Clinical, Functional and Kinematic Correlations using the Virtual Reality System Toyra® as Upper Limb Rehabilitation Tool in People with Spinal Cord Injury

Iris Dimbwadyo-Terrer, Fernando Trincado-Alonso, Ana de los Reyes-Guzmán, Alberto Bernal-Sahún, Patricia López-Monteagudo, Begoña Polonio-López, Ángel Gil-Agudo

Abstract

The aim of this study was to prove the validity and efficacy of the Virtual Reality (VR) System Toyra® as an assessment and rehabilitation tool for people with tetraplegia. We analysed the correlation between clinical and functional parameters with kinematic variables of upper limbs during a training protocol using Toyra®. Eighteen patients with cervical spinal cord injury (SCI) were selected to perform the study by comparing 2 treatments: patients in an intervention group (IG) conducted a program that included 12 sessions with Toyra® Activities of Daily Living (ADLs) module for 3 weeks, while a control group (CG) only had the traditional rehabilitation. Kinematic variables (shoulder, elbow and hand joint range of motion) were correlated to clinical [Motor Index (MI), Muscle Balance (MB)] and functional [Functional Independence Measure (FIM), Spinal Cord Independence Measure II (SCIM II), Barthel Index (BI)] evaluation scores. The results of the study showed a high correlation between these variables and also statistically significant differences (p=0.039) in a kinematic parameter (wrist extension), after treatment and in the follow-up evaluation. Toyra® system has been validated as upper limb assess and rehabilitation tool in people with SCI, to measure the patient´s functional evolution and improve the movement in upper limbs.

References

  1. Alt Murphy, M., Sunnerhagen, K. S., Johnels, B., Willén, C. J. (2006). Three-dimensional kinematic motion analysis of a daily activity drinking from a glass: a pilot study. Journal of neuroengineering and rehabilitation, 3, 18.
  2. Baydal-Bertomeu, J. M., Viosca-Herrero, E., OrtuñoCortés, M. A., Quinza-Valero, V., Garrido-Jaen, D., Vivas Broseta, M. J. (2010). Estudio de la eficacia y fiabilidad de un sistema de posturografia en comparación con la escala de Berg. Rehabilitación, 44(4), 304-310.
  3. Beninato, M., O'Kane, K. S., Sullivan, P. E. (2004). Relationship between motor FIM and muscle strength in lower cervical-level spinal cord injuries. Spinal Cord, 42, 533-540.
  4. Cacho, E. W., de Oliveira, R., Ortolan, R. L., Varoto, R., Cliquet, A. Jr. (2011). Upper limb assessment in tetraplegia: clinical, functional and kinematic correlations. International journal of rehabilitation research, 34(1), 65-72.
  5. Catz, A., Itzkovich, M., Agranov, E., Ring, H., Tamir, A. (1997). SCIM-spinal cord independence measure: a new disability scale for patients with spinal cord lesions. Spinal Cord, 35, 850 -856.
  6. Demeurisse, G., Demol, 0., Rolaye, E. (1980). Motor evaluation in vascular hemiplegia. European neurological journal, 19, 382-9.
  7. Eng, K., Siekierka, E., Pyk, P., et al. (2007). Interactive visuo-motor therapy system for stroke rehabilitation. Medical & biological engineering & computing, 45(9), 901-7.
  8. Gil-Agudo, A., Del Ama-Espinosa, A., De los ReyesGuzmán, A., Bernal-Sahún, A., Rocón, E. (2011). Applications of upper limb biomechanical models in spinal cord injury patients (internet monograph) in: V. Klika, Ed. Rijeka (Croatia): Biomechanics in Applications (pp. 125-164).
  9. Gil-Agudo, A., Dimbwadyo, I., Peñasco-Martín, B., De los Reyes-Guzmán, A., Bernal-Sahún, A., BerbelGarcía, A. (2012). Experiencia clínica de la aplicación del sistema de Realidad Virtual TOYRA en la neurorehabilitación de pacientes con lesión medular. Rehabilitación, 46(1), 41-48.
  10. Hamilton, B. B., Laughlin, J. A., Granger, C. V., Kayton, RM. (1991). Interrater Agreement of the Seven Level Functional Independence Measure (FIM). Archives of physical medicine and rehabilitation, 72, 790.
  11. Harvey, L. A., Batty, J., Jones, R., Crosbie, J. (2001). Hand function of C6 and C7 tetraplegics 1 - 16 years following injury. Spinal Cord, 39(1), 37-43.
  12. Mahoney, F. I., Barthel, D. W. (1965). Functional evaluation: the Barthel Index. Maryland state medical journal, 14, 61-65.
  13. Marino, R. J., Barros, T., Biering-Sorensen, F., Burns, S. P., Donovan, W. H., Graves, D. E., et al. (2003). International standards for neurological classification of spinal cord injury. The journal of spinal cord medicine (Vol. 26, pp. S50-56).
  14. Oess, N. P., Wanek, J., Curt, A. (2012). Design and evaluation of a low-cost instrumented glove for hand function assessment. Journal of neuroengineering and rehabilitation, 9, 2.
  15. Snoek, G. J., IJzerman, M. J., Hermens, H. J., Maxwell, D., Biering-Sorensen, F. (2004). Survey of the needs of patients with spinal cord injury: impact and priority for improvement in hand function in tetraplegics. Spinal Cord, 42 (9), 526-32.
  16. SPSS Statistics 17.0. SPSS Inc, Chicago, IL, USA. (2008).
  17. Stewart, J. C., Yeh, S. C., Jung, Y., Yoon, H., Whitford, M., Chen, S. Y., et al. (2007). Intervention to enhance skilled arm and hand movements after stroke: A feasibility study using a new virtual reality system. Journal of neuroengineering and rehabilitation, 23(4), 21.
  18. Tsao, C. C., Mirbagheri, M. M. (2007). Upper limb impairment associated with spasticity in neurological disorders. Journal of neuroengineering and rehabilitation, 4, 45.
  19. Van Tuijl, J. H., Janssen-Potten, Y. J., Seelen, H. A. (2002). Evaluation of upper extremity motor function tests in tetraplegics. Spinal Cord, 40(2), 51-64.
  20. Weiss, P. L., Kizony, R., Feintuch, U., Katz, N. (2006). Virtual reality in neurorehabilitation. En: Selzer M, Clarke S, Cohen L, Duncan P, Gage F, eds. Textbook of neural repair and rehabilitation (pp. 182-97). Cambridge: University Press,.
  21. Wyndaele, M., Wyndaele, J. J. (2006). Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey? Spinal Cord, 44(9), 523-9.
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Paper Citation


