A Systematic Review of Upper Limb Rehabilitation for Adults With Traumatic Brain Injury

2008 ◽  
Vol 9 (3) ◽  
pp. 237-246 ◽  
Author(s):  
Natasha A. Lannin ◽  
Annie McCluskey
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Systematic Reviews ◽  
Upper Limb ◽  
Methodological Quality ◽  
Hand Function ◽  
Controlled Trials ◽  
Upper Limb Rehabilitation ◽  
Evidence Database ◽  
Limb Rehabilitation

AbstractObjective:To summarise the effect of upper limb rehabilitation interventions on motor function in adults with traumatic brain injury.Data sources:Databases were last searched on August 2, 2008. Sources included the Cochrane Central Register of Controlled Trials (CENTRAL); Cochrane Database of Systematic Reviews, the Database of Effectiveness Reviews; MEDLINE, EMBASE, CINAHL, Physiotherapy Evidence Database (PEDro), Occupational Therapy Systematic Evaluation of Evidence database (OTseeker); Google Scholar; and reference lists of included studies.Review methods:Two reviewers determined whether retrieved abstracts met the inclusion criteria: systematic reviews and randomised controlled trials (RCTs); English language; adult participants; ≥ 50% of study participants with a brain injury; interventions designed to improve upper limb motor function. Included papers were appraised for: study design, participants, therapy approach, therapy protocol (indications, contra-indications, intensity and duration), safety and adverse events, and outcomes. The methodological quality of RCTs was rated using the PEDro scale (1–10 highest). Methodology of systematic reviews was rated using the QUOROM criteria.Results:Of the 333 references identified, six were appraised: three systematic reviews and three RCTs. Methodological quality was high for two RCTs, and moderate for one, based on the PEDro scale score. Interventions included upper limb casting, electrical stimulation, and coordination training using meal preparation tasks (making a sandwich and hot drink). In the latter trial, practice of functional kitchen tasks improved fine motor coordination speed on one of four Jebsen-Taylor hand function subtests by 9.38 seconds (95% CI, 1.1 to 17.7). Remaining trials reported non-significant effects for hand function. Small sample sizes and limited reporting of results reduce the interpretability of two RCTs.Conclusion:No conclusive evidence was found on which to base upper limb motor rehabilitation after brain injury, however, lack of evidence does not equate to evidence of no effect.

Arm function after stroke - can we make a difference?

1999 ◽  
Vol 55 (2) ◽  
pp. 4-7 ◽  
Author(s):  
L. Fearnhead ◽  
C. J. Eales ◽  
V. U. Fritz
Keyword(s):  
Motor Control ◽  
Upper Limb ◽  
Functional Disability ◽  
Hand Function ◽  
Review Of The Literature ◽  
Limb Function ◽  
Upper Limb Rehabilitation ◽  
Upper Limb Function ◽  
Recent Developments ◽  
Limb Rehabilitation

Impairment of upper limb function is a significant cause of functional disability after stroke. Based on a review of the literature this paper defines upper limb function and highlights some of the relevant recent developments in neuropathology. The effects of changes in sensation, muscle recruitment and tone are described. Reliable and valid outcome measures of upper limb impairment and disability are listed. The principles of rehabilitation are described in terms of timing of rehabilitation, sensory reeducation, motor control and functional use. Questions are raised regarding the need for counselling for the loss of fine discriminative hand function and for research into this behavioural aspect of upper limb rehabilitation.

scholarly journals Upper Limb Rehabilitation Robot Powered by PAMs Cooperates with FES Arrays to Realize Reach-to-Grasp Trainings

2017 ◽  
Vol 2017 ◽  
pp. 1-15 ◽  
Author(s):  
Xikai Tu ◽  
Hualin Han ◽  
Jian Huang ◽  
Jian Li ◽  
Chen Su ◽  
...  
Keyword(s):  
Upper Limb ◽  
Low Cost ◽  
Hand Function ◽  
Rehabilitation Robot ◽  
Reach To Grasp ◽  
Daily Lives ◽  
Upper Limb Rehabilitation ◽  
Highly Nonlinear ◽  
Rehabilitation System ◽  
Limb Rehabilitation

The reach-to-grasp activities play an important role in our daily lives. The developed RUPERT for stroke patients with high stiffness in arm flexor muscles is a low-cost lightweight portable exoskeleton rehabilitation robot whose joints are unidirectionally actuated by pneumatic artificial muscles (PAMs). In order to expand the useful range of RUPERT especially for patients with flaccid paralysis, functional electrical stimulation (FES) is taken to activate paralyzed arm muscles. As both the exoskeleton robot driven by PAMs and the neuromuscular skeletal system under FES possess the highly nonlinear and time-varying characteristics, iterative learning control (ILC) is studied and is taken to control this newly designed hybrid rehabilitation system for reaching trainings. Hand function rehabilitation refers to grasping. Because of tiny finger muscles, grasping and releasing are realized by FES array electrodes and matrix scan method. By using the surface electromyography (EMG) technique, the subject’s active intent is identified. The upper limb rehabilitation robot powered by PAMs cooperates with FES arrays to realize active reach-to-grasp trainings, which was verified through experiments.

scholarly journals ADAPTATION OF DASH OUTCOME MEASURES TO SLOVENIAN POPULATION - FUNCTIONALITY OF ARM, SHOULDER AND HAND

2015 ◽  
Vol 84 (2) ◽  
Author(s):  
Katja Semprimožnik ◽  
Ernest Novak
Keyword(s):  
Cultural Differences ◽  
Outcome Measures ◽  
Upper Limb ◽  
Hand Function ◽  
Upper Limb Rehabilitation ◽  
Upper Limb Function ◽  
Medical Centers ◽  
Slovenian Population ◽  
Limb Rehabilitation ◽  
Work And Health

