The feasibility, acceptability and preliminary efficacy of a low-cost, virtual-reality based, upper-limb stroke rehabilitation device: a mixed methods study

Warland, Alyson; Paraskevopoulos, Ioannis; Tsekleves, Emmanuel; Ryan, Jennifer M; Nowicky, Alexander V.; Griscti, Josephine; Levings, H. Patricia; Kilbride, Cherry

doi:10.1080/09638288.2018.1459881

Cited by 50 publications

(62 citation statements)

References 76 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A positive attitude toward the use of eRehabilitation was found among all end-users, including stroke patients, informal caregivers (13)(14)(15) and healthcare professionals (16,17). The use of eRehabilitation has been associated with enjoyment, extra feedback, physical and cognitive benefits and the possibility to address the limitations of the current rehabilitation system, such as limited therapy hours, low motivation and poor adherence to exercise (18).…”

mentioning

confidence: 99%

“…Healthcare professionals raised concerns about adapting the rehabilitation process when added eRehabilitation (22). Moreover, eRehabilitation is feasible only if tailored to the individual needs of the recovering patient (18,20). In addition, the safety of unsupervised rehabilitation exercises is unknown (11) and lack of substantial reimbursement by insurers is hampering its widespread implementation (6).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Factors associated with willingness to use eRehabilitation after stroke: A cross-sectional study among patients, informal caregivers and healthcare professionals

Brouns¹,

Meesters²,

Wentink³

et al. 2019

J Rehabil Med

View full text Add to dashboard Cite

The use of digital eRehabilitation after stroke (e.g. in serious games, e-consultation and education) is increasing. However, the use of eRehabilitation in daily practice is limited. As a first step in increasing the use of eRehabilitation in stroke care, this study examined which factors influence the willingness of stroke patients, informal caregivers and healthcare professionals to use eRehabilitation. Beliefs about the benefits of eRehabilitation were found to have the largest positive impact on willingness to use eRehabilitation. These benefits included reduced travel time, increased adherence to therapy or motivation, and better health outcomes. The willingness to use eRehabilitation is limited by a lack of knowledge about how to use eRehabilitation. Objective: Despite the increasing availability of eRehabilitation, its use remains limited. The aim of this study was to assess factors associated with willingness to use eRehabilitation. Design: Cross-sectional survey. Subjects: Stroke patients, informal caregivers, health care professionals. Methods: The survey included personal characteristics, willingness to use eRehabilitation (yes/no) and barriers/facilitators influencing this willingness (4-point scale). Barriers/facilitators were merged into factors. The association between these factors and willingness to use eRehabilitation was assessed using logistic regression analyses. Results: Overall, 125 patients, 43 informal caregivers and 105 healthcare professionals participated in the study. Willingness to use eRehabilitation was positively influenced by perceived patient benefits (e.g. reduced travel time, increased motivation, better outcomes), among patients (odds ratio (OR) 2.68; 95% confidence interval (95% CI) 1.34-5.33), informal caregivers (OR 8.98; 95% CI 1.70-47.33) and healthcare professionals (OR 6.25; 95% CI 1.17-10.48). Insufficient knowledge decreased willingness to use eRehabilitation among patients (OR 0.36, 95% CI 0.17-0.74). Limitations of the study include low response rates and possible response bias. Conclusion: Differences were found between patients/informal caregivers and healthcare professionals. However, for both groups, perceived benefits of the use of eRehabilitation facilitated willingness to use eRehabilitation. Further research is needed to determine the benefits of such programs, and inform all users about the potential benefits, and how to use eRehabilitation.

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

Factors associated with willingness to use eRehabilitation after stroke: A cross-sectional study among patients, informal caregivers and healthcare professionals

Brouns¹,

Meesters²,

Wentink³

et al. 2019

J Rehabil Med

View full text Add to dashboard Cite

show abstract

“…Assim, esta pesquisa cumpriu todos os pré-requisitos para uma aplicação bemsucedida de um jogo sério: [18], [23], [25], [68], [69], [83], [88]. Poucos trabalhos avaliam a ADM [21], [23], [72].…”

Section: Elaboração Da Terapia E Da Proposta Metodológicaunclassified

“…A síntese contendo as principais características encontradas nos trabalhos correlatos pode ser visualizada na Tabela 1. Aspectos como a quantidade de participantes da pesquisa, instrumentos utilizados para execução dos estudos, as ferramentas para avaliação dos dados, os principais resultados, conclusões podem visualizados no Apêndice, neste arquivo também é possível verificar as observações feitas pelos autores desta pesquisa.Os nossos pontos de concordância com as pesquisas relatadas são a possibilidade e necessidade de individualizar a terapia[57],[83],[94], para aumentar sua efetividade. O tipo de controle para captura dos movimentos, com utilização de sistemas de mãos livres para que a terapia possa ser aplicada a qualquer paciente, independente da severidade da sequela[18],[20],[72],[83].…”

