Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, January 23, 2016

Concurrent validity and test-retest reliability of the Virtual Peg Insertion Test to quantify upper limb function in patients with chronic stroke

I would completely fail at this test even today, 9.75 years later.
1. The peg would have to be at least 2-3 inches in diameter so I could grasp it with my whole hand.
2. I would have to be allowed to pry my fingers open with my good hand to insert the peg.
3. I would have to be standing.
4. I would have to be allowed to pry my fingers off the peg with my good hand once inserted.
5. I would need the pegboard lower than my shoulders.
Nothing here helps me to recover any of my upper limb.
My conclusion from this is that assessment research is almost completely worthless. Come up with interventions that actually bring back functionality. I really wish researchers would at least think a minuscule amount about how their research will help make survivors lives better. This one does nothing of the sort. This is exactly why we need a stroke strategy, because this was a complete fucking waste of time.
http://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-016-0116-y
  • Bernadette C. Tobler-Ammann,
  • Eling D. de BruinEmail authorView ORCID ID profile,
  • Marie-Christine Fluet,
  • Olivier Lambercy,
  • Rob A. de Bie and
  • Ruud H. Knols
Journal of NeuroEngineering and Rehabilitation201613:8
DOI: 10.1186/s12984-016-0116-y
Received: 7 August 2015
Accepted: 17 January 2016
Published: 22 January 2016

Abstract

Background

Measuring arm and hand function of the affected side is vital in stroke rehabilitation. Therefore, the Virtual Peg Insertion Test (VPIT), an assessment combining virtual reality and haptic feedback during a goal-oriented task derived from the Nine Hole Peg Test (NHPT), was developed. This study aimed to evaluate (1) the concurrent validity of key outcome measures of the VPIT, namely the execution time and the number of dropped pegs, with the NHPT and Box and Block Test (BBT), and (2) the test-retest-reliability of these parameters together with the VPIT’s additional kinetic and kinematic parameters in patients with chronic stroke.
The three tests were administered on 31 chronic patients with stroke in one session (concurrent validity), and the VPIT was retested in a second session 3–7 days later (test-retest reliability). Spearman rank correlation coefficients (ρ) were calculated for assessing concurrent validity, and intraclass correlation coefficients (ICCs) were used to determine relative reliability. Bland-Altman plots were drawn and the smallest detectable difference (SDD) was calculated to examine absolute reliability.

Results

For the 31 included patients, 11 were able to perform the VPIT solely via use of their affected arm, whereas 20 patients also had to utilize support from their unaffected arm. For n = 31, the VPIT showed low correlations with the NHPT (ρ = 0.31 for time (Tex[s]); ρ = 0.21 for number of dropped pegs (Ndp)) and BBT (ρ = −0.23 for number of transported cubes (Ntc); ρ = −0.12 for number of dropped cubes (Ndc)). The test-retest reliability for the parameters Tex[s], mean grasping force (Fggo[N]), number of zero-crossings (Nzc[1/sgo/return) and mean collision force (Fcmean[N]) were good to high, with ICCs ranging from 0.83 to 0.94. Fair reliability could be found for Fgreturn (ICC = 0.75) and trajectory error (Etrajgo[cm]) (0.70). Poor reliability was measured for Etrajreturn[cm] (0.67) and Ndp (0.58). The SDDs were: Tex = 70.2 s, Ndp = 0.4 pegs; Fggo/return = 3.5/1.2 Newton; Nzc[1/s]go/return = 0.2/1.8 zero-crossings; Etrajgo/return = 0.5/0.8 cm; Fcmean = 0.7 Newton.

Conclusions

The VPIT is a promising upper limb function assessment for patients with stroke requiring other components of upper limb motor performance than the NHPT and BBT. The high intra-subject variation indicated that it is a demanding test for this stroke sample, which necessitates a thorough introduction to this assessment. Once familiar, the VPIT provides more objective and comprehensive measurements of upper limb function than conventional, non-computerized hand assessments.

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