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Ohno K, Oi R, Harada A, Tomori K, Sawada T. Response Shifts in the Canadian Occupational Performance Measure: A Convergent Mixed-Methods Study. Am J Occup Ther 2024; 78:7803205100. [PMID: 38709675 DOI: 10.5014/ajot.2024.050487] [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: 05/08/2024] Open
Abstract
IMPORTANCE A response shift (RS) is a phenomenon in which there is an individual perceptual gap between pre and post assessments. RS effects were not considered in the Canadian Occupational Performance Measure (COPM) development process. OBJECTIVE To detect the effects of RS on the COPM. DESIGN Convergent mixed-methods research. SETTING Subacute rehabilitation hospital in Japan. PARTICIPANTS Nineteen adult patients with a range of neurological and musculoskeletal conditions recruited from a subacute rehabilitation hospital. OUTCOMES AND MEASURES In the qualitative analysis, patients' perceptions regarding occupation identified by the COPM were compared between the initial assessment (Time 1 [T1]) and a reassessment (Time 2 [T2]). In the quantitative study, patients were asked to re-rate the occupations in which the RS had occurred, giving feedback on their perceptions at T1 (T2'). The difference between T2 and T2' was calculated to clarify the magnitude of the RS. RESULTS Of the 19 patients, 18 had an RS in at least one occupation. The RS effects were classified into five categories: Replacing, Adding, Reducing, Unspecified, and Embodiment. Ninety occupations were extracted from all the patients, and 46 (51.1%) were affected by RS. The percentages of occupations for which the change in score due to RS exceeded the minimal clinically important difference (±2 points) was 26.1% (12 of 46) for COPM-Performance scores and 30.4% (14 of 46) for COPM-Satisfaction scores. CONCLUSIONS AND RELEVANCE Diverse RS effects have been identified in the COPM, which also affect score interpretation. Plain-Language Summary: The Canadian Occupational Performance Measure has a potential measurement bias that is due to a response shift in which there is an individual perceptual gap between pre and post assessments. The results of this study reveal a need to establish more accurate measurement methods to reduce the impact of response shifts on COPM scores.
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Affiliation(s)
- Kanta Ohno
- Kanta Ohno, PhD, is Assistant Professor, Department of Rehabilitation, School of Health Science, Tokyo University of Technology, Tokyo, Japan;
| | - Riho Oi
- Riho Oi, BOT, is Occupational Therapist, Department of Occupational Therapy, Gotanda Rehabilitation Hospital, Tokyo, Japan
| | - Ai Harada
- Ai Harada, BOT, is Occupational Therapist, Department of Occupational Therapy, Shizuoka Tokushukai Hospital, Shizuoka, Japan
| | - Kounosuke Tomori
- Kounosuke Tomori, PhD, is Professor, Department of Rehabilitation, School of Health Science, Tokyo University of Technology, Tokyo, Japan
| | - Tatsunori Sawada
- Tatsunori Sawada, PhD, is Professor, Department of Rehabilitation, School of Health Science, Tokyo University of Technology, Tokyo, Japan
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Koch-Borner S, Bersch U, Grether S, Fridén J, Schibli S, Bersch I. Different Thumb Positions in the Tetraplegic Hand. Arch Phys Med Rehabil 2024; 105:75-81. [PMID: 37419233 DOI: 10.1016/j.apmr.2023.06.014] [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: 11/30/2022] [Revised: 06/16/2023] [Accepted: 06/26/2023] [Indexed: 07/09/2023]
Abstract
OBJECTIVE To analyze factors associated with malposition that affects function of the thumb in individuals with tetraplegia. DESIGN Retrospective cross-sectional study. SETTING Rehabilitation Center for Spinal Cord Injury. PARTICIPANTS Anonymized data from 82 individuals (68 men), mean age 52.9±20.2 (SD) with acute/subacute cervical spinal cord injury C2-C8 AIS A-D recorded during 2018-2020. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Motor point (MP) mapping and manual muscle test (MRC) of 3 extrinsic thumb muscles (flexor pollicis longus (FPL), extensor pollicis longus (EPL), and abductor pollicis longus (APL)). RESULTS 159 hands in 82 patients with tetraplegia C2-C8 AIS A-D were analyzed and assigned to "key pinch" (40.3%), "slack thumb" (26.4%), and "thumb-in-palm" (7.5%) positions. There was a significant (P<.0001) difference between the 3 thumb positions depicted in lower motor neuron (LMN) integrity tested by MP mapping and muscle strength of the 3 muscles examined. All studied muscles showed a significantly different expression of MP and the MRC values (P<.0001) between the "slack thumb" and "key pinch" position. MRC of FPL was significantly greater in the group "thumb-in-palm" compared with "key pinch" position (P<.0001). CONCLUSIONS Malposition of the thumb due to tetraplegia seems to be related to the integrity of LMN and voluntary muscle activity of the extrinsic thumb muscles. Assessments such as MP mapping and MRC of the 3 thumb muscles enable the identification of potential risk factors for the development of thumb malposition in individuals with tetraplegia.
