Feedback training using a non-motorized device for long-term upper extremity impairment after stroke: a single group study
Identifieur interne : 004159 ( Ncbi/Merge ); précédent : 004158; suivant : 004160Feedback training using a non-motorized device for long-term upper extremity impairment after stroke: a single group study
Auteurs : Ki Hun Cho ; Won-Kyung SongSource :
- Journal of Physical Therapy Science [ 0915-5287 ] ; 2016.
Abstract
[Purpose] To investigate the effect of feedback training using a non-motorized device on the upper extremity kinematic performance of chronic stroke survivors. [Subjects] This study had a single group design. Thirteen chronic stroke survivors (onset duration: 11.5 years, 62.6 years, mini-mental state examination score: 26.0) were enrolled. [Methods] The feedback training system consisted of a non-motorized device that offered weight support, and a projective display device and loud speakers that provided suitable visual and auditory feedback to the user. Subjects participated in the feedback training for 40 min per day, two times a week for 4 weeks. Upper extremity kinematic performance (i.e., movement time) in three directions was confirmed twice (at baseline and post-intervention). [Results] After 4 weeks of the intervention, a significant improvement in upper extremity kinematic performance was observed in the three directions. [Conclusion] The present study demonstrated the positive effects of feedback training using a non-motorized device on the upper extremity kinematic performance of chronic stroke survivors. Therefore, the findings of this study may provide beneficial information for future studies on feedback training using a non-motorized device for chronic stroke survivors.
Url:
DOI: 10.1589/jpts.28.495
PubMed: 27064768
PubMed Central: 4792998
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Feedback training using a non-motorized device for long-term upper extremity
impairment after stroke: a single group study</title><author><name sortKey="Cho, Ki Hun" sort="Cho, Ki Hun" uniqKey="Cho K" first="Ki Hun" last="Cho">Ki Hun Cho</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author><author><name sortKey="Song, Won Kyung" sort="Song, Won Kyung" uniqKey="Song W" first="Won-Kyung" last="Song">Won-Kyung Song</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27064768</idno><idno type="pmc">4792998</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4792998</idno><idno type="RBID">PMC:4792998</idno><idno type="doi">10.1589/jpts.28.495</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000517</idno><idno type="wicri:Area/Pmc/Curation">000517</idno><idno type="wicri:Area/Pmc/Checkpoint">000111</idno><idno type="wicri:Area/Ncbi/Merge">004159</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Feedback training using a non-motorized device for long-term upper extremity
impairment after stroke: a single group study</title><author><name sortKey="Cho, Ki Hun" sort="Cho, Ki Hun" uniqKey="Cho K" first="Ki Hun" last="Cho">Ki Hun Cho</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author><author><name sortKey="Song, Won Kyung" sort="Song, Won Kyung" uniqKey="Song W" first="Won-Kyung" last="Song">Won-Kyung Song</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Physical Therapy Science</title><idno type="ISSN">0915-5287</idno><idno type="eISSN">2187-5626</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>[Purpose] To investigate the effect of feedback training using a non-motorized device on
the upper extremity kinematic performance of chronic stroke survivors. [Subjects] This
study had a single group design. Thirteen chronic stroke survivors (onset duration:
11.5 years, 62.6 years, mini-mental state examination score: 26.0) were enrolled.
[Methods] The feedback training system consisted of a non-motorized device that offered
weight support, and a projective display device and loud speakers that provided suitable
visual and auditory feedback to the user. Subjects participated in the feedback training
for 40 min per day, two times a week for 4 weeks. Upper extremity kinematic performance
(i.e., movement time) in three directions was confirmed twice (at baseline and
post-intervention). [Results] After 4 weeks of the intervention, a significant improvement
in upper extremity kinematic performance was observed in the three directions.
