
| | | | | | | | | | - Xiaoming Li
- University of South Carolina Arnold School of Public Health
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Vibhuti, Kumar N, Kataria C. Efficacy assessment of virtual reality therapy for neuromotor rehabilitation in home environment: a systematic review. Disabil Rehabil Assist Technol 2023; 18:1200-1220. [PMID: 34761705 DOI: 10.1080/17483107.2021.1998674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/16/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Neuromotor impairments can affect any part of the body. It leads to many disorders, injuries, or disabilities, conventional rehabilitation is a long, rigorous, and tedious process. There is a need to inculcate new and innovative techniques in rehabilitation processes, to increase individuals' interest and overall performance with such therapies. Virtual Reality is considered a new technology that has the potential to be a useful aid in overcoming therapeutic problems in clinical and home-based environments. However, providing home-based rehabilitation is more practicable, cost-effective, and even safer than in-hospital rehabilitation. In addition, the need for home-based rehabilitation is growing as the number of neuromotor disorders rises and the capacity of acute inpatient rehabilitation decreases. Therefore, the main objective of this study was to assess the efficacy of a home-based Virtual Reality exercise treatment to identify the areas for future rehabilitation research. MATERIALS AND METHODS Data Extraction of 24,257 articles from seven databases were identified and the review is narrowed down and only 45 studies were focussed on efficacy assessment of Virtual Reality in the home environment. RESULTS The significant outcome of the effective home-based therapy system for the exercise improved functional ability, increasing range of motion, and motivation through Virtual reality-based rehabilitation is inferred. CONCLUSION Unlike clinical settings, a home-based system provides efficacious therapy with a controlled environment. This survey facilitates bettering methods and devices for neuromotor disorders. It is a good living long-term problem-solving approach and investigates awareness, needs, and a preferred component of home-based rehabilitation services.IMPLICATIONS FOR REHABILITATIONVR-based rehabilitation in the home environment has many physical and mental benefits in persons with neuromotor disorders.The most commonly neuromotor disorders considered in the study were Stroke, Spinal Cord Injury, Parkinson's disease, and Cerebral Palsy.Assistive technologies in home environments can compensate for long-term disorders or be used in rehabilitation as an addition to conventional therapy.The study gives an overview of current interventions and how they can be of benefit for a person suffering from neuromotor disorders in the home environment.
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Affiliation(s)
- Vibhuti
- Academy of Scientific and Innovative Research, Ghaziabad, India
- Biomedical Applications, CSIR-Central Scientific Instruments Organisation, Chandigarh, India
| | - Neelesh Kumar
- Academy of Scientific and Innovative Research, Ghaziabad, India
- Biomedical Applications, CSIR-Central Scientific Instruments Organisation, Chandigarh, India
| | - Chitra Kataria
- Department of Rehabilitation Services, Indian Spinal Injuries Center, New Delhi, India
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Banduni O, Saini M, Singh N, Nath D, Kumaran SS, Kumar N, Srivastava MVP, Mehndiratta A. Post-Stroke Rehabilitation of Distal Upper Limb with New Perspective Technologies: Virtual Reality and Repetitive Transcranial Magnetic Stimulation-A Mini Review. J Clin Med 2023; 12:jcm12082944. [PMID: 37109280 PMCID: PMC10142518 DOI: 10.3390/jcm12082944] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/12/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Upper extremity motor impairment is the most common sequelae in patients with stroke. Moreover, its continual nature limits the optimal functioning of patients in the activities of daily living. Because of the intrinsic limitations in the conventional form of rehabilitation, the rehabilitation applications have been expanded to technology-driven solutions, such as Virtual Reality and Repetitive Transcranial Magnetic Stimulation (rTMS). The motor relearning processes are influenced by variables, such as task specificity, motivation, and feedback provision, and a VR environment in the form of interactive games could provide novel and motivating customized training solutions for better post-stroke upper limb motor improvement. rTMS being a precise non-invasive brain stimulation method with good control of stimulation parameters, has the potential to facilitate neuroplasticity and hence a good recovery. Although several studies have discussed these forms of approaches and their underlying mechanisms, only a few of them have specifically summarized the synergistic applications of these paradigms. To bridge the gaps, this mini review presents recent research and focuses precisely on the applications of VR and rTMS in distal upper limb rehabilitation. It is anticipated that this article will provide a better representation of the role of VR and rTMS in distal joint upper limb rehabilitation in patients with stroke.