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Affiliation(s)
- Sabrina Koch-Borner
- Swiss Paraplegic Centre Nottwil, Nottwil, Switzerland; Swiss Paraplegic Research Nottwil, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
| | - Ulf Bersch
- Swiss Paraplegic Centre Nottwil, Nottwil, Switzerland; International FES Centre®, Swiss Paraplegic Centre Nottwil, Nottwil, Switzerland
| | - Silke Grether
- Swiss Paraplegic Centre Nottwil, Nottwil, Switzerland
| | - Jan Fridén
- Swiss Paraplegic Centre Nottwil, Nottwil, Switzerland
| | | | - Ines Bersch
- Swiss Paraplegic Centre Nottwil, Nottwil, Switzerland; International FES Centre®, Swiss Paraplegic Centre Nottwil, Nottwil, Switzerland
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Lee HJ, Jin SM, Kim SJ, Kim JH, Kim H, Bae E, Yoo SK, Kim JH. Development and Validation of an Artificial Intelligence-Based Motion Analysis System for Upper Extremity Rehabilitation Exercises in Patients with Spinal Cord Injury: A Randomized Controlled Trial. Healthcare (Basel) 2023; 12:7. [PMID: 38200913 PMCID: PMC10779423 DOI: 10.3390/healthcare12010007] [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: 10/13/2023] [Revised: 12/07/2023] [Accepted: 12/10/2023] [Indexed: 01/12/2024] Open
Abstract
In this study, we developed an AI-based real-time motion feedback system for patients with spinal cord injury (SCI) during rehabilitation, aiming to enhance their interest and motivation. The effectiveness of the system in improving upper-limb muscle strength during the Thera band exercises was evaluated. The motion analysis program, including exercise repetition counts and calorie consumption, was developed using MediaPipe, focusing on three key motions (chest press, shoulder press, and arm curl) for upper extremity exercises. The participants with SCI were randomly assigned to the experimental group (EG = 4) or control group (CG = 5), engaging in 1 h sessions three times a week for 8 weeks. Muscle strength tests (chest press, shoulder press, lat pull-down, and arm curl) were performed before and after exercises. Although both groups did not show significant differences, the EG group exhibited increased strength in all measured variables, whereas the CG group showed constant or reduced results. Consequently, the computer program-based system developed in this study could be effective in muscle strengthening. Furthermore, these findings may serve as a valuable foundation for future AI-driven rehabilitation exercise systems.
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Affiliation(s)
- Hyun Jong Lee
- Department of Clinical Rehabilitation Research, Rehabilitation Research Institute, National Rehabilitation Center, Seoul 01022, Republic of Korea; (H.J.L.); (H.K.)
| | - Seung Mo Jin
- Department of Rehabilitation Exercise, National Rehabilitation Center, Seoul 01022, Republic of Korea
| | - Seck Jin Kim
- Ministry of Health and Welfare, Sejong 30113, Republic of Korea
| | - Jea Hak Kim
- Department of Rehabilitation Exercise, National Rehabilitation Center, Seoul 01022, Republic of Korea
| | - Hogene Kim
- Department of Clinical Rehabilitation Research, Rehabilitation Research Institute, National Rehabilitation Center, Seoul 01022, Republic of Korea; (H.J.L.); (H.K.)
| | | | - Sun Kook Yoo
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Jung Hwan Kim
- Department of Rehabilitation Exercise, National Rehabilitation Center, Seoul 01022, Republic of Korea
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Bertels N, Seelen H, Dembele J, Spooren A. Essential training variables of arm-hand training in people with cervical spinal cord injury: a systematic review. J Rehabil Med 2023; 55:jrm7147. [PMID: 37930130 PMCID: PMC10642344 DOI: 10.2340/jrm.v55.7147] [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: 01/13/2023] [Accepted: 08/29/2023] [Indexed: 11/07/2023] Open
Abstract
OBJECTIVE To identify and evaluate 3 training variables of motor training programmes involving people with a cervical spinal cord injury: i.e. motor training strategies, therapy dosage, and persons' motivation for arm-hand functioning in subacute and chronic phases. METHODS PubMed, Cochrane, CINAHL, EMBASE, and DARE databases were searched for active arm-hand motor training programmes. Two independent reviewers assessed methodological quality. Pre-post effect sizes were calculated using Hedge's g, and mean effect sizes were calculated to compare outcomes on the International Classification of Functioning, Disability, and Health levels of function and activity. RESULTS Twelve training programmes integrated mainly skill training alone or combined with strength and/or endurance training. Task-oriented training components included: multiple movement planes, functional movements, clear functional goals, and bimanual practice. Training duration of 8 weeks was common. Quantitative analyses of 8 training programmes showed an overall small effect (0.34) on function level and an overall moderate effect (0.55) on activity level. In depth-analysis of activity level showed moderate effects of skill training only (0.55) or combined with strength and endurance training (0.53). Moderate effects (0.53-0.60) were found for integrating functional movements, clear functional goals, real-life object manipulation, multiple movement planes, total skill practice, context-specific environment, exercise variety, and bimanual practice. Training of minimum 8 weeks showed a moderate effect (0.60-0.69). CONCLUSION Based on limited studies, arm-hand functioning aiming to improve activity level can be improved using skill training with at least 8 task-oriented training components, additional strength and endurance training, with a minimum training duration of 8 weeks.
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Affiliation(s)
- Nele Bertels
- Rehabilitation Research Center REVAL, Hasselt University, Diepenbeek, Belgium.
