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Cerfoglio S, Capodaglio P, Rossi P, Conforti I, D'Angeli V, Milani E, Galli M, Cimolin V. Evaluation of Upper Body and Lower Limbs Kinematics through an IMU-Based Medical System: A Comparative Study with the Optoelectronic System. SENSORS (BASEL, SWITZERLAND) 2023; 23:6156. [PMID: 37448005 DOI: 10.3390/s23136156] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/23/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023]
Abstract
In recent years, the use of inertial-based systems has been applied to remote rehabilitation, opening new perspectives for outpatient assessment. In this study, we assessed the accuracy and the concurrent validity of the angular measurements provided by an inertial-based device for rehabilitation with respect to the state-of-the-art system for motion tracking. Data were simultaneously collected with the two systems across a set of exercises for trunk and lower limbs, performed by 21 healthy participants. Additionally, the sensitivity of the inertial measurement unit (IMU)-based system to its malpositioning was assessed. Root mean square error (RMSE) was used to explore the differences in the outputs of the two systems in terms of range of motion (ROM), and their agreement was assessed via Pearson's correlation coefficient (PCC) and Lin's concordance correlation coefficient (CCC). The results showed that the IMU-based system was able to assess upper-body and lower-limb kinematics with a mean error in general lower than 5° and that its measurements were moderately biased by its mispositioning. Although the system does not seem to be suitable for analysis requiring a high level of detail, the findings of this study support the application of the device in rehabilitation programs in unsupervised settings, providing reliable data to remotely monitor the progress of the rehabilitation pathway and change in patient's motor function.
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Affiliation(s)
- Serena Cerfoglio
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
| | - Paolo Capodaglio
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
- Department of Surgical Sciences, Physical Medicine and Rehabilitation, University of Turin, 10126 Turin, Italy
| | - Paolo Rossi
- Clinica Hildebrand, Centro di Riabilitazione Brissago, Via Crodolo 18, 6614 Brissago, Switzerland
| | - Ilaria Conforti
- Euleria Health Società Benefit Rovereto, 38068 Trento, Italy
| | | | - Elia Milani
- Euleria Health Società Benefit Rovereto, 38068 Trento, Italy
| | - Manuela Galli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
| | - Veronica Cimolin
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, San Giuseppe Hospital, IRCCS Istituto Auxologico Italiano, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
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Wearable sensors and machine learning in post-stroke rehabilitation assessment: A systematic review. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2021.103197] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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McGlinchey MP, McKevitt C, Faulkner-Gurstein R, Sackley CM. The rehabilitation of physical function after severely disabling stroke: a survey of UK therapist practice. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2020.0143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/aims Individuals who are severely disabled from stroke (survivors of severely disabling stroke) experience poorer outcomes compared to those who are less disabled from stroke. However, there is a paucity of evidence describing current therapy practice in the management of severely disabling stroke. The aim of the study was to describe intervention and outcome measure use by physiotherapists and occupational therapists in the rehabilitation of physical function of survivors of severely disabling stroke. Methods A mixed-methods survey was conducted, involving an online questionnaire and follow-up interviews. Survey participants were UK-based physiotherapists and occupational therapists with experience treating stroke. Questionnaire data were analysed with descriptive and inferential statistics. Interview data were analysed using content analysis. Results A total of 452 therapists (59% physiotherapists) responded to the questionnaire. Out of the respondents, 18 self-selected therapists participated in follow-up interviews to explain questionnaire data. Whole body positioning, training of upper limb handling and positioning, and sitting balance practice were the most frequently used interventions. Inpatient-based therapists performed more active rehabilitation interventions, whereas community-based therapists performed more training and education. The Barthel Index, Modified Rankin Scale and National Institutes for Health Stroke Scale were the most frequently used outcome measures. Outcome measure use was generally low and was more likely to be completed when it was part of a national audit. Reasons for low outcome measure use were perceived lack of time and insensitivity to detect clinical change. Conclusions A variety of interventions and outcome measures are used in the rehabilitation of survivors of severely disabling stroke. There is a need to evaluate the effectiveness of frequently used interventions and identify outcome measures that are sensitive to the needs of survivors of severely disabling stroke.
