Posts Tagged cerebral palsy

[ARTICLE] How Can We Improve Current Practice in Spastic Paresis? – Full Text

Abstract:

Spastic paresis can arise from a variety of conditions, including stroke, spinal cord injury, multiple sclerosis, cerebral palsy, traumatic brain injury and hereditary spastic paraplegia. It is associated with muscle contracture, stiffness and pain, and can lead to segmental deformity. The positive, negative and biomechanical symptoms associated with spastic paresis can significantly affect patients’ quality of life, by affecting their ability to perform normal activities. This paper – based on the content of a global spasticity interdisciplinary masterclass presented by the authors for healthcare practitioners working in the field of spastic paresis – proposes a multidisciplinary approach to care involving not only healthcare practitioners, but also the patient and their family members/carers, and improvement of the transition between specialist care and community services. The suggested treatment pathway comprises assessment of the severity of spastic paresis, early access to neurorehabilitation and physiotherapy and treatment with botulinum toxin and new technologies, where appropriate. To address the challenge of maintaining patients’ motivation over the long term, tailored guided self-rehabilitation contracts can be used to set and monitor therapeutic goals. Current global consensus guidelines may have to be updated, to include a clinical care pathway related to the encompassing management of spastic paresis.

Spastic paresis may be caused by a variety of conditions, including stroke, spinal cord injury, multiple sclerosis, retroviral and other infectious spinal cord disorders, cerebral palsy, traumatic brain injury and hereditary spastic paraplegia.1 The exact prevalence of spastic paresis (in which spasticity is the most commonly recognised manifestation) is not known. However, it is estimated that around 30% of stroke survivors are affected by significant spasticity2 and 50% who present to hospital with stroke develop at least one severe contracture.3

Spastic paresis is a complex condition that may be associated with soft tissue contracture, pain and limitations of day-to-day activities, which have a substantial impact on patients’ and caregivers’ quality of life.4 Although treatment guidelines have been developed for (focal) spasticity,5 there remains a lack of consensus on key aspects of diagnosis, approaches to care and the care pathway that would help healthcare practitioners to more fully understand and manage this condition.

To address some of these limitations, a group of physicians and a physiotherapist with expertise in the management of spastic paresis developed a global spasticity masterclass for healthcare practitioners working in this field in order to share best practices and to discuss issues and current trends in the management of patients with spasticity. The outputs of this masterclass are presented here.

Continue —> How Can We Improve Current Practice in Spastic Paresis? | Touch Neurology | Independent Insight for Medical Specialists

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[ARTICLE] How Can We Improve Current Practice in Spastic Paresis? – Full Text HTML

Abstract:

Spastic paresis can arise from a variety of conditions, including stroke, spinal cord injury, multiple sclerosis, cerebral palsy, traumatic brain injury and hereditary spastic paraplegia. It is associated with muscle contracture, stiffness and pain, and can lead to segmental deformity. The positive, negative and biomechanical symptoms associated with spastic paresis can significantly affect patients’ quality of life, by affecting their ability to perform normal activities. This paper – based on the content of a global spasticity interdisciplinary masterclass presented by the authors for healthcare practitioners working in the field of spastic paresis – proposes a multidisciplinary approach to care involving not only healthcare practitioners, but also the patient and their family members/carers, and improvement of the transition between specialist care and community services. The suggested treatment pathway comprises assessment of the severity of spastic paresis, early access to neurorehabilitation and physiotherapy and treatment with botulinum toxin and new technologies, where appropriate. To address the challenge of maintaining patients’ motivation over the long term, tailored guided self-rehabilitation contracts can be used to set and monitor therapeutic goals. Current global consensus guidelines may have to be updated, to include a clinical care pathway related to the encompassing management of spastic paresis.

Spastic paresis may be caused by a variety of conditions, including stroke, spinal cord injury, multiple sclerosis, retroviral and other infectious spinal cord disorders, cerebral palsy, traumatic brain injury and hereditary spastic paraplegia.1 The exact prevalence of spastic paresis (in which spasticity is the most commonly recognised manifestation) is not known. However, it is estimated that around 30% of stroke survivors are affected by significant spasticity2 and 50% who present to hospital with stroke develop at least one severe contracture.3

Spastic paresis is a complex condition that may be associated with soft tissue contracture, pain and limitations of day-to-day activities, which have a substantial impact on patients’ and caregivers’ quality of life.4 Although treatment guidelines have been developed for (focal) spasticity,5 there remains a lack of consensus on key aspects of diagnosis, approaches to care and the care pathway that would help healthcare practitioners to more fully understand and manage this condition.

To address some of these limitations, a group of physicians and a physiotherapist with expertise in the management of spastic paresis developed a global spasticity masterclass for healthcare practitioners working in this field in order to share best practices and to discuss issues and current trends in the management of patients with spasticity. The outputs of this masterclass are presented here.

