Effects of Upper-Extremity Rehabilitation Using Smart Glove in Patients With Subacute Stroke: Results of a Prematurely Terminated Multicenter Randomized Controlled Trial

Kang, Min‐Gu; Yun, Seo Jung; Lee, Sang Yoon; Oh, Byung Mo; Lee, Hyun Haeng; Lee, Shi-Uk; Seo, Han Gil

doi:10.3389/fneur.2020.580393

Cited by 15 publications

(32 citation statements)

References 41 publications

(45 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, no significant improvement in fine motor function was observed. This finding suggests that VR systems that use input mechanisms that would facilitate fine motor movements, such as Leap Motion or gloves with sensors [ 41 , 63 ], may be more suitable for supporting fine movement exercises.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Using Virtual Reality–Supported Exercise Therapy for Upper Extremity Motor Rehabilitation in Patients With Stroke: Systematic Review and Meta-analysis of Randomized Controlled Trials

Chen

2022

J Med Internet Res

View full text Add to dashboard Cite

Background In recent years, efforts have been made to implement virtual reality (VR) to support the delivery of poststroke upper extremity motor rehabilitation exercises. Therefore, it is important to review and analyze the existing research evidence of its effectiveness. Objective Through a systematic review and meta-analysis of randomized controlled trials, this study examined the effectiveness of using VR-supported exercise therapy for upper extremity motor rehabilitation in patients with stroke. Methods This study followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The CINAHL Plus, MEDLINE, Web of Science, Embase, and Cochrane Library databases were searched on December 31, 2021. Changes in outcomes related to impairments in upper extremity functions and structures, activity limitations, and participation restrictions in life situations from baseline to after intervention, after intervention to follow-up assessment, and baseline to follow-up assessment were examined. Standardized mean differences (SMDs) were calculated using a random-effects model. Subgroup analyses were performed to determine whether the differences in treatment outcomes depended on age, stroke recovery stage, VR program type, therapy delivery format, similarities in intervention duration between study groups, intervention duration in VR groups, and trial length. Results A total of 42 publications representing 43 trials (aggregated sample size=1893) were analyzed. Compared with the control groups that used either conventional therapy or no therapy, the intervention groups that used VR to support exercise therapy showed significant improvements in upper extremity motor function (Fugl-Meyer Assessment-Upper Extremity; SMD 0.45, 95% CI 0.21-0.68; P<.001), range of motion (goniometer; SMD 1.01, 95% CI 0.50-1.52; P<.001), muscle strength (Manual Muscle Testing; SMD 0.79, 95% CI 0.28-1.30; P=.002), and independence in day-to-day activities (Functional Independence Measure; SMD 0.23, 95% CI 0.06-0.40; P=.01, and modified Rankin Scale; SMD 0.57, 95% CI 0.01-1.12; P=.046). Significant subgroup differences were observed in hand dexterity (Box and Block Test), spasticity (Ashworth Scale or modified Ashworth Scale), arm and hand motor ability (Wolf Motor Function Test and Manual Function Test), hand motor ability (Jebsen Hand Function Test), and quality of life (Stroke Impact Scale). There was no evidence that the benefits of VR-supported exercise therapy were maintained after the intervention ended. Conclusions VR-supported upper extremity exercise therapy can be effective in improving motor rehabilitation results. Our review showed that of the 12 rehabilitation outcomes examined during the course of VR-based therapy, significant improvements were detected in 2 (upper extremity motor function and range of motion), and both significant and nonsignificant improvements were observed in another 2 (muscle strength and independence in day-to-day activities), depending on the measurement tools or methods used. Trial Registration PROSPERO CRD42021256826; https://tinyurl.com/2uarftbh

show abstract

Section: Discussionmentioning

confidence: 99%

Effectiveness of Using Virtual Reality–Supported Exercise Therapy for Upper Extremity Motor Rehabilitation in Patients With Stroke: Systematic Review and Meta-analysis of Randomized Controlled Trials

