Efficacy of a technology-based client-centred training system in neurological rehabilitation: a randomised controlled trial.

Background: A client-centred task-oriented approach has advantages towards motivation and adherence to therapy in neurorehabilitation, but it is costly to integrate in practice. An intelligent Activity-based Client-centred Training (i-ACT), a low-cost Kinect-based system, was developed which integra...

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Publicado en:Journal of NeuroEngineering & Rehabilitation (JNER) Vol. 18; no. 1; pp. 1 - 17
Autores principales: Knippenberg, Els, Timmermans, Annick, Coolen, Jolijn, Neven, Katrien, Hallet, Peter, Lemmens, Jolien, Spooren, Annemie
Formato: research Journal Article
Publicado: BioMed Central 12/27/2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 12/27/2021
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      pub: BioMed Central
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        154341144
        154341144
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        154341144
        10.1186/s12984-021-00977-2
        NLM34961531
        154341144
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        atl: Efficacy of a technology-based client-centred training system in neurological rehabilitation: a randomised controlled trial.
      aug:
        au:
          Knippenberg, Els
          Timmermans, Annick
          Coolen, Jolijn
          Neven, Katrien
          Hallet, Peter
          Lemmens, Jolien
          Spooren, Annemie
        affil: Department of Healthcare, Centre of Expertise – Innovation in Care, PXL University of Applied Sciences and Arts, Guffenslaan 39, 3500, Hasselt, Belgium
      sug:
        subj:
          Quality of Life
          Single-Blind Studies
          Human
          Technology
          Canada
          Comparative Studies
          Multicenter Studies
          Evaluation Research
          Validation Studies
      ab: Background: A client-centred task-oriented approach has advantages towards motivation and adherence to therapy in neurorehabilitation, but it is costly to integrate in practice. An intelligent Activity-based Client-centred Training (i-ACT), a low-cost Kinect-based system, was developed which integrates a client-centred and task-oriented approach. The objectives were (1) to investigate the effect of additional i-ACT training on functioning. And (2) to assess whether training with i-ACT resulted in more goal oriented training.Methods: A single-blind randomised controlled trial was performed in 4 Belgian rehabilitation centres with persons with central nervous system deficits. Participants were randomly allocated through an independent website-based code generator using blocked randomisation (n = 4) to an intervention or control group. The intervention group received conventional care and additional training with i-ACT for 3 × 45 min/week during 6 weeks. The control group received solely conventional care. Functional ability and performance, quality of life (QoL), fatigue, trunk movement, and shoulder active range of motion (AROM) were assessed at baseline, after 3 weeks and 6 weeks of training, and 6 weeks after cessation of training. Data were analysed using non-parametric within and between group analysis.Results: 47 persons were randomised and 45 analysed. Both intervention (n = 25) and control (n = 22) group improved over time on functional ability and performance as measured by the Wolf Motor Function Test, Manual Ability Measure-36, and Canadian Occupational Performance Measure, but no major differences were found between the groups on these primary outcome measures. Regarding QoL, fatigue, trunk movement, and shoulder AROM, no significant between group differences were found. High adherence for i-ACT training was found (i.e. 97.92%) and no adverse events, linked to i-ACT, were reported. In the intervention group the amount of trained personal goals (88%) was much higher than in the control group (46%).Conclusions: Although additional use of i-ACT did not have a statistically significant added value regarding functional outcome over conventional therapy, additional i-ACT training provides more individualised client-centred therapy, and adherence towards i-ACT training is high. A higher intensity of i-ACT training may increase therapy effects, and should be investigated in future research.Trial Registration: ClinicalTrials.gov Identifier NCT02982811. Registered 29 November 2016.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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