| 제목 |
The effect of digital rehabilitation system with wearable IMU sensors in children with brain injury |
| 소속 |
Eulji University College of Medicine, Department of Physical and Rehabilitation Medicine1, Seoul Rehabilitation Hospital, Department of Physical and Rehabilitation Medicine2, Yonsei University College of Medicine, Department and Research Institute of Rehabilitation Medicine3 |
| 저자 |
Ja Young Choi1*, Sook-hee Yi2, Dain Shim3, Beomki Yoo3, Jinseok Bae1, Yonghyun Lee3, Dong-wook Rha3† |
Purpose:This study investigated the effect of digital rehabilitation system with wearable multi-inertial measurement unit (IMU) sensors on upper limb functions in children with brain injury.
Study design: A single blind randomized controlled trial, with an 8-weeks follow-up.
Participants:Forty children (mean age 7.0 yrs) with cerebral palsy or static brain injury (6 months after the onset) were included at 3 rehabilitation institutions.
Intervention: All participants received a daily rehabilitation treatment on upper limb for 60 minutes, 5 days per week for 4 weeks. The experimental group(n = 20) received 30 min of conventional occupational therapy(OT) and 30 min of therapy using the digital rehabilitation program with wearable IMU sensors. The control group(n = 20) received conventional OT alone for 60min per day for same duration. Training program using the digital rehabilitation system consisted of wrist and forearm articular movements: wrist flexion/extension, supination/pronation, ulnar/radial deviation correlated with visual stimuli using screen.
Outcome measure: Melbourne Assessment of Unilateral Upper Limb Function, version 2(MUUL-2) to measure the affected upper limb function; the Upper Limb Physician’s Rating Scale(ULPRS) to measure each affected limb segment; the Pediatric Evaluation of Disability Inventory-computer adaptive test(PEDI-CAT) to assess activities of daily living capability. Assessments were performed by blinded assessors at baseline, after intervention, and 8 weeks after intervention. The percent score of MUUL-2 and scaled score of PEDI-CAT were used for analysis. Linear mixed analysis was used to assess differences in outcome measure over time and group.
Results:Thirty-nine subjects completed the intervention and no safety issues were reported. In the experimental group, upper limb functions measured by range, accuracy, and dexterity domain of MUUL-2 were significantly improved after intervention(p<0.05). Segmental movements in affected limb measured by wrist dorsiflexion and total score of ULPRS showed significant improvements in experimental group(p<0.05). However, there were no significant differences in terms of interaction effect of group by time for any of the outcome measures of MUUL-2 and ULPRS. As for daily living capability, analysis of PEDI-CAT revealed group differences. The experimental group demonstrated significant improvements at 8-weeks follow up assessment in daily activity domain that were not observed in the control group.
Conclusion:Digital rehabilitation system with wearable IMU sensors is equally as effective as conventional OT in the training of upper limb function in children with brain injury. In addition, digital rehabilitation system remained superior for improving performances in daily activities. This new therapeutic approach using digital system may effectively complement standard rehabilitation by providing motivation and therapeutic support for children with brain injury. |
|
Table 1. Characteristics of Participants
Table 2. Descriptive Statistics of Outcome Measures at Baseline, After Intervention, and at 8 Weeks Follow-Up and Statistical Comparison
|
