Robot-supported upper limb training in a virtual learning environment : a pilot randomized controlled trial in persons with MS
Identifieur interne : 000609 ( Main/Exploration ); précédent : 000608; suivant : 000610Robot-supported upper limb training in a virtual learning environment : a pilot randomized controlled trial in persons with MS
Auteurs : Peter Feys [Belgique] ; Karin Coninx [Belgique] ; Lore Kerkhofs [Belgique] ; Tom De Weyer [Belgique] ; Veronik Truyens [Belgique] ; Anneleen Maris [Belgique] ; Ilse Lamers [Belgique]Source :
- Journal of NeuroEngineering and Rehabilitation [ 1743-0003 ] ; 2015.
Abstract
Despite the functional impact of upper limb dysfunction in multiple sclerosis (MS), effects of intensive exercise programs and specifically robot-supported training have been rarely investigated in persons with advanced MS.
To investigate the effects of additional robot-supported upper limb training in persons with MS compared to conventional treatment only.
Seventeen persons with MS (pwMS) (median Expanded Disability Status Scale of 8, range 3.5–8.5) were included in a pilot RCT comparing the effects of additional robot-supported training to conventional treatment only. Additional training consisted of 3 weekly sessions of 30 min interacting with the HapticMaster robot within an individualised virtual learning environment (I-TRAVLE). Clinical measures at body function (Hand grip strength, Motricity Index, Fugl-Meyer) and activity (Action Research Arm test, Motor Activity Log) level were administered before and after an intervention period of 8 weeks. The intervention group were also evaluated on robot-mediated movement tasks in three dimensions, providing active range of motion, movement duration and speed and hand-path ratio as indication of movement efficiency in the spatial domain. Non-parametric statistics were applied.
PwMS commented favourably on the robot-supported virtual learning environment and reported functional training effects in daily life. Movement tasks in three dimensions, measured with the robot, were performed in less time and for the transporting and reaching movement tasks more efficiently. There were however no significant changes for any clinical measure in neither intervention nor control group although observational analyses of the included cases indicated large improvements on the Fugl-Meyer in persons with more marked upper limb dysfunction.
Robot-supported training lead to more efficient movement execution which was however, on group level, not reflected by significant changes on standard clinical tests. Persons with more marked upper limb dysfunction may benefit most from additional robot-supported training, but larger studies are needed.
This trial is registered within the registry Clinical Trials GOV (
Url:
DOI: 10.1186/s12984-015-0043-3
PubMed: 26202325
PubMed Central: 4511982
Affiliations:
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tUL – iMinds, Hasselt University, Wetenschapspark 2, 3590 Diepenbeek, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Expertise Centre for Digital Media - tUL – iMinds, Hasselt University, Wetenschapspark 2, 3590 Diepenbeek</wicri:regionArea><wicri:noRegion>3590 Diepenbeek</wicri:noRegion></affiliation></author><author><name sortKey="Kerkhofs, Lore" sort="Kerkhofs, Lore" uniqKey="Kerkhofs L" first="Lore" last="Kerkhofs">Lore Kerkhofs</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Rehabilitation and MS Center Overpelt, 3900 Overpelt, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Rehabilitation and MS Center Overpelt, 3900 Overpelt</wicri:regionArea><wicri:noRegion>3900 Overpelt</wicri:noRegion></affiliation></author><author><name sortKey="De Weyer, Tom" sort="De Weyer, Tom" uniqKey="De Weyer T" first="Tom" last="De Weyer">Tom De Weyer</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Expertise Centre for Digital Media - 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tUL – iMinds, Hasselt University, Wetenschapspark 2, 3590 Diepenbeek, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Expertise Centre for Digital Media - tUL – iMinds, Hasselt University, Wetenschapspark 2, 3590 Diepenbeek</wicri:regionArea><wicri:noRegion>3590 Diepenbeek</wicri:noRegion></affiliation></author><author><name sortKey="Kerkhofs, Lore" sort="Kerkhofs, Lore" uniqKey="Kerkhofs L" first="Lore" last="Kerkhofs">Lore Kerkhofs</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Rehabilitation and MS Center Overpelt, 3900 Overpelt, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Rehabilitation and MS Center Overpelt, 3900 Overpelt</wicri:regionArea><wicri:noRegion>3900 Overpelt</wicri:noRegion></affiliation></author><author><name sortKey="De Weyer, Tom" sort="De Weyer, Tom" uniqKey="De Weyer T" first="Tom" last="De Weyer">Tom De Weyer</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Expertise Centre for Digital Media - tUL – iMinds, Hasselt University, Wetenschapspark 2, 3590 Diepenbeek, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Expertise Centre for Digital Media - tUL – iMinds, Hasselt University, Wetenschapspark 2, 3590 Diepenbeek</wicri:regionArea><wicri:noRegion>3590 Diepenbeek</wicri:noRegion></affiliation></author><author><name sortKey="Truyens, Veronik" sort="Truyens, Veronik" uniqKey="Truyens V" first="Veronik" last="Truyens">Veronik Truyens</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Rehabilitation and MS Center Overpelt, 