The Reality of Virtual Reality In Stroke Rehabilitation

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    17-Feb-2017

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<ul><li><p>Stroke e17Poster 20</p><p>Concurrent Validity of the Stroke Upper Limb Capacity Scale (SULCS)</p><p>Daniel C. Tufaro (New York Presbyterian Hospital), Joan Toglia,Michael ODell, Mark Villanueva</p><p>Objective: The SULCS is a new measure of upper limb capacity. Weexamine the relationship between the SULCS and measures of impairment</p><p>(Upper Extremity Motricity Index, UE-MI) and activity limitation</p><p>(Functional Independence Measure-Self Care, FIMsc).</p><p>Design: Criterion standard, descriptive.Setting: Inpatient Rehabilitation Unit.Participants: Inpatients with stroke (nZ74) with a mean ageZ71(14)years, National Institutes of Health Stroke ScaleZ 9(7), median dayspost strokeZ 7, and 38% with left brain lesion.Interventions: Not applicable.Main Outcome Measure(s): All measures were performed at admission.Frequency distributions of assessment scores and correlations with the</p><p>SULCS were analyzed.</p><p>Results: The SULCS held strong relationships with the UE-MI (rhoZ.90,pZ.000) and FIMsc (rhoZ.77, pZ.000).Eleven and 12% of SULCS scoreswere at the highest and lowest values, respectivelywhile 30% and 19%of the</p><p>UE-MI scores were at the highest and lowest value, respectively.</p><p>Conclusions: The SULCS is strongly related to measures of impairmentand activity limitations supporting its concurrent validity. Although both</p><p>are brief and easy to administer, the UE-MI demonstrated a ceiling and</p><p>floor effect compared to the SULCS. Results suggest the SULCS may be</p><p>useful as a brief measure of upper extremity capacity for persons with</p><p>stroke in the acute rehabilitation phase.</p><p>Key Words: assessment, stroke, upper extremity rehabDisclosure(s): None Disclosed.</p><p>Poster 21</p><p>The Reality of Virtual Reality In Stroke Rehabilitation</p><p>Jocelyn Harris (School of Rehabilitation Science, McMaster University),Heidi Sveistrup, Stephanie M N Glegg, Heather Colquhoun,Hillel Finestone, Pat Miller, Vincent DePaul, Laurie Wishart, Marie Brien</p><p>Objective: To design, implement and evaluate the effectiveness of aknowledge translation (KT) strategy to support therapists in acquiring</p><p>proficiency with the Interactive Rehabilitation Exercise System (IREX;</p><p>GestureTek) while emphasizing integration of motor learning strategies</p><p>(MLS) during virtual reality (VR) interventions. VR systems are promising</p><p>treatment options in stroke rehabilitation because they can incorporate</p><p>MLS supporting motivating task-oriented practice.</p><p>Design: Before-after trial.Setting: Stroke rehabilitation unit.Participants: Four physical therapists and 3 occupational therapists partici-pated in the KT strategy and provided VR-based therapy to 24 clients</p><p>with stroke.</p><p>Interventions: The KT strategy included e-learning modules, group andindividual practice, and audit and feedback. Content included practicalities</p><p>of VR system operation with a focus on clinical application of MLS.</p><p>Main Outcome Measure(s): Standardized instruments were used to evaluatechanges in therapists VR knowledge, attitudes and behaviors; use of MLS</p><p>(videotaped sessions), and decision-making related to integratingMLS during</p><p>VR use. Professional experiences were captured through a focus group.</p><p>Results: Significant pre-post changes in therapist self-efficacy (pZ0.041)were observed. However, therapists used few MLS, with no significant</p><p>improvement in MLS use over time. While therapists reported increased</p><p>knowledge about motor learning and understanding of the VR system,</p><p>difficulties with IREX operation appeared to lead to challenges assimi-</p><p>lating learning in the two domains. Integration of MLS seemed to take a</p><p>backseat to managing technical VR issues.</p><p>Conclusions: Future KT strategies should consider a phased approachwhereby proficiency in VR system operation precedes integration of a</p><p>theoretical approach to treatment.www.archives-pmr.orgKey Words: Knowledge translation, Virtual reality therapy, Stroke,Rehabilitation</p><p>Disclosure(s): None disclosed.</p><p>Poster 22</p><p>Comparing the Evidence for Interventions for CommunicationDeficits in Stroke and Acquired Brain Injuries</p><p>Danielle Brittany Rice (Lawson Health Research Institute),Laura Allen, Robert William Teasell</p><p>Objective: To compare and contrast the stroke and acquired brain injury(ABI) rehabilitation literature for communication deficits.