[Conclusion] The present study demonstrated the positive effects of feedback training
using a non-motorized device on the upper extremity kinematic performance of chronic
stroke survivors. Therefore, the findings of this study may provide beneficial information
for future studies on feedback training using a non-motorized device for chronic stroke
survivors.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Yoo, Dh" uniqKey="Yoo D">DH Yoo</name></author><author><name sortKey="Cha, Yj" uniqKey="Cha Y">YJ Cha</name></author><author><name sortKey="Kim, Sk" uniqKey="Kim S">SK Kim</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yoo, Dh" uniqKey="Yoo D">DH Yoo</name></author><author><name sortKey="Kim, Sy" uniqKey="Kim S">SY Kim</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Babaiasl, M" uniqKey="Babaiasl M">M Babaiasl</name></author><author><name sortKey="Mahdioun, Sh" uniqKey="Mahdioun S">SH Mahdioun</name></author><author><name sortKey="Jaryani, P" uniqKey="Jaryani P">P Jaryani</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kwakkel, G" uniqKey="Kwakkel G">G Kwakkel</name></author><author><name sortKey="Kollen, Bj" uniqKey="Kollen B">BJ Kollen</name></author><author><name sortKey="Krebs, Hi" uniqKey="Krebs H">HI Krebs</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Silvoni, S" uniqKey="Silvoni S">S Silvoni</name></author><author><name sortKey="Ramos Murguialday, A" uniqKey="Ramos Murguialday A">A Ramos-Murguialday</name></author><author><name sortKey="Cavinato, M" uniqKey="Cavinato M">M Cavinato</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Subramanian, Sk" uniqKey="Subramanian S">SK Subramanian</name></author><author><name sortKey="Massie, Cl" uniqKey="Massie C">CL Massie</name></author><author><name sortKey="Malcolm, Mp" uniqKey="Malcolm M">MP Malcolm</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sigrist, R" uniqKey="Sigrist R">R Sigrist</name></author><author><name sortKey="Rauter, G" uniqKey="Rauter G">G Rauter</name></author><author><name sortKey="Riener, R" uniqKey="Riener R">R Riener</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mehrholz, J" uniqKey="Mehrholz J">J Mehrholz</name></author><author><name sortKey="H Drich, A" uniqKey="H Drich A">A Hädrich</name></author><author><name sortKey="Platz, T" uniqKey="Platz T">T Platz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Burgar, Cg" uniqKey="Burgar C">CG Burgar</name></author><author><name sortKey="Lum, Ps" uniqKey="Lum P">PS Lum</name></author><author><name sortKey="Scremin, Am" uniqKey="Scremin A">AM Scremin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Masiero, S" uniqKey="Masiero S">S Masiero</name></author><author><name sortKey="Armani, M" uniqKey="Armani M">M Armani</name></author><author><name sortKey="Rosati, G" uniqKey="Rosati G">G Rosati</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Frisoli, A" uniqKey="Frisoli A">A Frisoli</name></author><author><name sortKey="Procopio, C" uniqKey="Procopio C">C Procopio</name></author><author><name sortKey="Chisari, C" uniqKey="Chisari C">C Chisari</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Morris, Dm" uniqKey="Morris D">DM Morris</name></author><author><name sortKey="Crago, Je" uniqKey="Crago J">JE Crago</name></author><author><name sortKey="Deluca, Sc" uniqKey="Deluca S">SC Deluca</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Michaelsen, Sm" uniqKey="Michaelsen S">SM Michaelsen</name></author><author><name sortKey="Dannenbaum, R" uniqKey="Dannenbaum R">R Dannenbaum</name></author><author><name sortKey="Levin, Mf" uniqKey="Levin M">MF Levin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Piron, L" uniqKey="Piron L">L Piron</name></author><author><name sortKey="Tonin, P" uniqKey="Tonin P">P Tonin</name></author><author><name sortKey="Piccione, F" uniqKey="Piccione F">F Piccione</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Coote, S" uniqKey="Coote S">S Coote</name></author><author><name sortKey="Murphy, B" uniqKey="Murphy B">B Murphy</name></author><author><name sortKey="Harwin, W" uniqKey="Harwin W">W Harwin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Magill, Ra" uniqKey="Magill R">RA Magill</name></author><author><name sortKey="Anderson, D" uniqKey="Anderson D">D Anderson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kleim, Ja" uniqKey="Kleim J">JA Kleim</name></author><author><name sortKey="Jones, Ta" uniqKey="Jones T">TA Jones</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Phys Ther Sci</journal-id><journal-id journal-id-type="iso-abbrev">J Phys Ther Sci</journal-id><journal-id journal-id-type="publisher-id">JPTS</journal-id><journal-title-group><journal-title>Journal of Physical Therapy Science</journal-title></journal-title-group><issn pub-type="ppub">0915-5287</issn><issn pub-type="epub">2187-5626</issn><publisher><publisher-name>The Society of Physical Therapy Science</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27064768</article-id><article-id pub-id-type="pmc">4792998</article-id><article-id pub-id-type="publisher-id">jpts-2015-825</article-id><article-id pub-id-type="doi">10.1589/jpts.28.495</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Feedback training using a non-motorized device for long-term upper extremity
impairment after stroke: a single group study</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Cho</surname><given-names>Ki Hun</given-names></name><degrees>PhD, PT</degrees><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Song</surname><given-names>Won-Kyung</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref rid="cor1" ref-type="corresp"><sup>*</sup></xref></contrib><aff id="aff1"><label>1)</label> Department of Rehabilitative and Assistive Technology, Korea National Rehabilitation Research Institute, Korea National Rehabilitation Center, Republic of Korea</aff></contrib-group><author-notes><corresp id="cor1"><label>*</label>Corresponding author. Won-Kyung Song, Department of Rehabilitative and Assistive Technology,
Korea National Rehabilitation Research Institute, Korea National Rehabilitation Center: 58
Samgaksan-ro, Gangbuk-gu, Seoul 01022, Republic of Kore. (E-mail: <email xlink:href="wksong@nrc.go.kr">wksong@nrc.go.kr</email>; <email xlink:href="wonksong@gmail.com">wonksong@gmail.com</email>)</corresp></author-notes><pub-date pub-type="epub"><day>29</day><month>2</month><year>2016</year></pub-date><pub-date pub-type="ppub"><month>2</month><year>2016</year></pub-date><volume>28</volume><issue>2</issue><fpage>495</fpage><lpage>499</lpage><history><date date-type="received"><day>30</day><month>9</month><year>2015</year></date><date date-type="accepted"><day>31</day><month>10</month><year>2015</year></date></history><permissions><copyright-statement>2016©by the Society of Physical Therapy Science. Published by IPEC
Inc.</copyright-statement><copyright-year>2016</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-nd/4.0/"><license-p>This is an open-access article distributed under the terms of the Creative
Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License. </license-p></license></permissions><abstract><p>[Purpose] To investigate the effect of feedback training using a non-motorized device on
the upper extremity kinematic performance of chronic stroke survivors. [Subjects] This
study had a single group design. Thirteen chronic stroke survivors (onset duration:
11.5 years, 62.6 years, mini-mental state examination score: 26.0) were enrolled.