Chen

2022

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…After first screening, there was a total of 71 studies, which were obtained and read in full text. Finally, 7 studies [ 18 , 19 , 20 , 21 , 22 , 23 , 24 ] were included in the qualitative analysis, and quantitative analysis, with a total of 230 subjects. The screening process is shown in the PRISMA flow diagram ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…The age range of the 230 patients was between 42 and 78 years, all studies included hemorrhagic and ischemic stroke. Kang et al [ 18 ], Park et al [ 20 ] and Patel et al [ 21 ], conducted the studies with acute post-stroke patients (<1 month), while the rest of the studies recruited chronic post-stroke patients (>12 months). The number of sessions ranged from 8 to 24, with a duration between 30 min to 1 h and with a minimum intensity of 3 sessions per week.…”

Section: Resultsmentioning

confidence: 99%

“…Different methods were used to assess UE functionality in the included studies. Of the included studies, five used the Fugl Meyer UE scale (FMA-UE) [ 17 , 19 , 20 , 22 , 23 ], five used the Jebsen-Taylor hand function test (JTT) [ 18 , 19 , 20 , 23 , 24 ], three used the Block and Box test (BBT) [ 18 , 19 , 22 ], three analyzed the hand grip strength (HGS) [ 18 , 20 , 24 ], one used the Wolf Motor Function Test (WMFT) [ 19 ], one used the action research arm test (ARAT) [ 22 ], and one used the Chedoke-McMaster Armand Hand Activity Inventory [ 24 ]. Seven studies evaluated the UE functionality in the short-term [ 18 , 19 , 20 , 21 , 22 , 23 , 24 ], and five evaluated the UE functionality in the long-term [ 18 , 21 , 22 , 23 , 24 ].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Haptic Glove Systems in Combination with Semi-Immersive Virtual Reality for Upper Extremity Motor Rehabilitation after Stroke: A Systematic Review and Meta-Analysis

Fernández-Vázquez

Cano‐de‐la‐Cuerda

Navarro-López

2022

IJERPH

View full text Add to dashboard Cite

Background: The effectiveness of the virtual reality (VR) for the upper extremity (UE) motor rehabilitation after stroke has been widely studied. However, the effectiveness of the combination between rehabilitation gloves and semi-immersive VR (SVR) compared to conventional treatment has not yet been studied. Methods: A systematic search was conducted in Pubmed, Web of Science, PEDRo, and Scopus, Cochrane, CINHAAL databases from inception to May 2022. Randomized controlled trials were included if patients were under rehabilitation with haptic gloves combined with SVR intervention focused on the UE rehabilitation in stroke patients. Risk of bias and methodological quality were evaluated with the Physiotherapy Evidence Database (PEDro), and the modified Cochrane library criteria. A random effects model was used for the quantitative assessment of the included studies using the standard mean difference with a 95% confidence interval. Heterogeneity among the included studies was assessed using Cochran’s Q test and the incoherence index (I2). Results: After a first screening, seven studies were included. Significant differences with a 95% confidence interval were obtained in favor of the rehabilitation glove combined with SVR in the short term (SMD—standardized mean differences = 0.38, 95% CI—confidence interval = 0.20; 0.56; Z: 4.24; p =< 0.001). In the long term, only the studies that performed an intervention based in rehabilitation glove combined with SVR with also included rehabilitation were able to maintain the improvements (SMD = 0.71, 95% CI = 0.40; 1.02; Z: 4.48; p =< 0.001). Conclusions: The combined use of rehabilitation haptic gloves and SVR with conventional rehabilitation produces significant improvements with respect to conventional rehabilitation treatment alone in terms of functionality of the UE in stroke patients.

show abstract

“…(4) Primary outcome measures in this study assessed the upper limb motor function and ADL performance, including Upper Extremity Fugl-Meyer Assessment (UE-FMA), Wolf Motor Function Test (WMFT), and Modified Barthel Index (MBI). The UE-FMA and WMFT are commonly used to assess the upper limb motor function in patients with stroke, in the clinic ( 18 , 19 ). The higher the scores of UE-FMA and WMFT, the better the upper limb motor functions.…”

Section: Methodsmentioning

confidence: 99%

Comparative Efficacy of Different Repetitive Transcranial Magnetic Stimulation Protocols for Stroke: A Network Meta-Analysis

Xia

et al. 2022

Front. Neurol.

