Posts Tagged home exercise program

[Abstract] Effect of Monitored Home Exercise Program on Quality of Life in Stroke Survivors

Abstract

Stroke or brain attack is the sudden loss of neurological function caused by an interruption of the blood flow to the brain and it is the second leading cause of death in the world and the first cause of functional incapacity for Activities of Daily Living (ADL).It can affect the survivor physically, emotionally and cognitively, ultimately resulting in behavioral changes and depression which leads to disability and functional dependence for ADL which reduces community participation and hence the Quality of Life (QoL). Studies showed that supervised exercises at hospital level have more significant improvement in the QoL in stroke survivors than the non supervised exercises at the community level. Hence the purpose of the study was to study the effect of community-based monitored home exercise programme in stroke survivors to improve the motor performance and the functional independence and hence the QoL. 58 subjects were included and randomly allocated in to monitored and non-monitored group. QoL was assessed by using Stroke Specific Quality of Life (SS-QoL) Questionnaire and functional independence was assessed by using Modified Barthel Index (MBI) on the first day and last day of treatment. Exercises were performed twice a day for 3 days/week for 10 weeks by both the groups. Result of the study showed significant difference in SSQoL (p<0.0001) and MBI (p<0.0001) of monitored group. Hence, the study concludes that the 10 weeks of monitored home exercise program was effective to improve the QoL in stroke survivors.

Source: Indian Journals

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[ARTICLE] FEASIBILITY OF A CUSTOMIZED, IN-HOME, GAMEBASED STROKE EXERCISE PROGRAM USING THE MICROSOFT KINECT® SENSOR – Full Text PDF

ABSTRACT

The objective of this study was to determine the feasibility of a 6-week, game-based, in-home telerehabilitation exercise program using the Microsoft Kinect® for individuals with chronic stroke. Four participants with chronic stroke completed the intervention based on games designed with the customized Mystic Isle software. The games were tailored to each participant’s specific rehabilitation needs to facilitate the attainment of individualized goals determined through the Canadian Occupational Performance Measure. Likert scale questionnaires assessed the feasibility and utility of the game-based intervention. Supplementary clinical outcome data were collected. All participants played the games with moderately high enjoyment. Participant feedback helped identify barriers to use (especially, limited free time) and possible improvements. An in-home, customized, virtual reality game intervention to provide rehabilitative exercises for persons with chronic stroke is practicable. However, future studies are necessary to determine the intervention’s impact on participant function, activity, and involvement.

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[ARTICLE] The HAAPI (Home Arm Assistance Progression Initiative) Trial

Abstract

Background. Geographical location, socioeconomic status, and logistics surrounding transportation impede access of poststroke individuals to comprehensive rehabilitative services. Robotic therapy may enhance telerehabilitation by delivering consistent and state-of-the art therapy while allowing remote monitoring and adjusting therapy for underserved populations. The Hand Mentor Pro (HMP) was incorporated within a home exercise program (HEP) to improve upper-extremity (UE) functional capabilities poststroke.

Objective. To determine the efficacy of a home-based telemonitored robotic-assisted therapy as part of a HEP compared with a dose-matched HEP-only intervention among individuals less than 6 months poststroke and characterized as underserved.

Methods. In this prospective, single-blinded, multisite, randomized controlled trial, 99 hemiparetic participants with limited access to UE rehabilitation were randomized to either (1) the experimental group, which received combined HEP and HMP for 3 h/d ×5 days ×8 weeks, or (2) the control group, which received HEP only at an identical dosage. Weekly communication between the supervising therapist and participant promoted compliance and progression of the HEP and HMP prescription. The Action Research Arm Test and Wolf Motor Function Test along with the Fugl-Meyer Assessment (UE) were primary and secondary outcome measures, respectively, undertaken before and after the interventions.

Results. Both groups demonstrated improvement across all UE outcomes. Conclusions. Robotic + HEP and HEP only were both effectively delivered remotely. There was no difference between groups in change in motor function over time. Additional research is necessary to determine the appropriate dosage of HMP and HEP.

Source: The HAAPI (Home Arm Assistance Progression Initiative) Trial

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[ARTICLE] Understanding Upper Extremity Home Programs and the use of Gaming Technology for Persons After Stroke

Abstract

Background

Many persons post stroke continue to have difficulty using their more involved upper extremity and home programs may be poorly adhered to limiting the amount of practice an individual receives. More information on the experience of traditional home program and the acceptability of a novel home intervention was sought.

