Abstract WP205: Home-Based Virtual Reality Therapy for Hand Recovery After Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adam MacLellan ◽  
Catherine Legault ◽  
Alay Parikh ◽  
Leonel Lugo ◽  
Stephanie Kemp ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Upper Extremity ◽  
Large Scale ◽  
Controlled Trial ◽  
Hand Function ◽  
Chronic Stroke ◽  
Stroke Survivors ◽  
Hand Rehabilitation ◽  
Stroke Patients ◽  
Home Based

Background: Stroke is the leading cause of disability worldwide, with many stroke survivors having persistent upper limb functional impairment. Aside from therapist-directed rehabilitation, few efficacious recovery tools are available for use by stroke survivors in their own home. Game-based virtual reality systems have already shown promising results in therapist-supervised settings and may be suitable for home-based use. Objective: We aimed to assess the feasibility of unsupervised home-based use of a virtual reality device for hand rehabilitation in stroke survivors. Methodology: Twenty subacute/chronic stroke patients with upper extremity impairment were enrolled in this prospective single-arm study. Participants were instructed to use the Neofect Smart Glove 5 days per week for 8 weeks, in single sessions of 50 minutes or two 25-minute sessions daily. We measured (1) compliance to prescribed rehabilitation dose, (2) patient impression of the intervention, and (3) efficacy measures including the upper extremity Fugl-Meyer (UE-FM), the Jebsen-Taylor hand function test (JTHFT) and the Stroke Impact Scale (SIS). Results: Seven subjects (35%) met target compliance of 40 days use, and 6 subjects (30%) used the device for 20-39 days; there were no age or gender differences in use. Subjective patient experience was favorable, with ninety percent of subjects reporting satisfaction with their overall experience, and 80% reporting perceived improvement in hand function (figure 1). There was a mean improvement of 26.6±48.8 seconds in the JTHFT ( p =0.03) and 16.1±15.3 points in the domain of the SIS that assesses hand function ( p <0.01). There was a trend towards improvement in the UE-FM (2.2±5.5 points, p =0.10). Conclusions: A novel virtual reality gaming device is suitable for unsupervised use in stroke patients and may improve hand/arm function in subacute/chronic stroke patients. A large-scale randomized controlled trial is needed to confirm these results.

scholarly journals EFFICACY OF TENS WITH CONVENTIONAL OCCUPATIONAL THERAPY IN IMPROVING HAND FUNCTION OF STROKE SURVIVORS

2019 ◽  
Vol 8 (1) ◽  
pp. 25-30
Author(s):  
Faiza Tahir ◽  
Quratulain Khan
Keyword(s):  
Occupational Therapy ◽  
Conventional Therapy ◽  
Controlled Trial ◽  
Hand Function ◽  
Low Frequency ◽  
Optimal Recovery ◽  
Stroke Survivors ◽  
Stroke Patients ◽  
Group A ◽  
Group B

BACKGROUND AND AIM Stroke is currently the second leading cause of death and third main cause of disability throughout the world. Around 75% of stroke survivors suffered from upper limb dysfunction with limited functional activities whereas distal parts of upper extremity such as hand and forearm are mostly affected by stroke. Therefore, this study aims to determine the benefits of TENS along with conventional Occupational therapy in the rehabilitation of stroke patients to ascertain the optimal recovery of hand function. METHODOLOGY A Single-blind Randomized Controlled Trial was conducted on 76 individuals with acute phase or one-year history post-stroke. Group-A (n=38) received Low Frequency Transcutaneous Electrical Nerve Stimulation on elbow and wrist extensors (3 Hz, 400 μs)along with conventional Occupational therapy while Group-B (n=38) received conventional Occupational therapy only. Both the groups received intervention for 5 days/week of duration 45 minutes till 3 weeks. RESULTS Group-A showed significant improvement in means scores of FMA-UE and ARAT (p<0.05) in comparison to Group-B which showed moderate improvements in sensorimotor and activity capacity of hand function. CONCLUSION Conventional therapy along with TENS significantly improved the hand function in acute stroke patients as compared to the conventional therapy.

scholarly journals Development of the Home based Virtual Rehabilitation System (HoVRS) to remotely deliver an intense and customized upper extremity training

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Qinyin Qiu ◽  
Amanda Cronce ◽  
Jigna Patel ◽  
Gerard G. Fluet ◽  
Ashley J. Mont ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Chronic Stroke ◽  
Hand Rehabilitation ◽  
Kinematic Data ◽  
Virtual Rehabilitation ◽  
Home Based ◽  
Rehabilitation System ◽  
Kinematic Measures ◽  
And Training ◽  
Training Protocol