[Methods] The feedback training system consisted of a non-motorized device that offered
weight support, and a projective display device and loud speakers that provided suitable
visual and auditory feedback to the user. Subjects participated in the feedback training
for 40 min per day, two times a week for 4 weeks. Upper extremity kinematic performance
(i.e., movement time) in three directions was confirmed twice (at baseline and
post-intervention). [Results] After 4 weeks of the intervention, a significant improvement
in upper extremity kinematic performance was observed in the three directions.
[Conclusion] The present study demonstrated the positive effects of feedback training
using a non-motorized device on the upper extremity kinematic performance of chronic
stroke survivors. Therefore, the findings of this study may provide beneficial information
for future studies on feedback training using a non-motorized device for chronic stroke
survivors.</p></abstract><kwd-group><title>Key words</title><kwd>Feedback</kwd><kwd>Stroke</kwd><kwd>Upper extremity rehabilitation</kwd></kwd-group></article-meta></front><body><sec sec-type="intro" id="s1"><title>INTRODUCTION</title><p>Stroke is a major cause of functional impairment, and problems with upper extremity
function are present in >50% of patients with stroke<xref rid="r1" ref-type="bibr">1</xref><sup>)</sup>. Therefore, restoring upper extremity function is an essential goal
of stroke rehabilitation. Recently, assistive device training has been proposed to enhance
the upper extremity functional movement of those with impaired upper extremity function
after stroke<xref rid="r2" ref-type="bibr">2</xref>, <xref rid="r3" ref-type="bibr">3</xref><sup>)</sup>. In particular, robotic-assisted device training of the upper
extremity can provide a repetitive, high-intensity, and interactive task<xref rid="r4" ref-type="bibr">4</xref><sup>)</sup>. In addition, upper extremity training using
a robotic-assisted device can provide objective and quantitative monitoring of the training
process<xref rid="r4" ref-type="bibr">4</xref>, <xref rid="r5" ref-type="bibr">5</xref><sup>)</sup>.</p><p>In the field of stroke rehabilitation, provision of the feedback concept has been applied
to enhance the motor learning process<xref rid="r6" ref-type="bibr">6</xref><sup>)</sup>. In
particular, the provision of feedback is useful for decreasing compensatory movements of the
upper extremity<xref rid="r6" ref-type="bibr">6</xref><sup>)</sup>. Recent technical
advances can provide complex and realistic tasks using a visual and auditory feedback
system, and this may lead to relearning of the motor process more efficiently<xref rid="r7" ref-type="bibr">7</xref><sup>)</sup>. Although the effect of assistive devices
and robot-assisted training with user interaction has been investigated<xref rid="r4" ref-type="bibr">4</xref>, <xref rid="r8" ref-type="bibr">8</xref>, <xref rid="r9" ref-type="bibr">9</xref><sup>)</sup>, studies on assistive devices, especially non-motorized devices and
robot-assisted training using visual and auditory feedback systems, with a focus on
long-term upper extremity impairment after stroke are lacking.</p><p>The purpose of the present study was to assess whether visual and auditory feedback
training using a non-motorized device that provides weight support can improve the upper
extremity kinematic performance of chronic stroke survivors. The hypothesis of this study
was that chronic stroke survivors would show improvement of upper extremity kinematic
performance after 4 weeks of feedback training using a non-motorized device.</p></sec><sec sec-type="methods" id="s2"><title>SUBJECTS AND METHODS</title><p>A single group design was used to investigate the effects of feedback training using a
non-motorized device on the upper extremity kinematic performance of chronic stroke
survivors. Thirteen chronic stroke survivors (8 men, 62.6 years, mini-mental state
examination [MMSE] score: 26.0, onset duration: 11.5 years) were enrolled in this study. The
subjects were recruited from the local community. At the time of their recruitment, they
were not receiving any rehabilitation services such as physical or occupational therapy. The
subjects were screened according to the following inclusion and exclusion criteria. The
inclusion criteria were hemiparesis from a single stroke occurring at least 6 months prior,
sufficient cognition to follow simple instructions and understand the study’s purpose (MMSE
score >18 points)<xref rid="r10" ref-type="bibr">10</xref><sup>)</sup>, the absence of a
musculoskeletal condition that could affect the subject’s ability to sit safely, and the
absence of hemispatial neglect. The exclusion criteria were participation in other studies
or rehabilitation programs, shoulder subluxation or pain in the upper extremity, or
spasticity (modified Ashworth scale score >2)<xref rid="r11" ref-type="bibr">11</xref><sup>)</sup>. Clinical and demographic data with the baseline assessment of
subjects at enrollment are presented in <xref rid="tbl_001" ref-type="table">Table
