scholarly journals Safety, Feasibility, and Acceptability of a New Virtual Rehabilitation Platform: A Supervised Pilot Study

2021 ◽  
Vol 10 ◽  
pp. 117957272110332
Author(s):  
Ana María Escalante-Gonzalbo ◽  
Yoás Saimon Ramírez-Graullera ◽  
Herminia Pasantes ◽  
José Jonathan Aguilar-Chalé ◽  
Gloria Ixchel Sánchez-Castillo ◽  
...  
Keyword(s):  
Pilot Study ◽  
Motor Function ◽  
Upper Limb ◽  
Virtual Rehabilitation ◽  
Function Test ◽  
Wolf Motor Function Test ◽  
Significant Impairment ◽  
Task Oriented ◽  
Movement Sensors ◽  
Significant Motor

Purpose: Stroke is the leading cause of disability in adults worldwide, with hemiparesis being the most prevalent consequence. The use of video games and movement sensors could contribute to improving patients’ chances of recovery. We performed a supervised pilot study to validate the safety, feasibility, and acceptability of a new virtual rehabilitation platform in patients with chronic post-stroke upper limb hemiparesis. Methods: The participants (n = 9) participated in 40 rehabilitation sessions, twice a week, for a period of 20 weeks. Their experiences with the platform were documented using a Likert-scale survey. Changes in motor function were evaluated using the Chedoke Arm and Hand Activity Inventory (CAHAI) and the Wolf Motor Function Test (WMFT). Results and conclusions: All participants expressed that they enjoyed the experience and felt comfortable using the platform. Preliminary results showed significant motor recovery ( P = .0039) according to the WMFT scores. Patients with significant impairment showed no improvement in upper limb task-oriented motor function after therapy. The new platform is safe and well-accepted by patients. The improvement in motor function observed in some of the participants should be attributed to the therapy since spontaneous functional recovery is not expected in chronic stroke patients.

scholarly journals Assist-as-needed control strategy for upper-limb rehabilitation based on subject’s functional ability

2019 ◽  
Vol 52 (9-10) ◽  
pp. 1354-1361 ◽  
Author(s):  
Shawgi Younis Ahmed Mounis ◽  
Norsinnira Zainul Azlan ◽  
Fatai Sado
Keyword(s):  
Motor Function ◽  
Upper Limb ◽  
Functional Ability ◽  
Measurement Unit ◽  
Robotic Assistance ◽  
Clinical Procedure ◽  
Function Test ◽  
Wolf Motor Function Test ◽  
Movement Ability ◽  
Ability Index

The assist-as-needed technique in robotic rehabilitation is a popular technique that encourages patients’ active participation to promote motor recovery. It has been proven beneficial for patients with functional motor disability. However, its application in robotic therapy has been hindered by a poor estimation method of subjects’ functional or movement ability which is required for setting the appropriate robotic assistance. Moreover, there is also the need for consistency and repeatability of the functional ability estimation in line with the clinical procedure to facilitate a wider clinical adoption. In this study, we propose a new technique of estimation of subject’s functional ability based on the Wolf Motor Function Test. We called this estimation the functional ability index. The functional ability index enables the modulation of robotic assistance and gives a more consistent indication of subjects’ upper-limb movement ability during therapy session. Our baseline controller is an adaptive inertia-related controller, which is integrated with the functional ability index algorithm to provide movement assistance as when needed. Experimental studies are conducted on three hemiplegic patients with different levels of upper-limb impairments. Each patient is requested to perform reaching task of lifting a can from table-to-mouth according to the guidelines stipulated in the Wolf Motor Function Test. Data were collected using two inertial measurement unit sensors installed at the flexion/extension joints, and the functional ability score of each patient was rated by an experienced therapist. Results showed that the proposed functional ability index algorithm can estimate patients’ functional ability level consistently with clinical procedure and can modify generated robotic assistance in accordance with patients’ functional movement ability.

scholarly journals Application of the Fugl-Meyer Assessment (FMA) and the Wolf Motor Function Test (WMFT) in the recovery of upper limb function in patients after chronic stroke: a literature review

2013 ◽  
Vol 20 (1) ◽  
pp. 42-49 ◽  
Author(s):  
Cauê Padovani ◽  
Cristhiane Valério Garabello Pires ◽  
Fernanda Pretti Chalet Ferreira ◽  
Gabriela Borin ◽  
Thais Raquel Martins Filippo ◽  
...  
Keyword(s):  
Literature Review ◽  
Motor Function ◽  
Upper Limb ◽  
Chronic Stroke ◽  
Limb Function ◽  
Upper Limb Function ◽  
Function Test ◽  
Wolf Motor Function Test

scholarly journals The effect of the Bobath therapy programme on upper limb and hand function in chronic stroke individuals with moderate to severe deficits

