Feedback-Mediated Upper Extremities Exercise: Increasing Patient Motivation in Poststroke Rehabilitation

Abstract

Purpose. This proof-of-concept study investigated whether feedback-mediated exercise (FME) of the affected arm of hemiplegic patients increases patient motivation and promotes greater improvement of motor function, compared to no-feedback exercise (NFE). Method. We developed a feedback-mediated treatment that uses gaming scenarios and allows online and offline monitoring of both temporal and spatial characteristics of planar movements. Twenty poststroke hemiplegic inpatients, randomly assigned to the FME and NFE group, received therapy five days a week for three weeks. The outcome measures were evaluated from the following: (1) the modified drawing test (mDT), (2) received therapy time—RTT, and (3) intrinsic motivation inventory—IMI. Results. The FME group patients showed significantly higher improvement in the speed metric (P < 0.01), and smoothness metric (P < 0.01), as well as higher RTT (P < 0.01). Significantly higher patient motivation is observed in the FME group (interest/enjoyment subscale (P < 0.01) and perceived competence subscale (P < 0.01)). Conclusion. Prolonged endurance in training and greater improvement in certain areas of motor function, as well as very high patient motivation and strong positive impressions about the treatment, suggest the positive effects of feedback-mediated treatment and its high level of acceptance by patients.

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

“…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.…”

Motivational Strategies for Stroke Rehabilitation: A Delphi Study

“…37 Rehabilitation programs with game properties such as virtual reality have been found to improve motivation and activities of daily living. 38,39 Thus, some strategies considered to be effective have been shown to have positive effects on recovery after stroke.…”

Management of Patients After Ischemic Stroke With Motor Disturbances

“…В качестве методов физиотерапии используются лечение положением, обучение пациентов стоянию, сидению, ходьбе (с помощью дополнительных средств и самостоятельно), бинтование конечности, ортопедические устройства, электрическая стимуляция определенных мышечных групп, например разгибателей пальцев кисти или передней большеберцовой мышцы [2]. Использование во время лечебной гимнастики, тренировок паретичных конечностей метода биологической обратной связи способно улучшить процесс восстановления, при этом во многом положительный эффект связан с повышением мотивации пациента к выполнению тех или иных упражнений [24]. В тех случаях, когда спастичность существенно ухудшает двигательные функции у пациентов, перенесших ИИ, могут быть использованы пероральные антиспастические средства: тизанидин, баклофен, дантролен и диазепам [2].…”