Posts Tagged physical activity

[NEWS] New Virtual Reality Therapy game could offer relief for patients with chronic pain, mobility issues

News-MedicalA Virtual Reality Therapy game (iVRT) which could introduce relief for patients suffering from chronic pain and mobility issues has been developed by a team of UK researchers.

Dr Andrew Wilson and colleagues from Birmingham City University built the CRPS app in collaboration with clinical staff at Sandwell and West Birmingham Hospitals NHS Trust for a new way to tackle complex regional pain syndrome and to aid people living with musculoskeletal conditions.

Using a head mounted display and controllers, the team created an immersive and interactive game which mimics the processes used in traditional ‘mirror therapy’ treatment. Within the game, players are consciously and subconsciously encouraged to stretch, move and position the limbs that are affected by their conditions.

Mirror therapy is a medical exercise intervention where a mirror is used to create areflective illusion that encourages patient’s brain to move their limb more freely. This intervention is often used by occupational therapists and physiotherapists to treat CRPS patients who have experienced a stroke. This treatment has proven to be successful exercises are often deemed routine and mundane by patients, which contributes to decline in the completion of therapy.

Work around the CRPS project, which could have major implications for other patient rehabilitation programmes worldwide when fully realised, was presented at the 12th European Conference on Game Based Learning (ECGBL) in France late last year.

Dr Wilson, who leads Birmingham City University’s contribution to a European research study into how virtual reality games can encourage more physical activity, and how movement science in virtual worlds can be used for both rehabilitation and treatment adherence, explained, “The first part of the CRPS project was to examine the feasibility of being able to create a game which reflects the rehabilitation exercises that the clinical teams use on the ground to reduce pain and improve mobility in specific patients.”

“By making the game enjoyable and playable we hope family members will play too and in doing so encourage the patient to continue with their rehabilitation. Our early research has shown that in healthy volunteers both regular and casual gamers enjoyed the game which is promising in terms of our theory surrounding how we may support treatment adherence by exploiting involvement of family and friends in the therapy processes.”

The CRPS project was realized through collaborative working between City Hospital, Birmingham, and staff at the School of Computing and Digital Technology, and was developed following research around the provision of a 3D virtual reality ophthalmoscopy trainer.

Andrea Quadling, Senior Occupational Therapist at Sandwell Hospital, said “The concept of using virtual reality to treat complex pain conditions is exciting, appealing and shows a lot of potential. This software has the potential to be very helpful in offering additional treatment options for people who suffer with CRPS.”

via New Virtual Reality Therapy game could offer relief for patients with chronic pain, mobility issues

, , , , , , , , , , , ,

Leave a comment

[Abstract] Adherence to a Long-Term Physical Activity and Exercise Program After Stroke Applied in a Randomized Controlled Trial

Abstract

Background: Persistent physical activity is important to maintain motor function across all stages after stroke.
Objective: The objective of this study was to investigate adherence to an 18-month physical activity and exercise program.
Design: The design was a prospective, longitudinal study including participants who had had a stroke randomly allocated to the intervention arm of a randomized controlled trial.
Methods: The intervention consisted of individualized monthly coaching by a physical therapist who motivated participants to adhere to 30 minutes of daily physical activity and 45 minutes of weekly exercise over an 18-month period. The primary outcome was the combination of participants’ self-reported training diaries and adherence, as reported by the physical therapists. Mixed-effect models were used to analyze change in adherence over time. Intensity levels, measured by the Borg scale, were a secondary outcome.
Results: In total, 186 informed, consenting participants who had had mild-to-moderate stroke were included 3 months after stroke onset. Mean age was 71.7 years (SD = 11.9). Thirty-four (18.3%) participants withdrew and 9 (4.8%) died during follow-up. Adherence to physical activity and exercise each month ranged from 51.2% to 73.1%, and from 63.5% to 79.7%, respectively. Adherence to physical activity increased by 2.6% per month (odds ratio = 1.026, 95% CI = 1.014–1.037). Most of the exercise was performed at moderate-to-high intensity levels, ranging from scores of 12 to 16 on the Borg scale, with an increase of 0.018 points each month (95% CI = 0.011–0.024).
Limitations: Limitations included missing information about adherence for participants with missing data and reasons for dropout.
Conclusions: Participants with mild and moderate impairments after stroke who received individualized regular coaching established and maintained moderate-to-good adherence to daily physical activity and weekly exercise over time.

 

via Adherence to a Long-Term Physical Activity and Exercise Program After Stroke Applied in a Randomized Controlled Trial | Physical Therapy | Oxford Academic

, , , , ,

Leave a comment

[ARTICLE] Evaluation of a smartwatch-based intervention providing feedback of daily activity within a research-naive stroke ward: a pilot randomised controlled trial – Full Text

Abstract

Background

The majority of stroke patients are inactive outside formal therapy sessions. Tailored activity feedback via a smartwatch has the potential to increase inpatient activity. The aim of the study was to identify the challenges and support needed by ward staff and researchers and to examine the feasibility of conducting a randomised controlled trial (RCT) using smartwatch activity monitors in research-naive rehabilitation wards. Objectives (Phase 1 and 2) were to report any challenges and support needed and determine the recruitment and retention rate, completion of outcome measures, smartwatch adherence rate, (Phase 2 only) readiness to randomise, adherence to protocol (intervention fidelity) and potential for effect.

Methods

First admission, stroke patients (onset < 4 months) aged 40–75, able to walk 10 m prior to stroke and follow a two-stage command with sufficient cognition and vision (clinically judged) were recruited within the Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine. Phase 1: a non-randomised observation phase (to allow practice of protocol)—patients received no activity feedback. Phase 2: a parallel single-blind pilot RCT. Patients were randomised into one of two groups: to receive daily activity feedback over a 9-h period or to receive no activity feedback. EQ-5D-5L, WHODAS and RMI were conducted at baseline, discharge and 3 months post-discharge. Descriptive statistics were performed on recruitment, retention, completion and activity counts as well as adherence to protocol.

