METHODS AND MEANS OF PROVIDING REHABILITATION PROCEDURES THROUGH A BIOTECHNICAL SYSTEM WITH BIOLOGICAL FEEDBACK AND A FUZZY CONTROL MODULE

2021 ◽  
pp. 71-83
Author(s):  
Андрей Андреевич Трифонов ◽  
Елена Валерьевна Петрунина ◽  
Александр Алексеевич Кузьмин ◽  
Зейнаб Усама Протасова ◽  
Людмила Петровна Лазурина
Keyword(s):  
Virtual Reality ◽  
Fuzzy Control ◽  
Control Group ◽  
Robotic Device ◽  
Biological Feedback ◽  
Stroke Patients ◽  
Control Module ◽  
Post Stroke ◽  
Rehabilitation System ◽  
Biotechnical System

В статье описана реабилитационная биотехническая система с виртуальной реальностью, позволяющая модулю нечеткого управления осуществлять биологическую обратную связь путем сопоставления стимулирующих сигналов виртуальной реальности, электроэнцефалографических сигналов и электромиосигналов. Предложена рекурсивная математическая модель планирования процедур реабилитации с использованием биологической обратной связи, основанная на понятии функций «обучения» и «забывания», позволяющая планировать сеансы тренинга и прогнозировать их результаты. Разработано аппаратное, алгоритмическое и программное обеспечение биотехничекой системы реабилитации постинсультных больных с модулем нечеткого управления экзоскелетом, позволяющее адаптировать программу реабилитации постинсультных больных с функциональным состоянием конкретного пациента. Сформирована экспериментальная группа для оценки эффективности БТС-тренинга постинсультных больных с паретичными нижними конечностями. Контрольная группа формировалась виртуально на основе статистического анализа ретроспективных стратифицированных результатов реабилитации постинсультных больных посредством биотехнической системы с робототехническим устройством без использования модуля нечеткого управления. Исследование показало, что можно изменить показатели клинического исхода у пациентов с подострым и хроническим течением инсульта после 12 сеансов БТС-тренинга. Биотехничесая система с нечетким управлением робототехническим устройством позволяет осуществлять индивидуальную стратегию реабилитации постинсультных больных (включая целенаправленную тренировку ходьбы) The article describes a biotechnical rehabilitation system with virtual reality, which allows the fuzzy control module to carry out biological feedback by comparing stimulating signals of virtual reality, electroencephalographic signals and electromyosignals. A recursive mathematical model for planning rehabilitation procedures using biofeedback is proposed, based on the concept of “learning” and “forgetting” functions, which allows planning training sessions and predicting their results. The hardware, algorithmic and software support of the biotechnical rehabilitation system for post-stroke patients with a fuzzy exoskeleton control module has been developed, which allows to adapt the rehabilitation program for post-stroke patients with the functional state of a particular patient. An experimental group was formed to assess the effectiveness of BPS training in post-stroke patients with paretic lower extremities. The control group was formed virtually on the basis of statistical analysis of retrospective stratified results of rehabilitation of post-stroke patients using a biotechnical system with a robotic device without using a fuzzy control module. The study showed that it is possible to change the indicators of clinical outcome in patients with subacute and chronic stroke after 12 sessions of BPS training. A biotechnical system with fuzzy control of a robotic device allows an individual strategy for the rehabilitation of post-stroke patients (including targeted walking training)

scholarly journals Stroke Telerehabilitation in Calabria: A Health Technology Assessment

2022 ◽  
Vol 12 ◽  
Author(s):  
Contrada Marianna ◽  
Arcuri Francesco ◽  
Tonin Paolo ◽  
Pignolo Loris ◽  
Mazza Tiziana ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Low Income ◽  
Cognitive Rehabilitation ◽  
Low Income Countries ◽  
Rehabilitation Services ◽  
Stroke Patients ◽  
Post Stroke ◽  
Home Service ◽  
Rehabilitation System ◽  
Specialist Rehabilitation

