scholarly journals Reinforced Feedback in Virtual Environment for Rehabilitation of Upper Extremity Dysfunction after Stroke: Preliminary Data from a Randomized Controlled Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Paweł Kiper ◽  
Michela Agostini ◽  
Carlos Luque-Moreno ◽  
Paolo Tonin ◽  
Andrea Turolla
Keyword(s):  
Randomized Controlled Trial ◽  
Virtual Environment ◽  
Upper Extremity ◽  
Motor Function ◽  
Upper Limb ◽  
Controlled Trial ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Stroke Etiology ◽  
Randomized Controlled

Objectives. To study whether the reinforced feedback in virtual environment (RFVE) is more effective than traditional rehabilitation (TR) for the treatment of upper limb motor function after stroke, regardless of stroke etiology (i.e., ischemic, hemorrhagic).Design. Randomized controlled trial.Participants. Forty-four patients affected by stroke.Intervention. The patients were randomized into two groups: RFVE (N=23) and TR (N=21), and stratified according to stroke etiology. The RFVE treatment consisted of multidirectional exercises providing augmented feedback provided by virtual reality, while in the TR treatment the same exercises were provided without augmented feedbacks.Outcome Measures. Fugl-Meyer upper extremity scale (F-M UE), Functional Independence Measure scale (FIM), and kinematics parameters (speed, time, and peak).Results. The F-M UE (P=0.030), FIM (P=0.021), time (P=0.008), and peak (P=0.018), were significantly higher in the RFVE group after treatment, but not speed (P=0.140). The patients affected by hemorrhagic stroke significantly improved FIM (P=0.031), time (P=0.011), and peak (P=0.020) after treatment, whereas the patients affected by ischemic stroke improved significantly only speed (P=0.005) when treated by RFVE.Conclusion. These results indicated that some poststroke patients may benefit from RFVE program for the recovery of upper limb motor function. This trial is registered withNCT01955291.

No evidence of effectiveness of mirror therapy early after stroke: an assessor-blinded randomized controlled trial

2019 ◽  
Vol 33 (5) ◽  
pp. 885-893 ◽  
Author(s):  
Paola Antoniotti ◽  
Laura Veronelli ◽  
Antonio Caronni ◽  
Alessia Monti ◽  
Evdoxia Aristidou ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Upper Limb ◽  
Controlled Trial ◽  
Intervention Group ◽  
Functional Independence ◽  
Control Group ◽  
Mirror Therapy ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Flexion Extension

Objective: The aim of this study was to investigate the efficacy of mirror therapy on upper-limb recovery in early post-stroke patients. Design: Assessor-blinded randomized controlled trial. Setting: Inpatient rehabilitation clinic. Subjects: A total of 40 patients with upper-limb impairment due to a first-ever ischaemic or haemorrhagic stroke, within four weeks from the cerebrovascular accident. Intervention: The intervention group received mirror therapy, while the control group received sham therapy. During mirror therapy, patients’ sound hand was reflected by a mirror. During sham therapy, an opaque surface replaced the mirror-reflecting surface. Both the mirror therapy and sham therapy groups practised their sound hand with exercises, ranging from the simple elbow flexion–extension to complex tasks (e.g. reaching and grasping). Mirror therapy and sham therapy were added to conventional rehabilitation. Main measures: Primary outcome includes Fugl–Meyer upper extremity scale. Secondary outcomes include action research arm test (ARAT) and functional independence measure (FIM) scale. Outcomes were measured at the beginning (T0) and end (T1) of the treatment. Results: At baseline, both groups (sham therapy vs. mirror therapy; mean (SD)) were comparable for Fugl–Meyer (30.9 (23.9) vs. 28.5 (21.8)), ARAT (25.1 (25.5) vs. 23.5 (24)) and FIM (71.0 (20.6) vs. 72.9 (17.8)) scores. At the end of the treatment, both groups significantly improved in the Fugl–Meyer (40.6 (21.3) vs. 38.3 (23.4)), ARAT (31.9 (23.0) vs. 30 (24.1)) and FIM (100.3 (21.9) vs. 99.4 (22.6)) scores. However, at T1, no significant difference was observed between the sham therapy and mirror therapy groups, neither for the Fugl–Meyer, nor for ARAT and FIM scores. Conclusion: Compared with sham therapy, mirror therapy did not add additional benefit to upper-limb recovery early after stroke.

scholarly journals Assessment of virtual teacher feedback for the recovery of the upper limb after a stroke. Study protocol for a randomized controlled trial.

