scholarly journals UPPER LIMB FUNCTIONAL INDEPENDENCE IN SUBACUTE STROKE PATIENTS: A STUDY PROTOCOL INVESTIGATING THE IMPACT OF HAPTIC ENHANCED VIRTUAL REALITY SYSTEM

2020 ◽  
Vol 7 (09) ◽  
Keyword(s):  
Virtual Reality ◽  
Study Protocol ◽  
Upper Limb ◽  
Functional Independence ◽  
Virtual Reality System ◽  
Stroke Patients ◽  
Subacute Stroke ◽  
The Impact

scholarly journals STUDY PROTOCOL The effect of a telerehabilitation virtual reality intervention on functional upper limb activities in people with multiple sclerosis: A study protocol for the TEAMS pilot randomized controlled trial

2020 ◽  
Author(s):  
Alon Kalron ◽  
Anat Achiron ◽  
Massimiliano Pau ◽  
Eleonora Cocco
Keyword(s):  
Multiple Sclerosis ◽  
Virtual Reality ◽  
Study Protocol ◽  
Upper Limb ◽  
Conventional Therapy ◽  
Home Based ◽  
Custom Made ◽  
The Impact

Abstract Background: Approximately 60% of people with multiple sclerosis (PwMS) suffer from upper limb dysfunction. Our primary goal is to implement a single-blind, randomized control trial (RCT) designed to compare the effectiveness of an 8-week home-based telerehab virtual reality (VR) program with conventional therapy in PwMS with manual dexterity difficulties. Secondary aims include: a) evaluating the impact of the programs on quality of life after the intervention and a follow up 1 month later; and b) evaluating the impact of the programs on adherence and satisfaction. Methods: Twenty-four PwMS will be recruited to the study which will be conducted at two established MS centers: (1) The Regional Center for Diagnosis and Treatment of Multiple Sclerosis, Binaghi Hospital, Cagliari, Italy; (2) The Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel. Participants will complete a total of three assessments focusing on upper limb functions. Both groups will receive 16 training sessions focusing on functional upper limb activities. The home-based telerehab VR intervention will comprise a custom-made software program running on a private computer or laptop. PwMS will perform several activities of daily living (ADL) functions associated with self-care, dressing and meal preparation. Conventional therapy will focus on task-related upper-limb treatments while in a sitting position, indicative of the standard care in MS. Following 8-weeks of training, participants will complete a further outcome assessment. The same tests will be conducted 1 month (as a follow-up) after completion of the intervention. Discussion: The outcomes of this study have tremendous potential to improve the quality of evidence and informed decisions of functional upper limb activities in PwMS. If comparable results are found between the treatments in improving upper limb outcomes, this would suggest that PwMS can choose the program that best meets their personal needs, e.g., financial concerns, transportation or accessibility issues. Secondly, this information can be used by healthcare providers and medical professionals in developing upper limb exercise programs that will most likely succeed in PwMS. Trial registration: ClinicalTrials.gov NCT04032431. Registered on 19 July 2019.

Investigation of the effects of mirror therapy on the spasticity, motor function and functionality of impaired upper limbs in chronic stroke patients

2019 ◽  
Vol 26 (7) ◽  
pp. 1-9
Author(s):  
Luciana Protásio de Melo ◽  
Valton da Silva Costa ◽  
Júlio César Cunha da Silveira ◽  
Tatiana Catarina Albuquerque Clementino
Keyword(s):  
Motor Function ◽  
Upper Limb ◽  
Functional Independence ◽  
Mirror Therapy ◽  
Stroke Patients ◽  
Number Of Patients ◽  
Limb Spasticity ◽  
Hemiparetic Stroke ◽  
Chronic Hemiparetic Stroke ◽  
The Impact

Background/Aims Strokes lead to different levels of disability. During the chronic stage, hemiparesis, spasticity and motor deficits may cause loss of functional independence. Mirror therapy aims to reduce deficits and increase functional recovery of the impaired upper limb. This study aimed to evaluate the effects of mirror therapy on upper limb spasticity and motor function, as well as its impact on functional independence in chronic hemiparetic patients. Methods In this quasi-experimental study, eight chronic hemiparetic patients (age 55.5 ± 10.8 years) were assessed to determine their degree of spasticity (Modified Ashworth Scale), level of upper limb motor function (Fugl-Meyer Assessment) and functionality (Functional Independence Measure). All participants received 12 sessions of mirror therapy delivered three times per week, over a period of 4 weeks. Participants were re-evaluated post-intervention and these results were compared to their pre-intervention scores to determine the impact of mirror therapy. Results A decrease in spasticity was observed, with significant improvements in shoulder extensors (P=0.033) and a significant increase in motor function (P=0.002). The therapeutic protocol adopted did not have a significant effect on functional independence (P=0.105). Conclusions Mirror therapy led to improvements in upper limb spasticity and motor function in chronic hemiparetic stroke patients. No effects on functional independence were observed. Further research with a larger number of patients is needed to provide more robust evidence of the benefits of mirror therapy in chronic hemiparetic stroke patients.