| | - Henk Seelen
- Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands; Maastricht University, Research School CAPHRI, dept. of Rehabilitation Medicine, Maastricht, Netherlands
| | - Justine Dembele
- Rehabilitation Research Center REVAL, Hasselt University, Diepenbeek, Belgium
| | - Annemie Spooren
- Rehabilitation Research Center REVAL, Hasselt University, Diepenbeek, Belgium
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Harvey LA, Glinsky JV, Chu J, Herbert RD, Liu H, Jan S, Billot L, Scivoletto G, Spooren AI, Seelen HA, Ben M, Tranter K, Chen LW, Rainey D, Rimmer C, Jorgensen V, Di Natal F, Denis S, Gollan EJ, Tamburella F, Agostinello J, van Laake-Geelen CM, Bell C, Lincoln C, Stolwijk JM, van der Lede J, Paddison S, Oostra K, Cameron ID, Weber G, Sherrington C, Nunn AK, Synnott EL, McCaughey E, Kaur J, Shetty S. Early and intensive motor training to enhance neurological recovery in people with spinal cord injury: trial protocol. Spinal Cord 2023; 61:521-527. [PMID: 37414835 PMCID: PMC10495259 DOI: 10.1038/s41393-023-00908-z] [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: 11/16/2022] [Revised: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 07/08/2023]
Abstract
STUDY DESIGN Protocol for a multi-centre randomised controlled trial (the SCI-MT trial). OBJECTIVES To determine whether 10 weeks of intensive motor training enhances neurological recovery in people with recent spinal cord injury (SCI). SETTING Fifteen spinal injury units in Australia, Scotland, England, Italy, Netherlands, Norway, and Belgium. METHODS A pragmatic randomised controlled trial will be undertaken. Two hundred and twenty people with recent SCI (onset in the preceding 10 weeks, American Spinal Injuries Association Impairment Scale (AIS) A lesion with motor function more than three levels below the motor level on one or both sides, or an AIS C or D lesion) will be randomised to receive either usual care plus intensive motor training (12 h of motor training per week for 10 weeks) or usual care alone. The primary outcome is neurological recovery at 10 weeks, measured with the Total Motor Score from the International Standards for Neurological Classification of SCI. Secondary outcomes include global measures of motor function, ability to walk, quality of life, participants' perceptions about ability to perform self-selected goals, length of hospital stay and participants' impressions of therapeutic benefit at 10 weeks and 6 months. A cost-effectiveness study and process evaluation will be run alongside the trial. The first participant was randomised in June 2021 and the trial is due for completion in 2025. CONCLUSIONS The findings of the SCI-MT Trial will guide recommendations about the type and dose of inpatient therapy that optimises neurological recovery in people with SCI. TRIAL REGISTRATION ACTRN12621000091808 (1.2.2021).
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Affiliation(s)
- Lisa A Harvey
- John Walsh Centre for Rehabilitation Research, University of Sydney, Kolling Institute, Sydney, NSW, Australia.
| | - Joanne V Glinsky
- John Walsh Centre for Rehabilitation Research, University of Sydney, Kolling Institute, Sydney, NSW, Australia
| | - Jackie Chu
- John Walsh Centre for Rehabilitation Research, University of Sydney, Kolling Institute, Sydney, NSW, Australia
| | | | - Hueiming Liu
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Stephen Jan
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Laurent Billot
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | | | | | - Henk A Seelen
- Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
| | - Marsha Ben
- John Walsh Centre for Rehabilitation Research, University of Sydney, Kolling Institute, Sydney, NSW, Australia
| | - Keira Tranter
- John Walsh Centre for Rehabilitation Research, University of Sydney, Kolling Institute, Sydney, NSW, Australia
| | - Lydia W Chen
- Royal North Shore Hospital, Sydney, NSW, Australia
| | | | | | | | | | - Sophie Denis
- Prince of Wales Hospital, Sydney, NSW, Australia
| | | | | | | | - Charlotte M van Laake-Geelen
- Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Chris Bell
- Repatriation General Hospital, Adelaide, SA, Australia
| | - Claire Lincoln
- Queen Elizabeth National Spinal Injures Unit, Glasgow, UK
| | - Janneke M Stolwijk
- Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Jessica van der Lede
- Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Sue Paddison
- London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital Trust, Middlesex, UK
| | | | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, University of Sydney, Kolling Institute, Sydney, NSW, Australia
| | | | - Catherine Sherrington
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Andrew K Nunn
- Victorian Spinal Cord Service, Austin Health, Melbourne, VIC, Australia
| | | | - Euan McCaughey
- Queen Elizabeth National Spinal Injures Unit, Glasgow, UK
| | - Jasbeer Kaur
- Royal North Shore Hospital, Sydney, NSW, Australia
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Combined Transcutaneous Electrical Spinal Cord Stimulation and Task-Specific Rehabilitation Improves Trunk and Sitting Functions in People with Chronic Tetraplegia. Biomedicines 2022; 11:biomedicines11010034. [PMID: 36672542 PMCID: PMC9855778 DOI: 10.3390/biomedicines11010034] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
The aim of this study was to examine the effects of transcutaneous electrical spinal cord stimulation (TSCS) and conventional task-specific rehabilitation (TSR) on trunk control and sitting stability in people with chronic tetraplegia secondary to a spinal cord injury (SCI). Five individuals with complete cervical (C4-C7) cord injury participated in 24-week therapy that combined TSCS and TSR in the first 12 weeks, followed by TSR alone for another 12 weeks. The TSCS was delivered simultaneously at T11 and L1 spinal levels, at a frequency ranging from 20-30 Hz with 0.1-1.0 ms. pulse width biphasically. Although the neurological prognosis did not manifest after either treatment, the results show that there were significant increases in forward reach distance (10.3 ± 4.5 cm), right lateral reach distance (3.7 ± 1.8 cm), and left lateral reach distance (3.0 ± 0.9 cm) after the combinational treatment (TSCS+TSR). The stimulation also significantly improved the participants' trunk control and function in sitting. Additionally, the trunk range of motion and the electromyographic response of the trunk muscles were significantly elevated after TSCS+TSR. The TSCS+TSR intervention improved independent trunk control with significantly increased static and dynamic sitting balance, which were maintained throughout the TSR period and the follow-up period, indicating long-term sustainable recovery.
