scholarly journals Occupational Therapy Assessment for Upper Limb Rehabilitation: A Multisensor-Based Approach

2021 ◽  
Vol 3 ◽  
Author(s):  
Seedahmed S. Mahmoud ◽  
Zheng Cao ◽  
Jianming Fu ◽  
Xudong Gu ◽  
Qiang Fang
Keyword(s):  
Muscle Strength ◽  
Occupational Therapy ◽  
Upper Limb ◽  
Measurement Unit ◽  
Fine Motor ◽  
Upper Limb Rehabilitation ◽  
Therapy Assessment ◽  
Upper Limb Function ◽  
Upper Limb Movements ◽  
Highly Correlated

Most post-stroke patients experience varying degrees of impairment in upper limb function and fine motor skills. Occupational therapy (OT) with other rehabilitation trainings is beneficial in improving the strength and dexterity of the impaired upper limb. An accurate upper limb assessment should be conducted before prescribing upper limb OT programs. In this paper, we present a novel multisensor method for the assessment of upper limb movements that uses kinematics and physiological sensors to capture the movement of the limbs and the surface electromyogram (sEMG). These sensors are Kinect, inertial measurement unit (IMU), Xsens, and sEMG. The key assessment features of the proposed model are as follows: (1) classification of OT exercises into four classes, (2) evaluation of the quality and completion of the OT exercises, and (3) evaluation of the relationship between upper limb mobility and muscle strength in patients. According to experimental results, the overall accuracy for OT-based motion classification is 82.2%. In addition, the fusing of Kinect and Xsens data reveals that muscle strength is highly correlated with the data with a correlation coefficient (CC) of 0.88. As a result of this research, occupational therapy specialists will be able to provide early support discharge, which could alleviate the problem of the great stress that the healthcare system is experiencing today.

scholarly journals Bilateral Upper Limb Training With Functional Electric Stimulation in Patients With Chronic Stroke

2008 ◽  
Vol 23 (4) ◽  
pp. 357-365 ◽  
Author(s):  
Marko Ka-leung Chan ◽  
Raymond Kai-yu Tong ◽  
Kenneth Yiu-kwan Chung
Keyword(s):  
Occupational Therapy ◽  
Range Of Motion ◽  
Upper Limb ◽  
Electric Stimulation ◽  
Control Group ◽  
Wrist Extension ◽  
Upper Limb Rehabilitation ◽  
Upper Limb Function ◽  
Active Range Of Motion ◽  
Limb Rehabilitation

Background. The recovery rate of upper limb function after stroke is poor when compared with independent walking. Therefore, effective methods are warranted for upper limb rehabilitation. Objective. The aim of this study was to investigate the effectiveness of functional electric stimulation (FES) with bilateral activities training on upper limb function. Methods. This study was a double-blinded randomized controlled trial. Twenty patients were recruited 6 months after the onset of stroke and completed 15 training sessions. Participants were randomly assigned to the FES group or to the control group. Each session consisted of stretching activities (10 minutes), FES with bilateral tasks (20 minutes), and occupational therapy treatment (60 minutes). The participants used a self-trigger mechanism, with an accelerometer as a motion detector, for generating an electric stimulation pattern that was synchronized with the bilateral upper limb activities during the training. The participants in the control group received the same duration of stretching and occupational therapy training except that they just received placebo stimulation with the bilateral tasks. The outcome measures included Functional Test for the Hemiplegic Upper Extremity (FTHUE), Fugl—Meyer Assessment (FMA), grip power, forward reaching distance, active range of motion of wrist extension, Functional Independence Measure, and Modified Ashworth Scale. Results. At baseline comparison, there was no significant difference in both groups. After 15 training sessions, the FES group had significant improvement in FMA ( P = .039), FTHUE ( P = .001), and active range of motion of wrist extension ( P = .020) when compared with the control group. Conclusions. Bilateral upper limb training with FES could be an effective method for upper limb rehabilitation of stroke patients after 15 training sessions.

