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    Rights statement: This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation on 12/04/2018, available online: http://www.tandfonline.com/10.1080/09638288.2018.1459881

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The feasibility, acceptability and preliminary efficacy of a low-cost, virtual-reality based, upper-limb stroke rehabilitation device: a mixed methods study

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The feasibility, acceptability and preliminary efficacy of a low-cost, virtual-reality based, upper-limb stroke rehabilitation device: a mixed methods study. / Warland, Alyson; Paraskevopoulos, Ioannis; Tsekleves, Emmanuel et al.
In: Disability and Rehabilitation, Vol. 41, No. 18, 01.07.2019, p. 2119-2134.

Research output: Contribution to Journal/MagazineJournal articlepeer-review

Harvard

Warland, A, Paraskevopoulos, I, Tsekleves, E, Ryan, J, Nowicky, A, Griscti, J, Levings, H & Kilbride, C 2019, 'The feasibility, acceptability and preliminary efficacy of a low-cost, virtual-reality based, upper-limb stroke rehabilitation device: a mixed methods study', Disability and Rehabilitation, vol. 41, no. 18, pp. 2119-2134. https://doi.org/10.1080/09638288.2018.1459881

APA

Warland, A., Paraskevopoulos, I., Tsekleves, E., Ryan, J., Nowicky, A., Griscti, J., Levings, H., & Kilbride, C. (2019). The feasibility, acceptability and preliminary efficacy of a low-cost, virtual-reality based, upper-limb stroke rehabilitation device: a mixed methods study. Disability and Rehabilitation, 41(18), 2119-2134. https://doi.org/10.1080/09638288.2018.1459881

Vancouver

Warland A, Paraskevopoulos I, Tsekleves E, Ryan J, Nowicky A, Griscti J et al. The feasibility, acceptability and preliminary efficacy of a low-cost, virtual-reality based, upper-limb stroke rehabilitation device: a mixed methods study. Disability and Rehabilitation. 2019 Jul 1;41(18):2119-2134. Epub 2018 Apr 12. doi: 10.1080/09638288.2018.1459881

Author

Warland, Alyson ; Paraskevopoulos, Ioannis ; Tsekleves, Emmanuel et al. / The feasibility, acceptability and preliminary efficacy of a low-cost, virtual-reality based, upper-limb stroke rehabilitation device : a mixed methods study. In: Disability and Rehabilitation. 2019 ; Vol. 41, No. 18. pp. 2119-2134.

Bibtex

@article{2d990a67391f441696369f1dea407182,
title = "The feasibility, acceptability and preliminary efficacy of a low-cost, virtual-reality based, upper-limb stroke rehabilitation device: a mixed methods study",
abstract = "PURPOSE: To establish feasibility, acceptability, and preliminary efficacy of an adapted version of a commercially available, virtual-reality gaming system (the Personalised Stroke Therapy system) for upper-limb rehabilitation with community dwelling stroke-survivors.METHOD: Twelve stroke-survivors (nine females, mean age 58 years, [standard deviation 7.1], median stroke chronicity 42 months [interquartile range 34.7], Motricity index 14-25 for shoulder and elbow) were asked to complete nine, 40-min intervention sessions using two activities on the system over 3 weeks. Feasibility and acceptability were assessed through a semi-structured interview, recording of adverse effects, adherence, enjoyment (using an 11-point Likert scale), and perceived exertion (using the BORG scale). Assessments of impairment (Fugl-Meyer Assessment Upper extremity), activity (ABILHAND, Action Research Arm Test, Motor Activity Log-28), and participation (Subjective Index of Physical and Social Outcome) were completed at baseline, following intervention, and at 4-week follow-up. Data were analysed using Thematic Analysis of interview and intervention field-notes and Wilcoxon Signed Ranks. Side-by-side displays were used to integrate findings.RESULTS: Participants received between 175 and 336 min of intervention. Thirteen non-serious adverse effects were reported by five participants. Participants reported a high level of enjoyment (8.1 and 6.8 out of 10) and rated exertion between 11.6 and 12.9 out of 20. Themes of improvements in impairments and increased spontaneous use in functional activities were identified and supported by improvements in all outcome measures between baseline and post-intervention (p < 0.05 for all measures).CONCLUSIONS: Integrated findings suggested that the system is feasible and acceptable for use with a group of community-dwelling stroke-survivors including those with moderately-severe disability. Implications for rehabilitation To ensure feasibility of use and maintenance of an appropriate level of challenge, gaming technologies for use in upper-limb stroke rehabilitation should be personalised, dependent on individual need. Through the use of hands-free systems and personalisation, stroke survivors with moderate and moderately-severe levels of upper-limb impairment following stroke are able to use gaming technologies as a means of delivering upper-limb rehabilitation. Future studies should address issues of acceptability, feasibility, and efficacy of personalised gaming technologies for delivery of upper-limb stroke rehabilitation in the home environment. Findings from this study can be used to develop future games and activities suitable for use in stroke rehabilitation.",
keywords = "Gaming technologies, stroke rehabilitation, technology, game-based rehabilitation, hemiplegia, virtual reality",
author = "Alyson Warland and Ioannis Paraskevopoulos and Emmanuel Tsekleves and Jennifer Ryan and Alexander Nowicky and Josephine Griscti and Hannah Levings and Cherry Kilbride",
note = "This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation on 12/04/2018, available online: http://www.tandfonline.com/10.1080/09638288.2018.1459881",
year = "2019",
month = jul,
day = "1",
doi = "10.1080/09638288.2018.1459881",
language = "English",
volume = "41",
pages = "2119--2134",
journal = "Disability and Rehabilitation",
issn = "0963-8288",
publisher = "Taylor and Francis Ltd.",
number = "18",