 ABSTRACT BackgroundIn Slovenia, there is no test for upper limb function, which would be uniform for all institutions and would allow comparison of results of the therapy and upper limb rehabilitation with medical centers. MethodsAfter reviewing the existing hand function tests and current literature we decided to translate the DASH test - Disabilities of arm, shoulder and hand. Adaptation was tested on patient population in outpatient hand clinic, General hospital Celje and showed good validity, reliability and responsiveness. Results and discussionAdaptation of DASH test to Slovene population is a procedure, where language and cultural differences must be considered. Testing the adapted DASH in the general population shows good validity, reliability and responsiveness of adapted test. ConclusionTranslations DASH test, QuickDASH test and instructions for scoring the DASH outcome measures are approved by the Institute for Work and Health. Translations are published on their site and available for use.

scholarly journals Low-value clinical practices in adult traumatic brain injury: an umbrella review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031747 ◽  
Author(s):  
Pier-Alexandre Tardif ◽  
Lynne Moore ◽  
François Lauzier ◽  
Imen Farhat ◽  
Patrick Archambault ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Systematic Reviews ◽  
Scoping Review ◽  
Methodological Quality ◽  
Healthcare Quality ◽  
Cochrane Central Register ◽  
Clinical Practices ◽  
Umbrella Review

IntroductionTraumatic brain injury (TBI) leads to 50 000 deaths, 85 000 disabilities and costs $60 billion each year in the USA. Despite numerous interventions and treatment options, the outcomes of TBI have improved little over the last three decades. In a previous scoping review and expert consultation survey, we identified 13 potentially low-value clinical practices in acute TBI. The objective of this umbrella review is to synthesise the evidence on potentially low-value clinical practices in the care of acute TBI.Methods and analysisUsing umbrella review methodology, we will search Cochrane Central Register of Controlled Trials, Embase, Epistemonikos, International Prospective Register of Systematic Reviews (PROSPERO) and PubMed to identify systematic reviews evaluating the effect of potential intrahospital low-value practices using tailored population, intervention, comparator, outcome and study design questions based on the results of a previous scoping review. We will present data on the methodological quality of these reviews (Assessing the Methodological Quality of Systematic Reviews-2), reported effect sizes and strength of evidence (Grading of Recommendations, Assessment, Development and Evaluation).Ethics and disseminationEthics approval is not required as original data will not be collected. Knowledge users from five healthcare quality organisations and clinical associations are involved in the design and conduct of the study. Results will be disseminated in a peer-reviewed journal, at international scientific meetings and to clinical, healthcare quality and patient–partner associations. This work will support the development of metrics to measure the use of low-value practices, inform policy makers on potential targets for deimplementation and in the long term reduce the use of low-value clinical practices in acute TBI care.PROSPERO registration numberCRD42019132428.

Usability of RePlay: An Automated Upper Limb Rehabilitation System for Brain Injury Tele-rehabilitation

2020 ◽  
Vol 101 (11) ◽  
pp. e104
Author(s):  
Y-Nhy Duong ◽  
Michael Kilgard ◽  
Seth Hays ◽  
Robert Rennaker ◽  
David Pruitt ◽  
...  
Keyword(s):  
Brain Injury ◽  
Upper Limb ◽  
Upper Limb Rehabilitation ◽  
Rehabilitation System ◽  
Limb Rehabilitation

scholarly journals Telerehabilitation Versus Standard Care for Improving Cognitive Function and Quality of Life for Adults with Traumatic Brain Injury: a Systematic Review

2018 ◽  
Author(s):  
Samantha Betts ◽  
Lana Feichter ◽  
Zoe Kleinig ◽  
Alice O'Connell-Debais ◽  
Henry Thai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Methodological Quality ◽  
Randomised Controlled Trials ◽  
Critical Appraisal ◽  
Current Evidence ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomised Controlled

ABSTRACT Traumatic brain injury (TBI) is the most significant cause of death and severe disability following major trauma within Australia. Populations at risk include young adults aged 15 to 34, older adults, and military personnel. The main form of intervention following traumatic brain injury is rehabilitation, which places a large demand on the healthcare system. Telerehabilitation involves interventions delivered via telecommunication, which can improve accessibility and reduce this burden. There have been no systematic reviews conducted on the effectiveness of telerehabilitation in treating traumatic brain injury. Purpose: To examine the effectiveness of telerehabilitation for adults with traumatic brain injury. Methods: A systematic search of Medline, Embase, the Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus, The Cochrane Library, OTSeeker and Google Scholar was conducted. Studies were included with participants aged 18 to 64 with traumatic brain injury and receiving telerehabilitation interventions. Methodological quality was assessed using the critical appraisal tools: Critical Appraisal Skills Programme (CASP) checklist for randomised controlled trials, and McMaster Critical Review for Quantitative Studies for non-randomised studies. Results: Three randomised controlled trials, one pseudo-randomised controlled trial, one case-control trial and one pre-post case series were included in this systematic review. Critical appraisal of the included studies revealed overall methodological quality to be moderate. A range of interventions with differing parameters were used as part of telerehabilitation. Collectively, there is some consistent evidence to indicate that telerehabilitation may be equally effective as other forms of care in the delivery of cognitive and psychological interventions, in addressing memory and depressive symptoms for adults with mild to severe traumatic brain injury. However, it is unclear if it is superior to other forms of care. Conclusions: A small number of studies have investigated the effect of telerehabilitation for adults with traumatic brain injury. The current evidence base is limited due to lack of standardised intervention parameters, outcomes measures and robust sample size. Despite these limitations, telerehabilitation may offer a complementary model of care for adults with traumatic brain injury, especially in instances where traditional models of care may not be readily accessible (such as those in rural and remote areas).

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