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Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke

BACKGROUND: Virtual and mixed reality systems have been suggested to promote motor recovery after stroke. Basing on the existing evidence on motor learning, we have developed a portable and low-cost mixed reality tabletop system that transforms a conventional table in a virtual environment for upper...

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Autores principales: Colomer, Carolina, Llorens, Roberto, Noé, Enrique, Alcañiz, Mariano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864937/
https://www.ncbi.nlm.nih.gov/pubmed/27169462
http://dx.doi.org/10.1186/s12984-016-0153-6
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author Colomer, Carolina
Llorens, Roberto
Noé, Enrique
Alcañiz, Mariano
author_facet Colomer, Carolina
Llorens, Roberto
Noé, Enrique
Alcañiz, Mariano
author_sort Colomer, Carolina
collection PubMed
description BACKGROUND: Virtual and mixed reality systems have been suggested to promote motor recovery after stroke. Basing on the existing evidence on motor learning, we have developed a portable and low-cost mixed reality tabletop system that transforms a conventional table in a virtual environment for upper limb rehabilitation. The system allows intensive and customized training of a wide range of arm, hand, and finger movements and enables interaction with tangible objects, while providing audiovisual feedback of the participants’ performance in gamified tasks. This study evaluates the clinical effectiveness and the acceptance of an experimental intervention with the system in chronic stroke survivors. METHODS: Thirty individuals with stroke were included in a reversal (A-B-A) study. Phase A consisted of 30 sessions of conventional physical therapy. Phase B consisted of 30 training sessions with the experimental system. Both interventions involved flexion and extension of the elbow, wrist, and fingers, and grasping of different objects. Sessions were 45-min long and were administered three to five days a week. The body structures (Modified Ashworth Scale), functions (Motricity Index, Fugl-Meyer Assessment Scale), activities (Manual Function Test, Wolf Motor Function Test, Box and Blocks Test, Nine Hole Peg Test), and participation (Motor Activity Log) were assessed before and after each phase. Acceptance of the system was also assessed after phase B (System Usability Scale, Intrinsic Motivation Inventory). RESULTS: Significant improvement was detected after the intervention with the system in the activity, both in arm function measured by the Wolf Motor Function Test (p < 0.01) and finger dexterity measured by the Box and Blocks Test (p < 0.01) and the Nine Hole Peg Test (p < 0.01); and participation (p < 0.01), which was maintained to the end of the study. The experimental system was reported as highly usable, enjoyable, and motivating. CONCLUSIONS: Our results support the clinical effectiveness of mixed reality interventions that satisfy the motor learning principles for upper limb rehabilitation in chronic stroke survivors. This characteristic, together with the low cost of the system, its portability, and its acceptance could promote the integration of these systems in the clinical practice as an alternative to more expensive systems, such as robotic instruments. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12984-016-0153-6) contains supplementary material, which is available to authorized users.
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spelling pubmed-48649372016-05-13 Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke Colomer, Carolina Llorens, Roberto Noé, Enrique Alcañiz, Mariano J Neuroeng Rehabil Research BACKGROUND: Virtual and mixed reality systems have been suggested to promote motor recovery after stroke. Basing on the existing evidence on motor learning, we have developed a portable and low-cost mixed reality tabletop system that transforms a conventional table in a virtual environment for upper limb rehabilitation. The system allows intensive and customized training of a wide range of arm, hand, and finger movements and enables interaction with tangible objects, while providing audiovisual feedback of the participants’ performance in gamified tasks. This study evaluates the clinical effectiveness and the acceptance of an experimental intervention with the system in chronic stroke survivors. METHODS: Thirty individuals with stroke were included in a reversal (A-B-A) study. Phase A consisted of 30 sessions of conventional physical therapy. Phase B consisted of 30 training sessions with the experimental system. Both interventions involved flexion and extension of the elbow, wrist, and fingers, and grasping of different objects. Sessions were 45-min long and were administered three to five days a week. The body structures (Modified Ashworth Scale), functions (Motricity Index, Fugl-Meyer Assessment Scale), activities (Manual Function Test, Wolf Motor Function Test, Box and Blocks Test, Nine Hole Peg Test), and participation (Motor Activity Log) were assessed before and after each phase. Acceptance of the system was also assessed after phase B (System Usability Scale, Intrinsic Motivation Inventory). RESULTS: Significant improvement was detected after the intervention with the system in the activity, both in arm function measured by the Wolf Motor Function Test (p < 0.01) and finger dexterity measured by the Box and Blocks Test (p < 0.01) and the Nine Hole Peg Test (p < 0.01); and participation (p < 0.01), which was maintained to the end of the study. The experimental system was reported as highly usable, enjoyable, and motivating. CONCLUSIONS: Our results support the clinical effectiveness of mixed reality interventions that satisfy the motor learning principles for upper limb rehabilitation in chronic stroke survivors. This characteristic, together with the low cost of the system, its portability, and its acceptance could promote the integration of these systems in the clinical practice as an alternative to more expensive systems, such as robotic instruments. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12984-016-0153-6) contains supplementary material, which is available to authorized users. BioMed Central 2016-05-11 /pmc/articles/PMC4864937/ /pubmed/27169462 http://dx.doi.org/10.1186/s12984-016-0153-6 Text en © Colomer et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Colomer, Carolina
Llorens, Roberto
Noé, Enrique
Alcañiz, Mariano
Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke
title Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke
title_full Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke
title_fullStr Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke
title_full_unstemmed Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke
title_short Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke
title_sort effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864937/
https://www.ncbi.nlm.nih.gov/pubmed/27169462
http://dx.doi.org/10.1186/s12984-016-0153-6
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