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Sensory interventions on motor function, activities of daily living, and spasticity of the upper limb in people with stroke: A randomized clinical trial. J Hand Ther 2021; 34:515-520. [PMID: 32565102 DOI: 10.1016/j.jht.2020.03.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN This is a single-blinded clinical trial study. Clinical Trial Number registry: IRCT201610223551N4. INTRODUCTION Stroke is the second cause of death around the world. Motor and sensory problems are common complications of the stroke. These defects in the upper limb cause reduced use of the affected limb and consequently a decrease in the quality of life. PURPOSE OF THE STUDY The purpose of this study was to examine the effect of exteroceptive and proprioceptive stimulations on motor function, spasticity of the upper limb, and activities of daily living in people who have had stroke. METHODS Sixty people with chronic stroke selected by convenience sampling. Before the intervention, Modified Ashworth Scale, Fugl-Meyer assessment of Motor Recovery after Stroke, and Barthel Index were measured and then the intervention phase was started. Exteroceptive and proprioceptive sensory stimulations were performed for 6 weeks. Independent t-test was used to compare groups. RESULTS The intervention group made improvement in motor function (P = .0001, Cohen's d = 2.14), activities of daily living of upper limb (P = .0001, Cohen's d = 1.32), and spasticity (P = .002, Cohen's d = -0.94). DISCUSSION Motor function and activities of daily living and spasticity of the upper limb can be improved through exteroceptive and proprioceptive stimulations. In this study, this type of intervention had the most impact on motor function compared with the rest. CONCLUSION Exteroceptive and proprioceptive stimulations in upper limb can be used in chronic phase of stroke. Improvement in motor function and activities of daily living and reducing spasticity are the results of these stimulations.
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Lee YC, Li YC, Lin KC, Chen CL, Wu YH, Kuo C, Yeh YP, Liu TX. Effects of proximal priority and distal priority robotic priming techniques with impairment-oriented training of upper limb functions in patients with chronic stroke: study protocol for a single-blind, randomized controlled trial. Trials 2021; 22:604. [PMID: 34496938 PMCID: PMC8424932 DOI: 10.1186/s13063-021-05561-6] [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: 02/20/2021] [Accepted: 08/24/2021] [Indexed: 11/12/2022] Open
Abstract
Background The sequence of establishing a proximal stability or function before facilitation of the distal body part has long been recognized in stroke rehabilitation practice but lacks scientific evidence. This study plans to examine the effects of proximal priority robotic priming and impairment-oriented training (PRI) and distal priority robotic priming and impairment-oriented training (DRI). Methods This single-blind, randomized, comparative efficacy study will involve 40 participants with chronic stroke. Participants will be randomized into the PRI or DRI groups and receive 18 intervention sessions (90 min/day, 3 days/weeks for 6 weeks). The Fugl-Meyer Assessment Upper Extremity subscale, Medical Research Council Scale, Revised Nottingham Sensory Assessment, and Wolf Motor Function Test will be administered at baseline, after treatment, and at the 3-month follow-up. Two-way repeated-measures analysis of variance and the chi-square automatic interaction detector method will be used to examine the comparative efficacy and predictors of outcome, respectively, after PRI and DRI. Discussion Through manipulating the sequence of applying wrist and forearm robots in therapy, this study will attempt to examine empirically the priming effect of proximal or distal priority robotic therapy in upper extremity impairment-oriented training for people with stroke. The findings will provide directions for further studies and empirical implications for clinical practice in upper extremity rehabilitation after stroke. Trial Registration ClinicalTrials.gov NCT04446273. Registered on June 23, 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05561-6.
