Técnicas y métodos para el seguimiento de la evolución de la habilidad motriz fina de miembro superior : revisión de la literatura

Introduction: This review article is the product of research on the methods, techniques and devices used in the measurement of fine motor skills of upper limbs and its respective evolution, developed at Universidad del Cauca in 2018. Problem: Objective measurement of the evolution of upper limb motor skills in the rehabilitation processes.  Objective: To identify the conventional techniques and electronic devices used in the measurement of the evolution of upper limb motor ability.  Methodology: Four scientific databases were reviewed in addition to the Google Scholar search engine. The keywords used for the search were: "fine motor skills", "hand measurement", "hand rehabilitation"and "hand function", among others.  Results: Approximately 3840 articles related to the subject were found. When applying the exclusion criteria, the article number to be revised was reduced to 63, which were analyzed in the present review. Conclusions: The tools applied by health professionals are convenient due to their rapid execution and easy access, however they can be subject to human error since they depend on the experience of the user. Electronic systems present objective measurements, however, their complexity and cost are high. Originality: This work presents information on the therapeutic techniques and technological devices used, in certain pathologies, for the evaluation of upper limb motor ability. Limitations: Not all articles analyzed have a detailed description of the people in which the studies were conducted.Introducción: El artículo es producto de una investigación sobre los métodos, técnicas y dispositivos utilizados en la medición de la habilidad motriz fina de miembro superior y su respectiva evolución, desarrollada en la Universidad del Cauca en el año 2018. Problema: Medición objetiva la evolución de la habilidad motriz de miembro superior en los procesos de rehabilitación. Objetivo: Identificar las técnicas convencionales y dispositivos electrónicos utilizados en la medición de la evolución de la habilidad motriz de miembro superior. Metodología: Se revisaron cuatro bases de datos científicas además del motor de búsqueda Google Académico. Para la búsqueda se utilizaron las palabras clave: “fine motor skills”, “hand measurement”, “hand rehabilitation”, “hand function”, entre otras. Resultados: Se encontraron aproximadamente 3840 artículos relacionados con la temática. Al aplicar los criterios de exclusión el número de artículo a revisar se redujo a 63, los cuales fueron analizados en la presente revisión. Conclusiones: Las herramientas aplicadas por profesionales de la salud son convenientes debido a su rápida ejecución y fácil acceso, sin embargo pueden estar sujetas al error humano puesto que dependen de la experiencia de quien las utiliza. Los sistemas electrónicos, presentan mediciones objetivas, no obstante, su complejidad y costo es elevado. Originalidad: Este trabajo presenta información sobre las técnicas terapéuticas y dispositivos tecnológicos, utilizados en ciertas patologías, para la evaluación de la habilidad motriz de miembro superior. Limitaciones: No todos los artículos analizados cuentan con una descripción detallada de las personas en las que los estudios fueron realizados

Técnicas y métodos para el seguimiento de la evolución de la habilidad motriz fina de miembro superior : revisión de la literatura

