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Takei K, Morita S, Watanabe Y, Suganami M, Inao M. Safety, feasibility, and acceptability of physiotherapy combined with strength training using active video games for older patients with musculoskeletal conditions. Disabil Rehabil Assist Technol 2024; 19:641-647. [PMID: 36001528 DOI: 10.1080/17483107.2022.2115562] [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: 03/05/2022] [Revised: 08/12/2022] [Accepted: 08/16/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE This study aimed to determine the safety, feasibility, and acceptability of physiotherapy (PT) combined with strength training using active video games (AVG) for older patients with musculoskeletal conditions. METHODS Sixteen patients underwent AVG + PT on day 1 and only conventional physiotherapy (CPT) on day 2. The AVG was conducted in 6 upper- and lower-limb training performed in standing position using Ring Fit Adventure (RFA) on Nintendo Switch. Outcome measured adverse events and deviant movements associated with the AVG as safety, execution rate of each AVG programme as feasibility, and questionnaires (4-point Likert scale) regarding enjoyment, motivation to continue, and feeling of efficacy as acceptability. RESULTS The berg balance scale/functional independence measure indicated 45 ± 8/90 ± 16. No adverse events occurred. Some of deviant movements were observed that could be an injury risk, such as a slight forward movement during the stepping exercise. The execution rate for each AVG programme ranged from 81% to 100%. The categories of enjoyment, motivation to continue, and feeling of efficacy had >90% of positive responses (strongly agree, slightly agree) in AVG + PT, and enjoyment tended to be higher in AVG + PT than in CPT. CONCLUSIONS Strength training using RFA was considered to be a safe and feasible exercise tool enough to be applicable as part of a rehabilitation programme in older patients with musculoskeletal conditions. However, should be supervised, at least during the introductory phase. It was also positively accepted by older adults, suggesting enhanced enjoyment.IMPLICATIONS FOR REHABILITATIONActive video games (AVG) training with Ring Fit Adventure (RFA) was found to be safe enough to be considered for application as part of a rehabilitation programme for older patients with musculoskeletal conditions, but should be supervised, at least during the introductory phase.AVG training comprising strength training with RFA was found to be a highly feasible exercise tool for rehabilitation in older patients with musculoskeletal conditions.Physiotherapy combined with AVG training using RFA was also well received, suggesting enhanced enjoyment for older patients with musculoskeletal conditions.
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Affiliation(s)
- Keiichi Takei
- Department of Physical Therapy, School of Rehabilitation, Tokyo Professional University of Health Sciences, Tokyo, Japan
| | - Shinpei Morita
- Department of Rehabilitation, Shiomi Hospital, Saitama, Japan
| | | | - Miho Suganami
- Department of Rehabilitation, Shiomi Hospital, Saitama, Japan
| | - Mie Inao
- Department of Gastroenterology, Shiomi Hospital, Saitama, Japan
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Song J, Hardin EC. Monitoring walking asymmetries and endpoint control in persons living with chronic stroke: Implications for remote diagnosis and telerehabilitation. Digit Health 2024; 10:20552076231220450. [PMID: 38188863 PMCID: PMC10768577 DOI: 10.1177/20552076231220450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/23/2023] [Indexed: 01/09/2024] Open
Abstract
Objective The objective of this study was to assess the feasibility of monitoring and diagnosing compromised walking motion in the frontal plane, particularly in persons living with the chronic effects of stroke (PwCS). The study aimed to determine whether active control of walking in the frontal plane could be monitored and provide diagnostic insights into compensations made by PwCS during community living. Methods The study recruited PwCS with noticeable walking asymmetries and employed a monitoring method to assess frontal plane motion. Monitoring was conducted both within a single assessment and between assessments. The study aimed to uncover baseline data and diagnostic information about active control in chronic stroke survivors. Data were collected using sensors during 6 minutes of walking and compared between the paretic and non-paretic legs. Results The study demonstrated the feasibility of monitoring frontal plane motion and diagnosing disturbed endpoint control (p < 0.0125) in chronic stroke survivors when comparing the paretic leg to the non-paretic leg. A greater variability was observed in the paretic leg (p < 0.0125), and sensors were able to diagnose a stronger coupling of the body with its endpoint on the paretic side (p < 0.0125). Similar results were obtained when monitoring was conducted over a six-minute walking period, and no significant diagnostic differences were found between the two monitoring assessments. Monitoring did not reveal performance fatigue or debilitation over time. Conclusions This study's findings indicate that monitoring frontal plane motion is a feasible approach for diagnosing compromised walking motion. The results suggest that individuals with walking asymmetries, exhibit differences in endpoint control and variability between their paretic and non-paretic legs. These insights could contribute to more effective rehabilitation strategies and highlight the potential for monitoring compensations during various activities of daily living.
