Investigation of therapeutic effects of wearable robotic gloves on improving hand function in stroke patients: A systematic review.

Background: Over the past decades, wearable robotic gloves due to their positive features are used by clinicians to improve motor function in the upper extremity. This systematic review aims to evaluate the studies that investigated the therapeutic effects of wearable robotic gloves to improve hand function in stroke patients. Methods: The most related databases including MEDLINE (PubMed), ISI Web of Knowledge, Scopus, IEEE, and Google Scholar were systematically searched and studies were collected up to September 2021. The methodological quality assessment was done using an adapted version of the Downs and Black checklist. Results: Of the 2674 articles searched, 5 studies were recognized as being relevant in this systematic review. The methodological quality of all included studies was between 7 to 10 points of adapted 12-point score of Downs and Black checklist. All studies concluded that the introduced robotic device had a good therapeutic effect on investigated patients' hand function. The studies had limitations in terms of the level of evidence, sample size, stroke patient groups, and therapeutic process. Conclusion: There is no standard approach with definite intervention timing to evaluate the effect of such devices. Therefore, more comprehensive studies are needed to confirm the therapeutic effects of wearable robotic gloves on improving hand function after a stroke.

First prototype of EMG-controlled power hand orthosis for restoring hand extension in stroke patients.

Weakness in finger extensors is a common post-stroke deficit that can disturb hand functioning. Despite introducing several powered hand orthoses in literature, most of these devices focused on providing finger flexion. There is a little consideration for providing active hand extension in stroke patients. Moreover, in many devices, the finger extensions were restored passively by spring component. In this study, a new Electromyography (EMG)-controlled powered hand orthosis was designed to improve hand function by restoring and training hand extension in stroke patients with paretic hand. This orthosis was a glove-like device that was developed from two mechanical and electrical sections. After construction and verifying of the orthosis, its applicability was tested on two patients with Cerebrovascular accident (1 woman and 1 man) with paretic hands in an 18-session therapeutic approach. To evaluate the effectiveness of orthosis, Wolf Motor Function Test and Box and Block test were conducted before and after the training sessions. The primary assessment of the prototype was conducted on a healthy subject and three stroke patients. These evaluations showed that the new powered hand orthosis could be effective for finger extension task and training. Furthermore, after the 18-session training approach, significant improvements were seen in the scores of both Wolf and Box and Block tests. The preliminary findings suggested that the first prototype of orthosis could provide a desirable function for stroke patients with paretic hand. Moreover, it could be used as a training device in the rehabilitation of these patients.

Cross-cultural adaptation, reliability, and validity of the Persian version of the Cumberland Ankle Instability Tool.

PURPOSE: The purpose of the present study was to translate and to cross-culturally adapt the Cumberland Ankle Instability Tool (CAIT) into Persian language and to evaluate its psychometric properties. METHOD: The International Quality of Life Assessment process was pursued to translate CAIT into Persian. Two groups of Persian-speaking individuals, 105 participants with a history of ankle sprain and 30 participants with no history of ankle sprain, were asked to fill out Persian version of CAIT (CAIT-P), Foot and Ankle Ability Measure (FAAM), and Visual Analog Scale (VAS). Data obtained from the first administration of CAIT were used to evaluate floor and ceiling effects, internal consistency, dimensionality, and criterion validity. To determine the test-retest reliability, 45 individuals re-filled CAIT 5-7 days after the first session. RESULTS: Cronbach's alpha was over the cutoff point of 0.70 for both ankles and in both groups. The intra-class correlation coefficient was high for right (0.95) and left (0.91) ankles. There was a strong correlation between each item and the total score of the CAIT-P. Although the CAIT-P had strong correlation with VAS, its correlation with both subscales of FAAM was moderate. CONCLUSIONS: The CAIT-P has good validity and reliability and it can be used by clinicians and researchers for identification and investigation of functional ankle instability. Implications for Rehabilitation Chronic ankle instability is one of the most common consequences of acute ankle sprain. Cumberland Ankle Instability Tool is an acceptable measure to determine functional ankle instability and its severity. The Persian version of Cumberland Ankle Instability Tool is a valid and reliable tool for clinical and research purpose in Persian-speaking individuals.

The Persian version of satisfaction assessment module of Orthotics and Prosthetics Users' Survey.

