Sensor-based technology for upper limb rehabilitation in patients with multiple sclerosis: A randomized controlled trial

2020 ◽  
Vol 38 (4) ◽  
pp. 333-341
Author(s):  
Marco Tramontano ◽  
Giovanni Morone ◽  
Sara De Angelis ◽  
Laura Casagrande Conti ◽  
Giovanni Galeoto ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Upper Limb ◽  
Controlled Trial ◽  
Control Group ◽  
Hand Rehabilitation ◽  
Upper Limb Rehabilitation ◽  
Rehabilitation Programs ◽  
Scale Scores ◽  
Limb Rehabilitation ◽  
Experimental Group

Background: Sensor-based technological therapy devices may be good candidates for neuromotor rehabilitation of people with Multiple Sclerosis (MS), especially for treating upper extremities function limitations. The sensor-based device rehabilitation is characterized by interactive therapy games with audio-visual feedback that allows training the movement of shoulders, elbows, and wrist, measuring the strength and the active range of motion of upper limb, registering data in an electronic database to quantitatively monitoring measures and therapy progress. Objective: This study aimed to investigate the effects of sensor-based motor rehabilitation in add-on to the conventional neurorehabilitation, on increasing the upper limb functions of patients with MS. Methods: Thirty patients were enrolled in the study and randomly assigned to the experimental group and the control group. The training consisting of twelve sessions of upper limb training was compared with twelve sessions of upper limb sensory-motor training, without robotic support. Both rehabilitation programs were performed for 40 minutes three times a week, for 4 weeks, in addition to conventional therapy. All patients were evaluated at the baseline (T0) and after 4 weeks of training (T1). Results: The within-subject analysis showed a statistically significant improvement in both groups, in the Modified Barthel Index and in the Rivermead Mobility Index scores and a significant improvement in Multiple Sclerosis Quality of Life-54 in the experimental. The analysis of effectiveness revealed that, compared with baseline (T0), the improvement percentage in all clinical scale scores was greater in the experimental group than the control group. Conclusions: Proposed training provides an intensive and functional-oriented rehabilitation that objectively evaluates achieved progress through exercises. Therefore, it can represent a good complementary strategy for hand rehabilitation in MS patients.

scholarly journals Influence of RehaCom Therapy on the Improvement of Manual Skills in Multiple Sclerosis Subjects

2020 ◽  
Vol 44 (2) ◽  
pp. 142-150
Author(s):  
Wioletta Pawlukowska ◽  
Natalia Dobrowolska ◽  
Aleksandra Szylinska ◽  
Dorota Koziarska ◽  
Agnieszka Meller ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Function ◽  
Manual Therapy ◽  
Upper Limb ◽  
Dominant Hand ◽  
Upper Limb Rehabilitation ◽  
Manual Skills ◽  
Limb Rehabilitation ◽  
Nine Hole Peg Test ◽  
Experimental Group

Objective To assess the influence of cognitive therapy, in combination with cognitive software, on manual dexterity in individuals with multiple sclerosis (MS).Methods The Nine-Hole Peg Test (NHPT) was used to establish the eligibility of individuals with MS for testing and to assess their upper limb performance. In addition to standard upper limb rehabilitation, 20 participants received RehaCom-based visual-motor therapy, administered three times a week in 20-minute routines.Results A significant relationship was found between the use of manual therapy that utilized the cognitive function platform and the improvement of the non-dominant hand (p=0.037). Compared to controls, the experimental group scored higher on the NHPT, when using the dominant hand (p=0.007). All members of the experimental group, aged ≤60 years, needed considerably less time to do the NHPT with the dominant hand (p=0.008).Conclusion Application of manual therapy using the cognitive function platform improves performance of the hand. However, further research is needed to analyze the correlation between cognitive function and motor performance in patients with MS.

scholarly journals Effect of Additional Rehabilitation After Botulinum Toxin-A on Upper Limb Activity in Chronic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (2) ◽  
pp. 556-562
Author(s):  
Natasha A. Lannin ◽  
Louise Ada ◽  
Coralie English ◽  
Julie Ratcliffe ◽  
Steven G. Faux ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Upper Limb ◽  
Goal Attainment ◽  
Botulinum Toxin A ◽  
Chronic Stroke ◽  
Mean Difference ◽  
Control Group ◽  
Toxin A ◽  
Upper Limb Rehabilitation ◽  
Experimental Group