Objective

To qualitatively describe 1) upper extremity use at home, 2) previous home exercise or activity programs, and 3) the acceptability of a novel upper extremity home program, NeuroGame Therapy (NGT), that combines surface electromyography (sEMG) biofeedback and a commercial computer game.

Methods

A purposeful sample of ten persons with moderate to severe upper extremity motor impairment used the NGT intervention in their home for four weeks and completed nested (pre and post) one-on-one interviews. Written transcripts from the interviews were coded and themes were identified to address stated objectives.

Results

Participants reported that while use of their upper extremity in daily activities was recommended it occurred infrequently. Most participants described previous home programs as being non-specific, were often not carried out as recommended or were self-modified. Participants found NGT to be engaging and motivating, but reported minimal changes in the functional uses of their upper extremity.

Conclusion

These findings suggest that after stroke upper extremity use may be infrequent and home program approaches could be re-examined. NGT was reported to be an acceptable home intervention, but it will require further development and study to understand its value and role in post-stroke rehabilitation.

via Understanding Upper Extremity Home Programs and the use of Gaming Technology for Persons After Stroke.

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[ARTICLE] Understanding Upper Extremity Home Programs and the use of Gaming Technology for Persons After Stroke

Abstract

Background

Many persons post stroke continue to have difficulty using their more involved upper extremity and home programs may be poorly adhered to limiting the amount of practice an individual receives. More information on the experience of traditional home program and the acceptability of a novel home intervention was sought.

Objective

To qualitatively describe 1) upper extremity use at home, 2) previous home exercise or activity programs, and 3) the acceptability of a novel upper extremity home program, NeuroGame Therapy (NGT), that combines surface electromyography (sEMG) biofeedback and a commercial computer game.

Methods

A purposeful sample of ten persons with moderate to severe upper extremity motor impairment used the NGT intervention in their home for four weeks and completed nested (pre and post) one-on-one interviews. Written transcripts from the interviews were coded and themes were identified to address stated objectives.

Results

Participants reported that while use of their upper extremity in daily activities was recommended it occurred infrequently. Most participants described previous home programs as being non-specific, were often not carried out as recommended or were self-modified. Participants found NGT to be engaging and motivating, but reported minimal changes in the functional uses of their upper extremity.

Conclusion

These findings suggest that after stroke upper extremity use may be infrequent and home program approaches could be re-examined. NGT was reported to be an acceptable home intervention, but it will require further development and study to understand its value and role in post-stroke rehabilitation.

via Understanding Upper Extremity Home Programs and the use of Gaming Technology for Persons After Stroke.

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[ARTICLE] Incorporating Robotic-Assisted Telerehabilitation in a Home Program to Improve Arm Function Following Stroke – Full Text HTML

Abstract

Background and Purpose: After stroke, many individuals lack resources to receive the intensive rehabilitation that is thought to improve upper extremity motor function. This case study describes the application of a telerehabilitation intervention using a portable robotic device combined with a home exercise program (HEP) designed to improve upper extremity function.

Case Description: The participant was a 54-year-old man, 22 weeks following right medullary pyramidal ischemic infarct. At baseline, he exhibited residual paresis of the left upper extremity, resulting in impaired motor control consistent with a flexion synergistic pattern, scoring 22 of 66 on the Fugl-Meyer Assessment.

Intervention: The participant completed 85 total hours of training (38 hours of robotic device and 47 hours of HEP) over the 8-week intervention period.

Outcomes: The participant demonstrated an improvement of 26 points on the Action Research Arm Test, 5 points on the Functional Ability Scale portion of the Wolf Motor Function Test, and 20 points on the Fugl-Meyer Assessment, all of which surpassed the minimal clinically important difference. Of the 17 tasks of the Wolf Motor Function Test, he demonstrated improvement on 11 of the 15 time-based tasks and both strength measures. The participant reported an overall improvement in his recovery from stroke on the Stroke Impact Scale quality-of-life questionnaire from 40 of 100 to 65 of 100. His score on the Center for Epidemiologic Studies Depression Scale improved by 19 points.

Discussion: This case demonstrates that robotic-assisted therapy paired with an HEP can be successfully delivered within a home environment to a person with stroke. Robotic-assisted therapy may be a feasible and efficacious adjunct to an HEP program to elicit substantial improvements in upper extremity motor function, especially in those persons with stroke who lack access to stroke rehabilitation centers.

Video Abstract available (See Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A52) for more insights from the authors.

Full Text HTML –> Incorporating Robotic-Assisted Telerehabilitation in a Home… : Journal of Neurologic Physical Therapy.

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