Introduction: Telerehabilitation (TR) is defined as a model of home service for motor and cognitive rehabilitation, ensuring continuity of care over time. TR can replace the traditional face-to-face approach as an alternative method of delivering conventional rehabilitation and applies to situations where the patient is unable to reach rehabilitation facilities or for low-income countries where outcomes are particularly poor. For this reason, in this study, we sought to demonstrate the feasibility and utility of a well-known TR intervention on post-stroke patients living in one of the poorest indebted regions of Italy, where the delivery of rehabilitation services is inconsistent and not uniform.Materials and Methods: Nineteen patients (13 male/6 female; mean age: 61.1 ± 8.3 years) with a diagnosis of first-ever ischemic (n = 14) or hemorrhagic stroke (n = 5), who had been admitted to the intensive rehabilitation unit (IRU) of the Institute S. Anna (Crotone, Italy), were consecutively enrolled to participate in this study. After the discharge, they continued the motor treatment remotely by means of a home-rehabilitation system. The entire TR intervention was performed (online and offline) using the Virtual Reality Rehabilitation System (VRRS) (Khymeia, Italy). All patients received intensive TR five times a week for 12 consecutive weeks (60 sessions, each session lasting about 1h).Results: We found a significant motor recovery after TR protocol as measured by the Barthel Index (BI); Fugl-Meyer motor score (FM) and Motricity Index (MI) of the hemiplegic upper limbs.Conclusions: This was the first demonstration that a well-defined virtual reality TR tool promotes motor and functional recovery in post-stroke patients living in a low-income Italian region, such as Calabria, characterized by a paucity of specialist rehabilitation services.

Method of virtual reality for early comprehensive rehabilitation of patients with acute stroke

2020 ◽  
pp. 39-45
Author(s):  
N. Nozdryukhina ◽  
E. Kabayeva ◽  
E. Kirilyuk ◽  
K. Tushova ◽  
A. Karimov
Keyword(s):  
Virtual Reality ◽  
Literature Review ◽  
Acute Stroke ◽  
Functional Outcome ◽  
Recovery Process ◽  
Stroke Patients ◽  
Post Stroke ◽  
Stroke Disability ◽  
Comprehensive Rehabilitation ◽  
High Level

Despite significant advances in the treatment and rehabilitation of stroke, level of post-stroke disability remains at a fairly high level. Recent innovative developments in the rehabilitation of these patients provide good results in terms of functional outcome. One of such developments is method of virtual reality (VR), which affects not only the speed and volume of regaining movement, as well as coordination, but also normalizes the psycho-emotional background, increasing the motivation of patients to improve the recovery process. This article provides a literature review of the use of the VR method in the rehabilitation of post-stroke patients, neurophysiological aspects of recovery of lost functions using this method are considered.

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.

Virtual reality as a new tool for the rehabilitation of post-stroke patients with chronic aphasia: an exploratory study

Aphasiology ◽  
2021 ◽  
pp. 1-11
Author(s):  
Rosaria De Luca ◽  
Simona Leonardi ◽  
Giuseppa Maresca ◽  
Foti Cuzzola Marilena ◽  
Desiree Latella ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Exploratory Study ◽  
Stroke Patients ◽  
Post Stroke ◽  
Chronic Aphasia

Abstract TP224: Interleukin-37 Level is Elevated in Acute Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Saif Bushnaq ◽  
Atif Zafar ◽  
Kempuraj Duraisamy ◽  
Nudrat Tasneem ◽  
Mohammad M Khan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Inflammatory Responses ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Delayed Presentation ◽  
Stroke Patients ◽  
Post Stroke ◽  
Urine And Serum ◽  
Serum And Urine

Background: Interleukin-37 (IL-37) is a new member of IL-1 cytokine family with a defined role as a negative feedback inhibitor of pro-inflammatory responses. IL-37 has yet to be evaluated in non-immune neurological diseases like ischemic or hemorrhagic stroke. This study aimed to measure the urine and serum IL-37 levels in patients with acute ischemic stroke. Method: Twelve patients consented for the study. Two sets of serum and urine samples were obtained and analyzed; one upon admission to the hospital, and the second the next morning after overnight fasting. The trends in serum level of IL-37 in 5 stroke patients, while trends in urine level of 6 patients were available, measured by real-time polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA). Prior studies with healthy volunteers as control group have consistently showed IL-37 plasma level around or less than 65 pg/ml with maximum normal levels on ELISA approximated at 130 pg/ml. Results: IL-37 level in urine in stroke patients ranged from 297 - 4467. IL-37 levels were in the range of 300s to 1000s in patients with ischemic stroke compared with reported healthy controls in literature where the level was always less than 90. Three of these 10 patients presented within 3 hours of stroke onset with IL-37 serum levels being 2655 pg/ml, 3517 pg/ml and 5235 pg/ml. In all others, it ranged much less than that, with the trend of delayed presentation giving less IL-37 levels, both in urine and serum. There were no clear differences found in patients with or without tPA, diabetes, hyperlipidemia and high blood pressure in our small study. Conclusion: The study shows a rather stable elevation of IL-37 levels post-ischemic stroke, which if compared to available data from other studies, is 3-10 times elevated after acute ischemic stroke with an uptrend in the first few days. IL-37 plays some role in mediating post-stroke inflammation with significant rise in serum and urine IL-37 levels suggesting a key role of this novel cytokine in post-stroke pathology. This is the first ever reported study measuring and trending IL-37 levels in human plasma after an acute ischemic stroke.