Abstract Background After stroke, sustained hand rehabilitation training is required for continuous improvement and maintenance of distal function. Methods In this paper, we present a system designed and implemented in our lab: the Home based Virtual Rehabilitation System (HoVRS). Fifteen subjects with chronic stroke were recruited to test the feasibility of the system as well as to refine the design and training protocol to prepare for a future efficacy study. HoVRS was placed in subjects’ homes, and subjects were asked to use the system at least 15 min every weekday for 3 months (12 weeks) with limited technical support and remote clinical monitoring. Results All subjects completed the study without any adverse events. Subjects on average spent 13.5 h using the system. Clinical and kinematic data were collected pre and post study in the subject’s home. Subjects demonstrated a mean increase of 5.2 (SEM = 0.69) on the Upper Extremity Fugl-Meyer Assessment (UEFMA). They also demonstrated improvements in six measurements of hand kinematics. In addition, a combination of these kinematic measures was able to predict a substantial portion of the variability in the subjects’ UEFMA score. Conclusion Persons with chronic stroke were able to use the system safely and productively with minimal supervision resulting in measurable improvements in upper extremity function.

Improvement of Hand Motor Function after Radial Shock Wave Therapy in Chronic Stroke Patients

2018 ◽  
pp. 2-12
Author(s):  
M Kamaluddin ◽  
Erna Setiawati ◽  
Tanti Ajoe Kesoema
Keyword(s):  
Shock Wave ◽  
Motor Function ◽  
Controlled Trial ◽  
Hand Function ◽  
Chronic Stroke ◽  
Control Group ◽  
Shock Wave Therapy ◽  
Stroke Patients ◽  
And Control ◽  
Experimental Group

Introduction: The Radial Shock Wave Therapy (RSWT) expected could improve spasticity and hand function in chronic stroke patients. This study aimed to find out the improvement of hand function after RSWT as an additional therapy in chronic stroke patients. Methods: Design study was a randomized controlled trial. The patients were assigned randomly to the experimental group (Infrared, Stretching, and RSWT) and control group (Infrared and Stretching) for six weeks. Hand motor function was measured using Fugl-Meyer Motor Assesment (FMA) before and after intervention. Conclusion: There were improvement of wrist and hand FMA scores in the experimental as well as control group Results: Median of wrist FMA scores in the experimental and control group before intervention were 2 and 3 respectively whereas median of wrist FMA scores in the experimental and control group after intervention were 5 and 4 respectively. Median of hand FMA scores in the experimental and control group before intervention were 4 and 4 respectively whereas median of hand FMA scores in the control and experimental group after intervention were 6 and 5 respectively. The scores of wrist- hand FMA in the control and experimental group after intervention were increased P = 0.001P < 0.001 (wrist) and P = 0.001 P < 0.001 (hand) respectively. However, difference increased of wrist and hand FMA scores in the experimental group after intervention were more significant. Keywords: Spasticity, Hand Function, Stroke, Radial Shock Therapy, Fugl-Meyer Motor Assesment

Effects of training with a passive hand orthosis and games at home in chronic stroke: a pilot randomised controlled trial

2016 ◽  
Vol 31 (2) ◽  
pp. 207-216 ◽  
Author(s):  
Sharon M Nijenhuis ◽  
Gerdienke B Prange-Lasonder ◽  
Arno HA Stienen ◽  
Johan S Rietman ◽  
Jaap H Buurke
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Hand Function ◽  
User Acceptance ◽  
Chronic Stroke ◽  
Control Group ◽  
Home Based ◽  
Randomised Controlled ◽  
Clinical Changes ◽  
At Home

Objectives: To compare user acceptance and arm and hand function changes after technology-supported training at home with conventional exercises in chronic stroke. Secondly, to investigate the relation between training duration and clinical changes. Design: A randomised controlled trial. Setting: Training at home, evaluation at research institute. Subjects: Twenty chronic stroke patients with severely to mildly impaired arm and hand function. Interventions: Participants were randomly assigned to six weeks (30 minutes per day, six days a week) of self-administered home-based arm and hand training using either a passive dynamic wrist and hand orthosis combined with computerised gaming exercises (experimental group) or prescribed conventional exercises from an exercise book (control group). Main measures: Main outcome measures are the training duration for user acceptance and the Action Research Arm Test for arm and hand function. Secondary outcomes are the Intrinsic Motivation Inventory, Fugl-Meyer assessment, Motor Activity Log, Stroke Impact Scale and grip strength. Results: The control group reported a higher training duration (189 versus 118 minutes per week, P = 0.025). Perceived motivation was positive and equal between groups ( P = 0.935). No differences in clinical outcomes over training between groups were found (P ⩾ 0.165). Changes in Box and Block Test correlated positively with training duration ( P = 0.001). Conclusions: Both interventions were accepted. An additional benefit of technology-supported arm and hand training over conventional arm and hand exercises at home was not demonstrated. Training duration in itself is a major contributor to arm and hand function improvements.

