scholarly journals Effectiveness of a New 3D-Printed Dynamic Hand–Wrist Splint on Hand Motor Function and Spasticity in Chronic Stroke Patients

2021 ◽  
Vol 10 (19) ◽  
pp. 4549
Author(s):  
Yu-Sheng Yang ◽  
Chi-Hsiang Tseng ◽  
Wei-Chien Fang ◽  
Ia-Wen Han ◽  
Shyh-Chour Huang
Keyword(s):  
Intervention Program ◽  
Controlled Trial ◽  
Chronic Stroke ◽  
Ease Of Use ◽  
Control Group ◽  
Stroke Survivors ◽  
Stroke Patients ◽  
Dynamic Splint ◽  
Experimental Group ◽  
At Home

Spasticity, a common stroke complication, can result in impairments and limitations in the performance of activities and participation. In this study, we investigated the effectiveness of a new dynamic splint on wrist and finger flexor muscle spasticity in chronic stroke survivors, using a randomized controlled trial. Thirty chronic stroke survivors were recruited and randomly allocated to either an experimental or control group; 25 completed the 6-week intervention program. The participants in the experimental group were asked to wear the dynamic splint at least 6 h/day at home, for the entire intervention. The participants in the control group did not wear any splint. All the participants were evaluated 1 week before, immediately, and after 3 and 6 weeks of splint use, with the modified Ashworth scale and the Fugl−Meyer assessment for upper extremity. User experience was evaluated by a self-reported questionnaire after the 6-week intervention. The timed within-group assessments showed a significant reduction in spasticity and improvements in functional movements in the experimental group. We found differences, in favor of the experimental group, between the groups after the intervention. The splint users indicated a very good satisfaction rating for muscle tone reduction, comfort, and ease of use. Therefore, this new splint can be used for at-home rehabilitation in chronic stroke patients with hemiparesis.

Improvement of Hand Motor Function after Radial Shock Wave Therapy in Chronic Stroke Patients

2018 ◽  
pp. 2-12
Author(s):  
M Kamaluddin ◽  
Erna Setiawati ◽  
Tanti Ajoe Kesoema
Keyword(s):  
Shock Wave ◽  
Motor Function ◽  
Controlled Trial ◽  
Hand Function ◽  
Chronic Stroke ◽  
Control Group ◽  
Shock Wave Therapy ◽  
Stroke Patients ◽  
And Control ◽  
Experimental Group

Introduction: The Radial Shock Wave Therapy (RSWT) expected could improve spasticity and hand function in chronic stroke patients. This study aimed to find out the improvement of hand function after RSWT as an additional therapy in chronic stroke patients. Methods: Design study was a randomized controlled trial. The patients were assigned randomly to the experimental group (Infrared, Stretching, and RSWT) and control group (Infrared and Stretching) for six weeks. Hand motor function was measured using Fugl-Meyer Motor Assesment (FMA) before and after intervention. Conclusion: There were improvement of wrist and hand FMA scores in the experimental as well as control group Results: Median of wrist FMA scores in the experimental and control group before intervention were 2 and 3 respectively whereas median of wrist FMA scores in the experimental and control group after intervention were 5 and 4 respectively. Median of hand FMA scores in the experimental and control group before intervention were 4 and 4 respectively whereas median of hand FMA scores in the control and experimental group after intervention were 6 and 5 respectively. The scores of wrist- hand FMA in the control and experimental group after intervention were increased P = 0.001P < 0.001 (wrist) and P = 0.001 P < 0.001 (hand) respectively. However, difference increased of wrist and hand FMA scores in the experimental group after intervention were more significant. Keywords: Spasticity, Hand Function, Stroke, Radial Shock Therapy, Fugl-Meyer Motor Assesment

scholarly journals Comparison of Aquatic Therapy vs. Dry Land Therapy to Improve Mobility of Chronic Stroke Patients

2020 ◽  
Vol 17 (13) ◽  
pp. 4728 ◽  
Author(s):  
Sagrario Pérez-de la Cruz
Keyword(s):  
Therapy Group ◽  
Controlled Trial ◽  
Chronic Stroke ◽  
Control Group ◽  
Stroke Patients ◽  
Aquatic Therapy ◽  
Dry Land ◽  
Increased Risk ◽  
Single Leg Stance ◽  
Experimental Group

