Virtual Rehabilitation and Training for Postural Balance and Neuromuscular Control

The anatomical and physiological heterogeneity of strokes and persons with stroke, along with the complexity of normal upper extremity movement make the possibility that any single treatment approach will become the definitive solution for all persons with upper extremity hemiparesis due to stroke unlikely. This situation and the non-inferiority level outcomes identified by many studies of virtual rehabilitation are considered by some to indicate that it is time to consider other treatment modalities. Our group, among others, has endeavored to build on the initial positive outcomes in studies of virtual rehabilitation by identifying patient populations, treatment settings and training schedules that will best leverage virtual rehabilitation's strengths. We feel that data generated by our lab and others suggest that (1) persons with stroke may adapt to virtual rehabilitation of hand function differently based on their level of impairment and stage of recovery and (2) that less expensive, more accessible home based equipment seems to be an effective alternative to clinic based treatment that justifies continued optimism and study.

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Development of the Home based Virtual Rehabilitation System (HoVRS) to remotely deliver an intense and customized upper extremity training

Journal of NeuroEngineering and Rehabilitation ◽

10.1186/s12984-020-00789-w ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Qinyin Qiu ◽

Amanda Cronce ◽

Jigna Patel ◽

Gerard G. Fluet ◽

Ashley J. Mont ◽

...

Keyword(s):

Upper Extremity ◽

Chronic Stroke ◽

Hand Rehabilitation ◽

Kinematic Data ◽

Virtual Rehabilitation ◽

Home Based ◽

Rehabilitation System ◽

Kinematic Measures ◽

And Training ◽

Training Protocol

Abstract Background After stroke, sustained hand rehabilitation training is required for continuous improvement and maintenance of distal function. Methods In this paper, we present a system designed and implemented in our lab: the Home based Virtual Rehabilitation System (HoVRS). Fifteen subjects with chronic stroke were recruited to test the feasibility of the system as well as to refine the design and training protocol to prepare for a future efficacy study. HoVRS was placed in subjects’ homes, and subjects were asked to use the system at least 15 min every weekday for 3 months (12 weeks) with limited technical support and remote clinical monitoring. Results All subjects completed the study without any adverse events. Subjects on average spent 13.5 h using the system. Clinical and kinematic data were collected pre and post study in the subject’s home. Subjects demonstrated a mean increase of 5.2 (SEM = 0.69) on the Upper Extremity Fugl-Meyer Assessment (UEFMA). They also demonstrated improvements in six measurements of hand kinematics. In addition, a combination of these kinematic measures was able to predict a substantial portion of the variability in the subjects’ UEFMA score. Conclusion Persons with chronic stroke were able to use the system safely and productively with minimal supervision resulting in measurable improvements in upper extremity function.

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Development of the Home based Virtual Rehabilitation System (HoVRS) to Remotely Deliver an Intense and Customized Upper Extremity Training

10.21203/rs.3.rs-64042/v1 ◽

2020 ◽

Author(s):

Qinyin Qiu ◽

Amanda Cronce ◽

Jigna Patel ◽

Gerard G Fluet ◽

Ashley Mont ◽

...

Keyword(s):

Hand Function ◽

Chronic Stroke ◽

Hand Rehabilitation ◽

Kinematic Data ◽

Virtual Rehabilitation ◽

Home Based ◽

Rehabilitation System ◽

Kinematic Measures ◽

And Training ◽

Training Protocol

Abstract Background: After stroke, sustained hand rehabilitation training is required for continuous improvement and maintenance of distal function. Methods: In this paper, we present a system designed and implemented in our lab: the Home based Virtual Rehabilitation System (HoVRS). Fifteen subjects with chronic stroke were recruited to test the feasibility of the system as well as to refine the design and training protocol to prepare for a future efficacy study. HoVRS was placed in subjects’ homes, and subjects were asked to use the system at least 15 minutes every weekday for 3 months (12 weeks) with limited technical support and remote clinical monitoring. Results: All patients completed the study without any adverse events. Subjects on average spent 13.5 hours using the system. Clinical and kinematic data were collected pre and post study. The whole group improved on the Fugl-Meyer (FM) assessment and on six kinematic measurements. In addition, a combination of these kinematic measures was able to predict a substantial portion of subjects’ FM scores. Conclusion: The outcomes of this pilot study warrant further investigation of the system’s ability to promote recovery of hand function in subacute and chronic stroke.

