Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 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:

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's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Tuesday, August 16, 2016

Self-directed arm therapy at home after stroke with a sensor-based virtual reality training system

What the hell will this take to get it written up as a stroke protocol so survivors can DEMAND they get this from their therapists? Our fucking failures of stroke associations most certainly will not do it. That would require some brains and initiative instead of all the incompetence displayed by our stroke associations.
Full article here if you want to do this on your own since your complete medical staff will do nothing on this:
Self-directed arm therapy at home after stroke with a sensor-based virtual reality training system

Abstract here:
http://www.ncbi.nlm.nih.gov/pubmed/27515583

Abstract

BACKGROUND:

The effect of rehabilitative training after stroke is dose-dependent. Out-patient rehabilitation training is often limited by transport logistics, financial resources and a lack of motivation/compliance. We studied the feasibility of an unsupervised arm therapy for self-directed rehabilitation therapy in patients' homes.

METHODS:

An open-label, single group study involving eleven patients with hemiparesis due to stroke (27 ± 31.5 months post-stroke) was conducted. The patients trained with an inertial measurement unit (IMU)-based virtual reality system (ArmeoSenso) in their homes for six weeks. The self-selected dose of training with ArmeoSenso was the principal outcome measure whereas the Fugl-Meyer Assessment of the upper extremity (FMA-UE), the Wolf Motor Function Test (WMFT) and IMU-derived kinematic metrics were used to assess arm function, training intensity and trunk movement. Repeated measures one-way ANOVAs were used to assess differences in training duration and clinical scores over time.

RESULTS:

All subjects were able to use the system independently in their homes and no safety issues were reported. Patients trained on 26.5 ± 11.5 days out of 42 days for a duration of 137 ± 120 min per week. The weekly training duration did not change over the course of six weeks (p = 0.146). The arm function of these patients improved significantly by 4.1 points (p = 0.003) in the FMA-UE. Changes in the WMFT were not significant (p = 0.552). ArmeoSenso based metrics showed an improvement in arm function, a high number of reaching movements (387 per session), and minimal compensatory movements of the trunk while training.

CONCLUSIONS:

Self-directed home therapy with an IMU-based home therapy system is safe and can provide a high dose of rehabilitative therapy. The assessments integrated into the system allow daily therapy monitoring, difficulty adaptation and detection of maladaptive motor patterns such as trunk movements during reaching.

TRIAL REGISTRATION:

Unique identifier: NCT02098135 .

KEYWORDS:

Arm; Feasibility; Rehabilitation; Stroke; Video games; Virtual reality therapy

3 comments:

  1. This type of "technical Rehab" makes a lot of sense to me, and it is very frustrating to me, that it is not widely available yet.

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    Replies
    1. Everything I write about makes a lot of sense but we have no leadership in stroke to implement such stuff.

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  2. Dean: I did a search of “Armeo Senso” and found these related websites:
    1. Game demo video by the guy that created the game
    https://www.youtube.com/watch?v=ae-Rk58jZ7c
    2. Company website (most products by this company are really expensive)
    https://www.hocoma.com/world/de/produkte/armeo/
    3. University of Zurich website on their organization (Note Hocoma is listed on the organizational chart)
    http://www.neuro-rehab.uzh.ch/en/Organization3.html
    4. University of Zurich website on their research on reward systems for stroke patients
    http://www.neuro-rehab.uzh.ch/en/Research/Group1.html (
    These guys are on the right track. Developing a system with 2-4 sensors (wrist, elbow, torso) that interact with a well-crafted computer game, just cannot be that expensive. Especially, if initial development cost is spread out to the hundreds of thousands (millions?) of people with upper limb hemi-hemplegia from brain injury that could benefit from its use. A fun & even addicting game like this that helps the patients move with intention as many times as possible should be available to all stroke survivors that can move at all. Of course, this is still “experimental” and our providers & insurance companies (and Medicare) do not want to go there without a gazillion dollar double blind study done over several years proving it works.
    Ridiculous!

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