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Masayko S, McGowan J, Grampurohit N. Parents' Perceptions of Eye-Gaze Technology Use by Children With Complex Communication Needs. Am J Speech Lang Pathol 2024; 33:1254-1265. [PMID: 38319681 DOI: 10.1044/2023_ajslp-23-00100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
PURPOSE Some preschool students with complex communication needs explore eye-gaze computer technology (EGCT) and adopt computer-based augmentative and alternative communication (AAC). The objective of this study was to follow preschool explorers of EGCT who are now school aged to describe the children's use of technology and parents' perceptions of its utility for communication, participation, or leisure. METHOD Ten parents completed survey questions by Internet and phone and reported their perceptions of nine children's effectiveness in the use and acceptance of AAC and the support they received in implementing technology. The results are reported as a descriptive study. RESULTS All children in this research continue to use AAC technology in school and most at home. Many children who tried and obtained EGCT while in preschool continue to use that technology. Most parents agreed that the children understood how to use the devices, which enhanced the children's communication, and that the parents received sufficient support. Most children were limited in their use of the devices for leisure and control of their environments. CONCLUSIONS Computer-based AAC for school-aged children who trialed it when they were in preschool appears to be a powerful means for them to communicate and participate. However, the technology appears not to be used to its full capabilities to support the children's agency to control environments and to pursue leisure. Teams may want to consider how to support children in using their AAC devices to meet multiple needs. The study was limited by its small sample size and its descriptive nature. Additional research on this subject is needed.
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Affiliation(s)
- Sandra Masayko
- Department of Assistive Technology, Easterseals Southeastern Pennsylvania, Philadelphia
| | - Joy McGowan
- Department of Assistive Technology, Easterseals Southeastern Pennsylvania, Philadelphia
| | - Namrata Grampurohit
- Department of Occupational Therapy, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA
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Hammelef E, Zakaria SJ, Andersen SH, Kelly TJ, Grampurohit N, Avery M, Napoli A, Mulcahey MJ, Serruya MD. A Pilot Feasibility Trial of an Upper Extremity Assistive System. Arch Rehabil Res Clin Transl 2023; 5:100308. [PMID: 38163018 PMCID: PMC10757169 DOI: 10.1016/j.arrct.2023.100308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Objective To develop and clinically evaluate a customizable active upper extremity (UE) assistive system with integrated functional electrical stimulation (FES) that improves function and independence of individuals during activities of daily living (ADLs). Design Single-arm, prospective, open-label cohort feasibility trial. Setting An academic research institution. Participants Subjects were 5 adults with a medical history of stroke resulting in distal UE impairment (N=5). The subjects volunteered from recruitment materials that detailed information about the study. Interventions A novel, wearable, lightweight, low-profile, and patient-tailored UE assistive system. It comprises a splint component and FES unit that may each be controlled by electromyography (EMG) signals, inertial measurement units (IMUs), manual control source (joystick), and/or voice control. Main Outcome Measures Several occupational therapy outcome measures were used, including the Canadian Occupational Performance Measure (COPM), Action Research Arm Test (ARAT), The Box and Blocks Test (BBT), the ABILHAND-Manual Ability Measure, and Patient Reported Outcomes Measurement Information System (PROMIS) UE Short Form. Results All participants learned to use our UE assistive system to perform ADLs and were able to use it independently at home. Most participants experienced a clinically meaningful improvement in both performance and satisfaction for the majority of their COPM goals while using the system. All participants experienced improvement in hand grip and release as shown by their baseline and post assessment scores for hand function (BBT, ARAT) and patient-reported outcomes (ABILHAND, PROMIS). Conclusions The clinical outcomes suggest that our UE assistive system improves functional performance in patients with UE impairment, allowing them to engage more actively in ADLs. Further innovation including elbow and shoulder components will allow users to have more degrees of freedom during tasks.
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Affiliation(s)
- Emma Hammelef
- Raphael Center for Neurorestoration, Farber Institute for Neuroscience, Thomas Jefferson University, 130 S 9th Street, Suite 2400, Philadelphia, PA 19107
| | - Saami J. Zakaria
- Raphael Center for Neurorestoration, Farber Institute for Neuroscience, Thomas Jefferson University, 130 S 9th Street, Suite 2400, Philadelphia, PA 19107
| | - Sarah H. Andersen
- Raphael Center for Neurorestoration, Farber Institute for Neuroscience, Thomas Jefferson University, 130 S 9th Street, Suite 2400, Philadelphia, PA 19107
| | - Thomas J. Kelly
- Raphael Center for Neurorestoration, Farber Institute for Neuroscience, Thomas Jefferson University, 130 S 9th Street, Suite 2400, Philadelphia, PA 19107
| | - Namrata Grampurohit
- Center for Outcomes and Measurement, College of Rehabilitation Sciences, Thomas Jefferson University, 901 Walnut Street, Suite 642, Philadelphia, PA 19107
| | - Mikael Avery
- Raphael Center for Neurorestoration, Farber Institute for Neuroscience, Thomas Jefferson University, 130 S 9th Street, Suite 2400, Philadelphia, PA 19107
- Studio Krea, Collingswood, NJ
| | - Alessandro Napoli
- Raphael Center for Neurorestoration, Farber Institute for Neuroscience, Thomas Jefferson University, 130 S 9th Street, Suite 2400, Philadelphia, PA 19107
| | - Mary Jane Mulcahey
- Center for Outcomes and Measurement, College of Rehabilitation Sciences, Thomas Jefferson University, 901 Walnut Street, Suite 642, Philadelphia, PA 19107
| | - Mijail Demian Serruya
- Raphael Center for Neurorestoration, Farber Institute for Neuroscience, Thomas Jefferson University, 130 S 9th Street, Suite 2400, Philadelphia, PA 19107
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Kim R, Gerhardt N, Grampurohit N, Mulcahey M. The Spinal Cord Injury-Movement Index: Results from a Reliability Study. Arch Phys Med Rehabil 2023. [DOI: 10.1016/j.apmr.2022.12.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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Kim R, Grampurohit N, Gerhardt N, Potvin MC, Mulcahey MJ. Development and Validation of Fidelity of Coaching for Spinal Cord Injury. Arch Phys Med Rehabil 2023. [DOI: 10.1016/j.apmr.2022.12.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Li R, Grampurohit N. Goal Priorities for Coaching in Community-Dwelling Individuals with Stroke and their Caregivers. Arch Phys Med Rehabil 2023. [DOI: 10.1016/j.apmr.2022.12.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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Abstract
A cross-sectional descriptive survey of 105 occupational therapy practitioners examined the practice patterns in sleep management within skilled nursing facilities. All participants viewed sleep as essential to address in their settings, since clients frequently reported inadequate sleep, daytime sleepiness, difficulty staying asleep, and situational interruption. Majority of the practitioners reported not screening, assessing, treating, or documenting sleep issues and lack the use of standardized assessments and evidence-based interventions for sleep. Results suggest that practitioners need more training, education, and advocacy skills to promote the role of occupational therapy in addressing sleep management in skilled nursing facilities.