1</xref><table-wrap id="tbl_001" orientation="portrait" position="float"><label>Table 1.</label><caption><title>General characteristics of the subjects (N = 13)</title></caption><table frame="hsides" rules="groups"><thead><tr><th align="center" rowspan="1" colspan="1">Subjects</th><th align="center" rowspan="1" colspan="1">Gender (M/F)</th><th align="center" rowspan="1" colspan="1">Age (years)</th><th align="center" rowspan="1" colspan="1">Time since stroke (years)</th><th align="center" rowspan="1" colspan="1">Height (cm)</th><th align="center" rowspan="1" colspan="1">Weight (kg)</th><th align="center" rowspan="1" colspan="1">Etiology (I/H)</th><th align="center" rowspan="1" colspan="1">Paretic side (L/R)</th><th align="center" rowspan="1" colspan="1">MAS (0/1/1+)</th><th align="center" rowspan="1" colspan="1">MRC (shoulder) (3/4/5)</th><th align="center" rowspan="1" colspan="1">MMSE (scores)</th></tr></thead><tbody><tr><td align="center" valign="top" rowspan="1" colspan="1">1</td><td align="center" valign="top" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">64</td><td align="center" rowspan="1" colspan="1">13</td><td align="center" rowspan="1" colspan="1">149.5</td><td align="center" rowspan="1" colspan="1">149.5</td><td align="center" rowspan="1" colspan="1">I</td><td align="center" rowspan="1" colspan="1">L</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">25</td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1">2</td><td align="center" valign="top" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">51</td><td align="center" rowspan="1" colspan="1">10</td><td align="center" rowspan="1" colspan="1">175.2</td><td align="center" rowspan="1" colspan="1">175.2</td><td align="center" rowspan="1" colspan="1">H</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">29</td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1">3</td><td align="center" valign="top" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">44</td><td align="center" rowspan="1" colspan="1">5</td><td align="center" rowspan="1" colspan="1">171.7</td><td align="center" rowspan="1" colspan="1">171.7</td><td align="center" rowspan="1" colspan="1">H</td><td align="center" rowspan="1" colspan="1">L</td><td align="center" rowspan="1" colspan="1">1+</td><td align="center" rowspan="1" colspan="1">4</td><td align="center" rowspan="1" colspan="1">29</td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1">4</td><td align="center" valign="top" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">71</td><td align="center" rowspan="1" colspan="1">16</td><td align="center" rowspan="1" colspan="1">166.3</td><td align="center" rowspan="1" colspan="1">166.3</td><td align="center" rowspan="1" colspan="1">I</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">29</td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1">5</td><td align="center" valign="top" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">71</td><td align="center" rowspan="1" colspan="1">17</td><td align="center" rowspan="1" colspan="1">156.2</td><td align="center" rowspan="1" colspan="1">156.2</td><td align="center" rowspan="1" colspan="1">H</td><td align="center" rowspan="1" colspan="1">L</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">4</td><td align="center" rowspan="1" colspan="1">24</td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1">6</td><td align="center" valign="top" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">72</td><td align="center" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">158.0</td><td align="center" rowspan="1" colspan="1">158.0</td><td align="center" rowspan="1" colspan="1">I</td><td align="center" rowspan="1" colspan="1">L</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">5</td><td align="center" rowspan="1" colspan="1">25</td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1">7</td><td align="center" valign="top" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">71</td><td align="center" rowspan="1" colspan="1">12</td><td align="center" rowspan="1" colspan="1">163.7</td><td align="center" rowspan="1" colspan="1">163.7</td><td align="center" rowspan="1" colspan="1">H</td><td align="center" rowspan="1" colspan="1">L</td><td align="center" rowspan="1" colspan="1">1+</td><td align="center" rowspan="1" colspan="1">4</td><td align="center" rowspan="1" colspan="1">24</td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1">8</td><td align="center" valign="top" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">63</td><td align="center" rowspan="1" colspan="1">10</td><td align="center" rowspan="1" colspan="1">159.1</td><td align="center" rowspan="1" colspan="1">159.1</td><td align="center" rowspan="1" colspan="1">I</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">26</td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1">9</td><td align="center" valign="top" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">59</td><td align="center" rowspan="1" colspan="1">16</td><td align="center" rowspan="1" colspan="1">155.1</td><td align="center" rowspan="1" colspan="1">155.1</td><td align="center" rowspan="1" colspan="1">H</td><td align="center" rowspan="1" colspan="1">L</td><td align="center" rowspan="1" colspan="1">1+</td><td align="center" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">30</td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1">10</td><td align="center" valign="top" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">58</td><td align="center" rowspan="1" colspan="1">13</td><td align="center" rowspan="1" colspan="1">169.4</td><td align="center" rowspan="1" colspan="1">169.4</td><td align="center" rowspan="1" colspan="1">I</td><td align="center" rowspan="1" colspan="1">L</td><td align="center" rowspan="1" colspan="1">1+</td><td align="center" rowspan="1" colspan="1">4</td><td