Thursday, April 24, 2014

Robot therapy for children’s arm rehabilitation

Effects of robotic therapy on upper-extremity function in children with cerebral palsy: A systematic review

Chen, Y-P & Howard, A. M.

Development Neurorehabilitation, Early Online 1-8, 2014
DOI: 10.3109/17518423.2014.899648

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/24724587

Objective: To systematically review the evidence of robotic therapy for the effects on upper extremity function for children with cerebral palsy.

Process: Robotic therapy is understood here to be “the application of electronic, computerized control systems to mechanical devices designed to perform human functions”. A literature search resulted in nine articles (7 case studies, one single case study and one randomized crossover design) relating to three robotic systems; CosmoBot, InMotion2, and NJIT-RAVR. These were reviewed on 11 qualitative scales, with results ranging from 3/11 to 9/11 and averaging 6/11, using a protocol developed by Kwakkel et al and Cambach et al. The studies’ outcome measures were grouped using the ICF model: range of motion, muscle tone and kinematics outcomes were classified as either body structure and function; or activity outcomes, which were scored on the QUEST, Melbourne or Fugl-Meyer scales; or on parent questionnaires. Effect sizes were calculated using the Cochrane Review Manager.

Results: Studies all reported either increased reach duration, smoothness, reduced tone or improvement in some clinical measure. The majority of case studies in this systematic review limit the recommendations that could come from more robust, group design studies. No recommendations can be made.

Tuesday, April 15, 2014

Wii balance board for rehabilitation

Review

Using the Wii Fit as a tool for balance assessment and neurorehabilitation: the first half decade of “Wii-search”

Goble, D. J., Cone, B. L. & Fling, B. W., Journal of Neuroeng Rehabil. 2014; 11:12

DOI: 10.1186/1743-0003-11-12

Link to full text article: www.jneuroengrehab.com/content/11/1/12

Objective: to review the Wii balance board controller (WBB) as a balance force platform measurement tool and as a neurorehabilitation intervention.

Process: WBB was compared with a scientific grade balance platform.

A literature search for “Wii Fit system or WBB for the assessment or training of balance ability” resulted in 11 papers that “trained balance in healthy adults” and 8 papers “that rehabilitated balance in clinical populations”; these were reviewed.

Outcomes: Custom applications have potential to provide low-cost ways to assess balance. Wii research using custom software is “an extremely promising area of exploration”. Research using Wii metrics for measuring balance is “far less convincing to date”. There is little correlation between Wii outcomes and clinical balance tests.

Wii is a motivating tool that typically generates improvements in balance. More robust research is required for the Wii Fit system as a balance intervention.

Wednesday, April 2, 2014

Balance measurement: Wii vs. BOT-2

Instrument Assessment

Evaluating the Nintendo Wii for Assessing Return to Activity Readiness in Youth with Mild Traumatic Brain Injury

DeMatteo, C., Greenspoon, D., Levac, D., Harper, J. A. & Rubinoff, M., Physical and Occupational Therapy in Pediatrics, Early online 1-16 2014-02-26

doi: 10-3109/01942638.2014.855103>/p>

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/24547689

Intent: “Post-injury assessments that challenge activity tolerance and balance are needed to determine readiness return to activity.” The maximal exertion and a count of loss-of-balance instances while playing Wii is compared to balance measures within Bruininks – Oseretsky Test of Motor Proficiency 2 ed. and the Community Balance and Mobility Scale.

Process: 24- 9 to 18 year olds who had experienced mild traumatic brain injury within the past year played a suite of Wii games one time. Losses of balance requiring a protective response were counted during game play and exertion as measured by heart rate, respiration rate and calorie expenditure.

Results: The technique of counting losses of balance during game play did not prove to be a useful assessment of balance and did not correlate with balance measures in BOT-2 and CBM. Of 6 games played, maximal exertion was generated by “Wii Fit Basic Run”.