in Harvard Style

Dimbwadyo-Terrer I., Trincado-Alonso F., de los Reyes-Guzmán A., Bernal-Sahún A., López-Monteagudo P., Polonio-López B. and Gil-Agudo Á. (2013). Clinical, Functional and Kinematic Correlations using the Virtual Reality System Toyra® as Upper Limb Rehabilitation Tool in People with Spinal Cord Injury . In Proceedings of the International Congress on Neurotechnology, Electronics and Informatics - Volume 1: VirtRehab, (NEUROTECHNIX 2013) ISBN 978-989-8565-80-8, pages 81-88. DOI: 10.5220/0004642600810088


in Bibtex Style

@conference{virtrehab13,
author={Iris Dimbwadyo-Terrer and Fernando Trincado-Alonso and Ana de los Reyes-Guzmán and Alberto Bernal-Sahún and Patricia López-Monteagudo and Begoña Polonio-López and Ángel Gil-Agudo},
title={Clinical, Functional and Kinematic Correlations using the Virtual Reality System Toyra® as Upper Limb Rehabilitation Tool in People with Spinal Cord Injury},
booktitle={Proceedings of the International Congress on Neurotechnology, Electronics and Informatics - Volume 1: VirtRehab, (NEUROTECHNIX 2013)},
year={2013},
pages={81-88},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0004642600810088},
isbn={978-989-8565-80-8},
}


in EndNote Style

TY - CONF
JO - Proceedings of the International Congress on Neurotechnology, Electronics and Informatics - Volume 1: VirtRehab, (NEUROTECHNIX 2013)
TI - Clinical, Functional and Kinematic Correlations using the Virtual Reality System Toyra® as Upper Limb Rehabilitation Tool in People with Spinal Cord Injury
SN - 978-989-8565-80-8
AU - Dimbwadyo-Terrer I.
AU - Trincado-Alonso F.
AU - de los Reyes-Guzmán A.
AU - Bernal-Sahún A.
AU - López-Monteagudo P.
AU - Polonio-López B.
AU - Gil-Agudo Á.
PY - 2013
SP - 81
EP - 88
DO - 10.5220/0004642600810088