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

Journal of NeuroEngineering and Rehabilitation

Annemie Spooren¹  Els Knippenberg¹  Jolien Lemmens²  Annick Timmermans³  Jolijn Coolen⁴  Katrien Neven⁵  Peter Hallet⁶ 

[1] Department of Healthcare, Centre of Expertise – Innovation in Care, PXL University of Applied Sciences and Arts, Guffenslaan 39, 3500, Hasselt, Belgium;Faculty of Rehabilitation Sciences, REVAL, Hasselt University, Agoralaan, Gebouw A, 3590, Diepenbeek, Belgium;Department of Healthcare, Centre of Expertise – Innovation in Care, PXL University of Applied Sciences and Arts, Guffenslaan 39, 3500, Hasselt, Belgium;Sint-Gerardus, Multifunctioneel Centrum, Sint-Gerardusdreef 1, 3590, Diepenbeek, Belgium;Faculty of Rehabilitation Sciences, REVAL, Hasselt University, Agoralaan, Gebouw A, 3590, Diepenbeek, Belgium;Noorderhart, Rehabilitation and MS Center, Boemerangstraat 2, 3900, Pelt, Belgium;St-Trudo Hospital, Diestersteenweg 100, 3800, St-Truiden, Belgium;Ziekenhuis Oost-Limburg, Campus Sint-Barbara, Bessemerstraat 478, 3620, Lanaken, Belgium;

关键词: Client-centred;    Task-oriented;    Rehabilitation;    Technology;    Efficacy;   

DOI  :  10.1186/s12984-021-00977-2

来源: Springer

【 摘 要 】

BackgroundA 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.MethodsA 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.Results47 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%).ConclusionsAlthough 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.

【 授权许可】

CC BY