title: A telerehabilitation approach to delivery of constraint-induced movement therapy.
abstract: We have developed a device called AutoCITE (Automated Constraint-Induced Therapy Extension) that automates the intensive training component of constraint-induced (CI) movement therapy, also known as CI therapy. This study evaluated the effectiveness of AutoCITE training in a telerehabilitation setting when supervised remotely and with only intermittent interaction with a therapist. Seven participants with chronic stroke trained with AutoCITE for 3 h/d for 10 consecutive weekdays. The therapist supervised the training from a different room in the clinic using remote control of the AutoCITE computer and teleconferencing equipment when needed. Treatment gains on the Motor Activity Log were quite large (p < 0.001, d' = 3), while gains on the Wolf Motor Function Test and the Jebsen-Taylor Hand Function Test were large (p < 0.05, d' > 0.9). Gains were comparable in size with those previously reported for participants who received equal intensities of directly supervised AutoCITE training or standard one-on-one CI therapy without the device.
authors.affiliation: Hunter Holmes McGuire Department of Veterans Affairs Medical Center (VAMC), Richmond, VA, USA. lum@cua.edu
authors.forename: Peter S
authors.initials: PS
authors.lastname: Lum
authors.forename: Gitendra
authors.initials: G
authors.lastname: Uswatte
authors.forename: Edward
authors.initials: E
authors.lastname: Taub
authors.forename: Phillip
authors.initials: P
authors.lastname: Hardin
authors.forename: Victor W
authors.initials: VW
authors.lastname: Mark
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001676:Biofeedback, Psychology; D003194:Computer-Assisted Instruction / Q000295:instrumentation / Q000379:methods*; D005081:Exercise Therapy; D006801:Humans; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D012149:Restraint, Physical / Q000379:methods*; D012371:Robotics; D000071939:Stroke Rehabilitation; D014584:User-Computer Interface