Introduction: This review article is the product of research on the methods, techniques and devices used in the measurement of fine motor skills of upper limbs and its respective evolution, developed at Universidad del Cauca in 2018. Problem: Objective measurement of the evolution of upper limb motor skills in the rehabilitation processes.  Objective: To identify the conventional techniques and electronic devices used in the measurement of the evolution of upper limb motor ability.  Methodology: Four scientific databases were reviewed in addition to the Google Scholar search engine. The keywords used for the search were: "fine motor skills", "hand measurement", "hand rehabilitation"and "hand function", among others.  Results: Approximately 3840 articles related to the subject were found. When applying the exclusion criteria, the article number to be revised was reduced to 63, which were analyzed in the present review. Conclusions: The tools applied by health professionals are convenient due to their rapid execution and easy access, however they can be subject to human error since they depend on the experience of the user. Electronic systems present objective measurements, however, their complexity and cost are high. Originality: This work presents information on the therapeutic techniques and technological devices used, in certain pathologies, for the evaluation of upper limb motor ability. Limitations: Not all articles analyzed have a detailed description of the people in which the studies were conducted.Introducción: El artículo es producto de una investigación sobre los métodos, técnicas y dispositivos utilizados en la medición de la habilidad motriz fina de miembro superior y su respectiva evolución, desarrollada en la Universidad del Cauca en el año 2018. Problema: Medición objetiva la evolución de la habilidad motriz de miembro superior en los procesos de rehabilitación. Objetivo: Identificar las técnicas convencionales y dispositivos electrónicos utilizados en la medición de la evolución de la habilidad motriz de miembro superior. Metodología: Se revisaron cuatro bases de datos científicas además del motor de búsqueda Google Académico. Para la búsqueda se utilizaron las palabras clave: “fine motor skills”, “hand measurement”, “hand rehabilitation”, “hand function”, entre otras. Resultados: Se encontraron aproximadamente 3840 artículos relacionados con la temática. Al aplicar los criterios de exclusión el número de artículo a revisar se redujo a 63, los cuales fueron analizados en la presente revisión. Conclusiones: Las herramientas aplicadas por profesionales de la salud son convenientes debido a su rápida ejecución y fácil acceso, sin embargo pueden estar sujetas al error humano puesto que dependen de la experiencia de quien las utiliza. Los sistemas electrónicos, presentan mediciones objetivas, no obstante, su complejidad y costo es elevado. Originalidad: Este trabajo presenta información sobre las técnicas terapéuticas y dispositivos tecnológicos, utilizados en ciertas patologías, para la evaluación de la habilidad motriz de miembro superior. Limitaciones: No todos los artículos analizados cuentan con una descripción detallada de las personas en las que los estudios fueron realizados

Técnicas y métodos para el seguimiento de la evolución de la habilidad motriz fina de miembro superior : revisión de la literatura

Introduction: This review article is the product of research on the methods, techniques and devices used in the measurement of fine motor skills of upper limbs and its respective evolution, developed at Universidad del Cauca in 2018. Problem: Objective measurement of the evolution of upper limb motor skills in the rehabilitation processes.  Objective: To identify the conventional techniques and electronic devices used in the measurement of the evolution of upper limb motor ability.  Methodology: Four scientific databases were reviewed in addition to the Google Scholar search engine. The keywords used for the search were: "fine motor skills", "hand measurement", "hand rehabilitation"and "hand function", among others.  Results: Approximately 3840 articles related to the subject were found. When applying the exclusion criteria, the article number to be revised was reduced to 63, which were analyzed in the present review. Conclusions: The tools applied by health professionals are convenient due to their rapid execution and easy access, however they can be subject to human error since they depend on the experience of the user. Electronic systems present objective measurements, however, their complexity and cost are high. Originality: This work presents information on the therapeutic techniques and technological devices used, in certain pathologies, for the evaluation of upper limb motor ability. Limitations: Not all articles analyzed have a detailed description of the people in which the studies were conducted.Introducción: El artículo es producto de una investigación sobre los métodos, técnicas y dispositivos utilizados en la medición de la habilidad motriz fina de miembro superior y su respectiva evolución, desarrollada en la Universidad del Cauca en el año 2018. Problema: Medición objetiva la evolución de la habilidad motriz de miembro superior en los procesos de rehabilitación. Objetivo: Identificar las técnicas convencionales y dispositivos electrónicos utilizados en la medición de la evolución de la habilidad motriz de miembro superior. Metodología: Se revisaron cuatro bases de datos científicas además del motor de búsqueda Google Académico. Para la búsqueda se utilizaron las palabras clave: “fine motor skills”, “hand measurement”, “hand rehabilitation”, “hand function”, entre otras. Resultados: Se encontraron aproximadamente 3840 artículos relacionados con la temática. Al aplicar los criterios de exclusión el número de artículo a revisar se redujo a 63, los cuales fueron analizados en la presente revisión. Conclusiones: Las herramientas aplicadas por profesionales de la salud son convenientes debido a su rápida ejecución y fácil acceso, sin embargo pueden estar sujetas al error humano puesto que dependen de la experiencia de quien las utiliza. Los sistemas electrónicos, presentan mediciones objetivas, no obstante, su complejidad y costo es elevado. Originalidad: Este trabajo presenta información sobre las técnicas terapéuticas y dispositivos tecnológicos, utilizados en ciertas patologías, para la evaluación de la habilidad motriz de miembro superior. Limitaciones: No todos los artículos analizados cuentan con una descripción detallada de las personas en las que los estudios fueron realizados

