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Ludic Table: a comparative study between playful rehabilitation and kinesiotherapy in restricting upper limb movements in individuals with stroke

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Abstract

Stroke is a neurological syndrome resulting from the sudden interruption of blood flow. Among the symptoms/consequences of the stroke are muscle weakness in the lower and/or upper limbs, decreased sensitivity, altered fine motor skills, proprioception, and reflections. The treatment for the motor consequences is orthopedic management, in which the physiotherapist assists the individual in repetitive range of motion exercises, which can be demotivating during the treatment. The Ludic Table (LT), on the other hand, incorporates playfulness into therapy, making it a motivating tool. This research describes the comparative study between kinesiotherapy techniques and exercises using the LT, applied to the development of upper limb movements. For this, fourteen volunteers were divided into groups, submitted to interventions according to the techniques, and evaluated using systems such as goniometry, HAQ-DI, GMFM-88, and neurofunctional assessment. In general, it can be stated that regardless of the intervention, the individuals obtained gain in movements (minimum average of 7 degrees) and that the use of the LT allows the development of the angular amplitude and the reduction of the effects of spasticity. The individuals submitted to the intervention through the LT obtained the development of a greater number of articular movements of the shoulder and elbow.

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References

  1. Lundy-Ekman L (2000) Neuroscience: Fundamental for Rehabilitation, 1a. Editora Guanabara Koogan, Rio de Janeiro

    Google Scholar 

  2. Lüscher TF (2015) Stroke: cardiac causes and their management. Eur Heart J 36:2339–2341. https://doi.org/10.1093/eurheartj/ehv374

    Article  PubMed  Google Scholar 

  3. Markus H (2016) Stroke: causes and clinical features. Medicine (Baltimore) 44:515–520. https://doi.org/10.1016/j.mpmed.2016.06.006

    Article  Google Scholar 

  4. Chen S, Zeng L, Hu Z (2014) Progressing haemorrhagic stroke: categories, causes, mechanisms and managements. J Neurol 261:2061–2078. https://doi.org/10.1007/s00415-014-7291-1

    Article  PubMed  PubMed Central  Google Scholar 

  5. Pallesen H, Bjerk M, Pedersen AR et al (2019) The effects of high-intensity aerobic exercise on cognitive performance after stroke: a pilot randomised controlled trial. J Cent Nerv Syst Dis 11:117957351984349. https://doi.org/10.1177/1179573519843493

    Article  Google Scholar 

  6. Hurley MA (2014) Light smoking at base-line predicts a higher mortality risk to women than to men; evidence from a cohort with long follow-up. BMC Public Health 14. https://doi.org/10.1186/1471-2458-14-95

  7. Carlton C, Banks M, Sundararajan S (2018) Oral contraceptives and ischemic stroke risk. Stroke 49:e157–e159. https://doi.org/10.1161/STROKEAHA.117.020084

    Article  PubMed  Google Scholar 

  8. LaRusso L (2016) Obesity, oral contraceptives, and stroke risk. Nurs Womens Health 20:240. https://doi.org/10.1016/j.nwh.2016.04.007

    Article  Google Scholar 

  9. Truelsen T, Begg S (2006) The global burden of cerebrovascular disease. World Heal Organ

    Google Scholar 

  10. World Health Organization, WHO (2014) Global status report on noncommunicable diseases 2014. 298

  11. WHO (2018) The top 10 causes of death. Switzerland

  12. Thrift AG, Thayabaranathan T, Howard G et al (2017) Global stroke statistics. Int J Stroke 12:13–32. https://doi.org/10.1177/1747493016676285

    Article  PubMed  Google Scholar 

  13. Williams MR (2018) A pilot study into reaching performance after severe to moderate stroke using upper arm support. PLoS One 13:e0200787. https://doi.org/10.1371/journal.pone.0200787

    Article  PubMed  PubMed Central  Google Scholar 

  14. de Santana NM, dos Santos Figueiredo FW, de Melo Lucena DM et al (2018) The burden of stroke in Brazil in 2016: an analysis of the Global Burden of Disease study findings. BMC Res Notes 11:735. https://doi.org/10.1186/s13104-018-3842-3

    Article  PubMed  PubMed Central  Google Scholar 

  15. Hanger HC, Wills KL, Wilkinson T (2014) Classification of falls in stroke rehabilitation – not all falls are the same. Clin Rehabil 28:183–195. https://doi.org/10.1177/0269215513496801

    Article  PubMed  Google Scholar 

  16. Howard VJ, Safford MM, Allen S et al (2016) Stroke symptoms as a predictor of future hospitalization. J Stroke Cerebrovasc Dis 25:702–709. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.11.040

    Article  PubMed  PubMed Central  Google Scholar 

  17. Gao L, Meschia JF, Judd SE et al (2012) What stroke symptoms tell us: association of risk factors and individual stroke symptoms in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. J Stroke Cerebrovasc Dis 21:411–416. https://doi.org/10.1016/j.jstrokecerebrovasdis.2012.04.009

