Grigore C Burdea1,2, Namrata Grampurohit1,3, Nam Kim1, Kevin Polistico1, Ashwin Kadaru1, Simcha Pollack4, Mooyeon Oh-Park5,6, A M Barrett5, Emma Kaplan5, Jenny Masmela5, Phalgun Nori7. 1. Corporate Headquarters, Bright Cloud International Corp , Highland Park, NJ, USA. 2. Department of Electrical and Computer Engineering, Rutgers - The State University of NJ , Piscataway, NJ, USA. 3. Department of Occupational Therapy, Jefferson College of Rehabilitation Sciences , Philadelphia, PA, USA. 4. The Tobin College of Business, St John's University , Queens, NY, USA. 5. Kessler Foundation , West Orange, NJ, USA. 6. Burke Rehabilitation Hospital , White Plains, NY, USA. 7. Physical Medicine and Rehabilitation, Kessler Institute for Rehabilitation , West Orange, NJ, USA.
Abstract
BACKGROUND: Intensive, adaptable and engaging telerehabilitation is needed to enhance recovery and maximize outcomes. Such services may be provided under early supported discharge, or later for chronic populations. A novel virtual reality game-based telerehabilitation system was designed for individuals post-stroke to enhance their bimanual upper extremity motor function, cognition, and wellbeing. OBJECTIVES: To evaluate the feasibility of novel therapeutic game controller and telerehabilitation system for home use. METHODS: Individuals chronic post-stroke and their caregivers were recruited (n = 8 + 8) for this feasibility study. One was a screen failure and seven completed 4 weeks (20 sessions) of home-based therapy with or without remote monitoring. Standardized clinical outcome measures were taken pre- and post-therapy. Game performance outcomes were sampled at every session, while participant and caregiver subjective evaluations were done weekly. RESULTS: There was a 96% rate of compliance to protocol, resulting in an average of 13,000 total arm repetitions/week/participant. Group analysis showed significant (p <.05) improvements in grasp strength (effect size [ES] = 0.15), depression (Beck Depression Inventory II, ES = 0.75), and cognition (Neuropsychological Assessment Battery for Executive Function, ES = 0.46). Among the 49 outcome variables, 36 variables (73.5%) improved significantly (p = .001, binomial sign test). Technology acceptance was very good with system rating by participants at 3.7/5 and by caregivers at 3.5/5. CONCLUSIONS: These findings indicate the feasibility and efficacy of the system in providing home-based telerehabilitation. The BrightBrainer system needs to be further evaluated in randomized control trials and with individuals early post-stroke.
BACKGROUND: Intensive, adaptable and engaging telerehabilitation is needed to enhance recovery and maximize outcomes. Such services may be provided under early supported discharge, or later for chronic populations. A novel virtual reality game-based telerehabilitation system was designed for individuals post-stroke to enhance their bimanual upper extremity motor function, cognition, and wellbeing. OBJECTIVES: To evaluate the feasibility of novel therapeutic game controller and telerehabilitation system for home use. METHODS: Individuals chronic post-stroke and their caregivers were recruited (n = 8 + 8) for this feasibility study. One was a screen failure and seven completed 4 weeks (20 sessions) of home-based therapy with or without remote monitoring. Standardized clinical outcome measures were taken pre- and post-therapy. Game performance outcomes were sampled at every session, while participant and caregiver subjective evaluations were done weekly. RESULTS: There was a 96% rate of compliance to protocol, resulting in an average of 13,000 total arm repetitions/week/participant. Group analysis showed significant (p <.05) improvements in grasp strength (effect size [ES] = 0.15), depression (Beck Depression Inventory II, ES = 0.75), and cognition (Neuropsychological Assessment Battery for Executive Function, ES = 0.46). Among the 49 outcome variables, 36 variables (73.5%) improved significantly (p = .001, binomial sign test). Technology acceptance was very good with system rating by participants at 3.7/5 and by caregivers at 3.5/5. CONCLUSIONS: These findings indicate the feasibility and efficacy of the system in providing home-based telerehabilitation. The BrightBrainer system needs to be further evaluated in randomized control trials and with individuals early post-stroke.
Authors: Bert M Chesworth; Clayon B Hamilton; David M Walton; Melissa Benoit; Tracy A Blake; Heather Bredy; Cameron Burns; Lianne Chan; Elizabeth Frey; Graham Gillies; Teresa Gravelle; Rick Ho; Robert Holmes; Roland L J Lavallée; Melanie MacKinnon; Alishah Jamal Merchant; Tammy Sherman; Kelly Spears; Darryl Yardley Journal: Physiother Can Date: 2014 Impact factor: 1.037
Authors: Julie Bernhardt; Kathryn S Hayward; Gert Kwakkel; Nick S Ward; Steven L Wolf; Karen Borschmann; John W Krakauer; Lara A Boyd; S Thomas Carmichael; Dale Corbett; Steven C Cramer Journal: Int J Stroke Date: 2017-07 Impact factor: 5.266
Authors: Colleen O'Brien Cherry; Neale R Chumbler; Kimberly Richards; Amber Huff; David Wu; Laura M Tilghman; Andrew Butler Journal: Disabil Rehabil Assist Technol Date: 2015-07-02