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.

Influence of task-oriented circuit training on upper limb function among rural community-dwelling survivors of stroke

2020 ◽  
Vol 27 (8) ◽  
pp. 1-8
Author(s):  
Shruti Deshpande ◽  
Sidhiparada Mohapatra ◽  
N Girish
Keyword(s):  
Upper Limb ◽  
Chronic Stroke ◽  
Community Dwelling ◽  
Rank Test ◽  
Circuit Training ◽  
Rehabilitation Centre ◽  
Limb Function ◽  
Upper Limb Rehabilitation ◽  
Upper Limb Function ◽  
Task Oriented

Background Task-oriented circuit training using a Multi-Activities workstation emphasises goal-oriented tasks practiced in a circuit or series in order to learn a new skill. It can be used for upper limb rehabilitation among stroke patients in a community setting, but there is currently very little evidence available regarding its use in this patient group and setting. This study aimed to explore the influence of task-oriented circuit training using a Multi-Activities workstation on upper limb function among community-dwelling individuals with chronic stroke. Methods A pre-test–post-test study was conducted involving 17 community-dwelling individuals with chronic stroke who were attending a stroke rehabilitation centre. Six weeks of task-oriented circuit training was given using a Multi-Activities workstation aimed to improve strength, range of motion and dexterity. Streamlined Wolf Motor Function Test and Chedoke Arm and Hand Activity Inventory were used to measure outcomes. Wilcoxon signed-rank test was used for data analysis. Results A total of 12 sessions of task-oriented circuit training using Multi-Activities workstations did not result in any statistically significant differences in outcome measures. Conclusions Task-oriented circuit training using the Multi-Activities workstation did not improve upper limb function in community-dwelling individuals with chronic stroke.

scholarly journals Clinical Validation of Kinematic Assessments of Post-Stroke Upper Limb Movements with a Multi-Joint Arm Exoskeleton

2020 ◽  
Author(s):  
Florian Grimm ◽  
Jelena Kraugmann ◽  
Georgios Naros ◽  
Alireza Gharabaghi
Keyword(s):  
Clinical Outcome ◽  
Upper Limb ◽  
Convergent Validity ◽  
Degrees Of Freedom ◽  
Clinical Status ◽  
Multiple Regression Model ◽  
Fine Grained ◽  
Starting Position ◽  
Upper Limb Function ◽  
Upper Limb Movements

Abstract Background: Robotic and gravity-balancing exoskeletons, originally designed for the rehabilitation training of neurological patients, are now being increasingly applied in objective and fine-grained sensor-based assessments of upper limb function. However, gravity compensation, inertia and damping properties of the exoskeleton interfere with the natural sensorimotor interaction, proprioceptive and visual feedback during movement execution. This may endanger the validity of the kinematic assessments in relation to the clinical outcome measures that they were supposed to reflect. Here, we appliedMethods: In a proof of concept study involving nineteen severely impaired chronic stroke patients, we assessed sensor-based kinematic data acquired with a multi-joint arm exoskeleton and compared it to the clinical outcome measure Upper Extremity Fugl-Meyer Assessment (UE-FMA) scale. During this assessment, real-time movement feedback of the system’s seven degrees of freedom was provided with a biomorphic 3D virtual representation of the upper limb, including the proximal component of the arm. To align posture and to minimize the exoskeleton-patient interaction, the same position (neutral zero) with a distance of 90 degrees between forearm and upper arm was taken as the starting position for all assessments. Within self-contained tasks, we assessed separately and subsequently the range of motion/spatial posture of four single joints (i.e., joint angles of wrist, elbow, arm, and shoulder movement) and the closing and opening of the hand with a pressure sensor placed in the handle.Results: A strong correlation was observed between wrist and elbow movements within the kinematic parameters (r > 0.7, p<0.003; Bonferroni corrected). A multiple regression model predicted the UE-FMA significantly (F (5, 13) = 12.22, p < 0.0005, adj. R2 = 0.83). Both shoulder rotation and grip pressure added significantly (p < 0.05) to the prediction with the standardized coefficients β of 0.55 and 0.38, respectively.Conclusions: Exoskeleton-based evaluation of single-joint movements and grip force facilitates the assessment of upper limb kinematics after stroke with high structural and convergent validity. Proximal and distal measures may contribute independently to the prediction of the clinical status.

