The use of visual feedback in upper limb stroke rehabilitation: a pilot randomized controlled trial

Lucy Jones, Frederike van Wijck, Madeleine Grealy, P J Rowe

Research output: Contribution to conferenceAbstract

Abstract

Background and objectives: For a significant proportion of stroke survivors arm function is limited. Visual feedback (VF) using 3D motion capture may enhance understanding of correct movement patterns and encourage motor relearning, however clinically this is predominantly limited to gait analysis laboratories. This study assessed the feasibility and preliminary effects of 3D VF of upper limb movement during stroke rehabilitation. Methods: Adults within 3 months of stroke onset and with limited arm function consented to being recruited into a pilot RCT consisting of: (1) an Intervention Group (IG) receiving additional upper limb therapy with VF, (2) a dose-matched Placebo Group and (3) a Control Group receiving standard care only. Additional therapy was 12 one-hour sessions over six weeks in a community-based setting. Measures evaluated the feasibility (adverse events and drop-out rates) and outcomes (Action Research Arm Test (ARAT), 9 Hole Peg Test (9HPT), Stroke Impact Scale, (SIS)). Results: Eleven of 72 (15%) participants screened were recruited. No adverse events observed and only one drop-out from IG. No participants received all 12 sessions although non-attendance was lowest in IG. Functional improvement (ARAT) was seen across all groups immediately post intervention although dexterity remained reduced (9HPT). Those in IG reported the greatest increases in function (SIS). [Low numbers prevent significance testing] Conclusions: VF in upper limb stroke rehabilitation is feasible. Preliminary outcomes suggest it may improve gross movement but has less impact on dexterity, limiting fuller functional recovery. Further modifications are required to optimize the intervention before embarking on a larger RCT.
Original languageEnglish
DOIs
Publication statusPublished - 15 Apr 2015
EventThe European Stroke Organisation - Annual Conference - Glasgow, United Kingdom
Duration: 17 Apr 201519 Apr 2015

Conference

ConferenceThe European Stroke Organisation - Annual Conference
CountryUnited Kingdom
CityGlasgow
Period17/04/1519/04/15

Fingerprint

Sensory Feedback
Upper Extremity
Patient rehabilitation
Randomized Controlled Trials
Stroke
Feedback
Health Services Research
Arm
Gait analysis
Feasibility Studies
Gait
Survivors
Research Design
Placebos
Outcome Assessment (Health Care)
Recovery
Control Groups
Stroke Rehabilitation
Testing
Therapeutics

Keywords

  • stroke rehabilitation
  • feedback
  • arm function

Cite this

Jones, L., van Wijck, F., Grealy, M., & Rowe, P. J. (2015). The use of visual feedback in upper limb stroke rehabilitation: a pilot randomized controlled trial. Abstract from The European Stroke Organisation - Annual Conference, Glasgow, United Kingdom. https://doi.org/10.1111/ijs.12478
Jones, Lucy ; van Wijck, Frederike ; Grealy, Madeleine ; Rowe, P J . / The use of visual feedback in upper limb stroke rehabilitation : a pilot randomized controlled trial. Abstract from The European Stroke Organisation - Annual Conference, Glasgow, United Kingdom.
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abstract = "Background and objectives: For a significant proportion of stroke survivors arm function is limited. Visual feedback (VF) using 3D motion capture may enhance understanding of correct movement patterns and encourage motor relearning, however clinically this is predominantly limited to gait analysis laboratories. This study assessed the feasibility and preliminary effects of 3D VF of upper limb movement during stroke rehabilitation. Methods: Adults within 3 months of stroke onset and with limited arm function consented to being recruited into a pilot RCT consisting of: (1) an Intervention Group (IG) receiving additional upper limb therapy with VF, (2) a dose-matched Placebo Group and (3) a Control Group receiving standard care only. Additional therapy was 12 one-hour sessions over six weeks in a community-based setting. Measures evaluated the feasibility (adverse events and drop-out rates) and outcomes (Action Research Arm Test (ARAT), 9 Hole Peg Test (9HPT), Stroke Impact Scale, (SIS)). Results: Eleven of 72 (15{\%}) participants screened were recruited. No adverse events observed and only one drop-out from IG. No participants received all 12 sessions although non-attendance was lowest in IG. Functional improvement (ARAT) was seen across all groups immediately post intervention although dexterity remained reduced (9HPT). Those in IG reported the greatest increases in function (SIS). [Low numbers prevent significance testing] Conclusions: VF in upper limb stroke rehabilitation is feasible. Preliminary outcomes suggest it may improve gross movement but has less impact on dexterity, limiting fuller functional recovery. Further modifications are required to optimize the intervention before embarking on a larger RCT.",
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Jones, L, van Wijck, F, Grealy, M & Rowe, PJ 2015, 'The use of visual feedback in upper limb stroke rehabilitation: a pilot randomized controlled trial', The European Stroke Organisation - Annual Conference, Glasgow, United Kingdom, 17/04/15 - 19/04/15. https://doi.org/10.1111/ijs.12478

The use of visual feedback in upper limb stroke rehabilitation : a pilot randomized controlled trial. / Jones, Lucy; van Wijck, Frederike; Grealy, Madeleine; Rowe, P J .

