Feasibility of incorporating functionally relevant virtual rehabilitation in sub-acute stroke care: perception of patients and clinicians

Demers, Marika; Kong, Daniel Chan Chun; Levin, Mindy F.

doi:10.1080/17483107.2018.1449019

Cited by 24 publications

(13 citation statements)

References 31 publications

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“…6c we demonstrate role of the Eu 3? concentration for the 100-nm-thick Eu-TP films. The Eu 3? concentration was varied in these films by mixing Eu(thd) 3 and Y(thd) 3 cycles in the depositions. Very interestingly, the optimal Eu 3?…”

Section: Resultsmentioning

confidence: 99%

“…Lanthanide (Ln)-based luminescent materials exhibit all of the aforementioned photon conversion processes and can be implemented for a breadth of applications, such as solar cells, lasers, displays, lighting, sensors, bioimaging, disease diagnostics and therapy, (bio)chemical analysis and security tags [1][2][3][4][5]. A majority of these applications require the luminescent material in the form of a thin film or coating.…”

Section: Introductionmentioning

confidence: 99%

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Effect of carbon backbone on luminescence properties of Eu-organic hybrid thin films prepared by ALD/MLD

et al. 2021

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Here we show that the backbone of the organic ligand has a profound impact on the luminescence characteristics of lanthanide-organic materials. We employ the emerging atomic/molecular layer deposition (ALD/MLD) technique to deposit europium-based thin films where the organic ligands vary in terms of the number of aromatic rings in their backbone (benzene, naphthalene and anthracene). Enlarging the backbone shifts the excitation towards visible wavelengths, but it simultaneously decreases the emission intensity. Moreover, for the Eu-terephthalate films with the single benzene ring as the organic backbone, we investigate the effects of diluting the Eu3+ concentration with Y3+ to reveal that the emission intensity is optimized around 12% Eu3+ concentration. Interestingly, such a dependence of luminescence intensity on the concentration of emitting species suggests that our (Eu,Y)-organic thin films behave more like ionic phosphors than discrete metal–ligand molecules. Graphical abstract

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of carbon backbone on luminescence properties of Eu-organic hybrid thin films prepared by ALD/MLD

et al. 2021

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“…Robotic and virtual-reality UL training technologies have been shown in trials to be as good as, or superior to, conventional supervised therapy, when used typically at least several times a week, over 2-4 months, in sessions of 30-60 minutes, achieving 300-600 repetitions per session. [44][45][46][47][48][49][50][51][52] However, in these trials, intervention sessions are generally set up and/or supervised by therapists, to encourage highintensity training and support complex equipment set up etc. 53 These aspects can be problematic when translating technologies to practice, because higher doses of training entails higher staffing requirements, offsetting their costeffectiveness.…”

Section: Discussionmentioning

confidence: 99%

Self-Directed Exergaming for Stroke Upper Limb Impairment Increases Exercise Dose Compared to Standard Care

Broderick

Almedom

Burdet

et al. 2021

Neurorehabil Neural Repair

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Background. One of the strongest modifiable determinants of rehabilitation outcome is exercise dose. Technologies enabling self-directed exercise offer a pragmatic means to increase dose, but the extent to which they achieve this in unselected cohorts, under real-world constraints, is poorly understood. Objective. Here we quantify the exercise dose achieved by inpatient stroke survivors using an adapted upper limb (UL) exercise gaming (exergaming) device and compare this with conventional (supervised) therapy. Methods. Over 4 months, patients presenting with acute stroke and associated UL impairment were screened at a single stroke centre. Participants were trained in a single session and provided with the device for unsupervised use during their inpatient admission. Results. From 75 patients referred for inpatient UL therapy, we recruited 30 (40%), of whom 26 (35%) were able to use the device meaningfully with their affected UL. Over a median enrolment time of 8 days (IQR: 5–14), self-directed UL exercise duration using the device was 26 minutes per day (median; IQR: 16–31), in addition to 25 minutes daily conventional UL therapy (IQR: 12–34; same cohort plus standard care audit; joint n = 50); thereby doubling total exercise duration (51 minutes; IQR: 32–64) relative to standard care (Z = 4.0, P <.001). The device enabled 104 UL repetitions per day (IQR: 38–393), whereas conventional therapy achieved 15 UL repetitions per day (IQR: 11–23; Z = 4.3, P <.001). Conclusion. Self-directed adapted exergaming enabled participants in our stroke inpatient cohort to increase exercise duration 2-fold, and repetitions 8-fold, compared to standard care, without requiring additional professional supervision.

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“…(Colombo et al, 2007;Mihelj et al, 2012;Saposnik & Levin, 2011;Zimmerli, Jacky, Lünenburger, Riener, & Bolliger, 2013). Since a sense of real-world relevance and usefulness is also an important motivator for exercise (Demers, Chan Chun Kong, & Levin, 2019;Lewis & Rosie, 2012), some rehabilitation VEs also aim to mimic everyday activities such as cooking or shopping (Guidali et al, 2011;Laver et al, 2012). Additionally, to ensure appropriate exercise intensity (amount of movement, muscle activation, or heart rate) that is neither overwhelming nor boring for the patient, these VEs generally include intelligent difficulty adaptation algorithms that adapt the environment to the patient's skills and abilities over time (Colombo et al, 2007;Koenig et al, 2011;Zimmerli et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

A Multisession Evaluation of a Collaborative Virtual Environment for Arm Rehabilitation

Goršič

Cikajlo

Goljar

et al. 2018

Presence: Teleoperators and Virtual Environments

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In recent years, several multi-user virtual environments (VEs) have been developed to promote motivation and exercise intensity in motor rehabilitation. While competitive VEs have been extensively evaluated, collaborative and competitive rehabilitation VEs have seen relatively little study. Therefore, this article presents an evaluation of a VE for post-stroke arm rehabilitation that mimics everyday kitchen tasks and can be used either solo or collaboratively. Twenty subacute stroke survivors exercised with the VE for four sessions, with the first and third sessions involving solo exercise and the other two involving collaborative exercise. Exercise intensity was measured using inertial sensors while motivation was measured with questionnaires. Results showed high motivation and exercise intensity over all four sessions, and 11 of 20 participants preferred collaborative over solo exercise while only 4 preferred solo exercise. However, there were no differences in motivation, exercise duration, or exercise intensity between solo and collaborative sessions. Thus, we cannot currently claim that collaborative exercises are beneficial for upper limb rehabilitation. Future studies should evaluate other collaborative VE designs in different settings (e.g., at home) and with different participant pairs (e.g., patient-unimpaired) to find effective ways to utilize collaborative exercises in motor rehabilitation.

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Feasibility of incorporating functionally relevant virtual rehabilitation in sub-acute stroke care: perception of patients and clinicians

Cited by 24 publications

References 31 publications

Effect of carbon backbone on luminescence properties of Eu-organic hybrid thin films prepared by ALD/MLD

Effect of carbon backbone on luminescence properties of Eu-organic hybrid thin films prepared by ALD/MLD

Self-Directed Exergaming for Stroke Upper Limb Impairment Increases Exercise Dose Compared to Standard Care

A Multisession Evaluation of a Collaborative Virtual Environment for Arm Rehabilitation

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