Home-based Computer Assisted Arm Rehabilitation (hCAAR) robotic device for upper limb exercise after stroke: results of a feasibility study in home setting
Identifieur interne : 001151 ( Main/Merge ); précédent : 001150; suivant : 001152Home-based Computer Assisted Arm Rehabilitation (hCAAR) robotic device for upper limb exercise after stroke: results of a feasibility study in home setting
Auteurs : Manoj Sivan ; Justin Gallagher ; Sophie Makower ; David Keeling ; Bipin Bhakta ; Rory J. O Onnor [Royaume-Uni] ; Martin LevesleySource :
- Journal of NeuroEngineering and Rehabilitation [ 1743-0003 ] ; 2014.
Abstract
Home-based robotic technologies may offer the possibility of self-directed upper limb exercise after stroke as a means of increasing the intensity of rehabilitation treatment. The current literature has a paucity of robotic devices that have been tested in a home environment. The aim of this research project was to evaluate a robotic device Home-based Computer Assisted Arm Rehabilitation (hCAAR) that can be used independently at home by stroke survivors with upper limb weakness.
hCAAR device comprises of a joystick handle moved by the weak upper limb to perform tasks on the computer screen. The device provides assistance to the movements depending on users ability. Nineteen participants (stroke survivors with upper limb weakness) were recruited. Outcome measures performed at baseline (A0), at end of 8-weeks of hCAAR use (A1) and 1 month after end of hCAAR use (A2) were: Optotrak kinematic variables, Fugl Meyer Upper Extremity motor subscale (FM-UE), Action Research Arm Test (ARAT), Medical Research Council (MRC) and Modified Ashworth Scale (MAS), Chedoke Arm and Hand Activity Inventory (CAHAI) and ABILHAND.
Two participants were unable to use hCAAR: one due to severe paresis and the other due to personal problems. The remaining 17 participants were able to use the device independently in their home setting. No serious adverse events were reported. The median usage time was 433 minutes (IQR 250 – 791 min). A statistically significant improvement was observed in the kinematic and clinical outcomes at A1. The median gain in the scores at A1 were by: movement time 19%, path length 15% and jerk 19%, FM-UE 1 point, total MAS 1.5 point, total MRC 2 points, ARAT 3 points, CAHAI 5.5 points and ABILHAND 3 points. Three participants showed clinically significant improvement in all the clinical outcomes.
The hCAAR feasibility study is the first clinical study of its kind reported in the current literature; in this study, 17 participants used the robotic device independently for eight weeks in their own homes with minimal supervision from healthcare professionals. Statistically significant improvements were observed in the kinematic and clinical outcomes in the study.
The online version of this article (doi:10.1186/1743-0003-11-163) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/1743-0003-11-163
PubMed: 25495889
PubMed Central: 4280043
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Home-based Computer Assisted Arm Rehabilitation (hCAAR) robotic device for upper limb exercise after stroke: results of a feasibility study in home setting</title><author><name sortKey="Sivan, Manoj" sort="Sivan, Manoj" uniqKey="Sivan M" first="Manoj" last="Sivan">Manoj Sivan</name><affiliation><nlm:aff id="Aff1">Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, LS1 3EX UK</nlm:aff><wicri:noCountry code="subfield">LS1 3EX UK</wicri:noCountry></affiliation></author><author><name sortKey="Gallagher, Justin" sort="Gallagher, Justin" uniqKey="Gallagher J" first="Justin" last="Gallagher">Justin Gallagher</name><affiliation><nlm:aff id="Aff2">School of Mechanical Engineering, University of Leeds, Leeds, LS1 3EX UK</nlm:aff><wicri:noCountry code="subfield">LS1 3EX UK</wicri:noCountry></affiliation></author><author><name sortKey="Makower, Sophie" sort="Makower, Sophie" uniqKey="Makower S" first="Sophie" last="Makower">Sophie Makower</name><affiliation><nlm:aff id="Aff1">Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, LS1 3EX UK</nlm:aff><wicri:noCountry code="subfield">LS1 3EX UK</wicri:noCountry></affiliation></author><author><name sortKey="Keeling, David" sort="Keeling, David" uniqKey="Keeling