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Towersey NCM, Sasse K, Stavric V, Alder G, Saywell NL. Freely available, online videos to support neurological physiotherapists and students in task-specific training skill acquisition: a scoping review. BMC MEDICAL EDUCATION 2024; 24:603. [PMID: 38822287 PMCID: PMC11143672 DOI: 10.1186/s12909-024-05545-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 05/09/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Videos to support learning of clinical skills are effective; however, little is known about the scope and educational quality of the content of freely available online videos demonstrating task-specific training (TST). This review aimed to determine the extent, characteristics of freely available online videos, and whether the content is suitable to guide skill acquisition of task-specific training for neurological physiotherapists and students. METHODS A scoping review was conducted. Google video and YouTube were searched in December 2022. Videos that met our eligibility criteria and were explicitly designed for (TST) skill acquisition were included in the report. RESULTS Ten videos met the inclusion criteria and were difficult to find amongst the range of videos available. Most were presented by physiotherapists or occupational therapists, originated from the USA, featured stroke as the condition of the person being treated, and involved a range of interventions (upper limb, constraint induced movement therapy, balance, bicycling). Most videos were created by universities or private practices and only two used people with a neurological condition as the participant. When the content of videos and their presentation (instruction and/or demonstration), was assessed against each key component of TST (practice structure, specificity, repetition, modification, progression, feedback), five of the videos were rated very suitable and five moderately suitable to guide skill acquisition. Most videos failed to demonstrate and provide instruction on each key component of TST and were missing at least one component, with feedback most frequently omitted. CONCLUSIONS There are many freely available online videos which could be described as demonstrating TST; very few are suitable to guide skill acquisition. The development of a standardised and validated assessment tool, that is easy to use and assesses the content of TST videos is required to support learners to critically evaluate the educational quality of video content. Guidelines based on sound teaching theory and practice are required to assist creators of online videos to provide suitable resources that meet the learning needs of neurological physiotherapists and students.
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Affiliation(s)
- Nicola C M Towersey
- School of Clinical Sciences, Department of Physiotherapy, Health and Rehabilitation Research Institute, Auckland University of Technology, Northshore Campus, Private Bag 92006, Auckland, 1142, New Zealand.
| | - Kelvin Sasse
- School of Clinical Sciences, Department of Physiotherapy, Health and Rehabilitation Research Institute, Auckland University of Technology, Northshore Campus, Private Bag 92006, Auckland, 1142, New Zealand
| | - Verna Stavric
- School of Clinical Sciences, Department of Physiotherapy, Health and Rehabilitation Research Institute, Auckland University of Technology, Northshore Campus, Private Bag 92006, Auckland, 1142, New Zealand
| | - Gemma Alder
- School of Clinical Sciences, Department of Physiotherapy, Health and Rehabilitation Research Institute, Auckland University of Technology, Northshore Campus, Private Bag 92006, Auckland, 1142, New Zealand
| | - Nicola L Saywell
- School of Clinical Sciences, Department of Physiotherapy, Health and Rehabilitation Research Institute, Auckland University of Technology, Northshore Campus, Private Bag 92006, Auckland, 1142, New Zealand
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Kim SY, Lee MY, Lee BH. Effects of Rehabilitation Robot Training on Physical Function, Functional Recovery, and Daily Living Activities in Patients with Sub-Acute Stroke. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:811. [PMID: 38792996 PMCID: PMC11123305 DOI: 10.3390/medicina60050811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024]
Abstract
Stroke often results in sensory deficits, muscular weakness, and diminished postural control, thereby restricting mobility and functional capabilities. It is important to promote neuroplasticity by implementing task-oriented exercises that induce changes in patients. Therefore, this study aimed to investigate the effects of rehabilitation robot training on physical function, functional recovery, and activities of daily living (ADLs) in patients with subacute stroke. The study participants were patients with subacute stroke receiving treatment at Hospitals A and B. They were selected as research subjects based on selection and exclusion criteria. The experimental group received rehabilitation robot training in sessions of 30 min, five times weekly, for a total of 20 sessions over four weeks. Conversely, the control group underwent standard rehabilitation equipment training with an identical frequency, duration, and number of sessions. Measurements were taken before and after the training period to assess changes in physical function, functional recovery, and activities of daily living using tools such as the MMT, BBS, FBG, FAC, FIM, and MBI. The results were as follows: in the within-group comparison, the rehabilitation robot training group showed significant differences in MMT, BBS, FBG, FAC, FIM, and MBI (p < 0.05), while the control group showed significant differences in FIM (p < 0.05). Statistically significant differences were observed in the time, group, and time × group interaction effects among the MMT, static seated FBG, dynamic seated FBG, FIM, and MBI (p < 0.05). Based on these results, rehabilitation robotic training resulted in significant improvements in physical function, functional recovery, and activities of daily living in patients with subacute stroke. Based on these findings, providing a basic protocol for a rehabilitation program that applies rehabilitation robot training to patients with subacute stroke may offer more effective treatment and outcomes in the future.