Pathophysiology and definitions
Spastic paresis
Spasticity is one of several components of spastic paresis, also known as the upper motor neuron (UMN) syndrome. Spastic paresis is primarily characterised by a quantitative lack of command directed to agonist muscles involved in performing movements.1,6,7 In addition, hyperactive spinal reflexes mediate some of the positive phenomena seen in spastic paresis, while other positive symptoms are related to disordered control of voluntary movement in terms of an abnormal efferent drive or are caused

Continue —> How Can We Improve Current Practice in Spastic Paresis? | Touch Neurology | Independent Insight for Medical Specialists

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[WEB SITE] Overcome loss of Hand Function and Foot Drop. – Bioness FES – Inquiries

Regain Independence, Function, and Mobility.


Regain function with Bioness’ innovative solutions designed to help those living with Foot Drop or Hand Paralysis due to conditions such as Stroke, Multiple Sclerosis, Cerebral Palsy, Traumatic Brain Injury, or Incomplete Spinal Cord Injury.
Visit Site —> Bioness FES | Inquiries

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[Review] How Can We Improve Current Practice in Spastic Paresis? – Full Text PDF/HTML

Abstract

Spastic paresis can arise from a variety of conditions, including stroke, spinal cord injury, multiple sclerosis, cerebral palsy, traumatic brain injury and hereditary spastic paraplegia. It is associated with muscle contracture, stiffness and pain, and can lead to segmental deformity.

The positive, negative and biomechanical symptoms associated with spastic paresis can significantly affect patients’ quality of life, by affecting their ability to perform normal activities.

This paper – based on the content of a global spasticity interdisciplinary masterclass presented by the authors for healthcare practitioners working in the field of spastic paresis – proposes a multidisciplinary approach to care involving not only healthcare practitioners, but also the patient and their family members/carers, and improvement of the transition between specialist care and community services.

The suggested treatment pathway comprises assessment of the severity of spastic paresis, early access to neurorehabilitation and physiotherapy and treatment with botulinum toxin and new technologies, where appropriate. To address the challenge of maintaining patients’ motivation over the long term, tailored guided self-rehabilitation contracts can be used to set and monitor therapeutic goals. Current global consensus guidelines may have to be updated, to include a clinical care pathway related to the encompassing management of spastic paresis.

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[ARTICLE] Preparing a neuropediatric upper limb exergame rehabilitation system for home-use: a feasibility study | Journal of NeuroEngineering and Rehabilitation | Full Text

Fig. 1 The portable YouGrabber system. a A patient playing the Airplane game on the portable YouGrabber system. b The complete data glove with sensor-“box”, bending sensors, and vibrating units attached to the size fit neoprene glove. c The complete equipment packed for “take away”

Abstract

Background

Home-based, computer-enhanced therapy of hand and arm function can complement conventional interventions and increase the amount and intensity of training, without interfering too much with family routines. The objective of the present study was to investigate the feasibility and usability of the new portable version of the YouGrabber® system (YouRehab AG, Zurich, Switzerland) in the home setting.

Methods

Fifteen families of children (7 girls, mean age: 11.3y) with neuromotor disorders and affected upper limbs participated. They received instructions and took the system home to train for 2 weeks. After returning it, they answered questions about usability, motivation, and their general opinion of the system (Visual Analogue Scale; 0 indicating worst score, 100 indicating best score; ≤30 not satisfied, 31–69 average, ≥70 satisfied). Furthermore, total pure playtime and number of training sessions were quantified. To prove the usability of the system, number and sort of support requests were logged.

Results

The usability of the system was considered average to satisfying (mean 60.1–93.1). The lowest score was given for the occurrence of technical errors. Parents had to motivate their children to start (mean 66.5) and continue (mean 68.5) with the training. But in general, parents estimated the therapeutic benefit as high (mean 73.1) and the whole system as very good (mean 87.4). Children played on average 7 times during the 2 weeks; total pure playtime was 185 ± 45 min. Especially at the beginning of the trial, systems were very error-prone. Fortunately, we, or the company, solved most problems before the patients took the systems home. Nevertheless, 10 of 15 families contacted us at least once because of technical problems.

Conclusions

Despite that the YouGrabber® is a promising and highly accepted training tool for home-use, currently, it is still error-prone, and the requested support exceeds the support that can be provided by clinical therapists. A technically more robust system, combined with additional attractive games, likely results in higher patient motivation and better compliance. This would reduce the need for parents to motivate their children extrinsically and allow for clinical trials to investigate the effectiveness of the system.

