Effectiveness of the RAPAEL Smart Board for Upper Limb Therapy in Stroke Survivors: A Pilot Controlled Trial

2018 ◽  
Author(s):  
Joonwoo Park ◽  
Hee-Tae Jung ◽  
Jean-Francois Daneault ◽  
Sungji Park ◽  
Taekyeong Ryu ◽  
...  
Keyword(s):  
Upper Limb ◽  
Controlled Trial ◽  
Stroke Survivors ◽  
Smart Board

scholarly journals Effect of home-based rehabilitation of purposeful activity-based electrical stimulation therapy for chronic stroke survivors: a crossover randomized controlled trial

2021 ◽  
pp. 1-8
Author(s):  
Seigo Minami ◽  
Yoshihiro Fykumoto ◽  
Ryuji Kobayashi ◽  
Hideaki Aoki ◽  
Tomoki Aoyama
Keyword(s):  
Upper Limb ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Phase 1 ◽  
Chronic Stroke ◽  
Stroke Survivors ◽  
Electrical Stimulation Therapy ◽  
Home Based ◽  
Group A ◽  
Purposeful Activity

Background: In this trial we combined the effect of purposeful activity and electrical stimulation therapy (PA-EST) to promote transition of severely hemiparetic upper limb to auxiliary upper limb in chronic stroke survivors in a single-case study. Objective: The purpose of this study was to examine the effect of PA-EST on the upper limb motor function in a crossover randomized controlled trial. Methods: The study included eight stroke survivors (age: 63.1±10.9 years) who were receiving home-based visiting occupational therapy. The average time since stroke onset was 8.8±5.6 years. All participants had severely hemiparetic upper limb, with the Fugl–Meyer Assessment upper extremity (FMA-U) score of 21.3±8.5. Participants were randomly assigned to group A or B. Group A received PA-EST for 3 months (phase 1), followed by standard stretching and exercise for 3 months (phase 2), whereas group B had the inverse order of treatments. To avoid carry-over effect, 1-month washout period was provided between the phase 1 and 2. Two-way analysis of variance (ANOVA) with repeated measures was used for the analysis. The primary outcome was FMA-U, and the secondary outcomes were, Motor Activity Log (MAL; amount of use [AOU] and quality of movement [QOM]), and Goal attainment scale-light (GAS-light). Results: Repeated measures-ANOVA revealed a significant interaction between type of intervention and time for FMA-U (F = 16.303, P = 0.005), MAL AOU (F = 7.966, P = 0.026) and QOM (F = 6.408, P = 0.039), and GAS-light (F = 6.905, P = 0.034), where PA-EST was associated with significantly improved motor function and goal achievement compared with standard stretching. Conclusions: The PA-EST may have greater effects than stretch/exercise in the recovery of hand function as reflected in FMA-U, MAL, and GAS-light. Our results suggest that PA-EST is an important and useful home-based rehabilitation program for promoting the use of the severely hemiparetic upper limb in chronic stroke survivors.

scholarly journals Robotic-based ACTive somatoSENSory (Act.Sens) retraining on upper limb functions with chronic stroke survivors: study protocol for a pilot randomised controlled trial

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ananda Sidarta ◽  
Yu Chin Lim ◽  
Christopher Wee Keong Kuah ◽  
Yong Joo Loh ◽  
Wei Tech Ang
Keyword(s):  
Randomised Controlled Trial ◽  
Study Protocol ◽  
Upper Limb ◽  
Controlled Trial ◽  
Chronic Stroke ◽  
Community Dwelling ◽  
Control Group ◽  
Stroke Survivors ◽  
Pilot Randomised Controlled Trial ◽  
Randomised Controlled

