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Scheermesser M, Baumgartner D, Nast I, Bansi J, Kool J, Bischof P, Bauer CM. Therapists and patients perceptions of a mixed reality system designed to improve trunk control and upper extremity function. Sci Rep 2024; 14:6598. [PMID: 38503795 PMCID: PMC10951291 DOI: 10.1038/s41598-024-55692-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 02/27/2024] [Indexed: 03/21/2024] Open
Abstract
A prototype system aimed at improving arm function and trunk control after stroke has been developed that combines mixed-reality (MR) feedback with a mobile seat system (Holoreach). The purpose of this study was to assess the usability of Holoreach in a rehabilitation setting from both the patient and therapist perspective. Ten therapists (eight physiotherapists and two occupational therapists) used the device in their regular therapy programs for fifteen stroke patients with trunk control issues. Each patient received four individual therapy sessions with the device performed under the supervision of the therapist. Therapists and patients kept therapy diaries and used customized questionnaires. At the end of the study two focus groups were conducted to further assess usability. Generally, the prototype system is suitable for training trunk and arm control. The therapists expressed overall positive views on the impact of Holoreach. They characterized it as new, motivating, fresh, joyful, interesting, and exciting. All therapists and 80% of the patients agreed with the statement that training with Holoreach is beneficial for rehabilitation. Nonetheless, improvements are required in the hardware and software, and design. The prototype system contributes at various levels to the rapidly evolving advances in neurorehabilitation, particularly regarding the practical aspect of exercise delivery.
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Affiliation(s)
- M Scheermesser
- School of Health Sciences, Institute of Physiotherapy, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland.
| | - D Baumgartner
- School of Engineering, Institute of Mechanical Systems IMES, Zurich University of Applied Sciences, Technikumstrasse 71, 8400, Winterthur, Switzerland
| | - I Nast
- School of Health Sciences, Institute of Physiotherapy, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland
| | - J Bansi
- Kliniken-Valens, Research and Development, Rehabilitation Centre Valens, Taminaplatz 1, 7317, Valens, Switzerland
- Department of Health, Physiotherapy, OST-University of Applied Sciences Eastern Switzerland, Rosenbergstrasse 59, 9001, St. Gallen, Switzerland
| | - J Kool
- Kliniken-Valens, Research and Development, Rehabilitation Centre Valens, Taminaplatz 1, 7317, Valens, Switzerland
| | - P Bischof
- School of Engineering, Institute of Mechanical Systems IMES, Zurich University of Applied Sciences, Technikumstrasse 71, 8400, Winterthur, Switzerland
| | - C M Bauer
- School of Health Sciences, Institute of Physiotherapy, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland.
- Lake Lucerne Institute, Seestrasse 18, 6354, Vitznau, Switzerland.
- Faculty of Sport and Health Science, University of Jyväskylä, PO Box 35, 40014, Jyvaskyla, Finland.
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Sommer B, Haas M, Karrer S, Jörger M, Graf E, Huber M, Baumgartner D, Bansi J, Kool J, Bauer C. The Effect on Muscle Activity of Reaching Beyond Arm's Length on a Mobile Seat: A Pilot Study for Trunk Control Training for People After Stroke. Arch Rehabil Res Clin Transl 2023; 5:100289. [PMID: 38163026 PMCID: PMC10757194 DOI: 10.1016/j.arrct.2023.100289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Objective This pilot study compared muscle activity during lateral reaching tasks between mobile and stable sitting using a novel therapy chair in people after stroke and healthy controls. Design Observational pilot study. Setting This study was conducted in a rehabilitation center for people after stroke and at the university's movement laboratory for healthy participants. Participants A total of eleven people after stroke and fifteen healthy people (N=26) took part. Interventions Lateral reaching exercises to the ipsilateral and contralateral sides were performed on a mobile and a stable seat. Main Outcome Measure Muscular activity of the multifidus, erector spinae and external oblique was measured bilaterally. A within-subject linear mixed model was applied to analyze the effects of seat condition, task, muscle side, and group. Results A seat condition effect was found for the multifidus and external oblique that was dependent on the muscle side and task. During ipsilateral reaching, the activity of the multifidi decreased for people after stroke on the mobile seat, while increasing for healthy participants. The erector spinae showed no condition effect. Decreased activity of the external oblique was found for both groups on the mobile seat. Conclusions Mobile sitting influences muscular activity. However, these preliminary results should be further investigated in order to generate recommendations for rehabilitation.