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Knippenberg E, Timmermans A, Coolen J, Neven K, Hallet P, Lemmens J, Spooren A. Efficacy of a technology-based client-centred training system in neurological rehabilitation: a randomised controlled trial. J Neuroeng Rehabil 2021; 18:184. [PMID: 34961531 PMCID: PMC8712106 DOI: 10.1186/s12984-021-00977-2] [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: 07/06/2021] [Accepted: 11/30/2021] [Indexed: 11/21/2022] Open
Abstract
Background A client-centred task-oriented approach has advantages towards motivation and adherence to therapy in neurorehabilitation, but it is costly to integrate in practice. An intelligent Activity-based Client-centred Training (i-ACT), a low-cost Kinect-based system, was developed which integrates a client-centred and task-oriented approach. The objectives were (1) to investigate the effect of additional i-ACT training on functioning. And (2) to assess whether training with i-ACT resulted in more goal oriented training. Methods A single-blind randomised controlled trial was performed in 4 Belgian rehabilitation centres with persons with central nervous system deficits. Participants were randomly allocated through an independent website-based code generator using blocked randomisation (n = 4) to an intervention or control group. The intervention group received conventional care and additional training with i-ACT for 3 × 45 min/week during 6 weeks. The control group received solely conventional care. Functional ability and performance, quality of life (QoL), fatigue, trunk movement, and shoulder active range of motion (AROM) were assessed at baseline, after 3 weeks and 6 weeks of training, and 6 weeks after cessation of training. Data were analysed using non-parametric within and between group analysis. Results 47 persons were randomised and 45 analysed. Both intervention (n = 25) and control (n = 22) group improved over time on functional ability and performance as measured by the Wolf Motor Function Test, Manual Ability Measure-36, and Canadian Occupational Performance Measure, but no major differences were found between the groups on these primary outcome measures. Regarding QoL, fatigue, trunk movement, and shoulder AROM, no significant between group differences were found. High adherence for i-ACT training was found (i.e. 97.92%) and no adverse events, linked to i-ACT, were reported. In the intervention group the amount of trained personal goals (88%) was much higher than in the control group (46%). Conclusions Although additional use of i-ACT did not have a statistically significant added value regarding functional outcome over conventional therapy, additional i-ACT training provides more individualised client-centred therapy, and adherence towards i-ACT training is high. A higher intensity of i-ACT training may increase therapy effects, and should be investigated in future research. Trial registration: ClinicalTrials.gov Identifier NCT02982811. Registered 29 November 2016.
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Affiliation(s)
- Els Knippenberg
- Department of Healthcare, Centre of Expertise - Innovation in Care, PXL University of Applied Sciences and Arts, Guffenslaan 39, 3500, Hasselt, Belgium. .,Faculty of Rehabilitation Sciences, REVAL, Hasselt University, Agoralaan, Gebouw A, 3590, Diepenbeek, Belgium.
| | - Annick Timmermans
- Faculty of Rehabilitation Sciences, REVAL, Hasselt University, Agoralaan, Gebouw A, 3590, Diepenbeek, Belgium
| | - Jolijn Coolen
- Noorderhart, Rehabilitation and MS Center, Boemerangstraat 2, 3900, Pelt, Belgium
| | - Katrien Neven
- St-Trudo Hospital, Diestersteenweg 100, 3800, St-Truiden, Belgium
| | - Peter Hallet
- Ziekenhuis Oost-Limburg, Campus Sint-Barbara, Bessemerstraat 478, 3620, Lanaken, Belgium
| | - Jolien Lemmens
- Department of Healthcare, Centre of Expertise - Innovation in Care, PXL University of Applied Sciences and Arts, Guffenslaan 39, 3500, Hasselt, Belgium.,Sint-Gerardus, Multifunctioneel Centrum, Sint-Gerardusdreef 1, 3590, Diepenbeek, Belgium
| | - Annemie Spooren
- Department of Healthcare, Centre of Expertise - Innovation in Care, PXL University of Applied Sciences and Arts, Guffenslaan 39, 3500, Hasselt, Belgium.,Faculty of Rehabilitation Sciences, REVAL, Hasselt University, Agoralaan, Gebouw A, 3590, Diepenbeek, Belgium
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8
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Knippenberg E, Van Hout L, Smeets W, Palmaers S, Timmermans A, Spooren A. Developing an intelligent activity-based client-centred training system with a user-centred approach. Technol Health Care 2021; 28:355-368. [PMID: 31796713 DOI: 10.3233/thc-191854] [Citation(s) in RCA: 4] [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 neurorehabilitation, clinicians and managers are searching for new client-centred task-oriented applications which can be administered without extra costs and effort of therapists, and increase the client's motivation. OBJECTIVE To develop and evaluate a prototype of an intelligent activity-based client-centred training (i-ACT) system based on Microsoft Kinect®. METHODS Within an iterative user centred process, the i-ACT prototype was developed and necessary features were established for use in neurological settings. After the test trial with a high fidelity prototype, the value, usefulness, and credibility were evaluated. RESULTS Seven therapists participated in focus groups and 54 persons with neurological problems participated in test trials. A prototype was established based on the user's experience. Results show that clients and therapists acknowledge the value and usefulness (clients 5.71/7; therapists 4.86/7), and credibility (clients 21.00/27; therapists 14.50/27) of i-ACT. CONCLUSIONS Therapists want to be able to record an endless range of movements and activities which enables individualised exercise programs for persons with disabilities. For therapists it is important that the system provides feedback about the quality of movement and not only results. In future work, clinical trials will be performed towards feasibility and effectiveness of i-ACT in neurorehabilitation and other rehabilitation domains.
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Affiliation(s)
- Els Knippenberg
- Innovation in Care, Centre of Expertise, PXL University College, 3500 Hasselt, Belgium.,Reval Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Lode Van Hout
- Smart-ICT, Centre of Expertise, PXL University College, 3500 Hasselt, Belgium
| | - Wout Smeets
- Reval Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Steven Palmaers
- Smart-ICT, Centre of Expertise, PXL University College, 3500 Hasselt, Belgium
| | - Annick Timmermans
- Reval Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Annemie Spooren
- Innovation in Care, Centre of Expertise, PXL University College, 3500 Hasselt, Belgium.,Reval Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
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9
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Grampurohit N, Bell A, Duff SV, Mulcahey MJ, Thielen CC, Kaplan G, Marino RJ. Highlighting gaps in spinal cord injury research in activity-based interventions for the upper extremity: A scoping review. NeuroRehabilitation 2021; 49:23-38. [PMID: 33967071 DOI: 10.3233/nre-210042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Upper extremity activity-based therapy for neurologic disorders employs high-intensity, high repetition functional training to exploit neuroplasticity and improve function. Research focused on high-intensity upper extremity activity-based therapy for persons with spinal cord injury (SCI) is limited. OBJECTIVE To summarize high-intensity activity-based interventions used in neurological disorders for their current or potential application to SCI. METHODS The scoping review included articles from MEDLINE, CINAHL, Cochrane CENTRAL, and OTSeeker with the criteria: non-invasive activity-based interventions delivered at least three times/week for two weeks, upper extremity functional outcomes, age 13 years or older, English language, and neurological disorders three months post onset/injury. RESULTS The search yielded 172 studies. There were seven studies with SCI, all in adults. Activity-based interventions in SCI included task-specific training and gaming, with and without electrical stimulation, and a robotic exoskeleton. The other populations found in the review included studies in stroke, cerebral palsy, and multiple sclerosis. Thirty-four different interventions were reported in other populations. In comparison to the extensive stroke research, work in SCI was not found for high-intensity interventions using virtual reality, brain stimulation, rehabilitation devices, and applications to the home and telerehab settings. CONCLUSION The results highlight critical gaps within upper extremity high-intensity activity-based research in SCI.
