Browsing by Keyword "Upper extremity"
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Item Analysis of the movements generated by a multi-field functional electrical stimulation device for upper extremity rehabilitation(2022-10) Martín-Odriozola, Aitor; Rodríguez-de-Pablo, Cristina; Caceres-Salegi, Ane; García-Calleja, Andrea; Marín-Ojea, Juan Ignacio; Hernández, Erik; Imatz-Ojanguren, Eukene; Keller, Thierry; Zabaleta-Rekondo, Haritz; Martín‐Odriozola, Aitor; Rodríguez‐de‐Pablo, Cristina; Caceres‐Salegi, Ane; García‐Calleja, Andrea; Marín‐Ojea, Juan Ignacio; Imatz‐Ojanguren, Eukene; Zabaleta‐Rekondo, Haritz; Medical Technologies; Tecnalia Research & InnovationBackground: The most common chronic sequela after stroke is the loss of arm function, and functional electrical stimulation (FES) applied to the forearm muscles is one of the options to treat it. Surface multi-field electrodes have emerged, showing a great potential to improve the selectivity of the stimulation, delay muscle fatigue, and provide easier donning and doffing. The muscular selectivity takes on special relevance in the rehabilitation of the upper extremity as hand dexterity requires a wide diversity of specific muscle actions. Methods: This pilot study analyses the movements generated in the wrist and fingers using a commercial multi-field technology-based FES device (Fesia Grasp). The study included five patients with hemiplegic subacute stroke, in which scanning of all cathodes of the electrode was carried out daily for 5 days, in two different forearm positions, with the resulting movements being labeled by experienced therapists. Results: The aim of this pilot study was to determine if there were differences between subjects and between forearm positions in terms of produced movements. Movements of the wrist (two movements) and the fingers (six movements) could be achieved in two different forearm positions. Conclusions: The multi-field electrode of Fesia Grasp enables to generate a wide range of movements of the hand in different positions. This fact could allow to produce more physiological movement patterns during the rehabilitation process with FES, which could have a beneficial effect on the recovery of patients with neurological diseases.Item European evidence-based recommendations for clinical assessment of upper limb in neurorehabilitation (CAULIN): data synthesis from systematic reviews, clinical practice guidelines and expert consensus: data synthesis from systematic reviews, clinical practice guidelines and expert consensus(2021-12) Prange-Lasonder, Gerdienke B.; Alt Murphy, Margit; Lamers, Ilse; Hughes, Ann-Marie; Buurke, Jaap H.; Feys, Peter; Keller, Thierry; Klamroth-Marganska, Verena; Tarkka, Ina M.; Timmermans, Annick; Burridge, Jane H.; Tecnalia Research & InnovationBackground: Technology-supported rehabilitation can help alleviate the increasing need for cost-effective rehabilitation of neurological conditions, but use in clinical practice remains limited. Agreement on a core set of reliable, valid and accessible outcome measures to assess rehabilitation outcomes is needed to generate strong evidence about effectiveness of rehabilitation approaches, including technologies. This paper collates and synthesizes a core set from multiple sources; combining existing evidence, clinical practice guidelines and expert consensus into European recommendations for Clinical Assessment of Upper Limb In Neurorehabilitation (CAULIN). Methods: Data from systematic reviews, clinical practice guidelines and expert consensus (Delphi methodology) were systematically extracted and synthesized using strength of evidence rating criteria, in addition to recommendations on assessment procedures. Three sets were defined: a core set: strong evidence for validity, reliability, responsiveness and clinical utility AND recommended by at least two sources; an extended set: strong evidence OR recommended by at least two sources and a supplementary set: some evidence OR recommended by at least one of the sources. Results: In total, 12 measures (with primary focus on stroke) were included, encompassing body function and activity level of the International Classification of Functioning and Health. The core set recommended for clinical practice and research: Fugl-Meyer Assessment of Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT); the extended set recommended for clinical practice and/or clinical research: kinematic measures, Box and Block Test (BBT), Chedoke Arm Hand Activity Inventory (CAHAI), Wolf Motor Function Test (WMFT), Nine Hole Peg Test (NHPT) and ABILHAND; the supplementary set recommended for research or specific occasions: Motricity Index (MI); Chedoke-McMaster Stroke Assessment (CMSA), Stroke Rehabilitation Assessment Movement (STREAM), Frenchay Arm Test (FAT), Motor Assessment Scale (MAS) and body-worn movement sensors. Assessments should be conducted at pre-defined regular intervals by trained personnel. Global measures should be applied within 24 h of hospital admission and upper limb specific measures within 1 week. Conclusions: The CAULIN recommendations for outcome measures and assessment procedures provide a clear, simple, evidence-based three-level structure for upper limb assessment in neurological rehabilitation. Widespread adoption and sustained use will improve quality of clinical practice and facilitate meta-analysis, critical for the advancement of technology-supported neurorehabilitation.Item A usability study in patients with stroke using MERLIN, a robotic system based on serious games for upper limb rehabilitation in the home setting(2021-02) Guillén-Climent, Silvia; Garzo, Ainara; Muñoz-Alcaraz, María Nieves; Casado-Adam, Pablo; Arcas-Ruiz-Ruano, Javier; Mejías-Ruiz, Manuela; Mayordomo-Riera, Fernando Jesús; Tecnalia Research & Innovation; Medical TechnologiesNeuroscience and neurotechnology are transforming stroke rehabilitation. Robotic devices, in addition to telerehabilitation, are increasingly being used to train the upper limbs after stroke, and their use at home allows us to extend institutional rehabilitation by increasing and prolonging therapy. The aim of this study is to assess the usability of the MERLIN robotic system based on serious games for upper limb rehabilitation in people with stroke in the home environment.Item The Use of Functional Electrical Stimulation on the Upper Limb and Interscapular Muscles of Patients with Stroke for the Improvement of Reaching Movements: A Feasibility Study: A feasibility study(2017-05-10) Cuesta-Gómez, Alicia; Molina-Rueda, Francisco; Carratala-Tejada, Maria; Imatz-Ojanguren, Eukene; Torricelli, Diego; Miangolarra-Page, Juan Carlos; Tecnalia Research & Innovation; Medical TechnologiesIntroduction: Reaching movements in stroke patients are characterized by decreased amplitudes at the shoulder and elbow joints and greater displacements of the trunk, compared to healthy subjects. The importance of an appropriate and specific contraction of the interscapular and upper limb (UL) muscles is crucial to achieving proper reaching movements. Functional electrical stimulation (FES) is used to activate the paretic muscles using short-duration electrical pulses. Objective: To evaluate whether the application of FES in the UL and interscapular muscles of stroke patients with motor impairments of the UL modifies patients’ reaching patterns, measured using instrumental movement analysis systems. Design: A cross-sectional study was carried out. Setting: The VICON Motion System® was used to conduct motion analysis. Participants: Twenty-one patients with chronic stroke. Intervention: The Compex® electric stimulator was used to provide muscle stimulation during two conditions: a placebo condition and a FES condition. Main outcome measures: We analyzed the joint kinematics (trunk, shoulder, and elbow) from the starting position until the affected hand reached the glass. Results: Participants receiving FES carried out the movement with less trunk flexion, while shoulder flexion elbow extension was increased, compared to placebo conditions. Conclusion: The application of FES to the UL and interscapular muscles of stroke patients with motor impairment of the UL has improved reaching movements.