Results

Out of 470 ward admissions, 11% were recruited across the two phases, over a 30-week period. Retention rate at 3 months post-discharge was 48%. Twenty-two percent of patients dropped out post-baseline assessment, 78% completed baseline and discharge admissions, from which 62% were assessed 3 months post-discharge. Smartwatch data were received from all patients. Patients were correctly randomised into each RCT group. RCT adherence rate to wearing the smartwatch was 80%. Baseline activity was exceeded for 65% of days in the feedback group compared to 55% of days in the no feedback group.

Conclusions

Delivery of a smartwatch RCT is feasible in a research-naive rehabilitation ward. However, frequent support and guidance of research-naive staff are required to ensure completeness of clinical assessment data and protocol adherence.

Background

Exercise has an important role in the recovery of stroke, increasing cognition, arm function, balance and gait, in addition to reducing the risk of subsequent cardiovascular events []. Despite the importance of general physical activity in recovery, the majority of stroke survivors receiving rehabilitation in hospital are inactive outside formal therapy sessions []. In order to encourage long-term exercise adherence, it is recommended that physical activity goals are customised to the individual tolerance of the stroke patient [].

Modern electronic activity monitors are able to provide a wide range of behavioural monitoring tools and are therefore emerging as a possible method to provide customised activity goals and feedback to promote exercise []. Coinciding with the technological developments in activity monitoring, there is evidence to suggest that activity feedback of exercise may increase motivation to exercise. The provision of activity feedback has been found to be more effective in increasing physical activity levels than providing activity goals alone, in healthy controls [] and in older adults undergoing rehabilitation []. Interventions providing feedback and monitoring of activity have shown positive outcomes in relation to exercise adherence amongst older individuals []. However, personalised activity feedback has also found to have no effect on actual or intended activity levels amongst controls []. Despite studies suggesting a positive effect, more evidence is needed before such activity feedback interventions can be recommended to be used in treatment.

The literature has shown that remote monitoring of physical activity is feasible after stroke []; however, the impact of activity feedback on exercise levels within this population is less clear. A systematic review of studies investigating augmented feedback on motor activities after stroke concluded that findings were inconsistent due to the combination of multiple aspects and types of augmented feedback used []. One study found that feedback of physical activity provided three times a week had no significant effect on the daily walking time of stroke inpatients []. Little research to date has investigated the use of periodic feedback of daily activity amongst stroke patients undergoing rehabilitation. It is of interest to see whether increasing the frequency of activity feedback will elicit greater physical activity levels. The provision of daily activity feedback (via a smartwatch), relative to activity at fixed time points through-out the previous day, may have the potential to motivate stroke rehabilitation patients to be more active.

Conducting clinical trials within research-naive settings are commonly accompanied with ethical, cultural and organisational challenges []. The present study will evaluate the feasibility of conducting the smartwatch intervention mentioned above within a research-naive stroke rehabilitation centre in Hefei, China (whereby no rehabilitation research has previously been conducted).

The aim of this feasibility study was to identify the challenges and support needed by ward staff and researchers and to examine the feasibility of conducting an RCT using smartwatch activity monitors in research-naive rehabilitation wards. The objectives were to report any challenges and support needed and determine the recruitment and retention rate, completion of outcome measures, adherence to wearing the smartwatch, readiness to randomise, adherence to protocol (intervention fidelity) and potential for effect.[…]

 

Continue —> Evaluation of a smartwatch-based intervention providing feedback of daily activity within a research-naive stroke ward: a pilot randomised controlled trial

An external file that holds a picture, illustration, etc.Object name is 40814_2018_345_Fig2_HTML.jpg

Activity feedback as displayed on the smartwatch screen for the feedback group (a), which included both the feedback bars and clock face, and the no feedback (control) group (b), which included the clock face only

, , , , , ,

Leave a comment

[TED Talk] The Brain-Changing Effects of Exercise

What’s the most transformative thing that you can do for your brain today? Exercise! says neuroscientist Wendy Suzuki. Get inspired to go to the gym as Suzuki discusses the science of how working out boosts your mood and memory — and protects your brain against neurodegenerative diseases like Alzheimer’s.

This talk was presented at an official TED conference, and was featured by our editors on the home page.

ABOUT THE SPEAKER
Wendy Suzuki · Neuroscientist, author Wendy Suzuki is researching the science behind the extraordinary, life-changing effects that physical activity can have on the most important organ in your body: your brain.

Transcript

03:54
05:02
07:13
09:41
11:13
12:12
12:43
12:46
12:47

via The Brain-Changing Effects of Exercise

, , , , , ,

Leave a comment

[Abstract + References] Epilepsy, Physical Activity and Sports: A Narrative Review

Abstract

People with epilepsy (PWE) are less physically active compared with the general population. Explanations include prejudice, overprotection, unawareness, stigma, fear of seizure induction and lack of knowledge of health professionals. At present, there is no consensus on the role of exercise in epilepsy. This paper reviews the current evidence surrounding the risks and benefits associated with physical activity (PA) in this group of patients. In the last decade, several publications indicate significant benefits in physiological and psychological health parameters, including mood and cognition, physical conditioning, social interaction, quality of life, as well as potential prevention of seizure presentation. Moreover, experimental studies suggest that PA provides mechanisms of neuronal protection, related to biochemical and structural changes including release of β-endorphins and steroids, which may exert an inhibitory effect on the occurrence of abnormal electrical activity. Epileptic discharges can decrease or disappear during exercise, which may translate into reduced seizure recurrence. In some patients, exercise may precipitate seizures. Available evidence suggests that PA should be encouraged in PWE in order to promote wellbeing and quality of life. There is a need for prospective randomized controlled studies that provide stronger clinical evidence before definitive recommendations can be made.