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Affiliation(s)
- Namrata Grampurohit
- Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Alison Bell
- Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Susan V Duff
- Crean College of Health and Behavioral Sciences, Chapman University, Irvine, CA, USA
| | - M J Mulcahey
- Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Gary Kaplan
- Scott Memorial Library, Academic Commons, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ralph J Marino
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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10
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Kang E, Kim MY, Lipsey KL, Foster ER. Person-Centered Goal Setting: A systematic review of intervention components and level of active engagement in rehabilitation goal setting interventions. Arch Phys Med Rehabil 2021; 103:121-130.e3. [PMID: 34375632 DOI: 10.1016/j.apmr.2021.06.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 06/15/2021] [Accepted: 06/28/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This systematic review aims to examine 1) what components are used in current person-centered goal setting interventions for adults with health conditions in rehabilitation and 2) the extent to which the engagement of people in their rehabilitation goal setting is encouraged. DATA SOURCES PubMed/MEDLINE, EMBASE, Cumulative Index of Nursing and Allied Health Literature, SCOPUS, and Web of Science from inception to November 2020. STUDY SELECTION Primary inclusion criteria were peer-reviewed articles that evaluated person-centered goal setting interventions for adults with health conditions in rehabilitation. Two independent reviewers screened 28,294 records, and 22 articles met inclusion criteria. DATA EXTRACTION Two reviewers independently completed data extraction and quality assessment using the Physiotherapy Evidence Database (PEDRo) scale based on the original authors' descriptions, reports, and protocol publications. Any discrepancies were resolved by consensus or in consultation with another senior reviewer. DATA SYNTHESIS Using narrative synthesis, we found that current person-centered goal setting has variability in their inclusion of intervention components. A considerable number of components are under-implemented in current practice, with formulation of coping plan and follow-up being most commonly left out. The active engagement of people does appear to be promoted within the components that are included in the interventions. Nine studies were high-quality defined as a total PEDro scale score of 6 or above. CONCLUSIONS Although current person-centered goal setting encourages the active engagement of people, many of these interventions lack components considered important for supporting goal achievement and optimal outcomes. Future practice may be improved by incorporating a comprehensive set of goal setting components and encouraging the active engagement of people throughout the entire goal setting process. Together, these practices may facilitate the achievement of meaningful rehabilitation goals and improve rehabilitation outcomes for adults with health conditions.
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Affiliation(s)
- Eunyoung Kang
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.
| | - Moon Young Kim
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.
| | - Kim L Lipsey
- Bernard Becker Medical Library, Washington University School of Medicine, St. Louis, MO, USA.
| | - Erin R Foster
- Program in Occupational Therapy, Department of Neurology, & Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
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Knippenberg E, Lamers I, Timmermans A, Spooren A. Motivation, Usability, and Credibility of an Intelligent Activity-Based Client-Centred Training System to Improve Functional Performance in Neurological Rehabilitation: An Exploratory Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7641. [PMID: 34300092 PMCID: PMC8304931 DOI: 10.3390/ijerph18147641] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/12/2021] [Accepted: 07/15/2021] [Indexed: 12/29/2022]
Abstract
(1) Background: technology-based training systems are increasingly integrated in neurorehabilitation but are rarely combined with a client-centred task-oriented approach. To provide a low-cost client-centred task-oriented system, the intelligent activity-based client-centred task-oriented training (i-ACT) was developed. The objective was to evaluate the usability, credibility and treatment expectancy of i-ACT, and the motivation towards i-ACT use in rehabilitation over time. Additionally, this study will evaluate the upper limb treatment effects after training with i-ACT. (2) Methods: a mixed-method study was performed in four rehabilitation centres. Training with i-ACT was provided during six weeks, three times per week, forty-five minutes per day, additional to conventional care. (3) Results: seventeen persons with central nervous system diseases were included. High scores were seen in the system usability scale (score ≥ 73.8/100), credibility (score ≥ 22.0/27.0)/expectancy (score ≥ 15.8/27.0) questionnaire, and intrinsic motivation inventory (score ≥ 5.2/7.0), except the subscale pressure (score ≤ 2.0/7.0). Results from the interviews corroborate these findings and showed that clients and therapists believe in the i-ACT system as an additional training support system. Upper limb functional ability improved significantly (p < 0.05) over time on the Wolf motor function test. (4) Conclusion: i-ACT is a client-centred task-oriented usable and motivational system which has the potential to enhance upper limb functional training in persons with neurological diseases.
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Affiliation(s)
- Els Knippenberg
- Department of Healthcare, Centre of Expertise–Innovation in Care, PXL University of Applied Sciences and Arts, 3500 Hasselt, Limburg, Belgium;
- Faculty of Rehabilitation Sciences, REVAL, Hasselt University, 3590 Diepenbeek, Limburg, Belgium; (A.T.); (I.L.)
| | - Ilse Lamers
- Faculty of Rehabilitation Sciences, REVAL, Hasselt University, 3590 Diepenbeek, Limburg, Belgium; (A.T.); (I.L.)