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Affiliation(s)
- Nabila Enam
- Occupational Therapy, University of the Sciences, Philadelphia, PA, USA
| | - Namrata Grampurohit
- Occupational Therapy, Thomas Jefferson University - Center City Campus, Philadelphia, PA, USA
| | - Ruth S Farber
- Rehabilitation Sciences/Occupational Therapy, Temple University, Philadelphia, PA, USA
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Bell A, Grampurohit N, Kains G, Marino RJ. Developing guiding principles for technology-based rehabilitation program by engaging people with motor incomplete tetraplegia. J Neuroeng Rehabil 2022; 19:128. [PMID: 36424612 PMCID: PMC9694851 DOI: 10.1186/s12984-022-01096-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/25/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Technology-aided rehabilitation is well established in the field of neurologic rehabilitation. Despite the widespread availability, the development of technology-based interventions that incorporate perspectives of the people who will use them is lacking. OBJECTIVES This qualitative study aims to understand how people with chronic motor incomplete cervical spinal cord injury view rehabilitation technology to improve upper extremity function and neuromuscular recovery to inform future intervention development. METHODS Seven participants with chronic upper extremity impairment due to spinal cord injury/dysfunction trialed five rehabilitation technology devices. After a 30-45 min trial for each device, participants engaged in a semi-structured interview. Interviews were analyzed using a qualitative approach to explore the experience using and understand features that support motivation to use of rehabilitation technology. RESULTS Qualitative analysis revealed three major themes: (1) devices must be flexible to meet diverse needs; (2) intervention protocols must be individualized to address unique needs and contexts of users; (3) intervention protocols should be developed and updated by a skilled clinician. These themes and subthemes were used to describe guiding principles to inform future intervention design. CONCLUSION The experiences of people with cervical spinal cord injury can be elicited as part of the intervention design process to systematically develop protocols for future feasibility trials. The findings from this study can be used to inform the development of technology-aided rehabilitation programs to improve upper extremity function in people with chronic motor incomplete tetraplegia. CLINICAL TRIALS REGISTRATION NUMBER NCT04000256.
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Affiliation(s)
- Alison Bell
- Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, 901 Walnut Street, Suite 600, Philadelphia, PA, 19107, USA.
| | - Namrata Grampurohit
- Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, 901 Walnut Street, Suite 600, Philadelphia, PA, 19107, USA
| | | | - Ralph J Marino
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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Mendonca R, Grampurohit N, Hartman B, O’Connor AR, Xing S, Quirin CR. Effectiveness of Robotic Therapy on Upper Extremity Functioning in Adults With Chronic Stroke: A Systematic Review. Am J Occup Ther 2022. [DOI: 10.5014/ajot.2022.76s1-po230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Date Presented 04/01/2022
Stroke has a significant impact on patient function and requires extensive therapy for rehabilitation. This poster systematically reviews evidence on implementing robotic therapies as a rehabilitation technique for individuals with chronic stroke to determine its effectiveness in improving functional outcomes. This review will inform OTs about the use of robotic therapy with their clients, including its dosage and costs.
Primary Author and Speaker: Rochelle Mendonca
Additional Authors and Speakers: Brooke Hartman, Amanda R. O’Connor, Susan Xing, Carley R. Quirin
Contributing Authors: Namrata Grampurohit
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Grampurohit N, Gerhardt N, Kim RN, Santacroce D, Sivori TT, Santos G, Alpajora B, Piersol CV, Mulcahey MJ. Postdischarge Telehealth Support for Caregivers Through a Coaching Approach: A Case Study. Am J Occup Ther 2022. [DOI: 10.5014/ajot.2022.76s1-po204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Date Presented 04/02/2022
Coaching care partners through the transition from hospital to home can be beneficial for both the caregiver and the care recipient. In this case study, we describe the benefits of coaching the caregiver postdischarge through a telehealth coaching-in-context approach. Both care partners made remarkable gains in occupational performance, self-efficacy, and quality of life. The preliminary data presented here are part of a pilot randomized controlled trial that compares coaching with usual care.
Primary Author and Speaker: Namrata Grampurohit
Contributing Authors: Nicole Gerhardt, Rachel Namrata Kim, David Santacroce, Taylor T. Sivori, Gabriella Santos, Bernadette Alpajora, Catherine Verrier Piersol, Mary Jane Mulcahey
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Affiliation(s)
| | - Nicole Gerhardt
- Thomas Jefferson University, Philadelphia, Pennsylvania, United States
| | | | | | - Taylor T. Sivori
- Thomas Jefferson University, Philadelphia, Pennsylvania, United States
| | - Gabriella Santos
- Kessler Institute for Rehabilitation, Chester, New Jersey, United States
| | - Bernadette Alpajora
- Jefferson College of Rehabilitation Sciences, Philadelphia, Pennsylvania, United States
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Whitten M, Silfies SP, Grampurohit N, Fedorczyk JM. A modified-delphi study establishing consensus in the therapeutic management of posttrauamtic elbow stiffness. J Hand Ther 2022; 35:299-307. [PMID: 35033398 DOI: 10.1016/j.jht.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 10/30/2021] [Accepted: 11/13/2021] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Web-based modified Delphi study. BACKGROUND Therapy is widely considered the first choice of treatment for posttraumatic stiffness of the elbow since loss of motion is a common sequela following traumatic elbow injuries. There is high variability in practice patterns for the management of the posttraumtic elbow. PURPOSE The aim of this study is to identify the current therapeutic management of posttraumatic elbow stiffness using expert consensus. METHODS This study surveyed experts using a web-based 3 round modified Delphi method. Quantitative data and comments were collected during the first round. Questions with Likert scaling were used to identify consensus (defined as 75% agreement) with each statement and comment boxes enabled open-ended responses to gather expert opinion. Lack of consensus and data from comments guided the second-round of the survey. This process was repeated after Round 2 to develop the Round 3 survey. Consensus was achieved at Round 3 and no further rounds were needed. RESULTS Round 1 included 34 experts (response rate 20%), not all experts were able to continue through all rounds. Round 2 included 18 experts and Round 3 included 15 experts. Survey items were categorized as follows: examination procedures, therapeutic interventions, orthotic intervention considerations, contributing patient factors, and clinical decisions and rehabilitation challenges. Twenty-five percent of items achieved consensus after Round 1, 30% after Round 2 and 52% after Round 3. Although most participants agreed that orthotic intervention is critical to patient outcomes, there were conflicting thoughts about the orthotic design and wearing schedule. CONCLUSIONS The findings of this web-based modified Delphi study helped to establish a current body of knowledge using expert consensus to guide practice and identify specific questions that can be studied in future clinical studies on posttraumatic elbow stiffness.
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Affiliation(s)
- Mary Whitten
- Drexel University, Bay Path University, VA Connecticut Healthcare System, West Haven, CT, USA.
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11
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Burdea G, Kim N, Polistico K, Kadaru A, Grampurohit N, Hundal J, Pollack S. Robotic Table and Serious Games for Integrative Rehabilitation in the Early Poststroke Phase: Two Case Reports. JMIR Rehabil Assist Technol 2022; 9:e26990. [PMID: 35416787 PMCID: PMC9047881 DOI: 10.2196/26990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 08/16/2021] [Accepted: 01/25/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND BrightArm Compact is a new rehabilitation system for the upper extremities. It provides bimanual training with gradated gravity loading and mediates interactions with cognitively challenging serious games. OBJECTIVE The aim of this study is to design and test a robotic rehabilitation table-based virtual rehabilitation system for functional impact of the integrative training in the early poststroke phase. METHODS A new robotic rehabilitation table, controllers, and adaptive games were developed. The 2 participants underwent 12 experimental sessions in addition to the standard of care. Standardized measures of upper extremity function (primary outcome), depression, and cognition were administered before and after the intervention. Nonstandardized measures included game variables and subjective evaluations. RESULTS The 2 case study participants attained high total arm repetitions per session (504 and 957) and achieved high grasp and finger-extension counts. Training intensity contributed to marked improvements in affected shoulder strength (225% and 100% increase), grasp strength (27% and 16% increase), and pinch strength (31% and 15% increase). The shoulder flexion range increased by 17% and 18% and elbow supination range by 75% and 58%. Improvements in motor function were at or above minimal clinically important difference for the Fugl-Meyer Assessment (11 and 10 points), Chedoke Arm and Hand Activity Inventory (11 and 14 points), and Upper Extremity Functional Index (19 and 23 points). Cognitive and emotive outcomes were mixed. Subjective rating by participants and training therapists were positive (average 4, SD 0.22, on a 5-point Likert scale). CONCLUSIONS The design of the robotic rehabilitation table was tested on 2 participants in the early poststroke phase, and results are encouraging for upper extremity functional gains and technology acceptance. TRIAL REGISTRATION ClinicalTrials.gov NCT04252170; https://clinicaltrials.gov/ct2/show/NCT04252170.