</p><p>Data Sources: Using the Evidence Based Review of Stroke Rehabilitation(EBRSR) and the Evidence Based Review of Acquired Brain Injury</p><p>(ERABI) databases, we extracted all randomized control trials (RCTs)</p><p>from 1970 to 2013. Articles were identified through a literature search of</p><p>multiple databases (e.g. Psychinfo, Scopus, PubMed).</p><p>Study Selection: Studies were included if the sample population includedpatients 18 years old post ABI (moderate to severe) or stroke receivingan intervention for a communication disorder.</p><p>Data Extraction: The sample size, year of publication and type of inter-vention were extracted from each study that met inclusion criteria.</p><p>Data Synthesis: The literature for communication disorders revealed moreRCTs for stroke interventions (nZ50) than RCTs for ABI interventions(nZ31). There was overlap in many interventions used in both populationssuch as training communication partners, pharmaceuticals and group</p><p>therapy. Speech language therapy was an effective and common inter-</p><p>vention for aphasia post stroke (8 RCTs); however, for ABI there were no</p><p>RCTs looking at speech language therapy. The prevalence of aphasia in</p><p>ABI patients has been reported as high as 30% suggesting that in the case</p><p>of speech language therapy for aphasia in ABI, evidence-based practice</p><p>may need to rely on stroke rehabilitation evidence.</p><p>Conclusions: Considering the commonalities of communication deficitswithin stroke and ABI, when supporting evidence for interventions is weak</p><p>in one population, such as aphasia treatment after ABI, it may be beneficial</p><p>to rely on strong evidence within the other area, i.e. stroke rehabilitation.</p><p>Key Words: Aphasia, Communication deficits, Stroke, AcquiredBrain Injury</p><p>Disclosure(s): None Disclosed.</p><p>Poster 23</p><p>Interventions for Depression: Combining the Stroke and AcquiredBrain Injury Rehabilitation Literature</p><p>Danielle Brittany Rice (Lawson Health Research Institute),Mona Madady, Marina Richardson, Swati Mehta, Robert William Teasell</p><p>Objective: To compare and contrast the stroke and acquired brain injury(ABI) rehabilitation literature of depression.</p><p>Data Sources: Using the Evidence Based Review of Stroke Rehabilitation(EBRSR) and the Evidence Based Review of Acquired Brain Injury</p><p>(ERABI) databases we extracted all randomized control trials (RCTs) from</p><p>1970 to 2013. These databases include articles identified through a sys-</p><p>tematic search of the research literature from databases such as PsychInfo</p><p>and Scopus.</p><p>Study Selection: Studies were included if the sample population includedpatients 18 years old post ABI (moderate to severe) or stroke, receivingan intervention for depression.</p><p>Data Extraction: The sample size, year of publication and type of inter-vention were extracted from each study that met inclusion criteria.</p><p>Data Synthesis: Each RCT was categorized according to type of interven-tion, and was further classified as pharmacological or non-pharmacological</p><p>interventions. The numbers of RCTs, sample sizes, and publication dates</p><p>were compared between stroke and ABI. Both pharmacological and non-</p><p>pharmacological intervention data sets were dominated by stroke RCTs.</p><p>There were over 3 times as many pharmacological RCTs in stroke compared</p><p>to ABI, and over 4 times as many non-pharmacological RCTs. The</p><p>http://www.archives-pmr.org</p><p>Concurrent Validity of the Stroke Upper Limb Capacity Scale (SULCS)ObjectiveDesignSettingParticipantsInterventionsMain Outcome Measure(s)ResultsConclusionsKey WordsDisclosure(s)</p><p>The Reality of Virtual Reality In Stroke RehabilitationObjectiveDesignSettingParticipantsInterventionsMain Outcome Measure(s)ResultsConclusionsKey WordsDisclosure(s)</p><p>Comparing the Evidence for Interventions for Communication Deficits in Stroke and Acquired Brain InjuriesObjectiveData SourcesStudy SelectionData ExtractionData SynthesisConclusionsKey WordsDisclosure(s)</p><p>Interventions for Depression: Combining the Stroke and Acquired Brain Injury Rehabilitation LiteratureObjectiveData SourcesStudy SelectionData ExtractionData Synthesis</p></li></ul>

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