References

1. World Health Organization. Epilepsy Fact sheet: Bulletin 999 2017 [cited 2017 December 5]. Available at:http://www.who.int/mediacentre/factsheets/fs999/en/.Google Scholar
2. RaiDKerrMPMcManusSJordanovaVLewisGBrughaTSEpilepsy and psychiatric comorbidity—a nationally representative population-based study: epilepsy and psychiatric morbidityEpilepsia2012;53(6):10951103.CrossRef | Google Scholar
3. AridaRMScorzaFACavalheiroEAPeruccaEMoshéSLCan people with epilepsy enjoy sports? Epilepsy Res.2012;98(1):9495.CrossRef | Google Scholar | PubMed
4. NakkenKOLøyningALøyningTGløersenGLarssonPGDoes physical exercise influence the occurrence of epileptiform EEG discharges in children? Epilepsia1997;38(3):279284.CrossRef | Google Scholar | PubMed
5. EomSLeeMKParkJ-Het alThe impact of an exercise therapy on psychosocial health of children with benign epilepsy: a pilot studyEpilepsy Behav2014;37:151156.CrossRef | Google Scholar | PubMed
6. AridaRMImpact of physical exercise therapy on behavioral and psychosocial aspects of epilepsyEpilepsy Behav.2014;40:9091.CrossRef | Google Scholar | PubMed
7. AridaRMScorzaFAda SilvaSGSchachterSCCavalheiroEAThe potential role of physical exercise in the treatment of epilepsyEpilepsy Behav2010;17(4):432435.CrossRef | Google Scholar | PubMed
8. CapovillaGKaufmanKRPeruccaEMoshéSLAridaRMEpilepsy, seizures, physical exercise, and sports: a report from the ILAE Task Force on sports and epilepsyEpilepsia2016;57(1):612.CrossRef | Google Scholar | PubMed
9. ElliottJOMooreJLLuBHealth status and behavioral risk factors among persons with epilepsy in Ohio based on the 2006 Behavioral Risk Factor Surveillance SystemEpilepsy Behav2008;12(3):434444.CrossRef | Google Scholar | PubMed
10. NakkenKOPhysical exercise in outpatients with epilepsyEpilepsia1999;40(5):643651.CrossRef | Google Scholar | PubMed
11. AblahEHaugAKondaKet alExercise and epilepsy: a survey of Midwest epilepsy patientsEpilepsy Behav.2009;14(1):162166.CrossRef | Google Scholar | PubMed
12. SteinhoffBJNeusüssKThegederHReimersCDLeisure time activity and physical fitness in patients with epilepsy.Epilepsia1996;37(12):12211227.CrossRef | Google Scholar | PubMed
13. AridaRMScorzaFAde AlbuquerqueMCysneirosRMde OliveiraRJCavalheiroEAEvaluation of physical exercise habits in Brazilian patients with epilepsyEpilepsy Behav2003;4(5):507510.CrossRef | Google Scholar | PubMed
14. HanKChoi-KwonSLeeS-KLeisure time physical activity in patients with epilepsy in Seoul, South KoreaEpilepsy Behav2011;20(2):321325.CrossRef | Google Scholar | PubMed
15. HinnellCWilliamsJMetcalfeAet alHealth status and health-related behaviors in epilepsy compared to other chronic conditions—a national population-based study: health status and behaviors in epilepsyEpilepsia2010;51(5):853861.CrossRef | Google Scholar | PubMed
16. CuiWZackMMKobauRHelmersSLHealth behaviors among people with epilepsy—results from the 2010 National Health Interview SurveyEpilepsy Behav2015;44:121126.CrossRef | Google Scholar | PubMed
17. WongJWirrellEPhysical activity in children/teens with epilepsy compared with that in their siblings without epilepsyEpilepsia2006;47(3):631639.CrossRef | Google Scholar | PubMed
18. SaengsuwanJBoonyaleepanSTiamkaoSDiet, exercise, sleep, sexual activity, and perceived stress in people with epilepsy in NE ThailandEpilepsy Behav2015;45:3943.CrossRef | Google Scholar | PubMed
19. ChongJKudrimotiHSLopezDCLabinerDMBehavioral risk factors among Arizonans with epilepsy: Behavioral Risk Factor Surveillance System 2005/2006Epilepsy Behav2010;17(4):511519.CrossRef | Google Scholar | PubMed
20. JalavaMSillanpääMPhysical activity, health-related fitness, and health experience in adults with childhood-onset epilepsy: a controlled studyEpilepsia1997;38(4):424429.CrossRef | Google Scholar | PubMed
21. ElliottJOLuBMooreJLMcAuleyJWLongLExercise, diet, health behaviors, and risk factors among persons with epilepsy based on the California Health Interview Survey, 2005Epilepsy Behav2008;13(2):307315.CrossRef | Google Scholar | PubMed
22. GordonKEDooleyJMBrnaPMEpilepsy and activity—a population-based study: epilepsy and activityEpilepsia.2010;51(11):22542259.CrossRef | Google Scholar | PubMed
23. EppsSAKahnABHolmesPVBoss-WilliamsKAWeissJMWeinshenkerDAntidepressant and anticonvulsant effects of exercise in a rat model of epilepsy and depression comorbidityEpilepsy Behav2013;29(1):4752.CrossRef | Google Scholar
24. LernerJTSankarRMazaratiAMGalanin and epilepsyEXS2010;102:183194.Google Scholar | PubMed
25. BabyakMBlumenthalJAHermanSet alExercise treatment for major depression: maintenance of therapeutic benefit at 10 monthsPsychosom Med2000;62(5):633638.CrossRef | Google Scholar | PubMed
26. GuptaRAggarwalAExercise and rheumatoid arthritis: a low-cost intervention with major benefitsNatl Med J India.2015;28(3):132133.Google Scholar | PubMed
27. WestergrenTFegranLNilsenTHaraldstadKKittangOBBerntsenSActive play exercise intervention in children with asthma: a pilot studyBMJ Open2016;6(1):e009721.CrossRef | Google Scholar | PubMed
