Home-Based Auditory Stimulation Training for Gait Rehabilitation of Chronic Stroke Patients

Objective: We developed a footpad-type locomotion interface called the GaitMaster. The purpose of this pilot study was to examine the effects of gait rehabilitation using the GaitMaster in chronic stroke patients. Design: Randomized cross-over design. Setting: An outpatient department. Subjects: Twelve patients with chronic post-stroke hemiparesis. Intervention: In group A, patients underwent an ‘intervention phase’ followed by a ‘non-intervention phase’, whereas in group B, patients underwent the non-intervention phase first, followed by the intervention phase. In the four- or six-week intervention phase, participants underwent twelve 20-minute sessions of gait rehabilitation using the GaitMaster4. Main outcome measures: We measured gait speed and timed up-and-go test. Results: No differences between the two groups were observed in the baseline clinical data. For the combined groups A and B, the maximum gait and timed up-and-go test speeds improved significantly only in the intervention phase ( P = 0.0001 and P = 0.003, respectively). The percentages of improvement from baseline at the end of GaitMaster training were 16.6% for the maximum gait speed and 8.3% for the timed up-and-go test. The effect size for GaitMaster4 training was 0.58 on the maximum gait speed and 0.43 on the timed up-and-go test. Conclusions: This pilot study showed that gait rehabilitation using the GaitMaster4 was a feasible training method for chronic stroke patients. Calculation of the sample size indicated that a sample size of 38 participants would be adequate to test a null hypothesis of nil benefit additional to routine rehabilitation for chronic stroke patients in a future randomized controlled trial.

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

Stroke ◽

10.1161/str.51.suppl_1.wp205 ◽

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.

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The Effect of Home Based Rehabilitation Program on Activities of Daily Living, Self-efficacy, Quality of Life Among Chronic Stroke Patients

JOURNAL OF SPECIAL EDUCATION & REHABILITATION SCIENCE ◽

10.15870/jsers.2015.09.54.3.275 ◽

2015 ◽

Vol 54 (3) ◽

pp. 275 ◽

Cited By ~ 2

Author(s):

Ha Young Lee ◽

Sagong Bong

Keyword(s):

Quality Of Life ◽

Activities Of Daily Living ◽

Self Efficacy ◽

Daily Living ◽

Rehabilitation Program ◽

Chronic Stroke ◽

Stroke Patients ◽

Home Based

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Preliminary Study of the Effect of Low-Intensity Home-Based Physical Therapy in Chronic Stroke Patients

The Kaohsiung Journal of Medical Sciences ◽

10.1016/s1607-551x(09)70079-8 ◽

2004 ◽

Vol 20 (1) ◽

pp. 18-22 ◽

Cited By ~ 23

Author(s):

Jau-Hong Lin ◽

Ching-Lin Hsieh ◽

Sing Kai Lo ◽

Huei-Ming Chai ◽

Long-Ren Liao

Keyword(s):

Physical Therapy ◽

Chronic Stroke ◽

Stroke Patients ◽

Low Intensity ◽

Home Based ◽

Preliminary Study

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

BMC Neurology ◽

10.1186/s12883-020-02019-1 ◽

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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