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Affiliation(s)
- Onika Banduni
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi (IITD), New Delhi 110016, India
| | - Megha Saini
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi (IITD), New Delhi 110016, India
| | - Neha Singh
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi (IITD), New Delhi 110016, India
| | - Debasish Nath
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi (IITD), New Delhi 110016, India
| | - S Senthil Kumaran
- Department of Nuclear Medicine and Resonance, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - Nand Kumar
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - M V Padma Srivastava
- Department of Neurology, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - Amit Mehndiratta
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi (IITD), New Delhi 110016, India
- Department of Biomedical Engineering, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
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Fernández-González D, Rodriguez-Costa I, Sanz-Esteban I, Estrada-Barranco C. Therapeutic intervention with virtual reality in patients with Parkinson's disease for upper limb motor training: A systematic review. Rehabilitacion (Madr) 2023; 57:100751. [PMID: 36344299 DOI: 10.1016/j.rh.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/05/2022] [Accepted: 06/06/2022] [Indexed: 11/06/2022]
Abstract
To analyze the scientific evidence regarding changes in upper extremities in patients with Parkinson's disease who use virtual reality as part of their neurological rehabilitation treatment. The search was carried out in the following databases: MEDLINE, Cochrane Library, PEDROs and SCOPUS. The following inclusion criteria were applied to a total of 106 articles: Randomized clinical trials with an age of 5 years, the sample had to be of patients with PD (regardless of their state of involvement) and who had performed RV in the treatment of limbs superiors. A total of n=7 articles were used, in which the variables corresponding to upper limb motor control were measured, such as: fine motor dexterity, gross motor dexterity, strength, tremor, functionality and speed. Virtual Reality as tool in neurorehabilitation in patients with Parkinson's disease shows positive effects in all measurements related to upper limb motor control.
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Affiliation(s)
| | - I Rodriguez-Costa
- Humanization in the Intervention of Physiotherapy for the Integral Attention to the People (HIPATIA) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - I Sanz-Esteban
- Universidad Europea de Madrid, Faculty of Sport Sciences, Department of Physiotherapy, Villaviciosa de Odón, Madrid, Spain
| | - C Estrada-Barranco
- Universidad Europea de Madrid, Faculty of Sport Sciences, Department of Physiotherapy, Villaviciosa de Odón, Madrid, Spain.