Abstract Background Prior studies have established that senses of the limb position in space (proprioception and kinaesthesia) are important for motor control and learning. Although nearly one-half of stroke patients have impairment in the ability to sense their movements, somatosensory retraining focusing on proprioception and kinaesthesia is often overlooked. Interventions that simultaneously target motor and somatosensory components are thought to be useful for relearning somatosensory functions while increasing mobility of the affected limb. For over a decade, robotic technology has been incorporated in stroke rehabilitation for more controlled therapy intensity, duration, and frequency. This pilot randomised controlled trial introduces a compact robotic-based upper-limb reaching task that retrains proprioception and kinaesthesia concurrently. Methods Thirty first-ever chronic stroke survivors (> 6-month post-stroke) will be randomly assigned to either a treatment or a control group. Over a 5-week period, the treatment group will receive 15 training sessions for about an hour per session. Robot-generated haptic guidance will be provided along the movement path as somatosensory cues while moving. Audio-visual feedback will appear following every successful movement as a reward. For the same duration, the control group will complete similar robotic training but without the vision occluded and robot-generated cues. Baseline, post-day 1, and post-day 30 assessments will be performed, where the last two sessions will be conducted after the last training session. Robotic-based performance indices and clinical assessments of upper limb functions after stroke will be used to acquire primary and secondary outcome measures respectively. This work will provide insights into the feasibility of such robot-assisted training clinically. Discussion The current work presents a study protocol to retrain upper-limb somatosensory and motor functions using robot-based rehabilitation for community-dwelling stroke survivors. The training promotes active use of the affected arm while at the same time enhances somatosensory input through augmented feedback. The outcomes of this study will provide preliminary data and help inform the clinicians on the feasibility and practicality of the proposed exercise. Trial registration ClinicalTrials.gov NCT04490655. Registered 29 July 2020.

scholarly journals Effectiveness of combined modified constraint-induced movement therapy for upper and lower limb in stroke rehabilitation: a study protocol for randomized controlled trial (Preprint)

2018 ◽  
Author(s):  
Lawan Umar
Keyword(s):  
Motor Function ◽  
Upper Limb ◽  
Lower Limb ◽  
Gait Speed ◽  
Stride Length ◽  
Controlled Trial ◽  
Stroke Survivors ◽  
Hrqol Score ◽  
Randomized Controlled ◽  
Post Hoc

BACKGROUND Background: The translation of neuroscientific research into care has led to new approaches and renewed promise. Stroke survivors with hemiparesis often exhibit impaired balance, ambulation dysfunction and asymmetrical weight distribution leading to physical dysfunction and decreased Health-Related Quality of Life (HRQoL).Constraint-induced movement therapy (CIMT) approach could be translated into a clinical protocol for gait rehabilitation. Modified CIMT for upper limb and lower limb when applied singly improve lower limb motor function, balance, gait and HRQoL of stroke survivors OBJECTIVE However, effects of combined modified CIMT for upper and lower limbs (CoMCIMTULL) have not been investigated. Therefore, the effects of four-week CoMCIMTULL was compared with Modified CIMT Lower Limb (MCIMTLL) and Modified CIMT Upper Limb (MCIMTUL) among hemiparetic stroke survivors in this study. METHODS This single-blind randomized controlled trial involved random assignment of 56 consecutive stroke survivors to three groups: CoMCIMTULL (n=19), MCIMTLL (n=20), and MCIMTUL (n=17). The CoMCIMTULL group received both upper and lower limb CIMT for the reduced use of the upper limb and maladaptive use of the lower limb. The MCIMTLL group used the affected lower limb to lead weight bearing activities and exercises while the MCIMTUL group used the affected upper limbs for motor task practice following the unaffected hand’s restraining in a special splint. These treatments were administared in the clinic for two hours daily, five times per week for four consecutive weeks. Lower Limb Motor Function (LLMF) and balance were assessed using Fugyl Meyer Motor Assessement Scale, Lower Limb Use (LLU) with Lower Extremity Motor Activity Log, balance confidence using Activities-specific Balance Confidence Scale, Weight Asymmetry Ratio (WAR) using two weighing scales, spatiotemporal gait parameters [gait speed (m/s) and stride length (m)] using foot print method and HRQoL using the Stroke Impact Scale. These assessments were done at baseline, ends of weeks two and four. Data were analysed using descriptive statistics, ANOVA with post-hoc, Kruskal-Wallis with post-hoc and Wilcoxon Signed Rank at ᾳ0.05. RESULTS MBetween-group comparisons showed that the differences were significant in CoMCIMTULL (HRQoL score=70.00(10.00) ; LLMF = 29.00(5.00); gait speed=0.650(0.70)m/s ; Stride length=0.60(0.30)m ; and WAR=0.90(0.80) ) compared to MCIMTLL (HRQoL score=80.00(17.50); LLMF =29.50(2.50) ; gait speed=0.80(0.28)m/s; Stride length=0.65(0.40)m; and WAR=0.85(0.40) and MCIMTUL (HRQoL score= 60.00(10.00; LLMF =26.00(4.00) ; gait speed= 0.60(0.20)m/s;Stride length= 0.40(0.40)m; and WAR= 0.80(0.40) CONCLUSIONS It is expected, the outcome of this study will clarify whether the effect of combined modified CIMT upper and lower limb (CoMCIMTULL), Modified CIMT Lower Limb (MCIMTLL) and Modified CIMT Upper Limb (MCIMTUL) will leads to better recovery of motor function in stroke survivors. CLINICALTRIAL This study has been approved by both Health Research Ethics Committee of Universty of Ibadan/University College Hospital (UI/EC/14/0101) and the Murtala Muhammad Specialist Hospital, Kano (HMB/GEN/488/VOL.I)(Nigeria). Additionaly, the study employed a randomized controlled clinical trial design, registered with Pan Africa Clinical Trial Registry PACTR 201611001646207, available on www.pactr.org.