View full text Add to dashboard Cite

BackgroundAlthough repetitive transcranial magnetic stimulation (rTMS) has been proven to be effective in the upper limb motor function and activities of daily living (ADL), the therapeutic effects of different stimulation protocols have not been effectively compared. To fill this gap, this study carried out the comparison of the upper limb motor function and ADL performance of patients with stroke through a network meta-analysis.MethodsRandomized controlled trials (RCTs) on the rTMS therapy for stroke were searched from various databases, including PubMed, web of science, Embase, Cochrane Library, ProQuest, Wanfang database, the China National Knowledge Infrastructure (CNKI), and VIP information (www.cqvip.com). The retrieval period was from the establishment of the database to January 2021. Meanwhile, five independent researchers were responsible for the study selection, data extraction, and quality evaluation. The outcome measures included Upper Extremity Fugl-Meyer Assessment (UE-FMA), Wolf Motor Function Test (WMFT), Modified Barthel Index (MBI), the National Institute of Health stroke scale (NIHSS), and adverse reactions. The Gemtc 0.14.3 software based on the Bayesian model framework was used for network meta-analysis, and funnel plots and network diagram plots were conducted using Stata14.0 software.ResultsNinety-five studies and 5,016 patients were included ultimately. The intervention measures included were as follows: placebo, intermittent theta-burst stimulation (ITBS), continuous theta-burst stimulation (CTBS),1 Hz rTMS,3–5 Hz rTMS, and ≥10 Hz rTMS. The results of the network meta-analysis show that different rTMS protocols were superior to placebo in terms of UE-FMA, NIHSS, and MBI outcomes. In the probability ranking results, ≥10 Hz rTMS ranked first in UE-FMA, WMFT, and MBI. For the NIHSS outcome, the ITBS ranked first and 1 Hz rTMS ranked the second. The subgroup analyses of UE-FMA showed that ≥10 Hz rTMS was the best stimulation protocol for mild stroke, severe stroke, and the convalescent phase, as well as ITBS was for acute and subacute phases. In addition, it was reported in 13 included studies that only a few patients suffered from adverse reactions, such as headache, nausea, and emesis.ConclusionOverall, ≥10 Hz rTMS may be the best stimulation protocol for improving the upper limb motor function and ADL performance in patients with stroke. Considering the impact of stroke severity and phase on the upper limb motor function, ≥10 Hz rTMS may be the preferred stimulation protocol for mild stroke, severe stroke, and for the convalescent phase, and ITBS for acute and subacute phases.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier [CRD42020212253].

show abstract

Effects of Upper-Extremity Rehabilitation Using Smart Glove in Patients With Subacute Stroke: Results of a Prematurely Terminated Multicenter Randomized Controlled Trial

Cited by 15 publications

References 41 publications

Effectiveness of Using Virtual Reality–Supported Exercise Therapy for Upper Extremity Motor Rehabilitation in Patients With Stroke: Systematic Review and Meta-analysis of Randomized Controlled Trials

Effectiveness of Using Virtual Reality–Supported Exercise Therapy for Upper Extremity Motor Rehabilitation in Patients With Stroke: Systematic Review and Meta-analysis of Randomized Controlled Trials

Haptic Glove Systems in Combination with Semi-Immersive Virtual Reality for Upper Extremity Motor Rehabilitation after Stroke: A Systematic Review and Meta-Analysis

Comparative Efficacy of Different Repetitive Transcranial Magnetic Stimulation Protocols for Stroke: A Network Meta-Analysis

Contact Info

Product

Resources

About