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.

Tuesday, November 8, 2022

Virtual reality and serious game therapy for post-stroke individuals: A preliminary study with humanized rehabilitation approach protocol humanized rehabilitation approach

 If you want to humanize your stroke therapy you'll create 100% recovery protocols.  Since you're not even attempting 100% recovery, you're just wasting time and money.

Virtual reality and serious game therapy for post-stroke individuals: A preliminary study with humanized rehabilitation approach protocol humanized rehabilitation approach


Camille MarquesAlvesafAndressa RastreloRezendeaLuanne CardosoMendesefThiago Sá dePaivaaGabriel FernandesCyrinobJúlia Tannús deSouzabMarco Aurélio MaiaSilvacLuciane Aparecida Pascucci Sande deSouzadEduardo Lázaro MartinsNavesa
https://doi.org/10.1016/j.ctcp.2022.101681Get rights and content

Abstract

Objective

The current study proposed the development and preliminary validation of a humanized training approach for upper limb rehabilitation of chronic post-stroke individuals, using serious game (SG) and virtual reality (VR) technologies.

Materials and methods

Ten individuals with chronic stroke participated in the study. Accompanied by a health professional, 15 sessions of the SG were performed in a laboratory, in a humanized way, lasting between 30 and 45 min each. The assessments were made pre- and post-intervention with the SG, and the following parameters were evaluated (considering the elbow joint): Modified Ashworth Scale (MAS), range of movement (ROM) and tonic stretch reflex threshold (TSRT). Global measures such as quality of life (QOL) were also assessed by the Stroke-Specific Quality of Life Scale (SSQL), Brunnstrom Recovery Scale (BRS) and General Health Questionnaire (GHQ-28). The following tests were applied to verify statistically significant differences: Shapiro-Wilk test, t-test, and Wilcoxon-Mann-Whitney test.

Results

The parameters ROM, TSRT, BRS, and SSQL showed statistically significant differences between pre- and post-intervention (p < 0.01). The ROM increase was about 8%. The objective evaluation of spasticity (provided by the TRST) showed an increase of 28% over the average pre- and post-intervention values. Three participants showed decreased resistance to passive stretching according to the results of the MAS, and seven participants moved to the next stage of the BRS. For QOL, the scores indicated around 20% of post-intervention improvement.

Conclusion

The intervention had no adverse effects, showed a high degree of compliance, provided increased ROM, improved QOL, reduced spasticity and allowed these individuals the opportunity to test a promising technology for upper limb rehabilitation with emphasis in humanized aspects of therapy.

Introduction

Approximately 16 million individuals worldwide are victims to stroke every year, making this condition one of the leading causes of mortality and disability [1]. It is estimated that 80% of people affected by stroke do not regain proper arm function even six months after the event [2,3]. This condition limits or prohibits the performance of several activities of daily living, such as eating, getting dressed, taking care of personal hygiene, among others, negatively impacting the quality of life [4].

Several studies have reported the difficulty of rehabilitating the motor function of the upper limbs (UL), especially for those individuals in chronic phase. For those individuals, spontaneous neuroplasticity has almost disappeared, leading to the necessity of constant rehabilitation activities with adequate intensity and volume of practice, variety, specificity, motivation and biofeedback [5]. Due to the monotony of traditional methods and slow improvement in patients' conditions, some of these individuals end up stopping the rehabilitation process altogether or are discharged from treatment in hospitals and rehabilitation clinics when the therapeutic possibilities are exhausted and the chances of functional recovery are diminished [2,6].

In this context, the implementation of technologies such as serious games (SG) and virtual reality (VR) provide an alternative strategy for the treatment of UL of people with chronic post-stroke conditions. Studies have shown that therapy using such technologies can contribute significantly in maintaining quality of life (QOL) and enable neurological rehabilitation in these individuals. These methods also provide greater engagement and efficiency in rehabilitation treatments [7,8], with proven clinical benefits [9].

In order to propose more efficient ways of interaction with SG and VR, researchers have been trying to underline important characteristics that contribute to the increase of engagement of individuals in therapy, increasing the chances of success of the rehabilitation program [10]. A humanized approach can reduce the barriers to seek help and reduce the suffering of the patient and his family from the first contact with the team [11]. However, the focus of each of those studies is generally restricted to aspects related to the construction and development of the SG such as visuals, music and goals 11. The implementation of technological devices and the automation of healthcare services can bring an aspect of dehumanization to the relationship between the health professional and the patient, making it extremely necessary to propose a humanized approach, in which the health professional is able to make the patient feel truly well and welcome [12].

No studies were found that focused on evaluating whether the presence, support and adoption of a humanized treatment for the health professional towards patients positively influenced the clinical outcomes of a SG and VR therapy. Therefore, this study proposed a preliminary humanized approach protocol of application and interaction with the SG, incorporating actions by which the humanization of care can be understood and applied, aimed at individuals with chronic post-stroke. In addiction, the health professional was not only an adjuvant during the therapy sessions, but rather actively participated in creating a hospitable environment for the participants and provided social support through positive feedback and instructions on how to use the game. Motor aspects and global measures were registered in order to verify the impact of this intervention on the UL, and consequently in the QOL of chronic post-stroke individuals.


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