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Affiliation(s)
- Grigore Burdea
- Corporate Laboratories, Bright Cloud International Corp, North Brunswick, NJ, United States
- Electrical and Computer Engineering Department, Rutgers-The State University of New Jersey, Piscataway, NJ, United States
| | - Nam Kim
- Corporate Laboratories, Bright Cloud International Corp, North Brunswick, NJ, United States
| | - Kevin Polistico
- Corporate Laboratories, Bright Cloud International Corp, North Brunswick, NJ, United States
| | - Ashwin Kadaru
- Corporate Laboratories, Bright Cloud International Corp, North Brunswick, NJ, United States
| | - Namrata Grampurohit
- Corporate Laboratories, Bright Cloud International Corp, North Brunswick, NJ, United States
- Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, PA, United States
| | - Jasdeep Hundal
- Hundal Neuropsychology Group, Hillsborough, NJ, United States
- Robert Wood Johnson Medical School, Rutgers-The State University of New Jersey, Department of Neurology, New Brunswick, NJ, United States
| | - Simcha Pollack
- Computer Information Systems and Decision Sciences, St John's University, New York City, NY, United States
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Mallinson T, Kozlowski AJ, Johnston MV, Weaver J, Terhorst L, Grampurohit N, Juengst S, Ehrlich-Jones L, Heinemann AW, Melvin J, Sood P, de Winckel AV. Rasch Reporting Guideline for Rehabilitation Research (RULER): The RULER Statement. Arch Phys Med Rehabil 2022; 103:1477-1486. [PMID: 35421395 DOI: 10.1016/j.apmr.2022.03.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/04/2022] [Accepted: 03/14/2022] [Indexed: 11/25/2022]
Abstract
The application of Rasch Measurement (RM) Theory to rehabilitation assessments has proliferated in recent years. RM Theory helps design and refine assessments so that items reflect a unidimensional construct, in an equal interval metric that distinguishes among persons of different abilities in a manner that is consistent with the underlying trait. Rapid growth of RM in rehabilitation assessment studies has led to inconsistent results reporting. Clear, consistent, transparent reporting of RM Theory results is important for advancing rehabilitation science and practice based on precise measures. Precise measures, in turn, provide researchers, practitioners, patients, and other stakeholders with tools for effective decision-making. The goal of this Rasch Reporting Guideline for Rehabilitation Research (RULER) is to provide peer-reviewed, evidence-based, transparent, and consistent recommendations for reporting studies that apply RM Theory in a rehabilitation context. The purpose of the guideline is to ensure that authors, reviewers, and editors have uniform expectations about how to write and evaluate research on rehabilitation outcome assessments. A task force of rehabilitation researchers, clinicians, and editors met regularly between November 2018 and August 2020 to identify the need for the guideline, develop an organizing framework, identify content areas, and develop the recommendations. This RULER statement includes the organizing framework and a checklist of 59 recommendations. The guideline is supported by an Explanation & Elaboration manuscript that provides more detail about the framework and recommendations in the checklist. A glossary of key terms and a recommended iterations table are provided in supplemental, online only materials.
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Affiliation(s)
- Trudy Mallinson
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University
| | - Allan J Kozlowski
- Department of Epidemiology and Biostatistics, Michigan State University - College of Human Medicine and Mary Free Bed Rehabilitation Hospital
| | - Mark V Johnston
- Professor Emeritus, Department of Occupational Science & Technology, College of Health Sciences, University of Wisconsin-Milwaukee
| | - Jennifer Weaver
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University; Department of Occupational Therapy, College of Health and Human Sciences, Colorado State University
| | - Lauren Terhorst
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh
| | - Namrata Grampurohit
- Department of Occupational Therapy, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University
| | - Shannon Juengst
- Department of Physical Medicine and Rehabilitation, School of Health Professions, University of Texas Southwestern Medical Center
| | - Linda Ehrlich-Jones
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern University and Shirley Ryan AbilityLab, Chicago, Illinois
| | - Allen W Heinemann
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern University and Shirley Ryan AbilityLab, Chicago, Illinois
| | - John Melvin
- Department of Rehabilitation Medicine, Sidney Kimmel Medical College at Thomas Jefferson University
| | - Pallavi Sood
- Department of Aging & Geriatric Research, Institute of Aging, University of Florida
| | - Ann Van de Winckel
- Division of Physical Therapy, Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota.
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de Winckel AV, Kozlowski AJ, Johnston MV, Weaver J, Grampurohit N, Terhorst L, Juengst S, Ehrlich-Jones L, Heinemann AW, Melvin J, Sood P, Mallinson T. Reporting Guideline for RULER: Rasch Reporting Guideline for Rehabilitation Research – Explanation & Elaboration manuscript. Arch Phys Med Rehabil 2022; 103:1487-1498. [DOI: 10.1016/j.apmr.2022.03.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/04/2022] [Accepted: 03/14/2022] [Indexed: 11/30/2022]
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Benham S, Trinh L, Kropinski K, Grampurohit N. Effects of Community-Based Virtual Reality on Daily Activities and Quality of Life. Physical & Occupational Therapy In Geriatrics 2022. [DOI: 10.1080/02703181.2022.2033903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sara Benham
- Department of Rehabilitation Sciences, Moravian University, Bethlehem, Pennsylvania, USA
| | | | | | - Namrata Grampurohit
- Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Bell A, Grampurohit N, Marino R. Upper Extremity Training with Rehabilitation Technology: A Qualitative Exploration of Individuals With Spinal Cord Injury. Arch Phys Med Rehabil 2021. [DOI: 10.1016/j.apmr.2021.07.616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Kalbian I, Marino R, Grampurohit N. Upper Extremity Activity-based Interventions for Functional Recovery in Spinal Cord Injury. Arch Phys Med Rehabil 2021. [DOI: 10.1016/j.apmr.2021.07.748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kalbian I, Marino R, Grampurohit N. Upper Extremity Activity-based Interventions for Functional Recovery in Spinal Cord Injury. Arch Phys Med Rehabil 2021. [DOI: 10.1016/j.apmr.2021.07.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Parekh A, Serruya M, Grampurohit N, Kelly T, Kardine J, Mass J, Napoli A. Restoring Moderate to Severe Loss of Upper Extremity Function Post-stroke with a Neuromotor Prosthesis: A Case Report. Arch Phys Med Rehabil 2021. [DOI: 10.1016/j.apmr.2021.07.618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Grampurohit N, Bell A, Duff SV, Mulcahey MJ, Thielen CC, Kaplan G, Marino RJ. Highlighting gaps in spinal cord injury research in activity-based interventions for the upper extremity: A scoping review. NeuroRehabilitation 2021; 49:23-38. [PMID: 33967071 DOI: 10.3233/nre-210042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Upper extremity activity-based therapy for neurologic disorders employs high-intensity, high repetition functional training to exploit neuroplasticity and improve function. Research focused on high-intensity upper extremity activity-based therapy for persons with spinal cord injury (SCI) is limited. OBJECTIVE To summarize high-intensity activity-based interventions used in neurological disorders for their current or potential application to SCI. METHODS The scoping review included articles from MEDLINE, CINAHL, Cochrane CENTRAL, and OTSeeker with the criteria: non-invasive activity-based interventions delivered at least three times/week for two weeks, upper extremity functional outcomes, age 13 years or older, English language, and neurological disorders three months post onset/injury. RESULTS The search yielded 172 studies. There were seven studies with SCI, all in adults. Activity-based interventions in SCI included task-specific training and gaming, with and without electrical stimulation, and a robotic exoskeleton. The other populations found in the review included studies in stroke, cerebral palsy, and multiple sclerosis. Thirty-four different interventions were reported in other populations. In comparison to the extensive stroke research, work in SCI was not found for high-intensity interventions using virtual reality, brain stimulation, rehabilitation devices, and applications to the home and telerehab settings. CONCLUSION The results highlight critical gaps within upper extremity high-intensity activity-based research in SCI.