- Noorderhart, Rehabilitation and MS Center, 3900 Pelt, Limburg, Belgium
| | - Annick Timmermans
- Faculty of Rehabilitation Sciences, REVAL, Hasselt University, 3590 Diepenbeek, Limburg, Belgium; (A.T.); (I.L.)
| | - Annemie Spooren
- Department of Healthcare, Centre of Expertise–Innovation in Care, PXL University of Applied Sciences and Arts, 3500 Hasselt, Limburg, Belgium;
- Faculty of Rehabilitation Sciences, REVAL, Hasselt University, 3590 Diepenbeek, Limburg, Belgium; (A.T.); (I.L.)
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Thielen CC, Marino RJ, Duff S, Kaplan G, Mulcahey MJ. Activity-based Rehabilitation Interventions of the Neurologically Impaired Upper Extremity: Description of a Scoping Review Protocol. Top Spinal Cord Inj Rehabil 2018; 24:288-294. [PMID: 29997431 DOI: 10.1310/sci2403-288] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction: A scoping review provides a means to synthesize and present a large body of literature on a broad topic, such as methods for various upper extremity activity-based therapy (ABT) interventions. Objectives: To describe our scoping review protocol to evaluate peer-reviewed articles focused on ABT interventions for individuals with neurologically impaired upper extremities. Methods: At Jefferson College of Health Professions and Sidney Kimmel Medical College at Jefferson, Philadelphia, the authors will follow this protocol to conduct a scoping review by establishing a research question and conducting a search of bibliographic databases to identify relevant studies. Using specific inclusion and exclusion criteria, abstracts will be screened and full-text articles will be reviewed for inclusion in charting, summarizing, and reporting results of appropriate studies. Conclusion: This protocol will guide the scoping review process to develop a framework for establishing a noninvasive ABT intervention informed by evidence for individuals with neurologically impaired upper extremities.
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Affiliation(s)
- Christina Calhoun Thielen
- Jefferson College of Health Professions, Jefferson (Philadelphia University + Thomas Jefferson University), Philadelphia, Pennsylvania
| | - Ralph J Marino
- Sidney Kimmel Medical College at Jefferson (Philadelphia University + Thomas Jefferson University), Philadelphia, Pennsylvania
| | - Susan Duff
- Crean College of Health and Behavioral Sciences, Chapman University, Irvine, California
| | - Gary Kaplan
- Center for Teaching and Learning, Jefferson (Philadelphia University + Thomas Jefferson University), Philadelphia, Pennsylvania
| | - M J Mulcahey
- Jefferson College of Health Professions, Jefferson (Philadelphia University + Thomas Jefferson University), Philadelphia, Pennsylvania
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Johanson ME. Rehabilitation After Surgical Reconstruction to Restore Function to the Upper Limb in Tetraplegia: A Changing Landscape. Arch Phys Med Rehabil 2017; 97:S71-4. [PMID: 27233593 DOI: 10.1016/j.apmr.2016.03.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 03/28/2016] [Accepted: 03/30/2016] [Indexed: 10/21/2022]
Abstract
Upper limb reconstructive surgical procedures for individuals with tetraplegia are performed in many centers internationally. Most recipients of surgery return to local communities and nonsurgical centers for postoperative rehabilitation and long-term follow-up. This supplement focuses on the clinical significance of upper extremity reconstruction, addressing issues related to the availability and choice for surgery, preoperative assessments, postoperative training paradigms, and appropriate outcome measures. Comprehensive intervention protocols are described in terms of dose, timing, specific activities, modalities, and related outcomes. Shared knowledge of current rehabilitation practice, as it relates to reconstructive surgery, can expand treatment options communicated to patients, increase the availability of postoperative muscle reeducation programs, and motivate long-term follow-up assessments.
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Johanson ME, Jaramillo JP, Dairaghi CA, Murray WM, Hentz VR. Multicenter Survey of the Effects of Rehabilitation Practices on Pinch Force Strength After Tendon Transfer to Restore Pinch in Tetraplegia. Arch Phys Med Rehabil 2017; 97:S105-16. [PMID: 27233585 DOI: 10.1016/j.apmr.2016.01.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 01/13/2016] [Accepted: 01/14/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To identify key components of conventional therapy after brachioradialis (BR) to flexor pollicis longus (FPL) transfer, a common procedure to restore pinch strength, and evaluate whether any of the key components of therapy were associated with pinch strength outcomes. DESIGN Rehabilitation protocols were surveyed in 7 spinal cord injury (SCI) centers after BR to FPL tendon transfer. Key components of therapy, including duration of immobilization, participation, and date of initiating therapy activities (mobilization, strengthening, muscle reeducation, functional activities, and home exercise), were recorded by the patient's therapist. Pinch outcomes were recorded with identical equipment at 1-year follow-up. SETTING Seven SCI rehabilitation centers where the BR to FPL surgery is performed on a routine basis. PARTICIPANTS Thirty-eight arms from individuals with C5-7 level SCI injury who underwent BR to FPL transfer surgery (N=34). INTERVENTION Conventional therapy according to established protocol in each center. MAIN OUTCOME MEASURES The frequency of specific activities and their time of initiation (relative to surgery) were expressed as means and 95% confidence intervals. Outcome measures included pinch strength and the Canadian Occupational Performance Measure (COPM). Spearman rank-order correlations determined significant relations between pinch strength and components of therapy. RESULTS There was similarity in the key components of therapy and in the progression of activities. Early cast removal was associated with pinch force (Spearman ρ=-.40, P=.0269). Pinch force was associated with improved COPM performance (Spearman ρ=.48, P=.0048) and satisfaction (Spearman ρ=.45, P=.0083) scores. CONCLUSIONS Initiating therapy early after surgery is beneficial after BR to FPL surgery. Postoperative therapy protocols have the potential to significantly influence the outcome of tendon transfers after tetraplegia.