Collaboration of Rehabilitation Robot With Virtual Reality Development Engine

2018 ◽  
pp. 1377-1392
Author(s):  
Yogendra Patil ◽  
Guilherme Galdino Siqueira ◽  
Iara Brandao ◽  
Fei Hu
Keyword(s):  
Virtual Reality ◽  
User Interface ◽  
Design Process ◽  
Stroke Rehabilitation ◽  
Daily Routine ◽  
Rehabilitation Robot ◽  
Rehabilitation Process ◽  
Post Stroke ◽  
Rehabilitation System ◽  
Rehabilitation Exercises

Stroke rehabilitation techniques have gathered an immense attention due to the addition of virtual reality environment for rehabilitation purposes. Current techniques involve ideas such as imitating various stroke rehabilitation exercises in virtual world. This makes rehabilitation process more attractive as compared to conventional methods and motivates the patient to continue the therapy. However, most of the virtual reality based stroke rehabilitation studies focus on patient performing sedentary rehabilitation exercises. In this chapter, we introduce our virtual reality based post stroke rehabilitation system that allows a post stroke patient to perform dynamic exercises. With the introduction of our system, we hope to increase post stroke patient's ability to perform their daily routine exercises independently. Our discussion in this chapter is mainly centered around collaboration of rehabilitation system with virtual reality software. We also detail the design process of our modern user interface for collecting useful data during rehabilitation. A simple experiment is carried out to validate the visibility of our system.

scholarly journals Gothenburg Very Early Supported Discharge study (GOTVED): a randomised controlled trial investigating anxiety and overall disability in the first year after stroke

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lena Rafsten ◽  
Anna Danielsson ◽  
Asa Nordin ◽  
Ann Björkdahl ◽  
Asa Lundgren-Nilsson ◽  
...  
Keyword(s):  
Multidisciplinary Team ◽  
Controlled Trial ◽  
Stroke Care ◽  
Secondary Outcome ◽  
Outpatient Rehabilitation ◽  
Control Group ◽  
Stroke Patients ◽  
Post Stroke ◽  
Early Supported Discharge ◽  
Significant Difference

Abstract Background and purpose Early supported discharge (ESD) has been shown to be efficient and safe as part of the stroke care pathway. The best results have been seen with a multidisciplinary team and after mild to moderate stroke. However, how very early supported discharge (VESD) works has not been studied. The aim of this study was to investigate whether VESD for stroke patients in need of ongoing individualized rehabilitation affects the level of anxiety and overall disability for the patient compared with ordinary discharge routine. Methods A randomized controlled trial was performed with intention to treat analyses comparing VESD and ordinary discharge from hospital. All patients admitted at the stroke care unit at Sahlgrenska University Hospital of Gothenburg between August 2011 and April 2016 were screened. Inclusion occurred on day 4 using a block randomization of 20 and with a blinded assessor. Assessments were made 5 days post-stroke and 3 and 12 months post-stroke. Patients in the VESD group underwent continued rehabilitation in their homes with a multidisciplinary team from the stroke care unit for a maximum of 1 month. The patients in the control group had support as usual after discharge when needed such as home care service and outpatient rehabilitation. The primary outcome was anxiety as assessed by the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A). The secondary outcome was the patients’ degree of overall disability, measured by the modified Rankin Scale (mRS). Results No significant differences were found between the groups regarding anxiety at three or 12 months post-stroke (p = 0.811). The overall disability was significantly lower in the VESD group 3 months post-stroke (p = 0.004), compared to the control group. However, there was no significant difference between the groups 1 year post-stroke. Conclusions The VESD does not affects the level of anxiety compared to ordinary rehabilitation. The VESD leads to a faster improvement of overall disability compared to ordinary rehabilitation. We suggest considering coordinated VESD for patients with mild to moderate stroke in addition to ordinary rehabilitation as part of the service from a stroke unit. Trial registration Clinical Trials.gov: NCT01622205. Registered 19 June 2012 (retrospectively registered).

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