Posts Tagged home-based rehabilitation

[Abstract] Effectiveness of Home-based rehabilitation in improving physical function of persons with Stroke and other physical disability: A systematic review of randomized controlled trials

Abstract

Background

A significant number of people with physical disabilities in the world, especially in most developing countries face a lot of impediments. There is a dearth of literature describing the consensus of effectiveness of home-based rehabilitation programs designed specifically for people living with different types of physical disabilities resulting from stroke, Parkinson’s and other musculoskeletal conditions.

Objective

To determine if home-based rehabilitation is effective in improving physical function of people with physical disabilities.

Method

A systematic review of randomized controlled trials was done. An electronic search of the literature was done by PubMed, Cochrane Library, the Physiotherapy Evidence Database and Cumulative Index to Nursing and Allied Health Literature from 1990 to March 2018 to identify full text, peer-reviewed randomized controlled trials, Published in English. Selected randomized controlled trials were critically appraised with 11 items Physiotherapy Evidence Database scale scores extracted from the Physiotherapy Evidence Database and studies were included if the cutoff of 5 points was reached on Physiotherapy Evidence Database scale score.

Results

Nine randomized controlled trials met the preset eligibility criteria. This systematic review found that there is the consistency of findings among the included studies which showed that home-based rehabilitation is an effective option for people with physical disabilities.

Conclusion

Home-based rehabilitation is not superior to hospital-based rehabilitation in improving nearly all patient outcomes assessed. However, home-based exercise programs require patient enthusiasm and regular follow-up to yield positive outcomes.

via Effectiveness of Home-based rehabilitation in improving physical function of persons with Stroke and other physical disability: A systematic review of randomized controlled trials – ScienceDirect

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[Abstract] GAMEREHAB@HOME: a new engineering system using serious game and multi-sensor fusion for functional rehabilitation at home

Abstract

Biomedical connected objects like kinematic sensors have been commonly used for patient monitoring in many clinical applications. Moreover, serious games have become widely used to improve patients‘ motivation during functional rehabilitation.
In this work, we developed and evaluated a new engineering system as a solution for functional rehabilitation at home. A multi-sensor fusion between Kinect camera and inertial sensors was developed to animate a 3D avatar during rehabilitation and to estimate kinematic data of different joints for clinical monitoring.
Two serious game scenarios were designed for upper and lower limb rehabilitation. The developed system was evaluated through patient kinematic data and a questionnaire-based approach with a panel of eight post-stroke patients and four clinical experts. The evaluation of the system showed that multi-sensor fusion provides useful data for clinical follow-up. The virtual game scenarios lead to a high level of immersion for patients. Feedbacks from clinical experts concerning the system’s GUIs and the clinical relevance of the acquired data for each rehabilitation session are positive. The developed system paves the way to deploy recent technologies, such as multi-sensor fusion and serious games, as a solution for home-based rehabilitation, which can optimize the benefit of the involved patients and medical experts.

via GAMEREHAB@HOME: a new engineering system using serious game and multi-sensor fusion for functional rehabilitation at home – IEEE Journals & Magazine

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[Abstract] A novel backstepping adaptive impedance control for an upper limb rehabilitation robot

Abstract

Stroke contributes to hemiplegia, which severely reduces people’s ability to perform activities of daily living. Due to the insufficiency of medical resources, there is an urgent need for home-based rehabilitation robot. In this paper, we design a home-based upper limb rehabilitation robot, based on the principle that three axes intersect at one point. A three-dimensional force sensor is equipped at the end of the manipulator to measure the interaction forces between the affected upper limb and the robot during rehabilitation training. The virtual rehabilitation training environment is designed to improve the enthusiasm of patients. A backstepping adaptive fuzzy based impedance control method is proposed for the home-based upper limb rehabilitation robot to prevent secondary injury of the affected limb. The adaptive law is introduced, and the backstepping adaptive fuzzy based impedance controller is proved in details. Experiments results demonstrate the effectiveness of the proposed control method.

 

via A novel backstepping adaptive impedance control for an upper limb rehabilitation robot – ScienceDirect

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[Abstract] Understanding User Requirements for the Design of a Home-Based Stroke Rehabilitation System

Limitations following stroke make it one of the leading causes of disability. The current medical pathway provides intensive care in the acute stages, but rehabilitation services are commonly discontinued after one year. While written home exercise programs are regularly prescribed at the time of discharge, compliancy is an issue. The goal of this study was to inform the design of a home-based portable rehabilitation system based on feedback from individuals with stroke and clinicians. A main component under consideration is the type and format of information feedback provided to the user, as this is hypothesized to support compliance with the rehabilitation program. From a series of focus groups and usability testing, a set of design requirements for the hardware and software were constructed. Essential features mentioned for the feedback interface included: task completion time, quality of movement, a selection of exercises, goal tracking, and a display of historical data.

