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Kang D, Eun SD, Park J. Pilot Study of Home-Based Virtual Reality Fitness Training in Post-Discharge Rehabilitation for Patients with Spinal Cord Injury: A Randomized Double-Blind Multicenter Trial. Life (Basel) 2024; 14:859. [PMID: 39063613 PMCID: PMC11278213 DOI: 10.3390/life14070859] [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: 06/09/2024] [Revised: 07/04/2024] [Accepted: 07/06/2024] [Indexed: 07/28/2024] Open
Abstract
Spinal cord injury (SCI) patients require continuous rehabilitation post-discharge to ensure optimal recovery. This study investigates the effectiveness of home-based virtual reality fitness training (VRFT) as a convenient and accessible rehabilitation method for SCI patients. This randomized, double-blind, multicenter trial will enroll 120 participants, assigning them to either an 8-week VRFT program (exercise group) or a control group engaging in regular daily activities. The outcomes measured include muscle function, cardiopulmonary fitness, body composition, and physical performance. Our study will determine the safety and feasibility of VRFT in a home setting for SCI patients and evaluate whether these patients can effectively participate in such a program post-discharge. The results of this study are expected to inform future exercise protocols for SCI rehabilitation, offering valuable insights into the utility of VRFT as a therapeutic tool.
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Affiliation(s)
- Dongheon Kang
- Department of Healthcare and Public Health Research, National Rehabilitation Center, Ministry of Health and Welfare, Seoul 01022, Republic of Korea;
| | - Seon-Deok Eun
- Department of Healthcare and Public Health Research, National Rehabilitation Center, Ministry of Health and Welfare, Seoul 01022, Republic of Korea;
| | - Jiyoung Park
- Department of Safety and Health, Wonkwang University, Iksan 54538, Republic of Korea
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Bremer E, Liska TM, Arbour-Nicitopoulos KP, Best KL, Sweet SN. Examining long-term motivational and behavioral outcomes of two physical activity interventions. J Spinal Cord Med 2023; 46:807-817. [PMID: 35254230 PMCID: PMC10446818 DOI: 10.1080/10790268.2022.2033935] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To examine possible impacts of two theory-based interventions - "Enhancing quality of life through exercise: A tele-rehabilitation approach (TEQ) and Active Living Lifestyles for individuals with SCI who use Wheelchair (ALLWheel)" - 12-18 months post-intervention on the satisfaction of psychological needs and motivation for leisure-time physical activity (LTPA), LTPA participation, and participation experience. DESIGN A mixed-methods follow-up study. SETTING Community. PARTICIPANTS Sixteen TEQ and six ALLWheel participants completed questionnaires and a semi-structured interview, 12-18 months after completing the interventions. INTERVENTION TEQ intervention participants received a weekly LTPA counseling session with a trained kinesiologist through videoconferencing for 8 weeks. ALLWheel participants interacted with a peer mentor who provided LTPA counseling using smartphones for 10 weeks. OUTCOME MEASURES The Psychological Need Satisfaction in Exercise, and the Treatment Self-Regulation Questionnaire were used as primary outcome measures. The LTPA barrier self-efficacy scale, the Measure of Experiential Aspects of Participation, and the 7-day LTPA Questionnaire for Adults with SCI were used as secondary outcome measures. A coding framework was created and deductive thematic analyses were used to analyze the qualitative data. RESULTS Medium to large effects were found for autonomous motivation (TEQ), competence (TEQ and ALLWheel), and barrier self-efficacy (TEQ and ALLWheel). LTPA remained higher for the TEQ intervention group compared to the control group at follow-up, while an increase in moderate-to-vigorous LTPA was found in ALLWheel participants. CONCLUSION Community-based tele-rehabilitation and virtual rehabilitation approaches, informed by theory, may assist adults with SCI in implementing LTPA over the long term.
