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.

Friday, October 6, 2023

Effect of sonification types in upper-limb movement: a quantitative and qualitative study in hemiparetic and healthy participants

 

You'll have to ask your doctor and therapists for sonification, it's only been out there for 10+ years.

Sonification has been written about for 10+ years. It is about time for our fucking failures of stroke associations to step up to the plate and write a stroke protocol on this. I can guarantee this won't occur.

 

sonification (13 posts to May 2012)

Effect of sonification types in upper-limb movement: a quantitative and qualitative study in hemiparetic and healthy participants

Abstract

Background

Movement sonification, the use of real-time auditory feedback linked to movement parameters, have been proposed to support rehabilitation. Nevertheless, if promising results have been reported, the effect of the type of sound used has not been studied systematically. The aim of this study was to investigate in a single session the effect of different types of sonification both quantitatively and qualitatively on patients with acquired brain lesions and healthy participants.

Methods

An experimental setup enabling arm sonification was developed using three different categories of sonification (direct sound modulation, musical interaction, and soundscape). Simple moving forward movements performed while sliding on a table with both arms were investigated with all participants. Quantitative analysis on the movement timing were performed considering various parameters (sound condition, affected arm and dominance, sonification categories). Qualitative analysis of semi-structured interviews were also conducted, as well as neuropsychological evaluation of music perception.

Results

For both the patient and healthy groups (15 participants each), average duration for performing the arm movement is significantly longer with sonification compared to the no-sound condition (p < 0.001). Qualitative analysis of semi-structured interviews revealed different aspects of motivational and affective aspects of sonification. Most participants of both groups preferred to complete the task with sound (29 of 30 participants), and described the experience as playful (22 of 30 participants). More precisely, the soundscape (nature sounds) was the most constantly preferred (selected first by 14 of 30 participants).

Conclusion

Overall, our results confirm that the sonification has an effect on the temporal execution of the movement during a single-session. Globally, sonification is welcomed by the participants, and we found convergent and differentiated appreciations of the different sonification types.

Background

Acquired brain lesions in adults, following stroke, head injury, or brain tumor, are major causes of acquired disability worldwide [11, 46]. These lesions induce multiple sensory, motor, and cognitive disorders. Among these disorders, motor impairments could affect 40% of patients after stroke [33]. In particular, we consider in this study the specific case of upper limb hemiparesis, characterized by impaired motor control and muscle weakness, greatly reduces autonomy in daily living activities, and thus, the long-term quality of life of patients [10].

The use of music is being studied in a wide range of rehabilitation settings [16, 39, 44, 47, 61], particularly in the case of acquired brain lesions [27, 68]. Several different methods have been investigated, such as audio-rhythmic stimulation (RAS) [65, 67], exercises with musical instruments (music-supported therapy) [1, 2, 13, 28, 52], and movement sonification devices [26, 36, 48, 58].

In this paper we focus on movement sonification, which concerns systems that enable translating in real-time motion parameters into sound or musical parameters [21, 30]. Movement sonification devices have many advantages [60]: access to a continuous 3D auditory information, fast adaptation of sound feedback to the movements performed, flexibility of use by participants with various profiles thanks to possible adaptation according to individual abilities [7, 23]. Thus, these devices present a potential added value in comparison with other sound/musical methods and tools, and offer perspectives in adequacy with the needs described in the rehabilitation framework [12, 66]. Moreover, compared to other feedback modalities such as visual feedback, the use of the auditory modality does not constrain the user's posture. In this case, the dependence to the external feedback, called the guidance effect, might be less important with auditory compared to visual feedback since sonification could encourage to focus attention on intrinsic proprioceptive information [19]. The potential interest of sonification devices as a rehabilitation support tool is therefore under investigation for different rehabilitation applications [25, 26, 37, 53, 63].

Concerning more specifically rehabilitation after acquired brain lesions, respectively in a pilot study [54] and a large-scale study [48], Schmitz et al. and Raglio et al. showed an encouraging evolution of the global dexterity scores (Box and Block Test) with sonification devices. In both situations, standard motor rehabilitation exercises were sonified.

In 2015, Scholz et al. proposed an innovative device where users learn to move in a virtual space associated with a musical scale, with the aim of playing melodies [57]. In this case, a decrease in pain scores was reported, as well as a trend towards improvement in the Stroke Impact Scale functional hand assessment scores. Nevertheless, this study did not show any improvement in scores on the other functional assessments performed (Action Research Arm Test, Box and Block Test, Nine Hole Peg Test). In a pilot study, Robertson et al. suggested that in the presence of audio feedback different results could be obtained depending on the hemispheric location of the brain lesion, and more precisely a deterioration in kinematic performances in the presence of audio feedback in the case of left hemispheric brain lesions [50].

Thus, although encouraging results have been obtained in different settings, limited functional benefits have also been reported [40]. One reason for contrasted effects could be related to the choice of sound and interaction design. In early works, the choice made was to sonify errors, by emitting “alarm” sounds when the participant does not follow the predicted trajectory model [36]. More recent approaches propose to favor the participant motivation and avoid negative reinforcement [7].

Moreover, the quality of the sound rendering has not always been a central concern, yet the choices of sound design and mapping could be fundamental to ensure the adequacy between the sound and the gesture to be performed, and thus, the effect of sonification on the movement control and learning [3, 15]. Questions about sound design and coupling modalities require further investigations [31]. In particular, these investigations must be considered with regard to the performed tasks, the user profiles they address, and individual singularities. Importantly, the need to consider multiple sonification modalities and to evaluate their effects was notably highlighted in two recent literature reviews [26, 41]. Moreover, the user perception and experience of sonification has been insufficiently studied.

In this perspective, the novelty of the present study was to evaluate, during a single session, different modalities of gesture-sound interactions, categories and types of sound feedback, with both adult patients with hemiparesis following an acquired brain lesion and healthy participants. An originality of our approach consists in using a mixed methodology, evaluating the effect of different sonification modalities both quantitatively and qualitatively. Our specific goal in this study was to measure the spontaneous effects of the sound feedback on the temporality of execution of the movement, and the subjective experience of each participant through semi-directed interviews. On the contrary to typical rehabilitation assessments where the motor task must be performed as quickly as possible (i.e. scores in assessments typically indexed on the number of objects moved [15, 17], or the number of repetitions of a movement or targets reached), we rather chose to give no instruction concerning the speed of execution of the 

More at link.task, and assess how the sonification could influence spontaneously the average movement speed.

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