One of the most serious and disabling problems of stroke is pain and a decrease in balance, with the consequent increased risk of falls. The aim of the randomized controlled trial study was to compare the efficacy of three different treatment proposals to improve pain, gait, and balance in chronic stroke patients. Forty patients diagnosed with stroke were divided into three groups: the dry-land therapy group (control group) received sessions that included walking exercises and trunk mobility. The experimental group received Ai Chi aquatic therapy, and the combined group received alternating dry-land therapy sessions and Ai Chi aquatic therapy. The measurement instruments used were: the Tinetti balance and gait scale, the visual analog scale (VAS), 360° turn, single leg stance, and the 30-s stand test (CS-30). After twelve weeks of treatment, the results were significantly better for the combined therapy group and the experimental group compared to the dry-land therapy group (p < 0.01) in the VAS scale, CS-30, and 360° turn, although improvements were also found in the evaluations carried out in the aquatic therapy group. In total, for the Tinetti scale and single-leg stance, the differences between the groups were evident, although not statistically significant (p = 0.001). Aquatic therapy with Ai Chi and the combination of aquatic therapy with dry-land therapy was effective in improving pain, balance, and gait in patients with chronic stroke, thus improving their functional capacity and quality of life.

Rehabilitation of upper extremity by telerehabilitation combined with exergames in chronic stroke survivors: Preliminary findings from a feasibility clinical trial (Preprint)

2021 ◽  
Author(s):  
Dorra Rakia Allegue ◽  
Johanne Higgins ◽  
Shane N Sweet ◽  
Philippe S Archambault ◽  
Francois Michaud ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Upper Extremity ◽  
Conventional Therapy ◽  
Chronic Stroke ◽  
Control Group ◽  
Stroke Survivors ◽  
Post Intervention ◽  
Experimental Group ◽  
At Home

BACKGROUND Exergames are increasingly used among stroke survivors with chronic UE sequelae, to continue exercising at home, after discharge, and maintain activity level. The use of virtual reality exergames combined with telerehabilitation app (VirTele) may be an interesting alternative to rehabilitate the UE sequelae in chronic stroke survivors while allowing for ongoing monitoring with a clinician. OBJECTIVE 1) To determine the feasibility of using VirTele with chronic stroke survivors at home; 2) To explore the impact of VirTele on UE motor function, quantity and quality of use, quality of life, and motivation, in chronic stroke survivors, compared with conventional therapy (GRASP: Graded Repetitive Arm Supplementary Program). METHODS This is a feasibility clinical trial including a two-arm trial design. Eligible participants were randomly allocated to an experimental group (receiving VirTele for 8 weeks) or a control group (receiving conventional therapy for 8 weeks). Feasibility measurements included the number and active time spent on exergame sessions, frequency and time spent by the clinician during videoconferencing sessions, satisfaction with the technology, and resource utilization (equipment, technical support). Outcome measurements included the Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Motor Activity log-30 (MAL), Stroke Impact Scale-16 (SIS), and Treatment Self-Regulation Questionnaire-15 (TSRQ) and were administered to both groups at four-time points: T1: before starting the intervention; T2: post-intervention; T3: one-month post-intervention and T4: two-months post-intervention. RESULTS A total of 11 stroke survivors were randomized and allocated to the treatment group. At the COVID-19 onset, participants pursued the allocated treatment for 3-months. VirTele intervention dose was captured in term of time spent on exergames (mean-8 weeks: 16.6 hours; SD 3.0 and mean-third month: 9.3 hours; SD 7.1), frequency of use of exergames (total-mean: 62,5; range: 49-84 sessions), and total number of successful repetitions (mean-8weeks: 13 683; SD 2367 and mean-third month:12035,5; SD 9508,46) and frequency of video-conference- sessions (total mean: 6,6 , range: 3-11 sessions). The technical issues included loss of passwords, Internet issues, updates of the system, and problems with the avatar. Overall, most stroke survivors found the technology easy to use and quite useful, except for one participant. For the FMA-UE and MAL, both groups exhibited an improvement in more than 50% of the participants, maintained over time. Regarding the SIS scores, the control group reported improvement in activities of daily life (60% (3/5)), hand function (100% (5/5)), and mobility (40% (2/5)), while the experimental group reported varied and non-conclusive results. For the TSRQ, 75% (3/4) of the experimental group demonstrated an increase in the autonomous motivation score, while in the control group this improvement was shown in only one participant. CONCLUSIONS VirTele intervention constitutes another therapeutic alternative, in addition to the conventional therapy to deliver an intense personalized rehabilitation program in chronic stroke survivors with UE sequelae. CLINICALTRIAL ClinicalTrials.gov NCT03759106; http://clinicaltrials.gov/show/NCT03759106. INTERNATIONAL REGISTERED REPORT RR2-10.2196/14629