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Kilbride C, Warland A, Stewart V, Aweid B, Samiyappan A, Ryan J, Butcher T, Athanasiou DA, Baker K, Singla-Buxarrais G, Anokye N, Pound C, Gowing F, Norris M. Rehabilitation using virtual gaming for Hospital and hOMe-Based training for the Upper limb post Stroke (RHOMBUS II): protocol of a feasibility randomised controlled trial. BMJ Open 2022; 12:e058905. [PMID: 35672074 PMCID: PMC9174817 DOI: 10.1136/bmjopen-2021-058905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Upper limb (UL) rehabilitation is most effective early after stroke, with higher doses leading to improved outcomes. For the stroke survivor, the repetition may be monotonous. For clinicians, providing a clinically meaningful level of input can be challenging. As such, time spent engaged in UL activity among subacute stroke survivors remains inadequate. Opportunities for the stroke survivor to engage with UL rehabilitation in a safe, accessible and engaging way are essential to improving UL outcomes following stroke. The NeuroBall is a non-immersive virtual reality (VR) digital system designed for stroke rehabilitation, specifically for the arm and hand. The aim of the Rehabilitation using virtual gaming for Hospital and hOMe-Based training for the Upper limb post Stroke study is to determine the safety, feasibility and acceptability of the NeuroBall as a rehabilitation intervention for the UL in subacute stroke. METHODS AND ANALYSIS A feasibility randomised controlled trial (RCT) will compare the NeuroBall plus usual care with usual care only, in supporting UL rehabilitation over 7 weeks. Twenty-four participants in the subacute poststroke phase will be recruited while on the inpatient or early supported discharge (ESD) stroke pathway. Sixteen participants will be randomised to the intervention group and eight to the control group. Outcomes assessed at baseline and 7 weeks include gross level of disability, arm function, spasticity, pain, fatigue and quality of life (QoL). Safety will be assessed by recording adverse events and using pain, spasticity and fatigue scores. A parallel process evaluation will assess feasibility and acceptability of the intervention. Feasibility will also be determined by assessing fidelity to the intervention. Postintervention, semistructured interviews will be used to explore acceptability with 12 participants from the intervention group, four from the usual care group and with up to nine staff involved in delivering the intervention. ETHICS AND DISSEMINATION This trial has ethical approval from Brunel University London's Research Ethics Committee 25257-NHS-Oct/2020-28121-2 and the Wales Research Ethics Committee 5 Bangor (Health and Care Research Wales) REC ref: 20/WA/0347. The study is sponsored by Brunel University London. CONTACT Dr Derek Healy, Chair, University Research Ethics committee (Derek.healy@brunel.ac.uk). Trial results will be submitted for publication in peer-reviewed journals, presented at national and international conferences and distributed to people with stroke. TRIAL REGISTRATION NUMBER ISRCTN11440079; Pre-results.
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Affiliation(s)
- Cherry Kilbride
- College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, Middlesex, UK
| | - Alyson Warland
- College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, Middlesex, UK
| | | | - Basaam Aweid
- Stroke Unit, Hillingdon Hospitals NHS Foundation Trust, Uxbridge, Middlesex, UK
- Early Supported Discharge (Stroke), Central and North West London NHS Foundation Trust, London, UK
| | - Arul Samiyappan
- Adult Services, Central and North West London NHS Foundation Trust, London, UK
| | - Jennifer Ryan
- College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, Middlesex, UK
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Tom Butcher
- College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, Middlesex, UK
| | | | | | | | - Nana Anokye
- College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, Middlesex, UK
| | - Carole Pound
- Faculty of Health and Social Sciences, Bournemouth University, Poole, Dorset, UK
| | - Francesca Gowing
- College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, Middlesex, UK
| | - Meriel Norris
- College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, Middlesex, UK
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12
