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Çetin B, Kılınç M, Çakmaklı GY. The effects of exergames on upper extremity performance, trunk mobility, gait, balance, and cognition in Parkinson's disease: a randomized controlled study. Acta Neurol Belg 2024; 124:853-863. [PMID: 38182919 DOI: 10.1007/s13760-023-02451-3] [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: 08/17/2023] [Accepted: 11/27/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND In recent years, game-based exercises have been included more in the rehabilitation programs of Parkinson's disease (PD) patients and positive effects have been observed. AIM This study aims to investigate the effects of innovative games particularly designed for neurological patients on upper extremity performance, trunk mobility and cognition in patients with PD. METHOD Twenty-three patients were enrolled in this randomized controlled study and randomly allocated into two groups: Exergames Program (EP) and Conventional Exercise Program (CP). Both groups received supervised physiotherapy sessions for 3 days a week and 8 weeks in total (24 sessions). Each session lasted 1 h. Evaluations were applied before and after the treatment: 9-Hole Peg Test (9-HPT), Minnesota Manual Dexterity Test (MMDT), Trunk Impairment Scale (TIS), Montreal Cognitive Assessment (MoCA), Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Timed Up and Go (TUG), Functional Reach Test (FRT), and Parkinson Disease Questionnaire (PDQ-39). RESULTS Twenty patients were included in the analysis because of the dropouts. Our findings showed that both groups improved significantly in 9-HPT dominant side, MMDT, TIS, MDS-UPDRS, TUG, FRT, and PDQ-39 (p < 0.05). MoCA scores of EP group improved significantly (p < 0.05) while CP group's did not (p > 0.05). It was found that EP group had better improvements in 9-HPT dominant side, MMDT turning test, and MoCA than CP group when the differences in the changes within the groups were compared (p < 0.05). CONCLUSION Game-based training can be a useful rehabilitation tool to improve upper extremities performance, trunk mobility, cognition, functional mobility, balance, and quality of life and may have superiority over conventional exercises in improving cognition and upper extremity functions. CLINICAL TRIAL NUMBER NCT05235880. Release Date: April 1, 2022.
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Affiliation(s)
- Barış Çetin
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Muhammed Kılınç
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Gül Yalçın Çakmaklı
- Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Taraporewalla K, Barach P, van Zundert A. Teaching Medical Procedural Skills for Performance. Clin Pract 2024; 14:862-869. [PMID: 38804399 PMCID: PMC11130924 DOI: 10.3390/clinpract14030067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/03/2024] [Accepted: 05/13/2024] [Indexed: 05/29/2024] Open
Abstract
Procedures are a core element of medical professional practice. Today's training approach was formulated in the mid-twentieth century based on a computer analogue of the brain. Despite minor modifications, the system has remained relatively unchanged for the past 70 years. It delivers competence. However, competence is not reliable performance. The inability to adapt to the variety of patients and variations in the performance environments, such as the operating room, results in patient morbidity and mortality. There is a need for changes in the development and training of medical procedural skills based on current theories of skill acquisition, movement theory, and motor control. Achieving optimal performance necessitates the ability to adapt through training in diverse patient and performance environments rather than merely imitating prescribed movements. We propose a novel model of training, the Constraints-Led Approach, which allows for robust training by altering the factors affecting skill acquisition and lifelong learning.
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Affiliation(s)
- Kersi Taraporewalla
- Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Paul Barach
- Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
- Department of Surgery, Imperial College London, London SW7 2AZ, UK
- School of Medicine, Sigmund Freud University, 1020 Wien, Austria
- School of Population Health, Thomas Jefferson University, Philadelphia, PA 19144, USA
| | - André van Zundert
- Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
- Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women’s Hospital, The University of Queensland, Brisbane, QLD 4029, Australia
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Li Y, Lian Y, Chen X, Zhang H, Xu G, Duan H, Xie X, Li Z. Effect of task-oriented training assisted by force feedback hand rehabilitation robot on finger grasping function in stroke patients with hemiplegia: a randomised controlled trial. J Neuroeng Rehabil 2024; 21:77. [PMID: 38745227 PMCID: PMC11092254 DOI: 10.1186/s12984-024-01372-3] [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: 05/23/2023] [Accepted: 05/08/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Over 80% of patients with stroke experience finger grasping dysfunction, affecting independence in activities of daily living and quality of life. In routine training, task-oriented training is usually used for functional hand training, which may improve finger grasping performance after stroke, while augmented therapy may lead to a better treatment outcome. As a new technology-supported training, the hand rehabilitation robot provides opportunities to improve the therapeutic effect by increasing the training intensity. However, most hand rehabilitation robots commonly applied in clinics are based on a passive training mode and lack the sensory feedback function of fingers, which is not conducive to patients completing more accurate grasping movements. A force feedback hand rehabilitation robot can compensate for these defects. However, its clinical efficacy in patients with stroke remains unknown. This study aimed to investigate the effectiveness and added value of a force feedback hand rehabilitation robot combined with task-oriented training in stroke patients with hemiplegia. METHODS In this single-blinded randomised controlled trial, 44 stroke patients with hemiplegia were randomly divided into experimental (n = 22) and control (n = 22) groups. Both groups received 40 min/day of conventional upper limb rehabilitation training. The experimental group received 20 min/day of task-oriented training assisted by a force feedback rehabilitation robot, and the control group received 20 min/day of task-oriented training assisted by therapists. Training was provided for 4 weeks, 5 times/week. The Fugl-Meyer motor function assessment of the hand part (FMA-Hand), Action Research Arm Test (ARAT), grip strength, Modified Ashworth scale (MAS), range of motion (ROM), Brunnstrom recovery stages of the hand (BRS-H), and Barthel index (BI) were used to evaluate the effect of two groups before and after treatment. RESULTS Intra-group comparison: In both groups, the FMA-Hand, ARAT, grip strength, AROM, BRS-H, and BI scores after 4 weeks of treatment were significantly higher than those before treatment (p < 0.05), whereas there was no significant difference in finger flexor MAS scores before and after treatment (p > 0.05). Inter-group comparison: After 4 weeks of treatment, the experimental group's FMA-Hand total score, ARAT, grip strength, and AROM were significantly better than those of the control group (p < 0.05). However, there were no statistically significant differences in the scores of each sub-item of the FMA-Hand after Bonferroni correction (p > 0.007). In addition, there were no statistically significant differences in MAS, BRS-H, and BI scores (p > 0.05). CONCLUSION Hand performance improved in patients with stroke after 4 weeks of task-oriented training. The use of a force feedback hand rehabilitation robot to support task-oriented training showed additional value over conventional task-oriented training in stroke patients with hand dysfunction. CLINICAL TRIAL REGISTRATION INFORMATION NCT05841108.
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Affiliation(s)
- Yinghua Li
- Department of Rehabilitation Medicine, First Hospital of Jilin University, Changchun, China
| | - Yawen Lian
- Department of Rehabilitation Medicine, First Hospital of Jilin University, Changchun, China
| | - Xiaowei Chen
- Department of Rehabilitation Medicine, First Hospital of Jilin University, Changchun, China
| | - Hong Zhang
- Department of Rehabilitation Medicine, First Hospital of Jilin University, Changchun, China
| | - Guoxing Xu
- Department of Rehabilitation Medicine, First Hospital of Jilin University, Changchun, China
| | - Haoyang Duan
- Department of Rehabilitation Medicine, First Hospital of Jilin University, Changchun, China
| | - Xixi Xie
- Department of Rehabilitation Medicine, First Hospital of Jilin University, Changchun, China
| | - Zhenlan Li
- Department of Rehabilitation Medicine, First Hospital of Jilin University, Changchun, China.
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Chen Z, Tirosh O, Han J, Adams R, El-Ansary D, Pranata A. Lower Limb Proprioception in Low Back Pain and Its Relationship With Voluntary Postural Control. J Mot Behav 2024:1-12. [PMID: 38697938 DOI: 10.1080/00222895.2024.2341712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/08/2024] [Indexed: 05/05/2024]
Abstract
This study aimed to investigate whether patients with low back pain (LBP) had impaired lower limb proprioception and its association with somatosensory acuity. Thirty patients with LBP and 30 asymptomatic people volunteered, using Sway Discrimination Apparatus tests to assess somatosensory acuity during voluntary anteroposterior and mediolateral postural sway. Results showed significantly reduced somatosensory acuity in mediolateral sway in LBP patients (p = 0.005) with ankle, knee, and hip proprioception showing significantly impairment compared to asymptomatic controls (all p ≤ 0.012). Regression analysis showed that ankle and hip proprioception were significantly associated with somatosensory perception (0.001 ≤ p ≤ 0.026, 0.067 ≤ R2≤ 0.235). Overall, findings suggested a global deterioration of lower limb proprioception in LBP patients, with ankle and hip proprioception playing crucial role in somatosensory perception.
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Affiliation(s)
- Zhengquan Chen
- Shanghai Yangpu District Mental Health Center, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Oren Tirosh
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Jia Han
- Shanghai Yangpu District Mental Health Center, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Roger Adams
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Doa El-Ansary
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Department of Surgery, Melbourne Medical School, Melbourne, VIC, Australia
| | - Adrian Pranata
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Hawthorn, VIC, Australia
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Choo L, Novak A, Impellizzeri FM, Porter C, Fransen J. Skill acquisition interventions for the learning of sports-related skills: A scoping review of randomised controlled trials. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 72:102615. [PMID: 38401870 DOI: 10.1016/j.psychsport.2024.102615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 02/08/2024] [Accepted: 02/20/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Skill acquisition science is the study of how motor skills are acquired, developed and/or learned. There is substantive evidence for general motor skill acquisition in controlled laboratory settings yet the literature on the learning of sports-related skills is typically less conclusive. OBJECTIVES This scoping review aimed to summarise the current literature on skill acquisition intervention studies examining the learning of sports-related skills as part of a randomised controlled trial, by synthesizing and extracting the most relevant features. METHODS Four electronic databases (PsychINFO, PubMed, SPORTDiscus and Web of Science) were searched for relevant studies. The sample characteristics of these studies were extracted, and summarised. Two systematic searches of the literature were conducted. In the first search, eighty-six studies were retained. A second search was conducted in July 2022 to include new studies and specifically focused on the inclusion of within-subject design studies, resulting in the inclusion of 35 additional studies. A third search was conducted in May 2023 to include new studies resulting in the inclusion of 10 additional studies. RESULTS One hundred and thirty studies across 29 sports were included in the review. The vast majority of the studies in this scoping review (n = 104) examined the learning of a sport-related skill in participants with no experience. Twenty-eight percent of all retained studies (n = 35) considered only the learning of a golf skill, and all studies were practiced in a laboratory environment, examining closed motor skills (n = 130). The most common intervention categories reported were attention (n = 22), instruction and demonstration (n = 20), practice design (n = 20), and perceptual training (n = 19). Nearly half of all studies used an immediate retention test within 48 h of the cessation of practice (n = 63), and just over one quarter of studies (n = 34) reported incorporating some form of transfer test. Eighty-six percent (n = 112) reported positive findings. CONCLUSIONS The skewed focus on golf skills across a small number of skill acquisition interventions, the inconsistent use and reporting of performance measures, practice durations and measures of learning alongside the relatively small sample sizes consisting mostly of inexperienced learners and the skewed publication of positive findings should warrant caution. More empirical studies across a broader range of sports and with more consistent methodologies are needed to develop a robust pool of literature that can support academics and practitioners interested in which skill acquisition interventions could be used to influence the learning of sports-related skills.
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Affiliation(s)
- Leanne Choo
- Human Performance Research Centre, School of Sport, Exercise and Rehabilitation, Faculty of Health, University of Technology Sydney, Moore Park, Australia
| | - Andrew Novak
- Human Performance Research Centre, School of Sport, Exercise and Rehabilitation, Faculty of Health, University of Technology Sydney, Moore Park, Australia
| | - Franco M Impellizzeri
- Human Performance Research Centre, School of Sport, Exercise and Rehabilitation, Faculty of Health, University of Technology Sydney, Moore Park, Australia
| | - Courtney Porter
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia; Sport Performance Innovation and Knowledge Excellence, Queensland Academy of Sport, Brisbane, Australia
| | - Job Fransen
- Human Movement Sciences, University Medical Centre Groningen, Groningen, the Netherlands; School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Port Macquarie, Australia.
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Kleeren L, Mailleux L, McLean B, Elliott C, Dequeker G, Van Campenhout A, de Xivry JJO, Verheyden G, Ortibus E, Klingels K, Feys H. Does somatosensory discrimination therapy alter sensorimotor upper limb function differently compared to motor therapy in children and adolescents with unilateral cerebral palsy: study protocol for a randomized controlled trial. Trials 2024; 25:147. [PMID: 38409060 PMCID: PMC10895830 DOI: 10.1186/s13063-024-07967-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/05/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Besides motor impairments, up to 90% of the children and adolescents with unilateral cerebral palsy (uCP) present with somatosensory impairments in the upper limb. As somatosensory information is of utmost importance for coordinated movements and motor learning, somatosensory impairments can further compromise the effective use of the impaired upper limb in daily life activities. Yet, intervention approaches specifically designated to target these somatosensory impairments are insufficiently investigated in children and adolescents with uCP. Therefore, the aim of this randomized controlled trial (RCT) is to compare the effectiveness of somatosensory discrimination therapy and dose-matched motor therapy to improve sensorimotor upper limb function in children and adolescents with uCP, who experience somatosensory impairments in the upper limb. We will further explore potential behavioral and neurological predictors of therapy response. METHODS A parallel group, evaluator-blinded, phase-II, single-center RCT will be conducted for which 50 children and adolescents with uCP, aged 7 to 15 years, will be recruited. Participants will be randomized to receive 3 weekly sessions of 45 minutes of either somatosensory discrimination therapy or upper limb motor therapy for a period of 8 weeks. Stratification will be performed based on age, manual ability, and severity of tactile impairment at baseline. Sensorimotor upper limb function will be evaluated at baseline, immediately after the intervention and after 6 months follow-up. The primary outcome measure will be bimanual performance as measured with the Assisting Hand Assessment. Secondary outcomes include a comprehensive test battery to objectify somatosensory function and measures of bimanual coordination, unimanual motor function, and goal attainment. Brain imaging will be performed at baseline to investigate structural brain lesion characteristics and structural connectivity of the white matter tracts. DISCUSSION This protocol describes the design of an RCT comparing the effectiveness of somatosensory discrimination therapy and dose-matched motor therapy to improve sensorimotor upper limb function in children and adolescents with uCP. The results of this study may aid in the selection of the most effective upper limb therapy, specifically for children and adolescents with tactile impairments. TRIAL REGISTRATION ClinicalTrials.gov (NCT06006065). Registered on August 8, 2023.