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Affiliation(s)
- Se-Young Kim
- Graduate School of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea;
| | - Mi-Young Lee
- Department of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea;
| | - Byoung-Hee Lee
- Department of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea;
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Teodoro J, Fernandes S, Castro C, Fernandes JB. Current Trends in Gait Rehabilitation for Stroke Survivors: A Scoping Review of Randomized Controlled Trials. J Clin Med 2024; 13:1358. [PMID: 38592172 PMCID: PMC10932333 DOI: 10.3390/jcm13051358] [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: 01/21/2024] [Revised: 02/23/2024] [Accepted: 02/24/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Stroke stands as a significant global health concern, constituting a leading cause of disability worldwide. Rehabilitation interventions are crucial in aiding the recovery of stroke patients, contributing to an overall enhancement in their quality of life. This scoping review seeks to identify current trends in gait rehabilitation for stroke survivors. METHODS The review followed the methodological framework suggested by Arksey and O'Malley. Electronic databases, such as CINAHL Complete, MEDLINE Complete, and Nursing & Allied Health Collection, were systematically searched in November 2023. Inclusion criteria comprised papers published in either English or Portuguese from 2013 to 2023. RESULTS From the initial search, a total of 837 papers were identified; twenty-one papers were incorporated into this review. Thirteen distinct categories of gait rehabilitation interventions were identified, encompassing diverse approaches. These categories comprise conventional rehabilitation exercises, traditional gait training with integrated technology, and gait training supported by modern technologies. CONCLUSIONS Although traditional rehabilitation exercises have historically proven effective in aiding stroke survivors, a recent trend has emerged, emphasizing the development and integration of innovative therapeutic approaches that harness modern technologies.
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Affiliation(s)
- Joana Teodoro
- Department of Nursing, Hospital Garcia de Orta, 2805-267 Almada, Portugal;
- Nurs* Lab, 2829-511 Almada, Portugal; (S.F.); (C.C.)
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal
| | - Sónia Fernandes
- Nurs* Lab, 2829-511 Almada, Portugal; (S.F.); (C.C.)
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal
| | - Cidália Castro
- Nurs* Lab, 2829-511 Almada, Portugal; (S.F.); (C.C.)
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal
| | - Júlio Belo Fernandes
- Nurs* Lab, 2829-511 Almada, Portugal; (S.F.); (C.C.)