2019 ◽  
Vol 26 (10) ◽  
pp. 1-12
Author(s):  
Thanchanok Pumprasart ◽  
Noppol Pramodhyakul ◽  
Pagamas Piriyaprasarth
Keyword(s):  
Upper Extremity ◽  
Motor Function ◽  
Upper Limb ◽  
Muscle Tone ◽  
Chronic Stroke ◽  
Rank Test ◽  
Limb Function ◽  
Function Test ◽  
Wolf Motor Function Test ◽  
Therapy Programme

Background/Aims The Bobath concept has long been used to improve postural control and limb function post-stroke, yet its effect in patients with deficits have not been clearly demonstrated. This study aimed to investigate the effect of the latest Bobath therapy programme on upper limb functions, muscle tone and sensation in chronic stroke individuals with moderate to severe deficits. Methods A pre–post test design was implemented. The participants were chronic stroke individuals (n=26). Home-based intervention based on the Bobath concept was administered 3 days per week for 6 weeks (20 repetitions × 3 sets per task each session). Outcome measures consisted of the Wolf Motor Function Test, Fugl-Meyer Assessment for the upper extremity, Modified Ashworth Scale, and the Revised Nottingham Sensory Assessment. Data were analysed using the Wilcoxon Signed rank test. Results Almost all items of the Wolf Motor Function Test and the Fugl-Meyer Assessment for the upper extremity demonstrated statistically significant differences post-intervention. Finger flexor muscle tone and stereognosis were also significantly improved. Conclusions The 6-week Bobath therapy programme could improve upper limb function and impairments in chronic stroke individuals with moderate to severe deficits. Its effects were also demonstrated in improving muscle tone and cortical sensation.

scholarly journals Mirror and Vibration Therapies Effects on the Upper Limbs of Hemiparetic Patients after Stroke: A Pilot Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Maria da Conceição Barros Oliveira ◽  
Danylo Rafhael Costa Silva ◽  
Bruno Vieira Cortez ◽  
Constância Karyne da Silva Coêlho ◽  
Francisco Mayron de Sousa e Silva ◽  
...  
Keyword(s):  
Pilot Study ◽  
Motor Function ◽  
Upper Limb ◽  
Functional Ability ◽  
Therapy Group ◽  
Test Time ◽  
Control Group ◽  
Mirror Therapy ◽  
Mobility Index ◽  
Function Test

Background/Aim. To evaluate, in this pilot study, the effects of the mirror (MT) and vibration therapies (VT) on the functionality of hemiparesis patients after stroke.Materials and Methods. Twenty-one individuals after stroke with upper limb hemiparesis were randomized into control group (CG), Mirror Therapy Group (MTG), and Vibration Therapy Group (VTG). The functionality was evaluated before and after 12 sessions with three tests (i) Mobility Index Rivermead, (ii) Motor Function Wolf Test (time, functional ability), and (iii) Jebsen Taylor Test.Results. Significant findings were observed for MTG or VTG when compared to the CG, obtaining improvements in the three functional tests: Mobility Index Rivermead, Motor Function Test Wolf (time) and Motor Function Test Wolf (functional ability), and Jebsen Test Taylor.Conclusions. MT or VT showed enhancements on the functionality of subjects with poststroke hemiparesis. In consequence, these interventions may be used in the rehabilitation of these individuals in order to promote improvements of the affected upper limb functionality. Probably, neuromuscular responses of the used therapies would be related to these desirable effects. However, it is necessary conducting further controlled studies with more subjects.

Effects of peripheral sensory nerve stimulation plus task-oriented training on upper extremity function in patients with subacute stroke: a pilot randomized crossover trial

2012 ◽  
Vol 26 (11) ◽  
pp. 999-1009 ◽  
Author(s):  
Koki Ikuno ◽  
Saori Kawaguchi ◽  
Shinsuke Kitabeppu ◽  
Masaki Kitaura ◽  
Kentaro Tokuhisa ◽  
...  
Keyword(s):  
Motor Function ◽  
Nerve Stimulation ◽  
Sensory Nerve ◽  
Inpatient Rehabilitation ◽  
Subacute Stroke ◽  
Function Test ◽  
Wolf Motor Function Test ◽  
Task Oriented ◽  
Peripheral Sensory ◽  
Mean Time

Objective: To investigate the feasibility of peripheral sensory nerve stimulation combined with task-oriented training in patients with stroke during inpatient rehabilitation. Design: A pilot randomized crossover trial. Setting: Two rehabilitation hospitals. Subjects: Twenty-two patients with subacute stroke. Interventions: Participants were randomly assigned to two groups and underwent two weeks of training in addition to conventional inpatient rehabilitation. The immediate group underwent peripheral sensory nerve stimulation combined with task-oriented training in the first week, followed by another week with task-oriented training alone. The delayed group underwent the same training in reverse order. Main measures: Outcome measures were the level of fatigue and Wolf Motor Function Test. Patients were assessed at baseline, one and two weeks. Results: All participants completed the study with no adverse events. There was no significant difference in level of fatigue between each treatment. From baseline to one week, the immediate group showed larger improvements than the delayed groups in the Wolf Motor Function Test (decrease in mean time (± SD) from 41.9 ± 16.2 seconds to 30.6 ± 11.4 seconds versus from 46.8 ± 19.4 seconds to 42.9 ± 14.7 seconds, respectively) but the difference did not reach significance after Bonferroni correction ( P = 0.041). Within-group comparison showed significant improvements in the Wolf Motor Function Test mean time after the peripheral sensory nerve stimulation combined with task-oriented training periods in each group ( P < 0.01). Conclusion: Peripheral sensory nerve stimulation is feasible in clinical settings and may enhance the effects of task-oriented training in patients with subacute stroke.