28. HaxhiJLetoGdi PalumboASet alExercise at lunchtime: effect on glycemic control and oxidative stress in middle-aged men with type 2 diabetesEur J Appl Physiol2016;116(3):573582.CrossRef | Google Scholar | PubMed
29. de LimaCde LiraCABAridaRMet alAssociation between leisure time, physical activity, and mood disorder levels in individuals with epilepsyEpilepsy Behav2013;28(1):4751.CrossRef | Google Scholar | PubMed
30. McAuleyJWLongLHeiseJet alA prospective evaluation of the effects of a 12-week outpatient exercise program on clinical and behavioral outcomes in patients with epilepsyEpilepsy Behav2001;2(6):592600.CrossRef | Google Scholar | PubMed
31. RothDLGoodeKTWilliamsVLFaughtEPhysical exercise, stressful life experience, and depression in adults with epilepsyEpilepsia1994;35(6):12481255.CrossRef | Google Scholar | PubMed
32. GötzeWKubickiSMunterMTeichmannJEffect of physical exercise on seizure threshold (investigated by electroencephalographic telemetry)Dis Nerv Syst1967;28(10):664667.Google Scholar
33. HorydWGryziakJNiedzielskaKZielińskiJJEffect of physical exertion on seizure discharges in the EEG of epilepsy patientsNeurol Neurochir Pol1981;15(5–6):545552.Google Scholar | PubMed
34. VanciniRLde LiraCABScorzaFAet alCardiorespiratory and electroencephalographic responses to exhaustive acute physical exercise in people with temporal lobe epilepsyEpilepsy Behav2010;19(3):504508.CrossRef | Google Scholar | PubMed
35. De LimaCVanciniRLAridaRMet alPhysiological and electroencephalographic responses to acute exhaustive physical exercise in people with juvenile myoclonic epilepsyEpilepsy Behav2011;22:718722.CrossRef | Google ScholarPubMed
36. Engel – YegerBZlotnikSShaharEChildhood-onset primary generalized epilepsy—impacts on children’s preferences for participation in out-of-school activitiesEpilepsy Behav2014;34(1):15.CrossRef | Google Scholar | PubMed
37. FerlisiMShorvonSSeizure precipitants (triggering factors) in patients with epilepsyEpilepsy Behav2014;33:101105.CrossRef | Google Scholar
38. CamfieldCCamfieldPInjuries from seizures are a serious, persistent problem in childhood onset epilepsy: a population-based studySeizure2015;27:8083.CrossRef | Google Scholar | PubMed
39. CollardSSMarlowCThe psychosocial impact of exercising with epilepsy: a narrative analysisEpilepsy Behav.2016;61:199205.CrossRef | Google Scholar | PubMed
40. BrnaPMGordonKEWoolridgeEDooleyJMWoodEPerceived need for restrictions on activity for children with epilepsyEpilepsy Behav2017;73:236239.CrossRef | Google Scholar | PubMed
41. AguirreCQuintasSRuiz-TorneroAMet alDo people with epilepsy have a different lifestyle? Epilepsy Behav.2017;74:2732.CrossRef | Google Scholar | PubMed
42. Almeida-Souza-TedrusGMStercaGSBuarquePRPhysical activity, stigma, and quality of life in patients with epilepsyEpilepsy Behav2017;77:9698.CrossRef | Google Scholar
43. HäfeleCAFreitasMPda SilvaMCRombaldiAJAre physical activity levels associated with better health outcomes in people with epilepsy? Epilepsy Behav2017;72:2834.CrossRef | Google Scholar | PubMed
44. CollardSSEllis- HillCHow do you exercise with epilepsy? Insights into the barriers and adaptations to successfully exercise with epilepsyEpilepsy Behav2017;70:6671.CrossRef | Google Scholar | PubMed
45. HäfeleCAFreitasMPGerviniBLde CarvalhoRMRombaldiAJWho are the individuals diagnosed with epilepsy using the Public Health System in the city of Pelotas, southern Brazil? Epilepsy Behav2018;78:8490.CrossRef | Google Scholar | PubMed
46. Ben-MenachemEWeight issues for people with epilepsy—a reviewEpilepsia2007;48:4245.CrossRef | Google Scholar | PubMed
47. HellierJLDudekFESpontaneous motor seizures of rats with kainate-induced epilepsy: effect of time of day and activity stateEpilepsy Res1999;35(1):4757.CrossRef | Google Scholar | PubMed
48. TutkunEAyyildizMAgarEShort-duration swimming exercise decreases penicillin-induced epileptiform EcoG activity in ratsActa Neurobiol Exp (Wars)2010;70(4):382389.Google Scholar | PubMed
49. KayacanYTutkunEArslanGAyyildizMAgarEThe effects of treadmill exercise on penicillin-induced epileptiform activityArch Med Sci2016;12(5):935940.CrossRef | Google Scholar | PubMed
50. RadakZChungHYGotoSSystemic adaptation to oxidative challenge induced by regular exerciseFree Radic Biol Med2008;44(2):153159.CrossRef | Google Scholar | PubMed
51. Peixinho-PenaLFFernandesJde AlmeidaAAet alA strength exercise program in rats with epilepsy is protective against seizuresEpilepsy Behav2012;25(3):323328.CrossRef | Google Scholar | PubMed
52. NybergJAbergMAITorenKNilssonMBen-MenachemEKuhnHGCardiovascular fitness and later risk of epilepsy: a Swedish population-based cohort studyNeurology2013;81(12):10511057.CrossRef | Google Scholar | PubMed
53. SetkowiczZMazurAPhysical training decreases susceptibility to subsequent pilocarpine-induced seizures in the rat.Epilepsy Res2006;71(2–3):142148.CrossRef | Google Scholar | PubMed
54. AridaRMScorzaFAdos SantosNFPeresCACavalheiroEAEffect of physical exercise on seizure occurrence in a model of temporal lobe epilepsy in ratsEpilepsy Res1999;37(1):4552.CrossRef | Google Scholar
