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Valdes K, Gendernalik E, Hauser J, Tipton M. Use of mobile applications in hand therapy. J Hand Ther 2021; 33:229-234. [PMID: 32253058 DOI: 10.1016/j.jht.2019.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/04/2019] [Accepted: 10/03/2019] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Mobile devices can be incorporated into therapy as an engaging alternative to traditional therapy options. The use of mobile devices and smartphone applications can enhance the quality of care provided by health care professionals. PURPOSE To find mobile apps that can be incorporated into hand therapy practice. METHODS Hand therapy evaluation, interventions, proprioception, laterality, and home exercise program applications can be incorporated into practice. Patient education can also be provided via the use of mobile applications. CONCLUSION Smartphone applications can be a valuable intervention and impact performance in individuals with impaired hand function. Smartphone applications offer a client-centered, and potentially motivating, activity option that can be utilized to aid the hand therapist.
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Affiliation(s)
- Kristin Valdes
- Department of Occupational Therapy, Gannon University, Ruskin, FL, USA.
| | | | - Jacquelyn Hauser
- Department of Occupational Therapy, Gannon University, Ruskin, FL, USA
| | - Miranda Tipton
- Department of Occupational Therapy, Gannon University, Ruskin, FL, USA
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Kanitkar A, Szturm T, Parmar S, Gandhi DB, Rempel GR, Restall G, Sharma M, Narayan A, Pandian J, Naik N, Savadatti RR, Kamate MA. The Effectiveness of a Computer Game-Based Rehabilitation Platform for Children With Cerebral Palsy: Protocol for a Randomized Clinical Trial. JMIR Res Protoc 2017; 6:e93. [PMID: 28526673 PMCID: PMC5454217 DOI: 10.2196/resprot.6846] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 02/03/2017] [Accepted: 02/03/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It is difficult to engage young children with cerebral palsy (CP) in repetitive, tedious therapy. As such, there is a need for innovative approaches and tools to motivate these children. We developed the low-cost, computer game-based rehabilitation platform CGR that combines fine manipulation and gross movement exercises with attention and planning game activities appropriate for young children with CP. OBJECTIVE The objective of this study is to provide evidence of the therapeutic value of CGR to improve upper extremity (UE) motor function for children with CP. METHODS This randomized controlled, single-blind, clinical trial with an active control arm will be conducted at 4 sites. Children diagnosed with CP between the ages of 4 and 10 years old with moderate UE impairments and fine motor control abnormalities will be recruited. RESULTS We will test the difference between experimental and control groups using the Quality of Upper Extremity Skills Test (QUEST) and Peabody Developmental Motor Scales, Second Edition (PDMS-2) outcome measures. The parents of the children and the therapist experiences with the interventions and tools will be explored using semi-structured interviews using the qualitative description approach. CONCLUSIONS This research protocol, if effective, will provide evidence for the therapeutic value and feasibility of CGR in the pediatric rehabilitation of UE function. TRIAL REGISTRATION Clinicaltrials.gov NCT02728375; http:https://clinicaltrials.gov/ct2/show/NCT02728375 (Archived by WebCite at http://www.webcitation.org/6qDjvszvh).
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Affiliation(s)
- Anuprita Kanitkar
- Applied Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Tony Szturm
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Sanjay Parmar
- SDM College of Medical Sciences and Hospital, Rajiv Gandhi University of Health Sciences, Dharwad, India
| | - Dorcas Bc Gandhi
- Christian Medical College and Hospital, Department of Neurology, Baba Farid University of Health Sciences, Ludhiana, India
| | - Gina Ruth Rempel
- Max Rady College of Medicine, Rady Faculty of Health Sciences, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Gayle Restall
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Monika Sharma
- Christian Medical College and Hospital, Department of Pediatrics, Baba Farid University of Health Sciences, Ludhiana, India
| | - Amitesh Narayan
- Kasturba Medical College, Department of Physiotherapy, Manipal University, Mangalore, India
| | - Jeyaraj Pandian
- Christian Medical College and Hospital, Department of Neurology, Baba Farid University of Health Sciences, Ludhiana, India
| | - Nilashri Naik
- Department of Physiotherapy, Ushas School for Exceptional Children, Hubli, India
| | - Ravi R Savadatti
- SDM College of Physiotherapy, Rajiv Gandhi University of Health Sciences, Dharwad, India
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Srikesavan CS, Shay B, Szturm T. Test-retest reliability and convergent validity of a computer based hand function test protocol in people with arthritis. Open Orthop J 2015; 9:57-67. [PMID: 25861406 PMCID: PMC4384228 DOI: 10.2174/1874325001509010057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 01/27/2015] [Accepted: 02/15/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES A computer based hand function assessment tool has been developed to provide a standardized method for quantifying task performance during manipulations of common objects/tools/utensils with diverse physical properties and grip/grasp requirements for handling. The study objectives were to determine test-retest reliability and convergent validity of the test protocol in people with arthritis. METHODS Three different object manipulation tasks were evaluated twice in forty people with rheumatoid arthritis (RA) or hand osteoarthritis (HOA). Each object was instrumented