Posts Tagged motor skills

[Abstract] Repetitive Peripheral Sensory Stimulation and Upper Limb Performance in Stroke: A Systematic Review and Meta-analysis

Background. Enhancement of sensory input in the form of repetitive peripheral sensory stimulation (RPSS) can enhance excitability of the motor cortex and upper limb performance.

Objective. To perform a systematic review and meta-analysis of effects of RPSS compared with control stimulation on improvement of motor outcomes in the upper limb of subjects with stroke.

Methods. We searched studies published between 1948 and December 2017 and selected 5 studies that provided individual data and applied a specific paradigm of stimulation (trains of 1-ms pulses at 10 Hz, delivered at 1 Hz). Continuous data were analyzed with means and standard deviations of differences in performance before and after active or control interventions. Adverse events were also assessed.

Results. There was a statistically significant beneficial effect of RPSS on motor performance (standard mean difference between active and control RPSS, 0.67; 95% CI, 0.09-1.24; I2 = 65%). Only 1 study included subjects in the subacute phase after stroke. Subgroup analysis of studies that only included subjects in the chronic phase showed a significant effect (1.04; 95% CI, 0.66-1.42) with no heterogeneity. Significant results were obtained for outcomes of body structure and function as well as for outcomes of activity limitation according to the International Classification of Function, Disability and Health, when only studies that included subjects in the chronic phase were analyzed. No serious adverse events were reported.

Conclusions. RPSS is a safe intervention with potential to become an adjuvant tool for upper extremity paresis rehabilitation in subjects with stroke in the chronic phase.

via Repetitive Peripheral Sensory Stimulation and Upper Limb Performance in Stroke: A Systematic Review and Meta-analysis – Adriana Bastos Conforto, Sarah Monteiro dos Anjos, Wanderley Marques Bernardo, Arnaldo Alves da Silva, Juliana Conti, André G. Machado, Leonardo G. Cohen, 2018

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[Abstract] Eye Movements Interfere With Limb Motor Control in Stroke Survivors

Background. Humans use voluntary eye movements to actively gather visual information during many activities of daily living, such as driving, walking, and preparing meals. Most stroke survivors have difficulties performing these functional motor tasks, and we recently demonstrated that stroke survivors who require many saccades (rapid eye movements) to plan reaching movements exhibit poor motor performance. However, the nature of this relationship remains unclear.

Objective. Here we investigate if saccades interfere with speed and smoothness of reaching movements in stroke survivors, and if excessive saccades are associated with difficulties performing functional tasks.

Methods. We used a robotic device and eye tracking to examine reaching and saccades in stroke survivors and age-matched controls who performed the Trail Making Test, a visuomotor task that uses organized patterns of saccades to plan reaching movements. We also used the Stroke Impact Scale to examine difficulties performing functional tasks.

Results. Compared with controls, stroke survivors made many saccades during ongoing reaching movements, and most of these saccades closely preceded transient decreases in reaching speed. We also found that the number of saccades that stroke survivors made during ongoing reaching movements was strongly associated with slower reaching speed, decreased reaching smoothness, and greater difficulty performing functional tasks.

Conclusions. Our findings indicate that poststroke interference between eye and limb movements may contribute to difficulties performing functional tasks. This suggests that interventions aimed at treating impaired organization of eye movements may improve functional recovery after stroke.

  

via Eye Movements Interfere With Limb Motor Control in Stroke Survivors – Tarkeshwar Singh, Christopher M. Perry, Stacy L. Fritz, Julius Fridriksson, Troy M. Herter, 2018

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[SYSTEMATIC REVIEW] EXERGAMES AS A TOOL FOR THE ACQUISITION AND DEVELOPMENT OF MOTOR SKILLS AND ABILITIES – Full Text

ABSTRACT

Objective:

To analyze the literature on the effectiveness of exergames in physical education classes and in the acquisition and development of motor skills and abilities.