Realidade virtual para reabilitação do membro superior pós-AVC: jogos sérios usando seguimento de mãos

In recent years, Virtual Reality has been shown to have considerable potential as a rehabilitation tool, as it allows the creation of Virtual Environments providing multiple stimuli that can motivate, engage or distract the patients. Moreover, VR applications may meet the four basic principles of rehabilitation: intensity, task oriented training, biofeedback and motivation, all pivotal factors for the success of rehabilitation programs. Aware of this potential, and concerned with the lack of motivation of stroke patients while performing repetitive upper limb movements, a group of professionals working at a national rehabilitation center contacted the university to develop VR games aimed at increasing motivation by providing everyday life context to the movements. This dissertation establishes the initial iteration towards the addition of VR to the occupational therapy routine in the rehabilitation center, including the assessement of requirements for the applications to be developed, establishment of the system architecture, development of rehabilitation game prototypes and integration with a backend database server and a configuration web page. The work was concluded with a formal usability and satisfaction study with patients residing at the rehabilitation center.Recentemente, tecnologias de Realidade Virtual têm demonstrado grande potencial como ferramentas para a terapia de reabilitação, pois permitem a criação de Ambientes Virtuais que providenciam múltiplos estímulos que podem motivar, atrair ou distrair os pacientes. Além disso, aplicações de RV podem satisfazer os quatro princípios básicos da reabilitação: intensidade, treino orientado a tarefas, biofeedback e motivação, sendo todos estes fatores fundamentais para o sucesso do programa de reabilitação. Conscientes deste potencial e preocupados com a falta de motivação de pacientes a recuperar de AVC na execução de exercícios repetitivos para treino do membro superior, um grupo de médicos pertencentes a um centro de reabilitação nacional contactaram a universidade com o objetivo de desenvolver jogos de RV focados no aumento de motivação através do uso de contextos mais próximos de atividades da vida real para a execução dos movimentos. Esta dissertação estabelece a primeira iteração no processo de integração de RV na rotina de terapia ocupacional no centro de reabilitação, incluindo a avaliação de requisitos, estabelecimento da arquitetura geral do sistema, desenvolvimento de protótipos de jogos sérios para reabilitação e integração dos mesmos com uma base de dados remota e uma página web de configuração. O trabalho foi concluído com um estudo formal de usabilidade e satisfação no uso das aplicações de RV com pacientes residentes no centro de reabilitação.Mestrado em Engenharia de Computadores e Telemátic

Combining virtual reality and a myoelectric limb orthosis to restore active movement after stroke: a pilot study

We introduce a novel rehabilitation technology for upper limb rehabilitation after stroke that combines a virtual reality (VR) training paradigm with a myoelectric robotic limb orthosis. Our rehabilitation system is based on clinical guidelines and is designed to recruit specific motor networks to promote neuronal reorganization. The main hypothesis is that the restoration of active movement facilitates the full engagement of motor control networks during motor training. By using a robotic limb orthosis, we are able to restore active arm movement in severely affected stroke patients. In a pilot evaluation, we have successfully deployed and assessed our system with three chronic stroke patients by means of behavioral data and self-report questionnaires. The results show that our system is able to restore up to 60% of the active movement capability of patients. Further, we show that we can assess the specific contribution of the biceps/triceps movement of the paretic arm in a VR bilateral training task. Questionnaire data show enjoyment and acceptance of the developed rehabilitation system and its VR training task.info:eu-repo/semantics/publishedVersio

Development and implementation of technologies for physical telerehabilitation in Latin America:

