Search Results (11)

Background: Measurements are necessary in rehabilitation for evaluating service effectiveness. The ADL-focused Occupation-based Neurobehavioral Evaluation (A-ONE) is used for evaluating ADL performance and the impact of neurobehavioral impairments on the performance. Recently, Rasch-based software was constructed for the A-ONE ADL and neurobehavioral scales. It converts ordinal rating scale scores into measures, estimates missing data values and calculates the statistical significance of changes. Objectives: To expand the A-ONE software by developing a cerebrovascular accident (CVA) neurobehavioral subscale. Additionally, to pilot-test whether the ADL and CVA scales of the software can detect statistically significant improvements. Method: Rasch analysis was used for evaluating the item fit, PCA, person separation and reliability to establish the internal validity of the CVA subscale (n = 222). The external validity (n = 22) was obtained by comparing A-ONE software measures to Winsteps measures. Subsequently 21 pre–post-intervention comparisons were made of stroke patients using both the ADL and CVA scales. Results: All set criteria for internal and external validity were met. By using the software clinically after incorporating the CVA subscale, statistically significant changes were detected in 90.5% of comparisons using the ADL scale and 36.4% using the CVA scale. The intervention program used was determined to consist of 66.4% occupation-based activities. Conclusions: This study is the first to deliver a clinically deployable Rasch-based CVA subscale integrated into routine occupational therapy software. The A-ONE software offers considerable time saving for therapists and the potential to detect significant differences in performance and impairment impact. It contributes to the removal of clinical obstacles toward the use of the instrument as an outcome measure and encourages the use of measures in rehabilitation. Full article

Stroke is the main cause of disability among adults. Decision-making in stroke rehabilitation is increasingly complex; therefore, the use of decision support systems by healthcare providers is becoming a necessity. However, there is a significant lack of software for the management of post-stroke telerehabilitation (TR). This paper presents the results of the developed software “TeleRehab” to support the decision-making of clinicians and healthcare providers in post-stroke TR. We designed a Python-based software with a graphical user interface to manage post-stroke TR. We searched Scopus, ScienceDirect, and PubMed databases to obtain research papers with results of clinical trials for post-stroke TR and to form the knowledge base of the software. The findings show that TeleRehab suggests recommendations for TR to provide practitioners with optimal and real-time support. We observed feasible outcomes of the software based on synthetic data of patients with balance problems, spatial neglect, and upper and lower extremities dysfunctions. Also, the software demonstrated excellent usability and acceptability scores among healthcare professionals. Full article

Background and Objectives: This study explored the efficacy of customized anti-gravity treadmill (AGT) training, with adjustments in speed and incline, on rehabilitation outcomes for stroke patients, focusing on knee extensor muscle strength, joint angle, balance ability, and activities of daily living (ADLs). Materials and Methods: In this study, 30 individuals diagnosed with a stroke were divided into three groups. Experimental group 1 (EG1) underwent training without changes to speed and incline, experimental group 2 (EG2) received training with an increased incline, and experimental group 3 (EG3) underwent training with increased speed. Initially, all participants received AGT training under uniform conditions for two weeks. Subsequently, from the third to the sixth week, each group underwent their specified training intervention. Evaluations were conducted before the intervention and six weeks post-intervention using a manual muscle strength tester for knee strength, TETRAX for balance ability, Dartfish software for analyzing knee angle, and the Korean version of the Modified Barthel Index (K-MBI) for assessing activities of daily living. Results: Within-group comparisons revealed that AGT training led to enhancements in muscle strength, balance ability, joint angle, and ADLs across all participant groups. Between-group analyses indicated that EG2, which underwent increased incline training, demonstrated significant improvements in muscle strength and balance ability over EG1. EG3 not only showed significant enhancements in muscle strength, joint angle, and ADLs when compared to EG1 but also surpassed EG2 in terms of knee strength improvement. Conclusions: In conclusion, the application of customized AGT training positively impacts the rehabilitation of stroke patients, underscoring the importance of selecting a treatment method tailored to the specific needs of each patient. Full article

Hand-function recovery is often a goal for stroke survivors undergoing therapy. This work aimed to design, build, and verify a pneumatic hand training device for its eventual use in post-stroke rehabilitation. The system was built considering prior research in the field of robotic hand rehabilitation as well as specifications and design constraints developed with physiotherapists. The system contained pneumatic airbag actuators for the fingers and thumb of the hand, a set of flex, pressure, and flow sensors, and software and hardware controls. An experiment with the system was carried out on 30 healthy individuals. The sensor readings were analyzed for repeatability and reliability. Position sensors and an approximate biomechanical model of the index finger were used to estimate joint angles during operation. A survey was also issued to the users to evaluate their comfort levels with the device. It was found that the system was safe and comfortable when moving the fingers of the hand into an extension. Full article