 

via Understanding User Requirements for the Design of a Home-Based Stroke Rehabilitation System – Lora A. Cavuoto, Heamchand Subryan, Matthew Stafford, Zhuolin Yang, Sutanuka Bhattacharjya, Wenyao Xu, Jeanne Langan, 2018

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[BLOG POST] Rehabilitation in the Home – Transitions Physiotherapy

Physiotherapy Rehabilitation in the Home

There are two main reasons why physiotherapy rehabilitation in the home has become so popular. The first, is the simple convenience of mobile physiotherapy delivered in the comfort of your own home without having to tackle traffic and parking.The second is because home-based rehabilitation really works!

Rehabilitation takes hard work and requires a lot of practice. The environment around us can affect how easy or difficult it is to practice, practice, practice! Clinic based physiotherapy is important when extra space or specialised equipment is required, and some people prefer to attend a consultation room.

Home-based physiotherapy allows you to take what you have learnt in hospital or clinic and gain real life experience with guidance from an experienced physiotherapist. There are many therapeutic benefits to rehabilitation in the home for people with neurological conditions:

  • Feeling more comfortable in a familiar environment will enhance performance
  • Gain confidence to practice tasks that are the ‘just right challenge’ in your home environment
  • Completing tasks in your own home will have greater meaning so will provide greater motivation
  • Learning tasks in the same place that you will need to practice them will lead to greater practice and repetition
  • Functional tasks such as how to get out of bed or negotiate steps can be tailoredto the exact environment where you need to perform them

Tailoring neurological physiotherapy to real-life is the focus of home visiting physiotherapy.  Rehabilitation in your own home harnesses the principles of neuroplasticity because it can fuel the motivation to continue with the practice of meaningful tasks that are the ‘just right challenge’.

Source: Rehabilitation in the Home – Transitions Physiotherapy Perth

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[ARTICLE] Comparison of Two Post-Stroke Rehabilitation Programs: A Follow-Up Study among Primary versus Specialized Health Care – Full Text HTML

 

Abstract

Objective

To compare home-based rehabilitation (RITH) and standard outpatient rehabilitation in a hospital setting, in terms of improving the functional recovery and quality of life of stroke patients.

Study Design and Setting

This was a prospective cohort study in Andalusia (Spain).

Participants

One hundred and forty-five patients completed the outcome data.

Measures

Daily activities were measured by the Barthel index, Canadian Neurological Scale (to assess mental state), Tinetti scale (balance and gait), and Short Form Health Survey-36 (SF-36 to compare the quality of life).

Results

No statistically significant differences were found between the two groups regarding the clinical characteristics of patients in the initial measurement, except for age and mental state (younger and with greater neurological impairment in the hospital group). After physical therapy, both groups showed statistically significant improvements from baseline in each of the measures. These improvements were better in RITH patients than in the hospital patients on all functionality scales with a smaller number of sessions.

Conclusions

Home rehabilitation is at least as effective as the outpatient rehabilitation programs in a hospital setting, in terms of recovery of functionality in post-stroke patients. Overall quality of life is severely impaired in both groups, as stroke is a very disabling disease that radically affects patients’ lives.

Continue —> PLOS ONE: Comparison of Two Post-Stroke Rehabilitation Programs: A Follow-Up Study among Primary versus Specialized Health Care

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[Abstract] A Rehabilitation-Internet-of-Things in the Home to Augment Motor Skills and Exercise Training

Abstract

Although motor learning theory has led to evidence-based practices, few trials have revealed the superiority of one theory-based therapy over another after stroke. Nor have improvements in skills been as clinically robust as one might hope. We review some possible explanations, then potential technology-enabled solutions. Over the Internet, the type, quantity, and quality of practice and exercise in the home and community can be monitored remotely and feedback provided to optimize training frequency, intensity, and progression at home. A theory-driven foundation of synergistic interventions for walking, reaching and grasping, strengthening, and fitness could be provided by a bundle of home-based Rehabilitation Internet-of-Things (RIoT) devices. A RIoT might include wearable, activity-recognition sensors and instrumented rehabilitation devices with radio transmission to a smartphone or tablet to continuously measure repetitions, speed, accuracy, forces, and temporal spatial features of movement. Using telerehabilitation resources, a therapist would interpret the data and provide behavioral training for self-management via goal setting and instruction to increase compliance and long-term carryover. On top of this user-friendly, safe, and conceptually sound foundation to support more opportunity for practice, experimental interventions could be tested or additions and replacements made, perhaps drawing from virtual reality and gaming programs or robots. RIoT devices continuously measure the actual amount of quality practice; improvements and plateaus over time in strength, fitness, and skills; and activity and participation in home and community settings. Investigators may gain more control over some of the confounders of their trials and patients will have access to inexpensive therapies.

