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Moriichi K, Fujiya M, Ro T, Ota T, Nishimiya H, Kodama M, Yoshida N, Hattori Y, Hosokawa T, Hishiyama H, Kunimoto M, Hayashi H, Hirokawa H, Yoshida A. A novel telerehabilitation with an educational program for caregivers using telelecture is feasible for fall prevention in elderly people: A case series. Medicine (Baltimore) 2022; 101:e27451. [PMID: 35147084 PMCID: PMC8830826 DOI: 10.1097/md.0000000000027451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 09/07/2021] [Accepted: 09/20/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The importance of fall prevention rehabilitations has been well recognized. Recently telerehabilitation was developed, however, there have been no reports on telerehabilitation with direct support from specialists for fall prevention among the elderly. We herein reported telerehabilitation by caregivers educated by our novel educational program. METHODS Caregivers were educated with our educational program using a telelecture system and supported telerehabilitation following instructions from rehabilitation specialists in our university using the telemedicine system every two to four weeks for three months. Caregivers were assessed with our original questionnaire before and after the telelecture. Participants were assessed by the Berg Balance Scale (BBS), Timed Up & Go test (TUG test), Hand-held dynamometer (HHD) and Mini-Mental State Examination (MMSE) before and after telerehabilitation. Wilcoxon's signed-rank test was used for the statistical analyses. A value of P<.05 was considered statistically significant. RESULTS Nine elderly people were enrolled. The mean age was 84.7 (78-90) years old and the sex ratio was 1:8 (males:females). The average number of telerehabilitation sessions was 4.7. The average score of nineteen caregivers before the lecture was 15.3, while that after the lecture was 18.3. Caregivers' understanding was significantly increased after the telelecture (P<.001). No adverse events occurred during the study period. The median values of the BBSs, TUG test, right and left HHD and MMSE before and after 3 months' telerehabilitation were 43 (95% confidence interval [CI]: 40.10, 49.01) and 49 (95% CI: 41.75, 50.91), 17.89 (95% CI: 15.51, 23.66) and 18.53 (95% CI: 14.56, 25.67), 7.95 (95% CI: 4.38, 10.14) and 11.55 (95% CI: 7.06, 13.55), 9.85 (95% CI: 6.79, 12.59) and 13.20 (95% CI: 7.96, 14.42), and 19 (95% CI: 12.34, 21.66) and 16 (95% CI: 10.81, 21.00), respectively. Although approximately half of the participants showed improvement in the BBS, TUG test, right and left HHD and MMSE, no significant changes were observed (P=.7239, P=.3446, P=.1023, P=.3538 and P=.8253, respectively). CONCLUSIONS Our telerehabilitation program exhibited significant effects in elderly people and improved the degree of understanding concerning rehabilitation among caregivers in facilities for elderly people.
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Affiliation(s)
- Kentaro Moriichi
- Joint Research Department of Telemedicine and Telecare, Asahikawa Medical University, Asahikawa, Japan
- Gastroenterology and Endoscopy, Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Mikihiro Fujiya
- Joint Research Department of Telemedicine and Telecare, Asahikawa Medical University, Asahikawa, Japan
- Gastroenterology and Endoscopy, Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Takanori Ro
- Rehabilitation Unit, Asahikawa Medical University Hospital, Asahikawa, Japan
| | - Tetsuo Ota
- Department of Physical Medicine and Rehabilitation, Asahikawa Medical University Hospital, Asahikawa, Japan
| | - Hitomi Nishimiya
- Joint Research Department of Telemedicine and Telecare, Asahikawa Medical University, Asahikawa, Japan
| | - Mariko Kodama
- Department of Nursing, Asahikawa Medical University, Asahikawa, Japan
| | - Nana Yoshida
- Joint Research Department of Telemedicine and Telecare, Asahikawa Medical University, Asahikawa, Japan
| | - Yukari Hattori
- Department of Nursing, Asahikawa Medical University, Asahikawa, Japan
| | - Tetsuya Hosokawa
- Joint Research Department of Telemedicine and Telecare, Asahikawa Medical University, Asahikawa, Japan
| | | | | | - Hiroki Hayashi
- Telemedicine Center, Asahikawa Medical University, Asahikawa, Japan
| | - Hiroyuki Hirokawa
- Management Planning Department, Asahikawa Medical University Hospital, Asahikawa, Japan
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Junata M, Cheng KCC, Man HS, Lai CWK, Soo YOY, Tong RKY. Kinect-based rapid movement training to improve balance recovery for stroke fall prevention: a randomized controlled trial. J Neuroeng Rehabil 2021; 18:150. [PMID: 34635141 PMCID: PMC8503723 DOI: 10.1186/s12984-021-00922-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 08/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background Falls are more prevalent in stroke survivors than age-matched healthy older adults because of their functional impairment. Rapid balance recovery reaction with adequate range-of-motion and fast response and movement time are crucial to minimize fall risk and prevent serious injurious falls when postural disturbances occur. A Kinect-based Rapid Movement Training (RMT) program was developed to provide real-time feedback to promote faster and larger arm reaching and leg stepping distances