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal
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Hou Z, Gao S, Wang F, Wu J. Electroacupuncture combined with wet compress formula ameliorates upper limb dysfunction associated with stroke: A retrospective analysis of 126 cases. J Stroke Cerebrovasc Dis 2024; 33:107524. [PMID: 38103448 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107524] [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: 11/09/2023] [Revised: 11/23/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023] Open
Abstract
OBJECTIVES Upper limb motor dysfunction (ULMD) is one of the most common complications of ischemic stroke (IS). Electroacupuncture (EA) is a noninvasive procedure that has the potential to manage symptoms associated with IS. To improve the treatment effects of EA, our hospital performed combined treating strategy against ULMD by subjecting IS patients to both EA and external application of wet compress formula (WCF). In the current analysis, the potential improving effects of the combined treatment against ULMD were evaluated. MATERIALS AND METHODS 126 patients with ULMD induced by IS handled with normal rehabilitation treatment, EA treatment alone, and EA combined with WCF respectively were enrolled in the current analysis. The clinicopathological information and changes in motor function assessment scales, including Visual analogue (VAS), Fugl-Meyer assessment-upper extremity (FMA-UA), and Modified Barthel index (MBI) scales were collected and the difference between different treating strategies was assessed. RESULTS All the treating strategies improved the values of VAS, FMA-UA, and MBI scales, with combined treating strategy showing the strongest improving effects, and traditional rehabilitation strategy showing the weakest effects. Moreover, the assessment of hand and wrist motor function by FMA-UE also showed that the combined treatment strategy has significantly stronger improving effects against ULMD compared with other strategies. CONCLUSIONS The current analysis showed that the use of external application of WCF could substantially increase the treating effects of EA on ULMD induced by IS without severe side effects, which could guide the future clinical management of motor dysfunction.
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Affiliation(s)
- Zhizong Hou
- Department of Rehabilitation Medicine, First Hospital of Shanxi Medical University, No. 85, Jiefang South Road, Yingze District, Taiyuan, Shanxi 030001, China
| | - Shengwei Gao
- Department of Neurology, Taiyuan Central Hospital, Taiyuan, Shanxi 030001, China
| | - Fei Wang
- Department of Rehabilitation Medicine, First Hospital of Shanxi Medical University, No. 85, Jiefang South Road, Yingze District, Taiyuan, Shanxi 030001, China
| | - Junying Wu
- Department of Rehabilitation Medicine, First Hospital of Shanxi Medical University, No. 85, Jiefang South Road, Yingze District, Taiyuan, Shanxi 030001, China.
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Wang T, Liu Z, Gu J, Tan J, Hu T. Effectiveness of soft robotic glove versus repetitive transcranial magnetic stimulation in post-stroke patients with severe upper limb dysfunction: A randomised controlled trial. Front Neurol 2023; 13:887205. [PMID: 36712422 PMCID: PMC9874667 DOI: 10.3389/fneur.2022.887205] [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: 03/02/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023] Open
Abstract
Purpose To explore the difference in rehabilitation effect between soft robot gloves and repetitive transcranial magnetic stimulation (rTMS) in patients with severe upper limb motor dysfunction after a stroke. Methods A total of 69 post-stroke patients with severe upper limb dysfunction were randomly assigned to a repetitive transcranial magnetic group, a soft robotic glove group, and a conventional treatment group. The primary outcomes were the Fugl-Meyer Upper Extremity Assessment (FMA-UE) and the Modified Barthel Index (MBI). The secondary endpoints were the amplitude surface electromyogram of the extensor wrist muscle (sEMG) and the cerebral hemispheric resting motor threshold (RMT). Results The change of FMA-UE score in the soft robotic glove group was significantly better than that in the conventional treatment group (median difference: 2 points; 95% confidence interval [1, 3]; P < 0.05), but there was no significant difference compared with the repetitive transcranial magnetic stimulation group (median difference: 0 points; 95% confidence interval [-1, 2]; P [0.547] > 0.05). There was no significant difference in the change of MBI score between the soft robotic glove group and the conventional treatment and repetitive transcranial magnetic treatment groups [F = 2.458, P [0.093] > 0.05]. There was no significant difference in the change of sEMG score between the soft robotic glove group and the conventional treatment and repetitive transcranial magnetic treatment groups [H = 0.042, P [0.980] > 0.05]. Additionally, the change of RMT score in the soft robotic glove group was significantly inferior to that in the repetitive transcranial magnetic treatment group [difference: -1.09; 95% confidence interval [-2.048, 0.048]; P < 0.05], but there was no significant difference compared with the conventional treatment group [difference: 0.31 points; 95% confidence interval [-0.879, 0.358]; P [0.495] > 0.05]. Conclusion For patients with severe dyskinesia after a stroke, soft robotic gloves are as effective as repetitive transcranial magnetic stimulation and may be a good choice for home rehabilitation. In addition, conventional treatment combined with repetitive transcranial magnetic stimulation (rTMS) or a soft robotic glove produced better rehabilitation outcomes than conventional treatment alone.