55. ContetCGavériaux-RuffCMatifasACaradecCChampyM-FKiefferBLDissociation of analgesic and hormonal responses to forced swim stress using opioid receptor knockout miceNeuropsychopharmacology2006;31(8):17331744.CrossRef | Google Scholar | PubMed
56. AridaRMScorzaFAToscano-SilvaMCavalheiroEADoes exercise correct dysregulation of neurosteroid levels induced by epilepsy? Ann Neurol2010;68(6):971972.CrossRef | Google Scholar | PubMed
57. MevissenMEbertUAnticonvulsant effects of melatonin in amygdala-kindled ratsNeurosci Lett1998;257(1):1316.CrossRef | Google Scholar | PubMed
58. AridaRMScorzaCAScorzaFAGomes da SilvaSda Graça Naffah-MazzacorattiMCavalheiroEAEffects of different types of physical exercise on the staining of parvalbumin-positive neurons in the hippocampal formation of rats with epilepsyProg Neuropsychopharmacol Biol Psychiatry2007;31(4):814822.CrossRef | Google Scholar | PubMed
59. AridaRMSanabriaERGda SilvaACFariaLCScorzaFACavalheiroEAPhysical training reverts hippocampal electrophysiological changes in rats submitted to the pilocarpine model of epilepsyPhysiol Behav2004;83(1):165171.CrossRef | Google Scholar | PubMed
60. AridaRMde Jesus VieiraACavalheiroEAEffect of physical exercise on kindling developmentEpilepsy Res.1998;30(2):127132.CrossRef | Google Scholar | PubMed
61. YonedaYKanmoriKIdaSKuriyamaKStress-induced alterations in metabolism of gamma-aminobutyric acid in rat brainJ Neurochem1983;40(2):350356.CrossRef | Google Scholar | PubMed
62. SouzaMAOliveiraMSFurianAFet alSwimming training prevents pentylenetetrazol-induced inhibition of Na+, K+-ATPase activity, seizures, and oxidative stressEpilepsia2009;50(4):811823.CrossRef | Google Scholar
63. BlackJEIsaacsKRAndersonBJAlcantaraAAGreenoughWTLearning causes synaptogenesis, whereas motor activity causes angiogenesis, in cerebellar cortex of adult ratsProc Natl Acad Sci USA1990;87(14):55685572.CrossRef | Google Scholar | PubMed
64. KleimJACooperNRVandenBergPMExercise induces angiogenesis but does not alter movement representations within rat motor cortexBrain Res2002;934(1):16.CrossRef | Google Scholar
65. NisticòGCirioloMRFiskinKIannoneMde MartinoARotilioGNGF restores decrease in catalase activity and increases superoxide dismutase and glutathione peroxidase activity in the brain of aged ratsFree Radic Biol Med.1992;12(3):177181.CrossRef | Google Scholar | PubMed
66. CarroETrejoJLBusiguinaSTorres-AlemanICirculating insulin-like growth factor I mediates the protective effects of physical exercise against brain insults of different etiology and anatomyJ Neurosci Off J Soc Neurosci2001;21(15):56785684.CrossRef | Google Scholar | PubMed
67. OgunyemiAOGomezMRKlassDWSeizures induced by exerciseNeurology1988;38(4):6336334.CrossRef | Google Scholar | PubMed
68. SimpsonRK JrGrossmanRGSeizures after joggingN Engl J Med1989;321(12):835.Google Scholar | PubMed
69. BjørholtPGNakkenKORøhmeKHansenHLeisure time habits and physical fitness in adults with epilepsy.Epilepsia1990;31(1):8387.CrossRef | Google Scholar | PubMed
70. SchmittBThun-HohensteinLVontobelHBoltshauserESeizures induced by physical exercise: report of two cases.Neuropediatrics1994;25(01):5153.CrossRef | Google Scholar | PubMed
71. EriksenHREllertsenBGrønningsaeterHNakkenKOLøyningYUrsinHPhysical exercise in women with intractable epilepsyEpilepsia1994;35(6):12561264.CrossRef | Google Scholar | PubMed
72. SturmJWFediMBerkovicSFReutensDCExercise-induced temporal lobe epilepsyNeurology2002;59(8):12461248.CrossRef | Google Scholar | PubMed
73. WerzMAIdiopathic generalized tonic–clonic seizures limited to exercise in a young adultEpilepsy Behav.2005;6(1):98101.CrossRef | Google Scholar
74. KamelJTBadawyRACookMJExercise-induced seizures and lateral asymmetry in patients with temporal lobe epilepsyEpilepsy Behav Case Rep2014;2:2630.CrossRef | Google Scholar | PubMed
75. BennettDRSports and epilepsy: to play or not to playSemin Neurol1981;1:345357.CrossRef | Google Scholar
76. AridaRMCavalheiroEAda SilvaACScorzaFAPhysical activity and epilepsy: proven and predicted benefitsSports Med Auckl NZ2008;38(7):607615.CrossRef | Google Scholar | PubMed
77. RodenburgRMeijerAMScherphofCet alParenting and restrictions in childhood epilepsyEpilepsy Behav.2013;27(3):497503.CrossRef | Google Scholar | PubMed
78. MecarelliOMessinaPCapovillaGet alAn educational campaign toward epilepsy among Italian primary school teachersEpilepsy Behav2014;32:8491.CrossRef | Google Scholar | PubMed
79. PainterERauschJRModiACChanges in daily activity patterns of caregivers of children with newly diagnosed epilepsy: a case-controlled designEpilepsy Behav2014;31:16.CrossRef | Google Scholar | PubMed
80. ILAE Commission ReportRestrictions for children with epilepsy. Commission of Pediatrics of the ILAE. International League Against EpilepsyEpilepsia1997;38(9):10541056.CrossRef | Google Scholar
81. KaufmanKRAnticonvulsants in sports: ethical considerationsEpilepsy Behav2007;10(2):268271.CrossRef | Google Scholar | PubMed