Efeitos da terapia por contensão induzida nas lesões encefálicas adquiridas

2016 ◽  
Vol 17 (1) ◽  
pp. 30
Author(s):  
Gabriela Da Silva Matuti ◽  
Rafaela Do Nascimento Borges Marques ◽  
Amanda Conte Magesto ◽  
Rafael Eras Garcia ◽  
Clarissa Barros De Oliveira
Keyword(s):  
Motor Activity ◽  
Motor Function ◽  
Function Test ◽  
Wolf Motor Function Test

Introdução: A Terapia por Contensão Induzida (TCI) é uma técnica de reabilitação que tem como objetivo melhora da função do membro superior.acometido. Objetivos: Determinar se o protocolo da TCI é adequado para a reabilitação do membro superior em adultos com Lesões Encefálicas Adquiridas (LEA), analisar a manutenção dos resultados e identificar possíveis preditores de eficácia da técnica. Método: Estudo retrospectivo, 40 pacientes. As escalas utilizadas foram Motor Activity Log (MAL), Quantidade (QT) e Qualidade (QL) de movimento do membro superior acometido e Wolf Motor Function Test (WMFT). Resultados e discussão: As médias de QT e QL do membro superior acometido no pré e pós-tratamento tiveram um aumento significativo (p < 0,001), enquanto as do WMFT apresentaram uma redução significativa do tempo (p < 0,001), o que representa uma melhora na habilidade motora e maior uso fora do ambiente terapêutico. Os ganhos foram mantidos após 12 meses do término do protocolo, e não foi evidenciado nenhum preditor de evolução. Conclusão: A TCI demonstrou eficácia na melhora da habilidade motora e reversão do não uso aprendido do membro superior acometido, estes resultados foram mantidos após um ano da intervenção. Não foi evidenciado no estudo nenhum fator preditor de eficácia da técnica.Palavras-chave: lesões encefálicas adquiridas, hemiplegia, terapia por contensão induzida, reabilitação.

Revisiting Poststroke Upper Limb Stratification: Resilience in a Larger Cohort

2021 ◽  
pp. 154596832199204
Author(s):  
Benjamin J. Varley ◽  
Christine T. Shiner ◽  
Liam Johnson ◽  
Penelope A. McNulty ◽  
Angelica G. Thompson-Butel
Keyword(s):  
Clinical Practice ◽  
Motor Function ◽  
Upper Limb ◽  
Hierarchical Cluster ◽  
Community Dwelling ◽  
Stratification Method ◽  
Wolf Motor Function Test ◽  
Block Test ◽  
Time Restriction ◽  
Post Hoc

Background Upper limb (UL) impairment in stroke survivors is both multifactorial and heterogeneous. Stratification of motor function helps identify the most sensitive and appropriate assessments, which in turn aids the design of effective and individualized rehabilitation strategies. We previously developed a stratification method combining the Grooved Pegboard Test (GPT) and Box and Block Test (BBT) to stratify poststroke UL motor function. Objective To investigate the resilience of the stratification method in a larger cohort and establish its appropriateness for clinical practice by investigating limitations of the GPT completion time. Methods Post hoc analysis of motor function for 96 community-dwelling participants with stroke (n = 68 male, 28 female, age 60.8 ± 14 years, 24.4 ± 36.6 months poststroke) was performed using the Wolf Motor Function Test (WMFT), Fugl-Meyer Assessment (F-M), BBT, and GPT. Hypothesis-free and hypothesis-based hierarchical cluster analyses were conducted to determine the resilience of the stratification method. Results The hypothesis-based analysis identified the same functional groupings as the hypothesis-free analysis: low (n = 32), moderate (n = 26), and high motor function (n = 38), with 3 exceptions. Thirty-three of the 38 participants with fine manual dexterity completed the GPT in ≤5 minutes. The remaining 5 participants took 6 to 25 minutes to place all 25 pegs but used alternative movement strategies to complete the test. The GPT time restriction changed the functional profile of the moderate and high motor function groups leading to more misclassifications. Conclusion The stratification method unambiguously classifies participants by UL motor function. While the inclusion of a 5-minute cutoff time for the GPT is preferred for clinical practice, it is not recommended for stratification purposes.

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