Long-term Effectiveness and Adoption of a Cellphone Augmented Reality System on Patients with Stroke: Randomized Controlled Trial
Chong LiXinyu SongShugeng ChenChuankai WangJieying HeYongli ZhangShuo XuZhijie YanJie JiaPeter B. Shull
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A serious game-based cellphone augmented reality system (CARS) was developed for rehabilitation of stroke survivors, which is portable, convenient, and suitable for self-training.This study aims to examine the effectiveness of CARS in improving upper limb motor function and cognitive function of stroke survivors via conducting a long-term randomized controlled trial and analyze the patient's acceptance of the proposed system.A double-blind randomized controlled trial was performed with 30 poststroke, subacute phase patients. All patients in both the experimental group (n=15) and the control group (n=15) performed a 1-hour session of therapy each day, 5 days per week for 2 weeks. Patients in the experimental group received 30 minutes of rehabilitation training with CARS and 30 minutes of conventional occupational therapy (OT) each session, while patients in the control group received conventional OT for the full 1 hour each session. The Fugl-Meyer Assessment of Upper Extremity (FMA-UE) subscale, Action Research Arm Test (ARAT), manual muscle test and Brunnstrom stage were used to assess motor function; the Mini-Mental State Examination, Add VS Sub, and Stroop Game were used to assess cognitive function; and the Barthel index was used to assess activities of daily living before and after the 2-week treatment period. In addition, the User Satisfaction Evaluation Questionnaire was used to reflect the patients' adoption of the system in the experimental group after the final intervention.All the assessment scores of the experimental group and control group were significantly improved after intervention. After the intervention. The experimental group's FMA-UE and ARAT scores increased by 11.47 and 5.86, respectively, and were both significantly higher than the increase of the control group. Similarly, the score of the Add VS Sub and Stroop Game in the experimental group increased by 7.53 and 6.83, respectively, after the intervention, which also represented a higher increase than that in the control group. The evaluation of the adoption of this system had 3 sub-dimensions. In terms of accessibility, the patients reported a mean score of 4.27 (SD 0.704) for the enjoyment of their experience with the system, a mean 4.33 (SD 0.816) for success in using the system, and a mean 4.67 (SD 0.617) for the ability to control the system. In terms of comfort, the patients reported a mean 4.40 (SD 0.737) for the clarity of information provided by the system and a mean 4.40 (SD 0.632) for comfort. In terms of acceptability, the patients reported a mean 4.27 (SD 0.884) for usefulness in their rehabilitation and a mean 4.67 (0.617) in agreeing that CARS is a suitable tool for home-based rehabilitation.The rehabilitation based on combined CARS and conventional OT was more effective in improving both upper limb motor function and cognitive function than was conventional OT. Due to the low cost and ease of use, CARS is also potentially suitable for home-based rehabilitation.Chinese Clinical Trial Registry ChiCTR1800017568; https://tinyurl.com/xbkkyfyz.Keywords:
Stroke
Stroop effect
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The color-word Stroop task requires an individual to ignore one piece of information (word) while responding to another (color). Since self-monitors are good at adapting their responses to fit a situation and those high in need for cognition carefully think through information before responding, this study explored the relationship between self-monitoring and need for cognition using Stroop interference. It was anticipated that self-monitoring would reduce Stroop interference, while need for cognition would increase Stroop interference. 23 General Psychology students (10 men, 13 women, M(age) = 18.8 yr.) participated. Participants were given the Self-monitoring Scale, the Need for Cognition Scale, and the Stroop Color-Word Test. Analysis indicated that Need for Cognition was not correlated with Stroop interference (r = .31) but higher scores on Self-monitoring were correlated with lower Stroop interference (r = .43). Implications for research are suggested.
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The Stroop test was originally invented by Stroop to measure selective attention and cognitive flexibility and various versions of this test have been developed by many other researchers. Since the Stroop test requires the examinee's sustained efforts, it is not readily applicable to children with developmental disorders. In order to overcome this weakness, a modified Stroop test by reducing the total number of stimulations from 300 to 72 was proposed for clinical use. This study was performed to obtain the standard value of the modified Stroop test, and also to clarify the developmental changes in indices of interference effect. Two hundred eighty one normal children and adults, ranging from 6 to 20 years of age were examined. A simple regression analysis was performed to examine the relation between age and the score of indices such as Incongruent Color Naming (ICN), ICN--Color Naming (CN), ICN/CN. The results from this analysis showed significant age-related changes. Subjects between sixteen and seventeen showed the best score in each index. These findings suggest that a brain region and/or functional system of late maturation might participate in the execution of the interference task.
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The 37 hospitalized RA patients undergoing rehabilitation (for 4 weeks) were evaluated on effects of rehabilitation by comparing scores of ADL at the time of admission and discharge. Items of ADL were composed of 32. Items of ADL which were likely to be disabled were related to those of ADL which were influenced by rehabilitation (r = 0.7412, p < 0.01). From this result, 11 items of ADL which were likely to be disabled and influenced by rehabilitation could be selected in order. Usefulness of these selected items of ADL on evaluation of rehabilitation was admitted.
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To examine whether participants with ADHD showed a deficit in Stroop/reverse-Stroop interference by comparing them to non-ADHD participants.A group with ADHD, primarily inattentive type (n = 15), and a paired non-ADHD group (n = 15) completed the group version of the Stroop/reverse-Stroop test.Asymmetric interference was observed between the Stroop test and the reverse-Stroop test in ADHD participants, presenting evidence contrary to Barkley's behavioral inhibition model of ADHD in which response inhibition deficits pertained only to the ADHD-C subtype.Participants with ADHD showed a control deficit in reverse-Stroop interference but not in Stroop interference.
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The color-word Stroop task requires an individual to ignore one piece of information (word) while responding to another (color). Since self-monitors are good at adapting their responses to fir a situation and those high in need for cognition carefully think through information before responding, this study explored the relationship between self-monitoring and need for cognition using Stroop interference. It was anticipated that self-monitoring would reduce Stroop interference, while need for cognition would increase Stroop interference. 23 General Psychology students (10 men, 13 women, Mage = 18.8 yr.) participated. Participants were given the Self-monitoring Scale, the Need for Cognition Scale, and the Stroop Color-Word Test. Analysis indicated that Need for Cognition was not correlated with Stroop interference (r = .31) but higher scores on Self-monitoring were correlated with lower Stroop interference (r = .43), Implications for research are suggested.
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Abstract Stroop–reverse‐Stroop interference is a phenomenon based on word‐reading skill acquisition, especially the original color–word interference task. Few studies have examined preschool children, probably because early childhood school education is a requirement for the occurrence of Stroop–reverse‐Stroop interference and because of difficulties in application to young children. However, many Japanese students have begun to acquire word‐reading skills in preschool. To estimate the age at which Stroop interference occurs, standardized Stroop–reverse‐Stroop interference tests were conducted of 58 kindergarten children using a blinker board to facilitate attentional stability. Results revealed the presence of Stroop interference among participants in the 4–5‐year and 5–6‐year age groups, although no reverse‐Stroop interference was found. Developmental perspectives related to an older age group for Stroop–reverse‐Stroop interference are discussed.
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Abstract Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association’s Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings for occupational therapy and activities of daily living (ADL) interventions to improve ADL outcomes for adults with stroke.
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Independent living
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