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Affiliation(s)
- Jiafeng Song
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- Department of Biomedical Informatics, Emory University, Atlanta, GA, USA
| | - Elizabeth C Hardin
- Human Performance Virtual Reality Lab, Cleveland FES Center, Cleveland VA Medical Center, Cleveland, OH, USA
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Shariat A, Najafabadi MG, Nakhostin Ansari N, Anastasio AT, Bagheri K, Hassanzadeh G, Farghadan M. Outcome Measures Utilized to Assess the Efficacy of Telerehabilitation for Post-Stroke Rehabilitation: A Scoping Review. Brain Sci 2023; 13:1725. [PMID: 38137173 PMCID: PMC10741539 DOI: 10.3390/brainsci13121725] [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: 11/07/2023] [Revised: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Outcome measures using telerehabilitation (TR) in the context of post-stroke rehabilitation are an area of emerging research. The current review assesses the literature related to TR for patients requiring post-stroke rehabilitation. The purpose of this study is to survey the outcome measures used in TR studies and to define which parts of the International Organization of Functioning are measured in trials. METHODS TR studies were searched in Cochrane Central Register of Controlled Trials, PubMed, Embase, Scopus, Google Scholar, and Web of Science, The Cochrane Central Register of Controlled Trials (Cochrane Library), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Physiotherapy Evidence Database (PEDro) from 2016 to June 2023. Two reviewers individually assessed the full text. Discrepancies regarding inclusion or exclusion were resolved by an additional reviewer. RESULTS A total of 24 studies were included in the current review. The findings were synthesized and presented taking into account their implications within clinical practice, areas of investigation, and strategic implementation. CONCLUSIONS The scoping review has recognized a broad range of outcome measures utilized in TR studies, shedding light on gaps in the current literature. Furthermore, this review serves as a valuable resource for researchers and end users (such as clinicians and policymakers), providing insights into the most appropriate outcome measures for TR. There is a lack of studies examining the required follow-up after TR, emphasizing the need for future research in this area.
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Affiliation(s)
- Ardalan Shariat
- Department of Digital Health, School of Medicine, Tehran University of Medical Sciences, Tehran 1417613151, Iran; (A.S.); (G.H.)
| | - Mahboubeh Ghayour Najafabadi
- Department of Motor Behavior, Faculty of Sport Sciences and Health, University of Tehran, Tehran 1439957131, Iran
| | - Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran 141556559, Iran;
- Research Center for War-Affected People, Tehran University of Medical Sciences, Tehran 1417613151, Iran
| | | | - Kian Bagheri
- School of Osteopathic Medicine, Campbell University, Lillington, NC 27546, USA;
| | - Gholamreza Hassanzadeh
- Department of Digital Health, School of Medicine, Tehran University of Medical Sciences, Tehran 1417613151, Iran; (A.S.); (G.H.)
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran 1417613151, Iran
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran 1417613151, Iran
| | - Mahsa Farghadan
- Department of Artificial Intelligence, Faculty of Computer Engineering, Islamic Azad University of South Tehran Branch, Tehran 4147654919, Iran;
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Seinsche J, de Bruin ED, Saibene E, Rizzo F, Carpinella I, Ferrarin M, Ifanger S, Moza S, Giannouli E. Feasibility and Effectiveness of a Personalized Home-Based Motor-Cognitive Training Program in Community-Dwelling Older Adults: Protocol for a Pragmatic Pilot Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e49377. [PMID: 37943591 PMCID: PMC10667977 DOI: 10.2196/49377] [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: 05/30/2023] [Revised: 08/23/2023] [Accepted: 09/18/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Exergame-based motor-cognitive training in older adults has been associated with improvements in physical, cognitive, and psychological functioning. The novel Cocare system (Dividat GmbH), developed through a user-centered design process, allows motor-cognitive training in a telerehabilitation setting. It includes (1) a stationary stepping platform for supervised exergame training (Dividat Senso; Dividat GmbH), (2) a home-based version (Dividat Senso Flex, which is a rollable pressure-sensitive mat; Dividat GmbH), (3) an assessment system (including motor-cognitive tests), and (4) a rehabilitation cockpit for remote training supervision and management. OBJECTIVE The aim of this study is to test the feasibility and effectiveness of this novel training system. METHODS A total of 180 older adults from Switzerland, Italy, and Cyprus aged ≥60 years with a prescription for rehabilitation are randomly allocated to an intervention group or a control group. Both groups continue with their usual care, whereas participants in the intervention group additionally perform a 2-week supervised exergame training program at rehabilitation centers, followed by a 10-week home training program under remote supervision. The assessment system is used to indicate the start level of each participant, and, in both intervention periods, standardized progression rules are applied. The measures of feasibility include adherence, attrition, exergame enjoyment, willingness to perform such a training program, and the number and types of help requests. Effectiveness is assessed in terms of cognitive and physical functioning, balance confidence, and quality of life. RESULTS Data collection started in February 2023 and is ongoing. Final measurements are expected to be performed in January 2024. CONCLUSIONS Owing to the user-centered design approach, the Cocare system is expected to be user-friendly and offers several novel features to cover the whole continuum of care. This pragmatic trial will provide valuable information regarding final necessary adaptations and subsequent implementation efforts. TRIAL REGISTRATION ClinicalTrials.gov NCT05751551; https://www.clinicaltrials.gov/study/NCT05751551. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49377.
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Affiliation(s)
- Julia Seinsche
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zurich, Zurich, Switzerland
- Department of Health, OST - Eastern Swiss University of Applied Sciences, St Gallen, Switzerland
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Enrico Saibene
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Francesco Rizzo
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Ilaria Carpinella
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Maurizio Ferrarin
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Sarina Ifanger
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zurich, Zurich, Switzerland
| | | | - Eleftheria Giannouli
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zurich, Zurich, Switzerland
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Demeco A, Foresti R, Frizziero A, Daracchi N, Renzi F, Rovellini M, Salerno A, Martini C, Pelizzari L, Costantino C. The Upper Limb Orthosis in the Rehabilitation of Stroke Patients: The Role of 3D Printing. Bioengineering (Basel) 2023; 10:1256. [PMID: 38002380 PMCID: PMC10669460 DOI: 10.3390/bioengineering10111256] [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: 09/21/2023] [Revised: 10/22/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
Stroke represents the third cause of long-term disability in the world. About 80% of stroke patients have an impairment of bio-motor functions and over half fail to regain arm functionality, resulting in motor movement control disorder with serious loss in terms of social independence. Therefore, rehabilitation plays a key role in the reduction of patient disabilities, and 3D printing (3DP) has showed interesting improvements in related fields, thanks to the possibility to produce customized, eco-sustainable and cost-effective orthoses. This study investigated the clinical use of 3DP orthosis in rehabilitation compared to the traditional ones, focusing on the correlation between 3DP technology, therapy and outcomes. We screened 138 articles from PubMed, Scopus and Web of Science, selecting the 10 articles fulfilling the inclusion criteria, which were subsequently examined for the systematic review. The results showed that 3DP provides substantial advantages in terms of upper limb orthosis designed on the patient's needs. Moreover, seven research activities used biodegradable/recyclable materials, underlining the great potential of validated 3DP solutions in a clinical rehabilitation setting. The aim of this study was to highlight how 3DP could overcome the limitations of standard medical devices in order to support clinicians, bioengineers and innovation managers during the implementation of Healthcare 4.0.