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Affiliation(s)
- Taotao Wang
- Zhongshan People's Hospital, Zhongshan, China,*Correspondence: Taotao Wang ✉
| | | | - Jianxiong Gu
- Affiliated Hospital of Guangdong Medical University, Zhanjiang, China,Jianxiong Gu ✉
| | - Jizhi Tan
- Guangdong Medical University, Zhanjiang, China
| | - Tian Hu
- Guangdong Medical University, Zhanjiang, China
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Fujiwara K, Shimoda R, Shibata M, Awano Y, Shibayama K, Higashi T. A Method for Using Video Presentation to Increase Cortical Region Activity during Motor Imagery Tasks in Stroke Patients. Brain Sci 2022; 13:brainsci13010029. [PMID: 36672012 PMCID: PMC9855988 DOI: 10.3390/brainsci13010029] [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: 11/13/2022] [Revised: 12/17/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Previous studies have reported that stroke patients have difficulty recalling the motor imagery (MI) of a task, also known as MI vividness. Research on combining MI with action observation is gaining importance as a method to improve MI vividness. We enrolled 10 right-handed stroke patients and compared MI vividness and cortical activity under different presentation methods (no inverted image, inverted image of another individual’s hand, and an inverted image of the patient’s nonparalyzed hand) using near-infrared spectroscopy. Images of the nonparalyzed upper limb were inverted to make the paralyzed upper limb appear as if it were moving. Three tasks (non inverted image, AO + MI (other hand), AO + MI (own hand)) were randomly performed on 10 stroke patients. MI vividness was significantly higher when the inverted image of the nonparalyzed upper limb was presented compared to the other conditions (p < 0.01). The activity of the cortical regions was also significantly enhanced (p < 0.01). Our study highlights the potential application of inverted images of a stroke patient’s own nonparalyzed hand in mental practice to promote the motor recovery of stroke patients. This technique achieved higher levels of MI vividness and cortical activity when performing motor tasks.
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Affiliation(s)
- Kengo Fujiwara
- Medical Corporation Zeshinkai Nagasaki Rehabilitation Hospital, Ginya, Nagasaki 850-0854, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki 852-8520, Japan
- Correspondence: ; Tel.: +81-958-819-7994
| | - Rikako Shimoda
- Medical Corporation Zeshinkai Home Rehabilitation Center Ginya, Ginya, Nagasaki 850-0854, Japan
| | - Masatomo Shibata
- Medical Corporation Zeshinkai Nagasaki Rehabilitation Hospital, Ginya, Nagasaki 850-0854, Japan
| | - Yoshinaga Awano
- Medical Corporation Zeshinkai Nagasaki Rehabilitation Hospital, Ginya, Nagasaki 850-0854, Japan
| | - Koji Shibayama
- Medical Corporation Zeshinkai Nagasaki Rehabilitation Hospital, Ginya, Nagasaki 850-0854, Japan
| | - Toshio Higashi
- Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki 852-8520, Japan
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Fujiwara K, Shibata M, Awano Y, Shibayama K, Iso N, Matsuo M, Nakashima A, Moriuchi T, Mitsunaga W, Higashi T. A method for using video presentation to increase the vividness and activity of cortical regions during motor imagery tasks. Neural Regen Res 2021; 16:2431-2437. [PMID: 33907031 PMCID: PMC8374587 DOI: 10.4103/1673-5374.313058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/29/2020] [Accepted: 10/15/2020] [Indexed: 11/07/2022] Open
Abstract
In recent years, mental practice (MP) using laterally inverted video of a subject's non-paralyzed upper limb to improve the vividness of presented motor imagery (MI) has been shown to be effective for improving the function of a paralyzed upper limb. However, no studies have yet assessed the activity of cortical regions engaged during MI task performance using inverse video presentations and neurophysiological indicators. This study sought to investigate changes in MI vividness and hemodynamic changes in the cerebral cortex during MI performance under the following three conditions in near-infrared spectroscopy: MI-only without inverse video presentation (MI-only), MI with action observation (AO) of an inverse video presentation of another person's hand (AO + MI (other hand)), and MI with AO of an inverse video presentation of a participant's own hand (AO + MI (own hand)). Participants included 66 healthy right-handed adults (41 men and 25 women; mean age: 26.3 ± 4.3 years). There were 23 patients in the MI-only group (mean