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Which technical factors explain competition performance in air rifle shooting?

International Journal of Sports Science & Coaching ◽

10.1177/1747954117707481 ◽

2017 ◽

Vol 13 (1) ◽

pp. 78-85 ◽

Cited By ~ 8

Author(s):

Simo Ihalainen ◽

Kaisu Mononen ◽

Vesa Linnamo ◽

Sami Kuitunen

Keyword(s):

Postural Balance ◽

Multiple Regression Equation ◽

Team Members ◽

Training Interventions ◽

Psychological Training ◽

Technical Factors ◽

Competition Situation ◽

Study Participants ◽

And Training ◽

Air Rifle

The purpose of this study was to analyze whether the same shooting technical components determining performance in testing situation also affect performance in competition situation and how the technical skill level of these components changes from training to competition. Thirteen Finnish national (10) and junior national (3) rifle team members participated in the study. Participants were measured in competition and training situation within a five-day period. Shooting score, aiming point trajectory and postural balance were measured from both situations. Shooting performance decreased from training to competition situation (10.31 ± 0.13 vs. 10.14 ± 0.17, p < 0.05), accompanied by a decrease in holding ability, aiming accuracy, cleanness of triggering and postural balance. A multiple regression equation based on holding ability, aiming accuracy, cleanness of triggering and timing of triggering correlated with the competition situation shooting results ( R = 0.76, p < 0.01). Changes in shooting performance from training to competition situation were most strongly related to the changes in horizontal holding ability ( R = − 0.71, p < 0.01). Athletes and coaches should develop competition strategies and psychological training interventions in order to be able to maintain the horizontal holding ability in competition at training situation level.

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Concept Mapping for Virtual Rehabilitation and Training of the Blind

IEEE Transactions on Neural Systems and Rehabilitation Engineering ◽

10.1109/tnsre.2009.2032186 ◽

2010 ◽

Vol 18 (2) ◽

pp. 210-219 ◽

Cited By ~ 6

Author(s):

Jaime Sanchez ◽

Hector Flores

Keyword(s):

Concept Mapping ◽

Virtual Rehabilitation ◽

And Training

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Development of the Home based Virtual Rehabilitation System (HoVRS) to remotely deliver an intense and customized upper extremity training

10.21203/rs.3.rs-64042/v2 ◽

2020 ◽

Author(s):

Qinyin Qiu ◽

Amanda Cronce ◽

Jigna Patel ◽

Gerard G Fluet ◽

Ashley Mont ◽

...

Keyword(s):

Upper Extremity ◽

Chronic Stroke ◽

Hand Rehabilitation ◽

Kinematic Data ◽

Virtual Rehabilitation ◽

Home Based ◽

Rehabilitation System ◽

Kinematic Measures ◽

And Training ◽

Training Protocol

Abstract Background: After stroke, sustained hand rehabilitation training is required for continuous improvement and maintenance of distal function. Methods: In this paper, we present a system designed and implemented in our lab: the Home based Virtual Rehabilitation System (HoVRS). Fifteen subjects with chronic stroke were recruited to test the feasibility of the system as well as to refine the design and training protocol to prepare for a future efficacy study. HoVRS was placed in subjects’ homes, and subjects were asked to use the system at least 15 minutes every weekday for 3 months (12 weeks) with limited technical support and remote clinical monitoring. Results: All subjects completed the study without any adverse events. Subjects on average spent 13.5 hours using the system. Clinical and kinematic data were collected pre and post study in the subject’s home. Subjects demonstrated a mean increase of 5.2 (SEM=0.69) on the Upper Extremity Fugl-Meyer Assessment (UEFMA). They also demonstrated improvements in six measurements of hand kinematics. In addition, a combination of these kinematic measures was able to predict a substantial portion of the variability in the subjects’ UEFMA score. Conclusion: Persons with chronic stroke were able to use the system safely and productively with minimal supervision resulting in measurable improvements in upper extremity function.