Keywords

Data glove, Pediatrics ,Neurorehabilitation, Upper extremities ,YouGrabber, Tele-rehabilitation, Game-based, Cerebral palsy, Children and adolescents, Clinical utility, User satisfaction

Continue —>  Preparing a neuropediatric upper limb exergame rehabilitation system for home-use: a feasibility study | Journal of NeuroEngineering and Rehabilitation | Full Text

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[REVIEW] MIRROR THERAPY: A REVIEW OF EVIDENCES – Full Text PDF

Abstract

The aim of this review was to identify and summarize the existing evidences on mirror box therapy for the management of various musculoskeletal conditions. A systemic literature search was performed to identify studies concerning mirror therapy. The included journal articles were reviewed and assessed for itssignificance. Fifty one studies were identified and reviewed. Five different patient categories were studied: 24 studiesfocussed on mirror therapy after stroke, thirteen studies focussed on mirror therapy after an amputation, three studies focussed on mirror therapy with complex regional pain syndrome patients, two studies on mirror therapy for cerebral palsy and one study focussed on mirror therapy after a fracture. The articlesreviewed showed a trend that mirror therapy is effective in stroke, phantom limb pain, complex regional pain syndrome, cerebral palsy and fracture rehabilitation.

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[ARTICLE] Therapists’ Perceptions of Social Media and Video Game Technologies in Upper Limb Rehabilitation – Full Text HTML

ABSTRACT

Background: The application of technologies, such as video gaming and social media for rehabilitation, is garnering interest in the medical field. However, little research has examined clinicians’ perspectives regarding technology adoption by their clients.

Objective: The objective of our study was to explore therapists’ perceptions of how young people and adults with hemiplegia use gaming and social media technologies in daily life and in rehabilitation, and to identify barriers to using these technologies in rehabilitation.

Methods: We conducted two focus groups comprised of ten occupational therapists/physiotherapists who provide neurorehabilitation to individuals with hemiplegia secondary to stroke or cerebral palsy. Data was analyzed using inductive thematic analysis. The diffusion of innovations theory provided a framework to interpret emerging themes.

Results: Therapists were using technology in a limited capacity. They identified barriers to using social media and gaming technology with their clients, including a lack of age appropriateness, privacy issues with social media, limited transfer of training, and a lack of accessibility of current systems. Therapists also questioned their role in the context of technology-based interventions. The opportunity for social interaction was perceived as a major benefit of integrated gaming and social media.

Conclusions: This study reveals the complexities associated with adopting new technologies in clinical practice, including the need to consider both client and clinician factors. Despite reporting several challenges with applying gaming and social media technology with clinical populations, therapists identified opportunities for increased social interactions and were willing to help shape the development of an upper limb training system that could more readily meet the needs of clients with hemiplegia. By considering the needs of both therapists and clients, technology developers may increase the likelihood that clinicians will adopt innovative technologies.

Full Text HTML –>  JSG-Therapists’ Perceptions of Social Media and Video Game Technologies in Upper Limb Rehabilitation | Tatla | JMIR Serious Games.

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[Systematic REVIEW] Can non-immersive virtual reality improve physical outcomes of rehabilitation? – Full Text HTML/PDF

Purpose: To investigate whether non-immersive virtual reality interventions, either as an adjunct or an alternative to traditional therapy, can improve physical outcomes in rehabilitation.

Methods: We searched MEDLINE (1950 to present), CINAHL (1981 to present), AMED (1985 to present), EMBASE (1947 to present), Web of Science, PEDro, and Cochrane (no date limitation). Randomized controlled trials which explored the effects of non-immersive virtual reality on physical outcomes (physical function, movement, and balance) in populations of any age, sex, ethnicity or health condition, receiving rehabilitation were selected for review. We included virtual reality interventions that did not fully immerse the user; full immersion was defined as ‘a psychological state characterized by perceiving oneself to be enveloped by, included in, and interacting with an environment that provides a continuous stream of stimuli and experiences’.

Results: Sixteen randomized controlled trials were identified which matched inclusion and exclusion criteria. These studies explored the use of non-immersive virtual reality on physical outcomes in the rehabilitation of persons with stroke, cardiopulmonary conditions, cerebral palsy, osteoarthritis, and balance disorders.

Conclusion: There is growing evidence for the usefulness of non-immersive virtual reality as an adjunct to conventional therapy on physical outcomes particularly in stroke rehabilitation. There is little evidence to suggest that non-immersive virtual reality is more effective than conventional rehabilitation on physical outcomes in all populations included for review.

Can non-immersive virtual reality improve physical outcomes of rehabilitation?: Physical Therapy Reviews: Vol 17, No 1.

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[ARTICLE] Estimating Gesture Accuracy in Motion-Based Health Games – Full Text PDF

Abstract

This manuscript details a technique for estimating gesture accuracy within the context of motion-based health video games using the MICROSOFT KINECT. We created a physical therapy game that requires players to imitate clinically significant reference gestures. Player performance is represented by the degree of similarity between the performed and reference gestures and is quantified by collecting the Euler angles of the player’s gestures, converting them to a threedimensional vector, and comparing the magnitude between the vectors. Lower difference values represent greater gestural correspondence and therefore greater player performance. A group of thirty-one subjects was tested. Subjects achieved gestural correspondence sufficient to complete the game’s objectives while also improving their ability to perform reference gestures accurately…

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