toward targets in 22 different directions. Objective To evaluate the effectiveness of the interactive RMT and Conventional Balance Training (CBT) on chronic stroke survivors’ overall balance and balance recovery reaction. Methods In this assessor-blinded randomized controlled trial, chronic stroke survivors were randomized to receive twenty training sessions (60-min each) of either RMT or CBT. Pre- and post-training assessments included clinical tests, as well as kinematic measurements and electromyography during simulated forward fall through a “lean-and-release” perturbation system. Results Thirty participants were recruited (RMT = 16, CBT = 14). RMT led to significant improvement in balance control (Berg Balance Scale: pre = 49.13, post = 52.75; P = .001), gait control (Timed-Up-and-Go Test: pre = 14.66 s, post = 12.62 s; P = .011), and motor functions (Fugl-Meyer Assessment of Motor Recovery: pre = 60.63, post = 65.19; P = .015), which matched the effectiveness of CBT. Both groups preferred to use their non-paretic leg to take the initial step to restore stability, and their stepping leg’s rectus femoris reacted significantly faster post-training (P = .036). Conclusion The RMT was as effective as conventional balance training to provide beneficial effects on chronic stroke survivors’ overall balance, motor function and improving balance recovery with faster muscle response. Trial registration: The study was registered at Clinicaltrials.gov (https://clinicaltrials.gov/ct2/show/NCT03183635, NCT03183635) on 12 June 2017.
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Affiliation(s)
- Melisa Junata
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Kenneth Chik-Chi Cheng
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong, SAR, China.,Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Hok Sum Man
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong, SAR, China.,Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | | | - Yannie Oi-Yan Soo
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Raymond Kai-Yu Tong
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong, SAR, China.
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Lapierre N, Um Din N, Igout M, Chevrier J, Belmin J. Effects of a Rehabilitation Program Using a Patient-Personalized Exergame on Fear of Falling and Risk of Falls in Vulnerable Older Adults: Protocol for a Randomized Controlled Group Study. JMIR Res Protoc 2021; 10:e24665. [PMID: 34435968 PMCID: PMC8430847 DOI: 10.2196/24665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/16/2020] [Accepted: 03/05/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Older adults often experience physical, sensory, and cognitive decline. Therefore, they have a high risk of falls, which leads to severe health and psychological consequences and can induce fear of falling. Rehabilitation programs using exergames to prevent falls are being increasingly studied. Medimoov is a movement-based patient-personalized exergame for rehabilitation in older adults. A preliminary study showed that its use may influence functional ability and motivation. Most existing studies that evaluate the use of exergames do not involve an appropriate control group and do not focus on patient-personalized exergames. OBJECTIVE This study aims to evaluate the effects of Medimoov on risk of falls and fear of falling in older adults compared with standard psychomotor rehabilitation. METHODS This is a serial, comparative, randomized controlled group study. Both groups (n=25 in each) will receive psychomotor rehabilitation care. However, the methods of delivery will be different; one group will be exposed to the Medimoov exergame platform, and the other only to traditional means of psychomotor rehabilitation. The selection criteria will be (1) age of 65 years or older, (2) ability to answer a questionnaire, (3) ability to stand in a bipedal position for at least 1 minute, (4) score of 13 or greater on the Short Fall Efficacy Scale, and (5) stable medical condition. An evaluation will be made prior to starting the intervention, after 4 weeks of intervention, and at the end of the intervention (after 8 weeks), and it will focus on (1) risk of falls, (2) fear of falling, and (3) cognitive evaluations. Physical activity outside the session will also be assessed by actimetry. The outcome assessment will be performed according to intention-to-treat analysis. RESULTS The protocol (2019-11-22) has been approved by the Comité de Protection des Personnes Nord-Ouest I-Université de Rouen (2019-A00395-52), which is part of the French national ethical committee. The study received funding in February 2020. As of October 2020 (submission date), and due to the context of the COVID-19 pandemic, a total of 10 participants out of 50 had been enrolled in the study. The projected date for the end of the data collection is December 2021. Data analyses have not been started yet, and publication of the results is expected for Spring 2022. CONCLUSIONS The effects of psychomotor rehabilitation using the Medimoov exergame platform on the risk and fear of falls will be evaluated. This pilot study will be the basis for larger trials. TRIAL REGISTRATION ClinicalTrials.gov NCT04134988; https://clinicaltrials.gov/ct2/show/NCT04134988. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/24665.