align="center" rowspan="1" colspan="1">25</td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1">11</td><td align="center" valign="top" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">57</td><td align="center" rowspan="1" colspan="1">11</td><td align="center" rowspan="1" colspan="1">167.9</td><td align="center" rowspan="1" colspan="1">167.9</td><td align="center" rowspan="1" colspan="1">H</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">5</td><td align="center" rowspan="1" colspan="1">24</td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1">12</td><td align="center" valign="top" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">67</td><td align="center" rowspan="1" colspan="1">12</td><td align="center" rowspan="1" colspan="1">154.4</td><td align="center" rowspan="1" colspan="1">154.4</td><td align="center" rowspan="1" colspan="1">H</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">24</td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1">13</td><td align="center" valign="top" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">64</td><td align="center" rowspan="1" colspan="1">13</td><td align="center" rowspan="1" colspan="1">149.5</td><td align="center" rowspan="1" colspan="1">149.5</td><td align="center" rowspan="1" colspan="1">H</td><td align="center" rowspan="1" colspan="1">R</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">4</td><td align="center" rowspan="1" colspan="1">25</td></tr><tr><td colspan="11" rowspan="1"><hr></hr></td></tr><tr><td align="center" valign="top" rowspan="1" colspan="1">M (SD) or numbers</td><td align="center" rowspan="1" colspan="1">(8/5)</td><td align="center" rowspan="1" colspan="1">62.6 ± 8.5</td><td align="center" rowspan="1" colspan="1">11.5 ± 4.0</td><td align="center" rowspan="1" colspan="1">161.6 ± 7.9</td><td align="center" rowspan="1" colspan="1">67.5 ± 9.3</td><td align="center" rowspan="1" colspan="1">(5/8)</td><td align="center" rowspan="1" colspan="1">(7/6)</td><td align="center" rowspan="1" colspan="1">(2/7/4)</td><td align="center" rowspan="1" colspan="1">(6/5/2)</td><td align="center" rowspan="1" colspan="1">26.0 ± 2.3</td></tr></tbody></table><table-wrap-foot><p>Values are expressed as mean (SD) or numbers. H: Hemorrhage, I: Infarction, L: Left, R: Right, MAS: Modified Ashworth Scale, MRC
(shoulder): Medical Research Council scale (Shoulder), MMSE: Mini-Mental State
Examination</p></table-wrap-foot></table-wrap>.</p><p>The 13 subjects were briefed on the experimental procedure, and written consent to
participation in the study was collected from all subjects prior to the experiment. Human
subject ethical approval was obtained from the relevant committee of the Korea National
Rehabilitation Center’s Institutional Review Board (NRC-2012-05-035) prior to conducting the
experiment.</p><p>Feedback training using a non-motorized device was conducted on a test bed. The training
test bed consisted of a projective display device (<xref ref-type="fig" rid="fig_001">Fig.
1-A</xref><fig orientation="portrait" fig-type="figure" id="fig_001" position="float"><label>Fig. 1.</label><caption><p>Screenshot of the
projective display (A), upper extremity assistive device training with visual and
auditory feedback in the test bed (B) and a magnetic motion tracking sensor attached
the handle (B-1)</p></caption><graphic xlink:href="jpts-28-495-g001"></graphic></fig>), a non-motorized device that provided weight support (ReJoyce, Rehabtronics, Inc.,
Edmonton, Alberta, Canada) (<xref ref-type="fig" rid="fig_001">Fig. 1-B</xref>), and loud
speakers. The ReJoyce, a novel spring-loaded arm holding device that simulates activities of
daily life, is an upper extremity rehabilitation device designed for neurological patients
who exhibit impaired function of the arm. The ReJoyce can assist when either weight support
or force is required to complete the task. A 120-inch projective display attached to the
front of the test bed was used to provide suitable visual and auditory feedback to the user.
On the handle of the Rejoyce, a magnetic motion tracking sensor (Patriot™ Wireless, Polhemus
Patriot Wireless, Colchester, VT, USA) was attached to obtain the position information
(<xref ref-type="fig" rid="fig_001">Fig. 1-B</xref>-1). The position information was used
to provide feedback to the subject. Once the training began, red and gray balls appeared on
the projective display, and the subjects performed reaching movements toward targets in a
three-dimensional space in three directions (i.e., targets 1, 2, and 3). The red and gray
balls represented the target and hand point on the screen, respectively. The red ball was
linked with the subject’s upper extremity movements, and auditory feedback was provided when
the red and gray balls matched. One task consisted of two phases: moving toward the target
(approach) and returning from the target (return). While performing the training exercises,
the movement time from the starting point to the target position and from the target
position to the starting point was recorded, and excessive trunk displacement was restricted
by a trunk belt. All subjects participated in the feedback training using the non-motorized
device two times a week for 4 weeks. A single training session was 40 min in duration. Upper
extremity kinematic performance (i.e., movement time) was measured using the movement time
of upper extremity reaching, and it was measured twice: at baseline and post-intervention.