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Affiliation(s)
- Namrata Grampurohit
- Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Alison Bell
- Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Susan V Duff
- Crean College of Health and Behavioral Sciences, Chapman University, Irvine, CA, USA
| | - M J Mulcahey
- Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Gary Kaplan
- Scott Memorial Library, Academic Commons, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ralph J Marino
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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Bozec E, Grampurohit N, Gorska J. Implementation Challenges With Evidence-Based Practice Within Inpatient Rehabilitation to Incorporate Task-Specific Training. Am J Occup Ther 2021. [DOI: 10.5014/ajot.2021.75s2-rp266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
The study objective was to examine the implementation barriers and facilitators after a year of training and use of a task-specific training manual in inpatient rehabilitation. The Consolidated Framework for Implementation Research provided structure for the survey of OTs. Stakeholders reported confidence in evidence incorporation, and the barriers related to ease of selection and use of this intervention need to be addressed.
Primary Author and Speaker: Eron Bozec
Additional Authors and Speakers: Namrata Grampurohit
Contributing Authors: Namrata Grampurohit, Jaime Gorska
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Affiliation(s)
- Eron Bozec
- Marianjoy Rehabilitation Hospital, Wheaton, IL, USA
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21
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Mohammadi R, Hafez Yosephi M, Khanmohammadi R, Grampurohit N. Short-term Effects of Elastic Therapeutic Taping on Static and Dynamic Balance in Chronic Stroke. BCN 2021; 12:541-550. [PMID: 35154594 PMCID: PMC8817174 DOI: 10.32598/bcn.12.4.2979.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 02/28/2021] [Accepted: 06/30/2021] [Indexed: 11/20/2022]
Abstract
Introduction: The current pilot study aimed to examine the short-term effects of ankle Elastic Therapeutic Taping (ETT) on static and dynamic balance. Methods: Twenty-Four individuals with chronic stroke were assigned to an experimental or control group (n=12/group); they both received Conventional Physical Therapy (CT) for 3 weeks, 3 times per week. The experimental group additionally underwent taping to the ankle of the paretic side continuously for 3 weeks. Standardized measures for static and dynamic balance were administered at pre-test and post-test and analyzed using Wilcoxon and Analysis of Covariance (ANCOVA). Results: The experimental group significantly improved on two measures, Biodex anterior-posterior static (P=0.03) and medial-lateral dynamic (P=0.04) balance indices, compared to the controls. Both groups improved within their respective groups for Berg Balance Scale and Functional Reach (P<0.05). Static balance consistently improved across measures with the experimental intervention with large effect sizes. Conclusion: Ankle ETT, combined with CT, may be effective in the short-term for improving static and dynamic balance in stroke, compared to CT alone. A future larger randomized trial with longer follow-up is required to establish this method’s effectiveness.
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Affiliation(s)
- Roghayeh Mohammadi
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Corresponding Author: Roghayeh Mohammadi, PhD. Address:Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran.Tel:+98 (914) 3570295E-mail:;
| | - Mohaddeseh Hafez Yosephi
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Roya Khanmohammadi
- Department of Physical Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Namrata Grampurohit
- Department of Occupational Therapy, School of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, USA
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Bozec E, Gorska J, Grampurohit N. Upper Extremity Task-Specific Training: Manual Development and Implementation Research within Inpatient Rehabilitation. Occup Ther Health Care 2021; 35:336-354. [PMID: 34181500 DOI: 10.1080/07380577.2021.1938338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 05/21/2021] [Accepted: 05/29/2021] [Indexed: 10/21/2022]
Abstract
A structured program of manualization and implementation of neurologic upper extremity task-specific training was developed at an inpatient rehabilitation hospital. The study used the Consolidated Framework for Implementation Research and engaged 31 stakeholders in manual refinement and examination of barriers after a year of training and use. Occupational therapists, occupational therapy assistants, and clinical educators provided input for manual revisions until consensus was achieved on usability, applicability, and implementation. Practitioners reported barriers such as intervention complexity, insufficient idea sharing for implementation, and a lack of motivators outside of the organization. The results can inform future implementation research in occupational therapy.Supplemental data for this article is available online at https://doi.org/10.1080/07380577.2021.1938338 .
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Affiliation(s)
- Eron Bozec
- Outpatient Day Rehabilitation, Northwestern Medicine Marianjoy Rehabilitation Hospital, Wheaton, IL, USA
- Department of Occupational Therapy, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jaime Gorska
- Outpatient Day Rehabilitation, Northwestern Medicine Marianjoy Rehabilitation Hospital, Wheaton, IL, USA
| | - Namrata Grampurohit
- Department of Occupational Therapy, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
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Bell A, Grampurohit N, Marino RJ, Duff S, Kaplan G, Calhoun Thielen C, Mulcahey M. Home Activity-based Interventions for the Neurologically Impaired Upper Extremity: A Scoping Review. Home Health Care Management & Practice 2021. [DOI: 10.1177/1084822320953836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Activity-based therapy (ABT) for the upper extremity (UE) enables neurologic recovery with tasks that are functional, intense, and highly repetitive. A large proportion of rehabilitation occurs in the home and there is a gap in literature on the application of ABT within the home. The objective of this scoping review was to describe ABT in the home-setting for the neurologically-impaired UE. Methods: A systematic scoping review included searches of: MEDLINE, CINAHL, Cochrane, and OTSeeker. Results: A systematic search yielded 51 final studies. About 61% of ABT studies were exclusively within the home, others included outpatient visits (37%). Telerehabilitation was used in 37% of the studies with live-video and store forward techniques equally represented. ABT supported by technology was used in 61% of studies. Dosing of intervention ranged from 7 to 120 hours, with a mean of 34.5 hours of practice. Adherence with intended dosing was reported in 27% of studies and subjects completed a mean of 86% of the intended practice time. Sixty-seven percent of studies reported some degree of practice without therapist supervision. Conclusions: The results showed wide variability in the intervention methods, dosing and technology used in homebased settings. The high rate of adherence with dosing is encouraging for the application of homebased neurologic UE interventions. This scoping review highlights feasibility of UE ABT within the home and need for further research.
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Affiliation(s)
- Alison Bell
- Thomas Jefferson University, Philadelphia, PA, USA
| | | | | | | | - Gary Kaplan
- Thomas Jefferson University, Philadelphia, PA, USA
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Burdea G, Kim N, Polistico K, Kadaru A, Roll D, Grampurohit N. Novel integrative rehabilitation system for the upper extremity: Design and usability evaluation. J Rehabil Assist Technol Eng 2021; 8:20556683211012885. [PMID: 34422282 PMCID: PMC8373277 DOI: 10.1177/20556683211012885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 04/08/2021] [Indexed: 01/23/2023] Open
Abstract
PURPOSE Design and test the usability of a novel virtual rehabilitation system for bimanual training of gravity supported arms, pronation/supination, grasp strengthening, and finger extension. METHODS A robotic rehabilitation table, therapeutic game controllers, and adaptive rehabilitation games were developed. The rehabilitation table lifted/lowered and tilted up/down to modulate gravity loading. Arms movement was measured simultaneously, allowing bilateral training. Therapeutic games adapted through a baseline process. Four healthy adults performed four usability evaluation sessions each, and provided feedback using the USE questionnaire and custom questions. Participant's game play performance was sampled and analyzed, and system modifications made between sessions. RESULTS Participants played four sessions of about 50 minutes each, with training difficulty gradually increasing. Participants averaged a total of 6,300 arm repetitions, 2,200 grasp counts, and 2,100 finger extensions when adding counts for each upper extremity. USE questionnaire data averaged 5.1/7 rating, indicative of usefulness, ease of use, ease of learning, and satisfaction with the system. Subjective feedback on the custom evaluation form was 84% favorable. CONCLUSIONS The novel system was well-accepted, induced high repetition counts, and the usability study helped optimize it and achieve satisfaction. Future studies include examining effectiveness of the novel system when training patients acute post-stroke.
