Kinematic parameters obtained with the ArmeoSpring for upper-limb assessment after stroke: a reliability and learning effect study for guiding parameter use

Abstract Background After stroke, kinematic measures obtained with non-robotic and robotic devices are highly recommended to precisely quantify the sensorimotor impairments of the upper-extremity and select the most relevant therapeutic strategies. Although the ArmeoSpring exoskeleton has demonstrated its effectiveness in stroke motor rehabilitation, its interest as an assessment tool has not been sufficiently documented. The aim of this study was to investigate the psychometric properties of selected kinematic parameters obtained with the ArmeoSpring in post-stroke patients. Methods This study involved 30 post-stroke patients (mean age = 54.5 ± 16.4 years; time post-stroke = 14.7 ± 26.7 weeks; Upper-Extremity Fugl-Meyer Score (UE-FMS) = 40.7 ± 14.5/66) who participated in 3 assessment sessions, each consisting of 10 repetitions of the ‘horizontal catch’ exercise. Five kinematic parameters (task and movement time, hand path ratio, peak velocity, number of peak velocity) and a global Score were computed from raw ArmeoSpring’ data. Learning effect and retention were analyzed using a 2-way repeated-measures ANOVA, and reliability was investigated using the intra-class correlation coefficient (ICC) and minimal detectable change (MDC). Results We observed significant inter- and intra-session learning effects for most parameters except peak velocity. The measures performed in sessions 2 and 3 were significantly different from those of session 1. No additional significant difference was observed after the first 6 trials of each session and successful retention was also highlighted for all the parameters. Relative reliability was moderate to excellent for all the parameters, and MDC values expressed in percentage ranged from 42.6 to 102.8%. Conclusions After a familiarization session, the ArmeoSpring can be used to reliably and sensitively assess motor impairment and intervention effects on motor learning processes after a stroke. Trial registration The study was approved by the local hospital ethics committee in September 2016 and was registered under number 05-0916.

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Application Of Mirror Therapy On Upper Extremity Motor Recovery In Post-Stroke Patients

Jurnal Keterapian Fisik ◽

10.37341/jkf.v0i0.293 ◽

2021 ◽

pp. 136-144

Author(s):

Roh Hastuti Prasetyaningsih ◽

Hendri Kurniawan

Keyword(s):

Upper Extremity ◽

Motor Recovery ◽

The Body ◽

P Value ◽

Mirror Therapy ◽

Research Subjects ◽

Hand Rehabilitation ◽

Stroke Patients ◽

Post Stroke ◽

Significant Difference

Background: Stroke is a health problem for both developed and developing countries, including Indonesia. Paralysis in stroke is mainly due to damage to the internal capsule. This damage requires neuroplasticity involving a number of parts of the brain to restore. One therapy that is beneficial for neuroplasticity is Mirror Therapy (MT). MT is a rehabilitation tool that aims to restore some of the pathological conditions in which the body representation is affected, including post-stroke motor impairment. Methods: This research is a quantitative pre-experimental design with the type one group pretest-postest. The research subjects were 15 post-stroke patients in residency of Semarang. Research data were collected in August-September 2020. Sample selection with purposive sampling technique who conform inclusion criteria. The Fulg-Meyer Upper Extremity Assessment (FMA-UE) as an aoutcame measure that be avowed valid and reliabel. Data analysis using Paired Sample T-Test because of normally distributed. Results: Statistically the results represent a significant difference in the UE motor ability of post-stroke patients between baseline and after mirror therapy intervention, with a mean difference (5,14) and p value = 0.000 (ρ < 0,05). Application of MT effect on upper extremity motor recovery in post-stroke patients. Conclusions: MT program is an effective intervention for UE motor recovery and motor function improvement in post- stroke patients. MT program can be used as a standardized of hand rehabilitation intervention in hospital, clinics and homes.

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Reliability and validity of a computer game-based tool of upper extremity assessment for object manipulation tasks in children with cerebral palsy

Journal of Rehabilitation and Assistive Technologies Engineering ◽

10.1177/20556683211014023 ◽

2021 ◽

Vol 8 ◽

pp. 205566832110140

Author(s):

Anuprita Kanitkar ◽

Sanjay T Parmar ◽

Tony J Szturm ◽

Gayle Restall ◽

Gina Rempel ◽

...