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Kilbride C, Scott DJM, Butcher T, Norris M, Warland A, Anokye N, Cassidy E, Baker K, Athanasiou DA, Singla-Buxarrais G, Nowicky A, Ryan J. Safety, feasibility, acceptability and preliminary effects of the Neurofenix platform for Rehabilitation via HOMe Based gaming exercise for the Upper-limb post Stroke (RHOMBUS): results of a feasibility intervention study. BMJ Open 2022; 12:e052555. [PMID: 35228279 PMCID: PMC8886425 DOI: 10.1136/bmjopen-2021-052555] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To investigate the safety, feasibility and acceptability of the Neurofenix platform for home-based rehabilitation of the upper limb (UL). DESIGN A non-randomised intervention design with a parallel process evaluation. SETTING Participants' homes, South-East England. PARTICIPANTS Thirty adults (≥18 years), minimum 12-week poststroke, not receiving UL rehabilitation, scoring 9-25 on the Motricity Index (elbow and shoulder), with sufficient cognitive and communicative abilities to participate. INTERVENTIONS Participants were trained to use the platform, followed by 1 week of graded game-play exposure and 6-week training, aiming for a minimum 45 min, 5 days/week. OUTCOMES Safety was determined by assessing pain and poststroke fatigue at 8 and 12 weeks, and adverse events (AEs). Impairment, activity and participation outcomes were measured. Intervention feasibility was determined by the amount of specialist training and support required to complete the intervention, time and days spent training, and number of UL movements performed. Acceptability was assessed by a satisfaction questionnaire and semistructured interviews. RESULTS Participants (14 women; mean (SD) age 60.0 (11.3) years) were a median of 4.9 years poststroke (minimum-maximum: 1-28 years). Twenty-seven participants completed the intervention. The odds of having shoulder pain were lower at 8 weeks (OR 0.45, 95% CI 0.24 to 0.83, p=0.010) and 12 weeks (OR 0.46, 95% CI 0.25 to 0.86, p=0.014) compared with baseline. Fugl-Meyer upper extremity, Motor Activity Log and passive range of movement improved. No other gains were recorded. Poststroke fatigue did not change. Thirty mild and short-term AEs and one serious (unrelated) AE were reported by 19 participants. Participants trained with the platform for a median of 17.4 hours over 7 weeks (minimum-maximum: 0.3-46.9 hours), equating to a median of 149 min per week. The median satisfaction score was 36 out of 40. CONCLUSION The Neurofenix platform is a safe, feasible and well accepted way to support UL training for people at least three months poststroke. TRIAL REGISTRATION NUMBER ISRCTN60291412.
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Affiliation(s)
- Cherry Kilbride
- Department of Health Sciences, Brunel University London, London, UK
| | - Daniel J M Scott
- Department of Health Sciences, Brunel University London, London, UK
- Neurofenix, London, UK
| | - Tom Butcher
- Department of Health Sciences, Brunel University London, London, UK
| | - Meriel Norris
- Department of Health Sciences, Brunel University London, London, UK
| | - Alyson Warland
- Department of Health Sciences, Brunel University London, London, UK
| | - Nana Anokye
- Department of Health Sciences, Brunel University London, London, UK
| | | | - Karen Baker
- Department of Health Sciences, Brunel University London, London, UK
- Neurofenix, London, UK
| | | | | | | | - Jennifer Ryan
- Department of Health Sciences, Brunel University London, London, UK
- Public Health and Epidemiology, Royal College of Surgeons, Dublin, Ireland
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13
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Scott H, Griffin C, Coggins W, Elberson B, Abdeldayem M, Virmani T, Larson-Prior LJ, Petersen E. Virtual Reality in the Neurosciences: Current Practice and Future Directions. Front Surg 2022; 8:807195. [PMID: 35252318 PMCID: PMC8894248 DOI: 10.3389/fsurg.2021.807195] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/30/2021] [Indexed: 01/05/2023] Open
Abstract
Virtual reality has made numerous advancements in recent years and is used with increasing frequency for education, diversion, and distraction. Beginning several years ago as a device that produced an image with only a few pixels, virtual reality is now able to generate detailed, three-dimensional, and interactive images. Furthermore, these images can be used to provide quantitative data when acting as a simulator or a rehabilitation device. In this article, we aim to draw attention to these areas, as well as highlight the current settings in which virtual reality (VR) is being actively studied and implemented within the field of neurosurgery and the neurosciences. Additionally, we discuss the current limitations of the applications of virtual reality within various settings. This article includes areas in which virtual reality has been used in applications both inside and outside of the operating room, such as pain control, patient education and counseling, and rehabilitation. Virtual reality's utility in neurosurgery and the neurosciences is widely growing, and its use is quickly becoming an integral part of patient care, surgical training, operative planning, navigation, and rehabilitation.