D" first="David" last="Keeling">David Keeling</name><affiliation><nlm:aff id="Aff2">School of Mechanical Engineering, University of Leeds, Leeds, LS1 3EX UK</nlm:aff><wicri:noCountry code="subfield">LS1 3EX UK</wicri:noCountry></affiliation></author><author><name sortKey="Bhakta, Bipin" sort="Bhakta, Bipin" uniqKey="Bhakta B" first="Bipin" last="Bhakta">Bipin Bhakta</name><affiliation><nlm:aff id="Aff1">Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, LS1 3EX UK</nlm:aff><wicri:noCountry code="subfield">LS1 3EX UK</wicri:noCountry></affiliation></author><author><name sortKey="O Onnor, Rory J" sort="O Onnor, Rory J" uniqKey="O Onnor R" first="Rory J" last="O Onnor">Rory J. O Onnor</name><affiliation><nlm:aff id="Aff1">Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, LS1 3EX UK</nlm:aff><wicri:noCountry code="subfield">LS1 3EX UK</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">National Demonstration Centre in Rehabilitation Medicine, Leeds, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>National Demonstration Centre in Rehabilitation Medicine, Leeds</wicri:regionArea><wicri:noRegion>Leeds</wicri:noRegion></affiliation></author><author><name sortKey="Levesley, Martin" sort="Levesley, Martin" uniqKey="Levesley M" first="Martin" last="Levesley">Martin Levesley</name><affiliation><nlm:aff id="Aff2">School of Mechanical Engineering, University of Leeds, Leeds, LS1 3EX UK</nlm:aff><wicri:noCountry code="subfield">LS1 3EX UK</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25495889</idno><idno type="pmc">4280043</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4280043</idno><idno type="RBID">PMC:4280043</idno><idno type="doi">10.1186/1743-0003-11-163</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000834</idno><idno type="wicri:Area/Pmc/Curation">000834</idno><idno type="wicri:Area/Pmc/Checkpoint">000C04</idno><idno type="wicri:Area/Ncbi/Merge">003529</idno><idno type="wicri:Area/Ncbi/Curation">003529</idno><idno type="wicri:Area/Ncbi/Checkpoint">003529</idno><idno type="wicri:Area/Main/Merge">001151</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Home-based Computer Assisted Arm Rehabilitation (hCAAR) robotic device for upper limb exercise after stroke: results of a feasibility study in home setting</title><author><name sortKey="Sivan, Manoj" sort="Sivan, Manoj" uniqKey="Sivan M" first="Manoj" last="Sivan">Manoj Sivan</name><affiliation><nlm:aff id="Aff1">Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, LS1 3EX UK</nlm:aff><wicri:noCountry code="subfield">LS1 3EX UK</wicri:noCountry></affiliation></author><author><name sortKey="Gallagher, Justin" sort="Gallagher, Justin" uniqKey="Gallagher J" first="Justin" last="Gallagher">Justin Gallagher</name><affiliation><nlm:aff id="Aff2">School of Mechanical Engineering, University of Leeds, Leeds, LS1 3EX UK</nlm:aff><wicri:noCountry code="subfield">LS1 3EX UK</wicri:noCountry></affiliation></author><author><name sortKey="Makower, Sophie" sort="Makower, Sophie" uniqKey="Makower S" first="Sophie" last="Makower">Sophie Makower</name><affiliation><nlm:aff id="Aff1">Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, LS1 3EX UK</nlm:aff><wicri:noCountry code="subfield">LS1 3EX UK</wicri:noCountry></affiliation></author><author><name sortKey="Keeling, David" sort="Keeling, David" uniqKey="Keeling D" first="David" last="Keeling">David Keeling</name><affiliation><nlm:aff id="Aff2">School of Mechanical Engineering, University of Leeds, Leeds, LS1 3EX UK</nlm:aff><wicri:noCountry code="subfield">LS1 3EX UK</wicri:noCountry></affiliation></author><author><name sortKey="Bhakta, Bipin" sort="Bhakta, Bipin" uniqKey="Bhakta B" first="Bipin" last="Bhakta">Bipin Bhakta</name><affiliation><nlm:aff id="Aff1">Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, LS1 3EX UK</nlm:aff><wicri:noCountry code="subfield">LS1 3EX UK</wicri:noCountry></affiliation></author><author><name sortKey="O Onnor, Rory J" sort="O Onnor, Rory J" uniqKey="O Onnor R" first="Rory J" last="O Onnor">Rory J. O Onnor</name><affiliation><nlm:aff id="Aff1">Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, LS1 3EX UK</nlm:aff><wicri:noCountry code="subfield">LS1 3EX