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 Effect of Immersive Virtual Reality-Based Bilateral Arm Training in Patients with Chronic Stroke

2021 ◽  
Vol 11 (8) ◽  
pp. 1032
Author(s):  
Yo-Han Song ◽  
Hyun-Min Lee
Keyword(s):  
Virtual Reality ◽  
Upper Limb ◽  
Chronic Stroke ◽  
Limb Function ◽  
Upper Limb Rehabilitation ◽  
Upper Limb Function ◽  
Artificial Environment ◽  
Beta Power ◽  
Significant Difference ◽  
Bilateral Arm Training

Virtual reality (VR)-based therapies are widely used in stroke rehabilitation. Although various studies have used VR techniques for bilateral upper limb training, most have been only semi-immersive and have only been performed in an artificial environment. This study developed VR content and protocols based on activities of daily living to provide immersive VR-based bilateral arm training (VRBAT) for upper limb rehabilitation in stroke patients. Twelve patients with chronic stroke were randomized to a VRBAT group or a normal bilateral arm training (NBAT) group and attended 30-min training sessions five times a week for four weeks. At the end of the training, there was a significant difference in upper limb function in both groups (p < 0.05) and in the upper limb function sensory test for proprioception in the NBAT group (p < 0.05). There was no significant between-group difference in upper limb muscle activity after training. The relative alpha and beta power values for electroencephalographic measurements were significantly improved in both groups. These findings indicate that both VRBAT and NBAT are effective interventions for improving upper limb function and electroencephalographic activity in patients with chronic stroke.

scholarly journals Quantifying upper limb motor impairment in people with Parkinson’s disease: a physiological profiling approach

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10735
Author(s):  
Lewis A. Ingram ◽  
Vincent K. Carroll ◽  
Annie A. Butler ◽  
Matthew A. Brodie ◽  
Simon C. Gandevia ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Muscle Strength ◽  
Upper Limb ◽  
Bimanual Coordination ◽  
Handgrip Strength ◽  
Position Sense ◽  
Healthy Controls ◽  
Limb Function ◽  
Upper Limb Function

Background Upper limb motor impairments, such as slowness of movement and difficulties executing sequential tasks, are common in people with Parkinson’s disease (PD). Objective To evaluate the validity of the upper limb Physiological Profile Assessment (PPA) as a standard clinical assessment battery in people with PD, by determining whether the tests, which encompass muscle strength, dexterity, arm stability, position sense, skin sensation and bimanual coordination can (a) distinguish people with PD from healthy controls, (b) detect differences in upper limb test domains between “off” and “on” anti-Parkinson medication states and (c) correlate with a validated measure of upper limb function. Methods Thirty-four participants with PD and 68 healthy controls completed the upper limb PPA tests within a single session. Results People with PD exhibited impaired performance across most test domains. Based on validity, reliability and feasibility, six tests (handgrip strength, finger-press reaction time, 9-hole peg test, bimanual pole test, arm stability, and shirt buttoning) were identified as key tests for the assessment of upper limb function in people with PD. Conclusions The upper limb PPA provides a valid, quick and simple means of quantifying specific upper limb impairments in people with PD. These findings indicate clinical assessments should prioritise tests of muscle strength, unilateral movement and dexterity, bimanual coordination, arm stability and functional tasks in people with PD as these domains are the most commonly and significantly impaired.

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