A critical analysis of efficacy of commercial biofeedback devices on motor recovery in lower limb among stroke patients.
Introduction. A stroke has become one of the most serious diseases which threatens public health worldwide. A prevalence of a stroke increases with age but it is not natural part of aging process. According to the Australian Institute of Health and Welfare (2013), more than 375,000 Australians had suffered by stroke in 2009 and 70% of them were more than aged 65. Furthermore, more than a third of Australians among them had a disability from the stroke (Australian Institute of Health and Welfare, 2013). A stroke often leaves people with paralysis, balance problem, cognitive problem, speech impairment and loss of memory depends
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Recently, commercial gaming devices such as Nintendo Wii and virtual reality have gained attention as biofeedback in stroke rehabilitation. Biofeedback devices recognize intrinsic physiological feedback from patient and transforms into extrinsic feedback through visual, auditory and tactile system. Biofeedback may have advantages to enhance motor skills as it provides continuous, accurate feedback to the patient. Therefore, this essay examines the effectiveness of biofeedback devices in stroke rehabilitation especially on lower limb activities since impairment of lower limb such as walking and balancing is associated with independence of the patient, hence how these biofeedback devices influence neural plasticity among stroke patients.
Stroke occurs when the blood supply to the brain is restricted either through a blockage or bleeding, which reduces or restrains the supply of oxygen to the brain causing permanent neurological damage. Furthermore, it leaves a person impaired functional ability. In this essay, impairment of lower limb will be focused since it is highly related to independence of a patient’s life. The processes of motor impairment of
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It is a form of extrinsic feedback which transforms biological signals into an output through visual, auditory and tactile systems to provide feedbacks to the patients. Recently commercial gaming devices such as Nintendo Wii and virtual reality have gained attention as a form of biofeedback. Iruthayarajah et al(2017) and Stanton et al(2016) review articles with meta-analysis about efficacy of biofeedback devices in stroke rehabilitation. Iruthayarajah et al(2017) examine randomized controlled trials including Nintendo Wii balance board, treadmill training with virtual reality(VR) and postural training with VR in chronic stroke patients up to September 2015. Outcome of efficacy of VR was measured with Berg Balance Scale(BBC) which is a measurement of functional balance through standing exercises and the Timing Up and Go test(TUG) which measures time in seconds of a person standing from sitting(Iruthayarajah et al, 2017). Significant improvement of balance in chronic stroke patient were observed after VR treatment and superior to the effect of conventional physical therapy(Iruthayarajah et al, 2017). All of trainings with VR was shown to provide substantial benefit but improvement of balance training with VR was the most outstanding(Iruthayarajah et al, 2017). Stanton et al(2016) also reviewed 18 randomized controlled trials assessing motor function in lower limb with any
As an Occupational Therapist, it is crucial to consider the wellbeing of Martha as a whole person. She is not merely a stroke patient. She is a homemaker, wife, and game enthusiast. Two conditions hindering her accomplishment of these meaningful occupations are her motor planning deficit and the lack of functionality in her right upper extremity (RUE). Martha has difficulty following multi- step commands, and relies heavily on the assistance of others with mobility, transfers, and activities of daily living (ADLs). Despite these, two of her strengths are her abilities to consistently answer yes/no questions by moving her head, and the mobility of her left upper extremity (LUE). She is alert and oriented to herself, and the strength and sensation in her LUE are within functional limits. These factors shape a client’s Occupational Therapy experience.
Firstly Biofeedback is a technique on how to control your muscles that are not normally controlled for example blood pressure or your heart rate. This is meant to reduce ANS activity therefore reducing the symptoms related to stress such as illness. An individual participating in Biofeedback would be attached to a machine that produces feedback about some physiological activity. For example auditory or visual signals would be produced to indicate changes in the patients heart rate. It is possible even to control your own brain waves using biofeedback. The individual is also trained in how to reduce levels of stress that have been discovered. The biofeedback involves three stages 1: Developing an awareness of the particular response, 2: Learning ways to control the physiological response in quiet conditions and 3: transferring the control into everyday life.
...ter screen an arm that was placed onto his stump. When Ture Johanson saw his arm on the computer screen, he was able to control his own movements using his own neural command. In this particular study, Johanson was asked to perform numerous movements with his phantom hands such as driving a racecar. By driving a racecar, Catalan found that the subject moved muscles at the end of his existing arm to show the intent of moving his missing hand. From this study, subjects who had been experiencing PLP for several years had longer periods without pain and had shorter periods of intense pain. In addition, the phantom hand was relaxed from a tight fist to a half-open position. This study is different from others because the control signals are retrieved from the arm stump, and thus the affected arm is in charge. Moreover, it uses the signals from the damaged limbs itself.
All subjects had the ability to increase their skin temperature and decrease their muscle tension in at least one of their trials. The majority of the subjects were able to increase the skin temperature of their nondominant hands index finger, along with decrease the tension of their frontalis muscle during the second trial. The effects of biofeedback became greater after subjects had "practice" and "learned" just how to control their temperature or muscle tension. "Practice" created a greater out come in the second trial because they "learned" how to do increase their temperature or decrease their muscle tension. As discussed in the lab report, "this finding shows the effectiveness of biofeedback on reducing factors associated with stress, like muscle tension and low skin temperature; biofeedback impact is even greater when it is administered over time" (Thomas 177).
