April 21, 2010
Web-Based Hand, Arm, Shoulder Rehabilitation - Literature Review
A new study was published recently in the American Journal of Occupational Therapy detailing the results of a very small study involving a single post-stroke subject for one week of telerehabilitation. You can find more information here.
One may argue that such a study is anecdotal at best, and that a broader study is required to substantiate its claims.
Fortunately, there’s a long history of much more convincing scientific studies involving at-home rehabilitation of people with stroke and other neurological injuries like SCI. Such studies have generally shown positive results, which is why the results of the above study are not too surprising. I’ve provided links to abstracts and quick summaries of a few highlights below:
Efficacy of telemedicine in occupational therapy: a pilot study (2001) - The authors conclude that select occupational therapy evaluation data can be accurately transmitted and properly scored using low-bandwidth telemedicine systems.
Web-based telerehabilitation for the upper extremity after stroke (2002) - A description of a telerehabilitation system for stroke rehabilitation.
An Evaluation Framework for a Rural Home-Based Telerehabilitation Network (2005) - A survey of 43 professionals agreed that there are unmet needs among elderly people who are discharged from hospital settings.
Development of a teletechnology protocol for in-home rehabilitation (2006) - The authors’ results showed promise that both the telerehabilitation technology and intervention procedures were feasible in an elderly population.
A telerehabilitation approach to delivery of constraint-induced movement therapy (2006) - The authors reported large improvements in hand and arm function of post-stroke subjects. The gains were the same under both direct and remote supervision of a therapist.
Telerehabilitation using the Rutgers Master II glove following carpal tunnel release surgery: proof-of-concept (2007) - Dramatic improvements were achieved using the Rutgers Masters II haptic glove. All patients would either very strongly, or strongly recommend similar at-home therapy to others.
Telerehabilitation Using a Virtual Environment Improves Upper Extremity Function in Patients With Stroke (2007) -Home-based rehabilitation of 11 stroke subjects resulted in improvements of hand and arm function that were maintained at the time of a four month post-intervention evaluation.
Telerehabilitation is an exciting new field that holds the promise of providing cost-effective, high quality care to people facing a wide range of medical issues. For information about our telerehabilitation services, visit our stroke and SCI home rehabilitation page.
April 20, 2010
Stroke Rehabilitation with Robots
Researchers in the United States have found that robotic therapy can help stroke victims regain arm movement even years after their brain injuries. The study will be published in the online edition of the New England Journal of Medicine on Friday, April 23, 2010.
The study, a three-year randomized control trial (RCT) of 127 veterans in the U.S, found that stroke victims who had 12 weeks of robot-assisted therapy for their affected arm had an improved quality of life compared with those who had no additional therapy beyond the initial post-injury rehabilitation period. These findings go against conventional thinking that rehabilitation beyond the initial period had little benefit for stroke survivors.
Patients with moderate to severe disability in arm function resulting from stroke at least 6 months to five years earlier were included. After 6 months of therapy, the 49 patients in the robotic treatment group demonstrated clinically significant upper-arm function compared with the 28 patients who did not receive specific therapy for their upper limb.
Importantly, another 50 patients in the study did similar high-intensity exercises with the assistance of a therapist rather than a robot and demonstrated similar improvements.
Dr. Howard Kirshner, a professor and vice-chair in neurology at Vanderbilt Medical Center North in Nashville, commented to CBC:
“The most important take-away message for stroke survivors is that therapy, whether using new-fangled technologies, or using intensive standard therapy by trained therapists, is essential for optimal recovery of function after a stroke.”
CBC News
The study used the MIT Manus rehabilitation robot, developed at MIT, and commercialized by Interactive-Motion Technologies.
The findings are similar to those of another recent publication concerning the same device.
Here’s a video of the robot:
April 14, 2010
ReJoyce at GF Strong in Vancouver
ReJoyce was recently on display at the GF Strong Rehabilitation Institute in Vancouver. Below are some pictures of Jennifer Loffree demonstrating ReJoyce to a crowd of Canadian Federal and Provincial politicians, including British Columbia’s Lieutenant Governor.
ReJoyce At GF Strong in Vancouver | Spinal Cord Injury Rehabilitation
ReJoyce is centerpiece of an ongoing spinal cord injury rehabilitation study in Vancouver. The study is investigating the rehabilitation efficacy of ReJoyce in combination with a hand stimulation system for people who have suffered a spinal cord injury. Subjects are treated at home, using our at-home rehabilitation software.