Individual finger synchronized robot-assisted hand rehabilitation in subacute to chronic stroke: a prospective randomized clinical trial of efficacy

2012 ◽  
Vol 26 (8) ◽  
pp. 696-704 ◽  
Author(s):  
Chang Ho Hwang ◽  
Jin Wan Seong ◽  
Dae-Sik Son
Keyword(s):  
Clinical Trial ◽  
Hand Function ◽  
Intervention Group ◽  
Chronic Stroke ◽  
Sensory Loss ◽  
Hand Rehabilitation ◽  
Stroke Patients ◽  
Robot Assisted ◽  
Individual Finger ◽  
Taylor Test

Objective: To evaluate individual finger synchronized robot-assisted hand rehabilitation in stroke patients. Design: Prospective parallel group randomized controlled clinical trial. Subjects: The study recruited patients who were ≥18 years old, more than three months post stroke, showed limited index finger movement and had weakened and impaired hand function. Patients with severe sensory loss, spasticity, apraxia, aphasia, disabling hand disease, impaired consciousness or depression were excluded. Interventions: Patients received either four weeks (20 sessions) of active robot-assisted intervention (the FTI (full-term intervention) group, 9 patients) or two weeks (10 sessions) of early passive therapy followed by two weeks (10 sessions) of active robot-assisted intervention (the HTI (half-term intervention) group, 8 patients). Patients underwent arm function assessments prior to therapy (baseline), and at 2, 4 and 8 weeks after starting therapy. Results: Compared to baseline, both the FTI and HTI groups showed improved results for the Jebsen Taylor test, the wrist and hand subportion of the Fugl-Meyer arm motor scale, active movement of the 2nd metacarpophalangeal joint, grasping, and pinching power ( P < 0.05 for all) at each time point (2, 4 and 8 weeks), with a greater degree of improvement for the FTI compared to the HTI group ( P < 0.05); for example, in Jebsen Taylor test (65.9 ± 36.5 vs. 46.4 ± 37.4) and wrist and hand subportion of the Fugl-Meyer arm motor scale (4.3 ± 1.9 vs. 3.4 ± 2.5) after eight weeks. Conclusions: A four-week rehabilitation using a novel robot that provides individual finger synchronization resulted in a dose-dependent improvement in hand function in subacute to chronic stroke patients.

scholarly journals Enriched Music-supported Therapy for chronic stroke patients: a study protocol of a randomised controlled trial

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jennifer Grau-Sánchez ◽  
Emma Segura ◽  
David Sanchez-Pinsach ◽  
Preeti Raghavan ◽  
Thomas F. Münte ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomised Controlled Trial ◽  
Upper Limb ◽  
Controlled Trial ◽  
Well Being ◽  
Chronic Stroke ◽  
Stroke Patients ◽  
Home Based ◽  
Randomised Controlled

Abstract Background Residual motor deficits of the upper limb in patients with chronic stroke are common and have a negative impact on autonomy, participation and quality of life. Music-Supported Therapy (MST) is an effective intervention to enhance motor and cognitive function, emotional well-being and quality of life in chronic stroke patients. We have adapted the original MST training protocol to a home-based intervention, which incorporates increased training intensity and variability, group sessions, and optimisation of learning to promote autonomy and motivation. Methods A randomised controlled trial will be conducted to test the effectiveness of this enriched MST (eMST) protocol in improving motor functions, cognition, emotional well-being and quality of life of chronic stroke patients when compared to a program of home-based exercises utilizing the Graded Repetitive Arm Supplementary Program (GRASP). Sixty stroke patients will be recruited and randomly allocated to an eMST group (n = 30) or a control GRASP intervention group (n = 30). Patients will be evaluated before and after a 10-week intervention, as well as at 3-month follow-up. The primary outcome of the study is the functionality of the paretic upper limb measured with the Action Research Arm Test. Secondary outcomes include other motor and cognitive functions, emotional well-being and quality of life measures as well as self-regulation and self-efficacy outcomes. Discussion We hypothesize that patients treated with eMST will show larger improvements in their motor and cognitive functions, emotional well-being and quality of life than patients treated with a home-based GRASP intervention. Trial registration The trial has been registered at ClinicalTrials.gov and identified as NCT04507542 on 8 August 2020.

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