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Alashram AR. Effectiveness of combined robotics and virtual reality on lower limb functional ability in stroke survivors: A systematic review of randomized controlled trials. Neurol Sci 2024:10.1007/s10072-024-07618-1. [PMID: 38829579 DOI: 10.1007/s10072-024-07618-1] [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: 03/31/2024] [Accepted: 05/22/2024] [Indexed: 06/05/2024]
Abstract
Lower limb impairments are common consequences of stroke. Robotics and virtual reality (VR) play crucial roles in improving lower limb function post-stroke. This review aims to assess the effects of combined robot and VR interventions on lower limb functional ability poststroke and to provide recommendations for future studies in the rehabilitation field. PubMed, SCOPUS, CINAHL, MEDLINE, EMBASE, and Web of Science were searched from inception to March 1, 2024. Randomized controlled trials (RCTs) involving patients with a stroke, administering combined robot and VR compared with passive (i.e., rest) or active (any intervention), and including at least one outcome evaluating lower limb function (i.e., balance, gait, mobility, muscle tone, muscle strength, range of motion) or activities of daily living were selected. The Cochrane Collaboration tool was employed to evaluate the risk of bias in the included studies. Nine studies met the eligibility criteria. In total, 364 stroke survivors (Mean age 55.62 years) were involved in this review. According to the Cochrane Collaboration tool, five studies were classified as "high quality," "moderate quality" (n=3), and "low quality" (n=1). There are mixed findings on the effects of combined robot and VR on lower limb functional ability in stroke survivors. The evidence for the effects of combined robot and VR on lower limb functional ability post-stroke is promising. Further trials with long-term follow-up are strongly warranted to understand the immediate and long-term effect of combined robot and VR intervention on various lower limb impairments and to define the optimal treatment protocols.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Airport Road 11831, Amman, Jordan.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
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Tomita Y, Sekiguchi Y, Mayo NE. Efficacy of a Single-Bout of Auditory Feedback Training on Gait Performance and Kinematics in Healthy Young Adults. SENSORS (BASEL, SWITZERLAND) 2024; 24:3206. [PMID: 38794060 PMCID: PMC11125153 DOI: 10.3390/s24103206] [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: 02/27/2024] [Revised: 04/25/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024]
Abstract
This study investigated the immediate effects of auditory feedback training on gait performance and kinematics in 19 healthy young adults, focusing on bilateral changes, despite unilateral training. Baseline and post-training kinematic measurements, as well as the feedback training were performed on a treadmill with a constant velocity. Significant improvements were seen in step length (trained: 590.7 mm to 611.1 mm, 95%CI [7.609, 24.373]; untrained: 591.1 mm to 628.7 mm, 95%CI [10.698, 30.835]), toe clearance (trained: 13.9 mm to 16.5 mm, 95%CI [1.284, 3.503]; untrained: 11.8 mm to 13.7 mm, 95%CI [1.763, 3.612]), ankle dorsiflexion angle at terminal stance (trained: 8.3 deg to 10.5 deg, 95%CI [1.092, 3.319]; untrained: 9.2 deg to 12.0 deg, 95%CI [1.676, 3.573]), hip flexion angular velocity, (trained: -126.5 deg/s to -131.0 deg/s, 95%CI [-9.054, -2.623]; untrained: -130.2 deg/s to -135.3 deg/s, 95%CI [-10.536, -1.675]), ankle angular velocity at terminal stance (trained: -344.7 deg/s to -359.1 deg/s, 95%CI [-47.540, -14.924]; untrained: -340.3 deg/s to -376.9 deg/s, 95%CI [-37.280, -13.166s]), and gastrocnemius EMG activity (trained: 0.60 to 0.66, 95%CI [0.014, 0.258]; untrained: 0.55 to 0.65, 95%CI [0.049, 0.214]). These findings demonstrate the efficacy of auditory feedback training in enhancing key gait parameters, highlighting the bilateral benefits from unilateral training.
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Affiliation(s)
- Yosuke Tomita
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki 370-0033, Japan; (Y.T.); (Y.S.)
| | - Yoshihiro Sekiguchi
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki 370-0033, Japan; (Y.T.); (Y.S.)
| | - Nancy E. Mayo
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC H3G 1Y5, Canada
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Gonzalez-Hoelling S, Reig-García G, Bertran-Noguer C, Suñer-Soler R. The effects of rhythmic auditory stimulation on functional ambulation after stroke: a systematic review. BMC Complement Med Ther 2024; 24:45. [PMID: 38245704 PMCID: PMC10799424 DOI: 10.1186/s12906-023-04310-3] [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: 05/06/2023] [Accepted: 12/12/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Several studies have reported the effect of rhythmic auditory stimulation (RAS) on functional ambulation in stroke patients, yet no systematic overview has yet been published. This study aims to synthesize the available evidence describing changes in stroke patients after RAS intervention for functional ambulation and the use of walking assistive devices, and to find out if the effect of RAS and music-based RAS differs depending on the lesioned area. METHODS The PubMed, PEDro, Cochrane Central Register of Controlled Trials, Web of Science, Scopus and CINAHL electronic databases were searched for reports evaluating the effect of RAS on walking in stroke patients, applying the PICOS criteria for the inclusion of studies. RESULTS Twenty one articles were included (948 stroke survivors). Most studies were of good methodological quality according to the PEDro scale, but they had a high risk of bias. The most consistent finding was that RAS improves walking and balance parameters in stroke patients in all phases compared to baseline and versus control groups with conventional treatment. Functional ambulation and the use of walking assistive devices were inconsistently reported. Several studies also suggest that RAS may be as good as other complementary therapies (horse-riding and visual cueing). CONCLUSIONS Despite the beneficial effects of RAS, the question remains as to whether it is better than other complementary therapies. Given the heterogeneity of the interventions, the interventions in control groups, the varied durations, and the different outcome measures, we suggest that care should be taken in interpreting and generalizing findings. PROSPERO REGISTRATION CRD42021277940.
