Motor-cognitive intervention concepts can improve gait in chronic stroke, but their effect on cognitive functions is unclear: A systematic review with meta-analyses

Huber, Simone; Knols, Ruud H.; Arnet, Patrick; Bruin, Eling D. de

doi:10.1016/j.neubiorev.2021.11.013

Cited by 26 publications

(48 citation statements)

References 115 publications

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“…These desired characteristics were echoed by participants in the current study, who indicated that they would have liked for the robot to have the following attributes and functions: mobility; ease of operation; instructions written in large lettering; a loud voice and repetition of instructions with suitable intonation to emphasize parts of the sentence; adjustments to different levels of difficulty; capacity for longer response times by the user; and practice for language and communication impairments (speech, reading, and writing), cognition, memory, social contexts (like reading books) and other motor impairments specific to their injuries (such as hemispatial neglect). This expectation for a multi-modal assistive device echoes studies that show that a combined approach improves function—e.g., in upper-limb function ( 71 ) and in gait parameters ( 72 ) post-stroke.…”

Section: Discussionmentioning

confidence: 99%

A Socially Assistive Robot for Stroke Patients: Acceptance, Needs, and Concerns of Patients and Informal Caregivers

Dembovski

Amitai

Levy-Tzedek

2022

Front. Rehabilit. Sci.

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Stroke patients often contend with long-term physical challenges that require treatment and support from both formal and informal caregivers. Socially Assistive Robots (SARs) can assist patients in their physical rehabilitation process and relieve some of the burden on the informal caregivers, such as spouses and family members. We collected and analyzed information from 23 participants (11 stroke patients and 12 informal caregivers) who participated in a total of six focus-group discussions. The participants responded to questions regarding using a SAR to promote physical exercises during the rehabilitation process: (a) the advantages and disadvantages of doing so; (b) specific needs that they wish a SAR would address; (c) patient-specific adaptations they would propose to include; and (d) concerns they had regarding the use of such technology in stroke rehabilitation. We found that the majority of the participants in both groups were interested in experiencing the use of a SAR for rehabilitation, in the clinic and at home. Both groups noted the advantage of having the constant presence of a motivating entity with whom they can practice their rehabilitative exercises. The patients noted how such a device can assist formal caregivers in managing their workload, while the informal caregivers indicated that such a system could ease their own workload and sense of burden. The main disadvantages that participants noted related to the robot not possessing human abilities, such as the ability to hold a conversation, to physically guide the patient's movements, and to express or understand emotions. We anticipate that the data collected in this study—input from the patients and their family members, including the similarities and differences between their points of view—will aid in improving the development of SARs for rehabilitation, so that they can better suit people who have had a stroke, and meet their individual needs.

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Section: Discussionmentioning

confidence: 99%

A Socially Assistive Robot for Stroke Patients: Acceptance, Needs, and Concerns of Patients and Informal Caregivers

Dembovski

Amitai

Levy-Tzedek

2022

Front. Rehabilit. Sci.

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“…Learned non-use may occur as a result of neural shock, causing progressive underuse of the affected extremity [45,46]. Hemiparesis, or one-sided weakness, is a common post-stroke symptom that contributes to activity restriction and reduced quality of life [47]. Upper limb impairment, referred to as upper extremity hemiparesis, can lead to limited function, with only a small percentage of patients regaining full function after six months [48][49][50].…”

Section: Review Neural Changes and Disabilities After Strokementioning

confidence: 99%

“…It can be categorized based on clinical features and the degree of injury (Figure 1) [31]. Rehabilitation involves repetitive, challenging, motivating, and intensive exercises with meaningful and realistic tasks to enhance its efficacy [31,47]. Studies have shown that early rehabilitation after stroke can augment the duration of neuroplasticity, promoting cortical reorganization and compensatory mechanisms for improved function [59][60][61].…”