Data source:

The analyses were carried out by two independent evaluators, limited to English and Portuguese, in four databases: Web of Science, Science Direct, Scopus and PubMed, without restrictions related with year. The keywords used were: “Exergames and motor learning and motor skill” and “Exergames and motor skill and physical education”. The inclusion criteria were: articles that evaluated the effectiveness of exergames in physical education classes regarding the acquisition and development of motor skills. The following were excluded: books, theses and dissertations; repetitions; articles published in proceedings and conference summaries; and studies with sick children and/or use of the tool for rehabilitation purposes.

Data synthesis:

96 publications were found, and 8 studies were selected for a final review. The quality of the articles was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) scale and the Physiotherapy Evidence Database (PEDro) scale. Evidence was found on the recurring positive effects of exergames in both motor skills acquisition and motor skills development.

Conclusions:

Exergames, when used in a conscious manner – so as to not completely replace sports and other recreational activities -, incorporate good strategies for parents and physical education teachers in motivating children and adolescents to practice physical exercise.

INTRODUCTION

As an indispensable factor for success in sports activities, games and other physical activities, basic motor skills in childhood are determinant for a healthy and active lifestyle. 1 On the other hand, physical inactivity in childhood may result in the inability to acquire and develop motor skills and abilities, which leads to posterior deficit in learning and in the perfection of specialized motor abilities. 2Some variables make it difficult to practice physical activity in school environments, such as: limited time, large number of students per class and lack of adequate spaces. Besides, throughout the years there has been a change in the behavior of children, leading to the removal of games that involve the movement of several body segments, and to the approximation with technology and entertainment using a screen. Facing this phenomenon, new strategies are required to keep the children motivated for the practice of physical activity. 3

Aiming at allying technology and physical activity, the active games came up – or exergames, name given to the technologies that require the whole body to move, combining physical exercises and videogames. 4 These tools convert the real movements to the virtual environment, allowing the users to be more active 5 , practicing virtual sports, fitness exercises and/or other ludic and interactive physical activities, using movements that are similar to real life tasks. 6 The exergames are different from sedentary videogames 7 due to the physical effort and motor skills and abilities required during the games. 5

The insertion of exergames in the daily life may help children and adolescents to reach the recommended levels of physical activity, and, probably, have a positive impactive on the lives of children, since this is a useful way to acquire and develop motor skills and abilities. 4 , , , 10 Even if exergames are a reality in the lives of children and adolescents – and some researchers have been studying their applicability for the motor performance -, identifying evidence in the scientific literature that indicates the successful or little efficient initiatives in relation to their use for the acquisition and development of motor skills and abilities is essential to formulate new proposals for its broad application in the school context.

In this context, the objective of this study was to analyze the literature as to the efficacy of the use of exergames in Physical Education classes and in the acquisition and development of motor skills and abilities.[…]

 

Continue —>  EXERGAMES AS A TOOL FOR THE ACQUISITION AND DEVELOPMENT OF MOTOR SKILLS AND ABILITIES: A SYSTEMATIC REVIEW

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[Abstract] Eye Movements Interfere With Limb Motor Control in Stroke Survivors

Background. Humans use voluntary eye movements to actively gather visual information during many activities of daily living, such as driving, walking, and preparing meals. Most stroke survivors have difficulties performing these functional motor tasks, and we recently demonstrated that stroke survivors who require many saccades (rapid eye movements) to plan reaching movements exhibit poor motor performance. However, the nature of this relationship remains unclear.

Objective. Here we investigate if saccades interfere with speed and smoothness of reaching movements in stroke survivors, and if excessive saccades are associated with difficulties performing functional tasks.

Methods. We used a robotic device and eye tracking to examine reaching and saccades in stroke survivors and age-matched controls who performed the Trail Making Test, a visuomotor task that uses organized patterns of saccades to plan reaching movements. We also used the Stroke Impact Scale to examine difficulties performing functional tasks.

Results. Compared with controls, stroke survivors made many saccades during ongoing reaching movements, and most of these saccades closely preceded transient decreases in reaching speed. We also found that the number of saccades that stroke survivors made during ongoing reaching movements was strongly associated with slower reaching speed, decreased reaching smoothness, and greater difficulty performing functional tasks.