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Affiliation(s)
- Lize Kleeren
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Leuven, B-3001, Belgium.
- KU Leuven, Child and Youth Institute, Leuven, B-3000, Belgium.
- Hasselt University, Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Diepenbeek, B-3590, Belgium.
| | - Lisa Mailleux
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Leuven, B-3001, Belgium
- KU Leuven, Child and Youth Institute, Leuven, B-3000, Belgium
| | - Belinda McLean
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Kids Rehab WA, Telethon Kids Institute, Perth, Australia
| | - Catherine Elliott
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Kids Rehab WA, Telethon Kids Institute, Perth, Australia
| | - Griet Dequeker
- University Hospitals Leuven, Cerebral Palsy Reference Centre, Leuven, B-3000, Belgium
| | - Anja Van Campenhout
- KU Leuven, Child and Youth Institute, Leuven, B-3000, Belgium
- University Hospitals Leuven, Cerebral Palsy Reference Centre, Leuven, B-3000, Belgium
- KU Leuven, Department of Development and Regeneration, Leuven, B-3000, Belgium
| | - Jean-Jacques Orban de Xivry
- KU Leuven, Leuven Brain Institute, Leuven, B-3000, Belgium
- KU Leuven, Department of Movement Sciences, Research Group of Motor Control and Neuroplasticity, Leuven, B-3000, Belgium
| | - Geert Verheyden
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Leuven, B-3001, Belgium
| | - Els Ortibus
- KU Leuven, Child and Youth Institute, Leuven, B-3000, Belgium
- University Hospitals Leuven, Cerebral Palsy Reference Centre, Leuven, B-3000, Belgium
- KU Leuven, Department of Development and Regeneration, Leuven, B-3000, Belgium
| | - Katrijn Klingels
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Leuven, B-3001, Belgium
- Hasselt University, Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Diepenbeek, B-3590, Belgium
| | - Hilde Feys
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Leuven, B-3001, Belgium
- KU Leuven, Child and Youth Institute, Leuven, B-3000, Belgium
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Lassi M, Dalise S, Bandini A, Spina V, Azzollini V, Vissani M, Micera S, Mazzoni A, Chisari C. Neurophysiological underpinnings of an intensive protocol for upper limb motor recovery in subacute and chronic stroke patients. Eur J Phys Rehabil Med 2024; 60:13-26. [PMID: 37987741 DOI: 10.23736/s1973-9087.23.07922-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
BACKGROUND Upper limb (UL) motor impairment following stroke is a leading cause of functional limitations in activities of daily living. Robot-assisted therapy supports rehabilitation, but how its efficacy and the underlying neural mechanisms depend on the time after stroke is yet to be assessed. AIM We investigated the response to an intensive protocol of robot-assisted rehabilitation in sub-acute and chronic stroke patients, by analyzing the underlying changes in clinical scores, electroencephalography (EEG) and end-effector kinematics. We aimed at identifying neural correlates of the participants' upper limb motor function recovery, following an intensive 2-week rehabilitation protocol. DESIGN Prospective cohort study. SETTING Inpatients and outpatients from the Neurorehabilitation Unit of Pisa University Hospital, Italy. POPULATION Sub-acute and chronic stroke survivors. METHODS Thirty-one stroke survivors (14 sub-acute, 17 chronic) with mild-to-moderate UL paresis were enrolled. All participants underwent ten rehabilitative sessions of task-oriented exercises with a planar end-effector robotic device. All patients were evaluated with the Fugl-Meyer Assessment Scale and the Wolf Motor Function Test, at recruitment (T0), end-of-treatment (T1), and one-month follow-up (T2). Along with clinical scales, kinematic parameters and quantitative EEG were collected for each patient. Kinematics metrics were related to velocity, acceleration and smoothness of the movement. Relative power in four frequency bands was extracted from the EEG signals. The evolution over time of kinematic and EEG features was analyzed, in correlation with motor recovery. RESULTS Both groups displayed significant gains in motility after treatment. Sub-acute patients displayed more pronounced clinical improvements, significant changes in kinematic parameters, and a larger increase in Beta-band in the motor area of the affected hemisphere. In both groups these improvements were associated to a decrease in the Delta-band of both hemispheres. Improvements were retained at T2. CONCLUSIONS The intensive two-week rehabilitation protocol was effective in both chronic and sub-acute patients, and improvements in the two groups shared similar dynamics. However, stronger cortical and behavioral changes were observed in sub-acute patients suggesting different reorganizational patterns. CLINICAL REHABILITATION IMPACT This study paves the way to personalized approaches to UL motor rehabilitation after stroke, as highlighted by different neurophysiological modifications following recovery in subacute and chronic stroke patients.
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Affiliation(s)
- Michael Lassi
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Stefania Dalise
- Neurorehabilitation Unit, Pisa University Hospital, Pisa, Italy
| | - Andrea Bandini
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
- Health Science Interdisciplinary Research Center, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Vincenzo Spina
- Neurorehabilitation Unit, Pisa University Hospital, Pisa, Italy
| | | | - Matteo Vissani
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
- Harvard Medical School, Boston, MA, USA
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
| | - Silvestro Micera
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
- Bertarelli Foundation Chair in Translational Neural Engineering, Center for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fèdèrale de Lausanne, Lausanne, Switzerland
| | - Alberto Mazzoni
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Carmelo Chisari
- Neurorehabilitation Unit, Pisa University Hospital, Pisa, Italy -
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Taghizadeh A, Webster KE, Bhopti A, Hoare B. Development and content validation of the Upper Limb-Motor Learning Strategy Tool for cerebral palsy. Disabil Rehabil 2024:1-9. [PMID: 38279790 DOI: 10.1080/09638288.2024.2307382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 01/14/2024] [Indexed: 01/29/2024]
Abstract
PURPOSE To describe the development and content validation of the Upper Limb-Motor Learning Strategy Tool (UL-MLST) that aims to guide clinicians on how to implement and document the motor learning strategies used in the upper limb therapy approaches for children with cerebral palsy. METHODS The study consists of two main stages (1) item generation and development and (2) content validation and refinement. The UL-MLST Online Training Program, Manual and Checklist were developed by the authorship group in stage one. In stage 2, two experts evaluated the UL-MLST regarding the Relevance, Coherence, and Significance of the individual strategies and whether the tool is Relevant, Comprehensive, and Clinically useful. RESULTS Of sixty-two strategies included in the UL-MLST, 52 strategies were rated as being either "Moderately" or "Highly" Relevant, Coherent, and Significant. Ten strategies did not achieve mutual agreement; however, they did not meet the criteria for deletion and were revised according to expert feedback. Overall, the UL-MST was judged to be Relevant, Comprehensive, and Clinically useful. CONCLUSIONS The UL-MLST provides a valid tool to support clinicians in the implementation of the motor learning strategies for children with cerebral palsy.IMPLICATIONS FOR REHABILITATIONThe Upper Limb- Motor Learning Strategy Tool (UL-MLST) Online Training Program, Manual, and Checklist provide a comprehensive package of resources to support the application of motor learning strategies in upper limb therapy for children with cerebral palsy.The UL-MLST provides clinicians with a valid tool for self-appraising the implementation of motor learning-based therapies.The tool has the potential to improve fidelity, enhance the quality, and ensure consistency of evidence-based, task-focused approaches of therapy.
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Affiliation(s)
- Atefeh Taghizadeh
- Discipline of Occupational Therapy, La Trobe University, Melbourne, Australia
| | - Kate E Webster
- Department of Sport Exercise and Nutrition Sciences, La Trobe University, Melbourne, Australia
| | - Anoo Bhopti
- Discipline of Occupational Therapy, La Trobe University, Melbourne, Australia
- Department of Occupational Therapy, Monash University, Melbourne, Australia
| | - Brian Hoare
- Discipline of Occupational Therapy, La Trobe University, Melbourne, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
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Lai CC, Hsieh HC, Lee WK, Lin CH, Lin HY. Application of remodeled glove puppetry for children with developmental disabilities: a randomized controlled trial. Assist Technol 2023:1-8. [PMID: 37796439 DOI: 10.1080/10400435.2023.2267626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 10/01/2023] [Indexed: 10/06/2023] Open
Abstract
This study aimed to improve hand performance and play behavior in children with developmental disabilities (DD) using a remodeled glove puppetry approach. Overall, 62 children with DD were randomly assigned to experimental and control groups (n = 31 each). The experimental group underwent a 12-week rehabilitation program by playing with the remodeled glove puppetry, while the children in the control group played with non-remodeled glove puppetry. The Chinese puppet was remodeled using a Lego EV3® robot. Hand kinematics were analyzed through the Siliconcoach® Pro 7 software, which measured the force produced by the baseline ® hydraulic pinch gauge. Play behavior was measured using the Knox Preschool Play Scale-revised (KPPS-r). The experimental group exhibited significant improvements compared to the control group in hand kinematics (wrist range of motion [ROM], p < .05; metacarpophalangeal ROM, p < .05; proximal interphalangeal ROM, p < .05) and KPPS-r scores (space management, p < .05; material management, p < .05; pretense-symbolic, p < .05; participation, p < .05). After the 12-week rehabilitation with the remodeled glove puppetry, the experimental group exhibited significant improvement in kinematics and KPPS-r scores.
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Affiliation(s)
- Chia Ching Lai
- Department of Child Care and Education, Ling Tung University, Taichung, Taiwan
| | - Hsieh-Chun Hsieh
- Department of Special Education, National Tsing Hua University, Hsinchu, Taiwan
| | - Wai-Keung Lee
- Ministry of Health and Welfare, Taoyuan General Hospital, Taoyuan, Taiwan
| | - Chien-Heng Lin
- Department of Psychiatry, National Taiwan University Hospital Chu-Tung Branch, Hsinchu, Taiwan
| | - Hung-Yu Lin
- Department of Occupational Therapy, Asia University, Taichung, Taiwan
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Kanitkar A, Parmar ST, Szturm TJ, Restall G, Rempel GR, Sepehri N, Naik N. Evaluation of a computer game-assisted rehabilitation program for manual dexterity of children with cerebral palsy: Feasibility randomized control trial. PM R 2023; 15:1280-1291. [PMID: 36655404 DOI: 10.1002/pmrj.12947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 12/18/2022] [Accepted: 12/21/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND There is a need for innovation to improve the engagement and compliance of rehabilitation programs for children with upper extremity (UE) motor impairments due to cerebral palsy (CP); a computer games-based rehabilitation platform (GRP) was developed to address this need. The GRP provides engaging task-specific exercises targeting manual dexterity (object handling and manipulation). OBJECTIVE To evaluate the therapeutic value and treatment effect size of an exercise program using the GRP in children with CP. METHODS A total of 63 children with CP, aged 4 to 10 years, were recruited. The Peabody Developmental Motor Scale-2 (PDMS-2) Grasp and Visual-Motor Integration (VMI) subscores and Computer game-based Upper Extremity (CUE) assessment of manual dexterity were used to assess participants before and after a 16-week intervention program, delivered three times per week. The experimental group (XG) received a computer games-based exercise program targeting object manipulation tasks. The active control arm (CG) consisted of task-specific training similar to the tasks used in constrained induced movement therapy. RESULTS There were only a few dropouts during the 16-week program, and compliance was high. Both groups showed significant improvements with medium to large effect sizes. Improvements in the PDMS-2 Grasp and VMI subscores observed in the XG were significantly greater than that in the CG. There were significant improvements (p < .01) in PDMS-2 grasp and VMI subscores for XG with moderate to large effect sizes (0.5-0.8). For CG, the Grasp and VMI subscores did improve but these changes were not statistically significant. There was a significant improvement observed in the majority of CUE object manipulation test scores for XG (p < .01) with moderate to large effect sizes (0.50-1.2) Although CG did show improvements in all CUE object manipulation test scores, the changes did not reach statistical significance (p < .01). CONCLUSION This study demonstrates the utility of the GRP to practice a broad range of object manipulation tasks in children with CP. The present findings are positive and support further research and development. The long-term effects of the GRP program in children with CP will need to be confirmed in a future randomized controlled trial. In addition to measures of structure and function, future trials should also include outcome measures such as health-related quality of life and level of participation to validate the findings.