The movement time was defined as the time from the starting point to the target position and
the time from the target position to the starting point. The movement time was recorded
during the reaching movements toward the targets.</p><p>Data analysis was performed using SPSS, version 21.0 (SPSS Inc., Chicago, IL, USA). The
Shapiro-Wilk test was used to confirm the normal distribution of all outcome variables. All
variables (i.e., the movement time in all three directions) were normally distributed;
therefore, paired t-test was used to compare the data between pre-training and after 4 week
of training. All outcomes are expressed as mean values and standard deviations. Statistical
significance was accepted for p < 0.05.</p></sec><sec sec-type="results" id="s3"><title>RESULTS</title><p>A summary of the general characteristics of the 13 subjects who fulfilled the inclusion
criteria is shown in <xref rid="tbl_001" ref-type="table">Table 1</xref>. Changes of upper
extremity kinematic performance were as follows; After 4 weeks of training, a significant
improvement was observed in the upper extremity movement time in all directions (target 1:
from 5.4 ± 2.4 sec to 3.1 ± 1.0 sec, target 2: from 5.0 ± 1.9 sec to 3.2 ± 1.3 sec, and
target 3: from 5.2 ± 2.5 sec to 3.1 ± 1.1 sec; p < 0.05).</p></sec><sec sec-type="discussion" id="s4"><title>DISCUSSION</title><p>This study was conducted to investigate the efficacy of visual and auditory feedback
training using a non-motorized device that provides weight support for upper extremity
kinematic performance of chronic stroke survivors. After 4 weeks of feedback training using
the non-motorized device, improvement in upper extremity kinematic performance was observed
in the chronic stroke survivors.</p><p>Patients with stroke have abnormal movement on the affected side and a compensatory
movement pattern due to abnormal motor function, paresthesia, and spasticity<xref rid="r12" ref-type="bibr">12</xref><sup>)</sup>. In addition, they commonly use
inefficient or ineffective movement patterns due to compensatory movements<xref rid="r6" ref-type="bibr">6</xref>, <xref rid="r13" ref-type="bibr">13</xref><sup>)</sup>.
In particular, an inefficient or ineffective movement pattern does not provide appropriate
feedback<xref rid="r13" ref-type="bibr">13</xref><sup>)</sup>. Therefore, various methods
applying the feedback concept (i.e., intrinsic or extrinsic feedback) have been attempted in
stroke rehabilitation<xref rid="r6" ref-type="bibr">6</xref><sup>)</sup>. Piron et al.<xref rid="r14" ref-type="bibr">14</xref><sup>)</sup> reported that feedback training using
computer displayed virtual reality was useful for chronic stroke patients. In addition, the
effectiveness of robot-mediated therapy on arm functions after stroke was investigated by
Coote et al.<xref rid="r15" ref-type="bibr">15</xref><sup>)</sup>, and they reported that
robot-mediated therapy related to hand-to-mouse movement with visual feedback (visual
feedback was provided on a screen) was helpful for improving upper limb functions after
stroke. According to previous reports<xref rid="r6" ref-type="bibr">6</xref>, <xref rid="r7" ref-type="bibr">7</xref><sup>)</sup>, stroke survivors are able to preserve motor
learning abilities through feedback training. Thus, therapeutic intervention using the
feedback concept can improve the quality of movement through the motor relearning
process<xref rid="r16" ref-type="bibr">16</xref><sup>)</sup>.</p><p>In the present study, subjects were provided with visual and auditory feedback through
interaction between a non-motorized device and the subject’s arm movement. During feedback
training using the non-motorized device, a red ball on the projective display was linked
with the subject’s upper extremity movements, and as an auditory feedback, ding-dong sounds
were played when the red ball (hand point) and gray ball (target position) matched. Sigrist
et al.<xref rid="r7" ref-type="bibr">7</xref><sup>)</sup> reported that a visual and
auditory feedback system can elicit a more efficient motor relearning process. In addition,
visual and auditory feedback stimulus in rehabilitation is effective at increasing
motivation and enjoyment, and decreasing the perception of exertion<xref rid="r17" ref-type="bibr">17</xref><sup>)</sup>. In our study, after 4 weeks of training, improvement in
upper extremity kinematic performance was observed, and we think that visual and auditory
feedback during training acted as a motivating factor which helped to improve the upper
extremity kinematic performance of chronic stroke survivors. Also, even though the device
used in this study had no motorized function, gravity compensation with suitable feedback
provided valuable results. Thus, we think that the non-motorized device with appropriate
feedback has the potential to be applied usefully in stroke rehabilitation.</p><p>In conclusion, the findings of the present study demonstrated the positive effects of
feedback training using a non-motorized device on the upper extremity kinematic performance
of chronic stroke survivors. However, the present study had no control group, and only
movement quality was assessed (i.e., kinematic movement), not the subjects’ clinical
outcomes. Thus, it cannot be determined whether the improvement was the result of the
feedback training with a non-motorized device or participation alone. Further randomized
controlled trials will be conducted to clarify this issue.</p></sec></body><back><ack><p>This study was supported by the Research Program (NRCRI13-A-04, NRCTR-IN13004,
NRCTR-IN14006, and NRCTR-IN15005) of the Korea National Rehabilitation Center, Ministry of
Health and Welfare, Korea. We thank Mr. Ji Young Jeong, Ms. Yale Kim, Dr. Jung Yoon Kim, Dr.
Joon-Ho Shin, Dr. Dae-Sung Park, Mr. Jun-Yong Song, Mr. Soon-Joon Jeong, Ms. Hwi-Young Lee,
Mr. Byung-Woo Ko, Dr. Jongbae Kim, Dr. Dong-Ah Kim, and Dr. Hyun Choi for their assistance
and comments.</p></ack><ref-list><title>REFERENCES</title><ref id="r1"><label>1</label><mixed-citation publication-type="journal"><person-group><name><surname>Yoo</surname><given-names>DH</given-names></name><name><surname>Cha</surname><given-names>YJ</given-names></name><name><surname>Kim</surname><given-names>SK</given-names></name><etal>et al.</etal></person-group>: <article-title>Effect of three-dimensional robot-assisted therapy on
upper limb function of patients with stroke</article-title>. <source>J Phys Ther
Sci</source>, <year>2013</year>, <volume>25</volume>:
<fpage>407</fpage>–<lpage>409</lpage>. </mixed-citation></ref><ref id="r2"><label>2</label><mixed-citation publication-type="journal"><person-group><name><surname>Yoo</surname><given-names>DH</given-names></name><name><surname>Kim</surname><given-names>SY</given-names></name></person-group>: <article-title>Effects of upper limb robot-assisted therapy in the
rehabilitation of stroke patients</article-title>. <source>J Phys Ther Sci</source>,
<year>2015</year>, <volume>27</volume>: <fpage>677</fpage>–<lpage>679</lpage>.