Conclusions. Our findings indicate that poststroke interference between eye and limb movements may contribute to difficulties performing functional tasks. This suggests that interventions aimed at treating impaired organization of eye movements may improve functional recovery after stroke.

via Eye Movements Interfere With Limb Motor Control in Stroke Survivors – Tarkeshwar Singh, Christopher M. Perry, Stacy L. Fritz, Julius Fridriksson, Troy M. Herter, 2018

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[Abstract + References] Virtual System Using Haptic Device for Real-Time Tele-Rehabilitation of Upper Limbs – Conference paper

Abstract

This paper proposes a tool to support the rehabilitation of upper limbs assisted remotely, which makes it possible for the physiotherapist to be able to assist and supervise the therapy to patients who can not go to rehabilitation centers. This virtual system for real-time tele-rehabilitation is non-invasive and focuses on involving the patient with mild or moderate mobility alterations within a dynamic therapy based on virtual games; Haptics Devices are used to reeducate and stimulate the movement of the upper extremities, at the same time that both motor skills and Visual-Motor Integration skills are developed. The system contains a virtual interface that emulates real-world environments and activities. The functionality of the Novint Falcon device is exploited to send a feedback response that corrects and stimulates the patient to perform the therapy session correctly. In addition, the therapy session can vary in intensity through the levels presented by the application, and the amount of time, successes and mistakes made by the patient are registered in a database. The first results show the acceptance of the virtual system designed for real-time tele-rehabilitation.

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via Virtual System Using Haptic Device for Real-Time Tele-Rehabilitation of Upper Limbs | SpringerLink

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[Abstract] Systematic review of high-level mobility training in people with a neurological impairment.

Abstract

AIM:

The objective of this paper was to systematically review the efficacy of interventions targeting high-level mobility skills in people with a neurological impairment.

METHODS:

A comprehensive electronic database search was conducted. Study designs were graded using the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) system and methodological quality was described using the Physiotherapy Evidence Database (PEDro) scale.

RESULTS:

Twelve exploratory studies (AACPDM levels IV/V), of limited methodological quality (PEDro scores of 2-3 out of 10), were included. Interventions included treadmill training, a three-phase programme, a high-level mobility group, plyometric training, running technique coaching and walk training with blood flow restriction. Diagnoses included acquired brain injury, cerebral palsy, incomplete spinal cord injury and neurofibromatosis type 1. There were difficulties generalizing results from exploratory designs with a broad range of participants, interventions and outcome measures. However, it seems that people with a neurological impairment have the capacity to improve high-level mobility skills, running speed and distance with intervention. There were no adverse events that limited participation.

CONCLUSION:

There is preliminary evidence to support the efficacy of interventions to improve high-level mobility skills in people with neurological impairments. Well-controlled research with a larger sample is required to provide sufficient evidence to change clinical practice.

 

via Systematic review of high-level mobility training in people with a neurological impairment. – PubMed – NCBI

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[Abstract+References] Motion-Based Serious Games for Hand Assistive Rehabilitation

Abstract

Cerebral Palsy, trauma, and strokes are common causes for the loss of hand movements and the decrease in muscle strength for both children and adults. Improving fine motor skills usually involves the synchronization of wrists and fingers by performing appropriate tasks and activities. This demo introduces a novel patient-centered framework for the gamification of hand therapies in order to facilitate and encourage the rehabilitation process. This framework consists of an adaptive therapy-driven 3D environment augmented with our motion-based natural user interface. An intelligent game generator is developed, which translates the patient’s gestures into navigational movements with therapy-driven goals, while adapting the level of difficulty based on the patient profile and real-time performance. A comprehensive evaluation and clinical-based assessments were conducted in a local children disability center, and highlights of the results are presented.