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Affiliation(s)
- Andrea Demeco
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Ruben Foresti
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
- Center of Excellence for Toxicological Research (CERT), University of Parma, 43126 Parma, Italy
- Italian National Research Council, Institute of Materials for Electronics and Magnetism (CNR-IMEM), 43124 Parma, Italy
| | - Antonio Frizziero
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Nicola Daracchi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Francesco Renzi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Margherita Rovellini
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Antonello Salerno
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Chiara Martini
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
| | - Laura Pelizzari
- AUSL Piacenza, Neurorehabilitation and Spinal Unit, Department of Rehabilitative Medicine, 29121 Piacenza, Italy;
| | - Cosimo Costantino
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.F.); (N.D.); (F.R.); (M.R.); (A.S.); (C.M.); (C.C.)
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Sterke BT, Poggensee KL, Ribbers GM, Lemus D, Vallery H. Light-Weight Wearable Gyroscopic Actuators Can Modulate Balance Performance and Gait Characteristics: A Proof-of-Concept Study. Healthcare (Basel) 2023; 11:2841. [PMID: 37957986 PMCID: PMC10647239 DOI: 10.3390/healthcare11212841] [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: 07/31/2023] [Revised: 10/13/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
Falling is a major cause of morbidity, and is often caused by a decrease in postural stability. A key component of postural stability is whole-body centroidal angular momentum, which can be influenced by control moment gyroscopes. In this proof-of-concept study, we explore the influence of our wearable robotic gyroscopic actuator "GyroPack" on the balance performance and gait characteristics of non-impaired individuals (seven female/eight male, 30 ± 7 years, 68.8 ± 8.4 kg). Participants performed a series of balance and walking tasks with and without wearing the GyroPack. The device displayed various control modes, which were hypothesised to positively, negatively, or neutrally impact postural control. When configured as a damper, the GyroPack increased mediolateral standing time and walking distance, on a balance beam, and decreased trunk angular velocity variability, while walking on a treadmill. When configured as a negative damper, both peak trunk angular rate and trunk angular velocity variability increased during treadmill walking. This exploratory study shows that gyroscopic actuators can influence balance and gait kinematics. Our results mirror the findings of our earlier studies; though, with more than 50% mass reduction of the device, practical and clinical applicability now appears within reach.
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Affiliation(s)
- Bram T. Sterke
- Department of Rehabilitation Medicine, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (K.L.P.); (G.M.R.); (H.V.)
- Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands;
| | - Katherine L. Poggensee
- Department of Rehabilitation Medicine, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (K.L.P.); (G.M.R.); (H.V.)
- Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands;
| | - Gerard M. Ribbers
- Department of Rehabilitation Medicine, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (K.L.P.); (G.M.R.); (H.V.)
- Rijndam Revalidatie, Westersingel 300, 3015 LJ Rotterdam, The Netherlands
| | - Daniel Lemus
- Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands;
| | - Heike Vallery
- Department of Rehabilitation Medicine, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; (K.L.P.); (G.M.R.); (H.V.)
- Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands;
- Faculty of Mechanical Engineering, Rhine-Westphalia Technical University of Aachen, 52062 Aachen, Germany
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Su Z, Guo Z, Wang W, Liu Y, Liu Y, Chen W, Zheng M, Michael N, Lu S, Wang W, Xiao H. The effect of telerehabilitation on balance in stroke patients: is it more effective than the traditional rehabilitation model? A meta-analysis of randomized controlled trials published during the COVID-19 pandemic. Front Neurol 2023; 14:1156473. [PMID: 37265467 PMCID: PMC10229885 DOI: 10.3389/fneur.2023.1156473] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/04/2023] [Indexed: 06/03/2023] Open
Abstract
Objective Telerehabilitation and telemedicine have gradually gained popularity. In 2019, the outbreak of COVID-19 started in Wuhan and then spread across the world. To date, most countries have opted to coexist with the virus. However, patients, especially those who have suffered a stroke, should take measures to avoid being infected with any disease as much as possible since any infectious disease can lead to adverse events for them. Telerehabilitation can be beneficial to stroke patients as they are less likely to be infected by the virus. In recent years, several studies on telerehabilitation have been conducted globally. This meta-analysis aimed to investigate the effects of telerehabilitation on the balance ability of stroke patients, compare the efficacy of conventional rehabilitation with telerehabilitation, explore the characteristics of telerehabilitation and conventional rehabilitation, and provide recommendations for rehabilitation programs in the context of the global pandemic. Methods We searched Pubmed, Embase, the Web of Science, and The Cochrane Library databases from 1 January 2020 to 31 December 2022 for randomized controlled trials published in English that evaluated the improvement of balance function in stroke patients after telerehabilitation and compared the differences between telerehabilitation (TR) and conventional rehabilitation (CR). The random-effects model was utilized to calculate mean differences (MDs) with 95% confidence intervals (CIs) to estimate intervention effects. Statistical heterogeneity was assessed according to the I2 values. The risk of bias was measured using the Cochrane risk-of-bias assessment tool. Results We included nine studies in the system evaluation, all of which were included in the pooled analysis. All outcomes in the experimental and control groups improved over time. The comparison between groups concluded that people who received the telerehabilitation intervention had a significant improvement in the Berg Balance Scale (MD = 2.80; 95% CI 0.61, 4.98, P < 0.05, I2 = 51.90%) and the Fugl-Meyer Assessment (MD = 8.12; 95% CI 6.35, 9.88, P < 0.05, I2 = 0) compared to controls. The Timed Up and Go test (MD = -4.59; 95% CI -5.93, -.25, P < 0.05, I2 = 0) and Tinetti Performance-Oriented Mobility Assessment-Balance (MD = 2.50; 95% CI 0.39, 4.61, P < 0.05) scored better in the control group