Amadeo robot for kids rehab

Hand Robotic Therapy in Children with Hemiparesis

Pilot Study

Bishop L, Gordon AM & Kim H

American Journal of Physical Medicine and Rehabilitation 2016;00,00-00

DOI: 10.1097/PHM.0000000000000537

Objective: In a sample of children with hemiparetic upper extremity cerebral palsy, is the Amadeo Hand Robot System feasible for retraining grasp and release?
Amadeo Hand Robot System

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/27386804

Method: 12 participants, 6 – 17 years old with upper extremity hemiparesis were measured initially, after a 6 week pre-intervention stage and following 6 weeks of three- hour long sessions. The Assisting Hand Assessment was chosen as the primary measure.

Findings: Participants tolerated the Amadeo, and the Assisting Hand Assessment showed significant change pre- to post-test. The Jebson-Taylor Test of Hand Function, the Upper Extremity Fugl-Meyer and the Quality of Upper Skills Test all revealed non-significant positive change; and the Pediatric Evaluation of Disability Inventory showed no change.

VR on UE in Children with CP: Meta-analysis

Effect of Virtual Reality on Upper Extremity Function in Children with Cerebral Palsy: A Meta-analysis
Chen, Y-P., Lee, S-Y. & Howard A.M. Pediatric Physical Therapy 2014:00 1 - 12
DOI: 10.1097/PEP.0000000000000046

Link to abstract:
www.ncbi.nlm.nih.gov/pubmed/24819682

Purpose: To systematically examine studies that consider the effect of active video games, virtual reality and robot therapy (VR) on improving upper extremity motor function in children with CP.

Method: A considered search strategy was used to include 14 research articles. A scoring system was used for the 3 RCTs, for 10 case series and one cohort study; a level of evidence was assigned to each based on the Oxford Centre for Evidence Based Medicine rating system.

Results: The RCT studies compared VR to traditional therapy, and the case series compared children before and after VR interventions. 5 studies were based on commercially available systems: Wii (1), Sony EyeToy Play (1), Gesturetek (3); the rest were experimental, custom engineered systems (7) or robot assisted interventions (2). The meta-analysis reports the 3 RCTs showed effectiveness for VR vs. traditional therapy, and ‘at least one positive change in one outcome measure in all the case series’. No relationship was seen between effectiveness and intervention length, duration, or frequency. Engineer-built experimental systems are found to be more effective than commercial systems. Commercially available active video games do not meet children’s needs as they cannot be adjusted individually to the child. Overall, the evidence was poor to fair. This meta-analysis makes no conclusive recommendations.

Reaching in games: Does it help in reality?

Research Study Low-cost motion interactive video games in home training for children with cerebral palsy: a kinematic evaluation

Sandlund, M., Grip, H., Häger, C., Domellöf, E. & Rönnqvist, L. Proceedings of International Conference on Virtual Rehabilitation 2011, June 27 – 29, 2011

Link to the abstract ieeexplore.ieee.org/xpl/articleDetails.jsp?reload=true&arnumber=5971854&contentType=Conference+Publications

Objective: In children with cerebral palsy, does active video game play result in a pre- vs. post- intervention change in arm movement quality?

Method: 15 children (6 to16 years) with cerebral palsy and limitations in upper extremity movement were assessed before and after 4 weeks of daily, (20 minutes or more) game playing at home on Sony’s PlayStation2 EyeToy©. Motion analysis pre- and post-intervention measured spatiotemporal parameters, smoothness and precision while the children were engaging in game play and in real reaching activities.

Findings: Overall, arm movement velocities were lower post-intervention. However the game play demanded rhythmic movements where quickness was not required. Children showed post-intervention “reduced variability in shoulder angles and shorter center of pressure excursions which indicate increased economic reaching strategies”. Smoothness of movements was significantly increased post-intervention when reaching in the higher-accuracy condition of real targets, but not for virtual ones. Precision in reaching for targets improved in the virtual condition but not when reaching for real targets at post-intervention. There is some evidence for increased motor performance after video game play.

“According to earlier kinematic studies of reaching movements in children with cerebral palsy, fast and straight movements are often associated with improved movement control. It is important to consider the nature of the task and the context in which movements are performed when selecting kinematic and interpreting parameters.”