scholarly journals Effects of Training for Finger Perception on Functional Recovery of Hemiplegic Upper Limbs in Acute Stroke Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Naho Umeki ◽  
Jun Murata ◽  
Misako Higashijima
Keyword(s):  
Training Program ◽  
Functional Recovery ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Sensory Function ◽  
Control Group ◽  
Stroke Patients ◽  
Pressure Threshold ◽  
Sensory Training ◽  
Experimental Group

Background. Stroke causes severe disability, including motor and sensory impairments. We hypothesized that upper limb functional recovery after stroke may be augmented by combining treatments for motor and sensory functions. In order to examine this hypothesis, we conducted a controlled trial on rehabilitation for sensory function to the plegic hand. Methods. The sensory training program consisted of several types of discrimination tasks performed under blind conditions. The sensory training program was performed for 20 min per day, 5 days a week. An experimental group of 31 patients followed this sensory program, while a control group of 25 patients underwent standard rehabilitation. The efficacy of the intervention was evaluated by the tactile-pressure threshold, handgrip strength, and the completion time of manipulating objects. A two-way repeated measures analysis of variance was used to assess interactions between group and time. Moreover, to provide a meaningful analysis for comparisons, effect sizes were calculated using Cohen’s d. Results. The mean change in the tactile pressure threshold was significantly larger in the experimental group than in the control group (p<0.05, d=0.59). Moreover, the completion times to manipulate a middle-sized ball (d=0.53) and small ball (d=0.80) and a small metal disc (d=0.81) in the experimental group were significantly different from those in the control group (p<0.05). Conclusion. The present results suggest that the sensory training program to enhance finger discrimination ability contributes to improvements in not only sensory function but also manual function in stroke patients. The trial is registered with the UMIN Clinical Trials Registry (UMIN000032025).

Improvement of Hand Motor Function after Radial Shock Wave Therapy in Chronic Stroke Patients

2019 ◽  
pp. 2-12
Author(s):  
M. Kamaluddin K ◽  
Erna Setiawati ◽  
Tanti Ajoe Kesoema
Keyword(s):  
Shock Wave ◽  
Motor Function ◽  
Hand Function ◽  
Chronic Stroke ◽  
Control Group ◽  
Shock Wave Therapy ◽  
Stroke Patients ◽  
Before And After ◽  
And Control ◽  
Experimental Group

IIntroduction: The Radial Shock Wave Therapy (RSWT) expected could improve spasticity and hand function in chronic stroke patients. This study aimed to find out the improvement of hand function after RSWT as an additional therapy in chronic stroke patients. Methods: Design study was a randomized controlled trial, in December 2018. The patients were assigned randomly to the experimental group (Infrared, Stretching, and RSWT) and control group (Infrared and Stretching) for six weeks. Hand motor function was measured using Fugl-Meyer Motor Assesment (FMA) before and after intervention. Results: The median values of wrist FMA scores in the experimental and control group before and after intervention were 2 vs 5 (p=0.001) and 3 vs 4 (p<0.001) respectively. The median values of hand FMA scores in the experimental and control group before and intervention were 4 vs 6 (p=0,.001) and 4 vs 5 (p<0.001). However, the delta between before and after intervention was higher in experimental group. Conclusion: The improvement of wrist and hand FMA scores after added treatment by RSWT was tend to higher.Keywords: Spasticity, Hand Function, Stroke, Radial Shock Therapy, Fugl-Meyer Motor Assesment

Effects of training with a passive hand orthosis and games at home in chronic stroke: a pilot randomised controlled trial