than in the experimental group. There were no significant differences in other outcomes between the two groups. Conclusion Studies on changes in medical conditions during the COVID-19 pandemic also demonstrated that, for stroke patients, telerehabilitation achieves similar effects as the conventional rehabilitation model and can act as a continuation of the conventional rehabilitation model. Owing to the different equipment and intervention programs of telerehabilitation, its curative effect on the static balance and reactive balance of stroke patients may be different. Currently, telerehabilitation may be more conducive to the rehabilitation of patients' static balance abilities, while conventional rehabilitation is more effective for the rehabilitation of patients' reactive balance. Therefore, further studies are needed for investigating the difference in efficacy between varied devices and telerehabilitation programs. Further research is needed on static and reactive balance. In addition, such research should have a large body of literature and a large sample size to support more definitive findings based on the context of the COVID-19 pandemic. Systematic review registration CRD42023389456.
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Affiliation(s)
- Zhaoyin Su
- The First Clinical College of Medicine, Lanzhou University, Lanzhou, China
| | - Zhenxia Guo
- Department of Trauma Surgery, First Hospital of Lanzhou University, Lanzhou, China
| | - Weitao Wang
- The First Clinical College of Medicine, Lanzhou University, Lanzhou, China
| | - Yao Liu
- The First Clinical College of Medicine, Lanzhou University, Lanzhou, China
| | - Yatao Liu
- Department of Trauma Surgery, First Hospital of Lanzhou University, Lanzhou, China
- Department of Anesthesia Surgery, First Hospital of Lanzhou University, Lanzhou, China
| | - Wanqiang Chen
- Department of Rehabilitation, First Hospital of Lanzhou University, Lanzhou, China
| | - Maohua Zheng
- Department of Neurosurgery, First Hospital of Lanzhou University, Lanzhou, China
| | - Nerich Michael
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Shuai Lu
- The First Clinical College of Medicine, Lanzhou University, Lanzhou, China
| | - Weining Wang
- School of Stomatology, Lanzhou University, Lanzhou, China
| | - Handan Xiao
- The Second Clinical College of Medicine, Lanzhou University, Lanzhou, China
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Cheng HL, Lin CH, Tseng SH, Peng CW, Lai CH. Effectiveness of Repetitive Transcranial Magnetic Stimulation Combined with Visual Feedback Training in Improving Neuroplasticity and Lower Limb Function after Chronic Stroke: A Pilot Study. BIOLOGY 2023; 12:biology12040515. [PMID: 37106715 PMCID: PMC10135922 DOI: 10.3390/biology12040515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/20/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
After a stroke, sustained gait impairment can restrict participation in the activities listed in the International Classification of Functioning, Disability, and Health model and cause poor quality of life. The present study investigated the effectiveness of repetitive transcranial magnetic stimulation (rTMS) and visual feedback training (VF) training in improving lower limb motor performance, gait, and corticospinal excitability in patients with chronic stroke. Thirty patients were randomized into three groups that received either rTMS or sham stimulation over the contralesional leg region accompanied by VF training groups in addition to the conventional rehabilitation group. All participants underwent intervention sessions three times per week for four weeks. Outcome measures included the motor-evoked potential (MEP) of the anterior tibialis muscle, Berg Balance Scale (BBS) scores, Timed Up and Go (TUG) test scores, and Fugl–Meyer Assessment of Lower Extremity scores. After the intervention, the rTMS and VF group had significantly improved in MEP latency (p = 0.011), TUG scores (p = 0.008), and BBS scores (p = 0.011). The sham rTMS and VF group had improved MEP latency (p = 0.027). The rTMS and VF training may enhance the cortical excitability and walking ability of individuals with chronic stroke. The potential benefits encourage a larger trial to determine the efficacy in stroke patients.
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Affiliation(s)
- Hsien-Lin Cheng
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Chueh-Ho Lin
- International Ph.D. Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
- Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan
| | - Sung-Hui Tseng
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei 11031, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Chih-Wei Peng
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
| | - Chien-Hung Lai
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei 11031, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Correspondence: ; Tel.: +886-2-2737-2181 (ext. 3243)
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Chan YK, Tang YM, Teng L. A comparative analysis of digital health usage intentions towards the adoption of virtual reality in telerehabilitation. Int J Med Inform 2023; 174:105042. [PMID: 36965405 DOI: 10.1016/j.ijmedinf.2023.105042] [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: 10/26/2022] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND With the rapid development of the metaverse and the problem of non-attendance in traditional rehabilitation, virtual reality in telerehabilitation has become increasingly vital in modern medicine. However, research on determining predictors that influence the public's behavioral intention to adopt VR-based telerehabilitation has not been extensively studied. OBJECTIVE This study aims to propose a new research model with a comparative analysis on understanding factors affecting the public's behavioral intention to adopt VR in telerehabilitation for different user groups. METHODS A total of 215 respondents from the general public completed an online questionnaire to validate the proposed research model. The collected data was analyzed using SPSS and AMOS. The proposed model was additionally validated using CFA and multiple linear regression. RESULTS This study found that effort expectancy, threat appraisals, and trust had a positive significant influence on the public's behavioral intention to adopt VR in telerehabilitation. However, performance expectancy and facilitating conditions had no significant relationship with behavioral intention. Notably, the average of the primary factors for older adults was generally higher than for younger adults. CONCLUSIONS The present study confirms the applicability of the proposed research model. Our findings contribute up-to-date insights for related stakeholders to minimize implementation failures and develop successful adoption strategies for the future expansion of telerehabilitation.