3900 Overpelt, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Rehabilitation and MS Center Overpelt, 3900 Overpelt</wicri:regionArea><wicri:noRegion>3900 Overpelt</wicri:noRegion></affiliation></author><author><name sortKey="Maris, Anneleen" sort="Maris, Anneleen" uniqKey="Maris A" first="Anneleen" last="Maris">Anneleen Maris</name><affiliation wicri:level="1"><nlm:aff id="Aff1">REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3590 Diepenbeek, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3590 Diepenbeek</wicri:regionArea><wicri:noRegion>3590 Diepenbeek</wicri:noRegion></affiliation></author><author><name sortKey="Lamers, Ilse" sort="Lamers, Ilse" uniqKey="Lamers I" first="Ilse" last="Lamers">Ilse Lamers</name><affiliation wicri:level="1"><nlm:aff id="Aff1">REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3590 Diepenbeek, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3590 Diepenbeek</wicri:regionArea><wicri:noRegion>3590 Diepenbeek</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of NeuroEngineering and Rehabilitation</title><idno type="eISSN">1743-0003</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Despite the functional impact of upper limb dysfunction in multiple sclerosis (MS), effects of intensive exercise programs and specifically robot-supported training have been rarely investigated in persons with advanced MS.</p></sec><sec><title>Aim</title><p>To investigate the effects of additional robot-supported upper limb training in persons with MS compared to conventional treatment only.</p></sec><sec><title>Methods</title><p>Seventeen persons with MS (pwMS) (median Expanded Disability Status Scale of 8, range 3.5–8.5) were included in a pilot RCT comparing the effects of additional robot-supported training to conventional treatment only. Additional training consisted of 3 weekly sessions of 30 min interacting with the HapticMaster robot within an individualised virtual learning environment (I-TRAVLE). Clinical measures at body function (Hand grip strength, Motricity Index, Fugl-Meyer) and activity (Action Research Arm test, Motor Activity Log) level were administered before and after an intervention period of 8 weeks. The intervention group were also evaluated on robot-mediated movement tasks in three dimensions, providing active range of motion, movement duration and speed and hand-path ratio as indication of movement efficiency in the spatial domain. Non-parametric statistics were applied.</p></sec><sec><title>Results</title><p>PwMS commented favourably on the robot-supported virtual learning environment and reported functional training effects in daily life. Movement tasks in three dimensions, measured with the robot, were performed in less time and for the transporting and reaching movement tasks more efficiently. There were however no significant changes for any clinical measure in neither intervention nor control group although observational analyses of the included cases indicated large improvements on the Fugl-Meyer in persons with more marked upper limb dysfunction.</p></sec><sec><title>Conclusion</title><p>Robot-supported training lead to more efficient movement execution which was however, on group level, not reflected by significant changes on standard clinical tests. Persons with more marked upper limb dysfunction may benefit most from additional robot-supported training, but larger studies are needed.</p></sec><sec><title>Trial registration</title><p>This trial is registered within the registry Clinical Trials GOV (<ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/NCT02257606">NCT02257606</ext-link>).</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Motl, Rw" uniqKey="Motl R">RW Motl</name></author><author><name sortKey="Mcauley, E" uniqKey="Mcauley E">E McAuley</name></author><author><name sortKey="Snook, Em" uniqKey="Snook E">EM Snook</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stuifbergen, Ak" uniqKey="Stuifbergen A">AK Stuifbergen</name></author><author><name sortKey="Blozis, Sa" uniqKey="Blozis S">SA Blozis</name></author><author><name sortKey="Harrison, Tc" uniqKey="Harrison T">TC 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Robertson</name></author><author><name sortKey="Medee, B" uniqKey="Medee B">B Medee</name></author><author><name sortKey="Remy Neris, O" uniqKey="Remy Neris O">O Remy-Neris</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Belgique</li></country></list><tree><country name="Belgique"><noRegion><name sortKey="Feys, Peter" sort="Feys, Peter" uniqKey="Feys P" first="Peter" last="Feys">Peter Feys</name></noRegion><name sortKey="Coninx, Karin" sort="Coninx, Karin" uniqKey="Coninx K" first="Karin" last="Coninx">Karin Coninx</name><name sortKey="De Weyer, Tom" sort="De Weyer, Tom" uniqKey="De Weyer T" first="Tom" last="De Weyer">Tom De Weyer</name><name sortKey="Kerkhofs, Lore" sort="Kerkhofs, Lore" uniqKey="Kerkhofs L" first="Lore" last="Kerkhofs">Lore Kerkhofs</name><name sortKey="Lamers, Ilse" sort="Lamers, Ilse" uniqKey="Lamers I" first="Ilse" last="Lamers">Ilse Lamers</name><name sortKey="Maris, Anneleen" sort="Maris, Anneleen" uniqKey="Maris A" first="Anneleen" last="Maris">Anneleen Maris</name><name sortKey="Truyens, Veronik" sort="Truyens, Veronik" uniqKey="Truyens V" first="Veronik" last="Truyens">Veronik Truyens</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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