via Epilepsy, Physical Activity and Sports: A Narrative Review | Canadian Journal of Neurological Sciences | Cambridge Core

 

, , , , , , ,

Leave a comment

[Abstract + References] Methods of Motion Assessment of Upper Limb for Rehabilitation Application – IEEE Conference Publication

Abstract

The aim of this paper is to describe methods proposed for motion capture subsystem of smart orthosis for quantitative evaluation of movement activity of upper limbs during a rehabilitation process carried out at a clinic or at home. To quantify the description of motion we used methods of evaluation of the relationship between measured variables and nonlinear methods. To test the functionality of the methods, we compared the movement of the dominant and non-dominant limbs, assuming cyclical and acyclic movement, to obtain the expected values for a healthy population. In accordance with the goal, a group of cyclic and non-cyclic movements common to the home environment were proposed. The movements were divided according to the activities performed during sitting, standing and walking. It was: pen writing, typing on the keyboard / using the mouse, eating with a spoon and eating a croissant combing, lifting weights, reading a book, etc. Twenty healthy subjects participated in the study. Four gyro-accelerometers (Xsens Technologies B.V.) attached to the forearms and upper arms of both upper limbs were used to record the upper limb movements. The results show that the calculated values of dominant and non-dominant limb parameters differ significantly in most movements. The motion capture subsystem which uses the proposed methods can be used to valuate the physical activity for quantification of the evaluation of the rehabilitation process, and thus, it finds use in practice.
1. D. P Romilly, C Anglin, R. G Gosine, C Hershler, S. U. Raschke, “A Functional Task Analysis and Motion Simulation for the Development of a Powered Upper-Limb Orthosis”, IEEE Transactions on Rehabilitation Engineering, pp. 119-129, 1994.

2. R. Rupp, M. Rohm, M. Schneiders, A. Kreilinger, G. R Müller-Putz, “Functional rehabilitation of the paralyzed upper extremity after spinal cord injury by noninvasive hybrid neuroprostheses”, Proceedings of the IEEE, pp. 954-968, 2015.

3. R. C. Oldfield, “The assessment and analysis of handedness”, The Edinburgh inventory. Neuropsychologia, pp. 97-113, 1971.

4. P. Kutilek, O. Cakrt, J. Hejda, “Com-parative measurement of the head orientation using camera system and gyroscope system”, 13th Mediterranean conference on medical and biological engineering and computing Seville Spain IFMBE Proceedings Volume 41, pp. 1519-1522, 2013.

5. P. Kutilek, V. Socha, O. Cakrt, J. Schlenker, L. Bizovska, “Trajectory length of pitch vs. roll. Technique for assessment of postural stability”, Acta Gymnica, pp. 85-92, 2015.

6. J. H Allum, L. B. O. Nijhuis, M. G. Carpenter, “Differences in coding provided by proprioceptive and vestibular sensory signals may con-tribute to lateral instability in vestibular loss subjects”, Experimental brain research, vol. 184, no. 3, pp. 391-410, 2008.

7. Á. Gil-Agudo, L. A. Reyes-Guzman, Dimbwadyo-Terrer, I. Peñasco-Martín, B. Bernal-Sahún, A. P.López-Monteagudo, A. Ama-Espinosa, J. L Pons, “A novel motion tracking system for evaluation of functional rehabilitation of the upper limbs”, Neural regeneration research, vol. 8, no. 19, pp. 1773-1782, 2013.

8. D. Stirling, A. Hesami, C. Ritz, K. Kdistambha, F. Naghdy, “Symbolic Modelling of Dynamic Human Motions”, Biosensors. Pier Andrea Serra, 2013.

9. F. Lorussi, N. Carbonaro, D. D. Rossi, A. Tognetti, “A biarticular model for scapular-humeral rhythm reconstruction through data from wearable sensors”, J Neuroeng Rehabil, vol. 13, pp. 40, 2016.

10. D. Winter, “Stiffness Control of Balance in Quiet Standing”, Journal of Neurophysiology, pp. 1211-1221, 1998.

11. P. Kutilek, B. Farkasova, “Prediction of Lower Extremities’ Motion by Angle-angle Diagrams and Neural Networks”, Acta of Bioengineering and Biomechanics, pp. 57-65, 2011.

12. S. M. Bruijn, “Assessing Stability of Human Locomotion: a review of current measures” in Journal of the Royal Society Interface, 2013.

13. B. Coley, B. M. Jolles, A. Farron, A. Bourgeois, F. Nussbaumer, C. Pichonnaz, K. Aminian, “Outcome evaluation in shoulder surgery using 3D kinematics sensors”, Gait& Posture, vol. 25, pp. 523-532, 2007.

14. A. Wolf, J. B. Swift, H. L. Swinney, J. A. Vastano, “Determining Lyapunov exponents from a time series”, Physica 16D, pp. 285-317, 1985.

15. D. E. Lake, J. S. Richman, M. P. Griffin, J. R. Moorman, “Sample entropy analysis of neona-tal heart rate variability”, American Journal of Physiology – Regulatory Integrative and Comparative Physiology, vol. 283, no. 3, 2002.

16. M. O. Sokunbi, “Sample entropy reveals high discriminative power between young and elderly adults in short fMRI data sets”, Front. Neuroinform, 2014.

17. B. Singh, M. Singh, V. K. Banga, “Sample Entropy based HRV: Effect of ECG Sampling Frequency”, Biomedical Science and Engineering, 2014.

18. Z. Jian-Jun, N. Xin-Bao, Y. Xiao-Dong, H. Feng-Zhen, H. Cheng-Yu, “Decrease in Hurst expo-nent of human gait with aging and neurodegenerative diseases”, Chin. Phys. Soc. and IOP Publishing Ltd Chinese Physics B, vol. 17, 2008.