    Article  PubMed  PubMed Central  Google Scholar 

  18. Singer JC, Mansfield A, Danells CJ et al (2013) The effect of post-stroke lower-limb spasticity on the control of standing balance: inter-limb spatial and temporal synchronisation of centres of pressure. Clin Biomech 28:921–926. https://doi.org/10.1016/j.clinbiomech.2013.07.010

    Article  Google Scholar 

  19. Burke D, Wissel J, Donnan GA (2013) Pathophysiology of spasticity in stroke. Neurology 80. https://doi.org/10.1212/wnl.0b013e31827624a7

  20. Minutoli VP, Delfino M, Tortoza C (2007) Effect of isokinetic continuous passive mobilization in spastic hemiplegia. Acta Fisiátrica 14:142–148

    Google Scholar 

  21. Francisco GE, McGuire JR (2012) Poststroke spasticity management. Stroke 43:3132–3136. https://doi.org/10.1161/STROKEAHA.111.639831

    Article  PubMed  Google Scholar 

  22. Li S, Francisco GE (2015) New insights into the pathophysiology of post-stroke spasticity. Front Hum Neurosci 9:1–9. https://doi.org/10.3389/fnhum.2015.00192

    Article  Google Scholar 

  23. O’Dwyer NJ, Ada L, Neilson PD (1996) Spasticity and muscle contracture following stroke. Brain 119:1737–1749. https://doi.org/10.1093/brain/119.5.1737

    Article  PubMed  Google Scholar 

  24. Thilmann AF, Fellows SJ, Garms E (1991) The mechanism of spastic muscle hypertonus variation in reflex gain over the time course of spasticity. Brain 114A:233–244. https://doi.org/10.1093/oxfordjournals.brain.a101859

    Article  Google Scholar 

  25. Hung Y-X, Huang P-C, Chen K-T, Chu W-C (2016) What do stroke patients look for in game-based rehabilitation. medicine (Baltimore) 95:e3032. https://doi.org/10.1097/MD.0000000000003032

  26. Gilmore PE, Spaulding SJ, Vandervoort AA (2004) Hemiplegic shoulder pain: implications for occupational therapy treatment. Can J Occup Ther 71:36–46. https://doi.org/10.1177/000841740407100108

    Article  PubMed  Google Scholar 

  27. Lako A, Cani E, Bara R et al (2015) Hemiplegy and physiotherapeutic rehabilitation in albania in comparison with international statistics. J Assoc English Lang Am Stud 4:69–76. https://doi.org/10.0001/(aj).v4i10.1180

    Article  Google Scholar 

  28. Shahab F, Hunaifi I (2021) A Hemichorea and Hemiplegy as a clinical manifestation of acute ischemic stroke. J Kedokt. 10.29303/jku.v9i4.435

  29. Hsieh Y, Wu C, Wang W et al (2017) Bilateral robotic priming before task-oriented approach in subacute stroke rehabilitation: a pilot randomized controlled trial. Clin Rehabil 31:225–233. https://doi.org/10.1177/0269215516633275

    Article  PubMed  Google Scholar 

  30. Scrutinio D, Lanzillo B, Guida P et al (2017) Development and validation of a predictive model for functional outcome after stroke rehabilitation. Stroke 48:3308–3315. https://doi.org/10.1161/STROKEAHA.117.018058

    Article  PubMed  Google Scholar 

  31. López-Liria R, Vega-Ramírez FA, Rocamora-Pérez P et al (2016) Comparison of two post-stroke rehabilitation programs: a follow-up study among primary versus specialized health care. PLoS One 11:e0166242. https://doi.org/10.1371/journal.pone.0166242

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Chung BPH (2018) Stratification of stroke rehabilitation: five-year profiles of functional outcomes. Hong Kong Physiother J 38:141–147. https://doi.org/10.1142/S1013702518500129

    Article  PubMed  PubMed Central  Google Scholar 

  33. Krakauer JW (2006) Motor learning: its relevance to stroke recovery and neurorehabilitation. Curr Opin Neurol 19:84–90

    Article  Google Scholar 

  34. Yamato TP, Pompeu JE, Pompeu SMAA, Hassett L (2016) Virtual reality for stroke rehabilitation. Phys Ther 96:1508–1513. https://doi.org/10.2522/ptj.20150539

    Article  PubMed  Google Scholar 

  35. Barros SLA, Passos NRS, Nunes MASN (2013) Initial study on stroke and serious game for application in the UFS Assistive Technology Center’s “Stroke” Project. GEINTEC J 3:129–143. https://doi.org/10.7198/S2237-0722201300010012

    Article  Google Scholar 

  36. Thompson-Butel AG, Lin G, Shiner CT, McNulty PA (2015) Comparison of three tools to measure improvements in upper-limb function with poststroke therapy. Neurorehabil Neural Repair 29:341–348. https://doi.org/10.1177/1545968314547766

    Article  PubMed  Google Scholar 

  37. Borghese NA, Pirovano M, Lanzi PL et al (2013) Computational intelligence and game design for effective at-home stroke rehabilitation. Games Health J 2:81–88. https://doi.org/10.1089/g4h.2012.0073