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Affiliation(s)
- Mark P McGlinchey
- School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Physiotherapy Department, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Christopher McKevitt
- School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Rachel Faulkner-Gurstein
- School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Catherine M Sackley
- School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
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Most Important Factors for Deciding Rehabilitation Provision for Severe Stroke Survivors Post Hospital Discharge: A Study Protocol for a Best-Worst Scaling Experiment. Methods Protoc 2021; 4:mps4020027. [PMID: 34066439 PMCID: PMC8163167 DOI: 10.3390/mps4020027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/25/2021] [Accepted: 04/28/2021] [Indexed: 11/24/2022] Open
Abstract
Efficient decision-making is crucial to ensure adequate rehabilitation with optimal use of healthcare resources. Establishing the factors associated with making decisions concerning rehabilitation provision is important to guide clinical staff towards person-centred decisions for rehabilitation after severe stroke. In this study we conduct a best–worst scaling (BWS) experiment to identify the most important factors and their relative weight of importance for deciding the type of ongoing rehabilitation services a person with severe stroke might receive post hospital discharge. Fractional, efficient designs are applied regarding the survey design. Key multidisciplinary staff regularly involved in making decisions for rehabilitation in a stroke unit will be recruited to participate in an online BWS survey. Hierarchical Bayes estimation will be used as the main analysis method, with the best–worst count analysis as a secondary analysis. The survey is currently being piloted prior to commencing the process of data collection. Results are expected by the end of September 2021. The research will add to the current literature on clinical decision-making in stroke rehabilitation. Findings will quantify the preferences of factors among key multi-disciplinary clinicians working in stroke units in the UK, involved in decision-making concerning rehabilitation after stroke.
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Pereira S, Ross Graham J, Shahabaz A, Salter K, Foley N, Meyer M, Teasell R. Rehabilitation of Individuals With Severe Stroke: Synthesis of Best Evidence and Challenges in Implementation. Top Stroke Rehabil 2015; 19:122-31. [DOI: 10.1310/tsr1902-122] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Lindsay C, Simpson J, Ispoglou S, Sturman SG, Pandyan AD. The early use of botulinum toxin in post-stroke spasticity: study protocol for a randomised controlled trial. Trials 2014; 15:12. [PMID: 24401159 PMCID: PMC3895790 DOI: 10.1186/1745-6215-15-12] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 12/18/2013] [Indexed: 11/10/2022] Open
Abstract
Background Patients surviving stroke but who have significant impairment of function in the affected arm are at more risk of developing pain, stiffness and contractures. The abnormal muscle activity, associated with post-stroke spasticity, is thought to be causally associated with the development of these complications. Treatment of spasticity is currently delayed until a patient develops signs of these complications. Methods/Design This protocol is for a phase II study that aims to identify whether using OnabotulinumtoxinA (BoNT-A) in combination with physiotherapy early post stroke when initial abnormal muscle activity is neurophysiologically identified can prevent loss of range at joints and improve functional outcomes. The trial uses a screening phase to identify which people are appropriate to be included in a double blind randomised placebo-controlled trial. All patients admitted to Sandwell and West Birmingham NHS Trust Hospitals with a diagnosis of stroke will be screened to identify functional activity in the arm. Those who have no function will be appropriate for further screening. Patients who are screened and have abnormal muscle activity identified on EMG will be given electrical stimulation to forearm extensors for 3 months and randomised to have either injections of BoNT-A or normal saline. The primary outcome measure is the action research arm test - a measure of arm function. Further measures include spasticity, stiffness, muscle strength and fatigue as well as measures of quality of life, participation and caregiver strain. Trial registrations ISRCTN57435427, EudraCT2010-021257-39, NCT01882556
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Affiliation(s)
- Cameron Lindsay
- Physiotherapy Department, Sandwell and West Birmingham NHS Trust and School of Health and Rehabilitation, Keele University, Mackay Building, Keele, Staffordshire ST5 5BG, UK.