<pub-id pub-id-type="pmid">25931706</pub-id></mixed-citation></ref><ref id="r3"><label>3</label><mixed-citation publication-type="journal"><person-group><name><surname>Babaiasl</surname><given-names>M</given-names></name><name><surname>Mahdioun</surname><given-names>SH</given-names></name><name><surname>Jaryani</surname><given-names>P</given-names></name><etal>et al.</etal></person-group>: <article-title>A review of technological and clinical aspects of
robot-aided rehabilitation of upper-extremity after stroke</article-title>.
<source>Disabil Rehabil Assist Technol</source>, <year>2015</year>,
<fpage>1</fpage>–<lpage>18</lpage>. <pub-id pub-id-type="pmid">25600057</pub-id></mixed-citation></ref><ref id="r4"><label>4</label><mixed-citation publication-type="journal"><person-group><name><surname>Kwakkel</surname><given-names>G</given-names></name><name><surname>Kollen</surname><given-names>BJ</given-names></name><name><surname>Krebs</surname><given-names>HI</given-names></name></person-group>: <article-title>Effects of robot-assisted therapy on upper limb recovery
after stroke: a systematic review</article-title>. <source>Neurorehabil Neural
Repair</source>, <year>2008</year>, <volume>22</volume>:
<fpage>111</fpage>–<lpage>121</lpage>. <pub-id pub-id-type="pmid">17876068</pub-id></mixed-citation></ref><ref id="r5"><label>5</label><mixed-citation publication-type="journal"><person-group><name><surname>Silvoni</surname><given-names>S</given-names></name><name><surname>Ramos-Murguialday</surname><given-names>A</given-names></name><name><surname>Cavinato</surname><given-names>M</given-names></name><etal>et al.</etal></person-group>: <article-title>Brain-computer interface in stroke: a review of
progress</article-title>. <source>Clin EEG Neurosci</source>, <year>2011</year>,
<volume>42</volume>: <fpage>245</fpage>–<lpage>252</lpage>. <pub-id pub-id-type="pmid">22208122</pub-id></mixed-citation></ref><ref id="r6"><label>6</label><mixed-citation publication-type="journal"><person-group><name><surname>Subramanian</surname><given-names>SK</given-names></name><name><surname>Massie</surname><given-names>CL</given-names></name><name><surname>Malcolm</surname><given-names>MP</given-names></name><etal>et al.</etal></person-group>: <article-title>Does provision of extrinsic feedback result in improved
motor learning in the upper limb poststroke? A systematic review of the
evidence</article-title>. <source>Neurorehabil Neural Repair</source>,
<year>2010</year>, <volume>24</volume>: <fpage>113</fpage>–<lpage>124</lpage>.
<pub-id pub-id-type="pmid">19861591</pub-id></mixed-citation></ref><ref id="r7"><label>7</label><mixed-citation publication-type="journal"><person-group><name><surname>Sigrist</surname><given-names>R</given-names></name><name><surname>Rauter</surname><given-names>G</given-names></name><name><surname>Riener</surname><given-names>R</given-names></name><etal>et al.</etal></person-group>: <article-title>Augmented visual, auditory, haptic, and multimodal
feedback in motor learning: a review</article-title>. <source>Psychon Bull Rev</source>,
<year>2013</year>, <volume>20</volume>: <fpage>21</fpage>–<lpage>53</lpage>.