BACKGROUND: Orthotics and Prosthetics User's Survey (OPUS) was developed to measure patient satisfaction in Prosthetic and Orthotic (P&O) field. OBJECTIVE: To translate the satisfaction assessment module of OPUS (OPUS-SM) into Persian language (Persian OPUS-SM) and investigate its psychometric properties. METHODS: For cross-cultural adaptation of the OPUS-SM, the guideline suggested by the World Health Organization was recruited. A sample of 116 Persian-speaking people who received P&O devices and services, participated in this study. During the first session, participants filled out the Persian OPUS-SM and the Visual Analog Scale (VAS) regarding their satisfaction from delivered devices and services. Drawing from the above sample of 116 participants, 41 participants retook the Persian OPUS-SM 5-7 days after their first time. The results of the first and second administration sessions were analyzed to assess internal consistency, test-retest reliability, item-subscale correlation, minimal detectable change, floor and ceiling effects, criterion validity, and dimensionality of the Persian OPUS-SM. RESULTS: The Cronbach's alphas of the Persian OPUS-SM were 0.71 and 0.89 for device and service satisfaction subscales, respectively. The intraclass correlation coefficients were 0.76 and 0.90 for device and service satisfaction subscales, respectively. The SEM and MDC for device satisfaction were 6.21 and ±17.21, respectively. The SEM and MDC for service satisfaction were 2.25 and ±6.22, respectively. There was a strong correlation between VAS and satisfaction subscales of the Persian OPUS-SM. Dimensionality assessment revealed that Persian OPUS-SM is a unidimensional measure. CONCLUSIONS: The adapted and translated Persian OPUS-SM is a reliable and validated measure.

Effect of soft and semirigid ankle orthoses on Star Excursion Balance Test performance in patients with functional ankle instability.

OBJECTIVES: To evaluate the effect of soft and semirigid ankle orthoses on dynamic balance assessed using Star Excursion Balance Test in patients with functional ankle instability compared with healthy individuals. DESIGN: Non-experimental, observational study with multiple-factor design, including group (functional ankle instability and healthy) as the between-subjects factor and orthotics condition (no orthosis, soft orthosis and semirigid orthosis) as the within-subjects factor. METHODS: Sixteen unilateral functional ankle instability patients and a group of 16 healthy control individuals, matched for age, height and weight, participated in the study. Dynamic balance was tested with and without wearing ankle orthosis. Reach distance of participants in 3 bracing conditions were measured in anteromedial, medial and posteromedial directions of Star Excursion Balance Test. Average of 3 trials in 3 measured directions, normalized to leg length of each participant, was used for statistical analysis. RESULTS: There were no differences among orthotics conditions in healthy people. However, normalized reach distance increased from no-orthosis to semirigid to soft orthoses in FAI patients. Differences were significant between soft and no-orthosis (13% in anteromedial, 14% in medial and 15% in posteromedial direction p=0.01) and between semirigid and no-orthosis (10% in anteromedial, 8.5% in medial and 8.5% in posteromedial direction, p=0.01) conditions in all 3 measured directions. The difference between soft and semirigid orthoses was significant (6% difference, p<0.05) only in PM direction. CONCLUSIONS: Ankle orthoses improve reach distance in functional ankle instability patients in various reach directions. Soft orthosis has a more pronounced effect on dynamic balance, especially in posteromedial direction, compared with semirigid orthosis.

Effects of soft and semi-rigid ankle orthoses on postural sway in people with and without functional ankle instability.

Some studies have demonstrated improvement of postural control following use of ankle supports, whereas others reported no effect or even negative effects of bracing. The present study aimed to investigate the immediate effects of soft and semi-rigid orthosis on postural sway in patients with functional ankle instability (FAI). Twenty patients with unilateral FAI and twenty matched healthy individuals participated in the study. Balance in single limb stance on force platform with eyes-open was assessed for both legs while wearing no orthosis (control condition), soft or semi-rigid orthosis. The center of pressure (COP) measures derived from force platform signals were mean total velocity, standard deviation (SD) of velocity and phase plane portrait. A 2 × 2 × 3 (group by foot by orthotics) mixed model analysis of variance was used for statistical analysis. In the FAI group, there was a tendency to lower COP parameters while wearing either of the orthoses, with soft brace having a greater effect. For 2 dependent variables, significant effect of brace was found only for the injured limb. In the healthy group, postural sway increased from no-brace condition, to soft, to semi-rigid orthosis. Both injured and non-injured limbs of patients with FAI had greater postural sway compared to control limbs of healthy individuals.

The Persian version of Trinity Amputation and Prosthetics Experience Scale: translation, factor structure, reliability and validity.

PURPOSE: The purpose of the present study was to translate the Trinity Amputation and Prosthetics Experience Scale (TAPES) into Persian and to investigate its psychometric properties. METHOD: A sample of 182 Persian-speaker individuals with lower limb amputation completed the TAPES questionnaire, of whom 103 individuals completed the Short Form 36 Health survey as well. The TAPES was re-administered to 41 participants in the retest session, with an interval of 5-7 days between the two sessions. Internal consistency, test-retest reproducibility, dimensionality, item internal consistency and discriminant validity and construct validity were assessed. RESULTS: Cronbach's α's were greater than the cut-off point of 0.70 for all subscales with the exception of social adjustment subscale. Minimum intraclass correlation coefficient of 0.70 was exceeded by all subscales with the exception of social activity subscale. Principle component analysis performed on each section of the TAPES revealed loading of all items on their corresponding factors. The exceptions were item 4 of social adjustment subscale and the single item of weight subscale. Most items were stronger measures of their hypothesised subscale than the other subscales. In terms of construct validity, 75% of a priori hypotheses were confirmed. CONCLUSIONS: The Persian version of TAPES seems to be a reliable and valid measure of psychological adaptation to artificial limb.