Section: Post-stroke Rehabilitationmentioning

confidence: 99%

Virtual and Augmented Reality in Post-stroke Rehabilitation: A Narrative Review

Khokale¹,

Mathew²,

Ahmed³

et al. 2023

Cureus

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Virtual reality (VR) and augmented reality (AR) are noble adjunctive technologies currently being studied for the neuro-rehabilitation of post-stroke patients, potentially enhancing conventional therapy. We explored the literature to find if VR/AR improves neuroplasticity in stroke rehabilitation for a better quality of life. This modality can lay the foundation for telerehabilitation services in remote areas. We analyzed four databases, namely Cochrane Library, PubMed, Google Scholar, and Science Direct, by searching the following keywords: ("Stroke Rehabilitation" [Majr]) AND ("Augmented Reality" [Majr]), Virtual Augmented Reality in Stroke Rehabilitation. All the available open articles were reviewed and outlined. The studies conclude that VR/AR can help in early rehabilitation and yield better results in post-stroke patients in adjunct to conventional therapy. However, due to the limited research on this subject, we cannot conclude that this information is absolute. Moreover, VR/AR was seldom customized according to the needs of stroke survivors, which would have given us the full extent of its application. Around the world, stroke survivors are being studied to verify the accessibility and practicality of these innovative technologies. Observations conclude that further exploration of the extent of the implementations and efficacy of VR and AR, combined with conventional rehabilitation, is fundamental.

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“…For measuring gait control in these individuals, the WR may be a helpful parameter, as it adds valuable information regarding gait quality to clinical gait assessments such as gait speed ( Bogen et al, 2018 ). Nevertheless, the WR has so far rarely been measured in chronic stroke survivors ( Huber et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Agreement, Reliability, and Concurrent Validity of an Outdoor, Wearable-Based Walk Ratio Assessment in Healthy Adults and Chronic Stroke Survivors

Huber

Knols²,

Held³

et al. 2022

Front. Physiol.

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Purpose: The walk ratio (WR)—the step-length/cadence relation—is a promising measure for gait control. GPS-running watches deliver clinically relevant outcomes including the WR. The aim of this study was to determine test-retest agreement, reliability and concurrent validity of an outdoor WR assessment using a GPS-running watch.Methods: Healthy adults and moderate—high functioning stroke survivors (≥6 months), performed the 1 km-outdoor walk twice using a GPS-running watch (Garmin Forerunner 35, GFR35) and a Step Activity Monitor (SAM 3). Global cognition was assessed using the Montreal Cognitive Assessment. Test-retest agreement and reliability were assessed using Bland-Altman plots, standard error of measurement (SEM), intraclass correlation coefficients (ICCs) and smallest detectable changes (SDCs). Concurrent validity was determined by the mean difference (MD), standard error (SE), mean absolute percentage errors (MAPEs) and Spearman’s Rho between GFR35 and SAM3. WR values of the two groups were compared by a Welch’s test. A hierarchical multiple regression was performed with the WR as dependent variable and possible predictors as independent variables.Results: Fifty-one healthy adults [median: 60.0 (47.0, 67.0) years) and 20 stroke survivors [mean: 63.1 (12.4) years, median: 76 (30, 146) months post-stroke] were included. Test-retest agreement and reliability were excellent (SEM% ≤ 2.2, ICCs > 0.9, SDC% ≤ 6.1) and concurrent validity was high (MAPE < 5, ρ > 0.7) for those walking ≥ 1 m/s. Walking < 1 m/s impaired accurate step counting and reduced agreement, reliability, and validity. The WR differed between healthy adults and stroke survivors (t = −2.126, p = 0.045). The hierarchical regression model including stroke and global cognition (Montreal Cognitive Assessment, 0—30) explained 25% of the WR variance (ΔR2 = 0.246, p < 0.001). Stroke had no effect (β = −0.05, p = 0.682), but global cognition was a predictor for an altered WR (β = 0.44, p = 0.001).Discussion: The outdoor WR assessment using the GFR35 showed excellent test-retest agreement, reliability and concurrent validity in healthy adults and chronic stroke survivors walking at least 1 m/s. As the WR seems relevant in chronic stroke, future studies should further investigate this parameter.

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Motor-cognitive intervention concepts can improve gait in chronic stroke, but their effect on cognitive functions is unclear: A systematic review with meta-analyses

Cited by 26 publications

References 115 publications

A Socially Assistive Robot for Stroke Patients: Acceptance, Needs, and Concerns of Patients and Informal Caregivers

A Socially Assistive Robot for Stroke Patients: Acceptance, Needs, and Concerns of Patients and Informal Caregivers

Virtual and Augmented Reality in Post-stroke Rehabilitation: A Narrative Review

Agreement, Reliability, and Concurrent Validity of an Outdoor, Wearable-Based Walk Ratio Assessment in Healthy Adults and Chronic Stroke Survivors

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