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Affiliation(s)
- Hayden Scott
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- *Correspondence: Hayden Scott
| | - Connor Griffin
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - William Coggins
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Brooke Elberson
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Mohamed Abdeldayem
- Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Tuhin Virmani
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Linda J. Larson-Prior
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Erika Petersen
- Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
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Funao H, Tsujikawa M, Momosaki R, Shimaoka M. Virtual reality applied to home-visit rehabilitation for hemiplegic shoulder pain in a stroke patient: a case report. J Rural Med 2021; 16:174-178. [PMID: 34239631 PMCID: PMC8249364 DOI: 10.2185/jrm.2021-003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/09/2021] [Indexed: 11/27/2022] Open
Abstract
Objectives: Virtual reality (VR) has been shown to facilitate rehabilitation
at hospitals by distracting patients’ attention from pain and by providing a virtual
environment favorable for motivating the patients to continue rehabilitation. However, the
application of VR in a home-visit rehabilitation remains to be validated. Here, we report
a case in which home-visit rehabilitation using immersive VR was effective for post-stroke
hemiplegic shoulder pain. Case presentation: After treatment, at a general hospital, for the
hypertensive hemorrhage in the right brain capsule that resulted in the residual attention
deficit disorder and left hemiplegia, a 63-year-old woman was cared for with a home-visit
rehabilitation in a rural area. The patient had persistent pain in her left shoulder,
which increased during activities of daily living and during rehabilitation, and the pain
precluded rehabilitation. A VR relaxation program was delivered to the patient to
alleviate pain during rehabilitation. Her shoulder pain was successfully alleviated using
VR during training for muscle stretching and passive joint mobilization. Conclusion: The application of VR to home rehabilitation in rural areas may
augment the effectiveness of home rehabilitation by alleviating pain during the procedure
and sustaining the motivation for home rehabilitation.
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Affiliation(s)
- Hiroki Funao
- Course of Nursing Science, Graduate School of Medicine, Mie University, Japan
| | - Mayumi Tsujikawa
- Course of Nursing Science, Graduate School of Medicine, Mie University, Japan
| | - Ryo Momosaki
- Department of Rehabilitation Medicine, Graduate School of Medicine, Mie University, Japan
| | - Motomu Shimaoka
- Department of Molecular Pathobiology, Graduate School of Medicine, Mie University, Japan
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Effectiveness of an intensive, functional, gamified Rehabilitation program in improving upper limb motor function in people with stroke: A protocol of the EnteRtain randomized clinical trial. Contemp Clin Trials 2021; 105:106381. [PMID: 33862286 DOI: 10.1016/j.cct.2021.106381] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Game-based rehabilitation is an emerging therapeutic intervention that allows intensive, repetitive, task-based training to improve upper limb (UL) function following stroke, based on the principles of neuro-plasticity and motor (re)learning. Rehabilitation using commercial gaming system will be motivating, enjoyable, challenging and affordable. Therefore, the present study aims at assessing the effectiveness of an intensive, functional, gamified rehabilitation program using the ArmAble™ device in improving UL motor function in people with stroke. METHOD In this single-blinded, multi-centric, randomized clinical trial, 120 adults with acute/sub-acute unilateral stroke will be randomized to receive an intensive, functional, gamified training program using the ArmAble™ or task-based training along with a conventional therapy for 2 h/day, 6 days/week for 2 weeks, followed by a home-based, functional rehabilitation program for another 4 weeks (~30 min/day, 6 days/week). Primary outcomes evaluated by a blinded assessor at the baseline, 2 weeks and 6 weeks' post-intervention will include the Fugl-Meyer assessment - upper extremity and the action research arm test. A linear mixed effect regression model or relevant non-parametric tests will be used to analyze the data for all outcomes. An intention-to-treat analysis will be used with missing data handled by multiple imputation. DISCUSSION Rehabilitation provided with the ArmAble™ device, if found effective, can be used from the early stages post-stroke to provide intensive, repetitive, gamified training to improve UL motor function. TRIAL REGISTRATION NUMBER CTRI/2020/09/027651.
