Article

PURPOSE: To describe the novel BrightArm Duo bimanual upper extremity (UE)
rehabilitation system; to determine its technology acceptance and clinical
benefit for older hemiplegic participants. METHODS:
The system table tilted to
adjust arm gravity loading. Participants wore arm supports that sensed grasp
strength and wrist position on the table. Wrist weights further increased
shoulder exertion. Games were designed to improve UE strength, motor function,
cognition and emotive state and adapted automatically to each participant. The system underwent feasibility trials spanning 8 weeks in two skilled nursing
facilities (SNFs). Participants were evaluated pre-therapy and post-therapy using
standardized clinical measures. Computerized measures of supported arm reach,
table tilt and number of arm repetitions were stored on a remote server.
OUTCOMES: Seven participants had significant improvements in their active range
of shoulder movement, supported arm reach, shoulder strength, grasp strength and
their ability to focus. The group demonstrated higher arm function measured with
FMA (p = 0.01) and CAHAI (p = 0.05), and had an improvement in depression (Becks
Depression Inventory, II). BrightArm Duo technology was well accepted by
participants with a rating of 4.4 out of 5 points. CONCLUSIONS: Given these
findings, it will be beneficial to evaluate the BrightArm Duo application in SNF
maintenance programs. Implications for Rehabilitation Integrative rehabilitation
that addresses both physical and cognitive domains is promising for post-stroke
maintenance in skilled nursing facilities. Simultaneous bilateral arm exercise
may improve arm function in older hemiplegic patients several years after stroke.
Virtual reality games that adapt to the patient can increase attention and
working memory while decreasing depression in elderly.

Langue : ANGLAIS