Complex Versus Simple Ankle Movement Training in Stroke Using Telerehabilitation: A Randomized Controlled Trial.

Background. Telerehabilitation allows rehabilitative training to continue remotely after discharge from acute care and can include complex tasks known to create rich conditions for neural change. Objectives. The purposes of this study were: (1) to explore the feasibility of using telerehabilitation...

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Publicado en:Physical Therapy Vol. 92; no. 2; pp. 197 - 210
Autores principales: Deng, Huiqiong, Durfee, William K., Nuckley, David J., Rheude, Brandon S., Severson, Amy E., Skluzacek, Katie M., Spindler, Kristen K., Davey, Cynthia S., Carey, James R.
Formato: diagnostic images equations & formulas pictorial research tables/charts randomized controlled trial Journal Article
Publicado: Oxford University Press / USA Feb2012
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2012
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      pub: Oxford University Press / USA
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        10.2522/ptj.20110018
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        atl: Complex Versus Simple Ankle Movement Training in Stroke Using Telerehabilitation: A Randomized Controlled Trial.
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          Deng, Huiqiong
          Durfee, William K.
          Nuckley, David J.
          Rheude, Brandon S.
          Severson, Amy E.
          Skluzacek, Katie M.
          Spindler, Kristen K.
          Davey, Cynthia S.
          Carey, James R.
        affil: Program in Rehabilitation Science, University of Minnesota, Minneapolis, Minnesota
      sug:
        subj:
          Stroke Rehabilitation
          Telemedicine
          Ankle
          Gait Training Methods
          Dorsiflexion
          Human
          Randomized Controlled Trials
          Pilot Studies
          Gait Analysis
          Motion Analysis Systems
          Exercise Test
          Adult
          Middle Age
          Aged
          Female
          Male
          Kinematics
          Magnetic Resonance Imaging Methods
          Paired T-Tests
          T-Tests
          Wilcoxon Signed Rank Test
          Wilcoxon Rank Sum Test
          Fisher's Exact Test
          Data Analysis Software
          Outcome Assessment
          Funding Source
          Clinical Assessment Tools
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Female
          Male
      ab: Background. Telerehabilitation allows rehabilitative training to continue remotely after discharge from acute care and can include complex tasks known to create rich conditions for neural change. Objectives. The purposes of this study were: (1) to explore the feasibility of using telerehabilitation to improve ankle dorsiflexion during the swing phase of gait in people with stroke and (2) to compare complex versus simple movements of the ankle in promoting behavioral change and brain reorganization. Design. This study was a pilot randomized controlled trial. Setting. Training was done in the participant's home. Testing was done in separate research labs involving functional magnetic resonance imaging (fMRI) and multi-camera gait analysis. Patients. Sixteen participants with chronic stroke and impaired ankle dorsiflexion were assigned randomly to receive 4 weeks of telerehabilitation of the paretic ankle. Intervention. Participants received either computerized complex movement training (track group) or simple movement training (move group). Measurements. Behavioral changes were measured with the 10-m walk test and gait analysis using a motion capture system. Brain reorganization was measured with ankle tracking during fMRI. Results. Dorsiflexion during gait was significantly larger in the track group compared with the move group. For fMRI, although the volume, percent volume, and intensity of cortical activation failed to show significant changes, the frequency count of the number of participants showing an increase versus a decrease in these values from pretest to posttest measurements was significantly different between the 2 groups, with the track group decreasing and the move group increasing. Limitations. Limitations of this study were that no follow-up test was conducted and that a small sample size was used. Conclusions. The results suggest that telerehabilitation, emphasizing complex task training with the paretic limb, is feasible and can be effective in promoting further dorsiflexion in people with chronic stroke.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        equations & formulas
        pictorial
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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