Background and Purpose— The aim of this trial was to determine the effect of additional upper limb rehabilitation following botulinum toxin-A for upper limb activity in chronic stroke. Methods— We conducted a multicenter phase III randomized trial with concealed allocation, blinded measurement, and intention-to-treat analysis. One hundred forty stroke survivors who were scheduled to receive botulinum toxin-A in any muscle(s) that cross the wrist because of moderate to severe spasticity after a stroke >3 months ago, who had completed formal rehabilitation and had no significant cognitive impairment. Experimental group received botulinum toxin-A plus evidence-based movement training while the control group received botulinum toxin-A plus a handout of exercises. Primary outcomes were goal attainment (Goal Attainment Scaling) and upper limb activity (Box and Block Test) at 3 months (end of intervention). Secondary outcomes were spasticity, range of motion, strength, pain, burden of care, and health-related quality of life. Results— In terms of goal attainment, the experimental group scored the same (mean difference, 2 T-score [95% CI, −2 to 7]) as the control group on the Goal Attainment Scale. In terms of upper limb activity, by 3 months the experimental group moved blocks at the same speed (mean difference, 0.00 blocks/s [95% CI, −0.02 to 0.01]) as the control group on the Box and Block Test. There were no differences between groups on any secondary outcome except strength, in favor of the experimental group (mean difference, 1.4 kg [95% CI, 0.2–2.7]). Conclusions— Findings suggest that additional intensive upper limb rehabilitation following botulinum toxin-A in chronic stroke survivors with a disabled upper limb is not effective. Registration— URL: https://www.clinicaltrials.gov . Unique identifier: ACTRN12615000616572.

scholarly journals Effects of Virtual Reality Associated With Serious Games for Upper Limb Rehabilitation in Patients With Multiple Sclerosis. a Randomized Controlled Trial

2020 ◽  
Author(s):  
Alicia Cuesta-Gómez ◽  
Patricia Sanchez-Herrera Baeza ◽  
Edwin Daniel Oña-Simbaña ◽  
Alicia Martínez-Medina ◽  
Carmen Ortiz-Comino ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Randomized Controlled Trial ◽  
Serious Games ◽  
Controlled Trial ◽  
Control Group ◽  
Randomized Controlled ◽  
Experimental Group

Abstract Background: Dexterity and activities of daily living limitations on the upper limb (UL) represent one of the most common problems in patients with multiple sclerosis (MS). The aim of this study was to evaluate the effectiveness of the specially developed Serious Games that make use of the Leap Motion Controller (LMC) as main user interface for improving UL grip muscle strength, dexterity, fatigue, quality of life, satisfaction and compliance. Methods: A single-blinded randomized controlled trial was conducted. The sample was randomized into two groups: an experimental group who received treatment based on serious games designed by the research team using the developed LMC based Serious Games for the UL plus conventional rehabilitation, and a control group who received the same conventional rehabilitation for the UL. Both groups received two 60 min sessions per week over a ten-week period. Grip muscle strength, coordination, speed of movements, fine and gross UL dexterity, fatigue, quality of life, satisfaction and compliance were assessed in both groups pre-treatment, post-treatment and in a follow-up period of one month without receiving any treatment. Results : In the experimental group compared to the control group, significant improvements were observed in the post-treatment assessment for coordination, speed of movements, fine and gross UL dexterity. Also, significant results were found in the follow-up in coordination, speed of movements, fine and gross for the more affected side. Conclusions: An experimental protocol using an LMC based Serious Games designed for UL rehabilitation showed improvements for unilateral gross manual dexterity, fine manual dexterity, and coordination in MS patients with high satisfaction and excellent compliance.

Virtual Rehabilitation and Telerehabilitation for the Upper Limb

GeroPsych ◽  
2010 ◽  
Vol 23 (2) ◽  
pp. 79-90 ◽  
Author(s):  
Mehmet Gövercin ◽  
Isabelle M. Missala ◽  
Michael Marschollek ◽  
Elisabeth Steinhagen-Thiessen
Keyword(s):  
Upper Limb ◽  
Standard Care ◽  
Controlled Trial ◽  
Control Groups ◽  
Upper Limb Rehabilitation ◽  
Virtual Rehabilitation ◽  
Post Stroke ◽  
Randomized Controlled ◽  
Limb Rehabilitation ◽  
Positive Results

This paper provides a systematic overview of clinical trials investigating the effectiveness and usefulness of virtual rehabilitation (VR) and telerehabilitation (TR) for upper-limb recovery post stroke. Twenty-seven out of 116 hits showed positive results for outcome measurements. Whereas one randomized controlled trial (n = 81) showed no difference in outcome after VR, another (n = 10) yielded positive results in clinical outcome. Although general recommendations cannot be given, VR and TR approaches are feasible for upper-limb rehabilitation post stroke. Immersive VR approaches were shown to be effective compared to control groups. While nonimmersive VR did not prove to be effective, evidence from noncontrolled trials revealed that nonimmersive VR may prove to be effective compared to standard care.

Robot therapy for upper limb rehabilitation in multiple sclerosis: A virtual approach and a functional approach

2009 ◽  
Vol 30 ◽  
pp. S28-S29
Author(s):  
I. Carpinella ◽  
D. Cattaneo ◽  
R. Bertoni ◽  
M. Rovaris ◽  
D. Caputo ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Upper Limb ◽  
Functional Approach ◽  
Upper Limb Rehabilitation ◽  
Limb Rehabilitation
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