Authors (including presenting author) :
Cheung WL, Lam CM, Cheung TY
Affiliation :
Department of Occupational Therapy, Tuen Mun Hospital, New Territories West Cluster, Hospital Authority
Introduction :
Task-specific training was recommended as an evidence-based treatment for improving upper extremity (Hebert et al., 2016; Winstein et al., 2016) and ADL function (Winstein et al., 2016). Re-construction of the whole task, repetitiveness and positive reinforcement are essential to its application in clinical practice (Hubbard et al., 2009). They could be facilitated by wearable body motion sensor training program in virtual reality environment. The coordination of posture and limb movement might benefit the reintegration of skills relearnt into patient’s activities of daily living (ADL).
Objectives :
The objective of this study is to investigate the effectiveness in application of wearable sensor-mediated virtual reality (VR) program in occupational therapy intervention among sub-acute stroke patients.
Methodology :
Sub-acute stroke patients were recruited in rehabilitation stroke unit of Tuen Mun Hospital. After randomization, subjects in intervention group received 10 sessions of 30-minute motion senor-mediated VR program and 30-min conventional occupational therapy, while in control group, equivalent sessions of 60-minute conventional therapy were offered.
Outcome measures, which were conducted by blinded assessors, included Modified Bathel Index (MBI), Functional Test for Hemiplegic Upper Extremity (FTHUE), Fugl-Meyer Assessment- Upper Extremity (FMA), Chedoke Arm and Hand Activity Inventory (CAHAI), and Berg Balance Scale (BBS).
Result & Outcome :
48 subjects were recruited from September 2020 to November 2022. 30 of them completed the program, with 15 subjects randomized to each group. There was statistically significant 2-way interaction effect between groups and time in Modified Barthel Index (p=0.041). Regarding within group difference, statistically significant improvement was found in both groups in MBI, FMA total score, and FMA sub scores and CAHAI (p<0.05). Small sample size could be a possible limitation where future studies should work on.
The motion sensor-mediated intervention facilitated meaningful practices on missing components of functional activities through initiating patients’ motivation and active participation, benefitting stroke survivors’ functional recovery. Given that the intervention group could bring about statistically significant improvement in ADL, wearable motion sensors could also save therapists’ hands-on training time while expanding service capacity, thereby enhancing rehabilitation quality and efficiency.
The treatment could be variably adapted to patients’ different recovery stages by providing a wide spectrum of rehabilitation, including hand function and balance, ADL and instrumental ADL training. The portability and easy operation of the device could also be applied to home-based rehabilitation. This wearable sensor-mediated occupational therapy training program has tremendous potential to be extensively used in ambulatory rehabilitation training program and to alleviate the pressure on hospital-based rehabilitation services.