with a motion sensor and moved in concert with a computer generated visual target. Self-reported joint pain and stiffness levels were recorded before and after each task. Task performance was determined by comparing the object movement with the computer target motion. This was correlated with grip strength, nine hole peg test, Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire, and the Health Assessment Questionnaire (HAQ) scores. RESULTS The test protocol indicated moderate to high test-retest reliability of performance measures for three manipulation tasks, intraclass correlation coefficients (ICCs) ranging between 0.5 to 0.84, p<0.05. Strength of association between task performance measures with self- reported activity/participation composite scores was low to moderate (Spearman rho <0.7). Low correlations (Spearman rho < 0.4) were observed between task performance measures and grip strength; and between three objects' performance measures. Significant reduction in pain and joint stiffness (p<0.05) was observed after performing each task. CONCLUSION The study presents initial evidence on the test retest reliability and convergent validity of a computer based hand function assessment protocol in people with rheumatoid arthritis or hand osteoarthritis. The novel tool objectively measures overall task performance during a variety of object manipulation tasks done by tracking a computer based visual target. This allows an innovative method of assessing performance than considering the time taken to complete a task or relying on subjective measures of self-reports on a limited range of objects and tasks covered. In addition, joint pain and stiffness levels before and after a manipulation task are tracked, which is lacking in other hand outcome measures. Performance measures during a broad range of object manipulation tasks relate to many activities relevant to life role participation. Therefore, task performance evaluation of common objects, utensils, or tools would be more valuable to gauge the difficulties encountered in daily life by people with arthritis. Future studies should consider a few revisions of the present protocol and evaluate a number of different objects targeting strength, fine, and gross dexterity based tasks for a broader application of the tool in arthritis populations.
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Affiliation(s)
| | - Barbara Shay
- Department of Physical Therapy, College of Rehabilitation Sciences, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Tony Szturm
- Department of Physical Therapy, College of Rehabilitation Sciences, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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Szturm T, Polyzoi E, Marotta J, Srikesavan CS. An In-School-Based Program of Combined Fine Motor Exercise and Educational Activities for Children with Neurodevelopmental Disorders. Games Health J 2014; 3:326-32. [PMID: 26192639 DOI: 10.1089/g4h.2014.0051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This article introduces a game-based rehabilitation platform designed to integrate training of fine motor skills and cognitive functions. A novel computer interface device was developed that can effectively replace a standard computer mouse when doing exercises to rehabilitate hand function. This smart device converts signals from miniature motion sensors to signals equivalent to that of a computer mouse. In this way, nearly any object or utensil can be changed to function exactly as a computer mouse, simply by attaching the motion sensor. Multiple objects with varied sizes, shapes, weights, and functional demands for precision can be used for exercise and to practice a variety of gross or fine motor skills, and, importantly, while playing fun computer games. The platform was designed to work with modern and common computer games, which have a broad range of movement speeds and accuracy levels, cognitive activities (puzzles, choices, distractors), and educational content. The platform includes a designed assessment game with advanced data logging for electronic monitoring. Data analysis methods have been developed to quantify performance metrics that provide insights into the quality, efficiency, and skill of a child and thus mean to conduct trend analyses that indicate how the child is performing over time.
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Affiliation(s)
- Tony Szturm
- 1 Department of Physical Therapy, College of Rehabilitation Sciences, Faculty of Health Sciences, University of Manitoba , Winnipeg, Manitoba, Canada
| | - Eleoussa Polyzoi
- 2 Faculty of Education (Developmental Studies & Special Needs Education), University of Winnipeg , Winnipeg, Manitoba, Canada
| | - Jonathan Marotta
- 3 Department of Psychology, University of Manitoba , Winnipeg, Manitoba, Canada
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Srikesavan CS, Shay B, Robinson DB, Szturm T. Task-oriented training with computer gaming in people with rheumatoid arthritisor osteoarthritis of the hand: study protocol of a randomized controlled pilot trial. Trials 2013; 14:69. [PMID: 23497529 PMCID: PMC3599819 DOI: 10.1186/1745-6215-14-69] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 02/18/2013] [Indexed: 11/17/2022] Open
Abstract
