Effectiveness and cost-effectiveness of an optimized process of providing assistive technology for impaired upper extremity function: Protocol of a prospective, quasi-experimental non-randomized study (OMARM)

BACKGROUND: Impaired upper extremity function due to muscle paresis or paralysis has a major impact on independent living and quality of life (QoL). Assistive technology (AT) for upper extremity function (i.e. dynamic arm supports and robotic arms) can increase a client’s independence. Previous studies revealed that clients often use AT not to their full potential, due to suboptimal provision of these devices in usual care. OBJECTIVE: To optimize the process of providing AT for impaired upper extremity function and to evaluate its (cost-) effectiveness compared with care as usual. METHODS: Development of a protocol to guide the AT provision process in an optimized way according to generic Dutch guidelines; a quasi-experimental study with non-randomized, consecutive inclusion of a control group (n= 48) receiving care as usual and of an intervention group (optimized provision process) (n= 48); and a cost-effectiveness and cost-utility analysis from societal perspective will be performed. The primary outcome is clients’ satisfaction with the AT and related services, measured with the Quebec User Evaluation of Satisfaction with AT (Dutch version; D-QUEST). Secondary outcomes comprise complaints of the upper extremity, restrictions in activities, QoL, medical consumption and societal cost. Measurements are taken at baseline and at 3, 6 and 9 months follow-up.

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The effect of upper extremity weight bearing on upper extremity function in children with hemiplegic type of cerebral palsy

South African Journal of Physiotherapy ◽

10.4102/sajp.v66i1.58 ◽

2010 ◽

Vol 66 (1) ◽

Cited By ~ 1

Author(s):

P. Jayaraman ◽

T. Puckree

Keyword(s):

Upper Extremity ◽

Weight Bearing ◽

Rank Test ◽

Wrist Flexion ◽

Upper Limb Function ◽

Extremity Function ◽

Post Test ◽

Quasi Experimental ◽

Signed Rank Test ◽

Upper Extremity Function

The main objective of this study was to quantify the effects ofweight bearing on upper limb function in children with hemiplegic cerebralpalsy. This study also sought to monitor the change in spasticity immediatelyfollowing weight bearing exercises. A quasi-experimental, one group pre-test,post-test design was used. Eleven children with hemiplegic type of cerebral palsyfrom a special school in KwaZulu Natal participated after fully informed consentof the caretaking guardian. The intervention consisted of a standardized programof weight bearing. The Melbourne A ssessment of Upper Extremity function wasused to quantify upper extremity function of reach, grasp and manipulation and the modified A shworth grading of spasticity was used to grade and monitor spasticity. The data was analysed using the Wilcoxon signed rank test. A significant decrease in spasticity during elbow extension (p= 0,004), wrist flexion (p=0,026) and extension (p=0,004)was noted. Statistically significant improvement in function, reach (p=0, 00), grasp (p=0, 02) manipulation (p=0, 05)and overall quality of function (p= 0,003) was also found. A n overall significant effect of weight bearing exercises onupper extremity function was noted providing evidence for practice.

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Effect of Scapular Kinesiotaping as an Adjunct to Dynamic Neuromuscular Stabilization Exercises on Upper Extremity Functions in Stroke Patients

International Journal of Health Sciences and Research ◽

10.52403/ijhsr.20220103 ◽

2022 ◽

Vol 12 (1) ◽

pp. 13-22

Author(s):

Rutuja Jadhav ◽

Shamla Pazare

Keyword(s):