References

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[Abstract+References] The Effectiveness of Developing Motor Skills Through Motion-Based Video Gaming: A Review

Background. Technology growth affords innovative teaching techniques as video gaming within education has increased in popularity. Motion-based video gaming (MBVG) is a type of gaming that requires the individual playing the game to be physically interactive. Thus, whatever movements the individual playing the game does is picked up by motion sensors and is mimicked via the on-screen character. MBVG provides constant feedback to learners and has been found to help motivate students, replace sedentary with active gaming, and can facilitate social interactions with peers.

Aim. This literature review reveals the current knowledge regarding the potential educational benefits of MBVG, particularly in physical education and sport pedagogy settings. Developments of video gaming in education as well as recent research regarding MBVG and its potential impact on physical skill development within educational environments are discussed.

Conclusion. MBVG may be beneficial with novices in teaching basic sport concepts or with individuals with special needs who might otherwise not be able to participate in the full authentic version of the sport. However, empirical evidence is lacking which supports the effective use of MBVG in accurately teaching authentic sport-specific motor skills.

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[Abstract] Electrically Assisted Movement Therapy in Chronic Stroke Patients With Severe Upper Limb Paresis: A Pilot, Single-Blind, Randomized Crossover Study

 

Abstract

Objective

To evaluate the effects of electrically assisted movement therapy (EAMT) in which patients use functional electrical stimulation, modulated by a custom device controlled through the patient’s unaffected hand, to produce or assist task-specific upper limb movements, which enables them to engage in intensive goal-oriented training.

Design

Randomized, crossover, assessor-blinded, 5-week trial with follow-up at 18 weeks.

Setting

Rehabilitation university hospital.

Participants

Patients with chronic, severe stroke (N=11; mean age, 47.9y) more than 6 months poststroke (mean time since event, 46.3mo).

Interventions

Both EAMT and the control intervention (dose-matched, goal-oriented standard care) consisted of 10 sessions of 90 minutes per day, 5 sessions per week, for 2 weeks. After the first 10 sessions, group allocation was crossed over, and patients received a 1-week therapy break before receiving the new treatment.

Main Outcome Measures

Fugl-Meyer Motor Assessment for the Upper Extremity, Wolf Motor Function Test, spasticity, and 28-item Motor Activity Log.

Results

Forty-four individuals were recruited, of whom 11 were eligible and participated. Five patients received the experimental treatment before standard care, and 6 received standard care before the experimental treatment. EAMT produced higher improvements in the Fugl-Meyer scale than standard care (P<.05). Median improvements were 6.5 Fugl-Meyer points and 1 Fugl-Meyer point after the experimental treatment and standard care, respectively. The improvement was also significant in subjective reports of quality of movement and amount of use of the affected limb during activities of daily living (P<.05).

Conclusions

EAMT produces a clinically important impairment reduction in stroke patients with chronic, severe upper limb paresis.

Source: Electrically Assisted Movement Therapy in Chronic Stroke Patients With Severe Upper Limb Paresis: A Pilot, Single-Blind, Randomized Crossover Study – Archives of Physical Medicine and Rehabilitation

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[Conference paper] Assistance System for Rehabilitation and Valuation of Motor Skills – Abstract+References

Abstract

This article proposes a non-invasive system to stimulate the rehabilitation of motor skills, both of the upper limbs and lower limbs. The system contemplates two ambiances for human-computer interaction, depending on the type of motor deficiency that the patient possesses, i.e., for patients with chronic injuries, an augmented reality environment is considered, while virtual reality environments are used in people with minor injuries. In the cases mentioned, the interface allows visualizing both the routine of movements performed by the patient and the actual movement executed by him.

This information is relevant for the purpose of

  • (i) stimulating the patient during the execution of rehabilitation, and
  • (ii) evaluation of the movements made so that the therapist can diagnose the progress of the patient’s rehabilitation process.

The visual environment developed for this type of rehabilitation provides a systematic application in which the user first analyzes and generates the necessary movements in order to complete the defined task.

The results show the efficiency of the system generated by the human-computer interaction oriented to the development of motor skills.

References

Source: Assistance System for Rehabilitation and Valuation of Motor Skills | SpringerLink

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