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Affiliation(s)
- Anuprita Kanitkar
- College of rehabilitation sciences, University of Manitoba, Winnipeg, Canada
| | | | - Tony Joseph Szturm
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Gayle Restall
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Gina Ruth Rempel
- Max Rady College of Medicine, Rady Faculty of Health Sciences, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
| | - Nariman Sepehri
- Faculty of Engineering, University of Manitoba, Winnipeg, Canada
| | - Nilahri Naik
- Ushas' School for Exceptional Children, Hubli, India
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Kilcioglu S, Schiltz B, Araneda R, Bleyenheuft Y. Short- to Long-Term Effects of Virtual Reality on Motor Skill Learning in Children With Cerebral Palsy: Systematic Review and Meta-Analysis. JMIR Serious Games 2023; 11:e42067. [PMID: 37698895 PMCID: PMC10523212 DOI: 10.2196/42067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 04/24/2023] [Accepted: 07/18/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Many studies have started integrating virtual reality (VR) into neurorehabilitation for children with cerebral palsy (CP). The results of the effects of VR on motor skill learning, including the short- to long-term results of relevant studies, must be pooled in a generic framework. OBJECTIVE This systematic review and meta-analysis aimed to investigate the short- to long-term effects of therapies including VR on motor skill learning in children with CP. METHODS Two examiners followed the inclusion and exclusion criteria of the "Participant, Intervention, Control, and Outcome" framework. Randomized controlled trials (RCTs) and non-RCTs were considered if they compared VR-included interventions with control groups on motor functions and daily life activities in children with CP. PubMed, ScienceDirect, Embase, and IEEE Xplore databases were searched. The modified Downs and Black assessment was used to assess the methodological quality of the included studies. Meta-analyses and subgroup analyses for RCTs were conducted whenever possible. RESULTS A total of 7 RCTs, 2 non-RCTs, and 258 children with CP were included. The priority focus of 78% (7/9) of the studies was upper limb functions. There was a significant short-term effect of adding VR to conventional therapies on upper limb functions when compared with conventional therapies (P=.04; standardized mean difference [SMD]=0.39, 95% CI 0.01-0.76). The overall medium- to long-term effects showed a trend toward favoring the VR group, although the difference was not statistically significant (P=.06; SMD=0.37, 95% CI -0.02 to 0.77). For balance (P=.06; SMD=1.04, 95% CI -0.04 to 2.12), gross motor functions (P=.30; SMD=2.85, 95% CI -2.57 to 8.28), and daily life activities outcomes (P=.21; SMD=0.29, 95% CI -0.16 to 0.74), the overall effect in the short term also showed a trend toward favoring the VR group, but these results were not statistically significant. CONCLUSIONS VR seems to have additional benefits for motor skill learning in children with CP. Studies with follow-up outcomes of VR training focusing on balance and gross motor functions in patients with CP were quite limited. Future research on balance and gross motor function outcomes should target particularly long-term results of therapies including VR on motor skill learning. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42021227734; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021227734.
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Affiliation(s)
- Seyma Kilcioglu
- Institute of Neuroscience, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Benoît Schiltz
- Institute of Neuroscience, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Rodrigo Araneda
- Institute of Neuroscience, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
- Exercise and Rehabilitation Science Institute, School of Physical Therapy, Faculty of Rehabilitation Science, Universidad Andrés Bello, Santiago, Chile
| | - Yannick Bleyenheuft
- Institute of Neuroscience, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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Rao KN, Arora RD, Singh A, Dange P, Nagarkar NM. Observational Learning in Surgical Skill Development. Indian J Surg Oncol 2023; 14:540-544. [PMID: 37900636 PMCID: PMC10611665 DOI: 10.1007/s13193-023-01798-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/04/2023] [Indexed: 10/31/2023] Open
Abstract
Observation plays a key role in the development of surgical skills, as it allows trainees to learn from experts and improve their performance through trial-and-error practice. This process, known as motor learning, involves the creation of new neural pathways that enable precise control of surgical instruments through hand movements. In recent years, there has been a shift towards minimally invasive surgery, which requires surgeons to continually learn new motor skills to control specialized instrumentation. Motor learning can be enhanced through repetition and the observation of expert performances. Observational learning is particularly useful when it is used in combination with physical practice, as it can provide hints and clues about important aspects of the task that may not be immediately apparent through verbal instruction alone. The role of mirror neurons, which are activated both when an action is performed and when it is observed, is also important in the process of observational learning. By understanding the mechanisms behind observational learning and the factors that influence its effectiveness, trainers can optimize the use of this method in surgical training.
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Affiliation(s)
- Karthik Nagaraja Rao
- Head Neck Surgery and Oncology, Department of Head and Neck Oncology, All India Institute of Medical Sciences, Raipur, India
| | - Ripu Daman Arora
- Department of Otolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, Raipur, India
| | - Ambesh Singh
- Head Neck Surgery and Oncology, Department of Head and Neck Oncology, All India Institute of Medical Sciences, Raipur, India
| | - Prajwal Dange
- Head Neck Surgery and Oncology, Department of Head and Neck Oncology, All India Institute of Medical Sciences, Raipur, India
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Saussez G, Bailly R, Araneda R, Paradis J, Ebner-Karestinos D, Klöcker A, Sogbossi ES, Riquelme I, Brochard S, Bleyenheuft Y. Efficacy of integrating a semi-immersive virtual device in the HABIT-ILE intervention for children with unilateral cerebral palsy: a non-inferiority randomized controlled trial. J Neuroeng Rehabil 2023; 20:98. [PMID: 37516873 PMCID: PMC10385889 DOI: 10.1186/s12984-023-01218-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 07/13/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND The implementation of virtual devices can facilitate the role of therapists (e.g., patient motivation, intensity of practice) to improve the effectiveness of treatment for children with cerebral palsy. Among existing therapeutic devices, none has been specifically designed to promote the application of principles underlying evidence-based motor skill learning interventions. Consequently, evidence is lacking regarding the effectiveness of virtual-based sessions in motor function rehabilitation with respect to promoting the transfer of motor improvements into daily life activities. We tested the effectiveness of implementing a recently developed virtual device (REAtouch®), specifically designed to enable the application of therapeutic motor skill learning principles, during a Hand Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) intervention. METHODS Forty children with unilateral cerebral palsy (5-18 years; MACS I-III; GMFCS I-II) were randomly assigned to a control group or a "REAtouch®" experimental group for a 90-h HABIT-ILE day-camp intervention (two weeks). Children in the REAtouch® group spent nearly half of their one-on-one therapeutic time using the REAtouch®. Participants underwent three testing sessions: the week before (T1), after intervention (T2), and at three months follow-up (T3). The primary outcome was the Assisting Hand Assessment (T3-T1; blinded). Secondary outcomes measured uni-bimanual hand function, stereognosis, gait endurance, daily life abilities, and functional goals. Accelerometers and a manual report of daily activities served to document therapeutic dosage and treatment characteristics. We used one-way RMANOVA to compare the efficacies of the two interventions, and non-inferiority analyses to contrast changes in the "REAtouch®" group versus the "HABIT-ILE" control group. RESULTS We found significant improvements in both groups for most of the outcome measures (p < 0.05). There was significant non-inferiority of changes in the REAtouch® group for upper extremities motor function, functional goals attainment, and abilities in daily life activities (p < 0.05). CONCLUSIONS Use of the REAtouch® device during HABIT-ILE showed non-inferior efficacy compared to the conventional evidence-based HABIT-ILE intervention in children with unilateral cerebral palsy. This study demonstrates the feasibility of using this virtual device in a high dosage camp model, and establishes the possibility of applying the therapeutic principles of motor skill learning during specifically designed virtual-based sessions. TRIAL REGISTRATION Trial registration number: NCT03930836-Registration date on the International Clinical Trials Registry Platform (ICTRP): June 21th, 2018; Registration date on NIH Clinical Trials Registry: April 29th, 2019. First patient enrollment: July 3rd, 2018.
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Affiliation(s)
- G Saussez
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium.
- Motor Sciences department, FfH Lab, CeREF Santé, HELHa, Rue Trieu Kaisin, 136, 6061, Montignies-Sur-Sambre, Belgium.
| | - R Bailly
- Fondation Ildys, Brest, France
- Laboratoire de Traitement de l'information Médicale (LaTIM), Inserm U1101, Université Bretagne Occidentale, Brest, France
| | - R Araneda
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium
- Exercise and Rehabilitation Science Institute, School of Physical Therapy, Faculty of Rehabilitation Science, Universidad Andres Bello, Santiago, Chile
| | - J Paradis
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - D Ebner-Karestinos
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium
- Exercise and Rehabilitation Science Institute, School of Physical Therapy, Faculty of Rehabilitation Science, Universidad Andres Bello, Santiago, Chile
| | - A Klöcker
- Haute Ecole Leonard de Vinci, Parnasse-ISEI, Brussels, Belgium
| | - E S Sogbossi
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium
- School of Physical Therapy, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - I Riquelme
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, Palma, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain
| | - S Brochard
- Fondation Ildys, Brest, France
- Laboratoire de Traitement de l'information Médicale (LaTIM), Inserm U1101, Université Bretagne Occidentale, Brest, France
| | - Y Bleyenheuft
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium
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Rocco K, Drobnyk W, Bruce S, Soumerai SB. Ayres Sensory Integration Therapy for a Child With Rett Syndrome: A Case Report. Clin Med Insights Pediatr 2023; 17:11795565231188939. [PMID: 37529622 PMCID: PMC10387803 DOI: 10.1177/11795565231188939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 07/03/2023] [Indexed: 08/03/2023] Open
Abstract
Rett syndrome (RTT) is a neurodevelopmental disorder characterized by severe dyspraxia, hand stereotypies, and sensory processing issues for which there is no known treatment. This case describes a child with classic RTT and the child's responses to an Ayres Sensory Integration (ASI) treatment intervention (36 one-hour sessions, 3 per week). We coded and analyzed 36 detailed treatment notes to answer the following questions: What strategies and factors facilitated or interfered with participation in the intervention? What critical elements of treatment documentation might detect small changes in praxis and participation? How do patterns of motor or praxis milestones that emerge over time relate to this child's level of participation? We observed an increase in participation when the therapist incorporated elements of neurodevelopmental treatment (NDT) and motor learning theory- treatment strategies commonly used with children who have neuromotor conditions. This increase in participation in the ASI intervention emerged at approximately the same time that the therapist documented acquisition of new motor and praxis skills. We observed the importance of using: lateral movement activities to develop weight-shifting and bilateral coordination, rotary play to increase trunk rotation and improve postural transitions, and rhythm to promote continuing or initiating actions. The documentation of the specific amounts of assistance and prompting needed during treatment sessions was an important tool for tracking small yet meaningful responses to treatment. This case illustrates a novel use of ASI intervention supplemented with strategies that developed foundational skills, and the emergence of praxis and participation in the therapeutic intervention. We suggest further research is needed to determine efficacy of ASI for other children with this rare disorder.
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Affiliation(s)
| | | | - Susan Bruce
- Special Education, Curriculum & Instruction, Boston College, Chestnut Hill, MA, USA
| | - Stephen B Soumerai
- Department of Population Medicine and Harvard Pilgrim Healthcare Institute, Harvard Medical School, Boston, MA, USA
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15
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Duff SV, Kimbel JD, Grant-Beuttler M, Sukal-Moulton T, Moreau NG, Friel KM. Lifelong Fitness in Ambulatory Children and Adolescents with Cerebral Palsy II: Influencing the Trajectory. Behav Sci (Basel) 2023; 13:504. [PMID: 37366756 PMCID: PMC10295269 DOI: 10.3390/bs13060504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 06/28/2023] Open
Abstract
Physical activity of at least moderate intensity in all children contributes to higher levels of physical and psychological health. While essential, children with cerebral palsy (CP) often lack the physical capacity, resources, and knowledge to engage in physical activity at a sufficient intensity to optimize health and well-being. Low levels of physical activity place them at risk for declining fitness and health, contributing to a sedentary lifestyle. From this perspective, we describe a framework to foster a lifelong trajectory of fitness in ambulatory children with CP (GMFCS I-III) as they progress into adolescence and adulthood, implemented in conjunction with a training program to augment bone and muscle health. First, we recommend that altering the fitness trajectory of children with CP will require the use of methods to drive behavioral change prior to adolescence. Second, to promote behavior change, we suggest embedding lifestyle intervention into fitness programming while including meaningful activities and peer socialization to foster self-directed habit formation. If the inclusion of lifestyle intervention to drive behavior change is embedded into fitness programs and found to be effective, it may guide the delivery of targeted programming and community implementation. Participation in comprehensive programming could alter the long-term trajectory of musculoskeletal health while fostering strong self-efficacy in persons with CP.
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Affiliation(s)
- Susan V. Duff
- Department of Physical Therapy, Crean College of Health and Behavioral Sciences, Chapman University, Irvine, CA 92618, USA;
| | - Justine D. Kimbel
- Department of Physical Therapy, Crean College of Health and Behavioral Sciences, Chapman University, Irvine, CA 92618, USA;
| | - Marybeth Grant-Beuttler
- Department of Physical Therapy, Oregon Institute of Technology, Klamath Falls, OR 97601, USA;
| | - Theresa Sukal-Moulton
- Department of Physical Therapy & Human Movement Sciences, Northwestern University, Chicago, IL 60611, USA;
| | - Noelle G. Moreau
- Department of Physical Therapy, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA;
| | - Kathleen M. Friel
- Burke Neurological Institute, Weill Cornell Medicine, White Plains, NY 10605, USA;
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16
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Paraskevopoulos E, Pamboris GM, Papandreou M. The Changing Landscape in Upper Limb Sports Rehabilitation and Injury Prevention. Sports (Basel) 2023; 11:sports11040080. [PMID: 37104154 PMCID: PMC10145846 DOI: 10.3390/sports11040080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 04/28/2023] Open
Abstract
This editorial aims to feature authors who intend to submit their research to this Special Issue of Sports entitled "Clinical Advances in Upper Limb Sports Rehabilitation and Injury Prevention" in areas that need special consideration [...].
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Affiliation(s)
- Eleftherios Paraskevopoulos
- Department of Physiotherapy, University of West Attica, 12243 Athens, Greece
- Laboratory of Advanced Physiotherapy, University of West Attica, 12243 Athens, Greece
| | - George M Pamboris
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia 2404, Cyprus
| | - Maria Papandreou
- Department of Physiotherapy, University of West Attica, 12243 Athens, Greece
- Laboratory of Advanced Physiotherapy, University of West Attica, 12243 Athens, Greece
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17
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Spalding K, Gustafsson L, Di Tommaso A. Evaluation of an inpatient occupation-based group program using a process evaluation framework. Aust Occup Ther J 2023; 70:32-42. [PMID: 35854625 PMCID: PMC10083955 DOI: 10.1111/1440-1630.12829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/25/2022] [Accepted: 06/28/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Occupation-based groups are used in inpatient rehabilitation to enhance delivery and intensity of intervention; however, little research is available to understand their effectiveness. The aim of this study was to examine the process of an occupation-based group to understand mechanisms and success factors. METHODS A mixed methods process evaluation using an evidence-based framework guided implementation and analysis. Participants were those involved in the 'LifeSkills' group run daily in an adult inpatient general rehabilitation ward. Quantitative administrative data, goal achievement outcome measures, group observations and qualitative semistructured interviews were conducted. RESULTS Thirty participants were recruited. Factors for success included consistency in group structure and support, using meaningful practise opportunities and facilitating a real-world experience. There was no significant relationship between patient outcomes and dose of training or patient demographics. CONCLUSION This evaluation contributes to a growing body of evidence for incorporating occupation-based approaches into rehabilitation and offers insights into practice implementation.
