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Zhao CG, Ju F, Sun W, Jiang S, Xi X, Wang H, Sun XL, Li M, Xie J, Zhang K, Xu GH, Zhang SC, Mou X, Yuan H. Effects of Training with a Brain-Computer Interface-Controlled Robot on Rehabilitation Outcome in Patients with Subacute Stroke: A Randomized Controlled Trial. Neurol Ther 2022; 11:679-695. [PMID: 35174449 PMCID: PMC9095806 DOI: 10.1007/s40120-022-00333-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 01/25/2022] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Stroke is always associated with a difficult functional recovery process. A brain-computer interface (BCI) is a technology which provides a direct connection between the human brain and external devices. The primary aim of this study was to determine whether training with a BCI-controlled robot can improve functions in patients with subacute stroke. METHODS Subacute stroke patients aged 32-68 years with a course of 2 weeks to 3 months were randomly assigned to the BCI group or to the sham group for a 4-week course. The primary outcome measures were Loewenstein Occupational Therapy Cognitive Assessment (LOCTA) and Fugl-Meyer Assessment for Lower Extremity (FMA-LE). Secondary outcome measures included Fugl-Meyer Assessment for Balance (FMA-B), Functional Ambulation Category (FAC), Modified Barthel Index (MBI), serum brain-derived neurotrophic factor (BDNF) levels and motor-evoked potential (MEP). RESULTS A total of 28 patients completed the study. Both groups showed a significant increase in mean LOCTA (sham: P < 0.001, Cohen's d = - 2.972; BCI: P < 0.001, Cohen's d = - 4.266) and FMA-LE (sham: P < 0.001, Cohen's d = - 3.178; BCI: P < 0.001, Cohen's d = - 3.063) scores. The LOCTA scores in the BCI group were 14.89% higher than in the sham group (P = 0.049, Cohen's d = - 0.580). There were no significant differences between the two groups in terms of FMA-B (P = 0.363, Cohen's d = - 0.252), FAC (P = 0.363), or MBI (P = 0.493, Cohen's d = - 0.188) scores. The serum levels of BDNF were significantly higher within the BCI group (P < 0.001, Cohen's d = - 1.167), and the MEP latency decreased by 3.75% and 4.71% in the sham and BCI groups, respectively. CONCLUSION Training with a BCI-controlled robot combined with traditional physiotherapy promotes cognitive function recovery, and enhances motor functions of the lower extremity in patients with subacute stroke. These patients also showed increased secretion of BDNF. TRIAL REGISTRATION Chinese clinical trial registry: ChiCTR-INR-17012874.
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Affiliation(s)
- Chen-Guang Zhao
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Fen Ju
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Wei Sun
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Shan Jiang
- Department of Rehabilitation Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Xiao Xi
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Hong Wang
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xiao-Long Sun
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Min Li
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Jun Xie
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Kai Zhang
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Guang-Hua Xu
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Si-Cong Zhang
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Xiang Mou
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Hua Yuan
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
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Guzmán JM, Grajo LC. The Development and Preliminary Psychometric Properties of the TeleWrite: A Telehealth-Based Handwriting Assessment for School-Aged Children. Occup Ther Health Care 2022; 37:248-265. [PMID: 35020552 DOI: 10.1080/07380577.2022.2025553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This article describes the development and preliminary psychometric properties of the TeleWrite, a handwriting assessment tool designed to measure the rate, accuracy, and fluency of children's handwriting for children in first through third grade administered via telehealth. A series of three pilot studies were completed to determine initial interrater reliability, content validity, and clinical utility of the TeleWrite. A study with eight children was used to determine preliminary interrater reliability testing using a beta version of the TeleWrite with (n = 9) raters. The reliability coefficient was obtained using intraclass correlation (ICC) and yielded α = 0.92 for total scores, CI [0.815, 0.983] and the Cronbach's α measure for internal consistency was α = 0.95 (excellent). A clinical utility survey of (n = 55) pediatric occupational therapists was used to obtain their clinical impression regarding the usefulness and accuracy. Representing twelve different countries and twenty-two U.S. states, the respondents indicated that 61% (n = 33) are quite or extremely likely to use the TeleWrite in their practice and most participants (64%; n = 35) indicated that TeleWrite was quite/extremely accurate in measuring handwriting performance. Third, a content validity study with nine handwriting experts reviewed and concluded that all ten subtests of the TeleWrite tool are considered essential. All preliminary studies strengthen the development of the TeleWrite assessment to advance to construct validation of the tool.