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Affiliation(s)
- Bettina Sommer
- School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Michelle Haas
- School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Samuel Karrer
- School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Matthias Jörger
- School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Eveline Graf
- School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Martin Huber
- School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Daniel Baumgartner
- School of Engineering, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Jens Bansi
- Physiotherapy Department, Valens Rehabilitation Centre, Valens, Switzerland
- OST, University of Applied Sciences of Eastern Switzerland, St. Gallen, Switzerland
| | - Jan Kool
- Physiotherapy Department, Valens Rehabilitation Centre, Valens, Switzerland
| | - Christoph Bauer
- School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
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Haas MC, Sommer BB, Karrer S, Jörger M, Graf ES, Huber M, Baumgartner D, Bansi J, Kool J, Bauer CM. Surface electromyographic activity of trunk muscles during trunk control exercises for people after stroke; effect of a mobile and stable seat for rehabilitation. PLoS One 2022; 17:e0272382. [PMID: 35905083 PMCID: PMC9337656 DOI: 10.1371/journal.pone.0272382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/18/2022] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to explore differences in trunk muscle activity on a stable and mobile seat for people after stroke and healthy participants. Trunk control exercises are known to have a beneficial effect on trunk control, balance, and mobility after stroke. The effect of such exercises could be enhanced by the use of a mobile seat to provide further training stimuli. However, little research on the musculoskeletal effects of trunk training on mobile seats has been carried out. On a stable and a mobile seat, thirteen people after stroke and fifteen healthy participants performed two selective trunk control exercises, which were lateral flexion initiated by the pelvis and the thorax. The maximal surface electromyography relative to static sitting of the muscles multifidus, erector spinae, and obliquus externus was recorded bilaterally. The effects of group, seat condition, trunk control exercise, and muscle side were investigated employing within-subject linear-mixed-models. Compared to the stable seat, the maximal muscle activity of people after stroke on the mobile seat was higher during the thorax-initiated exercise and lower during the pelvis-initiated exercise. Healthy participants showed opposite results with higher muscle activity on the mobile seat during the pelvis-initiated exercise. For trunk control training on a mobile seat with high muscle activation people after stroke should perform trunk control exercises initiated by the thorax, for training with lower muscle activity people after stroke should initiate selective trunk movements by the pelvis. The results can support the planning of progressive trunk control rehabilitation programs.
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Affiliation(s)
- Michelle C. Haas
- School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
- * E-mail:
| | - Bettina B. Sommer
- School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Samuel Karrer
- School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Matthias Jörger
- School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Eveline S. Graf
- School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Martin Huber
- School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Daniel Baumgartner
- School of Engineering, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Jens Bansi
- Physiotherapy Department, Valens Rehabilitation Centre, Valens, Switzerland
| | - Jan Kool
- Physiotherapy Department, Valens Rehabilitation Centre, Valens, Switzerland
| | - Christoph M. Bauer
- School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
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Tahernejad S, Choobineh A, Razeghi M, Abdoli-Eramaki M, Parsaei H, Daneshmandi H, Seif M. Investigation of office workers' sitting behaviors in an ergonomically adjusted workstation. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:2346-2354. [PMID: 34622741 DOI: 10.1080/10803548.2021.1990581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objectives. Common ergonomic office workstations are designed for a few optimum postures. Nonetheless, sitting is a dynamic activity and the ideal sitting posture is rarely maintained in practice. Therefore, the present study aimed to investigate the sitting behavior of office workers in an actual working environment using ergonomically adjusted workstations to examine whether they promote maintaining appropriate sitting postures. Methods. Sitting behaviors (frequency of postures and position changes in different body parts) were explored among 26 office workers during a 60-min sitting duration, using the posture recording and classification method developed by Graf et al. The rapid upper limb assessment (RULA) method was also used to assess postural load. Then, the results of the RULA method were compared with the results from investigating the sitting behavior of office workers. Results. Common ergonomic workstations were effective in eliminating some awkward postures. However, some important risk factors such as holding postures with an inappropriate lumbar spine curve (86% of the observations) and maintaining a posture for a long time (for 7-12 min) were observed in the participants' sitting behaviors, while they were neglected in the RULA method. Conclusions. The common ergonomic workstations could not guarantee the users' appropriate sitting behaviors.
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Affiliation(s)
| | - Alireza Choobineh
- Department of Ergonomics, Shiraz University of Medical Sciences, Iran
| | - Mohsen Razeghi
- School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Iran
| | | | - Hossein Parsaei
- School of Medicine, Shiraz University of Medical Sciences, Iran
| | - Hadi Daneshmandi
- Institute of Health, Shiraz University of Medical Sciences, Iran
| | - Mozhgan Seif
- School of Health, Shiraz University of Medical Sciences, Iran
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Is active sitting on a dynamic office chair controlled by the trunk muscles? PLoS One 2020; 15:e0242854. [PMID: 33253292 PMCID: PMC7703901 DOI: 10.1371/journal.pone.0242854] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 11/10/2020] [Indexed: 12/02/2022] Open
Abstract
Today’s office chairs are not known to promote active sitting or to activate the lumbar trunk muscles, both of which functions are ergonomically recommended. This study investigated a newly developed dynamic office chair with a moveable seat, specifically designed to promote trunk muscle controlled active sitting. The study aimed to determine the means by which the seat movement was controlled during active sitting. This was accomplished by quantifying trunk and thigh muscular activity and body kinematics. Additionally, the effect of increased spinal motion on muscular activity and body kinematics was analysed. Ten subjects were equipped with reflective body markers and surface electromyography on three lumbar back muscles (multifidus, iliocostalis, longissimus) and two thigh muscles (vastus lateralis and medialis). Subjects performed a reading task during static and active sitting in spontaneous and maximum ranges of motion in a simulated office laboratory setting. The temporal muscle activation pattern, average muscle activity and body segment kinematics were analysed and compared using Friedman and post-hoc Wilcoxon tests (p≤0.05). Active sitting on the new chair significantly affected the lumbar trunk muscles, with characteristic cyclic unloading/loading in response to the seat movement. Neither thigh muscle activity nor lateral body weight shift were substantially affected by active sitting. When participants increased their range of motion, the lumbar back muscles were activated for longer and relaxation times were shorter. The characteristic activity pattern of the lumbar trunk muscles was shown to be the most likely dominant factor in controlling seat movement during active sitting. Consequently, the new chair may have a potential positive impact on back health during prolonged sitting. Further studies are necessary to analyse the frequency and intensity of active sitting during daily office work.
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