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Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke.
J Neuroeng Rehabil 2016; 13(1):45JN

Abstract

BACKGROUND

Virtual and mixed reality systems have been suggested to promote motor recovery after stroke. Basing on the existing evidence on motor learning, we have developed a portable and low-cost mixed reality tabletop system that transforms a conventional table in a virtual environment for upper limb rehabilitation. The system allows intensive and customized training of a wide range of arm, hand, and finger movements and enables interaction with tangible objects, while providing audiovisual feedback of the participants' performance in gamified tasks. This study evaluates the clinical effectiveness and the acceptance of an experimental intervention with the system in chronic stroke survivors.

METHODS

Thirty individuals with stroke were included in a reversal (A-B-A) study. Phase A consisted of 30 sessions of conventional physical therapy. Phase B consisted of 30 training sessions with the experimental system. Both interventions involved flexion and extension of the elbow, wrist, and fingers, and grasping of different objects. Sessions were 45-min long and were administered three to five days a week. The body structures (Modified Ashworth Scale), functions (Motricity Index, Fugl-Meyer Assessment Scale), activities (Manual Function Test, Wolf Motor Function Test, Box and Blocks Test, Nine Hole Peg Test), and participation (Motor Activity Log) were assessed before and after each phase. Acceptance of the system was also assessed after phase B (System Usability Scale, Intrinsic Motivation Inventory).

RESULTS

Significant improvement was detected after the intervention with the system in the activity, both in arm function measured by the Wolf Motor Function Test (p < 0.01) and finger dexterity measured by the Box and Blocks Test (p < 0.01) and the Nine Hole Peg Test (p < 0.01); and participation (p < 0.01), which was maintained to the end of the study. The experimental system was reported as highly usable, enjoyable, and motivating.

CONCLUSIONS

Our results support the clinical effectiveness of mixed reality interventions that satisfy the motor learning principles for upper limb rehabilitation in chronic stroke survivors. This characteristic, together with the low cost of the system, its portability, and its acceptance could promote the integration of these systems in the clinical practice as an alternative to more expensive systems, such as robotic instruments.

Authors+Show Affiliations

Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales NISA. Fundación Hospitales NISA, Valencia, Spain.Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales NISA. Fundación Hospitales NISA, Valencia, Spain. rllorens@labhuman.com. Instituto Interuniversitario de Investigación en Bioingeniería y Tecnología Orientada al Ser Humano, Universitat Politècnica de València, Camino de Vera s/n, Valencia, 46022, Spain. rllorens@labhuman.com.Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales NISA. Fundación Hospitales NISA, Valencia, Spain.Instituto Interuniversitario de Investigación en Bioingeniería y Tecnología Orientada al Ser Humano, Universitat Politècnica de València, Camino de Vera s/n, Valencia, 46022, Spain. Ciber, Fisiopatología Obesidad y Nutrición, CB06/03 Instituto de Salud Carlos III, Av. Sos Baynat s/n, Univesity of Jaume I, Castellón, 12071, Spain.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27169462

Citation

Colomer, Carolina, et al. "Effect of a Mixed Reality-based Intervention On Arm, Hand, and Finger Function On Chronic Stroke." Journal of Neuroengineering and Rehabilitation, vol. 13, no. 1, 2016, p. 45.
Colomer C, Llorens R, Noé E, et al. Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke. J Neuroeng Rehabil. 2016;13(1):45.
Colomer, C., Llorens, R., Noé, E., & Alcañiz, M. (2016). Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke. Journal of Neuroengineering and Rehabilitation, 13(1), p. 45. doi:10.1186/s12984-016-0153-6.
Colomer C, et al. Effect of a Mixed Reality-based Intervention On Arm, Hand, and Finger Function On Chronic Stroke. J Neuroeng Rehabil. 2016 05 11;13(1):45. PubMed PMID: 27169462.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke. AU - Colomer,Carolina, AU - Llorens,Roberto, AU - Noé,Enrique, AU - Alcañiz,Mariano, Y1 - 2016/05/11/ PY - 2015/07/09/received PY - 2016/05/03/accepted PY - 2016/5/13/entrez PY - 2016/5/14/pubmed PY - 2017/7/19/medline KW - Augmented reality KW - Hemiparesis KW - Physical therapy KW - Stroke KW - Tabletop systems KW - Upper limb KW - Virtual reality SP - 45 EP - 45 JF - Journal of neuroengineering and rehabilitation JO - J Neuroeng Rehabil VL - 13 IS - 1 N2 - BACKGROUND: Virtual and mixed reality systems have been suggested to promote motor recovery after stroke. Basing on the existing evidence on motor learning, we have developed a portable and low-cost mixed reality tabletop system that transforms a conventional table in a virtual environment for upper limb rehabilitation. The system allows intensive and customized training of a wide range of arm, hand, and finger movements and enables interaction with tangible objects, while providing audiovisual feedback of the participants' performance in gamified tasks. This study evaluates the clinical effectiveness and the acceptance of an experimental intervention with the system in chronic stroke survivors. METHODS: Thirty individuals with stroke were included in a reversal (A-B-A) study. Phase A consisted of 30 sessions of conventional physical therapy. Phase B consisted of 30 training sessions with the experimental system. Both interventions involved flexion and extension of the elbow, wrist, and fingers, and grasping of different objects. Sessions were 45-min long and were administered three to five days a week. The body structures (Modified Ashworth Scale), functions (Motricity Index, Fugl-Meyer Assessment Scale), activities (Manual Function Test, Wolf Motor Function Test, Box and Blocks Test, Nine Hole Peg Test), and participation (Motor Activity Log) were assessed before and after each phase. Acceptance of the system was also assessed after phase B (System Usability Scale, Intrinsic Motivation Inventory). RESULTS: Significant improvement was detected after the intervention with the system in the activity, both in arm function measured by the Wolf Motor Function Test (p < 0.01) and finger dexterity measured by the Box and Blocks Test (p < 0.01) and the Nine Hole Peg Test (p < 0.01); and participation (p < 0.01), which was maintained to the end of the study. The experimental system was reported as highly usable, enjoyable, and motivating. CONCLUSIONS: Our results support the clinical effectiveness of mixed reality interventions that satisfy the motor learning principles for upper limb rehabilitation in chronic stroke survivors. This characteristic, together with the low cost of the system, its portability, and its acceptance could promote the integration of these systems in the clinical practice as an alternative to more expensive systems, such as robotic instruments. SN - 1743-0003 UR - https://www.unboundmedicine.com/medline/citation/27169462/Effect_of_a_mixed_reality_based_intervention_on_arm_hand_and_finger_function_on_chronic_stroke_ L2 - https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-016-0153-6 DB - PRIME DP - Unbound Medicine ER -