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Learning and training of manual skills in dentistry

Journal of Dental Education ◽

10.1002/j.0022-0337.1965.29.4.tb00013.x ◽

1965 ◽

Vol 29 (4) ◽

pp. 409-418

Author(s):

WE Montague

Keyword(s):

Manual Skills ◽

And Training

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Infrastructures for research and training

Journal of Dental Education ◽

10.1002/j.0022-0337.1999.63.3.tb03273.x ◽

1999 ◽

Vol 63 (3) ◽

pp. 257-262 ◽

Cited By ~ 1

Author(s):

JJ Clarkson

Keyword(s):

And Training

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Functional Anatomy Underlying Pharyngeal Swallowing Mechanics and Swallowing Performance Goals

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig13-2018-0014 ◽

2019 ◽

Vol 4 (4) ◽

pp. 648-655

Author(s):

William G. Pearson ◽

Jacline V. Griffeth ◽

Alexis M. Ennis

Keyword(s):

Functional Anatomy ◽

Neuromuscular Control ◽

Upper Esophageal Sphincter ◽

Performance Goals ◽

Laryngeal Elevation ◽

Port Closure ◽

Swallowing Dysfunction ◽

Hyoid Movement ◽

Pharyngeal Swallowing ◽

Pharyngeal Constriction

Purpose Rehabilitation of pharyngeal swallowing dysfunction requires a thorough understanding of the functional anatomy underlying the performance goals of pharyngeal swallowing. These goals include the safe and efficient transfer of a bolus through the hypopharynx into the esophagus. Penetration or aspiration of a bolus threatens swallowing safety. Bolus residue indicates swallowing inefficiency. Several primary mechanics, or elements of the swallowing mechanism, underlie these performance goals, with some elements contributing to both goals. These primary mechanics include velopharyngeal port closure, hyoid movement, laryngeal elevation, pharyngeal shortening, tongue base retraction, and pharyngeal constriction. Each element of the swallowing mechanism is under neuromuscular control and is therefore, in principle, a potential target for rehabilitation. Secondary mechanics of pharyngeal swallowing, those movements dependent on primary mechanics, include opening the upper esophageal sphincter and epiglottic inversion. Conclusion Understanding the functional anatomy of pharyngeal swallowing underlying swallowing performance goals will facilitate anatomically informed critical thinking in the rehabilitation of pharyngeal swallowing dysfunction.

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An Exploratory Study on Augmentative and Alternative Communication Classroom Integration Training for Special Educators Who Work With Children With Complex Communication Needs in the Bahamas

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig12-2019-0007 ◽

2019 ◽

Vol 4 (5) ◽

pp. 991-1016

Author(s):

Shameka Stanford ◽

Ovetta Harris

Keyword(s):

Augmentative And Alternative Communication ◽

Special Educators ◽

Communication Disorders ◽

Alternative Communication ◽

The Bahamas ◽

Complex Communication Needs ◽

English Speaking ◽

Communication Needs ◽

Classroom Integration ◽

And Training

Purpose In 2011, the United Nations estimated there were between 180 and 220 million youth with disabilities living around the world, and 80% of them resided in developing countries. Over the last 6 years, this number has increased significantly, and now, over 1 million people live in the Caribbean with some form of disability such as communication disorders resulting in complex communication needs (CCN). Method This publication discusses the benefits of an exploratory, descriptive, nonexperimental study on augmentative and alternative communication (AAC) classroom integration training for 8 special educators in the Bahamas who work with children with CCN. Results The results of this study revealed that 100% of the participants reported the study to be effective in increasing their knowledge and skill in the area of implementing AAC into their classrooms, enhancing their ability to team teach and incorporate AAC opportunities for all students with CCN within their classrooms, and increasing their knowledge and skill overall in the areas of AAC and CCN. Conclusion The findings highlight an important area of potential professional development and training that can be replicated in other English-speaking Caribbean territories focused on AAC classroom integration training program for special educators who teach students with CCN.

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