scholarly journals Cost Analysis of a Home-Based Virtual Reality Rehabilitation to Improve Upper Limb Function in Stroke Survivors

2020 ◽  
Vol 12 (2) ◽  
pp. 98
Author(s):  
Mirella Veras ◽  
Jennifer Stewart ◽  
Raywat Deonandan ◽  
José Carlos Tatmatsu-Rocha ◽  
Johanne Higgins ◽  
...  
Keyword(s):  
Cost Analysis ◽  
Upper Limb ◽  
Controlled Trial ◽  
Intervention Group ◽  
Future Research ◽  
Rehabilitation Services ◽  
Stroke Survivors ◽  
Fixed Costs ◽  
Upper Limb Function ◽  
Home Based

Loss of arm function occurs in up to 85% of stroke survivors. Home-based telerehabilitation is a viable approach for upper limb training post-stroke when rehabilitation services are not available. Method: A costing analysis of a telerehabilitation program was conducted under several scenarios, alongside a single-blind two-arm randomized controlled trial with participants randomly allocated to control (N=25) or intervention group (N=26). Detailed analysis of the cost for two different scenarios for providing telerehabilitation were conducted. The fixed costs of the telerehabilitation are an important determinant of the total costs of the program. The detailed breakdown of the costs allows for costs of future proposed telerehabilitation programs to be easily estimated. The costs analysis found that a program supplying all required technology costs between CAD$475 per patient and CAD$482 per patient, while a program supplying only a camera would have total costs between CAD$242 per patient and $245 per patient. The findings of this study support the potential implementation of telerehabilitation for stroke survivors for improving accessibility to rehabilitation services. This cost-analysis study will facilitate the implementation and future research on cost-effectiveness of such interventions.

scholarly journals SMART Arm Training With Outcome-Triggered Electrical Stimulation in Subacute Stroke Survivors With Severe Arm Disability: A Randomized Controlled Trial

2017 ◽  
Vol 31 (12) ◽  
pp. 1005-1016 ◽  
Author(s):  
Ruth N. Barker ◽  
Kathryn S. Hayward ◽  
Richard G. Carson ◽  
David Lloyd ◽  
Sandra G. Brauer
Keyword(s):  
Randomized Controlled Trial ◽  
Electrical Stimulation ◽  
Upper Limb ◽  
Controlled Trial ◽  
Stroke Survivors ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial ◽  
Usual Therapy ◽  
Arm Function ◽  
Clinically Significant