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Affiliation(s)
- Samira Gonzalez-Hoelling
- Neurorehabilitation department, Hospital Sociosanitari Mutuam Girona, 17007, Girona, Catalonia, Spain
| | - Gloria Reig-García
- Department of Nursing, Faculty of Nursing, University of Girona, 17003, Girona, Spain
| | - Carme Bertran-Noguer
- Health and Health Care Research Group, University of Girona, 17003, Girona, Spain
| | - Rosa Suñer-Soler
- Health and Health Care Research Group, University of Girona, 17003, Girona, Spain.
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Smayda KE, Cooper SH, Leyden K, Ulaszek J, Ferko N, Dobrin A. Validating the Safe and Effective Use of a Neurorehabilitation System (InTandem) to Improve Walking in the Chronic Stroke Population: Usability Study. JMIR Rehabil Assist Technol 2023; 10:e50438. [PMID: 37983080 PMCID: PMC10696501 DOI: 10.2196/50438] [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: 06/30/2023] [Revised: 09/06/2023] [Accepted: 10/12/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND Persistent walking impairment following a stroke is common. Although rehabilitative interventions exist, few exist for use at home in the chronic phase of stroke recovery. InTandem (MedRhythms, Inc) is a neurorehabilitation system intended to improve walking and community ambulation in adults with chronic stroke walking impairment. OBJECTIVE Using design best practices and human factors engineering principles, the research presented here was conducted to validate the safe and effective use of InTandem. METHODS In total, 15 participants in the chronic phase of stroke recovery (≥6 months after stroke) participated in this validation study. Participants were scored on 8 simulated use tasks, 4 knowledge assessments, and 7 comprehension assessments in a simulated home environment. The number and types of use errors, close calls, and operational difficulties were evaluated. Analyses of task performances, participant behaviors, and follow-up interviews were conducted to determine the root cause of use errors and difficulties. RESULTS During this validation study, 93% (14/15) of participants were able to successfully complete the critical tasks associated with the simulated use of the InTandem system. Following simulated use task assessments, participants' knowledge and comprehension of the instructions for use and key safety information were evaluated. Overall, participants were able to find and correctly interpret information in the materials in order to answer the knowledge assessment questions. During the comprehension assessment, participants understood warning statements associated with critical tasks presented in the instructions for use. Across the entire study, 3 "use errors" and 1 "success with difficulty" were recorded. No adverse events, including slips, trips, or falls, occurred in this study. CONCLUSIONS In this validation study, people in the chronic phase of stroke recovery were able to safely and effectively use InTandem in the intended use environment. This validation study contributes to the overall understanding of residual use-related risks of InTandem in consideration of the established benefits.
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Peyre I, Roby-Brami A, Segalen M, Giron A, Caramiaux B, Marchand-Pauvert V, Pradat-Diehl P, Bevilacqua F. Effect of sonification types in upper-limb movement: a quantitative and qualitative study in hemiparetic and healthy participants. J Neuroeng Rehabil 2023; 20:136. [PMID: 37798637 PMCID: PMC10552218 DOI: 10.1186/s12984-023-01248-y] [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: 11/11/2022] [Accepted: 09/13/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Movement sonification, the use of real-time auditory feedback linked to movement parameters, have been proposed to support rehabilitation. Nevertheless, if promising results have been reported, the effect of the type of sound used has not been studied systematically. The aim of this study was to investigate in a single session the effect of different types of sonification both quantitatively and qualitatively on patients with acquired brain lesions and healthy participants. METHODS An experimental setup enabling arm sonification was developed using three different categories of sonification (direct sound modulation, musical interaction, and soundscape). Simple moving forward movements performed while sliding on a table with both arms were investigated with all participants. Quantitative analysis on the movement timing were performed considering various parameters (sound condition, affected arm and dominance, sonification categories). Qualitative analysis of semi-structured interviews were also conducted, as well as neuropsychological evaluation of music perception. RESULTS For both the patient and healthy groups (15 participants each), average duration for performing the arm movement is significantly longer with sonification compared to the no-sound condition (p < 0.001). Qualitative analysis of semi-structured interviews revealed different aspects of motivational and affective aspects of sonification. Most participants of both groups preferred to complete the task with sound (29 of 30 participants), and described the experience as playful (22 of 30 participants). More precisely, the soundscape (nature sounds) was the most constantly preferred (selected first by 14 of 30 participants). CONCLUSION Overall, our results confirm that the sonification has an effect on the temporal execution of the movement during a single-session. Globally, sonification is welcomed by the participants, and we found convergent and differentiated appreciations of the different sonification types.