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Non-Immersive Virtual Reality for Post-Stroke Upper Extremity Rehabilitation: A Small Cohort Randomized Trial. Brain Sci 2020; 10:brainsci10090655. [PMID: 32967160 PMCID: PMC7563455 DOI: 10.3390/brainsci10090655] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/17/2020] [Accepted: 09/18/2020] [Indexed: 12/11/2022] Open
Abstract
Immersive and non-immersive virtual reality (NIVR) technology can supplement and improve standard physiotherapy and neurorehabilitation in post-stroke patients. We aimed to use MIRA software to investigate the efficiency of specific NIVR therapy as a standalone intervention, versus standardized physiotherapy for upper extremity rehabilitation in patients post-stroke. Fifty-five inpatients were randomized to control groups (applying standard physiotherapy and dexterity exercises) and experimental groups (applying NIVR and dexterity exercises). The two groups were subdivided into subacute (<six months post-stroke) and chronic (>six months to four years post-stroke survival patients). The following standardized tests were applied at baseline and after two weeks post-therapy: Fugl-Meyer Assessment for Upper Extremity (FMUE), the Modified Rankin Scale (MRS), Functional Independence Measure (FIM), Active Range of Motion (AROM), Manual Muscle Testing (MMT), Modified Ashworth Scale (MAS), and Functional Reach Test (FRT). The Kruskal-Wallis test was used to determine if there were significant differences between the groups, followed with pairwise comparisons. The Wilcoxon Signed-Rank test was used to determine the significance of pre to post-therapy changes. The Wilcoxon Signed-Rank test showed significant differences in all four groups regarding MMT, FMUE, and FIM assessments pre- and post-therapy, while for AROM, only experimental groups registered significant differences. Independent Kruskal-Wallis results showed that the subacute experimental group outcomes were statistically significant regarding the assessments, especially in comparison with the control groups. The results suggest that NIVR rehabilitation is efficient to be administered to post-stroke patients, and the study design can be used for a further trial, in the perspective that NIVR therapy can be more efficient than standard physiotherapy within the first six months post-stroke.
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Chen S, Lv C, Wu J, Zhou C, Shui X, Wang Y. Effectiveness of a home-based exercise program among patients with lower limb spasticity post-stroke: A randomized controlled trial. Asian Nurs Res (Korean Soc Nurs Sci) 2020; 15:1-7. [PMID: 32890770 DOI: 10.1016/j.anr.2020.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 08/11/2020] [Accepted: 08/17/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To evaluate the effectiveness of advanced practice nurse-guided home-based rehabilitation exercise program (HREPro) among patients with lower limb spasticity post-stroke. METHODS This randomized controlled study recruited 121 patients with lower limb spasticity post-stroke. Intervention (n = 59) and control (n = 62) groups underwent 12-month HREPro and conventional rehabilitation, respectively, after discharge. The Fugl-Meyer assessment of spasticity measurement, modified Ashworth scale of motor function, 10-Meter Walk Test of walking ability, and Barthel index of activities of daily living (ADL) were evaluated at 0, 3, 6, and 12 months after discharge. RESULTS Significant differences were found in spasticity degree, motor function, walking ability, and ADL at 6 and 12 months after discharge between the control and intervention groups. Lower limb spasticity and ADL in the intervention group were significantly improved. CONCLUSION HREPro is effective for rehabilitation of patients with lower limb spasticity post-stroke and has favorable home application.
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Affiliation(s)
- Shaomin Chen
- Department of Rehabilitation, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China
| | - Chang Lv
- Department of Rehabilitation, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China
| | - Jiaozhen Wu
- Department of Orthopedics, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China
| | - Chengwei Zhou
- Department of Orthopedics, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China
| | - Xiaolong Shui
- Department of Orthopedics, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China
| | - Yi Wang
- Department of Orthopedics, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China.
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