Telerehabilitation is important for post-stroke or post-surgery rehabilitation because the tasks it uses are reproducible. When combined with assistive technologies, such as robots, virtual reality, tracking systems, or a combination of them, it can also allow the recording of a patient’s progression and rehabilitation monitoring, along with an objective evaluation. In this paper, we present the structure, from actors and functionalities to software and hardware views, of a novel framework that allows cooperation between patients and therapists. The system uses a computer-vision-based system named virtual glove for real-time hand tracking (40 fps), which is translated into a light and precise system. The novelty of this work lies in the fact that it gives the therapist quantitative, not only qualitative, information about the hand’s mobility, for every hand joint separately, while at the same time providing control of the result of the rehabilitation by also quantitatively monitoring the progress of the hand mobility. Finally, it also offers a strategy for patient–therapist interaction and therapist–therapist data sharing. Full article

Background: Recently, it was reported that the extent of cortico-cortical functional connections can be estimated by the correlation coefficient based on electroencephalography (EEG) monitoring. We aimed to investigate whether the EEG correlation coefficient change with motor task activation can predict the functional outcomes of hemiparetic stroke patients. Methods: Sixteen post-stroke hemiparetic patients admitted to our rehabilitation ward were studied. On admission, EEG recording to calculate the correlation coefficient was performed at rest and during motor task activation. For the analysis of the EEG data, the program software FOCUS (NIHON KOHDEN, Japan) was used. The motor function of paretic limbs was evaluated with the Fugl–Meyer Assessment (FMA) on admission and 4 weeks after admission. Results: Significant increases in the correlation coefficient with motor task activation were noted in C3-F3 or C4-F4, C3-F7 or C4-F8, and F3-F7 or F4-F8 of the lesional hemisphere. Among them, the rate of the correlation coefficient change in F3-F7 or F4-F8 in the lesional hemisphere was significantly correlated with the rate of the upper-limb FMA score change. Conclusion: The extent of the EEG correlation coefficient change with motor task activation in F3-F7 or F4-F8 of the lesional hemisphere may help predict the motor functional outcomes of hemiparetic upper limbs after stroke. Full article

Diagnostics of a hand requires measurements of kinematics and joint limits. The standard tools for this purpose are manual devices such as goniometers which allow measuring only one joint simultaneously, making the diagnostics time-consuming. The paper presents a system for automatic measurement and computer presentation of essential parameters of a hand. Constructed software uses an integrated vision system, a haptic device for measurement, and has a web-based user interface. The system provides a simplified way to obtain hand parameters, such as hand size, wrist, and finger range of motions, using the homogeneous-matrix-based notation. The haptic device allows for active measurement of the wrist’s range of motion and additional force measurement. A study was conducted to determine the accuracy and repeatability of measurements compared to the gold standard. The system functionality was confirmed on five healthy participants, with results showing comparable results to manual measurements regarding fingers’ lengths. The study showed that the finger’s basic kinematic structure could be measured by a vision system with a mean difference to caliper measurement of 4.5 mm and repeatability with the Standard Deviations up to 0.7 mm. Joint angle limits measurement achieved poorer results with a mean difference to goniometer of 23.6º. Force measurements taken by the haptic device showed the repeatability with a Standard Deviation of 0.7 N. The presented system allows for a unified measurement and a collection of important parameters of a human hand with therapist interface visualization and control with potential use for post-stroke patients’ precise rehabilitation. Full article

The accurate and reliable assessment of gait parameters is assuming an important role, especially in the perspective of designing new therapeutic and rehabilitation strategies for the remote follow-up of people affected by disabling neurological diseases, including Parkinson’s disease and post-stroke injuries, in particular considering how gait represents a fundamental motor activity for the autonomy, domestic or otherwise, and the health of neurological patients. To this end, the study presents an easy-to-use and non-invasive solution, based on a single RGB-D sensor, to estimate specific features of gait patterns on a reduced walking path compatible with the available spaces in domestic settings. Traditional spatio-temporal parameters and features linked to dynamic instability during walking are estimated on a cohort of ten parkinsonian and eleven post-stroke subjects using a custom-written software that works on the result of a body-tracking algorithm. Then, they are compared with the “gold standard” 3D instrumented gait analysis system. The statistical analysis confirms no statistical difference between the two systems. Data also indicate that the RGB-D system is able to estimate features of gait patterns in pathological individuals and differences between them in line with other studies. Although they are preliminary, the results suggest that this solution could be clinically helpful in evolutionary disease monitoring, especially in domestic and unsupervised environments where traditional gait analysis is not usable. Full article