age: 26.4 ± 4.1 years), 20 in the AO + MI (other hand) group (mean age: 25.9 ± 5.0 years), and 23 in the AO + MI (own hand) group (mean age: 26.9 ± 4.1 years). The MI task involved transferring 1 cm × 1 cm blocks from one plate to another, once per second, using chopsticks held in the non-dominant hand. Based on a visual analog scale (VAS), MI vividness was significantly higher in the AO + MI (own hand) group than in the MI-only group and the AO + MI (other hand) group. A main effect of condition was revealed in terms of MI vividness, as well as regions of interest (ROIs) in certain brain areas associated with motor processing. The data suggest that inverse video presentation of a person's own hand enhances the MI vividness and increases the activity of motor-related cortical areas during MI. This study was approved by the Institutional Ethics Committee of Nagasaki University Graduate School of Biomedical and Health Sciences (approval No. 18121303) on January 18, 2019.
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Affiliation(s)
- Kengo Fujiwara
- Department of Clinical Services, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Masatomo Shibata
- Department of Clinical Services, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Yoshinaga Awano
- Department of Clinical Services, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Koji Shibayama
- Department of Clinical Services, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Naoki Iso
- Department of Rehabilitation, Faculty of Health Sciences, Tokyo Kasei University, Tokyo, Japan
| | - Moemi Matsuo
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Akira Nakashima
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Takefumi Moriuchi
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Wataru Mitsunaga
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Toshio Higashi
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Palumbo A, Vizza P, Calabrese B, Ielpo N. Biopotential Signal Monitoring Systems in Rehabilitation: A Review. SENSORS 2021; 21:s21217172. [PMID: 34770477 PMCID: PMC8587479 DOI: 10.3390/s21217172] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 12/14/2022]
Abstract
Monitoring physical activity in medical and clinical rehabilitation, in sports environments or as a wellness indicator is helpful to measure, analyze and evaluate physiological parameters involving the correct subject’s movements. Thanks to integrated circuit (IC) technologies, wearable sensors and portable devices have expanded rapidly in monitoring physical activities in sports and tele-rehabilitation. Therefore, sensors and signal acquisition devices became essential in the tele-rehabilitation path to obtain accurate and reliable information by analyzing the acquired physiological signals. In this context, this paper provides a state-of-the-art review of the recent advances in electroencephalogram (EEG), electrocardiogram (ECG) and electromyogram (EMG) signal monitoring systems and sensors that are relevant to the field of tele-rehabilitation and health monitoring. Mostly, we focused our contribution in EMG signals to highlight its importance in rehabilitation context applications. This review focuses on analyzing the implementation of sensors and biomedical applications both in literature than in commerce. Moreover, a final review discussion about the analyzed solutions is also reported at the end of this paper to highlight the advantages of physiological monitoring systems in rehabilitation and individuate future advancements in this direction. The main contributions of this paper are (i) the presentation of interesting works in the biomedical area, mainly focusing on sensors and systems for physical rehabilitation and health monitoring between 2016 and up-to-date, and (ii) the indication of the main types of commercial sensors currently being used for biomedical applications.
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Affiliation(s)
- Arrigo Palumbo
- Department of Medical and Surgical Sciences, Magna Græcia University, 88100 Catanzaro, Italy; (A.P.); (B.C.); (N.I.)
| | - Patrizia Vizza
- Mater Domini University Hospital, 88100 Catanzaro, Italy
- Interdepartmental Center of Services (CIS), Magna Græcia University, 88100 Catanzaro, Italy
- Correspondence:
| | - Barbara Calabrese
- Department of Medical and Surgical Sciences, Magna Græcia University, 88100 Catanzaro, Italy; (A.P.); (B.C.); (N.I.)
| | - Nicola Ielpo
- Department of Medical and Surgical Sciences, Magna Græcia University, 88100 Catanzaro, Italy; (A.P.); (B.C.); (N.I.)