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Affiliation(s)
- Nolwenn Lapierre
- Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris, AP-HP.Sorbonne Université, Ivry-Sur-Seine, France.,Centre de Recherches Interdisciplinaires, Université Paris Descartes, Paris, France
| | - Nathavy Um Din
- Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris, AP-HP.Sorbonne Université, Ivry-Sur-Seine, France
| | - Manuella Igout
- Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris, AP-HP.Sorbonne Université, Ivry-Sur-Seine, France
| | - Joël Chevrier
- Centre de Recherches Interdisciplinaires, Université Paris Descartes, Paris, France
| | - Joël Belmin
- Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris, AP-HP.Sorbonne Université, Ivry-Sur-Seine, France.,Faculté de Médecine Sorbonne, Sorbonne Université, Paris, France
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Sápi M, Fehér-Kiss A, Csernák K, Domján A, Pintér S. The Effects of Exergaming on Sensory Reweighting and Mediolateral Stability of Women Aged Over 60: Usability Study. JMIR Serious Games 2021; 9:e27884. [PMID: 34287215 PMCID: PMC8339979 DOI: 10.2196/27884] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/30/2021] [Accepted: 05/29/2021] [Indexed: 12/19/2022] Open
Abstract
Background Older adults tend to experience difficulties in switching quickly between various reliable sensory inputs, which ultimately may contribute to an increased risk of falls and injuries. Sideward falls are the most frequent cause of hip fractures among older adults. Recently, exergame programs have been confirmed as beneficial tools for enhancing postural control, which can reduce the risk of falls. However, studies to explore more precisely which mechanism of exergaming directly influences older women’s ability to balance are still needed. Objective Our aim was to evaluate, in a single-group pretest/posttest/follow-up usability study, whether Kinect exergame balance training might have a beneficial impact on the sensory reweighting in women aged over 60. Methods A total of 14 healthy women (mean age 69.57 [SD 4.66] years, mean body mass index 26.21 [SD 2.6] kg/m2) participated in the study. The volunteers trained with the commercially available games of Kinect for Xbox 360 console 3 times (30 minutes/session) a week over a 6-week period (total of 18 visits). Participants’ postural sway in both the anteroposterior (AP) and mediolateral (ML) directions was recorded with NeuroCom Balance Master 6.0. To assess and measure postural sensory reweighting, the Modified Clinical Test of Sensory Interaction in Balance was used, where volunteers were exposed to various changes in visual (eyes open or eyes closed) and surface conditions (firm or foam surface). Results In the ML direction, the Kinect exergame training caused a significant decrease in the sway path on the firm surface with the eyes open (P<.001) and eyes closed (P=.001), and on the foam surface with the eyes open (P=.001) and eyes closed (P<.001) conditions compared with baseline data. The follow-up measurements when compared with the baseline data showed a significant change in the sway path on the firm surface with the eyes open (P<.001) and eyes closed (P<.001) conditions, as well as on the foam surface with the eyes open (P=.003) and eyes closed (P<.001) conditions. Besides, on the firm surface, there were no significant differences in sway path values in the AP direction between the baseline and the posttraining measurements (eyes open: P=.49; eyes closed: P=.18). Likewise, on the foam surface, there were no significant differences in sway path values in the AP direction under both eyes open (P=.24) and eyes closed (P=.84) conditions. Conclusions The improved posturography measurements of the sway path in the ML direction might suggest that the Kinect exergame balance training may have effects on sensory reweighting, and thus on the balance of women aged over 60. Based on these results, Kinect exergaming may provide a safe and potentially useful tool for improving postural stability in the crucial ML direction, and thus it may help reduce the risk of falling.