Grip Strength ◽

Upper Extremity ◽

Control Group ◽

Stroke Patients ◽

Extremity Function ◽

Function Index ◽

Intergroup Comparison ◽

Significant Difference ◽

Upper Extremity Function ◽

And Control

Background and Purpose: Stroke is one of the leading causes of death and disability in India. Upper extremities get more affected in Middle cerebral artery syndrome. Stroke patients have lack of functional ability of upper extremity due to scapular malalignment resulting from paralysis of the scapular muscles. Kinesiotape helps to realign the muscles and thus it becomes easy to activate or inhibit them. We hypothesised that Dynamic Neuromuscular Stabilisation exercises along with kinesiotape could improve upper extremity function. Methodology: Ethical clearance was obtained. Informed consent was taken. 30 patients were selected according to inclusion and exclusion criteria. 15 subjects were randomly divided into experimental and control group. Subjects were given Dynamic neuromuscular stabilisation exercises for scapular strengthening. The experimental group was given Kinesiotaping to the scapula using muscle technique. Pre and post treatment assessment was done using Upper Extremity Function Index, grip strength and scapular abduction position with MB ruler. Result: The intergroup comparison revealed a highly significant difference for upper extremity function index and grip strength whereas scapular abduction was not significant. Conclusion: The Scapular Kinesiotaping as an adjunct to Dynamic Neuromuscular Stabilization Exercises is significantly effective to improve upper extremity functions and grip strength in post stroke patients. Key words: Stroke, Upper Extremity Functions, Dynamic Neuromuscular Stabilization Exercises, Scapular Kinesiotaping.

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Effect of Gravity and Task Specific Training of Elbow Extensors on Upper Extremity Function after Stroke

Neurology Research International ◽

10.1155/2018/4172454 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Mohamed E. Khallaf

Keyword(s):

Range Of Motion ◽

Upper Extremity ◽

Motor Planning ◽

Control Group ◽

Elbow Extension ◽

Specific Training ◽

Extremity Function ◽

Upper Extremity Function ◽

Hemiparetic Stroke ◽

Nine Hole Peg Test

Background.In individuals with hemiparetic stroke, reaching with the paretic arm can be impaired by abnormal muscle coactivation. Prior trails for improving upper extremity functions after stroke have underestimated the role of gravitational force in motor planning and execution.Objective.The aims this trial were to study the effect of gravity as a facilitator for elbow extension and to estimate the immediate and retention effects of task specific training of elbow extensors on upper extremity function after stroke.Methods.Twenty-six right handed patients with first ever stroke represented the sample of the study. The participants were randomly assigned into two equal groups. The study group received treatment through two phases. Phase one included training for the elbow extensors in an antigravity position. Phase two included a set of task specific exercise for 16 weeks. The control group received traditional passive stretch and range of motion exercises. Manual dexterity and upper limb function were assessed by Nine-Hole Peg Test and Fugl-Meyer upper extremity. Goniometry was used for measuring elbow extension and forearm supination active ranges of motion.Results.Significant improvements were observed in Nine-Hole Peg Test, Fugl-Meyer upper extremity, and ranges of motion at postintervention and follow-up compared to preintervention at P≤0.05.Conclusions.The results of this study provide an evidence that antigravity positions can be used as a centrally presented facilitator of elbow extension. Additionally, task specific training was effective in improving upper extremity function and elbow extension range of motion.

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Effect of Leap Motion-based 3D Immersive Virtual Reality Usage on Upper Extremity Function in Ischemic Stroke Patients

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20190129 ◽

2019 ◽

Vol 77 (10) ◽

pp. 681-688 ◽

Cited By ~ 3

Author(s):

Muhammed Nur ÖGÜN ◽

Ramazan KURUL ◽

Mustafa Fatih YAŞAR ◽

Sule Aydin TURKOGLU ◽

Şebnem AVCI ◽

...

Keyword(s):

Virtual Reality ◽

Ischemic Stroke ◽

Upper Extremity ◽

Self Care ◽

Functional Independence ◽

Control Group ◽

Immersive Virtual Reality ◽

Extremity Function ◽

Upper Extremity Function ◽

And Control

ABSTRACT Immersive virtual reality (VR) is a technology that provides a more realistic environmental design and object tracking than ordinary VR. The aim of this study was to investigate the effectiveness of immersive VR on upper extremity function in patients with ischemic stroke. Sixty-five patients with ischemic stroke were included in this randomized, controlled, double-blind study. Patients were randomly divided into VR (n = 33) and control (n = 32) groups. The VR group received 60 minutes of the upper extremity immersive VR rehabilitation program and the control group received 45 minutes of conventional therapy and 15 minutes of a sham VR program. Rehabilitation consisted of 18 sessions of therapy, three days per week, for six weeks. The outcome measures were the Action Research Arm Test (ARAT), Functional Independence Measure (FIM), Fugl-Meyer Upper Extremity Scale (FMUE) and Performance Assessment of Self-Care Skills (PASS). In both the VR and control groups all parameters except the PASS improved over time. However independent t-test results showed that all of the FMUE, ARAT, FIM and PASS scores were significantly higher in the VR group compared with the control (p < 0.05). The minimal clinically important difference (MCID) scores of the FMUE and ARAT were higher than the cut-off MCID scores described in the literature in the VR group, whereas the FIM scores were below the cut-off MCID scores. All scores in the control group were below the cut-off scores. Immersive VR rehabilitation appeared to be effective in improving upper extremity function and self-care skills, but it did not improve functional independence.