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Affiliation(s)
- Yee Kiu Chan
- Department of Industrial and Systems Engineering, Hong Kong Polytechnic University, Hong Kong Special Administrative Region
| | - Yuk Ming Tang
- Department of Industrial and Systems Engineering, Hong Kong Polytechnic University, Hong Kong Special Administrative Region; Faculty of Business, City University of Macau, Macau.
| | - Long Teng
- Department of Industrial and Systems Engineering, Hong Kong Polytechnic University, Hong Kong Special Administrative Region
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10
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Hao J, Pu Y, Chen Z, Siu KC. Effects of virtual reality-based telerehabilitation for stroke patients: A systematic review and meta-analysis of randomized controlled trials. J Stroke Cerebrovasc Dis 2023; 32:106960. [PMID: 36586244 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106960] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/18/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Telerehabilitation provides an essential opportunity to deliver continuous rehabilitation services for stroke patients at home, especially amid a global pandemic. Virtual reality is a simulation technology that has shown promising outcomes in stroke rehabilitation. Combining telerehabilitation and virtual reality is an emerging and innovative approach that enriches the rehabilitation experience and potentially enhances functional recovery outcomes. This review synthesized current evidence of using virtual reality-based telerehabilitation for patients after stroke and compared it with conventional in-person rehabilitation. METHODS Randomized controlled trials were searched across six databases published after 2000. Two independent reviewers conducted study selection, data extraction and quality assessment. The Physiotherapy Evidence Databases scale was used to evaluate the methodological quality. Qualitative synthesis and meta-analysis were conducted to compare functional outcomes after Virtual reality-based telerehabilitation with conventional in-person rehabilitation. RESULTS Nine studies including 260 participants were selected from 933 relevant records. Seven studies met the criteria for good quality based on the Physiotherapy Evidence Databases scale, two studies were fair quality. Compared with conventional in-person rehabilitation, the meta-analysis indicated that virtual reality-based telerehabilitation had comparable outcomes of upper extremity function and balance function. Both groups demonstrated similar effects on outcomes in mobility, cognition, activities of daily life, and quality of life. CONCLUSIONS Virtual reality-based telerehabilitation is an effective alternative approach for patients with stroke, given the barriers and restrictions of traditional in-person rehabilitation.
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Affiliation(s)
- Jie Hao
- Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE 68198-4420, United States
| | - Yuqi Pu
- Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE 68198-4420, United States
| | - Zhen Chen
- Department of Neurorehabilitation, The First Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Ka-Chun Siu
- Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE 68198-4420, United States.
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11
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SARAL İ, SURUCU S, YAYLA YT, ÇAKAR E. Face-to-face assessment versus tele-assessment of chronic stroke patients: do the results meet the needs? JOURNAL OF HEALTH SCIENCES AND MEDICINE 2023. [DOI: 10.32322/jhsm.1183595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Aim: Baseline evaluation of stroke patients is valuable to manage the treatment plan. As in the case of stroke evaluation and rehabilitation, in every aspects of healthcare, tele-medicine is growing gradually. The aim of this descriptive study was to explore whether initial tele-assessment of chronic stroke patients is similar to face-to-face assessment in terms of clinical scales.
Material and Method: Thirty-four chronic stroke patients (mean post-stroke duration 21.44±15.47 months; stroke etiology, 58.8% ischemic; hemiplegic side, 52.9% left; mean age 49.24±12.51; 22 males; 12 females) were included in this trial. Firstly, all the patients were evaluated online, and then at the same day they were evaluated face-to-face by the clinical scales including Chair Stand Test, Berg Balance Scale, Stroke specific Quality of Life scale, Motricity Index.
Results: The findings of the present study revealed that there was no statistically significant difference between tele-assessment and face-to-face assessment for all the scales (p>0.05) except Chair Stand Test (mean time to stand: 9.41 secs vs 8.94 secs in tele-assessment and face-to-face respectively; p
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Affiliation(s)
- İlknur SARAL
- BAHCESEHIR UNIVERSITY, FACULTY OF HEALTH SCIENCES
| | - Serkan SURUCU
- Yale University School of Medicine, Department of Orthopaedics and Rehabilitation
| | | | - Engin ÇAKAR
- USKUDAR UNIVERSITY, FACULTY OF HEALTH SCIENCES
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12
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Yen JM, Lim JH. A Clinical Perspective on Bespoke Sensing Mechanisms for Remote Monitoring and Rehabilitation of Neurological Diseases: Scoping Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:536. [PMID: 36617134 PMCID: PMC9823649 DOI: 10.3390/s23010536] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/17/2022] [Accepted: 12/29/2022] [Indexed: 06/17/2023]
Abstract
Neurological diseases including stroke and neurodegenerative disorders cause a hefty burden on the healthcare system. Survivors experience significant impairment in mobility and daily activities, which requires extensive rehabilitative interventions to assist them to regain lost skills and restore independence. The advent of remote rehabilitation architecture and enabling technology mandates the elaboration of sensing mechanisms tailored to individual clinical needs. This study aims to review current trends in the application of sensing mechanisms in remote monitoring and rehabilitation in neurological diseases, and to provide clinical insights to develop bespoke sensing mechanisms. A systematic search was performed using the PubMED database to identify 16 papers published for the period between 2018 to 2022. Teleceptive sensors (56%) were utilized more often than wearable proximate sensors (50%). The most commonly used modality was infrared (38%) and acceleration force (38%), followed by RGB color, EMG, light and temperature, and radio signal. The strategy adopted to improve the sensing mechanism included a multimodal sensor, the application of multiple sensors, sensor fusion, and machine learning. Most of the stroke studies utilized biofeedback control systems (78%) while the majority of studies for neurodegenerative disorders used sensors for remote monitoring (57%). Functional assessment tools that the sensing mechanism may emulate to produce clinically valid information were proposed and factors affecting user adoption were described. Lastly, the limitations and directions for further development were discussed.