Stroke remains one of the leading causes of disability in adults, and lower limb spasticity, affected stance, and balance impact everyday life and activities of such patients. Robotic therapy and assessment are becoming important tools to clinical evaluation for post-stroke rehabilitation. The aim of this study was to determine in a more objective manner the effects of visual feedback balance training through a balance trainer system and radial extracorporeal shock wave therapy (rESWT), along with conventional physiotherapy, on lower limb post-stroke spasticity, trunk control, and static and dynamic balance through clinical and stabilometric assessment. The study was designed as a randomized controlled trial. The experimental group underwent conventional physiotherapy, visual feedback balance training, and rESWT. The control group underwent conventional physiotherapy, visual feedback training and sham rESWT. The statistical analysis was performed using GraphPad Software and MATLAB. Primary clinical outcome measures were The Modified Ashworth Scale (MAS), passive range of motion (PROM), Visual Analogue Scale (VAS), and Clonus score. Secondary outcome measures were trunk performance, sensorimotor, and lower limb function. Stabilometric outcome measures were trunk control, static balance, and dynamic balance. Visual feedback training using the Prokin system and rESWT intervention, along with conventional physiotherapy, yielded statistically significant improvement both on clinical and stabilometric outcome measures, enhancing static and dynamic balance, trunk performance, sensorimotor outcome, and limb function and considerably diminishing lower limb spasticity, pain intensity, and clonus score in the experimental group. Full article

In the aging world population, the occurrence of neuromotor deficits arising from stroke and other medical conditions is expected to grow, demanding the design of new and more effective approaches to rehabilitation. In this paper, we show how the combination of robotic technologies with progress in exergaming methodologies may lead to the creation of new rehabilitation protocols favoring motor re-learning. To this end, we introduce the Track-Hold system for neuromotor rehabilitation based on a passive robotic arm and integrated software. A special configuration of weights on the robotic arm fully balances the weight of the patients’ arm, allowing them to perform a purely neurological task, overcoming the muscular effort of similar free-hand exercises. A set of adaptive and configurable exercises are proposed to patients through a large display and a graphical user interface. Common everyday tasks are also proposed for patients to learn again the associated actions in a persistent way, thus improving life independence. A data analysis module was also designed to monitor progress and compute indices of post-stroke neurological damage and Parkinsonian-type disorders. The system was tested in the lab and in a pilot project involving five patients in the post-stroke chronic stage with partial paralysis of the right upper limb, showing encouraging preliminary results. Full article

Immersive and non-immersive virtual reality (NIVR) technology can supplement and improve standard physiotherapy and neurorehabilitation in post-stroke patients. We aimed to use MIRA software to investigate the efficiency of specific NIVR therapy as a standalone intervention, versus standardized physiotherapy for upper extremity rehabilitation in patients post-stroke. Fifty-five inpatients were randomized to control groups (applying standard physiotherapy and dexterity exercises) and experimental groups (applying NIVR and dexterity exercises). The two groups were subdivided into subacute (<six months post-stroke) and chronic (>six months to four years post-stroke survival patients). The following standardized tests were applied at baseline and after two weeks post-therapy: Fugl–Meyer Assessment for Upper Extremity (FMUE), the Modified Rankin Scale (MRS), Functional Independence Measure (FIM), Active Range of Motion (AROM), Manual Muscle Testing (MMT), Modified Ashworth Scale (MAS), and Functional Reach Test (FRT). The Kruskal–Wallis test was used to determine if there were significant differences between the groups, followed with pairwise comparisons. The Wilcoxon Signed-Rank test was used to determine the significance of pre to post-therapy changes. The Wilcoxon Signed-Rank test showed significant differences in all four groups regarding MMT, FMUE, and FIM assessments pre- and post-therapy, while for AROM, only experimental groups registered significant differences. Independent Kruskal–Wallis results showed that the subacute experimental group outcomes were statistically significant regarding the assessments, especially in comparison with the control groups. The results suggest that NIVR rehabilitation is efficient to be administered to post-stroke patients, and the study design can be used for a further trial, in the perspective that NIVR therapy can be more efficient than standard physiotherapy within the first six months post-stroke. Full article