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Home treatment for acute mental healthcare in Ticino: protocol of the Financial Outputs, Risks, Efficacy, Satisfaction Index and Gatekeeping of Home Treatment (FORESIGHT) study (Preprint)

10.2196/preprints.28191 ◽

2021 ◽

Author(s):

Sara Levati ◽

Zefiro Benedetto Mellacqua ◽

Maria Caiata Zufferey ◽

Emiliano Soldini ◽

Emiliano Albanese ◽

...

Keyword(s):

Mental Health ◽

Experimental Study ◽

Economic Evaluation ◽

Cost Effectiveness ◽

Mental Disorders ◽

Qualitative Study ◽

Intervention Group ◽

Home Treatment ◽

Control Group ◽

Quasi Experimental

BACKGROUND Crisis Resolution and Home Treatment (CRHT) teams represent a community-based mental health service offering a valid alternative to hospitalisation. CRHT teams have been widely implemented in various mental health systems worldwide and their goal is to take care of people with severe acute mental disorders that would be considered for admission to acute psychiatric wards. The evaluation of several home-treatment experiences shows promising results; however, it remains unclear which specific elements and characteristics of CRHT are more effective and acceptable. OBJECTIVE This study aims to assess the acceptability, effectiveness and cost-effectiveness of a new CRHT intervention in Ticino, Southern Switzerland. METHODS The study includes an interventional non-randomised quasi-experimental study combined with a qualitative study and an economic evaluation over a 48-month period. The quasi-experimental evaluation will involve two groups: patients in the northern area of the region will be offered with the CRHT service and be defined as the intervention group; patients in the southern area of the region will act as the control group and receive care as usual. Individual interviews with patients receiving the home treatment intervention and their family members will be conducted. CRHT members will be asked to take part in a focus group. The economic evaluation will include a cost-effectiveness analysis. RESULTS As of February 2021, data for the non-randomised quasi-experimental study have been collected and results are expected to be published by the end of the year. Data are currently being collected for the qualitative study and the economic evaluation, and the results will be disseminated through publication when the analysis is complete. CONCLUSIONS Compared to other Swiss CRHT experiences, the CRHT intervention in Ticino represents a unique case, as the introduction of the service is backed by the closing of one of its acute wards. The proposed study will address several areas where there are evidence gaps or contradictory findings relating to the home treatment of acute mental crisis. Findings from this study will allow local services to improve their effectiveness in a challenging domain of public health and contribute to improving access to more effective care for people with severe mental disorders. CLINICALTRIAL Trial registration ISRCTN38472626 (ISRCTN registry)

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A Pilot Study on the Efficacy of Volunteer Mentorship for Young Adults With Self-Harm Behaviors Using a Quasi-Experimental Design

Crisis ◽

10.1027/0227-5910/a000393 ◽

2016 ◽

Vol 37 (6) ◽

pp. 415-426 ◽

Cited By ~ 4

Author(s):

Yik-Wa Law ◽

Paul S. F. Yip ◽

Carmen C. S. Lai ◽

Chi Leung Kwok ◽

Paul W. C. Wong ◽

...

Keyword(s):

Experimental Design ◽

Suicide Ideation ◽

Intervention Group ◽

Well Being ◽

Control Group ◽

Treatment As Usual ◽

Prevention Services ◽

Quasi Experimental ◽

Self Harm ◽

Volunteer Support

Abstract. Background: Studies have shown that postdischarge care for self-harm patients is effective in reducing repeated suicidal behaviors. Little is known about whether volunteer support can help reduce self-harm repetition and improve psychosocial well-being. Aim: This study investigated the efficacy of volunteer support in preventing repetition of self-harm. Method: This study used a quasi-experimental design by assigning self-harm patients admitted to the emergency departments to an intervention group with volunteer support and treatment as usual (TAU) for 9 months and to a control group of TAU. Outcome measures include repetition of self-harm, suicidal ideation, hopelessness, and level of depressive and anxiety symptoms. Results: A total of 74 cases were recruited (38 participants; 36 controls). There were no significant differences in age, gender, and clinical condition between the two groups at the baseline. The intervention group showed significant improvements in hopelessness and depressive symptoms. However, the number of cases of suicide ideation and of repetition of self-harm episodes was similar for both groups at the postintervention period. Conclusion: Postdischarge care provided by volunteers showed significant improvement in hopelessness and depression. Volunteers have been commonly involved in suicide prevention services. Further research using rigorous methods is recommended for improving service quality in the long term.