Keyword(s):

Cerebral Palsy ◽

Upper Extremity ◽

Performance Measures ◽

Assessment Tool ◽

Computer Game ◽

Object Manipulation ◽

Manual Dexterity ◽

Assessment Tools ◽

Significant Difference ◽

Children With Cerebral Palsy

Introduction A computer game-based upper extremity (CUE) assessment tool is developed to quantify manual dexterity of children with Cerebral Palsy (CP). The purpose of this study was to determine test-retest reliability of the CUE performance measures (success rate, movement onset time, movement error, and movement variation) and convergent validity with the Peabody Developmental Motor Scale version 2 (PDMS-2) and the Quality of Upper Extremity Skills Test (QUEST). Methods Thirty-five children with CP aged four to ten years were tested on two occasions two weeks apart. Results CUE performance measures of five chosen object manipulation tasks exhibited high to moderate intra-class correlation coefficient (ICC) values. There was no significant difference in the CUE performance measures between test periods. With few exceptions, there was no significant correlation between the CUE performance measures and the PDMS-2 or the QUEST test scores. Conclusions The high to moderate ICC values and lack of systematic errors indicate that the CUE assessment tool has the ability to repeatedly record reliable performance measures of different object manipulation tasks. The lack of a correlation between the CUE and the PDMS-2 or QUEST scores indicates that performance measures of these assessment tools represent distinct attributes of manual dexterity.

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Evaluation of an Innovative Digital Assessment Tool in Dental Anatomy

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1691 ◽

2015 ◽

Vol 16 (5) ◽

pp. 366-371 ◽

Cited By ~ 4

Author(s):

Matt T Lam ◽

So Ran Kwon ◽

Fang Qian ◽

Gerald E Denehy

Keyword(s):

Gold Standard ◽

Repeated Measures ◽

Assessment Tool ◽

T Test ◽

Pearson’S Correlation ◽

Digital Assessment ◽

Dental Anatomy ◽

Significant Difference ◽

Pearson's Correlation ◽

One Way Anova

ABSTRACT Aim The E4D Compare software is an innovative tool that provides immediate feedback to students’ projects and competencies. It should provide consistent scores even when different scanners are used which may have inherent subtle differences in calibration. This study aimed to evaluate potential discrepancies in evaluation using the E4D Compare software based on four different NEVO scanners in dental anatomy projects. Additionally, correlation between digital and visual scores was evaluated. Materials and methods Thirty-five projects of maxillary left central incisors were evaluated. Among these, thirty wax-ups were performed by four operators and five consisted of standard dentoform teeth. Five scores were obtained for each project: one from an instructor that visually graded the project and from four different NEVO scanners. A faculty involved in teaching the dental anatomy course blindly scored the 35 projects. One operator scanned all projects to four NEVO scanners (D4D Technologies, Richardson, TX, USA). The images were aligned to the gold standard, and tolerance set at 0.3 mm to generate a score. The score reflected percentage match between the project and the gold standard. One-way ANOVA with repeated measures was used to determine whether there was a significant difference in scores among the four NEVO scanners. Paired-sample t-test was used to detect any difference between visual scores and the average scores of the four NEVO scanners. Pearson's correlation test was used to assess the relationship between visual and average scores of NEVO scanners. Results There was no significant difference in mean scores among four different NEVO scanners [F(3, 102) = 2.27, p = 0.0852 one-way ANOVA with repeated measures]. Moreover, the data provided strong evidence that a significant difference existed between visual and digital scores (p = 0.0217; a pairedsample t-test). Mean visual scores were significantly lower than digital scores (72.4 vs 75.1). Pearson's correlation coefficient of 0.85 indicated a strong correlation between visual and digital scores (p < 0.0001). Conclusion The E4D Compare software provides consistent scores even when different scanners are used and correlates well with visual scores. Clinical significance The use of innovative digital assessment tools in dental education is promising with the E4D Compare software correlating well with visual scores and providing consistent scores even when different scanners are used. How to cite this article Lam MT, Kwon SR, Qian F, Denehy GE. Evaluation of an Innovative Digital Assessment Tool in Dental Anatomy. J Contemp Dent Pract 2015;16(5):366-371.

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Efektivitas Alih Baring Tiap 2 Jam Terhadap Pencegahan Ulkus Dekubitus pada Pasien Pasca Stroke dengan Tirah Baring Lama di Bangsal Saraf RSUD Arifin Achmad Pekanbaru

Jurnal Ilmu Kedokteran ◽

10.26891/jik.v4i2.2010.133-140 ◽

2017 ◽

Vol 4 (2) ◽

pp. 133

Author(s):

Bevi Dewi Citra ◽

Hermes C. Sitompul ◽

Tuti Restuastuti

Keyword(s):

Intervention Study ◽

Preventive Intervention ◽

Decubitus Ulcer ◽

Medical Rehabilitation ◽

Neurological Deficits ◽

Stroke Patients ◽

Cross Sectional ◽

Post Stroke ◽

Rehabilitation Programs ◽

Significant Difference

Neurological deficits on stroke patients can caused immobility. Decubitus ulcer is one of immobilty’s complication.Two hours repositioning is one of medical rehabilitation programs in decubitus prevention. The aim of this study is todescribe effectiveness of two hours repositioning to prevent decubitus ulcer, especially on post-stroke patients. Thisstudy was a preventive intervention study with cross-sectional approach. Sample consists of 32 patients. Group Iconsists of 16 patients with repositioning intervention. On the otherhand, group II consists of 16 patients withoutrepositioning intervention. Then, this two groups were compared and were looked for the effectiveness. from thisstudy, we knew that prevalence of decubitus ulcer on post-stroke patients are 19.4% with the effectiveness of two hoursrepositioning is 87.5%. There was significant difference between these two groups to prevent decubitus. it occurred ongeriatric patients with percentage of 75%. Its Proportion for female: male are 2:1. It is commonly occurred on firstweek hospitalization, especially grade 2 (33.3%). It is mostly located on sacrum (100%).