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Affiliation(s)
- Mariann Sápi
- Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary
| | - Anna Fehér-Kiss
- Physiotherapy Center, Albert Szent-Györgyi Health Center, University of Szeged, Szeged, Hungary
| | - Krisztina Csernák
- Department of Psychiatry and Psychiatric Clinic, Bács-Kiskun County Hospital Kecskemét, Kecskemét, Hungary
| | - Andrea Domján
- Department of Physiotherapy, Faculty of Health Sciences and Social Studies, University of Szeged, Szeged, Hungary
| | - Sándor Pintér
- Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary
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Balance Measurement Using Microsoft Kinect v2: Towards Remote Evaluation of Patient with the Functional Reach Test. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11136073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To prevent falls, it is important to measure periodically the balance ability of an individual using reliable clinical tests. As Red Green Blue Depth (RGBD) devices have been increasingly used for balance rehabilitation at home, they may also be used to assess objectively the balance ability and determine the effectiveness of a therapy. For this, we developed a system based on the Microsoft Kinect v2 for measuring the Functional Reach Test (FRT); one of the most used balance clinical tools to predict falls. Two experiments were conducted to compare the FRT measures computed by our system using the Microsoft Kinect v2 with those obtained by the standard method, i.e., manually. In terms of validity, we found a very strong correlation between the two methods (r = 0.97 and r = 0.99 (p < 0.05), for experiments 1 and 2, respectively). However, we needed to correct the measurements using a linear model to fit the data obtained by the Kinect system. Consequently, a linear regression model has been applied and examining the regression assumptions showed that the model works well for the data. Applying the paired t-test to the data after correction indicated that there is no statistically significant difference between the measurements obtained by both methods. As for the reliability of the test, we obtained good to excellent within repeatability of the FRT measurements tracked by Kinect (ICC = 0.86 and ICC = 0.99, for experiments 1 and 2, respectively). These results suggested that the Microsoft Kinect v2 device is reliable and adequate to calculate the standard FRT.
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Koppelaar H, Kordestani-Moghadam P, Kouhkani S, Irandoust F, Segers G, de Haas L, Bantje T, van Warmerdam M. Proof of Concept of Novel Visuo-Spatial-Motor Fall Prevention Training for Old People. Geriatrics (Basel) 2021; 6:66. [PMID: 34210015 PMCID: PMC8293049 DOI: 10.3390/geriatrics6030066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/13/2021] [Accepted: 06/22/2021] [Indexed: 11/16/2022] Open
Abstract
Falls in the geriatric population are one of the most important causes of disabilities in this age group. Its consequences impose a great deal of economic burden on health and insurance systems. This study was conducted by a multidisciplinary team with the aim of evaluating the effect of visuo-spatial-motor training for the prevention of falls in older adults. The subjects consisted of 31 volunteers aged 60 to 92 years who were studied in three groups: (1) A group under standard physical training, (2) a group under visuo-spatial-motor interventions, and (3) a control group (without any intervention). The results of the study showed that visual-spatial motor exercises significantly reduced the risk of falls of the subjects.
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Affiliation(s)
- Henk Koppelaar
- Faculty of Electric and Electronic Engineering, Mathematics and Computer Science, Delft University of Technology, 2628 CD Delft, The Netherlands
| | | | - Sareh Kouhkani
- Department of Mathematics, Islamic University Shabestar Branch, Shabestar, Iran;
| | - Farnoosh Irandoust
- Department of Ophtalmology, Lorestan University of Medical Sciences, Korramabad, Iran;
| | - Gijs Segers
- Gymi Sports & Visual Performance, 4907 BC Oosterhout, The Netherlands;
| | - Lonneke de Haas
- Monné Physical Care and Exercise, 4815 HD Breda, The Netherlands; (L.d.H.); (T.B.)
| | - Thijmen Bantje
- Monné Physical Care and Exercise, 4815 HD Breda, The Netherlands; (L.d.H.); (T.B.)
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