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Affiliation(s)
- Emily Bremer
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, ON, Canada
| | - Tayah M. Liska
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
| | | | - Krista L. Best
- Faculty of Medicine, Université Laval, Quebec City, QC, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, QC, Canada
| | - Shane N. Sweet
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
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Giouridis N, Williams TL, Tomasone JR. Physical activity promotion to persons with spinal cord injury by health and exercise professionals: A scoping review. J Spinal Cord Med 2023; 46:126-145. [PMID: 34747675 PMCID: PMC9897751 DOI: 10.1080/10790268.2021.1977061] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Health and exercise professionals (HEPs) are ideal promoters and valued messengers of physical activity (PA) information among persons with spinal cord injury (SCI). However, little is known about what strategies used by HEPs increase PA behavior in persons with SCI, or what factors influence HEPs when promoting PA to persons with SCI. The purposes of this scoping review were to (1) ascertain the extent, range and nature of the literature, (2) identify strategies used by HEPs that are associated with an increase in PA behavior for persons with SCI, and (3) identify the facilitators and barriers to PA promotion by the HEPs. METHODS A comprehensive search was undertaken. Search terms were expanded surrounding three key terms: PA, promotion, and SCI. RESULTS Twenty-four articles representing 18 unique studies were identified. HEPs predominantly consisted of physiotherapists, occupational therapists, and leisure trainers/therapists. Most interventions were delivered by HEPs to persons with SCI in in-patient rehabilitation centres and community-based settings. Tailored exercise programs and on-going counseling support were considered essential for increasing PA behavior. HEPs' common barriers to PA promotion were perceived lack of time, education, and training. CONCLUSION A need to improve and sustain SCI-specific PA knowledge and education was identified if PA promotion is to become a structured and integral component of practice. This study provides valuable information for interventions to increase PA behavior among persons with SCI by improving PA promotion by HEPs.
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Affiliation(s)
- Nicole Giouridis
- School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario, Canada,Correspondence to: Nicole Giouridis, School of Kinesiology and Health Studies, Queen’s University, 28 Division Street, Kingston, Ontario, CanadaK7L3N6.
| | | | - Jennifer R. Tomasone
- School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario, Canada
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Feasibility of home hand rehabilitation using musicglove after chronic spinal cord injury. Spinal Cord Ser Cases 2022; 8:86. [PMID: 36347833 PMCID: PMC9643482 DOI: 10.1038/s41394-022-00552-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Study design
Randomized, controlled single-blind cross over study. This study was registered on ClinicalTrials.gov (NCT02473614).
Objectives
Examine usership patterns and feasibility of MusicGlove for at home hand rehabilitation therapy following chronic spinal cord injury.
Setting
Homes of participants.
Methods
Ten participants with chronic spinal cord injury completed two baseline assessments of hand function. After a stable baseline was determined all participants were randomized into two groups: Experimental and Control. Each group was given a recommended therapy dosage. Following this participants switched interventions.
Results
On average participants had higher levels of compliance (6.1 ± 3.5 h.), and completed more grips (15,760 ± 9,590 grips) compared to participants in previous stroke studies using the same device. Participants modulated game parameters in a manner consistent with optimal challenge principles from motor learning theory. Participants in the experimental group increased their prehension ability (1 ± 1.4 MusicGlove, 0.2 ± 0.5 Control) and performance (1.4 ± 2.2 MusicGlove, 0.4 ± 0.55 Control) on the Graded and Redefined Assessment of Strength, Sensibility, and Prehension subtests. Increases in performance on the Box and Blocks Test also favored the experimental group compared to the conventional group at the end of therapy (4.2 ± 5.9, −1.0 ± 3.4 respectively).
Conclusions
MusicGlove is a feasible option for hand therapy in the home-setting for individuals with chronic SCI. Participants completed nearly twice as many gripping movements compared to individuals from the sub-acute and chronic stroke populations, and a number far greater than the number of movements typically achieved during traditional rehabilitation.
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Lawrason SVC, Brown-Ganzert L, Campeau L, MacInnes M, Wilkins CJ, Martin Ginis KA. mHealth Physical Activity Intervention for Individuals With Spinal Cord Injury: Planning and Development Processes. JMIR Form Res 2022; 6:e34303. [PMID: 35984695 PMCID: PMC9440410 DOI: 10.2196/34303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 06/27/2022] [Accepted: 07/18/2022] [Indexed: 02/06/2023] Open
Abstract
Background Interventions to support physical activity participation among individuals with spinal cord injury (SCI) are required given this population’s low levels of physical activity and extensive barriers to quality physical activity experiences. Objective This study aimed to develop a mobile health intervention, called SCI Step Together, to improve the quantity and quality of physical activity among individuals with SCI who walk. Methods Our overarching methodological framework was the Person-Based approach. This included the following 4 steps: conduct primary and secondary research (step 1); design intervention objectives and features (step 2a); conduct behavioral analysis and theory (step 2b); create a logic model (step 3); and complete the SCI Step Together program content and integrated knowledge translation (IKT; step 4), which occurred throughout development. The partnership approach was informed by the SCI IKT Guiding Principles. Three end users pilot-tested the app and participated in the interviews. Results Step 1 identified issues to be addressed when designing intervention objectives and features (step 2a) and