Background Significant restriction in the ability to participate in home, work and community life results from pain, fatigue, joint damage, stiffness and reduced joint range of motion and muscle strength in people with rheumatoid arthritis or osteoarthritis of the hand. With modest evidence on the therapeutic effectiveness of conventional hand exercises, a task-oriented training program via real life object manipulations has been developed for people with arthritis. An innovative, computer-based gaming platform that allows a broad range of common objects to be seamlessly transformed into therapeutic input devices through instrumentation with a motion-sense mouse has also been designed. Personalized objects are selected to target specific training goals such as graded finger mobility, strength, endurance or fine/gross dexterous functions. The movements and object manipulation tasks that replicate common situations in everyday living will then be used to control and play any computer game, making practice challenging and engaging. Methods/Design The ongoing study is a 6-week, single-center, parallel-group, equally allocated and assessor-blinded pilot randomized controlled trial. Thirty people with rheumatoid arthritis or osteoarthritis affecting the hand will be randomized to receive either conventional hand exercises or the task-oriented training. The purpose is to determine a preliminary estimation of therapeutic effectiveness and feasibility of the task-oriented training program. Performance based and self-reported hand function, and exercise compliance are the study outcomes. Changes in outcomes (pre to post intervention) within each group will be assessed by paired Student t test or Wilcoxon signed-rank test and between groups (control versus experimental) post intervention using unpaired Student t test or Mann–Whitney U test. Discussion The study findings will inform decisions on the feasibility, safety and completion rate and will also provide preliminary data on the treatment effects of the task-oriented training compared with conventional hand exercises in people with rheumatoid arthritis or osteoarthritis of the hand. Trial registration ClinicalTrials.gov: NCT01635582
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Affiliation(s)
- Cynthia Swarnalatha Srikesavan
- Department of Physical Therapy, School of Medical Rehabilitation, Faculty of Medicine, University of Manitoba, R106 - 771 Mc Dermot Avenue, Winnipeg, Manitoba R3E 0T6, Canada
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Lockery D, Peters JF, Ramanna S, Shay BL, Szturm T. Store-and-Feedforward Adaptive Gaming System for Hand-Finger Motion Tracking in Telerehabilitation. ACTA ACUST UNITED AC 2011; 15:467-73. [DOI: 10.1109/titb.2011.2125976] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Manipulation of objects with and without the use of the index finger: implications for digital amputations. J Hand Ther 2011; 23:352-59; quiz 360. [PMID: 20609561 DOI: 10.1016/j.jht.2010.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Revised: 02/11/2010] [Accepted: 04/30/2010] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Clinical Measurement. PURPOSE To evaluate changes in temporal and amplitude movement accuracy with tasks requiring fine motor manipulation with and without the use of the index finger (WIF). PARTICIPANTS Twenty right-handed participants (10 males, 10 females, aged 24-47 years) were recruited. METHODS Three objects, ranging in weight and size, that required the use of 2 or 3 fingers were selected for this study. Motor performance was quantified during manipulation of a pen, cork, and wine glass using a computerized visual guided tracking task. The miniBird (Ascension Technology, Burlington, VT, USA) miniature motion tracking sensor was attached to each object to measure and record the 3D linear and angular motion. RESULTS Task performance and temporal accuracy of the pen task in the normal condition was more accurate (P=.033). During the WIF condition there was significantly more motion performing the wine task (P<.001). CONCLUSIONS The protocol directly measures the ability of the hand to coordinate movement in response to a visual tracking target. Both temporal accuracy and amplitude consistency can be objectively evaluated. The current study evaluates the ability of the hand to manipulate 3 objects used in fine motor manipulation, using motion analysis and visual tracking. LEVEL OF EVIDENCE 3b.
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Kim NH, Wininger M, Craelius W. Training grip control with a Fitts' paradigm: a pilot study in chronic stroke. J Hand Ther 2010; 23:63-72. [PMID: 20142007 DOI: 10.1016/j.jht.2009.10.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2009] [Revised: 10/02/2009] [Accepted: 10/04/2009] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN A clinical measurement study. PURPOSE To test the applicability of Fitts' paradigm to grasping tasks in individuals with chronic stroke. INTRODUCTION Fitts' Law relates the time of target achievement to task difficulty in repetitive motor tasks. METHODS Six male chronic stroke patients performed repetitive actuation of a grip force dynamometer with their affected hands for 12 sessions over four to six weeks. RESULTS Movement times followed Fitts' behavior with correlations of R(2)>0.8 for all subjects. Grasp control improved during training, as indicated by an average decrease in Fitts' slope of 26% at high difficulty levels (p<0.05), and decreases in the number of force corrections and in jerkiness, both at p<0.001 level. CONCLUSIONS The Fitts' grip force targeting protocol provides an objective standardized instrument for grasp proficiency quantification and a potentially efficacious platform for hand training for persons with stroke. LEVEL OF EVIDENCE N/A.
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Affiliation(s)
- Nam Hun Kim
- Rutgers University Rehabilitation Laboratory, Department of Biomedical Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey; Human Performance and Movement Analysis Laboratory, Kessler Foundation Research Center, West Orange, New Jersey.
| | - Michael Wininger
- Rutgers University Rehabilitation Laboratory, Department of Biomedical Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey; Clinical Brain Disorders Branch, National Institute of Mental Health, Bethesda, Maryland
| | - William Craelius
- Rutgers University Rehabilitation Laboratory, Department of Biomedical Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey
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