For information about ReJoyce, ongoing clinical trials, or anything else relating to home-based stroke and spinal cord injury rehabilitation, please contact us.
March 30, 2010
Improved Hand Function in Cerebral Palsy
A Rutgers-based study, recently published in the IEEE Transactions on Information Technology in Biomedicine journal, has shown that an at-home treatment regimen involving video games can improve hand function in teenagers with cerebral palsy.
The pilot study, involving only three teenage participants, combined a Sony Playstation 3 console and a commercial gaming glove with their custom-made games. Rutgers engineers created custom game and exercise software aimed at improving hand speed and range of motion.
The system enhanced the participants’ abilities to perform a range of daily personal and household activities.
After three months of therapy, two study participants were able to lift heavy objects, a task they were unable to accomplish before the trial. Participants showed varying improvement in activities of daily living including brushing teeth, shampooing, dressing and opening heavy doors.
The study was the result of a collaboration between engineers at Rutgers University’s Tele-Rehabilitation Institute and clinicians at the Indiana University School of Medicine.
In addition to game and exercise software, the apparatus features an online telerehabilitation platform that allowed researchers to oversee participants’ routines and evaluate their recovery of motor function.
Here’s a link to the full article (requires a subscription to the journal).
Here’s a video from the Rutgers website:
March 26, 2010
ReJoyce For Stroke and Spinal Cord Rehab: Video
This video was put together by Alberta Innovates and published in mid-March. It features interviews with ReJoyce inventors Dr. Jan Kowalczewski and Dr. Arthur Prochazka, as well as clinical trial investigators Dr. Mary Galea and Su Ling Chong. Ginny Bockman, a study participant, is also featured.
Here’s the transcript:
Dr. Prochazka - “As far as we know, this is the first large-scale study of in-home telerehabilitation in the world. I think this is the first study where we have learned how to interact with people in their homes, take them right through a training program of many weeks, measure the outcome, and then also, of course, develop the technology that allows all of this to happen.”
Dr. Kowalczewski - “I really hope it reaches as many people as it can. The reason why I’m saying this is because we’re seeing such positive results in our studies. I really hope that anyone that’s had a stroke or spinal cord injury can really benefit from this.”
Su-ling Chong - “In conventional therapy, you go to a place and you just do the functional tasks. We sneak the functions into the game, and patients enjoy it. Most of the time I have to tell the person that their hour is up because, usually, they just want to keep going.”
Dr. Galea - “A device like the ReJoyce is useful for people because it can be installed in their own home very simply, and people can use it in the comfort of their own home without needing to travel. The telerehabilitation enables the therapist to keep in touch with them, monitor their progress, and deal with any difficulties they might be having. That is a very important way to of continuing to enable people to continue improving without tying them to the hospital’s apron strings. It allows them to get on with their own lives.”
Mrs. Bockman - “When I woke up in the hospital, I couldn’t move my arms; I couldn’t move my hands and I thought, “how am I going to live my life?” When I started doing this [ReJoyce telerehabilitation], a lot more things started coming back to me. I’m able to hold my brush, with my hand, brush my own hair, brush my own teeth, feed myself. Senses have also gone back to playing with a Sony Playstation. I can kick my husband’s but on a lot of games, and I’m happy with that.”
January 14, 2010
Update from Vancouver Trial
ReJoyce telerehabilitation is currently being used in several SCI (Spinal Cord Injury) treatment studies around the world. Here’s a great comment we received today from Vancouver:
“I had a particularly exciting training session with my participant yesterday. For the first time he was able to play Weedo at Level 60 successfully, using the Peg and NO STIMULATION!! Six weeks ago when we started, he was not able to play Weedo with much success at Level One. He and I are both thrilled.”"
Jennifer Loffree, UBC
November 6, 2009
ReJoyce Stroke and SCI Clinical Trials
In addition to several completed trials funded by the Canadian Institutes of Health Research and Spinal Research UK, as well as three multi-centre clinical trials underway funded by the SCI-Solutions Network, Canadian Spinal Cord Injury Telerehabilitation and the Victorian Neurotrauma Initiative (Australian ReJoyce SCI Trials), ReJoyce is now part of two more studies coordinated by researchers at the University of Alberta in Edmonton. The first study compares two levels of FES and ReJoyce-based rehabilitation on the recovery of hand function in chronic stroke survivors: FES and ReJoyce. The second study, also based in Edmonton, investigates the effect of a new type of FES implant in combination with ReJoyce-based therapy on people with SCI.
For more information, please contact us.