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Affiliation(s)
- Grigore Burdea
- Bright Cloud International Corp, Corporate Laboratories, North
Brunswick, NJ, USA
- Department of Electrical and Computer Engineering, Rutgers – The
State University of New Jersey, Piscataway, NJ, USA
| | - Nam Kim
- Bright Cloud International Corp, Corporate Laboratories, North
Brunswick, NJ, USA
| | - Kevin Polistico
- Bright Cloud International Corp, Corporate Laboratories, North
Brunswick, NJ, USA
| | - Ashwin Kadaru
- Bright Cloud International Corp, Corporate Laboratories, North
Brunswick, NJ, USA
| | - Doru Roll
- Bright Cloud International Corp, Corporate Laboratories, North
Brunswick, NJ, USA
| | - Namrata Grampurohit
- Bright Cloud International Corp, Corporate Laboratories, North
Brunswick, NJ, USA
- Department of Occupational Therapy, Jefferson University,
Philadelphia, PA, USA
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25
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Grampurohit N, Duff S, Kains G, Burke S, Pivarunas C, Marino R. Client Perspectives on Using Technology-guided Activity-based Upper Extremity Interventions for Spinal Cord Injury Rehabilitation. Arch Phys Med Rehabil 2020. [DOI: 10.1016/j.apmr.2020.09.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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26
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Burdea GC, Grampurohit N, Kim N, Polistico K, Kadaru A, Pollack S, Oh-Park M, Barrett A, Kaplan E, Masmela J, Nori P. Feasibility of integrative games and novel therapeutic game controller for telerehabilitation of individuals chronic post-stroke living in the community. Top Stroke Rehabil 2020; 27:321-336. [PMID: 31875775 PMCID: PMC8130884 DOI: 10.1080/10749357.2019.1701178] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 11/30/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Intensive, adaptable and engaging telerehabilitation is needed to enhance recovery and maximize outcomes. Such services may be provided under early supported discharge, or later for chronic populations. A novel virtual reality game-based telerehabilitation system was designed for individuals post-stroke to enhance their bimanual upper extremity motor function, cognition, and wellbeing. OBJECTIVES To evaluate the feasibility of novel therapeutic game controller and telerehabilitation system for home use. METHODS Individuals chronic post-stroke and their caregivers were recruited (n = 8 + 8) for this feasibility study. One was a screen failure and seven completed 4 weeks (20 sessions) of home-based therapy with or without remote monitoring. Standardized clinical outcome measures were taken pre- and post-therapy. Game performance outcomes were sampled at every session, while participant and caregiver subjective evaluations were done weekly. RESULTS There was a 96% rate of compliance to protocol, resulting in an average of 13,000 total arm repetitions/week/participant. Group analysis showed significant (p <.05) improvements in grasp strength (effect size [ES] = 0.15), depression (Beck Depression Inventory II, ES = 0.75), and cognition (Neuropsychological Assessment Battery for Executive Function, ES = 0.46). Among the 49 outcome variables, 36 variables (73.5%) improved significantly (p = .001, binomial sign test). Technology acceptance was very good with system rating by participants at 3.7/5 and by caregivers at 3.5/5. CONCLUSIONS These findings indicate the feasibility and efficacy of the system in providing home-based telerehabilitation. The BrightBrainer system needs to be further evaluated in randomized control trials and with individuals early post-stroke.
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Affiliation(s)
- Grigore C. Burdea
- Bright Cloud International Corp (Highland Park, NJ)
- Department of Electrical and Computer Engineering, Rutgers
– The State University of NJ (Piscataway, NJ)
| | - Namrata Grampurohit
- Bright Cloud International Corp (Highland Park, NJ)
- Department of Occupational Therapy, Jefferson College of
Rehabilitation Sciences (Philadelphia, PA)
| | - Nam Kim
- Bright Cloud International Corp (Highland Park, NJ)
| | | | | | - Simcha Pollack
- The Tobin College of Business, St John’s University,
(Queens, NY)
| | - Mooyeon Oh-Park
- Kessler Foundation, (West Orange, NJ)
- Burke Rehabilitation Hospital (White Plains, NY)
| | | | | | | | - Phalgun Nori
- Kessler Institute for Rehabilitation, (West Orange,
NJ)
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Grampurohit N, Bozec E, Ehrlich-Jones L. Measurement Characteristics and Clinical Utility of the Frenchay Activities Index Among Adults With Limb Loss. Arch Phys Med Rehabil 2020. [DOI: 10.1016/j.apmr.2020.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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28
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Grampurohit N, Marino R, Bell A, Duff S, Kaplan G, Thielen C, Mulcahey M. A Scoping Review of Activity-based Therapy for the Neurologically Impaired Upper Extremity. Arch Phys Med Rehabil 2019. [DOI: 10.1016/j.apmr.2019.10.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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29
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Grampurohit N, Van de Winckel A, Ehrlich-Jones L. Measurement Characteristics and Clinical Utility of the ABILHAND-Kids Among Children With Neuromuscular Conditions. Arch Phys Med Rehabil 2019. [DOI: 10.1016/j.apmr.2019.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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30
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Mendonca R, Sheehy K, Freedman E, Grampurohit N. Effectiveness of Robotic Therapy on Upper-Extremity Function and Pain in Adults With Chronic Stroke: A Systematic Review. Am J Occup Ther 2019. [DOI: 10.5014/ajot.2019.73s1-po2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Date Presented 04/04/19
Approximately 795,000 Americans experience a stroke each year, which leads to a decrease in function. Robotic therapy is being tested as an intervention for upper-extremity rehabilitation in stroke. However, research indicates that there is insufficient evidence to support the effectiveness of robotic therapy over conventional therapy. As OTs consider additional methods of delivering therapy, this review informs them about the effectiveness of robotics.
Primary Author and Speaker: Rochelle Mendonca
Additional Authors and Speakers: Kerry Sheehy, Emily Freedman, Namrata Grampurohit
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31
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Grampurohit N, Slavin M, Ni P, Jette A, Mulcahey M. Sensitivity to Change of the Cerebral Palsy Profile of Health and Function Upper-Extremity (UE) Domain in Children Following Musculoskeletal Surgery. Am J Occup Ther 2019. [DOI: 10.5014/ajot.2019.73s1-po8021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Date Presented 04/06/19
The psychometric properties examined in this research study will enable evidence-informed decision making for OTs to select robust assessment tools when working with children with cerebral palsy. This study reports on the significantly better ability of the Upper-Extremity Cerebral Palsy Profile of Health and Function Computerized Adaptive Test in detecting a change in UE function of children with cerebral palsy when compared to other measures.
Primary Author and Speaker: Namrata Grampurohit
Contributing Authors: Mary Slavin, Pengsheng Ni, Alan Jette, MaryJane Mulcahey
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Affiliation(s)
| | | | | | - Alan Jette
- MGH Institute of Health Professions, Boston, MA, USA
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32
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Grampurohit N, Knoff A, Fritsch L, Mendonca R. Game-Based Versus Nongame-Based Virtual-Reality Interventions for Upper-Extremity Rehabilitation in Chronic Stroke: A Systematic Review. Am J Occup Ther 2019. [DOI: 10.5014/ajot.2019.73s1-po2026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Date Presented 04/04/19
OTs are increasingly using virtual reality to engage adults in physical rehabilitation after stroke. The results of this systematic review can guide clinical practice for OTs to make evidence-informed decisions when using game-based or nongame-based virtual reality for upper-extremity rehabilitation.