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Affiliation(s)
- Jia Min Yen
- Division of Rehabilitation Medicine, University Medicine Cluster, National University Hospital, Singapore 119074, Singapore
| | - Jeong Hoon Lim
- Division of Rehabilitation Medicine, University Medicine Cluster, National University Hospital, Singapore 119074, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
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13
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Alayat MS, Almatrafi NA, Almutairi AA, El Fiky AAR, Elsodany AM. The Effectiveness of Telerehabilitation on Balance and Functional Mobility in Patients with Stroke: A Systematic Review and Meta-Analysis. Int J Telerehabil 2022; 14:e6532. [PMID: 38026563 PMCID: PMC10681061 DOI: 10.5195/ijt.2022.6532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Objective The aim of this systematic review and meta-analysis was to investigate the effectiveness of telerehabilitation on improving balance and functional mobility in stroke survivors. Methods Comprehensive searching was conducted from inception to May 2022. The inclusion criteria were studies evaluating the effectiveness of telerehabilitation in stroke survivors. Data regarding participants, intervention, outcome measures, and main results were extracted. PEDro scale and the Grading of Recommendations Assessment Development and Evaluation (GRADE) were used to assess the methodological quality and quality of evidence, respectively. Data Analysis A total of fourteen articles) 594 patients) were included. A meta-analysis using a random-effect model was performed on thirteen studies )530 patients). Standardized mean difference (SMD) with 95% confidence interval (CI) was calculated for balance and functional mobility. Results: PEDro scale revealed ten good-quality studies, three fair-quality studies, and one poor-quality study. According to the available evidence, telerehabilitation has a small effect size in improving both balance (SMD 0.33 [95% CI 0.03 to 0.63]; P =0.03; low quality of evidence) and functional mobility (SMD 0.27 [95% CI 0.02 to 0.52]; P =0.03; low quality of evidence). Conclusion Telerehabilitation may improve balance and functional mobility in stroke survivors. However, it is evident that more high-quality research is required due to the existence of low to very low-quality evidence with limited confidence in the effect estimate. Registration PROSPERO registration number (CRD42022306410).
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Affiliation(s)
- Mohamed Salaheldien Alayat
- Department of Physiotherapy, Applied Medical Science College, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Nahla Ahmad Almatrafi
- Department of Physiotherapy, Applied Medical Science College, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Amir Abdel Raouf El Fiky
- Department of Physiotherapy, Applied Medical Science College, Umm Al-Qura University, Makkah, Saudi Arabia
- Department of Physical Therapy for Neurological Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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14
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Park EJ. Effects of Compression Stockings on Body Balance in Hemiplegic Patients with Subacute Stroke. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16212. [PMID: 36498287 PMCID: PMC9741381 DOI: 10.3390/ijerph192316212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/24/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Stroke patients with hemiplegia have an increased risk of developing deep vein thrombosis (DVT). DVT increases the risk of life-threatening pulmonary embolism and is associated with poor prognosis. The early wearing of compression stockings can help prevent DVT. This study aimed to assess the impact of compression stockings on body balance in stroke patients with unilateral lower extremity muscle weakness; (2) Methods: Hemiplegic stroke patients in the subacute phase who were able to walk with assistance were recruited. The patients were divided into two groups: one group received rehabilitation treatment with compression stockings, and the other received treatment without compression stockings. The rehabilitation treatment involved hospitalization for 4 weeks, the Trunk Control Test (TCT), the Trunk Impairment Scale (TIS), and the Berg Balance Scale (BBS). The patients were evaluated before and 4 weeks after the start of treatment. The differences in BBS, TCT, and TIS before and after treatment between the two groups were compared; (3) Results: Altogether, 236 hemiplegic stroke patients were recruited. There was an improvement in body balance after treatment in both groups, and BBS, TCT, and TIS scores significantly increased in the group that received rehabilitation treatment with compression stockings; (4) Conclusions: In patients with hemiplegic stroke in the subacute period, rehabilitation while wearing compression stockings appears to improve body balance.
