Autonomous Use of the Home Virtual Rehabilitation System: A Feasibility and Pilot Study

Fluet, Gerard G.; Qiu, Qinyin; Patel, Jignesh; Cronce, Amanda; Merians, Alma S.; Adamovich, Sergei V.

doi:10.1089/g4h.2019.0012

Cited by 26 publications

(54 citation statements)

References 35 publications

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“…Our group's study of home based rehabilitation in persons with chronic stroke has demonstrated some interesting new trends. Adherence rates with these subjects has been comparable to other studies of technology supported, home based rehabilitation and better than traditional home based exercise programs in persons with stroke ( 64 , 65 ). Interestingly, age and previous computer experience did not have an impact on adherence ( 76 ), similar to findings of a recent home based rehabilitation study ( 77 ).…”

Section: Comparing Home and Facility Based Rehabilitationsupporting

confidence: 68%

“…This high quality data also allows the system to provide kinematic data to therapists on or offline, allowing them to monitor and modify ‘patients’ rehabilitation programs remotely ( 64 ). Recent pilot study subjects demonstrated statistically and clinically significant improvements in hand motor performance as measured by clinical tests [mean UEMA improvement = 4.53 (SD = 2.3), Repeated Measures ANOVA ( p < 0.001)] ( 65 ). They also made statistically significant error reductions during sine wave tracing tasks controlled by hand opening, wrist extension and forearm pronation measured by the home rehabilitation system ( 64 ).…”

Section: Home Based Rehabilitationmentioning

confidence: 99%

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Virtual Rehabilitation of the Paretic Hand and Arm in Persons With Stroke: Translation From Laboratory to Rehabilitation Centers and the Patient's Home

et al. 2021

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The anatomical and physiological heterogeneity of strokes and persons with stroke, along with the complexity of normal upper extremity movement make the possibility that any single treatment approach will become the definitive solution for all persons with upper extremity hemiparesis due to stroke unlikely. This situation and the non-inferiority level outcomes identified by many studies of virtual rehabilitation are considered by some to indicate that it is time to consider other treatment modalities. Our group, among others, has endeavored to build on the initial positive outcomes in studies of virtual rehabilitation by identifying patient populations, treatment settings and training schedules that will best leverage virtual rehabilitation's strengths. We feel that data generated by our lab and others suggest that (1) persons with stroke may adapt to virtual rehabilitation of hand function differently based on their level of impairment and stage of recovery and (2) that less expensive, more accessible home based equipment seems to be an effective alternative to clinic based treatment that justifies continued optimism and study.

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Section: Comparing Home and Facility Based Rehabilitationsupporting

confidence: 68%

Section: Home Based Rehabilitationmentioning

confidence: 99%

Virtual Rehabilitation of the Paretic Hand and Arm in Persons With Stroke: Translation From Laboratory to Rehabilitation Centers and the Patient's Home

et al. 2021

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“…Following removal of duplicates, 561 titles and abstracts were screened for eligibility. From 128 full texts, 42 studies were included [ 10 , 28 – 68 ]: six qualitative [ 10 , 39 , 52 , 54 , 59 , 65 ], 28 quantitative [ 28 , 30 , 31 , 33 – 38 , 40 , 43 – 51 , 53 , 57 , 58 , 60 , 62 , 64 , 66 – 68 ], and eight mixed methods [ 29 , 32 , 41 , 42 , 55 , 56 , 61 , 63 ]. Figure 1 presents the flow of studies and reasons for exclusion.…”

Section: Resultsmentioning

confidence: 99%

Perseverance with technology-facilitated home-based upper limb practice after stroke: a systematic mixed studies review

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Hayward

et al. 2021

J NeuroEngineering Rehabil

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Background Technology is being increasingly investigated as an option to allow stroke survivors to exploit their full potential for recovery by facilitating home-based upper limb practice. This review seeks to explore the factors that influence perseverance with technology-facilitated home-based upper limb practice after stroke. Methods A systematic mixed studies review with sequential exploratory synthesis was undertaken. Studies investigating adult stroke survivors with upper limb disability undertaking technology-facilitated home-based upper limb practice administered ≥ 3 times/week over a period of ≥ 4 weeks were included. Qualitative outcomes were stroke survivors’ and family members’ perceptions of their experience utilising technology to facilitate home-based upper limb practice. Quantitative outcomes were adherence and dropouts, as surrogate measures of perseverance. The Mixed Methods Appraisal Tool was used to assess quality of included studies. Results Forty-two studies were included. Six studies were qualitative and of high quality; 28 studies were quantitative and eight were mixed methods studies, all moderate to low quality. A conceptual framework of perseverance with three stages was formed: (1) getting in the game; (2) sticking with it, and; (3) continuing or moving on. Conditions perceived to influence perseverance, and factors mediating these conditions were identified at each stage. Adherence with prescribed dose ranged from 13 to 140%. Participants were found to be less likely to adhere when prescribed sessions were more frequent (6–7 days/week) or of longer duration (≥ 12 weeks). Conclusion From the mixed methods findings, we propose a framework for perseverance with technology-facilitated home-based upper limb practice. The framework offers opportunities for clinicians and researchers to design strategies targeting factors that influence perseverance with practice, in both the clinical prescription of practice and technology design. To confirm the clinical utility of this framework, further research is required to explore perseverance and the factors influencing perseverance. Registration: PROSPERO CRD42017072799—https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=72799

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“…The player learns how to safely perform and practice the new skill. The player must master this skill before moving onto the next skill ( Fluet, 2019 ; Fluet et al, 2019 ). Therapists must be able to calibrate the degree of difficulty.…”

Section: Review Results and Discussionmentioning

confidence: 99%

“… Rodriguez-de-Pablo et al, (2015) used a robotic system with a set of VR serious games. Fluet et al, (2012) and Fluet et al, (2019) used a Leap motion controller to capture patient movements while Choi and Paik (2018) used a smartphone with built-in sensors. Piron et al, (2009) used a virtual reality-based system delivered via the Internet.…”

Section: Review Results and Discussionmentioning

confidence: 99%

Serious Games for Stroke Telerehabilitation of Upper Limb - A Review for Future Research

et al. 2020

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Maintaining appropriate home rehabilitation programs after stroke, with proper adherence and remote monitoring is a challenging task. Virtual reality (VR) - based serious games could be a strategy used in telerehabilitation (TR) to engage patients in an enjoyable and therapeutic approach. The aim of this review was to analyze the background and quality of clinical research on this matter to guide future research. The review was based on research material obtained from PubMed and Cochrane up to April 2020 using the PRISMA approach. The use of VR serious games has shown evidence of efficacy on upper limb TR after stroke, but the evidence strength is still low due to a limited number of randomized controlled trials (RCT), a small number of participants involved, and heterogeneous samples. Although this is a promising strategy to complement conventional rehabilitation, further investigation is needed to strengthen the evidence of effectiveness and support the dissemination of the developed solutions.

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Autonomous Use of the Home Virtual Rehabilitation System: A Feasibility and Pilot Study

Cited by 26 publications

References 35 publications

Virtual Rehabilitation of the Paretic Hand and Arm in Persons With Stroke: Translation From Laboratory to Rehabilitation Centers and the Patient's Home

Virtual Rehabilitation of the Paretic Hand and Arm in Persons With Stroke: Translation From Laboratory to Rehabilitation Centers and the Patient's Home

Perseverance with technology-facilitated home-based upper limb practice after stroke: a systematic mixed studies review

Serious Games for Stroke Telerehabilitation of Upper Limb - A Review for Future Research

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