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Gothenburg Very Early Supported Discharge study (GOTVED): a randomised controlled trial investigating anxiety and overall disability in the first year after stroke

BMC Neurology ◽

10.1186/s12883-019-1503-3 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Lena Rafsten ◽

Anna Danielsson ◽

Asa Nordin ◽

Ann Björkdahl ◽

Asa Lundgren-Nilsson ◽

...

Keyword(s):

Multidisciplinary Team ◽

Controlled Trial ◽

Stroke Care ◽

Secondary Outcome ◽

Outpatient Rehabilitation ◽

Control Group ◽

Stroke Patients ◽

Post Stroke ◽

Early Supported Discharge ◽

Significant Difference

Abstract Background and purpose Early supported discharge (ESD) has been shown to be efficient and safe as part of the stroke care pathway. The best results have been seen with a multidisciplinary team and after mild to moderate stroke. However, how very early supported discharge (VESD) works has not been studied. The aim of this study was to investigate whether VESD for stroke patients in need of ongoing individualized rehabilitation affects the level of anxiety and overall disability for the patient compared with ordinary discharge routine. Methods A randomized controlled trial was performed with intention to treat analyses comparing VESD and ordinary discharge from hospital. All patients admitted at the stroke care unit at Sahlgrenska University Hospital of Gothenburg between August 2011 and April 2016 were screened. Inclusion occurred on day 4 using a block randomization of 20 and with a blinded assessor. Assessments were made 5 days post-stroke and 3 and 12 months post-stroke. Patients in the VESD group underwent continued rehabilitation in their homes with a multidisciplinary team from the stroke care unit for a maximum of 1 month. The patients in the control group had support as usual after discharge when needed such as home care service and outpatient rehabilitation. The primary outcome was anxiety as assessed by the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A). The secondary outcome was the patients’ degree of overall disability, measured by the modified Rankin Scale (mRS). Results No significant differences were found between the groups regarding anxiety at three or 12 months post-stroke (p = 0.811). The overall disability was significantly lower in the VESD group 3 months post-stroke (p = 0.004), compared to the control group. However, there was no significant difference between the groups 1 year post-stroke. Conclusions The VESD does not affects the level of anxiety compared to ordinary rehabilitation. The VESD leads to a faster improvement of overall disability compared to ordinary rehabilitation. We suggest considering coordinated VESD for patients with mild to moderate stroke in addition to ordinary rehabilitation as part of the service from a stroke unit. Trial registration Clinical Trials.gov: NCT01622205. Registered 19 June 2012 (retrospectively registered).

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Non-Immersive Virtual Reality for Post-Stroke Upper Extremity Rehabilitation: A Small Cohort Randomized Trial

Brain Sciences ◽

10.3390/brainsci10090655 ◽

2020 ◽

Vol 10 (9) ◽

pp. 655

Author(s):

Roxana Miclaus ◽

Nadinne Roman ◽

Silviu Caloian ◽

Brindusa Mitoiu ◽

Oana Suciu ◽

...

Keyword(s):

Upper Extremity ◽

Rank Test ◽

Immersive Virtual Reality ◽

Stroke Patients ◽

Control Groups ◽

Post Stroke ◽

Signed Rank ◽

Signed Rank Test ◽

Upper Extremity Rehabilitation ◽

Post Therapy

Immersive and non-immersive virtual reality (NIVR) technology can supplement and improve standard physiotherapy and neurorehabilitation in post-stroke patients. We aimed to use MIRA software to investigate the efficiency of specific NIVR therapy as a standalone intervention, versus standardized physiotherapy for upper extremity rehabilitation in patients post-stroke. Fifty-five inpatients were randomized to control groups (applying standard physiotherapy and dexterity exercises) and experimental groups (applying NIVR and dexterity exercises). The two groups were subdivided into subacute (<six months post-stroke) and chronic (>six months to four years post-stroke survival patients). The following standardized tests were applied at baseline and after two weeks post-therapy: Fugl–Meyer Assessment for Upper Extremity (FMUE), the Modified Rankin Scale (MRS), Functional Independence Measure (FIM), Active Range of Motion (AROM), Manual Muscle Testing (MMT), Modified Ashworth Scale (MAS), and Functional Reach Test (FRT). The Kruskal–Wallis test was used to determine if there were significant differences between the groups, followed with pairwise comparisons. The Wilcoxon Signed-Rank test was used to determine the significance of pre to post-therapy changes. The Wilcoxon Signed-Rank test showed significant differences in all four groups regarding MMT, FMUE, and FIM assessments pre- and post-therapy, while for AROM, only experimental groups registered significant differences. Independent Kruskal–Wallis results showed that the subacute experimental group outcomes were statistically significant regarding the assessments, especially in comparison with the control groups. The results suggest that NIVR rehabilitation is efficient to be administered to post-stroke patients, and the study design can be used for a further trial, in the perspective that NIVR therapy can be more efficient than standard physiotherapy within the first six months post-stroke.