Source: A Rehabilitation-Internet-of-Things in the Home to Augment Motor Skills and Exercise Training

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[ARTICLE] A survey of home based rehabilitation model performance for movement disorders caused by neurological injuries – Full Text PDF

Abstract

The aim of this study was to determine the efficacy of home based rehabilitation model performance for movement disorders caused by neurological injuries.

Method: 24 volunteers with movement disorders caused by neurological injuries were included in the study. The participants randomly assigned in one of the two groups, the interventional and the control groups. Intervention program was carried out at home. The average ages of the two groups, interventional and control, were 5.8 and 6.3 years, respectively. Two measurements were applied to determine any alteration in patient improvement: Barthel index was used for measurement of ADL, and EQ-5D (euroqol) was used for quality of life. The assessments for the two groups were carried out twice (pre-tests and posttests). Reassessments were carried out for the two groups at the end of week 5.

Results: Comparison of pre- and post-treatment assessment results of Barthel index in the interventional group indicated a difference in terms of recovery, (P < 0.05). Comparison of pre- and post-treatment assessment results of quality of life in the interventional group indicated a difference in terms of recovery (P < 0.05). The results of the two assessment methods: Barthel index and quality of life, revealed no significant differences between pre and posttests.

Conclusion: The results of this study proved that home based rehabilitation model may enhance the function of the patients and improve the family quality of life.

Full Text PDF

 

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[CONFERENCE PAPER] Computer Vision-Based Hand Deviation Exercise for Rehabilitation – Full Text PDF

NOVEMBER 2015

Abstract

Computerized monitoring of the home based rehabilitation exercise has many benefits and it has attracted considerable interest among the computer vision community. Nowadays, many rehabilitation systems are proposed, most of the targeted disability is for stroke patient. Some of patient or user just wants to take certain part for rehabilitation. Therefore, this paper is focusing on hand rehabilitation system. The importance of the rehabilitation system is to implement the specific exercise for the specific requirements of the patients that needs rehabilitation therapy. This paper presents the specific hand rehabilitation system using computer vision method. The specific hand rehabilitation implemented in this system is a hand deviation exercise. This exercise is benefited to improve the mobility of the hand and reduce the pain. The hand tracking and finger detection method are used in this hand rehabilitation system. The result of the exercise can be used as a training data for the analysis of the injured hand recovery and healing process.

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[WEB SITE] Constraint-Induced Therapy Effective in Home Use

Published on August 26, 2015

Stroke patients affected by an upper-extremity movement dysfunction reported comparatively high levels of effectiveness from constraint-induced movement therapy (CIMT) in improving their daily activities. But in measures of motor function, CIMT fared no better than standard therapy, according to a study published recently in The Lancet Neurology.

The study, led by Anne Barzel, MD, was conducted in Germany and used study subjects from 71 therapy practices in northern Germany. One group of therapy practices was assigned at random to provide 4 weeks of home-based CIMT to study subjects, while another group provided 4 weeks of standard therapy.

Study subjects were qualified for the research based on having mild to moderate impairment of arm function at least 6 months after stroke. Study subjects in both groups received 5 hours of professional therapist contact in 4 weeks, according to a summary published in The Lancet Neurology.

Patients in the standard therapy group received conventional physical or occupational therapy, but additional home training was not obligatory. In the home CIMT group, therapists used the time allotted with the study subjects to instruct and supervise the study subjects as well as their coaches, who were a family member or friend.

According to the summary in The Lancet Neurology, there were two primary outcomes—the first of which was quality of movement, assessed by the Motor Activity Log (MAL-QOM, assessor-assisted self-reported). The second outcome was performance time, assessed by the Wolf Motor Function Test (WMFT-PT, assessor-reported).

Study subjects were assessed at 4 weeks. The researchers reported that study subjects in the home-based CIMT group demonstrated greater improvement than patients in the standard therapy group. The researchers note that while both groups also improved in motor function performance time, the extent of that improvement between the two groups was not significant.

“Home-based CIMT can enhance the perceived use of the stroke-affected arm in daily activities more effectively than conventional therapy but was not superior with respect to motor function,” the authors conclude.

Source: Constraint-Induced Therapy Effective in Home Use – Rehab Managment

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