La telerehabilitation ha surgido debido a la inclusión de tecnologías emergentes para la captura, transmisión, análisis y visualización de patrones de movimiento asociados a pacientes con trastornos músculo-esqueléticos. Esta estrategia permite llevar a cabo procesos de diagnóstico y tratamientos de rehabilitación a distancia. Este artículo presenta una revisión sistemática del desarrollo e implementación actual de las tecnologías de telerehabilitación en la región latinoamericana. El objetivo principal es explorar, a partir de la literatura científica reportada y fuentes divulgativas, si las tecnologías de telerehabilitación han logrado ser introducidas en esta región. Asimismo, este trabajo revela los prototipos actuales o sistemas que están en desarrollo o que ya están siendo usados. Se llevó a cabo una revisión sistemática, mediante dos búsquedas diferentes. La primera implicó una búsqueda bibliográfica rigurosa en los repositorios digitales científicos más relevantes en el área y la segunda incluyó proyectos y programas de telerehabilitación implementados en la región, encontrados a partir de una búsqueda avanzada en Google. Se encontró un total de 53 documentos de seis países (Colombia, Brasil, México, Ecuador, Chile y Argentina); la mayoría de ellos estaban enfocados en iniciativas académicas y de investigación para el desarrollo de prototipos tecnológicos para telerehabilitación de pacientes pediátricos y adultos mayores, afectados por deficiencias motoras o funcionales, parálisis cerebral, enfermedades neurocognitivas y accidente cerebrovascular. El análisis de estos documentos reveló la necesidad de un extenso enfoque integrado de salud y sistema social para aumentar la disponibilidad actual de iniciativas de telerehabilitación en la región latinoamericana.Telerehabilitation has arised by the inclusion of emerging technologies for capturing, transmitting, analyzing and visualizing movement patterns associated to musculoskeletal disorders. This therapeutic strategy enables to carry out diagnosis processes and provide rehabilitation treatments. This paper presents a systematic review of the current development and implementation of telerehabilitation technologies in Latin America. The main goal is to explore the scientific literature and dissemination sources to establish if such technologies have been introduced in this region. Likewise, this work highlights existing prototypes or systems that are to being used or that are still under development. A systematic search strategy was conducted by two different searches: the first one involves a rigorous literature search from the most relevant scientific digital repositories; the second one included telerehabilitation projects and programs retrieved by an advanced Google search. A total of 53 documents from six countries (Colombia, Brazil, Mexico, Ecuador, Chile and Argentina) were found. Most of them were focused on academic and research initiatives to develop in-home telerehabilitation technologies for pediatric and elderly populations affected by motor and functional impairment, cerebral palsy, neurocognitive disorders and stroke. The analysis of the findings revealed the need for a comprehensive approach that integrates health care and the social system to increase the current availability of telerehabilitation initiatives in Latin America

Immersive Virtual Reality in Stroke Patients as a New Approach for Reducing Postural Disabilities and Falls Risk: A Case Series

Stroke is a neurologic disorder considered the first cause of disability worldwide due to motor, cognitive, and sensorial sequels. Balance dysfunctions in stroke survivors increase the risk of falls and physiotherapeutic rehabilitation is essential to reduce it. Virtual reality (VR) seems to be an alternative to conventional physiotherapy (CT), providing virtual environments and multisensorial inputs to train balance in stroke patients. The aim of this study was to assess if immersive VR treatment is more effective than CT to improve balance after stroke. This study got the approval from the Ethics Committee of the University of Almeria. Three chronic ischemic stroke patients were selected. One patient who received 25 sessions of immersive VR intervention for two months was compared with another patient who received equivalent CT and a third patient with no intervention. Balance, gait, risk of falling, and vestibular and visual implications in the equilibrium were assessed. After the interventions, the two patients receiving any of the treatments showed an improvement in balance compared to the untreated patient. In comparison to CT, our results suggest a higher effect of immersive VR in the improvement of balance and a reduction of falls risk due to the active upright work during the VR intervention

Virtual reality for stroke rehabilitation (Review)