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Affiliation(s)
- Yi-Chen Lee
- School of Occupational Therapy, College of Medicine, National Taiwan University, No.17, F4, Xu Zhou Road, Zhongzheng Dist, Taipei City, 100, Taiwan
| | - Yi-Chun Li
- School of Occupational Therapy, College of Medicine, National Taiwan University, No.17, F4, Xu Zhou Road, Zhongzheng Dist, Taipei City, 100, Taiwan
| | - Keh-Chung Lin
- School of Occupational Therapy, College of Medicine, National Taiwan University, No.17, F4, Xu Zhou Road, Zhongzheng Dist, Taipei City, 100, Taiwan. .,Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, No.1, Changde St., Zhongzheng Dist, Taipei City, 100, Taiwan.
| | - Chia-Ling Chen
- Graduate Institute of Early Intervention, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 33302, Taiwan.,Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan
| | - Yi-Hsuan Wu
- Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, No.1, Changde St., Zhongzheng Dist, Taipei City, 100, Taiwan
| | - Chihchieh Kuo
- Rehabilitation Department, Feng Yuan Hospital, Ministry of Health and Welfare, No.100, An-Kan Road, Fengyuan Dist, Taichung City, 420, Taiwan
| | - Yi-Ping Yeh
- School of Occupational Therapy, College of Medicine, National Taiwan University, No.17, F4, Xu Zhou Road, Zhongzheng Dist, Taipei City, 100, Taiwan
| | - Ting-Xuan Liu
- School of Occupational Therapy, College of Medicine, National Taiwan University, No.17, F4, Xu Zhou Road, Zhongzheng Dist, Taipei City, 100, Taiwan
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Upper Limb Rehabilitation Tools in Virtual Reality Based on Haptic and 3D Spatial Recognition Analysis: A Pilot Study. SENSORS 2021; 21:s21082790. [PMID: 33921036 PMCID: PMC8071461 DOI: 10.3390/s21082790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/06/2021] [Accepted: 04/13/2021] [Indexed: 11/17/2022]
Abstract
With aging, cerebrovascular diseases can occur more often. Stroke cases involve hemiplegia, which causes difficulties in performing activities of daily living. Existing rehabilitation treatments are based on the subjective evaluation of the therapist as the need for non-contact care arises; it is necessary to develop a system that can self-rehabilitate and offer objective analysis. Therefore, we developed rehabilitation tools that enable self-rehabilitation exercises in a virtual space based on haptics. Thirty adults without neurological damage were trained five times in a virtual environment, and the time, number of collisions, and coordinates were digitized and stored in real time. An analysis of variance (ANOVA) of the time and distance similarity changes revealed that as the number of rounds increased, no changes or increases occurred (p ≥ 0.05), and the collisions and paths were stable as the training progressed (p < 0.05). ANOVA showed a high correlation (0.90) with a decrease in the number of crashes and time required. It was meaningful to users when performing rehabilitation training more than four times and significantly impacted the analysis. This study analyzed the upper limb and cognitive rehabilitation of able-boded people in three-dimensional space in a virtual environment; the performance difficulty could be controlled through variations in rehabilitation models.
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Hsu H, Chiu H, Kuan T, Tsai C, Su F, Kuo L. Robotic‐assisted therapy with bilateral practice improves task and motor performance in the upper extremities of chronic stroke patients: A randomised controlled trial. Aust Occup Ther J 2019; 66:637-647. [DOI: 10.1111/1440-1630.12602] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 04/15/2019] [Accepted: 06/16/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Hsiu‐Yun Hsu
- Department of Physical Medicine and Rehabilitation National Cheng Kung University Hospital College of Medicine National Cheng Kung University
- Department of Occupational Therapy College of Medicine National Cheng Kung University
- Medical Device Innovation Center National Cheng Kung University
| | - Haw‐Yen Chiu
- Section of Plastic Surgery, Department of Surgery ChiMei Medical Center
| | - Ta‐Shen Kuan
- Department of Physical Medicine and Rehabilitation National Cheng Kung University Hospital College of Medicine National Cheng Kung University
| | - Ching‐Liang Tsai
- Department of Physical Medicine and Rehabilitation National Cheng Kung University Hospital College of Medicine National Cheng Kung University
| | - Fong‐Chin Su
- Medical Device Innovation Center National Cheng Kung University
- Department of Biomedical Engineering College of Engineering National Cheng Kung University
| | - Li‐Chieh Kuo
- Department of Occupational Therapy College of Medicine National Cheng Kung University
- Medical Device Innovation Center National Cheng Kung University
- Institute of Allied Health Sciences, College of Medicine National Cheng Kung University Tainan Taiwan
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