    Article  PubMed  PubMed Central  Google Scholar 

  38. Hoda M, Hoda Y, Hage A et al (2015) Cloud-based rehabilitation and recovery prediction system for stroke patients. Cluster Comput 18:803–815. https://doi.org/10.1007/s10586-015-0448-6

    Article  Google Scholar 

  39. Kornet M, Głowacka-Mrotek I, Nowacka K, Hagner W (2017) Upper limb treatment techniques for stroke survivors. J Educ Heal Sport 7:234–257. https://doi.org/10.5281/zenodo.423313

    Article  Google Scholar 

  40. de Caneda MAG, Fernandes JG, de Almeida AG et al (2006) Reliability of neurological assessment scales in patients with stroke. Arq Neuropsiquiatr 64:690–697. https://doi.org/10.1590/S0004-282X2006000400034

    Article  PubMed  Google Scholar 

  41. Alberti EJ, Pichorim SF, Brawerman A (2019) An obstetric brachial plexus lesion rehabilitation platform. Res Biomed Eng 35:167–172. https://doi.org/10.1007/s42600-019-00018-x

    Article  Google Scholar 

  42. Pichorim SF (2019) Study on the relationship between higher members’ joint angles and the hand position on a table. 1–16. (in Portuguese). http://paginapessoal.utfpr.edu.br/pichorim/PESQUISA

  43. Bruce B, Fries JF (2003) The Stanford Health Assessment Questionnaire: dimensions and practical applications. Health Qual Life Outcomes 1:20. https://doi.org/10.1186/1477-7525-1-20

    Article  PubMed  PubMed Central  Google Scholar 

  44. Bruce B, Fries JF (2005) The Health Assessment Questionnaire (HAQ). Clin Exp Rheumatol 23:S14–S18

    CAS  PubMed  Google Scholar 

  45. Riddle DL, Rothstein JM, Lamb RL (1987) Goniometric reliability in a clinical setting: shoulder measurements. Phys Ther 67:668–673. https://doi.org/10.1093/ptj/67.5.668

    Article  CAS  PubMed  Google Scholar 

  46. Rothstein JM, Miller PJ, Roettger RF (1983) Goniometric reliability in a clinical setting. Elbow and knee measurements. Phys Ther 63:1611–1615. https://doi.org/10.1093/ptj/63.10.1611

    Article  CAS  PubMed  Google Scholar 

  47. Russell DJ, Rosenbaum PL, Wright M, Avery LM (2013) Gross Motor Function Measure (GMFM-66 & GMFM-88) User’s Manual, 2nd ed. Mac Keith Press

  48. Alberti EJ, Brawerman A, Pichorim SF (2020) Influence of the layout of the Ludic Tables on the amplitude and concentration of upper limb movements. In: Proceedings of the XXVII Brazilian Congress in Biomedical Engineering. Vitória, pp 13–17

  49. Brewer BW, Van Raalte JL, Cornelius AE et al (2000) Psychological factors, rehabilitation adherence, and rehabilitation outcome after anterior cruciate ligament reconstruction. Rehabil Psychol 45:20–37. https://doi.org/10.1037/0090-5550.45.1.20

    Article  Google Scholar 

  50. Cockburn JT, Thomas FN, Cockburn OJ (1997) Solution-focused therapy and psychosocial adjustment to orthopedic rehabilitation in a work hardening program. J Occup Rehabil 7:97–106. https://doi.org/10.1007/BF02765880

    Article  Google Scholar 

  51. Granata KP, Ikeda AJ, Abel MF (2000) Electromechanical delay and reflex response in spastic cerebral palsy. Arch Phys Med Rehabil 81:888–894. https://doi.org/10.1053/apmr.2000.5578

    Article  CAS  PubMed  Google Scholar 

  52. Sahrmann SA, Norton BJ (1977) The relationship of voluntary movement of spasticity in the upper motor neuron syndrome. Ann Neurol 2:460–465. https://doi.org/10.1002/ana.410020604

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Graduate School of Electrical Engineering and Computer Science (CPGEI), Federal University of Technology, Paraná (UTFPR), Curitiba, Paraná, Brazil

    Eduardo Juliano Alberti & Sérgio Francisco Pichorim

  2. Computer Engineering School, Positivo University, Bloco Vermelho, Sala 217, Rua Professor Pedro Viriato Parigot de Souza, 5300, Campo Comprido, Curitiba, Paraná, 81280-330, Brazil

    Eduardo Juliano Alberti

  3. Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain

    Adriano Dias Santos Targa

  4. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain

    Adriano Dias Santos Targa

  5. Bioinformatics Graduate Program, Federal University of Paraná, Curitiba, Paraná, Brazil

    Alessandro Brawerman

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  1. Eduardo Juliano Alberti
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  2. Adriano Dias Santos Targa
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  3. Sérgio Francisco Pichorim
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Correspondence to Eduardo Juliano Alberti.

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Alberti, E.J., Targa, A.D.S., Pichorim, S.F. et al. Ludic Table: a comparative study between playful rehabilitation and kinesiotherapy in restricting upper limb movements in individuals with stroke. Med Biol Eng Comput 60, 1187–1198 (2022). https://doi.org/10.1007/s11517-022-02532-0

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