Primary Author and Speaker: Namrata Grampurohit
Contributing Authors: Alexa Knoff, Laura Fritsch, Rochelle Mendonca
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33
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Buccellato KH, Nordstrom M, Murphy JM, Burdea GC, Polistico K, House G, Kim N, Grampurohit N, Sorensen J, Isaacson BM, Pasquina PF. A Randomized Feasibility Trial of a Novel, Integrative, and Intensive Virtual Rehabilitation Program for Service Members Post-Acquired Brain Injury. Mil Med 2019; 185:e203-e211. [DOI: 10.1093/milmed/usz150] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/10/2019] [Accepted: 06/05/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Acquired Brain Injury, whether resulting from Traumatic brain injury (TBI) or Cerebral Vascular Accident (CVA), represent major health concerns for the Department of Defense and the nation. TBI has been referred to as the “signature” injury of recent U.S. military conflicts in Iraq and Afghanistan – affecting approximately 380,000 service members from 2000 to 2017; whereas CVA has been estimated to effect 795,000 individuals each year in the United States. TBI and CVA often present with similar motor, cognitive, and emotional deficits; therefore the treatment interventions for both often overlap. The Defense Health Agency and Veterans Health Administration would benefit from enhanced rehabilitation solutions to treat deficits resulting from acquired brain injuries (ABI), including both TBI and CVA. The purpose of this study was to evaluate the feasibility of implementing a novel, integrative, and intensive virtual rehabilitation system for treating symptoms of ABI in an outpatient clinic. The secondary aim was to evaluate the system’s clinical effectiveness.
Materials and Methods
Military healthcare beneficiaries with ABI diagnoses completed a 6-week randomized feasibility study of the BrightBrainer Virtual Rehabilitation (BBVR) system in an outpatient military hospital clinic. Twenty-six candidates were screened, consented and randomized, 21 of whom completed the study. The BBVR system is an experimental adjunct ABI therapy program which utilizes virtual reality and repetitive bilateral upper extremity training. Four self-report questionnaires measured participant and provider acceptance of the system. Seven clinical outcomes included the Fugl-Meyer Assessment of Upper Extremity, Box and Blocks Test, Jebsen-Taylor Hand Function Test, Automated Neuropsychological Assessment Metrics, Neurobehavioral Symptom Inventory, Quick Inventory of Depressive Symptomatology-Self-Report, and Post Traumatic Stress Disorder Checklist- Civilian Version. The statistical analyses used bootstrapping, non-parametric statistics, and multilevel/hierarchical modeling as appropriate. This research was approved by the Walter Reed National Military Medical Center and Uniformed Services University of the Health Sciences Institutional Review Boards.
Results
All of the participants and providers reported moderate to high levels of utility, ease of use and satisfaction with the BBVR system (x̄ = 73–86%). Adjunct therapy with the BBVR system trended towards statistical significance for the measure of cognitive function (ANAM [x̄ = −1.07, 95% CI −2.27 to 0.13, p = 0.074]); however, none of the other effects approached significance.
Conclusion
This research provides evidence for the feasibility of implementing the BBVR system into an outpatient military setting for treatment of ABI symptoms. It is believed these data justify conducting a larger, randomized trial of the clinical effectiveness of the BBVR system.
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Affiliation(s)
- Kiara H Buccellato
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720 A Rockledge Dr, Bethesda, MD
- The Center for Rehabilitation Sciences Research 4301 Jones Bridge Rd, Bethesda, MD
| | - Michelle Nordstrom
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720 A Rockledge Dr, Bethesda, MD
- The Center for Rehabilitation Sciences Research 4301 Jones Bridge Rd, Bethesda, MD
- Department of Rehabilitation Medicine, Uniformed Services University of Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD
- Department of Rehabilitation Medicine, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD
| | - Justin M Murphy
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720 A Rockledge Dr, Bethesda, MD
- The Center for Rehabilitation Sciences Research 4301 Jones Bridge Rd, Bethesda, MD
| | - Grigore C Burdea
- Bright Cloud International Corp, 675 US Hwy 1, North Brunswick, NJ
| | - Kevin Polistico
- Bright Cloud International Corp, 675 US Hwy 1, North Brunswick, NJ
| | - Gregory House
- Bright Cloud International Corp, 675 US Hwy 1, North Brunswick, NJ
| | - Nam Kim
- Bright Cloud International Corp, 675 US Hwy 1, North Brunswick, NJ
| | | | - Jeff Sorensen
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720 A Rockledge Dr, Bethesda, MD
- The Center for Rehabilitation Sciences Research 4301 Jones Bridge Rd, Bethesda, MD
| | - Brad M Isaacson
- The Center for Rehabilitation Sciences Research 4301 Jones Bridge Rd, Bethesda, MD
- Department of Rehabilitation Medicine, Uniformed Services University of Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD
- The Geneva Foundation, 917 Pacific Ave, Tacoma, WA
| | - Paul F Pasquina
- Department of Rehabilitation Medicine, Uniformed Services University of Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD
- Department of Rehabilitation Medicine, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD
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Burdea G, Kim N, Polistico K, Kadaru A, Grampurohit N, Roll D, Damiani F. Assistive game controller for artificial intelligence-enhanced telerehabilitation post-stroke. Assist Technol 2019; 33:117-128. [PMID: 31180276 DOI: 10.1080/10400435.2019.1593260] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Off-the-shelf gaming technology is designed for young, fit, and motor intact individuals. Artificial intelligence (AI) has a role in making controllers and therapeutic games adaptable to the disabled. Post-stroke rehabilitation outcomes can be enhanced by gaming technology within the home to enable engaging telerehabilitation. BrightBrainer™ Grasp (BBG) is a novel therapeutic game controller designed to adapt to arm and hand impairments post-stroke. It mediates intensive arm reach, grasp and finger extension training and has the ability to track relevant outcomes. The newly designed controller uses BrightBrainer gamification system with AI technology to provide automatic adaptation, requiring minimal clinician input. This article describes the BBG design, hardware, force and movement detection and calibration, and its integration with the therapeutic games. The use of AI in adapting a library of custom therapeutic games is also described. Results of a usability study with healthy individuals and related design modifications are presented, with implications for future trials.
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Affiliation(s)
- Grigore Burdea
- Bright Cloud International Corp, Center for Commercialization of Innovative Technologies, North Brunswick, New Jersey, USA
| | - Nam Kim
- Bright Cloud International Corp, Center for Commercialization of Innovative Technologies, North Brunswick, New Jersey, USA
| | - Kevin Polistico
- Bright Cloud International Corp, Center for Commercialization of Innovative Technologies, North Brunswick, New Jersey, USA
| | - Ashwin Kadaru
- Bright Cloud International Corp, Center for Commercialization of Innovative Technologies, North Brunswick, New Jersey, USA
| | - Namrata Grampurohit
- Bright Cloud International Corp, Center for Commercialization of Innovative Technologies, North Brunswick, New Jersey, USA
| | - Doru Roll
- Bright Cloud International Corp, Center for Commercialization of Innovative Technologies, North Brunswick, New Jersey, USA
| | - Frank Damiani
- Patient Care Services, Roosevelt Care Center, Edison, New Jersey, USA
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35
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Mohammadi R, Semnani AV, Mirmohammadkhani M, Grampurohit N. Effects of Virtual Reality Compared to Conventional Therapy on Balance Poststroke: A Systematic Review and Meta-Analysis. J Stroke Cerebrovasc Dis 2019; 28:1787-1798. [PMID: 31031145 DOI: 10.1016/j.jstrokecerebrovasdis.2019.03.054] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/13/2019] [Accepted: 03/31/2019] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE The objective of this study was to systematically review the effect of virtual reality on balance as compared to conventional therapy alone poststroke. METHODS The databases of PubMed, Cochrane, and Ovid were searched using select keywords. The randomized controlled trials published between January 2000 and August 2017 in English language were included if they assessed the effect of virtual reality on balance ability compared to conventional therapy alone in adults' poststroke. The Physiotherapy Evidence Database scale was used to assess the methodological quality. RESULTS Fourteen papers were included in this review. The experimental groups largely (n = 13) used virtual reality in combination with conventional therapy. Among the high quality studies, significant between-group improvement favoring virtual reality in combination with conventional therapy was found on Berg Balance Scale (n = 7) and Timed Up and Go Scale (n = 7) when compared to conventional therapy alone. The studies were limited by low powered, small sample sizes ranging from 14 to 40, and lack of blinding, concealed allocation, and reporting of missing data. Thirteen homogenous (n = 348, I2 = 37.6%, P = .083) studies were included in the meta-analysis using Berg Balance Scale. Significant improvement was observed in the experimental group compared to control group with a medium effect size of .64, confidence interval of .36-.92. CONCLUSIONS The findings of this review indicate that virtual reality when combined with conventional therapy is moderately more effective in improving balance than conventional therapy alone in individuals' poststroke.