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PENGARUH PELATIHAN PENGENDALIAN VEKTOR DEMAM BERDARAH TERHADAP MAYA INDEX PADA SISWA SEKOLAH DASAR DI MAJALENGKA

Jurnal Ilmu dan Teknologi Kesehatan ◽

10.33666/jitk.v11i1.271 ◽

2020 ◽

Vol 11 (1) ◽

Author(s):

Wawan Kurniawan

Keyword(s):

Vector Control ◽

Dengue Fever ◽

Dengue Hemorrhagic Fever ◽

Intervention Group ◽

Hemorrhagic Fever ◽

Control Group ◽

Control Group Design ◽

Group Design ◽

Quasi Experimental ◽

Dengue Vector Control

ABSTRAK Latar belakang: Demam Berdarah Dengue (DBD) disebabkan oleh virus Dengue dapat menyebabkan kematian. Pencegahan DBD yang dianggap paling tepat adalah Pemberantasan Sarang Nyamuk (PSN). Penelitian ini bertujuan untuk mengetahui pengaruh pelatihan pengendalian vektor Demam Berdarah pada siswa sekolah dasar terhadap Maya Index di Majalengka. Metode: Penelitian ini menggunakan desain quasi experiment (pretest-posttest control group design). Sebanyak 4 sekolah terpilih sebagai kelompok intervensi dan 4 sekolah lainnya sebagai kontrol. Subyek penelitian adalah siswa kelas IV-VI yang terdiri dari 171 siswa pada kelompok intervensi dan 163 pada kelompok kontrol. Instrumen yang digunakan adalah formulir pemantauan jentik berkala. Hasil: Jumlah rumah dengan kategori Maya Index tinggi berkurang dari 27,5% menjadi 9,4%. Terjadi penurunan angka BRI kategori tinggi pada kelompok intervensi dari 20,5% menjadi 1,8%. Pada kelompok kontrol tidak terjadi penurunan angka BRI kategori tinggi (22,1%), sebaliknya terjadi penurunan kategori rendah dari 34,4% menjadi 3,7%. Tidak terjadi penurunan angka HRI pada kelompok intervensi maupun kontrol. Kesimpulan: Pelatihan pengendalian vektor Demam Berdarah dapat menurunkan nilai BRI dan Maya Index, tetapi tidak berpengaruh terhadap nilai HRI. Tidak adanya perubahan nilai HRI menunjukkan bahwa kebersihan dan sanitasi lingkungan merupakan faktor yang berpengaruh terhadap probabilitas kejadian demam berdarah. Kata Kunci : Demam Berdarah, Maya Index, pelatihan, pengendalian vektor ABSTRACT Background: Dengue Hemorrhagic Fever (DHF) caused by Dengue virus could cause death. The most appropriate prevention of Dengue is eradication of mosquito nests (PSN). This study aims to determine the effect of Dengue vector control training on elementary students towards Maya Index in Majalengka. Method: This study used quasi-experimental design (pretest-posttest control group design). A total of 4 schools were selected as intervention groups and 4 other schools as controls. The subjects were students in grades IV-VI consisting of 171 students in the intervention group and 163 in the control group. The instrument used was periodic larva monitoring form. Results: The number of houses with a high Maya Index category in the intervention group decreased from 27.5% to 9.4%. There was a decrease in the high BRI category in the intervention group from 20.5% to 1.8%. In the control group, there was no decrease in the high BRI category (22.1%), on the contrary, there was a decrease in the low category from 34.4% to 3.7%. There was no decrease in HRI rates both of intervention or control groups. Conclusion: Dengue Fever vector control training could decrease the value of BRI and Maya Index, but does not affect the value of HRI. The absence of changes in HRI indicate that environmental hygiene and sanitation are factors that influence the probability of dengue fever occurrence. Keywords: Dengue Hemorrhagic Fever, Maya Index, training, vector control

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