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Affiliation(s)
- Kaitlyn Spalding
- Discipline of Occupational Therapy, School of Health Sciences and Social WorkGriffith UniversityNathanQueenslandAustralia
- Occupational Therapy Department, Surgical Treatment and Rehabilitation ServiceBrisbaneQueenslandAustralia
- Occupational Therapy DepartmentRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| | - Louise Gustafsson
- Discipline of Occupational Therapy, School of Health Sciences and Social WorkGriffith UniversityNathanQueenslandAustralia
| | - Amelia Di Tommaso
- Discipline of Occupational Therapy, School of Health Sciences and Social WorkGriffith UniversityNathanQueenslandAustralia
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18
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Frayne DH, Norman-Gerum VT, Howarth SJ, Brown SH. Synergistic control of hand position, velocity, and acceleration fluctuates across time during simulated Nordic skiing. Hum Mov Sci 2022; 86:103014. [DOI: 10.1016/j.humov.2022.103014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 09/06/2022] [Accepted: 09/27/2022] [Indexed: 11/04/2022]
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Sevitz JS, Borders JC, Dakin AE, Kiefer BR, Alcalay RN, Kuo SH, Troche MS. Rehabilitation of Airway Protection in Individuals With Movement Disorders: A Telehealth Feasibility Study. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2741-2758. [PMID: 36279509 PMCID: PMC9911128 DOI: 10.1044/2022_ajslp-22-00063] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/02/2022] [Accepted: 07/28/2022] [Indexed: 05/03/2023]
Abstract
PURPOSE Airway protective deficits (swallowing and cough) greatly reduce health and quality of life and are a pervasive consequence of neurodegenerative movement disorders. Expiratory muscle strength training (EMST) and cough skill training (CST) are two treatment approaches to improve airway protection; however, many patients are unable to access these treatments. Telehealth may improve access to care, but it remains unknown whether these treatments are feasible and efficacious via telehealth. This study aimed to determine the practical feasibility and preliminary treatment effect of EMST and CST via telehealth. METHOD Twenty participants with movement disorders completed 4 weeks of EMST and 2 weeks of CST, including two clinician-directed treatment sessions via telehealth and 3 days of home practice per week. Feasibility was calculated for each treatment. Practical feasibility was defined as completing treatment (EMST or CST) and obtaining the relevant outcome measures-a proxy of maximum expiratory pressure (pMEP) for EMST and peak expiratory flow rate (PEFR) for CST-within a 30-min session/period. Session factors that may have influenced feasibility were examined. Preliminary treatment effect was defined as changes in pMEP and PEFR. RESULTS Time taken to obtain pMEP and complete EMST was 17.48 min, and time taken to obtain PEFR and complete CST was 17.69 min. pMEP, single voluntary cough PEFR, and sequential voluntary cough PEFR increased from pre- to posttreatment. CONCLUSIONS Findings suggest that the delivery of EMST and CST is feasible via telehealth and yield improvements to pMEP and PEFR. This has important implications for expanding service delivery of airway protective interventions and reducing health care disparities in people with neurodegenerative movement disorders. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21357669.
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Affiliation(s)
- Jordanna S Sevitz
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - James C Borders
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Avery E Dakin
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Brianna R Kiefer
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN
| | - Roy N Alcalay
- Department of Neurology, Columbia University Irving Medical Center, New York, NY
- Department of Neurology, Tel Aviv Sourasky Medical Center, Israel
| | - Sheng-Han Kuo
- Department of Neurology, Columbia University Irving Medical Center, New York, NY
| | - Michelle S Troche
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
- Department of Neurology, Columbia University Irving Medical Center, New York, NY
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20
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Nanbancha A, Mawhinney C, Sinsurin K. The effect of motor imagery and action observation in the rehabilitation of lower limb injuries: A scoping review. Clin Rehabil 2022; 37:145-161. [PMID: 36050928 DOI: 10.1177/02692155221123546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To synthesize research literature, which has investigated the application of motor imagery and action observation in rehabilitation protocols. Specifically, we aimed to review the implementation of motor imagery and action observation in the rehabilitation of lower limb injuries. METHODS This scoping review followed Arksey and O'Malley's framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension guidelines for scoping reviews checklist. The Medline (PubMed), Cochrane Library, Scopus, and Web of Science databases were searched for controlled clinical trials published between 2010 and 2021 using key search terms. Primary articles were screened for inclusion based upon applying motor imagery and action observation as a rehabilitation protocol (independently or in combination) after sustaining an injury or undergoing surgery. Data were charted by extracting the exercise duration, frequency, and the number of weeks from the rehabilitative intervention protocols, and the measured clinical outcomes (pain, range of motion, muscle activity, and functional outcomes). RESULTS The initial database search resulted in 1367 articles, with 1352 excluded after screening, resulting in a total of 15 articles eligible for inclusion in the review. Six of the included articles included an action observation intervention, eight studies a motor imagery intervention, and a single study included combined motor imagery and action observation approach. The motor imagery and action observation techniques were able to improve clinical outcomes, including daily activity, functional movement, rage of motion, pain, and muscle strength. CONCLUSION Motor imagery and action observation interventions may be effective to improve rehabilitative outcomes of lower limb injuries, thus its application should be considered alongside standard treatment protocols.
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Affiliation(s)
- Ampika Nanbancha
- College of Sports Science and Technology, 26685Mahidol University, Salaya, Thailand
| | - Chistopher Mawhinney
- College of Sports Science and Technology, 26685Mahidol University, Salaya, Thailand
| | - Komsak Sinsurin
- Biomechanics and Sports Research Unit, Faculty of Physical Therapy, 26685Mahidol University, Salaya, Thailand
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21
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Spalding K, Gustafsson L, Di Tommaso A. Exploring Patient Outcomes After Participation in an Inpatient Occupation-Based Group: A Longitudinal Observational Cohort Study. Am J Occup Ther 2022; 76:23880. [PMID: 35943844 DOI: 10.5014/ajot.2022.049241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Occupation-based interventions are used during inpatient rehabilitation, and group models may enhance intervention delivery. However, little is known about the impact of occupation-based groups on patient outcomes. OBJECTIVE To examine the effect of an occupation-based group on patient outcome measures of instrumental activities of daily living (IADL) skills over time and explore demographic differences among patients. DESIGN Longitudinal observational cohort study with four time points: preintervention, postintervention, 30-day follow-up, and 90-day follow-up. SETTING Tertiary hospital general rehabilitation ward. PARTICIPANTS Inpatient adults age 18 or older recruited using consecutive sampling from those referred to the group. INTERVENTION The LifeSkills group, which focused on repetitive practice of meaningful occupation-based activities. OUTCOMES AND MEASURES Demographic data were obtained, and the Canadian Occupational Performance Measure (COPM), Goal Attainment Scaling, Lawton IADL scale, and a self-efficacy scale were administered at each data point. RESULTS Thirty people (21 women, 9 men; ages 35-91 yr) participated, with 5 lost to follow-up. A statistically significant increase in scores postintervention occurred on all measures and was also seen at 90-day follow-up for COPM occupational performance, satisfaction, and self-efficacy scores. Lawton IADL scale scores at follow-up were lower than those at preintervention and statistically significant. No significant differences were found for age and diagnosis. CONCLUSIONS AND RELEVANCE Positive patient outcomes of goal achievement, occupational performance, satisfaction, and self-efficacy were seen at discharge, with evidence of sustainability over time. This could be a resource alternative for addressing skill retraining because people with different diagnoses and in different age groups benefited equally. What This Article Adds: Occupation-based group programs have encouraging application in general inpatient rehabilitation for addressing patient outcomes.
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Affiliation(s)
- Kaitlyn Spalding
- Kaitlyn Spalding, MPhil, BOccThy, is Graduate Master of Philosophy Student, Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia, and Advanced Occupational Therapist, Occupational Therapy Department, Surgical Treatment and Rehabilitation Service, Brisbane, Queensland, Australia;
| | - Louise Gustafsson
- Louise Gustafsson, PhD, BOccThy(Hons), FOTARA, is Professor, Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
| | - Amelia Di Tommaso
- Amelia Di Tommaso, PhD, BHlthSc(OT)(Hons), is Lecturer, Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
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22
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Cheng KY, Chapman CS, Hebert JS. Spatiotemporal Coupling of Hand and Eye Movements When Using a Myoelectric Prosthetic Hand. IEEE Int Conf Rehabil Robot 2022; 2022:1-6. [PMID: 36176081 DOI: 10.1109/icorr55369.2022.9896491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Upper limb prosthesis users have disruptions in hand-eye coordination, with increased fixations towards the hand and less visual allocation for feedforward planning. The purpose of this study was to explore whether improved motor planning, as reflected by eye gaze behaviour, was associated with more efficient hand movement patterns. Able-bodied participants wore a simulated prosthesis while performing a functional object movement task. Motion and eye tracking data were collected to quantify the eye gaze and hand movement during object interaction. The results of this study demonstrated that the latency of the eye to precede the hand at pick-up was correlated with measures of hand function, including hand variability, movement units, and grasp time, but not reach time. During transport and release, longer latency to disengage gaze from the grasped object and look ahead towards the target was correlated to hand kinematics of hand variability, distance travelled, and transport time. In addition, the latency of the eye to disengage the drop-off location was correlated to release time. Together these may point to control issues with opening and closing the prosthetic hand. Overall, increased feedforward fixations towards the target and reduced feedback fixations towards the hand were related to improved measures of hand function. Hence, coordination between eye and hand movements when using a myoelectric prosthesis may prove to be a useful metric to assess motor planning.
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23
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Christiansen A, Scythes M, Ritsma BR, Scott SH, DePaul V. Art skill-based rehabilitation training for upper limb sensorimotor recovery post-stroke: A feasibility study. Clin Rehabil 2022; 36:1476-1488. [PMID: 35642286 PMCID: PMC9515518 DOI: 10.1177/02692155221105586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective The objective of this study was to assess the feasibility of delivering Art
skill-based Rehabilitation Training (ART), a novel upper limb motor training
program, to patients with stroke as an adjunct to standard care in an
inpatient setting. Design Feasibility study. Setting Inpatient stroke rehabilitation unit at a university hospital. Participants Thirty-eight patients admitted to a stroke rehabilitation unit with upper
limb motor impairment were enrolled in the ART program facilitated by
trained non-healthcare professionals between December 2017 and June
2021. Intervention The ART program included nine, one-hour sessions of supervised tracing and
freehand drawing tasks completed with both hands. This program was intended
to be delivered at a frequency of three times per week over a duration of 3
weeks or for the length of inpatient stay. Main outcome measures Feasibility outcomes included ART program adherence, acceptability, and
safety. Results Thirty-two (84%) participants with subacute stroke completed the ART program
and 30 (79%) were included in the study analysis. Participants completed
93–100% of the ART tasks in a median [IQR] of 8 [6–10] ART sessions over a
median [IQR] duration of 15 [7–19] days. ART program facilitators
effectively provided upper limb assistance to patients with more severe
upper limb impairments. Adherence and acceptability were high and no
study-related adverse events occurred. Conclusion The ART program was feasible to deliver and highly acceptable to patients
with stroke. Further research is warranted to explore the impact of ART on
upper limb sensorimotor function and use.
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Affiliation(s)
- April Christiansen
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Marta Scythes
- Haliburton School of Art and Design, 125171Fleming College, Haliburton, ON, Canada
| | - Benjamin R Ritsma
- Department of Physical Medicine and Rehabilitation, 4257Queen's University, Kingston, ON, Canada
| | - Stephen H Scott
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.,Department of Biomedical and Molecular Sciences, 4257Queen's University, Kingston, ON, Canada.,Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Vincent DePaul
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.,School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
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24
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Ranganathan R, Doherty C, Gussert M, Kaplinski E, Koje M, Krishnan C. Scientific basis and active ingredients of current therapeutic interventions for stroke rehabilitation. Restor Neurol Neurosci 2022; 40:97-107. [DOI: 10.3233/rnn-211243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Despite tremendous advances in the treatment and management of stroke, restoring motor and functional outcomes after stroke continues to be a major clinical challenge. Given the wide range of approaches used in motor rehabilitation, several commentaries have highlighted the lack of a clear scientific basis for different interventions as one critical factor that has led to suboptimal study outcomes. Objective: To understand the content of current therapeutic interventions in terms of their active ingredients. Methods: We conducted an analysis of randomized controlled trials in stroke rehabilitation over a 2-year period from 2019-2020. Results: There were three primary findings: (i) consistent with prior reports, most studies did not provide an explicit rationale for why the treatment would be expected to work, (ii) most therapeutic interventions mentioned multiple active ingredients and there was not a close correspondence between the active ingredients mentioned versus the active ingredients measured in the study, and (iii) multimodal approaches that involved more than one therapeutic approach tended to be combined in an ad-hoc fashion, indicating the lack of a targeted approach. Conclusion: These results highlight the need for strengthening cross-disciplinary connections between basic science and clinical studies, and the need for structured development and testing of therapeutic approaches to find more effective treatment interventions.