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Affiliation(s)
- Roghayeh Mohammadi
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran.
| | | | - Majid Mirmohammadkhani
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Namrata Grampurohit
- Department of Occupational Therapy, College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, Pennsylvania
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Benham S, Kang M, Grampurohit N. Immersive Virtual Reality for the Management of Pain in Community-Dwelling Older Adults. OTJR: Occupation, Participation and Health 2018; 39:90-96. [DOI: 10.1177/1539449218817291] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Immersive virtual reality (VR) can provide a high level of engagement and distraction analgesia to address pain. However, community-based applications of this technology for older adults have not been studied. The objective of this study was to examine the applicability and effectiveness of an immersive VR intervention for pain, depression, and quality of life (QOL) in older adults. This pretest–posttest, mixed-methods design included senior center members ( n = 12) with pain that interfered with daily functioning. The outcomes included the Numeric Pain Rating Scale, Patient-Reported Outcomes Measurement Information System (PROMIS®) depression scale, World Health Organization Quality of Life Scale Brief Version (WHO QOL-BREF), and open-ended questions. The VR intervention (15- to 45-min sessions, 12 sessions over 6 weeks) was well accepted with no dropouts. There was a significant decrease in pain ( p = .002, d = −1.54) with no effect on depression and QOL. There were no adverse effects, and positive perceptions of VR were reported. The 6-week immersive VR intervention was applicable and effective in reducing pain intensity for community-dwelling older adults.
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Affiliation(s)
- Sara Benham
- University of the Sciences, Philadelphia, PA, USA
| | - Minhee Kang
- University of the Sciences, Philadelphia, PA, USA
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Dent K, Grampurohit N, Thielen CC, Sadowsky C, Davidson L, Taylor HB, Bultman J, Gaughan J, Marino RJ, Mulcahey MJ. Evaluation of the Capabilities of Upper Extremity Test (CUE-T) in Children With Tetraplegia. Top Spinal Cord Inj Rehabil 2018; 24:239-251. [PMID: 29997427 DOI: 10.1310/sci2403-239] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: The Capabilities of Upper Extremity Test (CUE-T) is a spinal cord injury (SCI)-specific instrument based on the CUE Questionnaire (CUE-Q). Objective: To evaluate the psychometric properties of CUE-T in children with cervical SCI and determine the lowest age appropriate for test administration. Method: In this repeated measures multicenter study, 39 youths, mean age 12.3 years and mean time post injury 5.14 years, completed two administrations of the CUE-T. Test-retest reliability, internal consistency, and known groups validity were measured. Concurrent and discriminant validity were measured against previously validated measures: CUE-Q, Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP), Spinal Cord Independence Measure (SCIM) III, SCIM III-Self Care (SCIM-SC), and SCIM-Mobility. Results: The CUE-T scores demonstrated strong test-retest reliability (ICC ≥ 0.95), strong internal consistency (α ≥ 0.90), and acceptable individual item agreement (κ ≥ 0.49). The hand subscale had better scores (p < .05) for the motor incomplete versus complete known groups, and the arm, hand, and side subscales had better scores (p < .05) for higher versus lower strength groups. The CUE-T had strong concurrent validity with the CUE-Q (r = 0.85-0.87), GRASSP (r = 0.78-0.90), and SCIM-SC (r = 0.70) and moderate-to-weak correlation with the total SCIM (r = 0.65) and SCIM-Mobility (r = 0.51). Children older than 6 years with mature grasp patterns were able to complete the CUE-T. Conclusion: The CUE-T scores are reliable and valid for use in children with cervical SCI older than 6 years of age.
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Affiliation(s)
- Kathryn Dent
- Department of Occupational Therapy, Jefferson College of Health Professions, Jefferson (Philadelphia University + Thomas Jefferson University), Philadelphia, Pennsylvania
| | - Namrata Grampurohit
- Department of Occupational Therapy, Jefferson College of Health Professions, Jefferson (Philadelphia University + Thomas Jefferson University), Philadelphia, Pennsylvania
| | - Christina Calhoun Thielen
- Department of Occupational Therapy, Jefferson College of Health Professions, Jefferson (Philadelphia University + Thomas Jefferson University), Philadelphia, Pennsylvania
| | | | | | | | - Jackie Bultman
- Mary Free Bed Rehabilitation Hospital, Grand Rapids, Michigan
| | - John Gaughan
- Department of Occupational Therapy, Jefferson College of Health Professions, Jefferson (Philadelphia University + Thomas Jefferson University), Philadelphia, Pennsylvania
| | - Ralph J Marino
- Department of Occupational Therapy, Jefferson College of Health Professions, Jefferson (Philadelphia University + Thomas Jefferson University), Philadelphia, Pennsylvania
| | - M J Mulcahey
- Department of Occupational Therapy, Jefferson College of Health Professions, Jefferson (Philadelphia University + Thomas Jefferson University), Philadelphia, Pennsylvania.,Shriners Hospitals for Children, Philadelphia, Pennsylvania
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Grampurohit N, Dent K, Calhoun CT, Mulcahey M. Evaluation of the Capabilities of Upper Extremities Test (CUE-T) in Children With Tetraplegia. Arch Phys Med Rehabil 2018. [DOI: 10.1016/j.apmr.2018.07.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nordstrom M, Murphy J, Burdea G, Polistico K, Kim N, Grampurohit N, Sharp W, Isaacson B, Pasquina P. Integrative and Intensive Virtual Rehabilitation Program for a Service Member Post Severe TBI. Arch Phys Med Rehabil 2017. [DOI: 10.1016/j.apmr.2017.08.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Grampurohit N, Dudgeon B, Kartin D. A Systematic Review of Hand Function Measures for Adults With Neurological Conditions. Arch Phys Med Rehabil 2017. [DOI: 10.1016/j.apmr.2017.08.459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Grampurohit N, Dudgeon B, Kelly V, Taylor C, Kartin D. Preliminary Development of the Hand and Arm Function Measure for People With Neurological Conditions. Am J Occup Ther 2017. [DOI: 10.5014/ajot.2017.71s1-po7064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Date Presented 4/1/2017
The Hand and Arm Function Measure was newly developed for people with neurological conditions. It advances occupational performance measurement with use of an evidence-centered design framework for scale development, engagement of stakeholders, and combination of self-report and performance.
Primary Author and Speaker: Namrata Grampurohit
Contributing Authors: Brian Dudgeon, Valerie Kelly, Catherine Taylor, Deborah Kartin
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House G, Burdea G, Grampurohit N, Polistico K, Roll D, Damiani F, Hundal J, Demesmin D. A feasibility study to determine the benefits of upper extremity virtual rehabilitation therapy for coping with chronic pain post-cancer surgery. Br J Pain 2016; 10:186-197. [PMID: 27867508 PMCID: PMC5102098 DOI: 10.1177/2049463716664370] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Persistent pain in shoulder and arm following post-surgical breast cancer treatment can lead to cognitive and physical deficits. Depression is also common in breast cancer survivors. Virtual reality therapy with integrative cognitive and physical rehabilitation has not been clinically trialed for this population. The novel BrightArm Duo technology improved cognition and upper extremity (UE) function for other diagnoses and has great potential to benefit individuals coping with post-surgical breast cancer pain. OBJECTIVES The aim of this study was to explore the feasibility of BrightArm Duo therapy for coping with post-surgical chronic pain and associated disability in breast cancer survivors with depression. METHODS BrightArm Duo is a robotic rehabilitation table modulating gravity loading on supported forearms. It tracks arm position and grasping strength while patients play three-dimensional (3D) custom integrative rehabilitation games. Community-dwelling women (N = 6) with post-surgical breast cancer pain in the upper arm trained on the system twice a week for 8 weeks. Training difficulty increased progressively in game complexity, table tilt and session length (20-50 minutes). Standardized assessments were performed before and after therapy for pain, cognition, emotion, UE function and activities of daily living. RESULTS Subjects averaged upwards of 1300 arm repetitions and 850 hand grasps per session. Pain intensity showed a 20% downward trend (p = 0.1) that was corroborated by therapist observations and participant feedback. A total of 10 out of 11 cognitive metrics improved post-training (p = 0.01) with a significant 8.3-point reduction in depression severity (p = 0.04). A total of 17 of 18 range of motion metrics increased (p < 0.01), with five affected-side shoulder improvements above the Minimal Clinically Important Difference (8°). In all, 13 out of 15 strength and function metrics improved (p = 0.02) with lateral deltoid strength increasing 7.4 N on the affected side (p = 0.05). CONCLUSION This pilot study demonstrated feasibility of using the BrightArm Duo Rehabilitation System to treat cancer survivors coping with upper body chronic pain. Outcomes indicate improvement in cognition, shoulder range, strength, function and depression.
