F Covarrubias-Escudero, F Balbontín-Miranda, B Urzúa-Soler, R Ciuffardi, M Muñoz, V Hernández, J P Appelgren-González
{"title":"Home-based functional electrical stimulation protocol for people with chronic stroke. Efficacy and usability of a single-center cohort.","authors":"F Covarrubias-Escudero, F Balbontín-Miranda, B Urzúa-Soler, R Ciuffardi, M Muñoz, V Hernández, J P Appelgren-González","doi":"10.1111/aor.14922","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Stroke survivors often face challenges in recovery and reintegration after acute care. Home-based rehabilitation, incorporating advanced technologies like Functional Electrical Stimulation (FES), shows promise for improving long-term outcomes by providing more accessible, high-intensity, and task-oriented rehabilitation outside traditional clinical settings.</p><p><strong>Method: </strong>This study assessed efficacy and usability of a 10-week home-based rehabilitation protocol for 52 individuals with chronic stroke. The intervention featured a cloud-based platform, a mobile application, and functional electrical stimulation devices. Participants were categorized into groups for tailored exercise training and received both synchronous and asynchronous sessions. Efficacy was measured through standardized motor function tests, while usability was evaluated based on adherence, patient satisfaction, and the frequency of technical support requests.</p><p><strong>Results: </strong>High adherence (74.03%) and a satisfaction of 73% were observed. On average, patients performed on average 414 min of unsupervised exercise per week. Significant improvement, including a median decrease of 6.08 s (22%) in Timed Up and Go (TUG) [z (24) = 4.17, p < 0.001], a median decrease of 4.04 s (17%) in Five Times Sit to Stand (5STS) [z (28) = 3.96, p < 0.001], Motor Assessment Scale (MAS) showed a mean increase of 3.2 ± 2.8 points, paired t-test [t (20) = -5.01 p < 0.001] and an increase of 0.095 m/s (28%) in 10-Meter Walk Test (10MWT) [z (24) = 3.71, p < 0.001]. Clinical relevance was observed in all outcome measures compared with the reported Minimum Detectable Change.</p><p><strong>Conclusion: </strong>This evaluation of a home-based physiotherapy protocol indicates that integrating FES devices with virtual platforms and mobile applications can sustain high adherence while improving functional outcomes in chronic stroke rehabilitation. The prescription of high-intensity training, significant improvements in balance, gait, and overall functionality were observed, highlighting the viability of this approach for home-based programs.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Artificial organs","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1111/aor.14922","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Stroke survivors often face challenges in recovery and reintegration after acute care. Home-based rehabilitation, incorporating advanced technologies like Functional Electrical Stimulation (FES), shows promise for improving long-term outcomes by providing more accessible, high-intensity, and task-oriented rehabilitation outside traditional clinical settings.
Method: This study assessed efficacy and usability of a 10-week home-based rehabilitation protocol for 52 individuals with chronic stroke. The intervention featured a cloud-based platform, a mobile application, and functional electrical stimulation devices. Participants were categorized into groups for tailored exercise training and received both synchronous and asynchronous sessions. Efficacy was measured through standardized motor function tests, while usability was evaluated based on adherence, patient satisfaction, and the frequency of technical support requests.
Results: High adherence (74.03%) and a satisfaction of 73% were observed. On average, patients performed on average 414 min of unsupervised exercise per week. Significant improvement, including a median decrease of 6.08 s (22%) in Timed Up and Go (TUG) [z (24) = 4.17, p < 0.001], a median decrease of 4.04 s (17%) in Five Times Sit to Stand (5STS) [z (28) = 3.96, p < 0.001], Motor Assessment Scale (MAS) showed a mean increase of 3.2 ± 2.8 points, paired t-test [t (20) = -5.01 p < 0.001] and an increase of 0.095 m/s (28%) in 10-Meter Walk Test (10MWT) [z (24) = 3.71, p < 0.001]. Clinical relevance was observed in all outcome measures compared with the reported Minimum Detectable Change.
Conclusion: This evaluation of a home-based physiotherapy protocol indicates that integrating FES devices with virtual platforms and mobile applications can sustain high adherence while improving functional outcomes in chronic stroke rehabilitation. The prescription of high-intensity training, significant improvements in balance, gait, and overall functionality were observed, highlighting the viability of this approach for home-based programs.
背景：脑卒中幸存者在急性护理后经常面临康复和重返社会的挑战。以家庭为基础的康复，结合了功能电刺激（FES）等先进技术，通过在传统临床环境之外提供更容易获得的、高强度的、以任务为导向的康复，有望改善长期疗效。方法：本研究评估了52例慢性脑卒中患者10周家庭康复方案的有效性和可用性。干预的特点是基于云的平台、移动应用程序和功能性电刺激设备。参与者被分为不同的组，分别接受同步和异步训练。通过标准化的运动功能测试来衡量疗效，而根据依从性、患者满意度和技术支持请求的频率来评估可用性。结果：依从性高（74.03%），满意度73%。患者平均每周进行414分钟的无监督运动。显着改善，包括Timed Up and Go （TUG）中位值下降6.08 s (22%) [z (24) = 4.17, p]。结论：对基于家庭的物理治疗方案的评估表明，将FES设备与虚拟平台和移动应用程序相结合可以维持高依从性，同时改善慢性卒中康复的功能结局。高强度训练的处方，在平衡、步态和整体功能方面的显著改善被观察到，强调了这种方法在家庭项目中的可行性。
期刊介绍：
Artificial Organs is the official peer reviewed journal of The International Federation for Artificial Organs (Members of the Federation are: The American Society for Artificial Internal Organs, The European Society for Artificial Organs, and The Japanese Society for Artificial Organs), The International Faculty for Artificial Organs, the International Society for Rotary Blood Pumps, The International Society for Pediatric Mechanical Cardiopulmonary Support, and the Vienna International Workshop on Functional Electrical Stimulation. Artificial Organs publishes original research articles dealing with developments in artificial organs applications and treatment modalities and their clinical applications worldwide. Membership in the Societies listed above is not a prerequisite for publication. Articles are published without charge to the author except for color figures and excess page charges as noted.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
