Technology-assisted training of arm-hand skills in stroke: concepts on reacquisition of motor control and therapist guidelines for rehabilitation technology design

Timmermans, Annick; Seelen, Henk; Willmann, Richard; Kingma, Herman

doi:10.1186/1743-0003-6-1

Cited by 340 publications

(296 citation statements)

References 154 publications

(213 reference statements)

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“…5 Regarding training physiology, a goal-dependent functional and specific skill training was offered with training loads exceeding the patient's metabolic capacity (overload principle 4 ). As to motor learning principles, 'over-learning strategies' (that is, continued practice after performance), 'exercise variability' to improve patient's motivation and conserve training effect and 'guidance and feedback' 5,9 (provided by the haptic robot device 8,11 ) were used. Patients were offered a task-oriented training, that is, a repetitive training of self-selected, real life activities, to also improve their motivation.…”

Section: Materials and Interventionmentioning

confidence: 99%

“…All skills were broken down into subskills or components. 9,11 For each of these components, exercises were offered at increasing levels of difficulty with the feedback delivered according to the shaping principles. 12 Exercise progression was based on principles of training physiology 4 and motor learning.…”

Section: Materials and Interventionmentioning

confidence: 99%

“…In clinical rehabilitation practice, however, it is well known that high levels of movement repetition and lack of training variation may lead to patients becoming bored, and thus may lead to decreased motivation to train and to lower levels of therapy adherence. To explore the possibilities for extending ToCUEST's training variation, which, in turn, might further improve patients' training motivation, 5,7 the use of training technology was considered, analogous to the work of Timmermans et al, 8,9 who developed and evaluated a technologyassisted task-oriented arm training approach (T-TOAT) for persons with stroke. The use of such a training approach to improve AHSP in persons with C-SCI has not yet been reported.…”

Section: Introductionmentioning

confidence: 99%

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Robot-assisted task-oriented upper extremity skill training in cervical spinal cord injury: a feasibility study

et al. 2015

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Study design: Prospective multiple case study. Objectives: To test (1) the feasibility of haptic robot technology (Haptic Master (HM)) use to improve arm-hand function (AHF) and arm-hand skill performance (AHSP) in persons with a cervical spinal cord injury (C-SCI), (2) inventory participants' motivation and expectation to work with the robot technology used and (3) to descriptively report the results in individual cases. Setting: Rehabilitation Centre. Methods: Five C-SCI patients were trained for 6 weeks, 3 days per week, 60 min per day. Therapists filled out the Usefulness, Satisfaction and Ease-of-use questionnaire (USE). The Intrinsic Motivational Inventory (IMI) and credibility and expectancy questionnaire (CEQ) were filled out by participants. Performance at activity level was gauged using the Van Lieshout test for AHF in Tetraplegia and the Spinal Cord Independence Measure. Function level was gauged using muscle strength testing and the International Classification for Surgery of the Hand in Tetraplegia. Results: As to the feasibility of the application of haptic robot technology, the mean USE score was 65%. Mean IMI and CEQ results were 67% and 60%, respectively. Participants were motivated to train with the HM. All participants rated credibility higher than expectations regarding the improvement. In the current patients, little progress was demonstrated at the International Classification of Functioning, Disability and Health function and the activity level. Conclusion: It is feasible to train C-SCI persons with the HM. Therapists report that working with the HM is easy to learn and easy to perform. Usability of the HM may be improved. Further research is needed to assess in which group of C-SCI and at which stage of rehabilitation HM training may be most beneficial.

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Section: Materials and Interventionmentioning

confidence: 99%

Section: Materials and Interventionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Robot-assisted task-oriented upper extremity skill training in cervical spinal cord injury: a feasibility study

et al. 2015

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“…A number of factors are thought to enhance plasticity-based rehabilitation, such as task-oriented movement practice in a challenging, engaging, functional, and meaningful way, and the rehabilitation should address body function and structures, activity, and participation level [9][10][11][12][13]15]. Rehabilitation has shown that, even in chronic stroke, improved upperlimb outcomes can be achieved [16][17].…”