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Affiliation(s)
- Rajiv Ranganathan
- Department of Kinesiology, Michigan State University, East Lansing, MI, USA
- Department of Mechanical Engineering, Michigan State University, East Lansing, MI, USA
| | - Carson Doherty
- Department of Kinesiology, Michigan State University, East Lansing, MI, USA
| | - Michael Gussert
- Department of Kinesiology, Michigan State University, East Lansing, MI, USA
| | - Eva Kaplinski
- Department of Kinesiology, Michigan State University, East Lansing, MI, USA
| | - Mary Koje
- Neuromuscular and Rehabilitation Robotics Laboratory (NeuRRo Lab), Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Chandramouli Krishnan
- Neuromuscular and Rehabilitation Robotics Laboratory (NeuRRo Lab), Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
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25
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Taghizadeh A, Webster KE, Bhopti A, Carey L, Hoare B. Are they really motor learning therapies? A scoping review of evidence-based, task-focused models of upper limb therapy for children with unilateral cerebral palsy. Disabil Rehabil 2022; 45:1536-1548. [PMID: 35468016 DOI: 10.1080/09638288.2022.2063414] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To identify the specific motor learning (ML) theories underpinning evidence-based, task-focused upper limb models of therapy for children with unilateral cerebral palsy; and to document the strategies used in the operationalisation of these theories. MATERIAL AND METHOD This scoping review searched for relevant studies using eight electronic databases. A list of 68 ML strategies and accompanying definitions was developed for data extraction. Three classifications; adequate, inadequate or not described were used to rate the description of ML strategies. A corresponding colour-coding system was used to provide a visual summary. RESULTS There is a limited description of the ML theories and strategies used to operationalise these theories in existing models of evidence-based upper limb therapy. Of 103 therapy protocols included, only 24 explicitly described the guiding ML theory. When described, there was significant variation in the underlying theories, leading to significantly different focus and content of therapy. Of the 68 ML strategies, only three were adequately described. CONCLUSIONS To support treatment fidelity and the implementation of evidence-based, task-focused models of upper limb therapy in clinical practice, future research needs to provide explicit details about the underlying theories and strategies used in the operationalisation of these theories.Implications for rehabilitationEvidence-based models of upper limb therapy purport to be based on motor learning theory, however, most provide a very limited description of the theories and strategies used.Dosage of practice is only one element that is specific to a therapy approach and other elements guided by the principles of type of task and type of feedback should be considered.To support the implementation of evidence-based approaches in clinical practice, and improve treatment fidelity, it is important for researchers to define the theories that guide therapy approaches and explicitly describe the strategies used to operationalise these theories.
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Affiliation(s)
- Atefeh Taghizadeh
- Department of Occupational Therapy, La Trobe University, Melbourne, Australia
| | - Kate E Webster
- Department of Occupational Therapy, La Trobe University, Melbourne, Australia
| | - Anoo Bhopti
- Department of Occupational Therapy, La Trobe University, Melbourne, Australia.,Department of Paediatrics, Monash University, Melbourne, Australia
| | - Leeanne Carey
- Department of Occupational Therapy, La Trobe University, Melbourne, Australia.,Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Brian Hoare
- Department of Occupational Therapy, La Trobe University, Melbourne, Australia.,Department of Paediatrics, Monash University, Melbourne, Australia
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26
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Dubé MO, Arel J, Paquette P, Roy JS, Desmeules F, Gagnon DH. Co-creation of an exercise inventory to improve scapular stabilization and control among individuals with rotator cuff-related shoulder pain: a survey-based study amongst physiotherapists. Arch Physiother 2022; 12:11. [PMID: 35410465 PMCID: PMC9003989 DOI: 10.1186/s40945-022-00132-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/26/2022] [Indexed: 12/15/2022] Open
Abstract
Background Scapular stabilization exercises (SSE) are often included in the treatment of individuals with rotator cuff-related shoulder pain (RCRSP) to decrease pain and improve function. These SSE typically aim to strengthen the scapular muscles and optimize dynamic neuromuscular control of the scapula, which may improve overall shoulder stability and movement quality. No consensus of the recommended SSE for the management of RCRSP is available. Hence, this study aimed to consult physiotherapists to co-create an inventory of recommended SSE based on the exercise’s relevance and frequency of prescriptions for the rehabilitation of individuals with RCRSP. Methods A group of 16 physiotherapists with experience in treating shoulder pain participated in a sequential consultation incorporating two distinct rounds of consultation focusing on SSE (modified Delphi design). In round 1, physiotherapists identified and demonstrated up to 10 SSE that they commonly recommend or use among individuals with RCRSP. The description and performance of all SSE were audio and video recorded. All SSE suggested by more than one participant in round 1 advanced to round 2. In round 2, physiotherapists rated these SSE on a 4-point Likert scale according to their perceived relevance and frequency of prescription for this population. Results In round 1, out of the 25 SSE recommended by participants, 19 SSE (76.0%) were recommended by more than one physiotherapist and advanced to round 2. In round 2, 13 SSE were consensually classified (agreement ≥75%) as being relevant for the rehabilitation of individuals with RCRSP. SSE targeting the recruitment of the serratus anterior and lower trapezius muscles were considered the most relevant for the management of RCRSP, whereas SSE targeting neuromuscular scapular control were the most prescribed SSE for the management of RCRSP. Conclusions An inventory composed of 13 SSE was co-created by physiotherapists based on their relevance and frequency of prescription for the rehabilitation of individuals with RCRSP. When designing an exercise program, physiotherapists can use this SSE inventory to inform their exercise selection, in combination with their current knowledge on shoulder rehabilitation, as well as patients’ preferences. Supplementary Information The online version contains supplementary material available at 10.1186/s40945-022-00132-7.
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Affiliation(s)
- Marc-Olivier Dubé
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, G1M 2S8, Canada.,Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, G1R 1P5, Canada
| | - Jasmine Arel
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Centre intégré universitaire de santé et services sociaux du Centre-Sud-de-l'Île-de-Montréal, Institut universitaire sur la réadaptation en déficience physique de Montréal, 6300 Avenue Darlington, Montreal, Quebec, H3S 2J4, Canada.,School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Philippe Paquette
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Centre intégré universitaire de santé et services sociaux du Centre-Sud-de-l'Île-de-Montréal, Institut universitaire sur la réadaptation en déficience physique de Montréal, 6300 Avenue Darlington, Montreal, Quebec, H3S 2J4, Canada.,School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Jean-Sébastien Roy
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, G1M 2S8, Canada.,Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, G1R 1P5, Canada
| | - François Desmeules
- Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Montreal, Canada
| | - Dany H Gagnon
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Centre intégré universitaire de santé et services sociaux du Centre-Sud-de-l'Île-de-Montréal, Institut universitaire sur la réadaptation en déficience physique de Montréal, 6300 Avenue Darlington, Montreal, Quebec, H3S 2J4, Canada. .,School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
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27
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Hsu HY, Kuo LC, Lin YC, Su FC, Yang TH, Lin CW. Effects of a Virtual Reality-Based Mirror Therapy Program on Improving Sensorimotor Function of Hands in Chronic Stroke Patients: A Randomized Controlled Trial. Neurorehabil Neural Repair 2022; 36:335-345. [PMID: 35341360 DOI: 10.1177/15459683221081430] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Embedding mirror therapy within a virtual reality (VR) system may have a superior effect on motor remediation for chronic stroke patients. Objective. The objective is to investigate the differences in the effects of using conventional occupational therapy (COT), mirror therapy (MT), and VR-based MT (VR-MT) training on the sensorimotor function of the upper limb in chronic stroke patients. Methods. This was a single-blinded randomized controlled trial. A total of 54 participants, including chronic stroke patients, were randomized into a COT, MT, or VR-MT group. In addition to 20-minute sessions of task-specific training, patients received programs of 30 minutes of VR-MT, 30 minutes of MT, and 30 minutes of COT, respectively, in the VR-MT, MT, and COT groups twice a week for 9 weeks. The Fugl-Meyer motor assessment for the upper extremities (FM-UE; primary outcome), Semmes-Weinstein monofilament, motor activity log, modified Ashworth scale, and the box and block test were recorded at pre-treatment, post-intervention, and 12-week follow-up. Results. Fifty-two participants completed the study. There was no statistically significant group-by-time interaction effects on the FM-UE score (generalized estimating equations, (GEE), P = .075). Meanwhile, there were statistically significant group-by-time interaction effects on the wrist sub-score of the FM-UE (GEE, P = .012) and the result of box and block test (GEE, P = .044). Conclusions. VR-MT seemed to have potential effects on restoring the upper extremity motor function for chronic stroke patients. However, further confirmatory studies are warranted for the rather weak evidence of adding VR to MT on improving primary outcome of this study. Clinical trial registration: NCT03329417.
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Affiliation(s)
- Hsiu-Yun Hsu
- Department of Physical Medicine and Rehabilitation, 63461National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Occupational Therapy, College of Medicine, 38026National Cheng Kung University, Tainan, Taiwan.,Medical Device Innovation Center, 34912National Cheng Kung University, Tainan, Taiwan
| | - Li-Chieh Kuo
- Department of Occupational Therapy, College of Medicine, 38026National Cheng Kung University, Tainan, Taiwan.,Medical Device Innovation Center, 34912National Cheng Kung University, Tainan, Taiwan.,Institute of Allied Health Sciences, College of Medicine, 38026National Cheng Kung University, Tainan, Taiwan
| | - Yu-Ching Lin
- Department of Physical Medicine and Rehabilitation, 63461National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Physical Medicine and Rehabilitation, College of Medicine, 38026National Cheng Kung University, Tainan, Taiwan
| | - Fong-Chin Su
- Medical Device Innovation Center, 34912National Cheng Kung University, Tainan, Taiwan.,Department of Biomedical Engineering, College of Engineering, 201908National Cheng Kung University, Tainan, Taiwan
| | - Tai-Hua Yang
- Medical Device Innovation Center, 34912National Cheng Kung University, Tainan, Taiwan.,Department of Biomedical Engineering, College of Engineering, 201908National Cheng Kung University, Tainan, Taiwan.,Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, 63461National Cheng Kung University, Tainan, Taiwan
| | - Che-Wei Lin
- Medical Device Innovation Center, 34912National Cheng Kung University, Tainan, Taiwan.,Department of Biomedical Engineering, College of Engineering, 201908National Cheng Kung University, Tainan, Taiwan
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28
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Torres J, Droppelmann G, Silvestre R, De la Fuente C. Supraspinatus activation precedes the infraspinatus muscle during the shoulder abduction in different levels of handgrip strengths. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-021-00875-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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29
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The Effect of Task-Oriented Training on Upper-Limb Function, Visual Perception, and Activities of Daily Living in Acute Stroke Patients: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063186. [PMID: 35328874 PMCID: PMC8954660 DOI: 10.3390/ijerph19063186] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/06/2022] [Accepted: 03/06/2022] [Indexed: 11/17/2022]
Abstract
This pilot study aimed to investigate the effects of task-oriented training on upper-limb functioning, visual perception, and activities of daily living (ADL) in acute stroke patients. Of 20 participants, 10 were randomly assigned in a 1:1 ratio to experimental and control groups. Task-oriented training and table-top activity training were implemented for 6 weeks. Change in upper-limb functioning was assessed with the Manual Function Test (MFT); visual perceptual skill and ADL performance were evaluated using the Motor-Free Visual Perception Test—Vertical (MVPT-V) and Korean Modified Barthel Index (K-MBI), respectively. There was a significant interaction in the MFT and MBI score between the group and time (p < 0.05), but the group effect was not significant (p > 0.05). The MFT and MBI score significantly increased in both groups after the intervention (p < 0.001), but the effect size was greater in the task-oriented training group than the table-top activity training group. No significant interaction with MVPT-V score was found between the group and time (p > 0.05), and no statistical group difference was found either (p > 0.05). Both groups showed significant improvement in their MVPT-V score after the intervention (p < 0.001). The pilot study findings demonstrate that both task-oriented training and table-top activity training are effective in recovering upper-limb function, visual perception, and ADL in acute stroke patients.
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30
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Diaz-Artiles A, Wang Y, Davis MM, Abbott R, Keller N, Kennedy DM. The Influence of Altered-Gravity on Bimanual Coordination: Retention and Transfer. Front Physiol 2022; 12:794705. [PMID: 35069255 PMCID: PMC8777123 DOI: 10.3389/fphys.2021.794705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/03/2021] [Indexed: 11/13/2022] Open
Abstract
Many of the activities associated with spaceflight require individuals to coordinate actions between the limbs (e.g., controlling a rover, landing a spacecraft). However, research investigating the influence of gravity on bimanual coordination has been limited. The current experiment was designed to determine an individual's ability to adapt to altered-gravity when performing a complex bimanual force coordination task, and to identify constraints that influence coordination dynamics in altered-gravity. A tilt table was used to simulate gravity on Earth [90° head-up tilt (HUT)] and microgravity [6° head-down tilt (HDT)]. Right limb dominant participants (N = 12) were required to produce 1:1 in-phase and 1:2 multi-frequency force patterns. Lissajous information was provided to guide performance. Participants performed 14, 20 s trials at 90° HUT (Earth). Following a 30-min rest period, participants performed, for each coordination pattern, two retention trials (Earth) followed by two transfer trials in simulated microgravity (6° HDT). Results indicated that participants were able to transfer their training performance during the Earth condition to the microgravity condition with no additional training. No differences between gravity conditions for measures associated with timing (interpeak interval ratio, phase angle slope ratio) were observed. However, despite the effective timing of the force pulses, there were differences in measures associated with force production (peak force, STD of peak force mean force). The results of this study suggest that Lissajous displays may help counteract manual control decrements observed during microgravity. Future work should continue to explore constraints that can facilitate or interfere with bimanual control performance in altered-gravity environments.