Copyright © 2017 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. This review is made available in accordance with Cochrane Database of Systematic Review's repositories policyBackground Virtual reality and interactive video gaming have emerged as recent treatment approaches in stroke rehabilitation with commercial gaming consoles in particular, being rapidly adopted in clinical settings. This is an update of a Cochrane Review published first in 2011 and then again in 2015. Objectives Primary objective: to determine the efficacy of virtual reality compared with an alternative intervention or no intervention on upper limb function and activity. Secondary objectives: to determine the efficacy of virtual reality compared with an alternative intervention or no intervention on: gait and balance, global motor function, cognitive function, activity limitation, participation restriction, quality of life, and adverse events. Search methods We searched the Cochrane Stroke Group Trials Register (April 2017), CENTRAL, MEDLINE, Embase, and seven additional databases. We also searched trials registries and reference lists. Selection criteria Randomised and quasi‐randomised trials of virtual reality ("an advanced form of human‐computer interface that allows the user to 'interact' with and become 'immersed' in a computer‐generated environment in a naturalistic fashion") in adults after stroke. The primary outcome of interest was upper limb function and activity. Secondary outcomes included gait and balance and global motor function. Data collection and analysis Two review authors independently selected trials based on pre‐defined inclusion criteria, extracted data, and assessed risk of bias. A third review author moderated disagreements when required. The review authors contacted investigators to obtain missing information. Main results We included 72 trials that involved 2470 participants. This review includes 35 new studies in addition to the studies included in the previous version of this review. Study sample sizes were generally small and interventions varied in terms of both the goals of treatment and the virtual reality devices used. The risk of bias present in many studies was unclear due to poor reporting. Thus, while there are a large number of randomised controlled trials, the evidence remains mostly low quality when rated using the GRADE system. Control groups usually received no intervention or therapy based on a standard‐care approach. Primary outcome: results were not statistically significant for upper limb function (standardised mean difference (SMD) 0.07, 95% confidence intervals (CI) ‐0.05 to 0.20, 22 studies, 1038 participants, low‐quality evidence) when comparing virtual reality to conventional therapy. However, when virtual reality was used in addition to usual care (providing a higher dose of therapy for those in the intervention group) there was a statistically significant difference between groups (SMD 0.49, 0.21 to 0.77, 10 studies, 210 participants, low‐quality evidence). Secondary outcomes: when compared to conventional therapy approaches there were no statistically significant effects for gait speed or balance. Results were statistically significant for the activities of daily living (ADL) outcome (SMD 0.25, 95% CI 0.06 to 0.43, 10 studies, 466 participants, moderate‐quality evidence); however, we were unable to pool results for cognitive function, participation restriction, or quality of life. Twenty‐three studies reported that they monitored for adverse events; across these studies there were few adverse events and those reported were relatively mild. Authors' conclusions We found evidence that the use of virtual reality and interactive video gaming was not more beneficial than conventional therapy approaches in improving upper limb function. Virtual reality may be beneficial in improving upper limb function and activities of daily living function when used as an adjunct to usual care (to increase overall therapy time). There was insufficient evidence to reach conclusions about the effect of virtual reality and interactive video gaming on gait speed, balance, participation, or quality of life. This review found that time since onset of stroke, severity of impairment, and the type of device (commercial or customised) were not strong influencers of outcome. There was a trend suggesting that higher dose (more than 15 hours of total intervention) was preferable as were customised virtual reality programs; however, these findings were not statistically significant

Isokinetic muscle strengthening after acquired cerebral damage: A literature review

AbstractObjectiveIsokinetic strengthening is a rehabilitation technique rarely used in stroke patients. However, the potential benefits of force and endurance training in this population are strongly suspected.MethodThis literature review synthesizes the results of clinical trials on this topic. The research was conducted on PubMed, using “Stroke”, “rehabilitation”, “isokinetic”, “upper limb” and “training” as keywords.ResultsSeventeen studies focusing on the use of isokinetics in assessment or rehabilitation (six studies) following stroke were reviewed. For the lower limb, muscle strength and walking ability improved after isokinetic rehabilitation programs. For the upper limb, the only two studies found in the literature suggest improvement in the strength of the trained muscles, of grip force, of the Fugl-Meyer motor score and of global functional capacities. This review does not reveal any consensus on the protocols to be implemented: type of muscle contraction, velocities….ConclusionWhile isokinetic strengthening has not proven its efficiency in rehabilitation of the upper limb following stroke, its interest with regard to rehabilitation of the lower limbs has been recognized. Randomized controlled trials in this field are necessary to confirm its efficiency, especially concerning upper arm rehabilitation