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Affiliation(s)
| | | | | | | | - Vincent R Hentz
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA; Department of Surgery, Stanford University, Palo Alto, CA
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Upper Extremity Assessment in Tetraplegia: The Importance of Differentiating Between Upper and Lower Motor Neuron Paralysis. Arch Phys Med Rehabil 2016; 97:S97-S104. [DOI: 10.1016/j.apmr.2015.11.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 10/06/2015] [Accepted: 11/02/2015] [Indexed: 12/25/2022]
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Van de Velde D, Devisch I, De Vriendt P. The client-centred approach as experienced by male neurological rehabilitation clients in occupational therapy. A qualitative study based on a grounded theory tradition. Disabil Rehabil 2016; 38:1567-77. [DOI: 10.3109/09638288.2015.1107628] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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The impact of task-oriented client-centered training on individuals with spinal cord injury in the community. Spinal Cord 2016; 54:849-854. [PMID: 26754477 DOI: 10.1038/sc.2015.237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 12/08/2015] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Quasi-experimental study. OBJECTIVES The objective of this study was to evaluate the impact of an 8-week, task-oriented client-centered training (TOCCT) on physical function, perception of performance and satisfaction with the activities and achievement of training goals of individuals with spinal cord injury (SCI). SETTING Khon Kaen, Thailand. METHODS Participants were 12 persons with SCI living in Ubolratana District, Khon Kaen Province, Thailand. Outcome measures consisted of physical function and perception of performance and satisfaction with the activities, which were assessed at pre- and post-training periods by using the Spinal Cord Independence Measure version III and the Canadian Occupational Performance Measure, respectively. The achievement of training goals was also determined by the Goal Attainment Scale. Data were analyzed by using paired t-tests. RESULTS The 8-week, TOCCT significantly improved physical function of the participants (P=0.001, 95% confidence interval (CI) 3.22-7.12). Another positive impact of the training was found in the perceived levels of performance and satisfaction with the activities (P=0.001, 95% CI 1.31-3.49 and 1.68-3.67, respectively). Furthermore, at the end of the study, most of the participants could reach their expected training goals. CONCLUSION The 8-week, TOCCT significantly improved physical function and perception of performance and satisfaction with the activities of individuals with SCI when compared with the pre-training period. The training could also help most of the participants to achieve their training goals. Future studies with randomized controlled trial and longitudinal design are suggested to reveal further benefits of such training on individuals with SCI.
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Robot-assisted task-oriented upper extremity skill training in cervical spinal cord injury: a feasibility study. Spinal Cord 2015; 53:547-51. [PMID: 25644390 DOI: 10.1038/sc.2014.250] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 12/24/2014] [Accepted: 12/29/2014] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Prospective multiple case study. OBJECTIVES To test (1) the feasibility of haptic robot technology (Haptic Master (HM)) use to improve arm-hand function (AHF) and arm-hand skill performance (AHSP) in persons with a cervical spinal cord injury (C-SCI), (2) inventory participants' motivation and expectation to work with the robot technology used and (3) to descriptively report the results in individual cases. SETTING Rehabilitation Centre. METHODS Five C-SCI patients were trained for 6 weeks, 3 days per week, 60 min per day. Therapists filled out the Usefulness, Satisfaction and Ease-of-use questionnaire (USE). The Intrinsic Motivational Inventory (IMI) and credibility and expectancy questionnaire (CEQ) were filled out by participants. Performance at activity level was gauged using the Van Lieshout test for AHF in Tetraplegia and the Spinal Cord Independence Measure. Function level was gauged using muscle strength testing and the International Classification for Surgery of the Hand in Tetraplegia. RESULTS As to the feasibility of the application of haptic robot technology, the mean USE score was 65%. Mean IMI and CEQ results were 67% and 60%, respectively. Participants were motivated to train with the HM. All participants rated credibility higher than expectations regarding the improvement. In the current patients, little progress was demonstrated at the International Classification of Functioning, Disability and Health function and the activity level. CONCLUSION It is feasible to train C-SCI persons with the HM. Therapists report that working with the HM is easy to learn and easy to perform. Usability of the HM may be improved. Further research is needed to assess in which group of C-SCI and at which stage of rehabilitation HM training may be most beneficial.
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Tetteroo D, Timmermans AAA, Seelen HAM, Markopoulos P. TagTrainer: supporting exercise variability and tailoring in technology supported upper limb training. J Neuroeng Rehabil 2014; 11:140. [PMID: 25252932 PMCID: PMC4182772 DOI: 10.1186/1743-0003-11-140] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 09/19/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rehabilitation technology for upper limb training can potentially increase the amount, duration, and quality of therapy offered to patients by targeting the needs of individual patients. Empirical evaluations of such technologies focus on clinical effectiveness; however, little is known regarding the implications of their implementation in daily practice. Tailoring training content to patients requires active participation by therapists, and requires an extension of their role to include authoring and modifying exercises. It is not yet known whether this is feasible, and the socio-technical requirements that will make it successful in practice have not yet been explored. The current study investigates the extent to which therapists can take the role of authoring patient-specific training content and whether effort savings can be achieved by sharing the created content. METHOD We present TagTrainer: an interactive tabletop system for rehabilitation that can be operated by manipulating every day physical objects in order to carry out exercises that simulate daily living tasks. TagTrainer supports therapists in creating their own exercises that fit individual patient needs, in adjusting existing exercises, and in putting together personalized exercise programs for and with patients. Four therapists in stroke- and paraplegia-rehabilitation have used TagTrainer for three weeks. Semi-structured interviews were conducted with the therapists, questionnaires were administered to them, and observation notes and usage logs were collected. RESULTS A total of 20 exercises were created from scratch, while another three exercises were created as variations of the existing ones. Importantly, all these exercises were created to address specific needs that patients expressed. The patients found the exercises motivating and these exercises were integrated into their regular training. CONCLUSIONS TagTrainer can support arm-hand rehabilitation training by increasing therapy variability and tailoring. Therapists consider TagTrainer most suited for group sessions where they supervise many patients at once. Therapists are motivated and are able to, with minimal training, create and tailor exercises for patients fitting individual needs and capabilities. Future research will examine the socio-technical conditions that will encourage therapists to contribute and share training content, and provide the peer support needed for the adoption of a new technology.