2015. Abstract from The European Stroke Organisation - Annual Conference, Glasgow, United Kingdom.

Research output: Contribution to conferenceAbstract

TY - CONF

T1 - The use of visual feedback in upper limb stroke rehabilitation

T2 - a pilot randomized controlled trial

AU - Jones, Lucy

AU - van Wijck, Frederike

AU - Grealy, Madeleine

AU - Rowe, P J

PY - 2015/4/15

Y1 - 2015/4/15

N2 - Background and objectives: For a significant proportion of stroke survivors arm function is limited. Visual feedback (VF) using 3D motion capture may enhance understanding of correct movement patterns and encourage motor relearning, however clinically this is predominantly limited to gait analysis laboratories. This study assessed the feasibility and preliminary effects of 3D VF of upper limb movement during stroke rehabilitation. Methods: Adults within 3 months of stroke onset and with limited arm function consented to being recruited into a pilot RCT consisting of: (1) an Intervention Group (IG) receiving additional upper limb therapy with VF, (2) a dose-matched Placebo Group and (3) a Control Group receiving standard care only. Additional therapy was 12 one-hour sessions over six weeks in a community-based setting. Measures evaluated the feasibility (adverse events and drop-out rates) and outcomes (Action Research Arm Test (ARAT), 9 Hole Peg Test (9HPT), Stroke Impact Scale, (SIS)). Results: Eleven of 72 (15%) participants screened were recruited. No adverse events observed and only one drop-out from IG. No participants received all 12 sessions although non-attendance was lowest in IG. Functional improvement (ARAT) was seen across all groups immediately post intervention although dexterity remained reduced (9HPT). Those in IG reported the greatest increases in function (SIS). [Low numbers prevent significance testing] Conclusions: VF in upper limb stroke rehabilitation is feasible. Preliminary outcomes suggest it may improve gross movement but has less impact on dexterity, limiting fuller functional recovery. Further modifications are required to optimize the intervention before embarking on a larger RCT.

AB - Background and objectives: For a significant proportion of stroke survivors arm function is limited. Visual feedback (VF) using 3D motion capture may enhance understanding of correct movement patterns and encourage motor relearning, however clinically this is predominantly limited to gait analysis laboratories. This study assessed the feasibility and preliminary effects of 3D VF of upper limb movement during stroke rehabilitation. Methods: Adults within 3 months of stroke onset and with limited arm function consented to being recruited into a pilot RCT consisting of: (1) an Intervention Group (IG) receiving additional upper limb therapy with VF, (2) a dose-matched Placebo Group and (3) a Control Group receiving standard care only. Additional therapy was 12 one-hour sessions over six weeks in a community-based setting. Measures evaluated the feasibility (adverse events and drop-out rates) and outcomes (Action Research Arm Test (ARAT), 9 Hole Peg Test (9HPT), Stroke Impact Scale, (SIS)). Results: Eleven of 72 (15%) participants screened were recruited. No adverse events observed and only one drop-out from IG. No participants received all 12 sessions although non-attendance was lowest in IG. Functional improvement (ARAT) was seen across all groups immediately post intervention although dexterity remained reduced (9HPT). Those in IG reported the greatest increases in function (SIS). [Low numbers prevent significance testing] Conclusions: VF in upper limb stroke rehabilitation is feasible. Preliminary outcomes suggest it may improve gross movement but has less impact on dexterity, limiting fuller functional recovery. Further modifications are required to optimize the intervention before embarking on a larger RCT.

KW - stroke rehabilitation

KW - feedback

KW - arm function

UR - http://eso.kenes.com/

U2 - 10.1111/ijs.12478

DO - 10.1111/ijs.12478

M3 - Abstract

ER -

Jones L, van Wijck F, Grealy M, Rowe PJ. The use of visual feedback in upper limb stroke rehabilitation: a pilot randomized controlled trial. 2015. Abstract from The European Stroke Organisation - Annual Conference, Glasgow, United Kingdom. https://doi.org/10.1111/ijs.12478