}

RIS

TY - JOUR

T1 - The feasibility, acceptability and preliminary efficacy of a low-cost, virtual-reality based, upper-limb stroke rehabilitation device

T2 - a mixed methods study

AU - Warland, Alyson

AU - Paraskevopoulos, Ioannis

AU - Tsekleves, Emmanuel

AU - Ryan, Jennifer

AU - Nowicky, Alexander

AU - Griscti, Josephine

AU - Levings, Hannah

AU - Kilbride, Cherry

N1 - This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation on 12/04/2018, available online: http://www.tandfonline.com/10.1080/09638288.2018.1459881

PY - 2019/7/1

Y1 - 2019/7/1

N2 - PURPOSE: To establish feasibility, acceptability, and preliminary efficacy of an adapted version of a commercially available, virtual-reality gaming system (the Personalised Stroke Therapy system) for upper-limb rehabilitation with community dwelling stroke-survivors.METHOD: Twelve stroke-survivors (nine females, mean age 58 years, [standard deviation 7.1], median stroke chronicity 42 months [interquartile range 34.7], Motricity index 14-25 for shoulder and elbow) were asked to complete nine, 40-min intervention sessions using two activities on the system over 3 weeks. Feasibility and acceptability were assessed through a semi-structured interview, recording of adverse effects, adherence, enjoyment (using an 11-point Likert scale), and perceived exertion (using the BORG scale). Assessments of impairment (Fugl-Meyer Assessment Upper extremity), activity (ABILHAND, Action Research Arm Test, Motor Activity Log-28), and participation (Subjective Index of Physical and Social Outcome) were completed at baseline, following intervention, and at 4-week follow-up. Data were analysed using Thematic Analysis of interview and intervention field-notes and Wilcoxon Signed Ranks. Side-by-side displays were used to integrate findings.RESULTS: Participants received between 175 and 336 min of intervention. Thirteen non-serious adverse effects were reported by five participants. Participants reported a high level of enjoyment (8.1 and 6.8 out of 10) and rated exertion between 11.6 and 12.9 out of 20. Themes of improvements in impairments and increased spontaneous use in functional activities were identified and supported by improvements in all outcome measures between baseline and post-intervention (p < 0.05 for all measures).CONCLUSIONS: Integrated findings suggested that the system is feasible and acceptable for use with a group of community-dwelling stroke-survivors including those with moderately-severe disability. Implications for rehabilitation To ensure feasibility of use and maintenance of an appropriate level of challenge, gaming technologies for use in upper-limb stroke rehabilitation should be personalised, dependent on individual need. Through the use of hands-free systems and personalisation, stroke survivors with moderate and moderately-severe levels of upper-limb impairment following stroke are able to use gaming technologies as a means of delivering upper-limb rehabilitation. Future studies should address issues of acceptability, feasibility, and efficacy of personalised gaming technologies for delivery of upper-limb stroke rehabilitation in the home environment. Findings from this study can be used to develop future games and activities suitable for use in stroke rehabilitation.

AB - PURPOSE: To establish feasibility, acceptability, and preliminary efficacy of an adapted version of a commercially available, virtual-reality gaming system (the Personalised Stroke Therapy system) for upper-limb rehabilitation with community dwelling stroke-survivors.METHOD: Twelve stroke-survivors (nine females, mean age 58 years, [standard deviation 7.1], median stroke chronicity 42 months [interquartile range 34.7], Motricity index 14-25 for shoulder and elbow) were asked to complete nine, 40-min intervention sessions using two activities on the system over 3 weeks. Feasibility and acceptability were assessed through a semi-structured interview, recording of adverse effects, adherence, enjoyment (using an 11-point Likert scale), and perceived exertion (using the BORG scale). Assessments of impairment (Fugl-Meyer Assessment Upper extremity), activity (ABILHAND, Action Research Arm Test, Motor Activity Log-28), and participation (Subjective Index of Physical and Social Outcome) were completed at baseline, following intervention, and at 4-week follow-up. Data were analysed using Thematic Analysis of interview and intervention field-notes and Wilcoxon Signed Ranks. Side-by-side displays were used to integrate findings.RESULTS: Participants received between 175 and 336 min of intervention. Thirteen non-serious adverse effects were reported by five participants. Participants reported a high level of enjoyment (8.1 and 6.8 out of 10) and rated exertion between 11.6 and 12.9 out of 20. Themes of improvements in impairments and increased spontaneous use in functional activities were identified and supported by improvements in all outcome measures between baseline and post-intervention (p < 0.05 for all measures).CONCLUSIONS: Integrated findings suggested that the system is feasible and acceptable for use with a group of community-dwelling stroke-survivors including those with moderately-severe disability. Implications for rehabilitation To ensure feasibility of use and maintenance of an appropriate level of challenge, gaming technologies for use in upper-limb stroke rehabilitation should be personalised, dependent on individual need. Through the use of hands-free systems and personalisation, stroke survivors with moderate and moderately-severe levels of upper-limb impairment following stroke are able to use gaming technologies as a means of delivering upper-limb rehabilitation. Future studies should address issues of acceptability, feasibility, and efficacy of personalised gaming technologies for delivery of upper-limb stroke rehabilitation in the home environment. Findings from this study can be used to develop future games and activities suitable for use in stroke rehabilitation.

KW - Gaming technologies

KW - stroke rehabilitation

KW - technology

KW - game-based rehabilitation

KW - hemiplegia

KW - virtual reality

U2 - 10.1080/09638288.2018.1459881

DO - 10.1080/09638288.2018.1459881

M3 - Journal article

C2 - 29644897

VL - 41

SP - 2119

EP - 2134

JO - Disability and Rehabilitation

JF - Disability and Rehabilitation

SN - 0963-8288

IS - 18

ER -