Autonomous rehabilitation at stroke patients home for balance and gait: safety, usability and compliance of a virtual reality system

Jp, Held; B, Ferrer; Mainetti, Renato; Steblin, Alexander; Hertler, Benjamin; Moreno-Conde, Alberto; Dueñas, Alvaro; Pajaro, M.; Cl, Parra-Calderón; Vargiu, Eloisa; M, Josè Zarco; Barrera, Manuel Pastor; Echevarría, C Luisa; Jódar-Sánchez, Francisco; Ar, Luft; Na, Borghese

doi:10.23736/s1973-9087.17.04802-x

Cited by 42 publications

(22 citation statements)

References 19 publications

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“…Today, balance rehabilitation service has been presented to patients with the use of either static or dynamic platforms. The former [32][33][34][35] gives a general overview of the patient's balance condition [31,36]. Balance performance of the patients standing on the static platform is also evaluated by ball catching and throwing exercises [31].…”

Section: Discussionmentioning

confidence: 99%

“…Balance performance of the patients standing on the static platform is also evaluated by ball catching and throwing exercises [31]. However, considering the validated efficacy of the PBT under the sole of the patients on motor learning [32,36] dynamic balance systems outperform the static ones. On the other hand, PBT is much more effective if the bio-performance of the patient is instantaneously measured and provided as feedback.…”

Section: Discussionmentioning

confidence: 99%

“…They have been put into the services of patients together with the VR environment to give visual feedback and commands and accordingly prolong the training period [1]. Although static balance platforms are effective in the regulation of pressure distribution [36], the findings indicate that rehabilitation of balance disorder in dynamic conditions contributes significantly to the recovery of plasticity [32].…”

Section: Introductionmentioning

confidence: 99%

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A 3-DoF robotic platform for the rehabilitation and assessment of reaction time and balance skills of MS patients

Tugce

Hocaoğlu²

2023

PLoS ONE

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The central nervous system (CNS) exploits anticipatory (APAs) and compensatory (CPAs) postural adjustments to maintain the balance. The postural adjustments comprising stability of the center of mass (CoM) and the pressure distribution of the body influence each other if there is a lack of performance in either of them. Any predictable or sudden perturbation may pave the way for the divergence of CoM from equilibrium and inhomogeneous pressure distribution of the body. Such a situation is often observed in the daily lives of Multiple Sclerosis (MS) patients due to their poor APAs and CPAs and induces their falls. The way of minimizing the risk of falls in neurological patients is by utilizing perturbation-based rehabilitation, as it is efficient in the recovery of the balance disorder. In light of the findings, we present the design, implementation, and experimental evaluation of a novel 3 DoF parallel manipulator to treat the balance disorder of MS. The robotic platform allows angular motion of the ankle based on its anthropomorphic freedom. Moreover, the end-effector endowed with upper and lower platforms is designed to evaluate both the pressure distribution of each foot and the CoM of the body, respectively. Data gathered from the platforms are utilized to both evaluate the performance of the patients and used in high-level control of the robotic platform to regulate the difficulty level of tasks. In this study, kinematic and dynamic analyses of the robot are derived and validated in the simulation environment. Low-level control of the first prototype is also successfully implemented through the PID controller. The capacity of each platform is evaluated with a set of experiments considering the assessment of pressure distribution and CoM of the foot-like objects on the end-effector. The experimental results indicate that such a system well-address the need for balance skill training and assessment through the APAs and CPAs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A 3-DoF robotic platform for the rehabilitation and assessment of reaction time and balance skills of MS patients

Tugce

Hocaoğlu²

2023

PLoS ONE

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“…The system provides data on the body sway, and these data provide indicators of postural stability. This system is used in research and clinical settings [ 23–25 ].…”

Section: Methodsmentioning

confidence: 99%

The correlation between physical and emotional stabilities: a cross-sectional observational preliminary study

2022

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Background Postural stability and gait are affected by an individual’s emotional state. Physical therapy practice does not usually include an explicit assessment of the individual’s emotional status. In contrast, complementary movement therapies often include the assessment of “grounding quality”, which refers to the individual’s physical and emotional stabilities. This study examined the correlation between conventional physical stability measures and grounding quality. Method A computerized balance board and an inertial sensor system measured the postural stability and gait parameters of 36 healthy volunteers (aged 19–35 years). Grounding was assessed using an observation-based assessment tool (Grounding Assessment Tool [GAT]). Spearman’s correlation and Cohen’s standard were used to assess correlation. Results No correlation was observed between gait parameters and GAT scores. However, significant negative moderate correlations were noted between postural sway measures and scores of several GAT items in the more demanding stance conditions. Conclusion Although grounding quality and sway measures are somewhat correlated, they focus on different aspects of movement stability. A comprehensive assessment and holistic intervention strategies require incorporating multiple approaches to stability assessment. Further research is necessary to determine the contribution of combining these approaches among individuals with balance impairments. KEY MESSAGES Gait stability measures were not correlated to “grounding quality” (a measure of emotional regulation and emotional awareness). Postural sway measures were found to be correlated to “grounding quality” items in the more demanding stance conditions. A comprehensive evaluation of an individual’s stability may facilitate reliable and valid objective measurement instruments for both physical and emotional aspects of the movement.

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“…So far, acceptability has been studied mostly using visual analogue scales (Macko et al, 2016) or questionnaires (Kringle et al, 2020;Lai et al, 2004). However, most have operationalized the concept through feasibility (Beit Yosef et al, 2019;Held et al, 2018;Isernia et al, 2019;Johansson & Wild, 2011), satisfaction (Beit Yosef et al, 2019;Benvenuti et al, 2014;Brouns et al, 2018;Chen et al, 2020;Crotty et al, 2014;Johansson & Wild, 2011) or adherence (Benvenuti et al, 2014).…”

Section: Tablementioning

confidence: 99%

Use of a Telerehabilitation Platform in a Stroke Continuum: A Qualitative Study of Patient and Therapist Acceptability

et al. 2022

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The purpose of this study was to describe the acceptability of a stroke telerehabilitation platform from the perspective of both patients and therapists. Two public rehabilitation centers participated in a pilot telerehabilitation trial. A theoretical framework was used to conceptualize acceptability. Semi-structured individual interviews with patients and focus groups of therapists were conducted. Most participants and therapists were satisfied with the intervention. Participants emphasized the advantages of staying at home to get their treatments. Therapists were more skeptical at first about their self-efficacy to deliver therapy remotely. There was a consensus among therapists about the need for a combination of telerehabilitation and in-person visits to optimize treatments. While we found overall good acceptability, effectiveness of this technology could be improved via an accessible user interface, complementary rehabilitation material, and ongoing training and technical just-in-time support with therapists.

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Autonomous rehabilitation at stroke patients home for balance and gait: safety, usability and compliance of a virtual reality system

Cited by 42 publications

References 19 publications

A 3-DoF robotic platform for the rehabilitation and assessment of reaction time and balance skills of MS patients

A 3-DoF robotic platform for the rehabilitation and assessment of reaction time and balance skills of MS patients

The correlation between physical and emotional stabilities: a cross-sectional observational preliminary study

Use of a Telerehabilitation Platform in a Stroke Continuum: A Qualitative Study of Patient and Therapist Acceptability

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