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Bryer A, Connor MD, Haug P, Cheyip B, Staub H, Tipping B, Duim WB, Pinkney-Atkinson V. The South African Guideline for the Management of Ischemic Stroke and Transient Ischemic Attack: Recommendations for a Resource-Constrained Health Care Setting. Int J Stroke 2011; 6:349-54. [DOI: 10.1111/j.1747-4949.2011.00629.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Alan Bryer
- Department of Medicine, Division of Neurology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Myles D. Connor
- Queen Margaret Hospital, NHS Fife, and University of Edinburgh, Edinburgh, UK
| | - Peter Haug
- Milnerton MediClinic, Cape Town, South Africa
| | | | - Hugh Staub
- Entabeni Hospital, Life Healthcare Rehabilitation Unit, Durban, South Africa
| | - Brent Tipping
- Division of Geriatric Medicine, Donald Gordon Medical Centre and University of the Witwatersrand, Johannesburg, South Africa
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Barker RN, Gill TJ, Brauer SG. ‘Factors contributing to upper limb recovery after stroke: A survey of stroke survivors in Queensland Australia’. Disabil Rehabil 2009; 29:981-9. [PMID: 17612983 DOI: 10.1080/09638280500243570] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To identify factors which contribute to upper limb recovery, from the perspective of stroke survivors. METHOD A retrospective cross-sectional survey was administered by post to 220 stroke survivors with upper limb impairment who were more than 3 months post-stroke. The content and language for the questionnaire were drawn from a series of focus groups and in-depth interviews with stroke survivors (n = 29). Where possible items or composite scales were replicated or adapted from existing surveys. RESULTS Many factors regarding the stroke survivors' commitment to recovery, the type and amount of exercise undertaken and their knowledge of how to progress were associated with self-reported upper limb recovery. The single most important factor was 'use of the arm in everyday tasks', which was independently responsible for more than 12% of the variance in recovery. 'Not enough movement to work with' was the second most important factor, representing the greatest barrier to recovery. CONCLUSIONS The findings of this survey highlight many practical day to day factors that may contribute to a stroke survivor's ability to advance the recovery of their upper limb. Stroke recovery services can use this information to tailor their services to ensure these practical concerns are addressed.
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Affiliation(s)
- Ruth N Barker
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia.
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Sackley C, Brittle N, Patel S, Ellins J, Scott M, Wright C, Dewey ME. The Prevalence of Joint Contractures, Pressure Sores, Painful Shoulder, Other Pain, Falls, and Depression in the Year After a Severely Disabling Stroke. Stroke 2008; 39:3329-34. [DOI: 10.1161/strokeaha.108.518563] [Citation(s) in RCA: 155] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Complications after stroke have been shown to impede rehabilitation, lead to poor functional outcome, and increase cost of care. This inception cohort study sought to investigate the prevalence of immobility-related complications during the first year after severely disabling stroke in relation to functional independence and place of residence.
Methods—
Over a 7-month period, 600 stroke survivors were identified in the hospital through the Nottingham Stroke Register. Those who had a Barthel Index score ≤10 3 months poststroke and did not have a primary diagnosis of dementia were eligible to participate in the study. Assessments of complications were carried out at 3, 6, and 12 months poststroke.
Results—
Complications were recorded for 122 stroke survivors (mean age, 76 years; 57% male). Sixty-three (52%) had significant language impairment and of the remaining 59 who were able to complete an assessment of cognitive function, 10 (8%) were cognitively impaired. The numbers of reported complications over 12 months, in rank order, were falls, 89 (73%); contracture, 73 (60%); pain, 67 (55%); shoulder pain, 64 (52%); depression, 61 (50%); and pressure sores, 26 (22%). A negative correlation was found between Barthel Index score and the number of complications experienced (low scores on the Barthel Index correlate with a high number of complications). The highest relative percentages of complications were experienced by patients who were living in a nursing home at the time of their last completed assessment.
