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Robots integrated with virtual reality simulations for customized motor training in a person with upper extremity hemiparesis: a case report

Identifieur interne : 002029 ( Ncbi/Merge ); précédent : 002028; suivant : 002030

Robots integrated with virtual reality simulations for customized motor training in a person with upper extremity hemiparesis: a case report

Auteurs : Gerard G. Fluet [États-Unis] ; Alma S. Merians [États-Unis] ; Qinyin Qiu ; Ian Lafond ; Soha Saleh ; Viviana Ruano ; Andrea R. Delmonico ; Sergei V. Adamovich [États-Unis]

Source :

RBID : PMC:4195597

Abstract

Background and Purpose

A majority of studies examining repetitive task practice facilitated by robots for the treatment of upper extremity paresis utilize standardized protocols applied to large groups. Others utilize interventions tailored to patients but don't describe the clinical decision making process utilized to develop and modify interventions. This case report will describe a robot-based intervention customized to match the goals and clinical presentation of a gentleman with upper extremity hemiparesis secondary to stroke.

Methods

PM is an 85 year-old man with left hemiparesis secondary to an intracerebral hemorrhage five years prior to examination. Outcomes were measured before and after a one month period of home therapy and after a one month robotic intervention. The intervention was designed to address specific impairments identified during his PT examination. When necessary, activities were modified based on the patient's response to his first week of treatment.

Outcomes

PM trained twelve sessions using six virtually simulated activities. Modifications to original configurations of these activities resulted in performance improvements in five of these activities. PM demonstrated a 35 second improvement in Jebsen Test of Hand Function time and a 44 second improvement in Wolf Motor Function Test time subsequent to the robotic training intervention. Reaching kinematics, 24 hour activity measurement and the Hand and Activities of Daily Living scales of the Stroke Impact Scale all improved as well.

Discussion

A customized program of robotically facilitated rehabilitation resulted in large short-term improvements in several measurements of upper extremity function in a patient with chronic hemiparesis.


Url:
DOI: 10.1097/NPT.0b013e3182566f3f
PubMed: 22592063
PubMed Central: 4195597

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PMC:4195597

Le document en format XML

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<title>Background and Purpose</title>
<p id="P1">A majority of studies examining repetitive task practice facilitated by robots for the treatment of upper extremity paresis utilize standardized protocols applied to large groups. Others utilize interventions tailored to patients but don't describe the clinical decision making process utilized to develop and modify interventions. This case report will describe a robot-based intervention customized to match the goals and clinical presentation of a gentleman with upper extremity hemiparesis secondary to stroke.</p>
</sec>
<sec id="S2">
<title>Methods</title>
<p id="P2">PM is an 85 year-old man with left hemiparesis secondary to an intracerebral hemorrhage five years prior to examination. Outcomes were measured before and after a one month period of home therapy and after a one month robotic intervention. The intervention was designed to address specific impairments identified during his PT examination. When necessary, activities were modified based on the patient's response to his first week of treatment.</p>
</sec>
<sec id="S3">
<title>Outcomes</title>
<p id="P3">PM trained twelve sessions using six virtually simulated activities. Modifications to original configurations of these activities resulted in performance improvements in five of these activities. PM demonstrated a 35 second improvement in Jebsen Test of Hand Function time and a 44 second improvement in Wolf Motor Function Test time subsequent to the robotic training intervention. Reaching kinematics, 24 hour activity measurement and the Hand and Activities of Daily Living scales of the Stroke Impact Scale all improved as well.</p>
</sec>
<sec id="S4">
<title>Discussion</title>
<p id="P4">A customized program of robotically facilitated rehabilitation resulted in large short-term improvements in several measurements of upper extremity function in a patient with chronic hemiparesis.</p>
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<name>
<surname>Fluet</surname>
<given-names>Gerard G.</given-names>
</name>
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<name>
<surname>Merians</surname>
<given-names>Alma S.</given-names>
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<contrib contrib-type="author">
<name>
<surname>Qiu</surname>
<given-names>Qinyin</given-names>
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<surname>Lafond</surname>
<given-names>Ian</given-names>
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<xref ref-type="aff" rid="A4">4</xref>
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Department of Rehabilitation and Movement Sciences, University of Medicine and Dentistry of New Jersey, Newark, NJ</aff>
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Department of Biomedical Engineering, New Jersey Institute of Technology, Newark NJ</aff>
<aff id="A3">
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Ruano Therapy Associates, Morris Plains NJ</aff>
<aff id="A4">
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Abilities Therapy Network, Midland Park NJ</aff>
<author-notes>
<corresp id="CR1">Corresponding Author: Gerard G. Fluet, DPT Phone: (973) 972-1550 Fax: (973) 596-5222
<email>fluetge@umdnj.edu</email>
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<pmc-comment>elocation-id from pubmed: 10.1097/NPT.0b013e3182566f3f</pmc-comment>
<abstract>
<sec id="S1">
<title>Background and Purpose</title>
<p id="P1">A majority of studies examining repetitive task practice facilitated by robots for the treatment of upper extremity paresis utilize standardized protocols applied to large groups. Others utilize interventions tailored to patients but don't describe the clinical decision making process utilized to develop and modify interventions. This case report will describe a robot-based intervention customized to match the goals and clinical presentation of a gentleman with upper extremity hemiparesis secondary to stroke.</p>
</sec>
<sec id="S2">
<title>Methods</title>
<p id="P2">PM is an 85 year-old man with left hemiparesis secondary to an intracerebral hemorrhage five years prior to examination. Outcomes were measured before and after a one month period of home therapy and after a one month robotic intervention. The intervention was designed to address specific impairments identified during his PT examination. When necessary, activities were modified based on the patient's response to his first week of treatment.</p>
</sec>
<sec id="S3">
<title>Outcomes</title>
<p id="P3">PM trained twelve sessions using six virtually simulated activities. Modifications to original configurations of these activities resulted in performance improvements in five of these activities. PM demonstrated a 35 second improvement in Jebsen Test of Hand Function time and a 44 second improvement in Wolf Motor Function Test time subsequent to the robotic training intervention. Reaching kinematics, 24 hour activity measurement and the Hand and Activities of Daily Living scales of the Stroke Impact Scale all improved as well.</p>
</sec>
<sec id="S4">
<title>Discussion</title>
<p id="P4">A customized program of robotically facilitated rehabilitation resulted in large short-term improvements in several measurements of upper extremity function in a patient with chronic hemiparesis.</p>
</sec>
</abstract>
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