UK</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">National Demonstration Centre in Rehabilitation Medicine, Leeds, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>National Demonstration Centre in Rehabilitation Medicine, Leeds</wicri:regionArea><wicri:noRegion>Leeds</wicri:noRegion></affiliation></author><author><name sortKey="Levesley, Martin" sort="Levesley, Martin" uniqKey="Levesley M" first="Martin" last="Levesley">Martin Levesley</name><affiliation><nlm:aff id="Aff2">School of Mechanical Engineering, University of Leeds, Leeds, LS1 3EX UK</nlm:aff><wicri:noCountry code="subfield">LS1 3EX UK</wicri:noCountry></affiliation></author></analytic><series><title level="j">Journal of NeuroEngineering and Rehabilitation</title><idno type="eISSN">1743-0003</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Home-based robotic technologies may offer the possibility of self-directed upper limb exercise after stroke as a means of increasing the intensity of rehabilitation treatment. The current literature has a paucity of robotic devices that have been tested in a home environment. The aim of this research project was to evaluate a robotic device Home-based Computer Assisted Arm Rehabilitation (hCAAR) that can be used independently at home by stroke survivors with upper limb weakness.</p></sec><sec><title>Methods</title><p>hCAAR device comprises of a joystick handle moved by the weak upper limb to perform tasks on the computer screen. The device provides assistance to the movements depending on users ability. Nineteen participants (stroke survivors with upper limb weakness) were recruited. Outcome measures performed at baseline (A0), at end of 8-weeks of hCAAR use (A1) and 1 month after end of hCAAR use (A2) were: Optotrak kinematic variables, Fugl Meyer Upper Extremity motor subscale (FM-UE), Action Research Arm Test (ARAT), Medical Research Council (MRC) and Modified Ashworth Scale (MAS), Chedoke Arm and Hand Activity Inventory (CAHAI) and ABILHAND.</p></sec><sec><title>Results</title><p>Two participants were unable to use hCAAR: one due to severe paresis and the other due to personal problems. The remaining 17 participants were able to use the device independently in their home setting. No serious adverse events were reported. The median usage time was 433 minutes (IQR 250 – 791 min). A statistically significant improvement was observed in the kinematic and clinical outcomes at A1. The median gain in the scores at A1 were by: movement time 19%, path length 15% and jerk 19%, FM-UE 1 point, total MAS 1.5 point, total MRC 2 points, ARAT 3 points, CAHAI 5.5 points and ABILHAND 3 points. Three participants showed clinically significant improvement in all the clinical outcomes.</p></sec><sec><title>Conclusions</title><p>The hCAAR feasibility study is the first clinical study of its kind reported in the current literature; in this study, 17 participants used the robotic device independently for eight weeks in their own homes with minimal supervision from healthcare professionals. Statistically significant improvements were observed in the kinematic and clinical outcomes in the study.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/1743-0003-11-163) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Murray, Cj" uniqKey="Murray C">CJ Murray</name></author><author><name sortKey="Lopez, Ad" uniqKey="Lopez A">AD Lopez</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Saka, O" uniqKey="Saka O">O Saka</name></author><author><name sortKey="Mcguire, A" uniqKey="Mcguire A">A McGuire</name></author><author><name sortKey="Wolfe, C" uniqKey="Wolfe C">C Wolfe</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Skilbeck, Ce" uniqKey="Skilbeck C">CE 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Smith</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Duncan, Pw" uniqKey="Duncan P">PW Duncan</name></author><author><name sortKey="Lai, Sm" uniqKey="Lai S">SM Lai</name></author><author><name sortKey="Keighley, J" uniqKey="Keighley J">J Keighley</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Merge/RBID.i -Sk "pubmed:25495889" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Merge/biblio.hfd \
| NlmPubMed2Wicri -a HapticV1
| This area was generated with Dilib version V0.6.23. |  |