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Zaborova V, Fesyun A, Gurevich K, Oranskaya A, Rylsky A, Kryuchkova K, Malakhovskiy V, Shestakov D. Changes in kinesiostabilogram parameters and movement speed of stroke patients while increasing their physical activity due to the use of biofeedback method. Eur J Transl Myol 2021; 31. [PMID: 34595898 PMCID: PMC8758953 DOI: 10.4081/ejtm.2021.9360] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 08/13/2021] [Indexed: 11/23/2022] Open
Abstract
Balance disorders are complications of stroke survivors. Aim of this study was the establish effectiveness of the biofeedback approach. In this intervention study 245 patients with early diagnosis of acute disturbance of cerebral circulation (ADCC) were examined. Patients able to move independently were treated by standard conservative ADCC therapy on an outpatient approach, but they continued to have problems with coordination of movement in upright position. Then they were submitted to an increasing physical activity based on five sessions of biofeedback, i.e., a complex rehabilitation of patients with motor pathology "Trust-M" according to TU 9442-001-63704475-2010. Mobility rates were assessed using a web camera. Patients' quality of life was evaluated by SF-36 questionnaire and the Hospital Anxiety and Depression Scale (HADS). All parameters were recorded before and after 5 sessions of biofeedback. After treatment, the stability indicators improved and all patients showed a significant increase in motion rate and quality of life. At the same time, the severity of pain and of depression and anxiety decreased. Negative correlations of average strength between the quadrant and patient HADS scaling rates were obtained. In conclusion, our work shows effectiveness of the biofeedback technique for correcting coordination in stroke survivors.
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Affiliation(s)
- Victoria Zaborova
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; Sports Adaptology Laboratory, Moscow Institute of Physics and Technology (National Research University), Moscow Region, Dolgoprudniy.
| | - Anatoly Fesyun
- FSBI "National Medical Research Center for Rehabilitation and Resortology" Ministry of Public Health of Russia, Moscow.
| | - Konstantin Gurevich
- FSBI "National Medical Research Center for Rehabilitation and Resortology" Ministry of Public Health of Russia, Moscow, Russia; UNESCO chair "Healthy life style for sustainable development" "Moscow State University of Medicine and Dentistry. A.I. Evdokimov", Ministry of Health of the Russian Federation, Moscow, Russia; Research Institute of Healthcare Organization and Medical Management of the Moscow Department of Healthcare, Moscow .
| | - Alevtina Oranskaya
- UNESCO chair "Healthy life style for sustainable development" "Moscow State University of Medicine and Dentistry. A.I. Evdokimov", Ministry of Health of the Russian Federation, Moscow.
| | - Alexey Rylsky
- Moscow scientific and practical center for medical rehabilitation, rehabilitation and sports medicine, Department of Health of Moscow, Moscow.
| | - Kira Kryuchkova
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University (Sechenov University), Moscow.
| | - Vladimir Malakhovskiy
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University (Sechenov University), Moscow.
| | - Dmitry Shestakov
- Department of Orthopedics and Complex Trauma of the Moscow Clinical Research Center A.S. Loginov, Moscow.
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Kulshrestha S, Agrawal M, Singh AK, Kulshreshtha D. Post Stroke Rehabilitation Using Computer-based Cognitive Intervention (CBCI): A Systematic Review. CURRENT PSYCHIATRY RESEARCH AND REVIEWS 2020. [DOI: 10.2174/2666082216999200622135105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Cognitive impairment as a consequence of stroke is a major cause affecting
the patient’s functional independence, activity participation, daily living skills, and occupation. Almost
75% of post-stroke patients are diagnosed with significant cognitive impairment, which includes
problems with attention, orientation, memory, language, and perception. Along with effective
pharmaceutical cures, cognitive intervention as a part of rehabilitation approaches that may prevent,
delay, or treat cognitive impairment is becoming increasingly important. Many studies have reported
improvement in cognitive functions of post-stroke patients after using computer-based cognitive
intervention (CBCI). CBCI can be an effective add-on to available rehabilitation programs.