scholarly journals Upper limb strength training in subacute stroke patients: study protocol of a randomised controlled trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Susan Högg ◽  
Manfred Holzgraefe ◽  
Insa Wingendorf ◽  
Jan Mehrholz ◽  
Christoph Herrmann ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Strength Training ◽  
Study Protocol ◽  
Upper Limb ◽  
Controlled Trial ◽  
Stroke Patients ◽  
Subacute Stroke ◽  
Randomised Controlled

scholarly journals Action Observation Therapy for Upper Limb Recovery in Patients with Stroke: A Randomized Controlled Pilot Study

2021 ◽  
Vol 11 (3) ◽  
pp. 290
Author(s):  
Mauro Mancuso ◽  
Serena Di Tondo ◽  
Enza Costantini ◽  
Alessio Damora ◽  
Patrizio Sale ◽  
...  
Keyword(s):  
Upper Limb ◽  
Action Observation ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Motor Recovery ◽  
Control Group ◽  
Stroke Patients ◽  
Rehabilitative Treatment ◽  
Subacute Stroke ◽  
The Moment

Due to the complexity of the interventions for upper limb recovery, at the moment there is a lack of evidence regarding innovative and effective rehabilitative interventions. Action Observation Training (AOT) constitutes a promising rehabilitative method to improve upper limb motor recovery in stroke patients. The aim of the present study was to evaluate the potential efficacy of AOT, both in upper limb recovery and in functional outcomes when compared to patients treated with task oriented training (TOT). Both treatments were added to traditional rehabilitative treatment. Thirty-two acute stroke patients at 15.6 days (±8.3) from onset, with moderate to severe upper limb impairment at baseline following their first-ever stroke, were enrolled and randomized into two groups: 16 in the experimental group (EG) and 16 in the control group (CG). The EG underwent 30 min sessions of AOT, and the CG underwent 30 min sessions of TOT. All participants received 20 sessions of treatment for four consecutive weeks (five days/week). The Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Box and Block Test (BBT), Functional Independence Measure (FIM) and Modified Ashworth Scale (MAS) were administered at baseline (T0) and at the end of treatment (T1). No statistical differences were found at T0 for inclusion criteria between the CG and EG, whereas both groups improved significantly at T1. After the treatment period, the rehabilitative gain was greater in the EG compared to the CG for FMA-UE and FIM (all p < 0.05). Our results suggest that AOT can contribute to increased motor recovery in subacute stroke patients with moderate to severe upper limb impairment in the early phase after stroke. The improvements presented in this article, together with the lack of adverse events, confirm that the use of AOT should be broadened out to larger pools of subacute stroke patients.

scholarly journals Effects of virtual reality training on upper limb function, balance, and walking ability in stroke patients: a systematic review and meta-meta analysis (Preprint)

2021 ◽  
Author(s):  
Jinlong Wu ◽  
Aihua Zeng ◽  
Ziyan Chen ◽  
Ye Wei ◽  
Kunlun Huang ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Upper Limb ◽  
Meta Analysis ◽  
Walking Ability ◽  
Stroke Patients ◽  
High Quality ◽  
Limb Function ◽  
Upper Limb Function ◽  
Vr Training ◽  
The Impact