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Affiliation(s)
- Ana Diaz-Artiles
- Bioastronautics and Human Performance Lab, Department of Aerospace Engineering, Texas A&M University, College Station, TX, United States
| | - Yiyu Wang
- Neuromuscular Coordination Lab, Department of Health and Kinesiology, Texas A&M University, College Station, TX, United States
| | - Madison M. Davis
- Neuromuscular Coordination Lab, Department of Health and Kinesiology, Texas A&M University, College Station, TX, United States
| | - Renee Abbott
- Bioastronautics and Human Performance Lab, Department of Aerospace Engineering, Texas A&M University, College Station, TX, United States
| | - Nathan Keller
- Bioastronautics and Human Performance Lab, Department of Aerospace Engineering, Texas A&M University, College Station, TX, United States
| | - Deanna M. Kennedy
- Neuromuscular Coordination Lab, Department of Health and Kinesiology, Texas A&M University, College Station, TX, United States
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31
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Kusano ME, Schmidt A. Teaching motor responses to a child with trisomy 18: A preliminary study. BEHAVIORAL INTERVENTIONS 2022. [DOI: 10.1002/bin.1862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Maria Elisa Kusano
- Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto (USP—FFCLRP), Departamento de Psicologia Universidade de São Paulo – Brasil São Paulo Brazil
| | - Andréia Schmidt
- Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto (USP—FFCLRP), Departamento de Psicologia Universidade de São Paulo – Brasil São Paulo Brazil
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Gao Y, Ma L, Lin C, Zhu S, Yao L, Fan H, Gong J, Yan X, Wang T. Effects of Virtual Reality-Based Intervention on Cognition, Motor Function, Mood, and Activities of Daily Living in Patients With Chronic Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Aging Neurosci 2021; 13:766525. [PMID: 34966267 PMCID: PMC8710683 DOI: 10.3389/fnagi.2021.766525] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 11/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The efficacy of virtual reality (VR)-based intervention for improving cognition in patients with the chronic stage of stroke is controversial. The aims of this meta-analysis were to evaluate the effect of VR-based training combined with traditional rehabilitation on cognition, motor function, mood, and activities of daily living (ADL) after chronic stroke. Methods: The search was performed in the Cochrane Library (CENTRAL), EBSCO, EMBASE, Medline (OVID), Web of Science databases, PubMed, CINAHL Ovid, and Scopus from inception to May 31, 2021. All included studies were randomized controlled trials (RCTs) examining VR-based intervention combined with traditional rehabilitation for chronic stroke. The main outcomes of this study were cognition, including overall cognition (combined with all cognitive measurement results), global cognition (measured by the Montreal Cognitive Assessment, MoCA, and/or Mini-Mental State Examination, MMSE), and attention/execution. The additional outcomes were motor function, mood, and ADL. Subgroup analyses were conducted to verify the potential factors for heterogeneity. Results: Six RCTs including 209 participants were included for systematic review, and five studies of 177 participants were included in meta-analyses. Main outcome analyses showed large and significant effect size (ES) of VR-based training on overall cognition (g = 0.642; 95% CI = 0.134-1.149; and P = 0.013) and attention/execution (g = 0.695; 95% CI = 0.052-1.339; and P = 0.034). Non-significant result was found for VR-based intervention on global cognition (g = 0.553; 95% CI = -0.273-1.379; and P = 0.189). Additional outcome analyses showed no superiority of VR-based intervention over traditional rehabilitation on motor function and ADL. The ES of VR-based intervention on mood (g = 1.421; 95% CI = 0.448-2.393; and P = 0.004) was large and significant. In the subgroup analysis, large effects for higher daily intensity, higher weekly frequency, or greater dose of VR intervention were found. Conclusion: Our findings indicate that VR-based intervention combined with traditional rehabilitation showed better outcomes for overall cognition, attention/execution, and depressive mood in individuals with chronic stroke. However, VR-based training combined with traditional rehabilitation showed a non-significant effect for global cognition, motor function, and ADL in individuals with chronic stroke.
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Affiliation(s)
- Yong Gao
- Department of Rehabilitation, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China,Yong Gao,
| | - Lu Ma
- Library, Zhejiang Industry Polytechnic College, Shaoxing, China
| | - Changsheng Lin
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China
| | - Shizhe Zhu
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China
| | - Lingling Yao
- Department of Rehabilitation, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
| | - Hong Fan
- Department of Rehabilitation, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
| | - Jianqiu Gong
- Department of Rehabilitation, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
| | - Xiaobo Yan
- Department of Rehabilitation, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
| | - Tong Wang
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China,Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China,*Correspondence: Tong Wang,
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Ghanamah R, Eghbaria-Ghanamah H, Karni A, Adi-Japha E. Practice schedule and testing per se affect children's transfer abilities in a grapho-motor task. J Exp Child Psychol 2021; 215:105323. [PMID: 34864374 DOI: 10.1016/j.jecp.2021.105323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 10/10/2021] [Accepted: 11/06/2021] [Indexed: 01/29/2023]
Abstract
Children's ability to transfer the gains of a motor experience, such as learning to write a letter, to novel conditions, such as cursive writing of the same letter, are affected by the way in which the learning experience is parsed. Parsing may have limitations because a short session may hamper the engagement of procedural memory consolidation processes. Here, we compared the effects of two practice schedules with the total amount of practice identical training provided in a single-session practice versus multi-session practice, wherein each session on its own was insufficient for generating long-term gains. A total of 40 7- and 8-year-old children practiced the production of a novel letter form by connecting dots, namely, the Invented Letter Task (ILT). Multiple ILT-related transfer tasks were assessed at 24 h post-training and again at 4-5 weeks post-training. Although by the end of training the single-session practice group outperformed the multi-session practice group in speed and accuracy, at 24 h post-training both groups showed comparable gains. However, after multi-session practice, children were as fast or faster and more accurate in the transfer tasks. By 4-5 weeks post-training, the multi-session practice group showed larger gains in the trained condition, a speed advantage in the transfer tasks, and a significant improvement on the transfer tasks. The results suggest that parsing training over several brief sessions may lead to long-term gains in children's grapho-motor skills. Moreover, multi-session practice protocols may contribute to the potential for transfer and to more effective learning from experiences such as transfer tasks.
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Affiliation(s)
- Rafat Ghanamah
- Edmond J. Safra Brain Research Center for the Study of Learning Disabilities, University of Haifa, Haifa 3498838, Israel; Oranim Academic College of Education, Kiryat Tevon 3600600, Israel.
| | - Hazar Eghbaria-Ghanamah
- Edmond J. Safra Brain Research Center for the Study of Learning Disabilities, University of Haifa, Haifa 3498838, Israel
| | - Avi Karni
- Edmond J. Safra Brain Research Center for the Study of Learning Disabilities, University of Haifa, Haifa 3498838, Israel; Sagol Department of Neurobiology, Brain-Behavior Research Center, University of Haifa, Haifa 3498838, Israel
| | - Esther Adi-Japha
- School of Education, Bar-Ilan University, Ramat Gan 5290002, Israel; Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan 5290002, Israel
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Veldkamp R, Moumdjian L, van Dun K, Six J, Vanbeylen A, Kos D, Feys P. Motor sequence learning in a goal-directed stepping task in persons with multiple sclerosis: a pilot study. Ann N Y Acad Sci 2021; 1508:155-171. [PMID: 34689347 DOI: 10.1111/nyas.14702] [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] [Received: 07/02/2021] [Revised: 09/07/2021] [Accepted: 09/26/2021] [Indexed: 11/24/2022]
Abstract
Motor sequence learning in persons with multiple sclerosis (pwMS) and healthy controls (HC) under implicit or explicit learning conditions has not yet been investigated in a stepping task. Given the prevalent cognitive and mobility impairments in pwMS, this is important in order to understand motor learning processes and optimize rehabilitation strategies. Nineteen pwMS (the Expanded Disability Status Scale = 3.4 ± 1.2) and 18 HC performed a modified serial reaction time task by stepping as fast as possible on a stepping tile when it lit up, either with (explicit) or without (implicit) knowledge of the presence of a sequence beforehand. Motor sequence learning was studied by examining response time changes and differences between sequence and random blocks during the learning session (acquisition), 24 h later (retention), and in three dual-task (DT) conditions at baseline and retention (automaticity) using subtracting sevens, verbal fluency, and vigilance as concurrent cognitive DTs. Response times improved and were lower for the sequenced compared with the random blocks at the post- and retention tests (P's < 0.001). Response times during DT conditions improved after learning, but DT cost improved only for the subtracting sevens DT condition. No differences in learning were observed between learning conditions or groups. This study showed motor sequence learning, by acquisition and retention, in a stepping task in pwMS with motor impairments, to a similar degree as HC and regardless of learning conditions. Whether automaticity increased remains unclear.
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Affiliation(s)
- Renee Veldkamp
- UMSC Hasselt, Pelt, Belgium.,REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Lousin Moumdjian
- UMSC Hasselt, Pelt, Belgium.,REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.,IPEM Institute of Psychoacoustics and Electronic Music, Faculty of Arts and Philosophy, Ghent University, Ghent, Belgium
| | - Kim van Dun
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Joren Six
- IPEM Institute of Psychoacoustics and Electronic Music, Faculty of Arts and Philosophy, Ghent University, Ghent, Belgium
| | | | - Daphne Kos
- National MS Center Melsbroek, Melsbroek, Belgium.,KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Peter Feys
- UMSC Hasselt, Pelt, Belgium.,REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
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Sogbossi ES, Sotindjo Adon S, Adjagodo L, Dossou S, Dakè H, Ebner-Karestinos D, Araneda R, Saussez G, Paradis J, Kpadonou TG, Bleyenheuft Y. Efficacy of hand-arm bimanual intensive therapy including lower extremities (HABIT-ILE) in young children with bilateral cerebral palsy (GMFCS III-IV) in a low and middle-income country: protocol of a randomised controlled trial. BMJ Open 2021; 11:e050958. [PMID: 34610941 PMCID: PMC8493925 DOI: 10.1136/bmjopen-2021-050958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Cerebral palsy (CP) is highly prevalent in sub-Saharan Africa, where clinically-based studies have shown a considerable over-representation of the severe bilateral subtype. However, children's access to rehabilitation care is limited by many local factors, notably the lacking of rehabilitation services, insufficient knowledge of caregivers and financial constraints. In such a context there is an urgent need for studies of the evidence-based rehabilitation approach. Here, we describe the protocol of a randomised controlled study to investigate the efficacy of Hand-Arm Bimanual Intensive Therapy Including the Lower Extremities (HABIT-ILE) in young children with bilateral CP in Benin Republic, a representative low and middle-income country of western Africa. METHODS AND ANALYSIS Forty children with bilateral CP aged between 24 and 59 months and with level III-IV in the gross motor function classification will be randomised to either a high intensity conventional therapy or HABIT-ILE therapy. Both therapies will be delivered as a day-camp model over 2 weeks to a total of 50 hours (5 hours per day). The assessor-blinded primary outcomes will include the gross motor function measure and both hands assessment. Secondary outcomes will be the adapted version of the ACTIVLIM-CP questionnaire, the Canadian Occupational Performance Measure, and a perception of CP interview form. Children will be assessed at baseline, after intervention and at 6-week follow-up. A 2 (group)×3 (test sessions) repeated analysis of variance will evaluate changes after the interventions. ETHICS AND DISSEMINATION This study has been approved by the ethics committee of the rehabilitation department of the National Teaching Hospital Hubert Koutoukou Maga of Cotonou, Benin (approval decision: N°01-2019/MS/CNHU-HKM/CEI/CUMPR). All participants' parents/caregivers will provide their written informed consent. Data will be managed with confidentiality. TRIAL REGISTRATION NUMBER PACTR201911894444879.
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Affiliation(s)
- Emmanuel Segnon Sogbossi
- Institute of Neuroscience, Université catholique de Louvain, Bruxelles, Belgium
- School of Physiotherapy, Université d'Abomey-Calavi, Faculté des Sciences de la Santé, Cotonou, Benin
| | - Solange Sotindjo Adon
- Service de Kinésithérapie et d'Appareillage Orthopédique, Centre Hospitalier Universitaire Départemental de Borgou/Alibori, Parakou, Benin
| | | | - Solange Dossou
- Centre Medico-social Sainte Elisabeth de la Trinité, Calavi, Benin
| | - Hyppolite Dakè
- Clinique universitaire de médecine physique et réadaptation, Centre National Hospitalier Universitaire Hubert Koutoukou Maga de Cotonou, Cotonou, Benin
| | | | - Rodrigo Araneda
- Institute of Neuroscience, Université catholique de Louvain, Bruxelles, Belgium
| | - Geoffroy Saussez
- Physical and Occupational Therapy, Haute Ecole Louvain en Hainaut - Montignies-sur-Sambre, Montignies-sur-Sambre, Belgium
| | - Julie Paradis
- Département Ergothérapie, HE Vinci, Italia, Vinci, Italy
| | - Toussaint G Kpadonou
- School of Physiotherapy, Université d'Abomey-Calavi, Faculté des Sciences de la Santé, Cotonou, Benin
- Clinique universitaire de médecine physique et réadaptation, Centre National Hospitalier Universitaire Hubert Koutoukou Maga de Cotonou, Cotonou, Benin
| | - Yannick Bleyenheuft
- Institute of Neuroscience, Université catholique de Louvain, Bruxelles, Belgium
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Li Y, Huang J, Li X, Qiao J, Huang X, Yang L, Yu H. Effect of Time-Dose-Matched Virtual Reality Therapy on Upper Limb Dysfunction in Patients Poststroke: A Meta-Analysis of Randomized Controlled Trials. Arch Phys Med Rehabil 2021; 103:1131-1143.e7. [PMID: 34619141 DOI: 10.1016/j.apmr.2021.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/18/2021] [Accepted: 09/05/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the efficacy and acceptability of virtual reality (VR) with time-dose-matched conventional therapy (CT) in patients poststroke with upper limb dysfunction. DATA SOURCES Cochrane, PubMed, Web of Science, Embase, and ProQuest were systematically searched up to May 24, 2021. STUDY SELECTION Randomized controlled trials comparing VR with time-dose-matched CT in patients poststroke with upper limb dysfunction were included. DATA EXTRACTION The extracted data included efficacy (mean change in structure/function, activity, and participation scores), acceptability (dropouts for all reasons), adverse events, and characteristics of the included studies. The Cochrane risk of bias assessment tool was used to assess the risk of bias. DATA SYNTHESIS Thirty-one randomized controlled trails were included. VR was superior to time-dose-matched CT in terms of the World Health Organization's International Classification of Functioning, Disability and Health structure/function, with a standardized mean difference (SMD) of 0.35, but not activity and participation. Subgroup analyses demonstrated that virtual environment was superior to CT in structure/function (SMD=0.38) and activity (SMD=0.27), whereas there were no significant differences between commercial gaming and CT in any World Health Organization International Classification of Functioning, Disability and Health domain. VR mixed with CT was more effective than time-dose-matched CT in structure/function (SMD=0.56), whereas VR only was not significantly different from CT. There were no significant differences in the incidence of adverse events and dropout rates between VR and CT. CONCLUSIONS The results suggest that VR is superior to time-dose-matched CT in terms of recovery of upper extremity motor function, especially when a virtual environment is used or VR is mixed with CT. However, VR (VR only or mixed with CT) does not improve patients' daily activity performance and participation compared with CT. Overall, VR appears to be safe and acceptable as CT. Large-scale definitive trials are needed to verify or refute these findings.
