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Tedesco Triccas L, Maris A, Lamers I, Calcius J, Coninx K, Spooren A, Feys P. Do people with multiple sclerosis perceive upper limb improvements from robotic-mediated therapy? A mixed methods study. Mult Scler Relat Disord 2022; 68:104159. [PMID: 36113274 DOI: 10.1016/j.msard.2022.104159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/29/2022] [Accepted: 09/04/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Robot-mediated training is increasingly considered as a rehabilitation intervention targeting upper limb disability. However, experiences of such an intervention have been rarely explored in the multiple sclerosis population. This mixed methods study sought to explore the impact of an eight week upper limb robotic intervention on experiences of people with multiple sclerosis. METHODS Eleven participants (Median EDSS- score: 6.5) with moderate to severe upper limb impairment, performed eight week robot- mediated training of the most affected arm. The training involved a virtual learning platform called I-TRAVLE with duration of 30 min per training session, twice to three times per week. Two subjective questionnaires with items from the Intrinsic Motivation Inventory (IMI) and Credibility and Expectancy Questionnaire (CEQ) were collected bi-weekly during the intervention. Approximately one month after completing the training, three focus groups were conducted. Main themes were identified using thematic analysis. RESULTS Results from the IMI and CEQ indicated high patient satisfaction and expectation that the intervention will be beneficial for them. Two main themes were identified: (1) Effect of the intervention on impairment and activity in that participants felt that there was a positive impact of the training on strength, endurance and during activities of daily living and that it met their expectations; (2) Experiences based on system usage from the system in that participants expressed feelings of motivation and self-improvement. The participants also perceived the training as enjoyable and concluded that the use of games instigated a competitive spirit between the participants. CONCLUSIONS Robot-mediated training could have a motivating effect and induce a general positive experience while reducing disabilities of people with multiple sclerosis.
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Affiliation(s)
- L Tedesco Triccas
- REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.
| | - A Maris
- REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - I Lamers
- REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium; UMSC Hasselt-Pelt (Universitair MS centrum), Belgium
| | - J Calcius
- REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - K Coninx
- HCI and eHealth, Faculty of Sciences, Hasselt University, Diepenbeek, Belgium
| | - A Spooren
- REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - P Feys
- REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium; UMSC Hasselt-Pelt (Universitair MS centrum), Belgium
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Amanzonwe RE, Kossi RO, Tedesco Triccas L, Codjo LH, Feys P, Hansen D. The type and dosage of exercise therapy to facilitate the recovery from stroke for balance, walking and quality of life: a systematic review and meta-analysis of randomized controlled trials. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Exercise therapy (aerobic or resistance therapy) could have a beneficial effect on balance, walking and quality of life (QoL).
Objective
This systematic review and meta-analysis aimed to quantify the effects of different modes, dosages and setting of exercise therapy on balance, walking capacity and QoL in stroke survivors.
Methods
We searched PubMed, CINHAL and Hinari to identify randomized controlled trials (RCT) that investigated the effects of aerobic (AT) and/or resistance therapy (RT) on balance, walking and QoL in stroke survivors. The treatment effect was computed by the standard mean differences (SMDs).
Results
We included 27 RCT comprising 1,549 chronic stroke survivors. Any modality was effective to improve balance. There was high-level evidence that AT interventions were most effective in improving walking capacity (SMD=0.36 [0.06, 0.66], p=0.02). Both AT, and AT combined with RT were effective to improve QoL (SMD=0.39 [0.09, 0.69], p=0.01). RT programs were not effective to improve walking and QoL. For walking capacity, a lower volume weekly (<60 minutes/session or <3 session/week) and higher intensity (>60% heart rate reserve; rate of perceived exertion (6–20) >14) of AT and RT exercises demonstrated significant higher effect. Hospital located rehabilitation settings trended to improve walking (SMD=0.23 [0.00, 0.45], p=0.05), when compared to home/community and laboratory settings.
Conclusions
In chronic stroke, in particular AT executed in hospital located settings, with a lower volume and high intensity seems more effective strategy to facilitate walking capacity and improve QoL and should thus be incorporated into rehabilitation programs for stroke.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R E Amanzonwe
- Hasselt University - transnational University Limburg, Faculty of Rehabilitation Sciences, Diepenbeek, Belgium
| | - R O Kossi
- Hasselt University - transnational University Limburg, Faculty of Rehabilitation Sciences, Diepenbeek, Belgium
| | - L Tedesco Triccas
- Hasselt University - transnational University Limburg, Faculty of Rehabilitation Sciences, Diepenbeek, Belgium
| | - L H Codjo
- Hasselt University - transnational University Limburg, Faculty of Rehabilitation Sciences, Diepenbeek, Belgium
| | - P Feys
- Hasselt University - transnational University Limburg, Faculty of Rehabilitation Sciences, Diepenbeek, Belgium
| | - D Hansen
- Hasselt University - transnational University Limburg, Faculty of Rehabilitation Sciences, Diepenbeek, Belgium
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Tedesco Triccas L, McLening B, Hendrie W, Peryer G. Is there a standard procedure for assessing and providing assistive devices for people with neuro-disabling conditions in United Kingdom? A nation-wide survey. Disabil Health J 2018; 12:93-97. [PMID: 30243487 DOI: 10.1016/j.dhjo.2018.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 06/27/2018] [Accepted: 08/01/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Assistive devices are currently provided to people with neuro-disabling conditions to promote or maintain independence in activities of daily living. However, it is unclear whether assessment procedures performed by health care professionals to guide the provision of assistive devices are standardized. OBJECTIVE To explore the assessment and service-delivery processes of assistive devices for people with multiple sclerosis, cerebrovascular disease and Parkinson's disease experiencing physical disability by health care professionals in the United Kingdom. METHODS A survey was conducted among UK health care professionals working with people with neuro-disabling conditions. Descriptive and content analyses were used to code survey data. RESULTS In total, 231 health care professionals completed the survey: 93 occupational therapists, 136 physiotherapists and 2 assistant practitioners. Less than half of the respondents (46%) reported use of local, national, or combined guidelines when assessing a service user's suitability or need for assistive devices. When guidelines were used, they were not consistent and not specifically for assistive devices. The respondents stated that when users were allocated small and portable assistive devices, they were supplied within four weeks. This period increased for large equipment, major home adaptions or if external specialist services and/or funding was needed. CONCLUSIONS Standardized operating procedures for assistive device provision are not being carried out within the UK. Variable access to assistive devices supplied by the state indicates inequity across regions. Future research should explore potential benefits of developing standardized assessment procedures for the provision of assistive devices and devise methods to reduce current variability in service delivery.
