Posts Tagged trunk
[ARTICLE] Development of a Novel Home Based Multiscene Upper Limb Rehabilitation Training and Evaluation System for Post-stroke Patients – Full Text PDF
Upper limb rehabilitation requires long-term, repetitive rehabilitation training and assessment, and many patients cannot pay for expensive medical fees in the hospital for so long time. It is necessary to design an effective, low cost, and reasonable home rehabilitation and evaluation system. In this paper, we developed a novel home based multi-scene upper limb rehabilitation training and evaluation system (HomeRehabMaster) for post-stroke patients. Based on the Kinect sensor and posture sensor, multi-sensors fusion method was used to track the motion of the patients. Multiple virtual scenes were designed to encourage rehabilitation training of upper limbs and trunk. A rehabilitation evaluation method integrating Fugl-meyer assessment (FMA) scale and upper limb reachable workspace relative surface area (RSA) was
proposed, and a FMA-RSA assessment model was established to assess upper limb motor function.
Correlation based dynamic time warping (CBDTW) was used to solve the problem of inconsistent upper limb movement path in different patients. Two clinical trials were conducted. The experimental results show that the system is very friendly to the subjects, the rehabilitation assessment results by this system are highly correlated with the therapist’s (the highest forecast accuracy was 92.7% in the 13th item), and longterm rehabilitation training can improve the upper limb motor function of the patients statistically significant (p=0.02<0.05). The system has the potential to become an effective home rehabilitation training and evaluation system.[…]
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[ARTICLE] Low cost objective diagnosis of learned non-use of the paretic arm after a stroke using Kinect technology
Background Post-stroke patient s tend to move their trunk forward to reach an object rather than extending their affected arm, which is detrimental to good recovery of the paretic arm. In order to avoid this maladaptive trunk compensation, an objective assessment is needed. In that context, learned non-use (LNU) of the paretic arm is the difference between what the patient is capable of doing with his paretic arm and what he actually does. LNU has been previously assessed with a costly movement analysis device (Zebris). However, the Kinect 2 (X-box) is an innovative movement sensor that costs a fraction of the price of Zebris (about 200 €). The aim of this study was to show that the results obtained by the Zebris and Kinect are comparable and to see if the Kinect is a valid alternative to Zebris.
Methods Four post-supratentorial stroke participants were asked to reach a cone placed in front of them at 80% of their arm length. The reaching movement was repeated 5 times with the paretic hand, then 5 times with the less-impaired hand. This sequence was first performed with the trunk free, then with the trunk restrained. LNU of the paretic arm was obtained from the difference of the amount of trunk compensation between the free trunk condition and the restrained trunk condition measured by the Zebris and Kinect systems simultaneously.
Results The results of a pilot study showed that the Kinect determination of LNU were similar to those obtained by the Zebris.
Discussion This LNU score measured by Kinect was similar to that measured by Zebris, so we consider Kinect to be accurate enough to measure maladaptive trunk compensation. This LNU score could also be implemented in Kinect video games stroke neurorehabilitation. In the near future, patients could benefit from using low cost Kinect system in their own homes for rehabilitation and to assess their progress.
Source: Elsevier: Article Locator
[ARTICLE] The effects of Bobath-based trunk exercises on trunk control, functional capacity, balance, and gait: a pilot randomized controlled trial
Objective: The aim of this study was to investigate the effects of Bobath-based individually designed trunk exercises on trunk control, upper and lower extremity function, and walking and balance in stroke patients. The main aim of treatment was to eliminate individual trunk impairments during various patient functions.
Methods: The study was planned as an assessor-blinded, randomized controlled trial. A total of 22 patients volunteered to participate in the study. Trunk function, functional capacity, and gait were assessed with the Trunk Impairment Scale (TIS), stroke rehabilitation assessment of movement (STREAM), and a 10-m walking test, respectively. The Berg Balance Test (BBT), functional reach (FR), and timed up-and-go (TUG) tests were used to evaluate balance. After the initial assessment, the patients were divided randomly into two groups, the study group (12 patients) and the control group (10 patients). The mean age of the patients in the study group was 55.91 years (duration of stroke 58.66 months) and that of the control group was 54.00 years (duration of stroke 67.20 months). Individual training programs were determined for the patients in the study group, taking into consideration their evaluation results; and strengthening, stretching, range of motion, and mat exercises were determined for the control group according to their functional level. The participants in both groups were taken into the physiotherapy program for 12 weeks, 3 days a week for 1 hour a day.
Results: In group analyses, both groups showed improvement in STREAM, TIS, and TUG tests. Only the study group produced significant gains in the BBT, FR, and 10 m walking tests (P 0.05).
Conclusion: Individually developed exercise programs in the Bobath concept improve trunk performance, balance, and walking ability in stroke patients more than do conventional exercises.
[ARTICLE] Faster Reaching in Chronic Spastic Stroke Patients Comes at the Expense of Arm-Trunk Coordination
Background. The velocity of reaching movements is often reduced in patients with stroke-related hemiparesis; however, they are able to voluntarily increase paretic hand velocity. Previous studies have proposed that faster speed improves movement quality.
Objective. To investigate the combined effects of reaching distance and speed instruction on trunk and paretic upper-limb coordination. The hypothesis was that increased speed would reduce elbow extension and increase compensatory trunk movement.
Methods. A single session study in which reaching kinematics were recorded in a group of 14 patients with spastic hemiparesis. A 3-dimensional motion analysis system was used to track the trajectories of 5 reflective markers fixed on the finger, wrist, elbow, acromion, and sternum. The reaching movements were performed to 2 targets at 60% and 90% arm length, respectively, at preferred and maximum velocity. The experiment was repeated with the trunk restrained by a strap.
Results. All the patients were able to voluntarily increase reaching velocity. In the trunk free, faster speed condition, elbow extension velocity increased but elbow extension amplitude decreased and trunk movement increased. In the trunk restraint condition, elbow extension amplitude did not decrease with faster speed. Seven patients scaled elbow extension and elbow extension velocity as a function of reach distance, the other 7 mainly increased trunk compensation with increased task constraints. There were no clear clinical characteristics that could explain this difference.
Conclusions. Faster speed may encourage some patients to use compensation. Individual indications for therapy could be based on a quantitative analysis of reaching coordination.