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Affiliation(s)
- Daniel Tetteroo
- Department of Industrial Design, Eindhoven University of Technology, Den Dolech 2, 5612 AZ, Eindhoven, the Netherlands.
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Lu X, Battistuzzo CR, Zoghi M, Galea MP. Effects of training on upper limb function after cervical spinal cord injury: a systematic review. Clin Rehabil 2014; 29:3-13. [DOI: 10.1177/0269215514536411] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objective: To summarize the evidence for the effectiveness of exercise training in promoting recovery of upper extremity function after cervical spinal cord injury. Data sources: Medline, Cochrane, CINAHL, EMBASE and PEDro were used to search the literature. Review methods: Two reviewers independently selected and summarized the included studies. Methodological quality of the selected articles was scored using the Downs and Black checklist. Results: A total of 16 studies were included, representing a total of 426 participants. Overall, the internal validity and reporting of the studies was fair to good, while power and external validity were poor. Interventions included exercise therapy, electrical stimulation, functional electrical stimulation, robotic training and repetitive transcranial magnetic stimulation. Most of the studies reported improvements in muscle strength, arm and hand function, activity of daily living or quality of life after intervention. Conclusions: Training including exercise therapy, electrical stimulation, functional electrical stimulation of the upper limb following cervical spinal cord injury leads to improvements in muscle strength, upper limb function and activity of daily living or quality of life. Further research is needed into the effects of repetitive transcranial magnetic stimulation and robotic training on upper limb function.
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Affiliation(s)
- Xiao Lu
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Camilla R Battistuzzo
- Physiotherapy Department, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Maryam Zoghi
- Physiotherapy Department, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Mary P Galea
- Physiotherapy Department, The University of Melbourne, Parkville, Victoria 3010, Australia
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Spooren AIF, Arnould C, Smeets RJEM, Snoek G, Seelen HAM. Reference values for the transformed Van Lieshout hand function test for tetraplegia. Spinal Cord 2013; 51:745-9. [DOI: 10.1038/sc.2013.73] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 06/18/2013] [Accepted: 06/20/2013] [Indexed: 11/09/2022]
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Spooren AIF, Arnould C, Smeets RJEM, Bongers HMH, Seelen HAM. Improvement of the Van Lieshout hand function test for Tetraplegia using a Rasch analysis. Spinal Cord 2013; 51:739-44. [DOI: 10.1038/sc.2013.54] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 12/17/2012] [Accepted: 12/27/2012] [Indexed: 11/09/2022]
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Spooren AIF, Timmermans AAA, Seelen HAM. Motor training programs of arm and hand in patients with MS according to different levels of the ICF: a systematic review. BMC Neurol 2012; 12:49. [PMID: 22747894 PMCID: PMC3527200 DOI: 10.1186/1471-2377-12-49] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 06/06/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The upper extremity plays an important role in daily functioning of patients with Multiple Sclerosis (MS) and strongly influences their quality of life. However, an explicit overview of arm-hand training programs is lacking. The present review aims to investigate the training components and the outcome of motor training programs for arm and hand in MS. METHODS A computerized systematic literature search in 5 databases (PubMed, CINAHL, EMBASE, PEDro and Cochrane) was performed using the following Mesh terms: Multiple Sclerosis, Rehabilitation, Physical Education and Training, Exercise, Patient-Centered Care, Upper Extremity, Activities of Daily Living, Motor Skills, Motor Activity, Intervention Studies and Clinical Trial. The methodological quality of the selected articles was scored with the Van Tulder Checklist. A descriptive analyses was performed using the PICO principle, including scoring of training components with the calculation of Hedges'g effect sizes. RESULTS Eleven studies were eligible (mean Van Tulder-score = 10.82(SD2.96)). Most studies reported a specific improvement in arm hand performance at the ICF level that was trained at. The mean number of training components was 5.5(SD2.8) and a significant correlation (r = 0.67; p < 0.05) between the number of training components and effect sizes was found. The components 'client-centered' and 'functional movement' were most frequently used, whereas 'distribution based practice', 'feedback' and 'random practice' were never used. The component 'exercise progression' was only used in studies with single ICF body function training, with the exception of 1 study with activity level training. Studies including the component 'client-centred' demonstrated moderate to high effect sizes. CONCLUSION Motor training programs (both at the ICF body function and activity level) have shown to improve arm and hand performance in MS in which the value of the training specificity was emphasized. To optimize upper extremity training in MS the component 'client-centred' and 'exercise progression' may be important. Furthermore, given the importance attributed to the components 'distribution based practice', 'feedback' and 'random practice' in previous research in stroke patients, the use of these components in arm hand training should be explored in future research.
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Affiliation(s)
- Annemie IF Spooren
- Department of Healthcare, PHL University College Hasselt, Hasselt, Belgium
- Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
- Department of Rehabilitation Medicine, Maastricht University, Research School CAPHRi, Maastricht, The Netherlands
- Guffenslaan 39, 3500, Hasselt, Belgium
| | - Annick AA Timmermans
- Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
- Department of Rehabilitation Medicine, Maastricht University, Research School CAPHRi, Maastricht, The Netherlands
| | - Henk AM Seelen
- Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
- Department of Rehabilitation Medicine, Maastricht University, Research School CAPHRi, Maastricht, The Netherlands
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Spooren AIF, Janssen-Potten YJM, Kerckhofs E, Bongers HMH, Seelen HAM. ToCUEST: a task-oriented client-centered training module to improve upper extremity skilled performance in cervical spinal cord-injured persons. Spinal Cord 2011; 49:1042-8. [DOI: 10.1038/sc.2011.52] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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