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Effects of bilateral arm training on upper extremity function in right and left hemispheric stroke

Journal of the Pakistan Medical Association ◽

10.47391/jpma.593 ◽

2020 ◽

pp. 1-9

Author(s):

Humera Ambreen ◽

Hina Tariq ◽

Imran Amjad

Keyword(s):

Upper Extremity ◽

Motor Function ◽

Recovery Of Function ◽

Hand Function ◽

Group Analysis ◽

Stroke Patients ◽

Hemispheric Stroke ◽

Beneficial Effects ◽

Significant Difference ◽

Bilateral Arm Training

Abstract Objective: This experimental study on 24 stroke patients aimed at evaluating and comparing the effects of bilateral arm training on upper extremity (UE) motor function between right and left hemispheric chronic stroke patients. Methods: Both groups received the same intervention involving 5 functional tasks for 1 hour, 3 days per week, for a total of 6 weeks. Fugl-Meyer Assessment-Upper Extremity and Wolf-Motor Function Test were applied as outcome measures at baseline and after 6 weeks of training to assess the recovery of function in the affected area. Results: Intra-group analysis showed no significant improvement in the wrist and hand function in the left hemispheric stroke (LHS) (p>0.05), while right hemispheric stroke (RHS) patients did not improve significantly in the coordination/speed domain (p>0.05). Inter-group analysis showed no significant difference between right and left hemispheric stroke patients (p>0.05). Conclusion: Bilateral arm training showed beneficial effects in improving UE function in both RHS and LHS patients. Distal UE function in LHS and coordination and speed of movement in RHS patients did not show any significant improvement. Key Words: Stroke, Upper extremity, Recovery of function, Bilateral arm training. Continuous...

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Predictive value of the Royal Melbourne Hospital Falls Risk Assessment Tool (RMH FRAT) for post-stroke patients

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2013.06.018 ◽

2014 ◽

Vol 21 (4) ◽

pp. 607-611 ◽

Cited By ~ 3

Author(s):

Colleen Ma ◽

Kelly Evans ◽

Carin Bertmar ◽

Martin Krause

Keyword(s):

Risk Assessment ◽

Predictive Value ◽

Assessment Tool ◽

Risk Assessment Tool ◽

Stroke Patients ◽

Royal Melbourne Hospital ◽

Falls Risk ◽

Post Stroke

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Effect of proprioceptive sensation and feedback required for motor learning on function, activity, and daily life behavior of patients after nerve injury

World Journal of Advanced Research and Reviews ◽

10.30574/wjarr.2021.11.3.0462 ◽

2021 ◽

Vol 11 (3) ◽

pp. 474-481

Author(s):

Jung-Ho Lee

Keyword(s):

Upper Extremity ◽

Daily Activities ◽

Control Group ◽

Mirror Therapy ◽

Stroke Patients ◽

Proprioceptive Sensation ◽

Significant Difference ◽

Upper Extremity Function ◽

Function Activity ◽

Experimental Group

Purpose: This study investigated the effects of modified mirror therapy and taping therapy for providing feedback on upper extremity function, activity, and daily activities of stroke patients. Methods: This study was conducted with 20 stroke patients and randomly assigned 10 subjects to the experimental group and 10 to the control group. In the experimental group, after proprioceptive neuromuscular stimulation treatment, the mirror therapy program was implemented. In the control group, upper extremity taping was performed before proprioceptive neuromuscular facilitation treatment. In this study, a prior evaluation using JTT, FIM, and MAL was performed before intervention to evaluate the patient's function and daily life behavior. Post-tests were performed after the last treatment. Results: In the paired-sample T-test used for within-group comparison of JTTs, FIM, and MAL, there was a significant difference between pre- and post-test for all groups. But there was no statistically significant difference between experimental group 1 and experimental group 2 in an independent t-test conducted to compare the effect sizes of treatments. Conclusion: In other words, by applying mirror therapy and taping therapy that can increase proprioceptive sensation and feedback information in stroke patients, upper extremity function and daily activities can be increased.

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