<pub-id pub-id-type="pmid">23132605</pub-id></mixed-citation></ref><ref id="r8"><label>8</label><mixed-citation publication-type="journal"><person-group><name><surname>Mehrholz</surname><given-names>J</given-names></name><name><surname>Hädrich</surname><given-names>A</given-names></name><name><surname>Platz</surname><given-names>T</given-names></name><etal>et al.</etal></person-group>: <article-title>Electromechanical and robot-assisted arm training for
improving generic activities of daily living, arm function, and arm muscle strength
after stroke</article-title>. <source>Cochrane Database Syst Rev</source>,
<year>2012</year>, <volume>6</volume>: <fpage>CD006876</fpage>. <pub-id pub-id-type="pmid">22696362</pub-id></mixed-citation></ref><ref id="r9"><label>9</label><mixed-citation publication-type="journal"><person-group><name><surname>Burgar</surname><given-names>CG</given-names></name><name><surname>Lum</surname><given-names>PS</given-names></name><name><surname>Scremin</surname><given-names>AM</given-names></name><etal>et al.</etal></person-group>: <article-title>Robot-assisted upper-limb therapy in acute rehabilitation
setting following stroke: Department of Veterans Affairs multisite clinical
trial</article-title>. <source>J Rehabil Res Dev</source>, <year>2011</year>,
<volume>48</volume>: <fpage>445</fpage>–<lpage>458</lpage>. <pub-id pub-id-type="pmid">21674393</pub-id></mixed-citation></ref><ref id="r10"><label>10</label><mixed-citation publication-type="journal"><person-group><name><surname>Masiero</surname><given-names>S</given-names></name><name><surname>Armani</surname><given-names>M</given-names></name><name><surname>Rosati</surname><given-names>G</given-names></name></person-group>: <article-title>Upper-limb robot-assisted therapy in rehabilitation of
acute stroke patients: focused review and results of new randomized controlled
trial</article-title>. <source>J Rehabil Res Dev</source>, <year>2011</year>,
<volume>48</volume>: <fpage>355</fpage>–<lpage>366</lpage>. <pub-id pub-id-type="pmid">21674388</pub-id></mixed-citation></ref><ref id="r11"><label>11</label><mixed-citation publication-type="journal"><person-group><name><surname>Frisoli</surname><given-names>A</given-names></name><name><surname>Procopio</surname><given-names>C</given-names></name><name><surname>Chisari</surname><given-names>C</given-names></name><etal>et al.</etal></person-group>: <article-title>Positive effects of robotic exoskeleton training of upper
limb reaching movements after stroke</article-title>. <source>J Neuroeng
Rehabil</source>, <year>2012</year>, <volume>9</volume>: <fpage>36</fpage>.
<pub-id pub-id-type="pmid">22681653</pub-id></mixed-citation></ref><ref id="r12"><label>12</label><mixed-citation publication-type="journal"><person-group><name><surname>Morris</surname><given-names>DM</given-names></name><name><surname>Crago</surname><given-names>JE</given-names></name><name><surname>Deluca</surname><given-names>SC</given-names></name><etal>et al.</etal></person-group>: <article-title>Constraint-induced movement therapy for moter recovery
after stroke</article-title>. <source>NeuroRehabilitation</source>, <year>1997</year>,
<volume>9</volume>: <fpage>29</fpage>–<lpage>43</lpage>. <pub-id pub-id-type="pmid">24526089</pub-id></mixed-citation></ref><ref id="r13"><label>13</label><mixed-citation publication-type="journal"><person-group><name><surname>Michaelsen</surname><given-names>SM</given-names></name><name><surname>Dannenbaum</surname><given-names>R</given-names></name><name><surname>Levin</surname><given-names>MF</given-names></name></person-group>: <article-title>Task-specific training with trunk restraint on arm
recovery in stroke: randomized control trial</article-title>. <source>Stroke</source>,
<year>2006</year>, <volume>37</volume>: <fpage>186</fpage>–<lpage>192</lpage>.
<pub-id pub-id-type="pmid">16339469</pub-id></mixed-citation></ref><ref id="r14"><label>14</label><mixed-citation publication-type="journal"><person-group><name><surname>Piron</surname><given-names>L</given-names></name><name><surname>Tonin</surname><given-names>P</given-names></name><name><surname>Piccione</surname><given-names>F</given-names></name><etal>et al.</etal></person-group>: <article-title>Virtual environment training therapy for arm motor
rehabilitation</article-title>. <source>Presence (Camb Mass)</source>,
<year>2005</year>, <volume>14</volume>:
<fpage>732</fpage>–<lpage>740</lpage>.</mixed-citation></ref><ref id="r15"><label>15</label><mixed-citation publication-type="journal"><person-group><name><surname>Coote</surname><given-names>S</given-names></name><name><surname>Murphy</surname><given-names>B</given-names></name><name><surname>Harwin</surname><given-names>W</given-names></name><etal>et al.</etal></person-group>: <article-title>The effect of the GENTLE/s robot-mediated therapy system
on arm function after stroke</article-title>. <source>Clin Rehabil</source>,
<year>2008</year>, <volume>22</volume>: <fpage>395</fpage>–<lpage>405</lpage>.
<pub-id pub-id-type="pmid">18441036</pub-id></mixed-citation></ref><ref id="r16"><label>16</label><mixed-citation publication-type="book"><person-group><name><surname>Magill</surname><given-names>RA</given-names></name><name><surname>Anderson</surname><given-names>D</given-names></name></person-group>: Motor learning and control: Concepts and applications. New York:
McGraw-Hill, <year>2007</year>.</mixed-citation></ref><ref id="r17"><label>17</label><mixed-citation publication-type="journal"><person-group><name><surname>Kleim</surname><given-names>JA</given-names></name><name><surname>Jones</surname><given-names>TA</given-names></name></person-group>: <article-title>Principles of experience-dependent neural plasticity:
implications for rehabilitation after brain damage</article-title>. <source>J Speech
Lang Hear Res</source>, <year>2008</year>, <volume>51</volume>:
<fpage>S225</fpage>–<lpage>S239</lpage>. <pub-id pub-id-type="pmid">18230848</pub-id></mixed-citation></ref></ref-list></back></pmc><affiliations><list></list><tree><noCountry><name sortKey="Cho, Ki Hun" sort="Cho, Ki Hun" uniqKey="Cho K" first="Ki Hun" last="Cho">Ki Hun Cho</name><name sortKey="Song, Won Kyung" sort="Song, Won Kyung" uniqKey="Song W" first="Won-Kyung" last="Song">Won-Kyung Song</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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