Background. Stroke survivors with severe upper limb disability need opportunities to engage in task-oriented practice to achieve meaningful recovery. Objective. To compare the effect of SMART Arm training, with or without outcome-triggered electrical stimulation to usual therapy, on arm function for stroke survivors with severe upper limb disability undergoing inpatient rehabilitation. Methods. A prospective, multicenter, randomized controlled trial was conducted with 3 parallel groups, concealed allocation, assessor blinding and intention-to-treat analysis. Fifty inpatients within 4 months of stroke with severe upper limb disability were randomly allocated to 60 min/d, 5 days a week for 4 weeks of (1) SMART Arm with outcome-triggered electrical stimulation and usual therapy, (2) SMART Arm alone and usual therapy, or (3) usual therapy. Assessment occurred at baseline (0 weeks), posttraining (4 weeks), and follow-up (26 and 52 weeks). The primary outcome measure was Motor Assessment Scale item 6 (MAS6) at posttraining. Results. All groups demonstrated a statistically ( P < .001) and clinically significant improvement in arm function at posttraining (MAS6 change ≥1 point) and at 52 weeks (MAS6 change ≥2 points). There were no differences in improvement in arm function between groups (P = .367). There were greater odds of a higher MAS6 score in SMART Arm groups as compared with usual therapy alone posttraining (SMART Arm stimulation generalized odds ratio [GenOR] = 1.47, 95%CI = 1.23-1.71) and at 26 weeks (SMART Arm alone GenOR = 1.31, 95% CI = 1.05-1.57). Conclusion. SMART Arm training supported a clinically significant improvement in arm function, which was similar to usual therapy. All groups maintained gains at 12 months.

scholarly journals EXPRESS: Telehealth coaching to improve self-management for secondary prevention after stroke: A randomized controlled trial of Stroke Coach

2021 ◽  
pp. 174749302110176
Author(s):  
Brodie M Sakakibara ◽  
Scott A Lear ◽  
Susan I Barr ◽  
Charles Goldsmith ◽  
Amy Schneeberg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Controlled Trial ◽  
Cognitive Status ◽  
Self Management ◽  
Community Living ◽  
Memory Training ◽  
Stroke Survivors ◽  
Post Intervention ◽  
Lifestyle Behaviour ◽  
Mild Stroke

Background: Stroke Coach is a lifestyle coaching telehealth program to improve self-management of stroke risk factors. Aims: To examine the efficacy of Stroke Coach on lifestyle behaviour and risk factor control among community-living stroke survivors within one-year post stroke. Methods: Participants were randomized to Stroke Coach or an attention control Memory Training group. Lifestyle behaviour was measured using the Health Promoting Lifestyle Profile II. Secondary outcomes included specific behavioural and cardiometabolic risk factors, health-related quality of life (HRQoL), cognitive status, and depressive symptoms. Measurements were taken at baseline, post-intervention (6 months), and retention (12 month). Linear mixed-effects models were used to test the study hypotheses (p<0.05). All analyses were intention-to-treat. Results: The mean age of the Stroke Coach (n=64) and Memory Training (n=62) groups was 67.2 and 69.1 years, respectively. The majority of participants (n = 100) had mild stroke (modified Rankin Scale = 1 or 2), were active, with controlled blood pressure (mean = 129/79 mmHg) at baseline. At post-intervention, there were no significant differences in lifestyle (b = -2.87; 95%CI -8.03 to 2.29; p=0.28). Glucose control, as measured by HbA1c (b = 0.17; 95%CI 0.17 to 0.32; p=0.03), and HRQoL, measured using SF-36 Physical Component Summary (b = -3.05; 95%CI -5.88 to -0.21; p=0.04), were significantly improved in Stroke Coach compared to Memory Training, and the improvements were maintained at retention. Conclusion: Stroke Coach did not improve lifestyle behaviour, however, there were improvements to HbA1c and HRQoL among community-living stroke survivors with mild stroke-related disability. (ClinicalTrials.gov identifier: NCT02207023)

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