BACKGROUND Virtual reality (VR) training is a promising intervention strategy, which has been utilized in healthcare fields like stroke rehabilitation and psychotherapy. The current study suggests that, VR training is effective in improving the locomotor ability of individuals with stroke patients. OBJECTIVE This is the first meta-meta-analysis of the effects of virtual reality on motor function in stroke patients. This study aimed to systematically summarize and quantify the present meta-analyses results of VR training, and produce high-quality meta-meta-analysis results to obtain a more accurate prediction. METHODS We searched four online databases (Web of Science, Scopus, PubMed, and Chinese National Knowledge Infrastructure) for the meta-analysis studies. After accounting for the overlap, ten studies (almost 550 stroke patients) were obtained. Based on the meta-meta-analysis of these patients, this study quantified the impact of VR training on stroke patients’ motor performance, mainly including upper limb function, balance, and walking ability. We combined the effects under the random effect model and pooled the estimates as standardized mean differences (SMD). RESULTS The results of the meta-meta analysis showed that VR intervention effectively improved the upper limb function (SMD= 4.606, 95% confidence interval (Cl): 2.733-6.479, P< 0.05) and balance (SMD=2.101, 95%Cl：0.202-4.000, P< 0.05) of stroke patients. However, the results showed considerable heterogeneity, and thus, may need to be treated with caution. Due to the limited research, the meta-meta-analysis of walking ability was not performed. CONCLUSIONS These findings represent a comprehensive body of high-quality evidence that, VR interventions were more effective at improving the upper limb function and balance of stroke patients.

Early non-invasive brain stimulation with modified constraint-induced movement therapy for motor and functional upper limb recovery in stroke patients: Study protocol

2020 ◽  
Vol 83 (8) ◽  
pp. 523-529
Author(s):  
Maricel A Garrido ◽  
Evelyn A Άlvarez ◽  
Fabrizio L Acevedo ◽  
Álvaro I Moyano ◽  
Natalia P Castillo ◽  
...  
Keyword(s):  
Upper Limb ◽  
Functional Recovery ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Movement Therapy ◽  
Functional Independence ◽  
Stroke Patients ◽  
Direct Current Stimulation ◽  
Constraint Induced Movement Therapy ◽  
Subacute Stroke

Introduction Upper limb motor impairment after a stroke is an important sequela. Constraint-induced movement therapy is a rehabilitation approach that has strong evidence. The incorporation of transcranial direct-current stimulation has been proposed; however, there is a lack of studies that confirm its benefits. The principal aim is to compare the effectiveness of 7 days of active versus sham bi-hemispheric transcranial direct-current stimulation, combined with modified constraint-induced movement therapy, for motor and functional recovery of the hemiparetic upper limb in subacute stroke patients. Method/design Randomized, double blind, sham-controlled, parallel group clinical trial in two stroke units. Participants: adults over 18 years, at least 2 days post unihemispheric stroke event, with hemiparesis, and without severe pain, aphasia or cognitive impairment. Intervention: Patients will receive 7 days of continuous therapy and be assigned to one of the treatment groups: active bi-hemispheric transcranial direct-current stimulation or sham bi-hemispheric transcranial direct-current stimulation. Measurement: Evaluations will take place at days 0, 5, 7 and 10, and at 3rd months. The Fugl-Meyer Assessment – Upper Extremity, Wolf Motor Function Test, Functional Independence Measure and Stroke Impact Scale are considered. Discussion Modified constraint-induced movement therapy plus transcranial direct-current stimulation in subacute stroke patients with hemiparesis could maximize motor and functional recovery. Trial registration: ClinicalTrials.gov identifier NCT03452254.

scholarly journals Postural Control Disturbances Induced by Virtual Reality in Stroke Patients

2021 ◽  
Vol 11 (4) ◽  
pp. 1510
Author(s):  
Charles Morizio ◽  
Maxime Billot ◽  
Jean-Christophe Daviet ◽  
Stéphane Baudry ◽  
Christophe Barbanchon ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Postural Control ◽  
Virtual Environments ◽  
Center Of Pressure ◽  
Dynamic Condition ◽  
Static Condition ◽  
Stroke Patients ◽  
Post Stroke ◽  
Subacute Stroke

People who survive a stroke are often left with long-term neurologic deficits that induce, among other impairments, balance disorders. While virtual reality (VR) is growing in popularity for postural control rehabilitation in post-stroke patients, studies on the effect of challenging virtual environments, simulating common daily situations on postural control in post-stroke patients, are scarce. This study is a first step to document the postural response of stroke patients to different challenging virtual environments. Five subacute stroke patients and fifteen age-matched healthy adults were included. All participants underwent posturographic tests in control conditions (open and closed eyes) and virtual environment without (one static condition) and with avatars (four dynamic conditions) using a head-mounted device for VR. In dynamic environments, we modulated the density of the virtual crowd (dense and light crowd) and the avoidance space with the avatars (near or far). Center of pressure velocity was collected by trial throughout randomized 30-s periods. Results showed that more challenging conditions (dynamic condition) induced greater postural disturbances in stroke patients than in healthy counterparts. Our study suggests that virtual reality environments should be adjusted in light of obtaining more or less challenging conditions.

Sign in / Sign up

Export Citation Format

Share Document