Conclusions—
Immobility-related complications are very common in the first year after a severely disabling stroke. Patients who are more functionally dependent in self-care are likely to experience a greater number of complications than those who are less dependent. Trials of techniques to limit and prevent complication are required.
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Affiliation(s)
- Catherine Sackley
- From Primary Care Clinical Sciences (C.S., S.P., N.B., C.W.), University of Birmingham, Birmingham, UK; Trent Institute for Health Services Research (J.E., M.S.), University of Nottingham, Nottingham, UK; and the Section of Epidemiology (M.E.D.), Institute of Psychiatry, King’s College London, UK
| | - Nicola Brittle
- From Primary Care Clinical Sciences (C.S., S.P., N.B., C.W.), University of Birmingham, Birmingham, UK; Trent Institute for Health Services Research (J.E., M.S.), University of Nottingham, Nottingham, UK; and the Section of Epidemiology (M.E.D.), Institute of Psychiatry, King’s College London, UK
| | - Smitaa Patel
- From Primary Care Clinical Sciences (C.S., S.P., N.B., C.W.), University of Birmingham, Birmingham, UK; Trent Institute for Health Services Research (J.E., M.S.), University of Nottingham, Nottingham, UK; and the Section of Epidemiology (M.E.D.), Institute of Psychiatry, King’s College London, UK
| | - Julie Ellins
- From Primary Care Clinical Sciences (C.S., S.P., N.B., C.W.), University of Birmingham, Birmingham, UK; Trent Institute for Health Services Research (J.E., M.S.), University of Nottingham, Nottingham, UK; and the Section of Epidemiology (M.E.D.), Institute of Psychiatry, King’s College London, UK
| | - Martin Scott
- From Primary Care Clinical Sciences (C.S., S.P., N.B., C.W.), University of Birmingham, Birmingham, UK; Trent Institute for Health Services Research (J.E., M.S.), University of Nottingham, Nottingham, UK; and the Section of Epidemiology (M.E.D.), Institute of Psychiatry, King’s College London, UK
| | - Cristine Wright
- From Primary Care Clinical Sciences (C.S., S.P., N.B., C.W.), University of Birmingham, Birmingham, UK; Trent Institute for Health Services Research (J.E., M.S.), University of Nottingham, Nottingham, UK; and the Section of Epidemiology (M.E.D.), Institute of Psychiatry, King’s College London, UK
| | - Michael E. Dewey
- From Primary Care Clinical Sciences (C.S., S.P., N.B., C.W.), University of Birmingham, Birmingham, UK; Trent Institute for Health Services Research (J.E., M.S.), University of Nottingham, Nottingham, UK; and the Section of Epidemiology (M.E.D.), Institute of Psychiatry, King’s College London, UK
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Leitlinien zum Management von Patienten mit akutem Hirninfarkt oder TIA der Europäischen Schlaganfallorganisation 2008. DER NERVENARZT 2008; 79:936-57. [DOI: 10.1007/s00115-008-2531-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. Cerebrovasc Dis 2008; 25:457-507. [PMID: 18477843 DOI: 10.1159/000131083] [Citation(s) in RCA: 1664] [Impact Index Per Article: 104.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2008] [Accepted: 03/27/2008] [Indexed: 12/13/2022] Open
Abstract
This article represents the update of the European Stroke Initiative Recommendations for Stroke Management. These guidelines cover both ischaemic stroke and transient ischaemic attacks, which are now considered to be a single entity. The article covers referral and emergency management, Stroke Unit service, diagnostics, primary and secondary prevention, general stroke treatment, specific treatment including acute management, management of complications, and rehabilitation.
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