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Affiliation(s)
- Iseline Peyre
- UMR STMS, Ircam, CNRS, Sorbonne Université, 75004, Paris, France
- ISIR, CNRS UMR 7222, Inserm U1150, Sorbonne Université, 75005, Paris, France
- Laboratoire d'Imagerie Biomédicale (LIB), Inserm, CNRS, Sorbonne Université, 75006, Paris, France
| | - Agnès Roby-Brami
- ISIR, CNRS UMR 7222, Inserm U1150, Sorbonne Université, 75005, Paris, France
| | - Maël Segalen
- UMR STMS, Ircam, CNRS, Sorbonne Université, 75004, Paris, France
- ISIR, CNRS UMR 7222, Inserm U1150, Sorbonne Université, 75005, Paris, France
| | - Alain Giron
- Laboratoire d'Imagerie Biomédicale (LIB), Inserm, CNRS, Sorbonne Université, 75006, Paris, France
| | - Baptiste Caramiaux
- ISIR, CNRS UMR 7222, Inserm U1150, Sorbonne Université, 75005, Paris, France
| | | | - Pascale Pradat-Diehl
- Laboratoire d'Imagerie Biomédicale (LIB), Inserm, CNRS, Sorbonne Université, 75006, Paris, France
- AP-HP, Hôpital Pitié-Salpêtrière, Maladies du Système Nerveux, 75013, Paris, France
- GRC HaMCRe, Sorbonne Université, 75013, Paris, France
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Yu L, Almeida QJ, Silva AF, He L. Editorial: Exercise-induced neuroplasticity in neurodegeneration diseases. Front Neurosci 2023; 17:1296291. [PMID: 37841683 PMCID: PMC10570825 DOI: 10.3389/fnins.2023.1296291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/17/2023] Open
Affiliation(s)
- Laikang Yu
- Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Quincy J. Almeida
- Movement Disorders Research and Rehabilitation Centre, Department of Kinesiology, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Ana Filipa Silva
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- The Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
- Research Center in Sports Performance, Recreation, Innovation and Technology (SPRINT), Melgaço, Portugal
| | - Lingxiao He
- School of Public Health, Xiamen University, Xiamen, China
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Zhao H, Ji N, Zhang W, Zhao J. Commentary: Effects of rhythmic auditory stimulation on motor function and balance ability in stroke: a systematic review and meta-analysis of clinical randomized controlled studies. Front Neurosci 2023; 17:1174540. [PMID: 37214401 PMCID: PMC10196024 DOI: 10.3389/fnins.2023.1174540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 04/10/2023] [Indexed: 05/24/2023] Open
Affiliation(s)
- Hongfei Zhao
- Department of Rehabilitation Medicine, Zibo Central Hospital, Zibo, Shandong, China
| | - Nanjun Ji
- Department of Rehabilitation Medicine, Zibo Hospital of Traditional Chinese Medicine, Zibo, Shandong, China
| | - Wei Zhang
- Department of Rehabilitation Medicine, Zhangdian District People's Hospital, Zibo, Shandong, China
| | - Jing Zhao
- Department of Rehabilitation Medicine, Zibo Central Hospital, Zibo, Shandong, China
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Ghai S. Does Music Therapy Improve Gait after Traumatic Brain Injury and Spinal Cord Injury? A Mini Systematic Review and Meta-Analysis. Brain Sci 2023; 13:brainsci13030522. [PMID: 36979332 PMCID: PMC10046548 DOI: 10.3390/brainsci13030522] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/12/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
There is a growing body of research examining the potential benefits of music therapy-based auditory stimulation (MT) for individuals with movement disorders in improving gait performance. However, there is limited knowledge about the effects of MT on gait outcomes in individuals with traumatic brain injury (TBI) or spinal cord injury (SCI). A previous review of MT's impact on gait in TBI had limitations, and there are no studies on its effects on gait in SCI. In this study, we conducted a meta-analysis to more thoroughly evaluate the impact of MT on gait outcomes in individuals with TBI and SCI. We systematically searched through eight databases and found six studies on MT in TBI and four on SCI. Our meta-analysis showed that MT has positive medium effect improvements on spatiotemporal aspects of gait in individuals with TBI (Hedge's g: 0.52) and SCI (0.53). These findings suggest that MT could be a practical intervention for enhancing different aspects of gait in these populations, although the limited number and "fair" quality of the studies included in the meta-analysis may affect the generalizability of the outcomes. Further research is needed to fully understand the mechanisms by which MT may influence gait and determine the optimal parameters for its use.
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Affiliation(s)
- Shashank Ghai
- Psychology of Learning and Instruction, Department of Psychology, School of Science, Technische Universität Dresden, 01069 Dresden, Germany
- Centre for Tactile Internet with Human-in-the-Loop (CeTI), Technische Universität Dresden, 01069 Dresden, Germany
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