unclassified

“…Aspectos como a quantidade de participantes da pesquisa, instrumentos utilizados para execução dos estudos, as ferramentas para avaliação dos dados, os principais resultados, conclusões podem visualizados no Apêndice, neste arquivo também é possível verificar as observações feitas pelos autores desta pesquisa.Os nossos pontos de concordância com as pesquisas relatadas são a possibilidade e necessidade de individualizar a terapia[57],[83],[94], para aumentar sua efetividade. O tipo de controle para captura dos movimentos, com utilização de sistemas de mãos livres para que a terapia possa ser aplicada a qualquer paciente, independente da severidade da sequela[18],[20],[72],[83]. Outro ponto de acordo é a necessidade de desenvolver jogos que sejam pensados nas debilitadas e na melhor forma de reabilitar uma amostra específica, como indivíduos pós AVC, visto que alguns os trabalhos já publicados sobre o assunto que utilizam de jogos prontos, adaptando os mesmos às necessidade dos pacientes[69],[76], não obtiveram grande sucesso.As formas de avaliação das terapias também foram analisadas.…”

unclassified

See 1 more Smart Citation

Jogo sério e realidade virtual na reabilitação do AVC crônico: protocolo individualizado

Marques¹

View full text Add to dashboard Cite

Stroke is the leading cause of disability in the world. Many individuals remain without upper limb (MS) function even six months after stroke. The function of MS directly affects the performance of activities of daily living, negatively affecting the quality of life (QOL) of these patients. Several researchers report the difficulty of restoring the motor function of paretic MS. Considering the above aspects, a new rehabilitation protocol was developed, applied and evaluated involving a user-centered serious virtual reality-based (VR) game in non-invasive and post-chronic chronic individuals. A total of 10 individuals with stroke sequelae who underwent 15 rehabilitation sessions, lasting between 30 and 40 minutes each, participated in the research. The quantitative parameters evaluated were: Modified Ashworth Scale (MAS), Tonic Stretch Reflex Threshold (TSRT), Brunnstrom Recovery Stages (BRS), Range of Motion (ROM), and Stroke-Specific Quality of Life Scale), and qualitative analysis made through a collection diary. For analysis of quantitative data we used the software R. The Shapiro-Wilk test was initially applied to identify if the samples had normal distribution. For data with normal distribution (ROM) the T test was used, and for non-normal data (LRET, EMA, BRS, QOL), the nonparametric Wilcoxon-Mann-Whitney test was used, both comparing pre and post evaluation. treatment. The results of the parameters measured for LRET, BRS, ADM and QL evaluation showed statistically significant differences between pre and post intervention evaluations, with 99% confidence. In this intervention it was observed, in general, that the offered protocol was able to reach the goal, since the results presented indicated that there was a decrease in muscle tone, increased range of motion and improved quality of life, besides , this intervention showed no adverse effect, was very motivating given the level of adherence of the participants and allowed a specific training for the upper limbs of these individuals.

show abstract

Wearable myoelectric interface enables high‐dose, home‐based training in severely impaired chronic stroke survivors

Hung

Paul

Prakash

et al. 2021

Ann Clin Transl Neurol

View full text Add to dashboard Cite

Background High‐intensity occupational therapy can improve arm function after stroke, but many people lack access to such therapy. Home‐based therapies could address this need, but they don’t typically address abnormal muscle co‐activation, an important aspect of arm impairment. An earlier study using lab‐based, myoelectric computer interface game training enabled chronic stroke survivors to reduce abnormal co‐activation and improve arm function. Here, we assess feasibility of doing this training at home using a novel, wearable, myoelectric interface for neurorehabilitation training (MINT) paradigm. Objective Assess tolerability and feasibility of home‐based, high‐dose MINT therapy in severely impaired chronic stroke survivors. Methods Twenty‐three participants were instructed to train with the MINT and game for 90 min/day, 36 days over 6 weeks. We assessed feasibility using amount of time trained and game performance. We assessed tolerability (enjoyment and effort) using a customized version of the Intrinsic Motivation Inventory at the conclusion of training. Results Participants displayed high adherence to near‐daily therapy at home (mean of 82 min/day of training; 96% trained at least 60 min/day) and enjoyed the therapy. Training performance improved and co‐activation decreased with training. Although a substantial number of participants stopped training, most dropouts were due to reasons unrelated to the training paradigm itself. Interpretation Home‐based therapy with MINT is feasible and tolerable in severely impaired stroke survivors. This affordable, enjoyable, and mobile health paradigm has potential to improve recovery from stroke in a variety of settings. Clinicaltrials.gov: NCT03401762.

show abstract

The feasibility, acceptability and preliminary efficacy of a low-cost, virtual-reality based, upper-limb stroke rehabilitation device: a mixed methods study

Cited by 50 publications

References 76 publications

Factors associated with willingness to use eRehabilitation after stroke: A cross-sectional study among patients, informal caregivers and healthcare professionals

Factors associated with willingness to use eRehabilitation after stroke: A cross-sectional study among patients, informal caregivers and healthcare professionals

Jogo sério e realidade virtual na reabilitação do AVC crônico: protocolo individualizado

Wearable myoelectric interface enables high‐dose, home‐based training in severely impaired chronic stroke survivors

Contact Info

Product

Resources

About