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Affiliation(s)
- Gregory House
- Bright Cloud International Corp, Highland Park, NJ, USA
| | | | | | | | - Doru Roll
- Bright Cloud International Corp, Highland Park, NJ, USA
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House G, Burdea G, Polistico K, Roll D, Kim J, Grampurohit N, Damiani F, Keeler S, Hundal J, Pollack S. Integrative rehabilitation of residents chronic post-stroke in skilled nursing facilities: the design and evaluation of the BrightArm Duo. Disabil Rehabil Assist Technol 2016; 11:683-94. [PMID: 26218427 DOI: 10.3109/17483107.2015.1068384] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 06/29/2015] [Indexed: 11/13/2022]
Abstract
PURPOSE To describe the novel BrightArm Duo bimanual upper extremity (UE) rehabilitation system; to determine its technology acceptance and clinical benefit for older hemiplegic participants. METHODS The system table tilted to adjust arm gravity loading. Participants wore arm supports that sensed grasp strength and wrist position on the table. Wrist weights further increased shoulder exertion. Games were designed to improve UE strength, motor function, cognition and emotive state and adapted automatically to each participant. The system underwent feasibility trials spanning 8 weeks in two skilled nursing facilities (SNFs). Participants were evaluated pre-therapy and post-therapy using standardized clinical measures. Computerized measures of supported arm reach, table tilt and number of arm repetitions were stored on a remote server. OUTCOMES Seven participants had significant improvements in their active range of shoulder movement, supported arm reach, shoulder strength, grasp strength and their ability to focus. The group demonstrated higher arm function measured with FMA (p = 0.01) and CAHAI (p = 0.05), and had an improvement in depression (Becks Depression Inventory, II). BrightArm Duo technology was well accepted by participants with a rating of 4.4 out of 5 points. CONCLUSIONS Given these findings, it will be beneficial to evaluate the BrightArm Duo application in SNF maintenance programs. Implications for Rehabilitation Integrative rehabilitation that addresses both physical and cognitive domains is promising for post-stroke maintenance in skilled nursing facilities. Simultaneous bilateral arm exercise may improve arm function in older hemiplegic patients several years after stroke. Virtual reality games that adapt to the patient can increase attention and working memory while decreasing depression in elderly.
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Affiliation(s)
- G House
- a Bright Cloud International Corp , Highland Park , NJ , USA
| | - G Burdea
- a Bright Cloud International Corp , Highland Park , NJ , USA
| | - K Polistico
- a Bright Cloud International Corp , Highland Park , NJ , USA
| | - D Roll
- a Bright Cloud International Corp , Highland Park , NJ , USA
| | - J Kim
- a Bright Cloud International Corp , Highland Park , NJ , USA
| | - N Grampurohit
- a Bright Cloud International Corp , Highland Park , NJ , USA
| | - F Damiani
- b Roosevelt Care Center , Edison , NJ , USA
| | - S Keeler
- c JFK Hartwyck at Edison Estates , Edison , NJ , USA
| | - J Hundal
- d Hundal Neuropsychology Group , Watchung , NJ , USA
| | - S Pollack
- e Data Driven Innovation , Westhampton , NY , USA , and
- f Computer Information Systems and Decision Sciences, St. John's University , Queens , NY , USA
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House G, Burdea G, Polistico K, Grampurohit N, Roll D, Damiani F, Keeler S, Hundal J. A Rehabilitation First-Tournament Between Teams of Nursing Home Residents with Chronic Stroke. Games Health J 2016; 5:75-83. [PMID: 26741697 DOI: 10.1089/g4h.2015.0072] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE This study describes the BrightArm™ Duo virtual reality system (Bright Cloud International Corp., Highland Park, NJ) and determines its clinical benefit for maintenance of upper extremity function in nursing home residents who are chronic poststroke. MATERIALS AND METHODS Participants sat at a low-friction robotic table with tilt and lift capability and interacted with serious games through computerized supports that measured forearm movement and grasp. The rehabilitation simulations were designed to improve arm and hand function, increase range of motion, and improve emotional well-being and cognition (attention, memory, and executive functioning). After 8 weeks of initial intensive therapy, there were three booster periods at 8-week intervals, each consisting of four sessions over 2 weeks. The last booster was a tournament competition, where pairs of residents played games collaboratively from remote nursing homes. Participants were evaluated before and after each booster period using standardized clinical measures. RESULTS Range of motion improved for 18 out of 23 upper extremity movement variables (P = 0.01) between pre- and post-tournament assessment, and the residents self-reported that they enjoyed playing with a partner (score of 4.7 out of 5.0). Participants were able to reduce game completion time through cooperative play (teamwork), and the times improved with successive sessions of the tournament. Affected hand and arm function and depression levels were maintained (no decline) after the tournament. CONCLUSIONS A rehabilitation tournament using virtual reality between teams of nursing home residents chronic poststroke is the first of its kind in clinical practice. This study demonstrates its effectiveness in improving range of motion of the upper extremity while engaging residents in the maintenance program at their nursing home.
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Affiliation(s)
- Gregory House
- 1 Bright Cloud International Corp , Highland Park, New Jersey
| | - Grigore Burdea
- 1 Bright Cloud International Corp , Highland Park, New Jersey
| | - Kevin Polistico
- 1 Bright Cloud International Corp , Highland Park, New Jersey
| | | | - Doru Roll
- 1 Bright Cloud International Corp , Highland Park, New Jersey
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Grampurohit N, Pradhan S, Kartin D. Efficacy of adhesive taping as an adjunt to physical rehabilitation to influence outcomes post-stroke: a systematic review. Top Stroke Rehabil 2015; 22:72-82. [PMID: 25776123 DOI: 10.1179/1074935714z.0000000031] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Adhesive taping as a therapeutic modality post-stroke has been investigated for two decades. No systematic review of the evidence to inform clinical practice exists. OBJECTIVE To systematically review the efficacy of adhesive taping as an adjunct to physical rehabilitation on outcomes related to body function and structure, activity, and participation post-stroke. METHODS The databases of PubMed, CINAHL, EMBASE, and Web of Science from 1966 through December 2013 were searched. Full-text articles in English from peer-reviewed journals reporting original research on the use of adhesive taping post-stroke were included. Two reviewers independently searched and then rated the quality of evidence using the PEDro evidence rating system. Randomized controlled trials were further assessed using the Consolidated Standards of Reporting Trials (CONSORT) guidelines. RESULTS Fifteen studies met the inclusion criteria. Two used elastic tape and 13 used rigid tape. The evidence quality ranged from poor to good, and included seven shoulder, one wrist, two hip, one knee, and four ankle studies. There were four good-quality studies. CONCLUSIONS Preliminary evidence in the domain of body function and structure suggests that use of rigid adhesive tape as an adjunct may increase the number of pain-free days at the shoulder. Evidence for the improvement of pain intensity, range of motion, muscle tone, strength, or function with taping is inconclusive. The evidence related to activity and participation is insufficient. The use of adhesive taping post-stroke needs further and more rigorous research to compare the types, methods and dosage of taping.
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