features were mapped onto the Behavior Change Wheel (step 2b) to determine the behavior change techniques (eg, action planning) to be included in the app. The logic model linked the mechanisms of action to self-determination theory (steps 2/3). Interviews with end users generated recommendations for the technology (eg, comparing physical activity levels with guidelines), trial (eg, emailing participants’ worksheets), and intervention content (eg, removing graded tasks; step 4). Conclusions Using the SCI IKT Guiding Principles to guide partner engagement and involvement ensured that design partners had shared decision-making power in intervention development. Equal decision-making power maximizes the meaningfulness of the app for end users. Future research will include testing the acceptability, feasibility, and engagement of the program. Partners will be involved throughout the research process. Trial Registration ClinicalTrials.gov: NCT05063617; https://clinicaltrials.gov/ct2/show/NCT05063617
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Affiliation(s)
- Sarah Victoria Clewes Lawrason
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada.,International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada.,Centre for Chronic Disease Prevention and Management, Faculty of Medicine, University of British Columbia, Kelowna, BC, Canada
| | | | | | | | - C J Wilkins
- Community Research Partner, Kelowna, BC, Canada
| | - Kathleen Anne Martin Ginis
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada.,International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada.,Centre for Chronic Disease Prevention and Management, Faculty of Medicine, University of British Columbia, Kelowna, BC, Canada.,Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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Allegue DR, Kairy D, Higgins J, Archambault P, Michaud F, Miller W, Sweet SN, Tousignant M. Optimization of Upper Extremity Rehabilitation by Combining Telerehabilitation With an Exergame in People With Chronic Stroke: Protocol for a Mixed Methods Study. JMIR Res Protoc 2020; 9:e14629. [PMID: 32097119 PMCID: PMC7273231 DOI: 10.2196/14629] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 11/28/2019] [Accepted: 02/07/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Exergames have the potential to provide an accessible, remote approach for poststroke upper extremity (UE) rehabilitation. However, the use of exergames without any follow-up by a health professional could lead to compensatory movements during the exercises, inadequate choice of difficulty level, exercises not being completed, and lack of motivation to pursue exercise programs, thereby decreasing their benefits. Combining telerehabilitation with exergames could allow continuous adjustment of the exercises and monitoring of the participant's completion and adherence. At present, there is limited evidence regarding the feasibility or efficacy of combining telerehabilitation and exergames for stroke rehabilitation. OBJECTIVE This study aims to (1) determine the preliminary efficacy of using telerehabilitation combined with exergames on UE motor recovery, function, quality of life, and motivation in participants with chronic stroke, compared with conventional therapy (the graded repetitive arm supplementary program; GRASP); (2) examine the feasibility of using the technology with participants diagnosed with stroke at home; and (3) identify the obstacles and facilitators for its use by participants diagnosed with stroke and stroke therapists and understand the shared decision-making process. METHODS A mixed methods study protocol is proposed, including a randomized, blinded feasibility trial with an embedded multiple case study. The intervention consists of the provision of a remote rehabilitation program, during which participants will use the Jintronix exergame for UE training and the Reacts Application to conduct videoconferenced sessions with the therapists (physical or occupational therapists). We plan to recruit 52 participants diagnosed with stroke, randomly assigned to a control group (n=26; 2-month on-paper home exercise program: the GRASP with no supervision) and an experimental group (n=26; 2-month home program using the technology). The primary outcome is the Fugl-Meyer UE Assessment, a performance-based measure of UE impairment. The secondary outcomes are self-reported questionnaires and include the Motor Activity Log-28 (quality and frequency of use of the UE), Stroke Impact Scale-16 (the quality of life), and Treatment Self-Regulation Questionnaire (motivation). Feasibility data include process, resources, management, and scientific outcomes. Qualitative data will be collected by interviews with both participants and therapists. RESULTS At present, data collection was ongoing with one participant who had completed the exergame- telerehabilitation based intervention. We expect to collect preliminary efficacy data of this technology on the functional and motor recovery of the UE, following a stroke; collect feasibility data with users at home (adherence, safety, and technical difficulties); and identify the obstacles and facilitators for the technology use and understand the shared decision-making process. CONCLUSIONS This paper describes the protocol underlying the study of a telerehabilitation-exergame technology to contribute to understanding its feasibility and preliminary efficacy for UE stroke rehabilitation. TRIAL REGISTRATION ClinicalTrials.gov NCT03759106; http://clinicaltrials.gov/show/NCT03759106. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/14629.
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Affiliation(s)
- Dorra Rakia Allegue
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Mission Universitaire de Tunisie, Montreal, QC, Canada
| | - Dahlia Kairy
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
| | - Johanne Higgins
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
| | | | | | | | - Shane Norman Sweet
- The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- McGill University, Montreal, QC, Canada
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Systemic inflammation in traumatic spinal cord injury. Exp Neurol 2019; 325:113143. [PMID: 31843491 DOI: 10.1016/j.expneurol.2019.113143] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 12/06/2019] [Accepted: 12/10/2019] [Indexed: 01/08/2023]
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