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Affiliation(s)
- Yi Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing
| | - Jiashang Huang
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaohong Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing
| | - Jia Qiao
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing
| | - Xin Huang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing
| | - Lining Yang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing.
| | - Heping Yu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing.
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Al-Sharman A, Al-Khazaaleh HM, Khalil H, Aburub A, El-Salem K. The Relationship Between Sleep Quality, Sleep-Related Biomarkers, and Motor Skill Acquisition in People With Multiple Sclerosis: A Pilot Study. Phys Ther 2021; 101:6322543. [PMID: 34270772 DOI: 10.1093/ptj/pzab175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 04/02/2021] [Accepted: 06/01/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Neurorehabilitation that involves learning new motor skills is one of the promising clinical methods for motor recovery in people with multiple sclerosis (PwMS); therefore, factors that influence the acquisition of motor skills in PwMS need to be investigated. Sleep disturbances are common in PwMS; however, no study has investigated the effect of sleep and sleep-related biomarkers on skill acquisition in PwMS. This study aimed to examine the effect of sleep and sleep-related biomarkers on motor acquisition in PwMS. METHODS Forty participants with MS and 40 controls were recruited in this study. To assess motor acquisition, each participant was asked to perform a novel game through a virtual reality (VR) system 5 times (blocks). The main outcome measures for each block were the required time to complete the VR game and the recorded errors. The difference in scores between Block 5 and Block 1 for both outcomes were considered to represent motor skill acquisition. Sleep was assessed by self-report using the Pittsburgh Sleep Quality Index (PSQI) and objectively using sleep monitor technology. Serotonin level was assessed using means of enzyme-linked immunosorbent assay using plasma samples. RESULTS There were significant positive correlations in both groups between motor skill acquisition and PSQI score. In PwMS, significant negative correlation between motor skill acquisition and sleep efficiency and significant positive correlation between motor skill acquisition and sleep latency were also observed. Interestingly, a significant negative correlation was observed between motor skill acquisition and the plasma serotonin level in both groups. Most of these correlations remained significant after controlling for disease severity, fatigue, baseline performance, and cognitive status. CONCLUSION Sleep quality may influence motor skill acquisition in PwMS. Circulatory serotonin level might explain this relationship. IMPACT Physical therapists are encouraged to be aware of sleep quality and sleep assessment. Sleep management strategies should be considered when treating PwMS.
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Affiliation(s)
- Alham Al-Sharman
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Heba Mefleh Al-Khazaaleh
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Hanan Khalil
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Ala'S Aburub
- Physical Therapy Department, Faculty of Allied Medical Sciences, Isra University, Amman, Jordan
| | - Khalid El-Salem
- Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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38
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Alighieri C, Van Lierde K, De Caesemaeker AS, Demuynck K, Bruneel L, D'haeseleer E, Bettens K. Is High-Intensity Speech Intervention Better? A Comparison of High-Intensity Intervention Versus Low-Intensity Intervention in Children With a Cleft Palate. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:3398-3415. [PMID: 34433000 DOI: 10.1044/2021_jslhr-21-00189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose The purpose of this study was to compare the effect of speech intervention provided with a low intensity with speech intervention provided with a high intensity on the speech and health-related quality of life (HRQoL) in Dutch-speaking children with a cleft palate with or without a cleft lip (CP ± L) between 4 and 12 years. Method A longitudinal, prospective, randomized controlled trial with a multiple baseline design was used. Twelve children with a CP ± L (M age = 8.0 years, SD = 1.54) were divided into two groups using block randomization stratified by age and gender: One group received low-intensity speech intervention (LISI; n = 6) and one group received high-intensity speech intervention (HISI; n = 6). Children in the LISI group received intervention with a session duration of 1 hr, a dose frequency of 1 session per week, and a total intervention duration of 10 weeks. Children in the HISI group received intervention with a session duration of 1 hr, a dose frequency of 5 sessions per week, and a total intervention duration of 2 weeks. The cumulative intervention intensity was kept constant. Both groups received identical therapy programs provided by the same experienced speech therapist. Perceptual speech assessments were performed on baseline and posttreatment data points. Changes in HRQoL were assessed using the Velopharyngeal Insufficiency Effects on Life Outcomes (VELO) questionnaire. Both groups were compared over time using (generalized) linear mixed models. Results No significant Time × Group interactions were observed for the percentage of correctly produced consonants at the word and sentence levels, indicating no differences in evolution over time among the two groups. The variables speech understandability, speech acceptability, and the total VELO scores significantly improved following HISI, but not following LISI. Conclusions Children in the HISI group made equal and, for some variables, even superior progress in only 2 weeks of therapy compared to children in the LISI group who received 10 weeks of therapy. HISI is a promising strategy to improve speech outcomes and HRQoL in a shorter time period.
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Affiliation(s)
| | - Kristiane Van Lierde
- Department of Rehabilitation Sciences, Ghent University, Belgium
- Faculty of Humanities, Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
| | | | - Kris Demuynck
- Department of Electronics and information systems, Ghent University, Belgium
| | - Laura Bruneel
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | | | - Kim Bettens
- Department of Rehabilitation Sciences, Ghent University, Belgium
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Parmar ST, Kanitkar A, Sepehri N, Bhairannawar S, Szturm T. Computer Game-Based Telerehabilitation Platform Targeting Manual Dexterity: Exercise Is Fun. "You Are Kidding-Right?". SENSORS (BASEL, SWITZERLAND) 2021; 21:5766. [PMID: 34502656 PMCID: PMC8434447 DOI: 10.3390/s21175766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/12/2021] [Accepted: 08/20/2021] [Indexed: 11/24/2022]
Abstract
There is a need for innovation to improve the engagement and accessibility of rehabilitation programs for children and adults with upper extremity motor impairments due to neurodevelopmental disorders, acquired brain injuries, or spinal cord injuries. For this purpose, a computer game-based telerehabilitation platform (GTP) was developed to address this need. Through the application of a miniature inertial-based computer mouse and the wide variety of commercial computer games, the developed GTP can provide engaging task-specific exercises for the rehabilitation of manual dexterity (object handling and manipulation). A purpose-built repetitive task practice software (RTP) was also developed to gather event data and synchronize it with patient movements during gameplays. This provides automated monitoring and quantification of patients' motor skills, while they practice a range of game-based exercises with their hand and/or arm. The GTP would initially be used in a supervised clinical setting followed by a transition to function at home and be monitored by clinician specialists. Clinical support for home and rural communities, with protocols that can be easily updated, will help increase accessibility to targeted and personalized solutions for patients and achieve the desired training effect.
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Affiliation(s)
| | - Anuprita Kanitkar
- College of Rehabilitation Science, University of Manitoba, Winnipeg, MB R3T 5V6, Canada;
| | - Nariman Sepehri
- Department of Mechanical Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, MB R3T 5V6, Canada;
| | - Satish Bhairannawar
- Department of Electronics and Communication Engineering, SDM College of Engineering and Technology, Dharwad 580009, Karnataka, India;
| | - Tony Szturm
- College of Rehabilitation Science, University of Manitoba, Winnipeg, MB R3T 5V6, Canada;
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40
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He C, Xiong CH, Chen ZJ, Fan W, Huang XL, Fu C. Preliminary Assessment of a Postural Synergy-Based Exoskeleton for Post-Stroke Upper Limb Rehabilitation. IEEE Trans Neural Syst Rehabil Eng 2021; 29:1795-1805. [PMID: 34428146 DOI: 10.1109/tnsre.2021.3107376] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Upper limb exoskeletons have drawn significant attention in neurorehabilitation because of the anthropomorphic mechanical structure analogous to human anatomy. Whereas, the training movements are typically unorganized because most exoskeletons ignore the natural movement characteristic of human upper limbs, particularly inter-joint postural synergy. This paper introduces a newly developed exoskeleton (Armule) for upper limb rehabilitation with a postural synergy design concept, which can reproduce activities of daily living (ADL) motion with the characteristics of human natural movements. The semitransparent active control strategy with the interactive force guidance and visual feedback ensured the active participation of users. Eight participants with hemiplegia due to a first-ever, unilateral stroke were recruited and included. They participated in exoskeleton therapy sessions for 4 weeks, with passive/active training under trajectories and postures with the characteristics of human natural movements. The primary outcome was the Fugl-Meyer Assessment for Upper Extremities (FMA-UE). The secondary outcomes were the Action Research Arm Test(ARAT), modified Barthel Index (mBI), and metric measured with the exoskeleton After the 4-weeks intervention, all subjects showed significant improvements in the following clinical measures: the FMA-UE (difference, 11.50 points, p = 0.002), the ARAT (difference, 7.75 points ), and the mBI (difference, 17.50 points, p = 0.003 ) score. Besides, all subjects showed significant improvements in kinematic and interaction force metrics measured with the exoskeleton. These preliminary results demonstrate that the Armule exoskeleton could improve individuals' motor control and ADL function after stroke, which might be associated with kinematic and interaction force optimization and postural synergy modification during functional tasks.
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41
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The S-Shaped Performance Curve Prevails in Practicing Juggling. JOURNAL OF MOTOR LEARNING AND DEVELOPMENT 2021. [DOI: 10.1123/jmld.2020-0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The development of performance, such as learning a new motor skill, can be represented in a performance curve. The shape of the performance curve is both of theoretical and practical relevance. Here, the author studied the interday performance of juggling over a period of 17 days in 112 college students. The results showed that 60% of participants followed an S-shaped performance curve with the inflection date on the 11th day, followed by a decelerated (20%), accelerated (14%), and linear curve (6%). As expected, except on Day 1, male participants performed at least 33% better than female participants on each practice day. Also as expected, learning performance was found to depend on the type of performance curve with the best learning performance exhibited by the linear group. The results further revealed that pooling all participants’ performance together without considering the percentage of each underlying type of performance curve would lead to biased, nonrepresentative results. Given the variety of the observed performance curves and the dominance of the S-shaped performance curve among them, coaches should continuously monitor the shape of an individual’s performance curve.
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Graser JV, Bastiaenen CHG, Gut A, Keller U, van Hedel HJA. Contextual interference in children with brain lesions: a pilot study investigating blocked vs. random practice order of an upper limb robotic exergame. Pilot Feasibility Stud 2021; 7:135. [PMID: 34172085 PMCID: PMC8228977 DOI: 10.1186/s40814-021-00866-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/03/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Evidence about contextual interference in children with brain lesions when practising motor tasks is lacking. Our main objective was to evaluate the feasibility of a randomised controlled trial (RCT) comparing blocked with random practice order of an upper limb robotic exergame to improve reaching in children with neuromotor disorders with a pilot trial. Methods We recruited children with brain lesions and impaired upper limb functions who underwent a 3-week schedule that consisted of baseline assessments, intervention period (participants were randomised to a blocked or random order group), and follow-up assessment. We evaluated ten feasibility criteria, including the practicability of the inclusion/exclusion criteria, recruitment rate, feasibility of randomisation, scheduling procedure, and the participants’ programme adherence. Results The inclusion/exclusion criteria were not completely feasible as patients who were not able to perform the exergames were included. Twelve participants were recruited, and six datasets were used for analysis. The scheduling and randomisation procedures were generally feasible, but the procedure was only partially feasible for the participants, as some sessions were aborted due to lack of motivation and fatigue. Conclusion An RCT following this study protocol is not feasible. We formulated suggestions for future studies that aim to investigate contextual interference as in this pilot study. Trial registration ClinicalTrials.gov Identifier: NCT02443857, registered on May 14, 2015 Supplementary Information The online version contains supplementary material available at 10.1186/s40814-021-00866-4.