2016 ◽  
Vol 20 (3) ◽  
pp. 13-20 ◽  
Author(s):  
Pawel Kiper ◽  
Carla Zucconi ◽  
Michela Agostini ◽  
Alfonc Baba ◽  
Francesco Dipalma ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Virtual Reality ◽  
Motor Function ◽  
Visual Feedback ◽  
Study Protocol ◽  
Upper Limb ◽  
Controlled Trial ◽  
Teacher Feedback ◽  
Randomized Controlled ◽  
Stroke Study

Enhanced feedback provided by virtual reality has been shown to promote motor learning both in healthy subjects and patients with motor impairments following lesions of the central nervous system. The aim of this study is to evaluate the effect of displaying a virtual teacher as visual feedback to promote the recovery of upper limb motor function after a stroke. The protocol reports the design of a single blind randomized controlled trial (RCT), blinded to outcome assessment. Two different treatments based on virtual reality will be compared: in the “Teacher” group, the patients receive treatment with continuous displaying of a virtual teacher, while in the “No-Teacher” group, the same exercises will be proposed without visualization of a virtual teacher. The Fugl-Meyer upper extremity scale will be considered as the primary outcome, while the Functional Independence Measure scale, Reaching Performance Scale and Modified Ashworth Scale will be considered as secondary outcomes. Moreover, kinematic parameters such as mean duration (seconds), mean linear velocity (cm/s) and smoothness (i.e. number of sub-movements) will be registered when performing standardised tasks. All tests will be performed before and after treatments. Both treatments will last four weeks with a daily session lasting one hour, five days a week (20 overall sessions). This study is designed to systematically assess the influence of using enhanced visual feedback for the recovery of upper limb motor function after a stroke. These findings will help to determine whether the use of a virtual teacher as enhanced visual feedback is effective for promoting better recovery of upper limb motor function over four weeks of post-stroke treatment. Current Controlled Trials registration number: NCT02234531 (registered on 29 August 2014, ClinicalTrials. gov) Kiper P., Zucconi C., Agostini M., Baba A., Dipalma F., Berlingieri C., Longhi C., Tonin P., Turolla A. Assessment of virtual teacher feedback for the recovery of the upper limb after a stroke. Study protocol for a randomized controlled trial. Med Rehabil 2016; 20(3): 13-20. DOI: 10.5604/01.3001.0009.5010

scholarly journals Effectiveness of the addition of rhythmic or discrete aiming movements training of the upper limbs on motor function and participation after stroke: protocol of a randomized controlled trial

2019 ◽  
Author(s):  
Renata Morales Banjai ◽  
Leonardo Oliveira Pena Costa ◽  
Sandra Maria Sbeghen Freitas ◽  
Vivian Farahte Giangiardi ◽  
Maria Liliane da Silva ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Motor Function ◽  
Upper Limb ◽  
Controlled Trial ◽  
Chronic Stroke ◽  
Upper Limbs ◽  
Discrete Movements ◽  
Randomized Controlled ◽  
Movement Training ◽  
Usual Therapy

Abstract Background Upper limb disabilities after a stroke compromise the activities of daily living. Several approaches to improve motor control and reduce disability are proposed, including specific unilateral training of the contralesional limb or bilateral training with appropriate equipment and/or robotic assistance. These approaches can be used with rhythmic or discrete movements along with usual therapy, but the most effective approach has never been determined. The objective of this study will be to verify the effect of training with rhythmic or discrete movements in conjunction with the usual therapy on motor function and participation regarding the patients’ upper limbs after chronic stroke. Methods/Design This is a 3-arm, assessor-blinded, randomized controlled trial. Seventy-five patients with chronic stroke (> 6 months) and upper limb paresis will be included. Participants will be randomly allocated into 3 groups: 1) discrete movement training and usual therapy (n = 25), 2) rhythmic movement training and usual therapy (n = 25) and 3) a control group, (n = 25) which will only receive the usual therapy. A five-week intervention period (10 sessions) with two sessions per week will be carried out. Outcome measures include participation, activity and motor function measured by the Stroke Impact Scale (SIS), Motor Activity Log (MAL) and Fugl-Meyer Scale, respectively; other measures are aiming movement performance, grip strength and spasticity, which will be obtained at follow-up assessments 5 weeks and 3 months after randomization. Discussion The results of this trial can support allied health professionals’ decision-making processes in the treatment of motor impairment and disability after chronic stroke and reduce this condition’s health-related costs.

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