Biofeedback is learning to manage functions like: brain waves, heart rate, body temperature and a few others. Biofeedback was created when two researchers were testing a woman’s skin temperature while she was undergoing relaxation techniques. While undergoing this her skin temperature rose about 10 degrees. After her temperature rose she noted that her migraine had dramatically went away. These researchers then went on to make a biofeedback device and taught many people how to ease pain by using relaxation techniques. A majority of people thought that if you could learn to manage certain functions, then many other diseases could be controlled. Biofeedback helps to treat problems such as: emotional problems, an arrhythmia and asthma (Billiterl 59).
This module has enabled the author to understand the concept of vulnerability, risk and resilience in relation to stroke. Therefore, it will contribute to her professional development and lifelong learning (NES, 2012). Additionally, the author has gained evidence based knowledge of person-centred care, compassion and self-awareness; all of which can be used to inform future practice (Miller, 2008). Consequently, she will be able to provide the appropriate level of care that can make a difference to a person’s recovery.
Patients with hemiplegia caused by a stroke show decreased limb sense and sensory movement due to weakening of the muscles; these problems cause difficulties in posture and tasks such as wearing clothes, eating and self-management18). BIA is reliable, non-invasive method, has high reproducibility, safe and easy-to-use.
Balance is used in our everyday lives. It is defined as the ability to move or to remain in a position without losing control or falling (Sibley, 2013). It is achieved from the mix of integration and coordination of several body systems such as the vestibular, visual, auditory, motor, and higher level premotor systems. Maintaining ones balance must incorporate maintaining his/her center of mass over the base of support or within ones limits of stability. Impairments with balance can occur in a big part of today’s population and have a big impact on function and daily activities.
Cerebrovascular Accident a) Overview - definition and the effects of the stroke on the body A stroke is a serious, life-threatening medical condition that occurs when the blood supply to part of the brain is cut off. (http://www.nhs.uk/conditions/Stroke/Pages/Introduction.aspx) This condition is a common cause of death and disability, especially in older people. Some predisposing factors include: • hypertension • atheroma • cigarette smoking • diabetes mellitus It occurs when blood flow to the brain suddenly interrupted, causing hypoxia. The effects include paralysis of a limb or one side of the body and disturbances of speech and vision.
Stroke is a commonly known disease that is often fatal. This cellular disease occurs when blood flow to the brain is interrupted by either a blood clot halting the progress of blood cells in an artery, called an Ischemic stroke, or a blood vessel in the brain bursting or leaking causing internal bleeding in the brain, called a hemorrhagic stroke. When this happens, brain cells are deprived of oxygen and nutrients because the blood cells carrying these essential things are stopped, causing them to die. When the cells in the brain die, sensation or movement in a limb might be cut off and may limit an organism’s abilities. A person with stroke is affected depending on where in the brain the stroke occurs. In other words, symptoms of a stroke
Hemiplegia, a condition in which one-half of a patient's body is paralyzed usually results from stroke or cerebrovascular accident. Individuals affected by hemiplegia have difficulty dealing with frustration, swallowing, walking, forming words, dressing, feeding self and bowel/urine incontinence. Quality of life from the individual’s own perspective is paramount because hemiplegia leads to self denial, self care deficit and need for minimal to total dependence. Therefore the goal of treatment is to help the individual reach his or her fullest potential for independence, functioning and accepting who they are as individuals.
Stroke is a serious medical condition that affects people of all ages specifically older adults. People suffer from a stroke when there is decreased blood flow to the brain. Blood supply decreases due to a blockage or a rupture of a blood vessel which then leads to brain tissues dying. The two types of stroke are ischemic stroke and hemorrhagic stroke. An ischemic stroke is caused by a blood clot blocking the artery that brings oxygenated blood to the brain. On the other hand, a hemorrhagic stroke is when an artery in the brain leaks or ruptures (“About Stroke,” 2013). According to the Centers for Disease Control and Prevention (CDC), “Stroke is the fourth leading cause of death in the United States and is a major cause of adult disability” (“About Stroke,” 2013). Stroke causes a number of disabilities and also leads to decreased mobility in over half of the victims that are 65 and older. The CDC lists several risk factors of stroke such as heredity, age, gender and ethnicity as well as medical conditions such as high blood pressure, high cholesterol, diabetes and excessive weight gain that in...
Prosthetics are an integral part in rehabilitating people who have lost limbs. They can allow for patients to try to get back to the normalcy they had before and make daily tasks more like the routine they had. With continual advancements in technology and science, prosthetics have come a long way from the rudimentary artificial limbs that had previously been the only options available. This has led to the development that allows patients to control their prosthetic, in this case an arm, using their mind as if it was their own.1,2 This works by sending signals from the brain to the prosthetic which receives them and follows them, all in real time.1,2 However, the more human-like and realistic the prosthetics can become as far capabilities
My grandfather's stroke affected his legs and his memory, which made it difficult for him to walk. My grandfather first used a cane, but his legs became too weak, so he tried a walker, but this lasted only a month. Not only could he not walk or take care of himself, but also he began to stay up at night and fall out of bed.
(2009) show, such kind of exercises can also be useful for the elderly. Old-aged people need to be physically active and move, otherwise, many adverse consequences will follow. In their article, Diest, Lamoth, Stegenga, Verkerke, and Postema (2013) focus on the poor postural control that can cause falls and, as a consequence, fall injuries. As the statistics provided in the article states, nearly 33% of community-dwelling elderly fall at least one time in a year (Diest et al., 2013, p. 1). Up to 20 percent of those falls have serious consequences, from lacerations to head traumas and even deaths. However, the postural control can and should be improved through training, and one of the best ways to do this is exergaming. In addition to the fact that such kind of training improves the balance abilities, it also increases the motivation and makes old-aged people enjoy their training programs (Diest et al., 2013, p.