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Affiliation(s)
- Julia M Guzmán
- Department of Occupational Therapy, School of Health and Medical Sciences, Seton Hall University, Interprofessional Health Sciences Campus (IHS), Nutley, NJ, USA'
| | - Lenin C Grajo
- Department of Rehabilitation and Regenerative Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
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Romero-Ayuso D, Castillero-Perea Á, González P, Navarro E, Molina-Massó JP, Funes MJ, Ariza-Vega P, Toledano-González A, Triviño-Juárez JM. Assessment of cognitive instrumental activities of daily living: a systematic review. Disabil Rehabil 2019; 43:1342-1358. [PMID: 31549907 DOI: 10.1080/09638288.2019.1665720] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE Cognitive instrumental activities of daily living are particularly related to executive functions, such as scheduling appointments, monthly payments, managing the household economy, shopping or taking the bus. The aim of this systematic review was to determine the available tests for the assessment of executive functions with ecological validity to predict individuals' functioning. MATERIALS AND METHODS An electronic search was conducted in MEDLINE, Cochrane Central, PsyCInfo and IEEE Xplore until May 2019, in addition to a manual search. The PRISMA criteria and the Covidence platform were used to select articles and extract data. RESULTS After applying the search selection criteria, 76 studies were identified. They referred to 110 tools to assess instrumental activities of daily living. Those that have received most attention are related to menu preparation and shopping. Performance-based measures are the most widely used traditional methods. Most tests were aimed at the adult population with acquired brain damage, cognitive impairment or dementia. There was a predominance of tests based on the Multiple Errands Test paradigm. CONCLUSIONS In recent years, it has increased the number of tools that assess the instrumental activities of daily living based on technologies such as personal or environmental sensors and serious games.IMPLICATIONS FOR REHABILITATIONAssessment of Instrumental Activities of Daily Living through performance-based measures is especially useful for the early detection of dysfunctions or preclinical disability.Difficulties in performing instrumental activities of daily living are closely associated with deficits in executive functions and prospective memory.Activities of Daily Living can be understood as multitasks.The use of virtual reality-based tests was shown to be sensitive to the detection of cognitive deficits in Activities of Daily Living.An advantage of using virtual reality in assessments is that it can help to predict the level of personal autonomy in patients who are in an institutional environment and could be a first approximation to the real environment.
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Affiliation(s)
- Dulce Romero-Ayuso
- Division of Occupational Therapy, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | | | - Pascual González
- LoUISE Research Group, Computing Systems Department, University of Castilla-La Mancha, Albacete, Spain
| | - Elena Navarro
- LoUISE Research Group, Computing Systems Department, University of Castilla-La Mancha, Albacete, Spain
| | - José Pascual Molina-Massó
- LoUISE Research Group, Computing Systems Department, University of Castilla-La Mancha, Albacete, Spain
| | - M Jesús Funes
- Mind, Brain and Behaviour Research Center (CIMCYC) and Department of Experimental Psychology, University of Granada, Granada, Spain
| | - Patrocinio Ariza-Vega
- Division of Occupational Therapy, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Rehabilitation and Traumatology Service, Virgen de Las Nieves University Hospital of Granada, Granada, Spain
| | - Abel Toledano-González
- Department of Psychology, Faculty of Occupational Therapy, Speech Therapy and Nursing, University of Castilla-La Mancha, Ciudad Real, Spain
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