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Affiliation(s)
- L Tedesco Triccas
- School of Health Sciences, University of East Anglia, Norwich, NR4 7TJ, United Kingdom; Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, Heverlee, 3001, Belgium.
| | - B McLening
- Norfolk Community Health and Care NHS Trust, Norfolk, United Kingdom
| | - W Hendrie
- MS Therapy Centre, 5 Hurricane Way, Norwich NR6 6EZ, United Kingdom
| | - G Peryer
- School of Health Sciences, University of East Anglia, Norwich, NR4 7TJ, United Kingdom
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Tedesco Triccas L, Burridge JH, Hughes AM, Meadmore KL, Donovan-Hall M, Rothwell JC, Verheyden G. A qualitative study exploring views and experiences of people with stroke undergoing transcranial direct current stimulation and upper limb robot therapy. Top Stroke Rehabil 2018; 25:1-9. [PMID: 30236033 DOI: 10.1080/10749357.2018.1493072] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 06/19/2018] [Indexed: 10/28/2022]
Abstract
Background Neurorehabilitation technologies used mainly in research such as robot therapy (RT) and transcranial direct current stimulation (tDCS) can promote upper limb motor recovery after stroke. Understanding the feasibility and efficacy of stroke rehabilitation technologies for upper limb impairments is crucial for effective implementation in practice. Small studies have explored views of RT by people with stroke; however experiences of people receiving tDCS in combination with RT have never been explored. Objective To explore views and experiences of people with sub-acute and chronic stroke that had previously taken part in a randomised controlled trial involving tDCS and RT for their impaired upper limb. Methods An interview study includes open and closed questions. Face-to-face interviews were audio recorded. Open-ended question responses were transcribed and analyzed using thematic analysis; closed questions were analyzed using descriptive analysis. Results Participants felt that RT was enjoyable (90%) and beneficial for their affected arm (100%). From the open question data, it was found that the intervention was effective for the impaired arm especially in the sub-acute stage. Main reported concerns were that tDCS caused painful, itching and burning sensations and RT was sometimes tiring and difficult. Participants recommended that future research should focus on designing a more comfortable method of tDCS and develop a robot that promotes hand movements. Conclusions This study provides new knowledge about the benefits and barriers associated with these technologies which are crucial to the future effective implementation of these tools in practice.
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Affiliation(s)
- L Tedesco Triccas
- a Faculty of Health Sciences , University of Southampton , Southampton , UK
- b Faculty of Kinesiology and Rehabilitation Sciences, Department of Rehabilitation Sciences , KU Leuven - University of Leuven , Leuven , Belgium
| | - J H Burridge
- a Faculty of Health Sciences , University of Southampton , Southampton , UK
| | - A M Hughes
- a Faculty of Health Sciences , University of Southampton , Southampton , UK
| | - K L Meadmore
- a Faculty of Health Sciences , University of Southampton , Southampton , UK
| | - M Donovan-Hall
- a Faculty of Health Sciences , University of Southampton , Southampton , UK
| | - J C Rothwell
- c Sobell Department of Motor Neuroscience , Institute of Neurology, University College of London , London , UK
| | - G Verheyden
- b Faculty of Kinesiology and Rehabilitation Sciences, Department of Rehabilitation Sciences , KU Leuven - University of Leuven , Leuven , Belgium
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Triccas LT, Burridge J, Hughes A, Verheyden G, Desikan M, Rothwell J. A double-blinded randomised controlled trial exploring the effect of anodal transcranial direct current stimulation and uni-lateral robot therapy for the impaired upper limb in sub-acute and chronic stroke. NeuroRehabilitation 2015; 37:181-91. [DOI: 10.3233/nre-151251] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
| | - J.H. Burridge
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - A. Hughes
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - G. Verheyden
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - M. Desikan
- Sobell Department of Motor Neuroscience, Institute of Neurology, University College of London, London, UK
| | - J. Rothwell
- Sobell Department of Motor Neuroscience, Institute of Neurology, University College of London, London, UK
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Tedesco Triccas L, Burridge J, Hughes AM, Verheyden G, Rothwell J. P20.14 Combining transcranial direct current stimulation with robot therapy for the impaired upper limb after sub-acute stroke. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60536-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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