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Affiliation(s)
- Judith V Graser
- Research Department, Swiss Children's Rehab, University Children's Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern am Albis, Switzerland. .,Children's Research Centre CRC, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland. .,Research Group Function, Participation and Rehabilitation CAPHRI, Department of Epidemiology, Maastricht University, Maastricht, the Netherlands.
| | - Caroline H G Bastiaenen
- Research Group Function, Participation and Rehabilitation CAPHRI, Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Anja Gut
- Research Department, Swiss Children's Rehab, University Children's Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern am Albis, Switzerland.,Children's Research Centre CRC, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Urs Keller
- Research Department, Swiss Children's Rehab, University Children's Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern am Albis, Switzerland.,Children's Research Centre CRC, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Hubertus J A van Hedel
- Research Department, Swiss Children's Rehab, University Children's Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern am Albis, Switzerland.,Children's Research Centre CRC, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
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Kanitkar A, Parmar ST, Szturm TJ, Restall G, Rempel G, Sepehri N. Parents' Perspectives on a Computer Game-Assisted Rehabilitation Program for Manual Dexterity in Children With Cerebral Palsy: Qualitative Analysis of Expectations, Child Engagement, and Benefits. JMIR Rehabil Assist Technol 2021; 8:e24337. [PMID: 34057424 PMCID: PMC8204242 DOI: 10.2196/24337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/20/2020] [Accepted: 04/11/2021] [Indexed: 12/04/2022] Open
Abstract
Background Children with motor impairments affecting the upper extremity benefit from task-specific therapy, such as constraint-induced movement therapy. However, there is a need to improve engagement and compliance with task-specific exercise programs that target manual dexterity for children with cerebral palsy (CP). A computer game–based rehabilitation (GRP) platform was developed that combines fine manipulation and gross movement exercises with engaging game activities appropriate for young children with CP. Objective The objectives of this qualitative analysis were to compare parents’ perspectives and opinions about expectations, challenges, and benefits between 2 interventions. Methods A mixed methods, randomized controlled trial (RCT) was conducted to examine the feasibility and estimate the effect size of 2 exercise programs for rehabilitation of manual dexterity of children with CP using either GRP or conventional therapy. Parents of 26 of the children who completed the GRP program (n=33) and parents of 15 of the children who completed the conventional therapy program (n=27) participated in the interviews. A general conductive approach was used to analyze the data recorded during the parents’ interviews. Results Five themes captured the range of the parent’s experiences, viewpoints, and ideas: (1) parents’ expectations, (2) child’s engagement with therapy, (3) positive effects of the interventions, (4) challenges, and (5) improving the protocol. Conclusions Parents from both groups recognized that their expectations related to improving children’s object handling and manipulation skills including participation in activities of daily life were addressed during the 16-week therapy program. Parents perceived a change in the children’s level of independence in their daily tasks at home, school, and leisure activities. Trial Registration ClinicalTrials.gov NCT02728375; https://clinicaltrials.gov/ct2/show/NCT02728375
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Affiliation(s)
| | | | | | | | - Gina Rempel
- University of Manitoba, Winnipeg, MB, Canada
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Demers M, Fung K, Subramanian SK, Lemay M, Robert MT. Integration of Motor Learning Principles Into Virtual Reality Interventions for Individuals With Cerebral Palsy: Systematic Review. JMIR Serious Games 2021; 9:e23822. [PMID: 33825690 PMCID: PMC8060861 DOI: 10.2196/23822] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/06/2020] [Accepted: 03/13/2021] [Indexed: 01/08/2023] Open
Abstract
Background Increasing evidence supports the use of virtual reality systems to improve upper limb motor functions in individuals with cerebral palsy. While virtual reality offers the possibility to include key components to promote motor learning, it remains unclear if and how motor learning principles are incorporated into the development of rehabilitation interventions using virtual reality. Objective The objective of this study was to determine the extent to which motor learning principles are integrated into virtual reality interventions targeting upper limb function in individuals with cerebral palsy. Methods A systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search was performed in 10 databases using a combination of keywords related to cerebral palsy, virtual reality, video games, and rehabilitation. Studies were divided into 2 categories: commercial video game platforms and devices and custom virtual reality systems. Study quality was assessed using the modified Downs and Black checklist. Results The initial search yielded 1497 publications. A total of 26 studies from 30 publications were included, with most studies classified as “fair” according to the modified Downs and Black checklist. The majority of studies provided enhanced feedback and variable practice and used functionally relevant and motivating virtual tasks. The dosage varied greatly (total training time ranged from 300 to 3360 minutes), with only 6 studies reporting the number of movement repetitions per session. The difficulty progression and the assessment of skills retention and transfer were poorly incorporated, especially for the commercial video games. Conclusions Motor learning principles should be better integrated into the development of future virtual reality systems for optimal upper limb motor recovery in individuals with cerebral palsy. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020151982; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020151982
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Affiliation(s)
- Marika Demers
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States
| | - Karen Fung
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec, QC, Canada
| | - Sandeep K Subramanian
- Department of Physical Therapy, School of Health Professions, UT Health San Antonio, San Antonio, TX, United States
| | - Martin Lemay
- Centre de Réadaptation Marie Enfant, Centre de Recherche du CHU Sainte Justine, Montreal, QC, Canada.,Département des Sciences de l'Activité Physique, Université du Québec à Montréal, Montreal, QC, Canada
| | - Maxime T Robert
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec, QC, Canada
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Wambaugh JL, Kallhoff L, Nessler C. Sound Production Treatment for Acquired Apraxia of Speech: An Examination of Dosage in Relation to Probe Performance. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:425-440. [PMID: 32631067 DOI: 10.1044/2020_ajslp-19-00110] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12-14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190.
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Affiliation(s)
- Julie L Wambaugh
- Research Department, VA Salt Lake City Health Care System, UT
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City
| | - Lydia Kallhoff
- Research Department, VA Salt Lake City Health Care System, UT
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City
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46
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Tuma F. Role and educational implications of cognitive surgical skills. Postgrad Med J 2021; 98:e18. [PMID: 33563708 DOI: 10.1136/postgradmedj-2020-139637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Faiz Tuma
- Central Michigan University College of Medicine East Campus, Saginaw, MI 48602-5303, USA
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Grohs MN, Craig BT, Kirton A, Dewey D. Effects of Transcranial Direct Current Stimulation on Motor Function in Children 8-12 Years With Developmental Coordination Disorder: A Randomized Controlled Trial. Front Hum Neurosci 2020; 14:608131. [PMID: 33362497 PMCID: PMC7759610 DOI: 10.3389/fnhum.2020.608131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 11/09/2020] [Indexed: 11/22/2022] Open
Abstract
Background and objectives: Developmental coordination disorder (DCD) is a neurodevelopmental motor disorder occurring in 5-6% of school-aged children. It is suggested that children with DCD show deficits in motor learning. Transcranial direct current stimulation (tDCS) enhances motor learning in adults and children but is unstudied in DCD. We aimed to investigate if tDCS, paired with motor skill training, facilitates motor learning in a pediatric sample with DCD. Methods: Twenty-eight children with diagnosed DCD (22 males, mean age: 10.62 ± 1.44 years) were randomized and placed into a treatment or sham group. Anodal tDCS was applied (1 mA, 20 min) in conjunction with fine manual training over 5 consecutive days. Children's motor functioning was assessed with the Purdue Pegboard Test and Jebsen-Taylor Hand Function Test at baseline, post-intervention and 6 weeks following intervention. Group differences in rates of motor learning and skill transfer/retention were examined using linear mixed modeling and repeated measures ANOVAs, respectively. Results: There were no serious adverse events or drop-outs and procedures were well-tolerated. Independent of group, all participants demonstrated improved motor scores over the 5 training days [F(69.280), p < 0.001, 95% CI (0.152, 0.376)], with no skill decay observed at retention. There was no interaction between intervention group and day [F(2.998), p = 0.086, 95% CI (−0.020, 0.297)]. Conclusion: Children with DCD demonstrate motor learning with long-term retention of acquired skill. Motor cortex tDCS did not enhance motor learning as seen in other populations. Before conclusions of tDCS efficacy can be drawn, additional carefully designed trials with reproducible results are required. Clinical Trial Registration:ClinicalTrials.gov: NCT03453983
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Affiliation(s)
- Melody N Grohs
- Department of Neurosciences, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada
| | - Brandon T Craig
- Department of Neurosciences, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada.,Hotchkiss Brain Institute (HBI), University of Calgary, Calgary, AB, Canada
| | - Adam Kirton
- Department of Neurosciences, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada.,Hotchkiss Brain Institute (HBI), University of Calgary, Calgary, AB, Canada.,Department of Pediatrics, University of Calgary, Calgary, AB, Canada
| | - Deborah Dewey
- Alberta Children's Hospital Research Institute (ACHRI), Calgary, AB, Canada.,Hotchkiss Brain Institute (HBI), University of Calgary, Calgary, AB, Canada.,Department of Pediatrics, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
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48
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Neva JL, Brown KE, Wadden KP, Mang CS, Borich MR, Meehan SK, Boyd LA. The effects of five sessions of continuous theta burst stimulation over contralesional sensorimotor cortex paired with paretic skilled motor practice in people with chronic stroke. Restor Neurol Neurosci 2020; 37:273-290. [PMID: 31227676 DOI: 10.3233/rnn-190916] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND In individuals with chronic stroke, impairment of the paretic arm may be exacerbated by increased contralesional transcallosal inhibition (TCI). Continuous theta burst stimulation (cTBS) can decrease primary motor cortex (M1) excitability and TCI. However, contralesional cTBS shows inconsistent effects after stroke. Variable effects of cTBS could stem from failure to pair stimulation with skilled motor practice or a focus of applying cTBS over M1. OBJECTIVE Here, we investigated the effects of pairing cTBS with skilled practice on motor learning and arm function. We considered the differential effects of stimulation over two different brain regions: contralesional M1 (M1c) or contralesional primary somatosensory cortex (S1c). METHODS 37 individuals with chronic stroke participated in five sessions of cTBS and paretic arm skilled practice of a serial targeting task (STT); participants received either cTBS over M1c or S1c or sham before STT practice. Changes in STT performance and Wolf Motor Function Test (WMFT) were assessed as primary outcomes. Assessment of bilateral corticospinal, intracortical excitability and TCI were secondary outcomes. RESULTS cTBS over sensorimotor cortex did not improve STT performance and paretic WMFT-rate beyond sham cTBS. TCI was reduced bi-directionally following the intervention, regardless of stimulation group. In addition, we observed an association between STT performance change and paretic WMFT-rate change in the M1c stimulation group only. CONCLUSIONS Multiple sessions of STT practice can improve paretic arm function and decrease TCI bilaterally, with no additional benefit of prior cTBS. Our results suggest that improvement in STT practice following M1c cTBS scaled with change in paretic arm function in some individuals. Our results highlight the need for a better understanding of the mechanisms of cTBS to effectively identify who may benefit from this form of brain stimulation.
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Affiliation(s)
- J L Neva
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - K E Brown
- Graduate Studies in Rehabilitation Sciences, University of British Columbia, Vancouver Canada
| | - K P Wadden
- Graduate Studies in Rehabilitation Sciences, University of British Columbia, Vancouver Canada
| | - C S Mang
- Graduate Studies in Rehabilitation Sciences, University of British Columbia, Vancouver Canada.,Division of Physical Medicine and Rehabilitation, Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - M R Borich
- Department of Rehabilitation Medicine, Division of Physical Therapy, School of Medicine, Emory University, Atlanta, GA, USA
| | - S K Meehan
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA
| | - L A Boyd
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,The Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
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MacIntosh A, Vignais N, Vigneron V, Fay L, Musielak A, Desailly E, Biddiss E. The design and evaluation of electromyography and inertial biofeedback in hand motor therapy gaming. Assist Technol 2020; 34:213-221. [PMID: 32207635 DOI: 10.1080/10400435.2020.1744770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
This article details the design of a co-created, evidence-based biofeedback therapy game addressing the research question: is the biofeedback implementation efficient, effective, and engaging for promoting quality movement during a therapy game focused on hand gestures? First, we engaged nine young people with Cerebral Palsy (CP) as design partners to co-create the biofeedback implementation. A commercially available, tap-controlled game was converted into a gesture-controlled game with added biofeedback. The game is controlled by forearm electromyography and inertial sensors. Changes required to integrate biofeedback are described in detail and highlight the importance of closely linking movement quality to short- and long-term game rewards. After development, 19 participants (8-17 years old) with CP played the game at home for 4 weeks. Participants played 17 ± 9 min/day, 4 ± 1 day/week. The biofeedback implementation proved efficient (i.e. participants reduced compensatory arm movements by 10.2 ± 4.0%), effective (i.e. participants made higher quality gestures over time), and engaging (i.e. participants consistently chose to review biofeedback). Participants found the game usable and enjoyable. Biofeedback design in therapy games should consider principles of motor learning, best practices in video game design, and user perspectives. Design recommendations for integrating biofeedback into therapy games are compiled in an infographic to support interdisciplinary knowledge sharing.
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Affiliation(s)
- A MacIntosh
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, Orsay, France.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
| | - N Vignais
- CIAMS, Univ. Paris-Sud, Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | - V Vigneron
- IBISC EA 4526, Université d'Evry, Université Paris-Saclay, Evry, France
| | - L Fay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - A Musielak
- Fondation Ellen Poidatz, Saint Fargeau-Ponthierry, Saint Fargeau-Ponthierry, France
| | - E Desailly
- Fondation Ellen Poidatz, Saint Fargeau-Ponthierry, Saint Fargeau-Ponthierry, France
| | - E Biddiss
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
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Spencer K, Yuen HK, Jenkins GR, Kirklin K, Griffin AR, Vogtle LK, Davis D. Evaluation of a Magic Camp for Children with Hemiparesis: A Pilot Study. Occup Ther Health Care 2020; 34:155-170. [PMID: 32202452 DOI: 10.1080/07380577.2020.1741055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 03/07/2020] [Accepted: 03/08/2020] [Indexed: 06/10/2023]
Abstract
This single-group open trial was designed to evaluate the effectiveness of a two-week magic camp as a means of hand-arm motor skills training to improve upper limb motor function (unilateral and bilateral) in children with hemiparesis. Seven children with hemiparesis participated in a magic camp program which met 3 days a week, 4 hours each day, for two consecutive weeks for a total of 24 hours. Participants completed three assessments at the beginning of the camp, post-camp, and at a three-month follow-up: the Jebsen Hand Function Test (JHFT), Children's Hand Experience Questionnaire (CHEQ), and a box opening task that required coordination of both upper limbs. A Wilcoxon signed-rank test revealed significant improvement in JHFT composite scores of the affected limb at post-camp (p = .04) and three-month follow-up (p = .04). In addition, a significant improvement in the number of activities performed using two hands from baseline to three-month follow-up was observed (p = .03). This pattern of improvement was also observed in the speed of completion for the box opening task. The improvement in motor function seems related to the participants' continuing performing daily activities with the affected hand and two hands after the magic camp.
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Affiliation(s)
- Kevin Spencer
- Hocus Focus, Inc., Lynchburg, VA, USA
- Department of Education, Carlow University, Pittsburgh, PA, USA
| | - Hon K Yuen
- Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gavin R Jenkins
- Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kimberly Kirklin
- UAB's Institute for Arts in Medicine, Alys Stephens Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Angla R Griffin
- Pediatric CI Therapy Program, Children's of Alabama, Birmingham, AL, USA
| | - Laura K Vogtle
- Department of Occupational Therapy, School of Health Professions Building, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Drew Davis
- Pediatric Rehabilitation Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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