2016 ◽  
Vol 31 (2) ◽  
pp. 207-216 ◽  
Author(s):  
Sharon M Nijenhuis ◽  
Gerdienke B Prange-Lasonder ◽  
Arno HA Stienen ◽  
Johan S Rietman ◽  
Jaap H Buurke
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Hand Function ◽  
User Acceptance ◽  
Chronic Stroke ◽  
Control Group ◽  
Home Based ◽  
Randomised Controlled ◽  
Clinical Changes ◽  
At Home

Objectives: To compare user acceptance and arm and hand function changes after technology-supported training at home with conventional exercises in chronic stroke. Secondly, to investigate the relation between training duration and clinical changes. Design: A randomised controlled trial. Setting: Training at home, evaluation at research institute. Subjects: Twenty chronic stroke patients with severely to mildly impaired arm and hand function. Interventions: Participants were randomly assigned to six weeks (30 minutes per day, six days a week) of self-administered home-based arm and hand training using either a passive dynamic wrist and hand orthosis combined with computerised gaming exercises (experimental group) or prescribed conventional exercises from an exercise book (control group). Main measures: Main outcome measures are the training duration for user acceptance and the Action Research Arm Test for arm and hand function. Secondary outcomes are the Intrinsic Motivation Inventory, Fugl-Meyer assessment, Motor Activity Log, Stroke Impact Scale and grip strength. Results: The control group reported a higher training duration (189 versus 118 minutes per week, P = 0.025). Perceived motivation was positive and equal between groups ( P = 0.935). No differences in clinical outcomes over training between groups were found (P ⩾ 0.165). Changes in Box and Block Test correlated positively with training duration ( P = 0.001). Conclusions: Both interventions were accepted. An additional benefit of technology-supported arm and hand training over conventional arm and hand exercises at home was not demonstrated. Training duration in itself is a major contributor to arm and hand function improvements.

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

Stroke ◽  
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.

scholarly journals Feasibility and effect of interactive telerehabilitation on balance in individuals with chronic stroke: a pilot study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Shih-Ching Chen ◽  
Chueh-Ho Lin ◽  
Sheng-Wen Su ◽  
Yu-Tai Chang ◽  
Chien-Hung Lai
Keyword(s):  
Pilot Study ◽  
Effect Size ◽  
Exercise Intervention ◽  
Chronic Stroke ◽  
Control Group ◽  
Stroke Survivors ◽  
Post Intervention ◽  
Timed Up And Go ◽  
Kinect Camera ◽  
Experimental Group

Abstract Background Stroke survivors need continuing exercise intervention to maintain functional status. This study assessed the feasibility and efficacy of an interactive telerehabilitation exergaming system to improve balance in individuals with chronic stroke, compared to conventional one-on-one rehabilitation. Methods In this prospective case–control pilot study, 30 Taiwanese individuals with chronic stroke were enrolled and randomly allocated to an experimental group and a control group. All participants received intervention 3 times per week for 4 weeks in the study hospital. The experiment group underwent telerehabilitation using a Kinect camera-based interactive telerehabilitation system in an independent room to simulate home environment. In contrast, the control group received conventional one-on-one physiotherapy in a dedicated rehabilitation area. The effectiveness of interactive telerehabilitation in improving balance in stroke survivors was evaluated by comparing outcomes between the two groups. The primary outcome was Berg Balance Scale (BBS) scores. Secondary outcomes were performance of the Timed Up and Go (TUG) test, Modified Falls Efficacy Scale, Motricity Index, and Functional Ambulation Category. Results Comparison of outcomes between experimental and control groups revealed no significant differences between groups at baseline and post-intervention for all outcome measures. However, BBS scores improved significantly in both groups (control group: p = 0.01, effect size = 0.49; experimental group: p = 0.01, effect size = 0.70). Completion times of TUG tests also improved significantly in the experimental group (p = 0.005, effect size = 0.70). Conclusion The Kinect camera-based interactive telerehabilitation system demonstrates superior or equal efficacy compared to conventional one-on-one physiotherapy for improving balance in individuals with chronic stroke. Trial registration ClinicalTrials.gov. NCT03698357. Registered October 4, 2018, retrospectively registered.

scholarly journals Robotic-based ACTive somatoSENSory (Act.Sens) retraining on upper limb functions with chronic stroke survivors: study protocol for a pilot randomised controlled trial