Objective:
This article provides reviews related to relevant literature and, represents a structure to
specify the efficacy of CBCI for the rehabilitation of post-stroke patients for future research.
Methods:
We searched many search engines namely MEDLINE, Web of Science, clinical key and
The Cochrane Library, for studies investigating the effect of cognitive intervention based on a computer
program for post-stroke patients. The results of selected studies were summarized. Total 19
publications from January 2007 to January 2019 are included in this review. The search terms entered
were a combination of these search areas that defined (1) the population as adults who had suffered
a stroke and cognitive dysfunction, (2) intervention search term included cognitive abilities, cognitive
training, and computer-based training; computer-based cognitive intervention for rehabilitation.
Results:
The results after computer-based training showed improvement in various cognitive functions
such as; memory, attention and executive functions of post-stroke patients. However, a significant
difference between the study groups has not been observed in all the studies. Most studies analyzed
in this research project indicated that such interventions might contribute to the improvement
of cognitive function, especially attention concentration and memory. Of the 19 kinds of research
that discussed CBCI outcomes 18 found significant improvements for one or more cognitive functions.
When the effect size for CBCI was reported, effects were large in comparison to other traditional
cognitive interventions of post-stroke patients.
Conclusion:
Studies related to cognitive functions strongly support CBCI except few have reported
a significant difference. The review of all the studies suggests that CBCI may help to change the
functional aspect of post-stroke patients by improving their cognitive functions. In this field, it is a
challenge to conduct well designed and sufficiently powered studies due to low budgets availability,
the limited number of available patients, heterogeneity of the population, and ethical considerations.
Future studies should examine all the challenges, limitations, and valuable insights into the study
and emphasize the need for a carefully designed computer-based cognitive intervention program for
the future. Future studies should target to compare CBCI with active and passive control conditions
and include a larger sample size.
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Affiliation(s)
- Sudhi Kulshrestha
- Amity Institute of Behavioral and Allied Sciences, Amity University, Lucknow, India
| | - Manju Agrawal
- Amity Institute of Behavioral and Allied Sciences, Amity University, Lucknow, India
| | - Ajai K. Singh
- Department of Neurology, Dr. Ram ManoharLohia Institute of Medical Sciences, Lucknow, India
| | - Dinkar Kulshreshtha
- Department of Neurology, Dr. Ram ManoharLohia Institute of Medical Sciences, Lucknow, India
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Baltaduonienė D, Kubilius R, Berškienė K, Vitkus L, Petruševičienė D. Change of Cognitive Functions after Stroke with Rehabilitation Systems. Transl Neurosci 2019; 10:118-124. [PMID: 31149357 PMCID: PMC6534057 DOI: 10.1515/tnsci-2019-0020] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/27/2019] [Indexed: 01/10/2023] Open
Abstract
The objective of this study is to assess and compare the effect of applying a computerised cognitive training programme and virtual environment rehabilitation system on cognitive functions in patients after a stroke. METHODS A controlled trial included 121 persons referred to second stage rehabilitation. The subjects were differentiated into three impact groups by a single blinded trial. RESULTS The trial revealed that cognitive functions improved in all patient groups (p<0.001). A paired comparison analysis of all groups demonstrated a tendency for cognitive functions, evaluated by the MoCA-LT test, to be more strongly improved in patients who practised a computerised cognitive training programme during their OT sessions than those who did not (p=0.054). CONCLUSIONS The final outcome of the trial was that cognitive functions significantly improved in patients who practised computerised cognitive training programmes or virtual environment rehabilitation systems, compared to those participants who only had occupational therapy sessions.
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Affiliation(s)
- Daiva Baltaduonienė
- Department of Rehabilitation, Medical Academy of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Raimondas Kubilius
- Department of Rehabilitation, Medical Academy of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Kristina Berškienė
- Institute of Sports, Medical Academy of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Daiva Petruševičienė
- Department of Rehabilitation, Medical Academy of Lithuanian University of Health Sciences, Kaunas, Lithuania
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