19. A. Goshvarpour, A. Goshvarpour, “Nonlinear Analysis of Human Gait Signals”, International Journal of Information Engineering and Electronic Business(IJIEEB), vol. 4, pp. 15-21, 2012.

via Methods of Motion Assessment of Upper Limb for Rehabilitation Application – IEEE Conference Publication

, , , , , , , , , , ,

Leave a comment

[Thesis] Designing an augmented reality video game to assist stroke patients with independent rehabilitation

Abstract

Early, intense practice of functional, repetitive rehabilitation interventions has shown positive results towards lower-limb recovery for stroke patients. However, long-term engagement in daily physical activity is necessary to maximise the physical and cognitive benefits of rehabilitation. The mundane, repetitive nature of traditional physiotherapy interventions and other personal, environmental and physical elements create barriers to participation. It is well documented that stroke patients engage in as little as 30% of their rehabilitation therapies. Digital gamified systems have shown positive results towards addressing these barriers of engagement in rehabilitation, but there is a lack of low-cost commercially available systems that are designed and personalised for home use. At the same time, emerging mixed reality technologies offer the ability to seamlessly integrate digital objects into the real world, generating an immersive, unique virtual world that leverages the physicality of the real world for a personalised, engaging experience.
This thesis explored how the design of an augmented reality exergame can facilitate engagement in independent lower-limb stroke rehabilitation. Our system converted prescribed exercises into active gameplay using commercially available augmented reality mobile technology. Such a system introduced an engaging, interactive alternative to existing mundane physiotherapy exercises.
The development of the system was based on a user-centered iterative design process. The involvement of health care professionals and stroke patients throughout each stage of the design and development process helped understand users’ needs, requirements and environment to refine the system and ensure its validity as a substitute for traditional rehabilitation interventions.
The final output was an augmented reality exergame that progressively facilitates sit-to-stand exercises by offering immersive interactions with digital exotic wildlife. We hypothesize that the immersive, active nature of a mobile, mixed reality exergame will increase engagement in independent task training for lower-limb rehabilitation.

via Designing an augmented reality video game to assist stroke patients with independent rehabilitation

, , , , , ,

Leave a comment

[Study] Home Is a Better Bet Than Hospitals for Achieving More PA Poststroke

There’s no place like home for engaging in the levels of physical activity (PA) that can aid in recovery poststroke—at least compared with the current hospital setting—according to a small study from Australia.

For the study, researchers used accelerometers and self-reports to track the PA and sitting time of 32 participants (mean age of 68, 53% male) who had experienced a stroke, comparing data gathered during their last week in the hospital with data gathered during their first week home. Participants were also assessed in a number of areas during their final week in the hospital, including physical function, functional independence, pain, anxiety, and depression.

The researchers were interested in finding out if an individual’s environment plays a role in PA poststroke—something they describe as “pivotal” to recovery—and whether other factors, such as depression, have an effect on any changes in PA levels. Results were e-published ahead of print in theArchives of Physical Medicine and Rehabilitation (abstract only available for free).

They found that environment does seem to make a difference—and a fairly big one at that. While the amount of time spent awake didn’t change much from hospital to home (13.1 hours a day in the hospital vs 13.5 hours per day at home), the amount of PA achieved—and time spent in sedentary behaviors—varied significantly. Participants sat for an average of 45 fewer minutes a day at home than they did in their last week in the hospital, were upright for 45 more minutes a day, spent 12 more minutes a day walking, and completed an average of 724 additional daily steps.

The results were similar when adjusted for demographic variables and didn’t seem to be significantly affected by any of the secondary factors assessed in the hospital, save one—depression, which when present was associated with no gains in PA at home.

The researchers don’t pin the improvement to any single factor but speculate that “the home environment may provide greater opportunity for activities of daily living such as cooking, cleaning, social and community activities, and there may be fewer external restrictions such as hospital routines and safety concerns around mobilization.”

Authors of the study also believe the gap between home and hospital PA poststroke could be closed if hospitals were to take more cues from the home environment.

“Physically, cognitively, and socially enriched stroke rehabilitation environments appear to increase activity by 20%,” they write. “Wards [that] include communal areas to promote more time spent upright, and the need to transport patients further for personal care may create opportunities for activity. The low activity levels in [the] hospital and at home found in our study, and in prior reports…indicate that there is clearly more work to be done in promoting activity after stroke.”

via Study: Home Is a Better Bet Than Hospitals for Achieving More PA Poststroke

, , , ,

Leave a comment

[WEB SITE] Could robots be counselors? Early research shows positive user experience

 

Many participants in the University of Plymouth study praised the ‘non-judgmental’ nature of the humanoid NAO robot as it delivered its session — with one even saying they preferred it to a human.
Credit: University of Plymouth

New research has shown for the first time that a social robot can deliver a ‘helpful’ and ‘enjoyable’ motivational interview (MI) — a counselling technique designed to support behaviour change.

Many participants in the University of Plymouth study praised the ‘non-judgemental’ nature of the humanoid NAO robot as it delivered its session — with one even saying they preferred it to a human.

Led by the School of Psychology, the study also showed that the robot achieved a fundamental objective of MI as it encouraged participants, who wanted to increase their physical activity, to articulate their goals and dilemmas aloud.

MI is a technique that involves the counsellor supporting and encouraging someone to talk about their need for change, and their reasons for wanting to change.

The role of the interviewer in MI is mainly to evoke a conversation about change and commitment, and the robot was programmed with a set script designed to elicit ideas and conversation on how someone could increase their physical activity.

When finished answering each question, the participant taped the top of NAO’s head to continue, with some sessions lasting up to an hour.

Lead academic Professor Jackie Andrade explained that, because they are perceived as nonjudgmental, robots may have advantages over more humanoid avatars for delivering virtual support for behavioral change.

“We were pleasantly surprised by how easily the participants adapted to the unusual experience of discussing their lifestyle with a robot,” she said. “As we have shown for the first time that a motivational interview delivered by a social robot can elicit out-loud discussion from participants.

“In addition, the participants perceived the interaction as enjoyable, interesting and helpful. Participants found it especially useful to hear themselves talking about their behaviour aloud, and liked the fact that the robot didn’t interrupt, which suggests that this new intervention has a potential advantage over other technology-delivered adaptations of MI.

“Concern about being judged by a human interviewer came across strongly in praise for the non-judgemental nature of the robot, suggesting that robots may be particularly helpful for eliciting talk about sensitive issues.