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Affiliation(s)
- Eo Jin Park
- Department of Rehabilitation Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea
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15
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Thwaites C, Nayyar R, Blennerhassett J, Egerton T, Tan J, Bower K. Is telehealth an effective and feasible option for improving falls-related outcomes in community-dwelling adults with neurological conditions? A systematic review and meta-analysis. Clin Rehabil 2022; 37:17-46. [PMID: 36263524 DOI: 10.1177/02692155221133468] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the effectiveness of telehealth interventions in reducing community falls risk or rates compared to equivalent in-person interventions in adults with neurological conditions. DATA SOURCES Eight electronic databases, trial registries and search engines were searched for the concepts 'falls', 'neurological conditions', and 'telehealth', limited to English language, from inception until August 2022. REVIEW METHODS Search for original research where the intervention was delivered via synchronous videoconferencing with the aim of reducing falls and falls-related outcomes. Screening and risk of bias assessment were completed by two independent researchers. Outcome data included falls rates, falls-related outcomes, safety, feasibility, and acceptability. Risk of bias was assessed using the ROB-2 and ROBINS-I tools. Quality of evidence was rated with the grading of recommendations, assessment, development and evaluation (GRADE) approach. RESULTS Seventeen studies with 581 participants were included; six were randomised controlled trials. Risk of bias ranged from low to high. Only one study (n = 76) reported falls and did not find differences between telehealth and in-person physiotherapy. There was low-quality evidence that telehealth interventions improve balance outcomes more than face-to-face interventions (pooled between-group mean difference 2.48 Berg Balance Scale units, 95%CI 0.77 to 4.20). Fear of falling was not different between intervention delivery modes. CONCLUSION Findings suggest that telehealth delivered falls prevention interventions are safe, feasible and acceptable in community-dwelling adults with neurological conditions, however, data related to effectiveness in reducing falls is limited. Low-quality evidence suggests that telehealth may deliver similar or better outcomes for standing balance in this population.PROSPERO Registration: (CRD42021240167).
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Affiliation(s)
- Claire Thwaites
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Melbourne, Australia.,The Victorian Rehabilitation Centre, Healthscope, Melbourne, Australia
| | - Rohini Nayyar
- Faculty of Medicine, Dentistry and Health Sciences, Department of Physiotherapy, 2281The University of Melbourne, Melbourne, Australia
| | - Jannette Blennerhassett
- Physiotherapy Department and Health Independence Program, 3805Austin Health, Heidelberg, Australia
| | - Thorlene Egerton
- Faculty of Medicine, Dentistry and Health Sciences, Department of Physiotherapy, 2281The University of Melbourne, Melbourne, Australia
| | - Jasmine Tan
- Faculty of Medicine, Dentistry and Health Sciences, Department of Physiotherapy, 2281The University of Melbourne, Melbourne, Australia
| | - Kelly Bower
- Faculty of Medicine, Dentistry and Health Sciences, Department of Physiotherapy, 2281The University of Melbourne, Melbourne, Australia
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16
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Nikolaev VA, Nikolaev AA. Recent trends in telerehabilitation of stroke patients: A narrative review. NeuroRehabilitation 2022; 51:1-22. [DOI: 10.3233/nre-210330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND: Stroke is the main reason for disabilities worldwide leading to motor dysfunction, spatial neglect and cognitive problems, aphasia, and other speech-language pathologies, reducing the life quality. To overcome disabilities, telerehabilitation (TR) has been recently introduced. OBJECTIVE: The aim of this review was to analyze current TR approaches for stroke patients’ recovery. METHODS: We searched 6 online databases from January 2018 to October 2021, and included 70 research and review papers in the review. We analyzed TR of 995 individuals, which was delivered synchronously and asynchronously. RESULTS: Findings show TR is feasible improving motor function, cognition, speech, and language communication among stroke patients. However, the dose of TR sessions varied significantly. We identified the following limitations: lack of equipment, software, and space for home-based exercises, insufficient internet capacity and speed, unavailability to provide hands on guidance, low digital proficiency and education, high cognitive demand, small samples, data heterogeneity, and no economic evaluation. CONCLUSIONS: The review shows TR is superior or similar to conventional rehabilitation in clinical outcomes and is used as complementary therapy or as alternative treatments. More importantly, TR provides access to rehabilitation services of a large number of patients with immobility, living in remote areas, and during COVID-19 pandemic or similar events.
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Affiliation(s)
- Vitaly A. Nikolaev
- Pirogov Russian National Research Medical University (Pirogov Medical University), Moscow, Russia
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Barak Ventura R, Stewart Hughes K, Nov O, Raghavan P, Ruiz Marín M, Porfiri M. Data-Driven Classification of Human Movements in Virtual Reality-Based Serious Games: Preclinical Rehabilitation Study in Citizen Science. JMIR Serious Games 2022; 10:e27597. [PMID: 35142629 PMCID: PMC8874800 DOI: 10.2196/27597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/14/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background Sustained engagement is essential for the success of telerehabilitation programs. However, patients’ lack of motivation and adherence could undermine these goals. To overcome this challenge, physical exercises have often been gamified. Building on the advantages of serious games, we propose a citizen science–based approach in which patients perform scientific tasks by using interactive interfaces and help advance scientific causes of their choice. This approach capitalizes on human intellect and benevolence while promoting learning. To further enhance engagement, we propose performing citizen science activities in immersive media, such as virtual reality (VR). Objective This study aims to present a novel methodology to facilitate the remote identification and classification of human movements for the automatic assessment of motor performance in telerehabilitation. The data-driven approach is presented in the context of a citizen science software dedicated to bimanual training in VR. Specifically, users interact with the interface and make contributions to an environmental citizen science project while moving both arms in concert. Methods In all, 9 healthy individuals interacted with the citizen science software by using a commercial VR gaming device. The software included a calibration phase to evaluate the users’ range of motion along the 3 anatomical planes of motion and to adapt the sensitivity of the software’s response to their movements. During calibration, the time series of the users’ movements were recorded by the sensors embedded in the device. We performed principal component analysis to identify salient features of movements and then applied a bagged trees ensemble classifier to classify the movements. Results The classification achieved high performance, reaching 99.9% accuracy. Among the movements, elbow flexion was the most accurately classified movement (99.2%), and horizontal shoulder abduction to the right side of the body was the most misclassified movement (98.8%). Conclusions Coordinated bimanual movements in VR can be classified with high accuracy. Our findings lay the foundation for the development of motion analysis algorithms in VR-mediated telerehabilitation.
