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- Björkdahl, Ann, 1959, et al.
(författare)
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Can rehabilitation in the home setting reduce the burden of care for the next-of-kin of stroke victims?
- 2007
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Ingår i: J Rehabil Med. - : Medical Journals Sweden AB. ; 39:1, s. 27-32
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: More evidence of the efficacy of caregiver interventions is needed. The aim of this study was to evaluate whether counselling in the home setting reduces the caregiver burden. METHODS: Thirty-six patients after stroke, median age 53 years, with a close family member, were selected for an evaluation of the burden of care and 35 participated. They were part of a randomized controlled trial, comparing rehabilitation in the home setting with outpatient rehabilitation. In the home setting, counselling about the stroke and its consequences was included. Assessments with the Caregiver Burden scale were made at 3 weeks, 3 months and one year after discharge. RESULTS: The burden of the 2 groups did not differ. After the intervention, there was a tendency to a lower burden for the home setting. The burden for the home setting was then unchanged from 3 weeks to 1 year, while outpatient rehabilitation showed a reduced burden over time. For the home setting, significant correlations to activity level were seen after the intervention. CONCLUSION: A positive effect of counselling was seen, as the home setting burden tends to be lower after the intervention, while outpatient rehabilitation seems to adjust with time. The results suggest that counselling reduces burden and the remaining burden is associated with the patient's ability.
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- Broeren, Jurgen, et al.
(författare)
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A kinematic analysis of a haptic handheld stylus in a virtual environment: a study in healthy subjects
- 2007
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Ingår i: J Neuroengineering Rehabil. - : Springer Science and Business Media LLC. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Virtual Reality provides new options for conducting motor assessment and training within computer-generated 3 dimensional environments. To date very little has been reported about normal performance in virtual environments. The objective of this study was to evaluate the test-retest reliability of a clinical procedure measuring trajectories with a haptic handheld stylus in a virtual environment and to establish normative data in healthy subjects using this haptic device. METHODS: Fifty-eight normal subjects; aged from 20 to 69, performed 3 dimensional hand movements in a virtual environment using a haptic device on three occasions within one week. Test-retest stability and standardized normative data were obtained for all subjects. RESULTS: No difference was found between test and retest. The limits of agreement revealed that changes in an individual's performance could not be detected. There was a training effect between the first test occasion and the third test occasion. Normative data are presented. CONCLUSION: A new test was developed for recording the kinematics of the handheld haptic stylus in a virtual environment. The normative data will be used for purposes of comparison in future assessments, such as before and after training of persons with neurological deficits.
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| 5. |
- Broeren, Jurgen, et al.
(författare)
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Assessment and training in a 3-dimensional virtual environment with haptics: a report on 5 cases of motor rehabilitation in the chronic stage after stroke.
- 2007
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Ingår i: Neurorehabilitation and Neural Repair. - : SAGE Publications. - 1545-9683 .- 1552-6844. ; 21:2, s. 180-189
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Tidskriftsartikel (refereegranskat)abstract
- Objective. This exploratory study assessed the possible effectiveness of hemiparetic upper extremity training in subjects with chronic stroke with computer instrumentation (haptic force feedback) and 3-dimensional visualization applied to computer games, as well as to evaluate concurrent computer-assisted assessment of the kinematics of movements and test whether any improvement detected in the computer environment was reflected in activities of daily living (ADLs). Methods. A single-subject repeated-measures experimental design (AB) was used. After baseline testing, 5 patients were assigned to the therapy 3 times a week for 45 min for 5 weeks. Velocity, time needed to reach, and hand path ratio (reflecting superfluous movements) were the outcome measures, along with the Assessment of Motor and Process Skills and the Box and Block test. The follow-up phase (C) occurred 12 weeks later. Results. Improvements were noted in velocity, time, and hand path ratio. One patient showed improvement in occupational performance in ADLs. Conclusions.The application of this strategy of using virtual reality (VR) technologies may be useful in assessing and training stroke patients. The results of this study must be reproduced in further studies. The VR systems can be placed in homes or other nonclinical settings.
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- Broeren, Jurgen, et al.
(författare)
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Neglect assessment as an application of virtual reality.
- 2007
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 116:3, s. 157-63
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: In this study a cancellation task in a virtual environment was applied to describe the pattern of search and the kinematics of hand movements in eight patients with right hemisphere stroke. METHODS: Four of these patients had visual neglect and four had recovered clinically from initial symptoms of neglect. The performance of the patients was compared with that of a control group consisting of eight subjects with no history of neurological deficits. RESULTS: Patients with neglect as well as patients clinically recovered from neglect showed aberrant search performance in the virtual reality (VR) task, such as mixed search pattern, repeated target pressures and deviating hand movements. The results indicate that in patients with a right hemispheric stroke, this VR application can provide an additional tool for assessment that can identify small variations otherwise not detectable with standard paper-and-pencil tests. CONCLUSION: VR technology seems to be well suited for the assessment of visually guided manual exploration in space.
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- Danielsson, Anna, 1957, et al.
(författare)
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Measurement of energy cost by the physiological cost index in walking after stroke.
- 2007
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Ingår i: Archives of physical medicine and rehabilitation. - : Elsevier BV. - 0003-9993. ; 88:10, s. 1298-303
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the Physiological Cost Index (PCI) with direct measurement of oxygen consumption (Vo(2)) as an estimate of energy cost in persons with stroke and healthy subjects. DESIGN: Test-retest on separate days. A comparison of 2 methods of measurement. Measurements with and without an orthosis. SETTING: A university hospital. PARTICIPANTS: A convenience sample of 20 persons with hemiparesis more than 6 months after stroke and 16 healthy subjects, ages 30 to 63 years. INTERVENTIONS: Five minutes of treadmill walking at self-selected speeds while recording Vo(2) levels and heart rates. Additional data was recorded for 11 of the stroke subjects with and without an ankle-foot orthosis. MAIN OUTCOME MEASURES: Vo(2) and the PCI. RESULTS: No significant differences were found in the PCI or Vo(2) between test and retest. Both PCI and Vo(2) per distance were higher for the stroke subjects compared with healthy subjects. PCI showed a larger dispersion than Vo(2) between test and retest. The regression analysis for PCI showed that the model including age, sex, group assignment, and Vo(2) could explain 53% of the variation. The PCI did not show a significant difference in walking with or without an orthosis, whereas Vo(2) differed significantly. CONCLUSIONS: The PCI showed limited reliability and validity as a measure of energy cost after stroke due to the extensive variability between test and retest.
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