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ananda Sidarta ◽  
Yu Chin Lim ◽  
Christopher Wee Keong Kuah ◽  
Yong Joo Loh ◽  
Wei Tech Ang
Keyword(s):  
Randomised Controlled Trial ◽  
Study Protocol ◽  
Upper Limb ◽  
Controlled Trial ◽  
Chronic Stroke ◽  
Community Dwelling ◽  
Control Group ◽  
Stroke Survivors ◽  
Pilot Randomised Controlled Trial ◽  
Randomised Controlled

Abstract Background Prior studies have established that senses of the limb position in space (proprioception and kinaesthesia) are important for motor control and learning. Although nearly one-half of stroke patients have impairment in the ability to sense their movements, somatosensory retraining focusing on proprioception and kinaesthesia is often overlooked. Interventions that simultaneously target motor and somatosensory components are thought to be useful for relearning somatosensory functions while increasing mobility of the affected limb. For over a decade, robotic technology has been incorporated in stroke rehabilitation for more controlled therapy intensity, duration, and frequency. This pilot randomised controlled trial introduces a compact robotic-based upper-limb reaching task that retrains proprioception and kinaesthesia concurrently. Methods Thirty first-ever chronic stroke survivors (> 6-month post-stroke) will be randomly assigned to either a treatment or a control group. Over a 5-week period, the treatment group will receive 15 training sessions for about an hour per session. Robot-generated haptic guidance will be provided along the movement path as somatosensory cues while moving. Audio-visual feedback will appear following every successful movement as a reward. For the same duration, the control group will complete similar robotic training but without the vision occluded and robot-generated cues. Baseline, post-day 1, and post-day 30 assessments will be performed, where the last two sessions will be conducted after the last training session. Robotic-based performance indices and clinical assessments of upper limb functions after stroke will be used to acquire primary and secondary outcome measures respectively. This work will provide insights into the feasibility of such robot-assisted training clinically. Discussion The current work presents a study protocol to retrain upper-limb somatosensory and motor functions using robot-based rehabilitation for community-dwelling stroke survivors. The training promotes active use of the affected arm while at the same time enhances somatosensory input through augmented feedback. The outcomes of this study will provide preliminary data and help inform the clinicians on the feasibility and practicality of the proposed exercise. Trial registration ClinicalTrials.gov NCT04490655. Registered 29 July 2020.

scholarly journals ‘Relearning How to Think’: A Brief Online Intervention to Modify Biased Interpretations in Emotional Disorders. Study Protocol for a Randomised Controlled Trial

2021 ◽  
Author(s):  
Inés Nieto ◽  
Carmelo Vazquez
Keyword(s):  
Emotional Disorders ◽  
Intervention Program ◽  
Cognitive Biases ◽  
Controlled Trial ◽  
Online Intervention ◽  
Control Group ◽  
Depression And Anxiety ◽  
The Impact ◽  
Experimental Group ◽  
Assessment Session

Abstract Background: Cognitive biases seem to play an important role in the development and maintenance of emotional disorders such as depression and anxiety. Novel procedures, known as Cognitive Bias Modification (CBM), aim to reduce these dysfunctional information processing modes. This study develops a brief online intervention program to modify biased interpretations in depression and anxiety, overcoming some methodological issues that have been addressed in previous literature. Methods: Volunteer participants will be recruited via social media, posters and universities. They will be randomly assigned to an experimental group or a waiting list control group. Both groups will attend two assessment sessions at the lab. The assessments will consist of questionnaires measuring cognitive and emotional variables as well as three experimental tasks to measure cognitive biases (i.e., attention, memory and interpretation). After the first assessment session, only participants in the experimental group will receive a link to follow the four-sessions program at home. All participants will receive, via email, follow-up questionnaires two weeks and three months after the second assessment session.Discussion: This study will test an online program potentially beneficial to modify cognitive variables in disorders such as depression and anxiety. Several limitations of previous CBM procedures are addressed and the impact of the program both on cognitive performance and clinical symptoms will be explored.Trial registration: This trial was prospectively registered on June 17, 2019 with the ClinicalTrials.gov NCT03987477

Sign in / Sign up

Export Citation Format

Share Document