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
Wittmann F1, Held JP2, Lambercy O1, Starkey ML3, Curt A3, Höver R4, Gassert R1, Luft AR5,6, Gonzenbach RR5.
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- PMID:
- 27515583
- DOI:
- 10.1186/s12984-016-0182-1
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.
ReplyDeleteEverything I write about makes a lot of sense but we have no leadership in stroke to implement such stuff.
DeleteDean: I did a search of “Armeo Senso” and found these related websites:
ReplyDelete1. 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!