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Affiliation(s)
- Roni Barak Ventura
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States
| | - Kora Stewart Hughes
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States
| | - Oded Nov
- Department of Technology Management and Innovation, New York University Tandon School of Engineering, Brooklyn, NY, United States
| | - Preeti Raghavan
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Manuel Ruiz Marín
- Department of Quantitative Methods, Law and Modern Languages, Technical University of Cartagena, Cartagena, Spain.,Murcia Bio-Health Institute (IMIB-Arrixaca), Health Science Campus, Cartagena, Spain
| | - Maurizio Porfiri
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States.,Center for Urban Science and Progress, New York University, Brooklyn, NY, United States.,Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States
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18
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Does Telerehabilitation Help in Reducing Disability among People with Musculoskeletal Conditions? A Preliminary Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010072. [PMID: 35010331 PMCID: PMC8751178 DOI: 10.3390/ijerph19010072] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 01/23/2023]
Abstract
Introduction: During the coronavirus pandemic, an initiative was launched in Saudi Arabia to provide telerehabilitation for people with musculoskeletal conditions who were unable to access in-person physiotherapy due to the associated lockdown. The purpose of this study was to explore the therapeutic impact and acceptability of telerehabilitation among the Saudi population. Methods: Ninety-five participants were recruited through an online advertisement and received a physiotherapy consultation and interventions via an online video conference platform (Google Meet). Following screening for red flags, participants received tailored education and conditioning exercises 2–3 times a week for 6 weeks. Outcome measures were recorded at baseline and 6 weeks and comprised the Pain Self-Efficacy Questionnaire, Patient-Specific Functional Scale, Musculoskeletal Health Questionnaire and a satisfaction survey. Results: The most frequent musculoskeletal conditions reported were lower back (37%), knee (14%) and neck (10%) pain and post-operative conditions (15%). Participants showed significant improvements in outcomes at the end of the program (p < 0.001) with effect sizes ranging from 0.6 to −1.9 and reported a high level of satisfaction with the telerehabilitation intervention. Conclusion: This study showed that telerehabilitation was an acceptable method of providing physiotherapy interventions for patients with musculoskeletal conditions in Saudi Arabia.
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Saragih ID, Tarihoran DETAU, Batubara SO, Tzeng HM, Lin CJ. Effects of telehealth interventions on performing activities of daily living and maintaining balance in stroke survivors: A systematic review and meta-analysis of randomised controlled studies. J Clin Nurs 2021; 31:2678-2690. [PMID: 34873756 DOI: 10.1111/jocn.16142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/01/2021] [Accepted: 11/09/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Stroke is one of the most common causes of disability worldwide. In recent years, diverse telehealth programmes for stroke survivors have suggested that this mode of rehabilitation could improve stroke survivors' abilities to perform activities of daily living (ADLs) and maintain balance. Although increasingly utilised in clinical and community settings, the effectiveness of telehealth interventions in stroke survivors remains inconclusive. This warrants investigation so that telehealth interventions are evidence-based and are not merely modalities of convenience. AIM To identify the effects of telehealth interventions on the ability to perform ADLs and maintain balance in stroke survivors. DESIGN A systematic literature review and meta-analysis were conducted in accordance with PRISMA guidelines. METHODS A systematic literature search was performed using seven databases for literature dated up to April 25, 2021. The revised Cochrane risk of bias tool for randomised trials was used to assess the methodological quality of the included studies. A meta-analysis was performed using a random-effects model to calculate the pooled effects of telehealth interventions. Stata 16.0 was used for the statistical analyses. RESULTS A total of 14 studies with 1,367 participants were included in the analysis. Overall, telehealth interventions were effective in improving stroke survivors' abilities to carry out their ADLs (standardised mean difference: .45; 95% confidence interval: .12 to .78); however, no significant effects were found on balance. CONCLUSION Telehealth interventions are beneficial for improving stroke survivors' performance of their ADLs. Future telehealth intervention trials should focus on identifying essential intervention delivery components that facilitate intervention adoption by clinicians and stroke survivors and sustain the positive effects on stroke survivors' performance of their ADLs in different settings. RELEVANCE TO CLINICAL PRACTICE It is essential to build flexibility in the telehealth-based intervention delivery protocol to meet individual stroke survivors' needs to motivate and enhance their ADL performance.
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Affiliation(s)
| | - Dame Elysabeth Tuty Arna Uly Tarihoran
- School of Nursing Faculty of Medical and Health Sciences and Assistant Professor, School of Nursing, Krida Wacana Christian University, UKRIDA, Jakarta, Indonesia, University of Auckland, New Zealand
| | | | - Huey-Ming Tzeng
- University of Texas, Medical Branch, School of Nursing, Galveston, Texas, USA
| | - Chia-Ju Lin
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Telerehabilitation—A Viable Option for the Recovery of Post-Stroke Patients. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app112110116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
As the number of stroke survivors is continuously growing, with an important number suffering from consequent functional deficits, the rehabilitation field is facing more complex demands. Technological progress gives us the opportunity to remotely assist patients while they exercise at home through telerehabilitation (TR), addressing the problems of limited medical resources and staff, difficult transportation, or living a long distance from rehabilitation centers. In addition, TR is a way to provide continuity in long-term post-stroke recovery during the COVID-19 pandemic, which limits traveling and human interaction. While the implementation of TR is increasing, the biggest challenges are to raise patients’ acceptability of the new method and their motivation and engagement during the program. In this review, we aimed to find methods to address these challenges by identifying the patients who benefit the most from this therapy and efficiently organizing the space and technology used for telerehabilitation. User-friendly technologies and devices along with therapists’ constant support and feedback are some of the most important aspects that make TR an efficient intervention and an alternative to conventional therapy.
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