Section: Introductionmentioning

confidence: 99%

“…Motor (re)learning and recovery are mainly possible because of plasticity of the brain [7], and the changes caused by plasticity in the lesioned hemisphere coincide with motor function improvement after activity-based rehabilitation [3]. In addition to neural plasticity changes in the lesioned side, motor recovery may occur because of a shift of balance in the motor cortical recruitment toward the undamaged hemisphere via the ipsilateral pathways [8][9].…”

Section: Introductionmentioning

confidence: 99%

Bilateral upper-limb rehabilitation after stroke using a movement-based game controller

Hijmans¹,

Hale²,

Satherley³

et al. 2011

JRRD

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Abstract-This study aimed to determine the effectiveness of a bilateral, self-supported, upper-limb rehabilitation intervention using a movement-based game controller for people with chronic stroke. Fourteen participants received a control treatment, followed by a washout period, and then the intervention. The intervention comprised playing computer games with the CyWee Z (CyWee Group Ltd; Taipei, Taiwan), a movement-based game controller similar to the Nintendo Wii remote. The CyWee Z was incorporated into a handlebar, making bilateral exercises possible by allowing the unaffected side to support and assist the affected side. The intervention lasted for 8 to 10 sessions of 45 to 60 minutes over a period of 2.5 weeks. The Fugl-Meyer Assessment upper-limb section (FMA-UL) was used as the primary outcome. The Wolf Motor Function Test and the Disabilities of Arm, Shoulder, and Hand outcome measure were used as secondary outcomes. Postintervention, motor performance as measured by the FMA-UL was significantly improved compared with all preintervention assessments (p < 0.001), whereas no changes were found on both secondary outcomes. It can be concluded from this pilot study that upper-limb motor performance of adults with chronic stroke improves with repetitive, game-assisted, selfsupported bilateral exercises.

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Interventions for improving upper limb function after stroke

Pollock

Farmer

Brady

et al. 2013

Cochrane Database of Systematic Reviews

139

198

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BackgroundImproving upper limb function is a core element of stroke rehabilitation needed to maximise patient outcomes and reduce disability. Evidence about effects of individual treatment techniques and modalities is synthesised within many reviews. For selection of effective rehabilitation treatment, the relative effectiveness of interventions must be known. However, a comprehensive overview of systematic reviews in this area is currently lacking. ObjectivesTo carry out a Cochrane overview by synthesising systematic reviews of interventions provided to improve upper limb function after stroke. MethodsSearch methods: We comprehensively searched the Cochrane Database of Systematic Reviews; the Database of Reviews of Effects; and PROSPERO (an international prospective register of systematic reviews) (June 2013). We also contacted review authors in an effort to identify further relevant reviews.Selection criteria: We included Cochrane and non-Cochrane reviews of randomised controlled trials (RCTs) of patients with stroke comparing upper limb interventions with no treatment, usual care or alternative treatments. Our primary outcome of interest was upper limb function; secondary outcomes included motor impairment and performance of activities of daily living. When we identified overlapping reviews, we systematically identified the most up-to-date and comprehensive review and excluded reviews that overlapped with this. Data collection and analysis: Two overview authors independently applied the selection criteria, excluding reviews that were superseded by more up-to-date reviews including the same (or similar) studies. Two overview authors independently assessed the methodological quality of reviews (using a modified version of the AMSTAR tool) and extracted data. Quality of evidence within each comparison in each review was determined using objective criteria (based on numbers of participants, risk of bias, heterogeneity and review quality) to apply GRADE (Grades of Recommendation, Assessment, Development and Evaluation) levels of evidence. We resolved disagreements through discussion. We systematically tabulated the effects of interventions and used quality of evidence to determine implications for clinical practice and to make recommendations for future research.

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Technology-assisted training of arm-hand skills in stroke: concepts on reacquisition of motor control and therapist guidelines for rehabilitation technology design

Abstract: Background: It is the purpose of this article to identify and review criteria that rehabilitation technology should meet in order to offer arm-hand training to stroke patients, based on recent principles of motor learning.

Cited by 340 publications

References 154 publications

Robot-assisted task-oriented upper extremity skill training in cervical spinal cord injury: a feasibility study

Robot-assisted task-oriented upper extremity skill training in cervical spinal cord injury: a feasibility study

Bilateral upper-limb rehabilitation after stroke using a movement-based game controller

Interventions for improving upper limb function after stroke

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