“The next stage is to undertake a quantitative study, where we can measure whether participants felt that the intervention actually increased their activity levels.”

Story Source:

Materials provided by University of PlymouthNote: Content may be edited for style and length.


Journal Reference:

  1. Joana Galvão Gomes da Silva, David J Kavanagh, Tony Belpaeme, Lloyd Taylor, Konna Beeson, Jackie Andrade. Experiences of a Motivational Interview Delivered by a Robot: Qualitative StudyJournal of Medical Internet Research, 2018; 20 (5): e116 DOI: 10.2196/jmir.7737

via Could robots be counselors? Early research shows positive user experience: New research has shown for the first time that a social robot can deliver a ‘helpful’ and ‘enjoyable’ motivational interview — ScienceDaily

, , , , ,

Leave a comment

[ARTICLE] Effectiveness of a multimodal exercise rehabilitation program on walking capacity and functionality after a stroke – Full Text

Abstract

The aim of this study was to determine the effectiveness of a 12-week multimodal exercise rehabilitation program on walking speed, walking ability and activities of daily living (ADLs) among people who had suffered a stroke. Thirty-one stroke survivors who had completed a conventional rehabilitation program voluntarily participated in the study. Twenty-six participants completed the multimodal exercise rehabilitation program (2 days/wk, 1 hr/session). Physical outcome measures were: walking speed (10-m walking test), walking ability (6-min walking test and functional ambulation classification) and ADLs (Barthel Index). The program consisted on: aerobic exercise; task oriented exercises; balance and postural tonic activities; and stretching. Participants also followed a program of progressive ambulation at home. They were evaluated at baseline, postintervention and at the end of a 6-month follow-up period. After the intervention there were significant improvements in all outcomes measures that were maintained 6 months later. Comfortable and fast walking speed increased an average of 0.16 and 0.40 m/sec, respectively. The walking distance in the 6-min walking test increased an average of 59.8 m. At the end of the intervention, participants had achieved independent ambulation both indoors and outdoors. In ADLs, 40% were independent at baseline vs. 64% at the end of the intervention. Our study demonstrates that a multimodal exercise rehabilitation program adapted to stroke survivors has benefits on walking speed, walking ability and independence in ADLs.
Keywords: Exercise, Physical activity, Stroke rehabilitation, Walking speed, Activities of daily living

INTRODUCTION

As life expectancy increases, a larger number of persons may suffer from stroke. Stroke mortality rates have decreased, but the burden of stroke is increasing in terms of stroke survivors per year, correlated deaths and disability-adjusted life-years lost. These deficiencies are further highlighted by a trend towards more strokes in younger people (Feigin et al., 2014). Stroke not only causes permanent neurological deficits, but also a profound degradation of physical condition, which worsens disability and increases cardiovascular risk. Stroke survivors are likely to suffer functional decline due to reduction of aerobic capacity. This may involve further secondary complications such as progressive muscular atrophy, osteoporosis, peripheral circulation worsening and increased cardiovascular risk (Ivey et al., 2006). All these factors cause increased dependency, need of assistance from third parties in activities of daily living (ADLs) and a restriction on participation that can have a profound psychosocial impact (Carod-Artal and Egido, 2009). Gait capacity is one of the main priorities of persons who have suffered a stroke, but is often limited due to the high energy demands of hemiplegic gait and the poor physical condition of these persons (Ivey et al., 2006). Gait speed is a commonly used measure in patients who have suffered a stroke to differentiate the functional capacity to walk indoors or outdoors. Gait speed has been classified as: allowing indoor ambulation (<0.4 m/sec), limited outdoor ambulation (0.4–0.8 m/sec), and outdoor functional ambulation (>0.8 m/sec) (Perry et al., 1995). Gait speed can also help to establish the functional prognosis of the patient. It has been stated that improvements in walking speed correlate with improved function and quality of life (QoL) (Schmid et al., 2007). It is essential to achieve a proper gait speed for outdoors functional ambulation.
Falls are common among stroke survivors and are associated with a worsening of disability and QoL. Balance is a complex process that involves the reception and integration of afferent inputs and the planning and execution of movement. Stroke can impact on different systems involved in postural control. Multifactorial falls risk assessment and management, combined with fitness programs, are effective in reducing risk of falls and fear of falling (Stroke Foundation of New Zealand and New Zealand Guidelines Group, 2010). Falls often occur when getting in and out of a chair (Brunt et al., 2002). The 2013 Cochrane review (Saunders et al., 2013) recommends the repetitive practice of sit-to-stand in order to promote an ergonomic and automatic pattern of this movement. Recent studies demonstrate that exercises that improve trunk stability and balance provide a solid base for body and leg movements that entail an improved gait in people affected by stroke (Sharma and Kaur, 2017). Conventional rehabilitation programs after stroke focus on the subacute period. The aim is to recover basic ADLs, but they do not provide maintenance exercises to provide long-term health gains. Cardiac monitoring demonstrates that conventional physiotherapy exercises do not regularly provide adequate exercise intensity to modify the physical deconditioning, nor sufficient exercise repetition to improve motor learning (Ivey et al., 2006). Therapeutic physical exercise to optimize function, physical condition and cardiovascular health after a stroke is an emerging field within neurorehabilitation (Teasell et al., 2009). The wide range of difficulties experienced by stroke survivors justify the need to explore rehabilitation programs designed to promote an overall improvement and to maintain the gains obtained after rehabilitation programs. Numerous studies have demonstrated the efficacy of aerobic exercise (Saunders et al., 2016), but there are few data on the long term effects of multimodal programs that incorporate aerobic exercise, complemented by task-oriented training and balance exercises. Consequently, the aim of this study is to analyse the impact of a multimodal exercise rehabilitation program tailored to stroke survivors on walking speed, walking ability and ADLs. […]

Continue —> Effectiveness of a multimodal exercise rehabilitation program on walking capacity and functionality after a stroke

, , , ,

Leave a comment

%d bloggers like this: