Funded Research Projects
Sutanuka Bhattacharjya
Occupational Therapy
Assessing Nutrition- and- Mealtime-Management Related Knowledge, Attitudes, and Practices Among Caregivers of Children with Cerebral Palsy in India
Title: Assessing Nutrition- and- Mealtime-Management Related Knowledge, Attitudes, and Practices Among Caregivers of Children with Cerebral Palsy in India
Agency: Lewis Foundation Grant
Project Period: 04/01/2021 – 03/31/2023
Abstract
Children with Cerebral Palsy (CP), a common neurodevelopmental condition inapproximately 2.5 of 1000 live births globally, and 5 to 10 times more common in most low- and middle-income countries (LMICs), including India, are highly prone to feeding difficulties, resulting in inadequate food intake and increased risk of malnutrition. Theprevalence of malnutrition among children with CP in LMICs is 29-65%. Caregivers ofchildren with CP report spending on average, seven hours a day feeding, whichcontributes to caregiver stress, fatigue, burnout, and poor quality of life, both for the caregiver and the child. Extended feeding time and effort is likely a result of lack ofknowledge and training for selecting appropriate foods, food preparation, and feedingand mealtime-management related practices. There is limited research addressing the factors that affect caregiver feeding practices in India. To address these gaps, wepropose a needs assessment study to determine the nutrition-and mealtime-management related factors that affect feeding practices of caregivers of children with CP in India. Specifically, we propose i) a scoping review of factors that influencedecisions on child nutrition- and mealtime-related practices and ii) a needs-basedassessment study, using mixed-methods, to assess the nutrition, physical, socio-cultural and environmental factors that influence mealtime feeding practices. For aim 1, the scoping review will be conducted using a structured, evidence-based methodological approach. For aim 2, using purposive sampling, 30 caregivers of children ages 4-12 years with CP will be recruited from urban and rural areas in WestBengal, India through Non-Government Organizations affiliated with the Indian Institute of Cerebral Palsy. Participants will complete an interviewer-administered Nutrition and Mealtime Management Questionnaire and participate in one of four focus group discussions (FGD). This bespoke questionnaire and protocol guide for the FGD will be developed drawing from the literature and pre-tested before use in the field. Analytical methods will include thematic analysis and quantitative descriptive analyses. Studyfindings will help to identify culturally tailored and evidence-based content areas that willbe used in a proposal to a larger grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) (Field Initiated Projects for Development) in 2023. This NIDILRR proposal will be aimed at the development and evaluation of the effectiveness of new nutrition-focused Mealtime Management Training Videos for caregivers of children with CP and will contribute to an ongoing library ofcontent-specific caregiver training videos.
mHandRehab: Virtual Hand Rehabilitation using Computer Vision
Title: mHandRehab: Virtual Hand Rehabilitation using Computer Vision
Agency: Intramural Grant Award
Project Period: 01/01/2021 – 12/31/2022
Adults over the age of 65 account for nearly three quarters of all incidents of stroke. Considering aging demographics, the need to better address post-stroke recovery continues to grow. Hand function is fundamental to making efficient movements in activities of daily living. However, in clinical rehabilitation, the current standard of practice is to discharge patients from therapy services with a written program to continue exercise at home. Whereas the exercises can be effective when adhered to, the lack of performance-based feedback to gauge one’s own hand function or level of improvement severely limits the effectiveness of home-based exercises. Creating an automated system that provides real-time movement feedback to the client while they engage in their rehabilitation, will allow the user to self-monitor their performance. Herein is a plan to transform home programs for hand function by using digital technology to offer remote rehabilitation and support self-management of home programs by individuals with stroke. We propose to use digital technology that will use state-of-the-art computer vision and deep learning models to recognize the time-series of hand movements. The mHandRehab application will provide real-time, quantitative, performance-based feedback during hand function activities performed by individuals with stroke in their homes. We hypothesize that receiving real-time quantitative feedback will improve functional mobility. We will examine performance changes in trained activities of daily living. In practice, receiving real-time feedback during home program s will serve to better inform the user of their progress and actively engage them in their rehabilitation, thus encouraging self-management skills.
Emily Buchman
Occupational Therapy
Student Learning Outcomes Using Simulated Learning Environments in Assistive Technology
Title: Student Learning Outcomes Using Simulated Learning Environments in Assistive Technology
Agency/Program: Lewis College NTT Faculty Intramural Grant Award
Award Date: Fall 2019 - 10/31/2022
Abstract:
For individuals with disabilities, assistive technology can help them to complete activities that they would otherwise be unable to do. Occupational therapists are trained to recommend equipment that meets the needs of each individual client to enhance quality of life. However, consumer needs as well as technologies are complex and require a great deal of analysis and understanding. Therefore, there is a current trend to develop training tools that enhance clinical understanding and reasoning for learners. Simulated environments are one such area of current interest for clinical training opportunities. So, this project proposes to critically evaluate the current literature on simulated learning environments and explore the scope of current training methods utilized to teach assistive technology in occupational therapy programs. These two foci of this project are proposed in preparation for re-submission of an external grant that was not accepted due to an inability to clearly delineate the need for development of innovative teaching tools in the area of assistive technology. The larger scope of this project, then, is to propose the development of a virtual to enhance training for providers of assistive technology.
Yi-An Chen
Occupational Therapy
Clinical Utility of Fitbit and Apple Watch to Measure Daily Arm/Hand Use in Stroke: A Comparison with Research-Grade ActiGraph Accelerometer
Title: Clinical Utility of Fitbit and Apple Watch to Measure Daily Arm/Hand Use in Stroke: A Comparison with Research-Grade ActiGraph Accelerometer
Project Period: 04/01/2022 – 03/31/2024
Agency: Intramural Grant Award
The benefit of continuous daily use of the paretic limb after stroke has been extensively addressed in neurorehabilitation. To better understand and promote the daily arm/hand use behavior, research-grade accelerometers, such as ActiGraph, have been commonly used to quantify and track stroke survivors’ paretic arm/hand use in everyday life. However, such sensors have demonstrated limited clinical use due to the need for additional programming and the high cost. In contrast, commercial fitness trackers, such as Fitbit and Apple Watch, are more user-friendly with a more acceptable price range. Previous studies have established the accuracy of Fitbit and Apple Watch in tracking gross physical activity. However, these sensors have not been used for measuring post-stroke arm/hand use. Our goal is to determine the clinical utility of commercial sensors for tracking arm/hand use behaviors in stroke survivors in the everyday environment. We propose to compare the fitness outcomes (i.e., step counts, active time) reported from Fitbit and Apple Watch with the validated “gold-standard” arm/hand use measures (i.e., time duration and magnitude intensity) calculated from ActiGraph data. In a laboratory setting, we will recruit healthy and stroke participants to perform several types of daily activities (e.g., fine vs. gross motor) with both types of sensors to establish a basic but thorough understanding of the accuracy of the commercial trackers. Stroke participants will be asked to continue a 3-day home monitoring period to allow us to understand the sensitivity of commercial trackers under natural, uncontrolled, real-world conditions. Results from this study may suggest an affordable and accessible alternative for clinical use in measuring post-stroke daily arm/hand use behavior. Building upon the findings, we will be able to explore and develop algorithms to transform the commercial tracker data to provide accurate daily arm/hand use information. We will then be able to utilize the low-cost, widely-used commercial trackers to develop real-time interventions (e.g., reminder systems) to promote stroke survivors’ paretic arm/hand use and to continue stroke recovery in everyday life.
Susan Lee
Occupational Therapy
The PPAL: The Bedside Commode as a Safe Self-Toilet Transfer Device for Aging Adults
Title:The PPAL: The Bedside Commode as a Safe Self-Toilet Transfer Device for Aging Adults
Project Period: 01/01/2022 - 02/28/2023
Agency: QUA, Inc.
The PPAL® SUMMARY
Despite being prescribed for older adults with mobility disabilities to manage toileting and to reduce falls risk, bedside commode chairs perversely present a new source of risk for falling. “PPAL®” is a novel and innovative approach that addresses that fall risk by resolving the transfer difficulties associated with using commodes. It re-conceptualizes the bedside commode as an elevating chair with an integral transfer board. With a securely affixed transfer board connected to a seat that is elevated by an internal motorized lift, the commode will provide a stable and “always downhill” transfer pathway, regardless of the height of the adjacent bed or wheelchair transfer surface. In doing so, PPAL® will enable adults aging with lower extremity weakness to safely self-toilet, thereby lowering their risk of falling.
To ensure success all three phases of this SBIR, the project will be a collaborative effort between the applicant, QUA Inc., which holds the PPAL® patent, Georgia Tech’s Center for Inclusive Design and Innovation, which has extensive experience in design of assistive technologies to facilitate toilet transfers by older adults, and Georgia State’s Department of Occupational Therapy, which has expertise in usability testing of product for use by people with disabilities. Phase 1 will refine the transfer interface based on the results of pilot testing of an earlier prototype and demonstrate feasibility of the refined design.
Specific aims of this Phase 1 SBIR project are to: 1) Design and fabricate a medium fidelity non-motorized prototype that responds to the problems identified with the transfer interface in the initial pilot testing; 2) conduct safety testing to demonstrate technical feasibility of the refined design based on load capacity of 250 pound minimum and stability in which the board remains in constant contact with both bed and chair surfaces during simulated transfers by occupational therapists; and 3) conduct user testing to demonstrate usability feasibility as measured by expert observation of transfer difficulty and safety, self-reported user acceptance and increased independence compared to a traditional transfer board.
Phase 1 will produce a prototype with a transfer interface that is feasible based on safety and usability as well as provide the necessary data to power the effectiveness testing in Phase 2.
Environmental Barriers and Facilitators to Assisted Toilet Transfers by People Aging with Disability and their Caregivers
Agency: U.S. Department of Health and Human Services
Project Period: 08/02/2020 - 09/29/2023
Title: Environmental Barriers and Facilitators to Assisted Toilet Transfers by People Aging with Disability and their Caregivers
This project identifies environmental factors that create barriers and facilitators to caregiver assisted transfers for individuals aging with disability to inform the development of design criteria for dyadic-centered AT/EM toilet transfer interventions. Specific aims are to: (1) describe the overall effectiveness of existing AT/EM toilet transfer interventions for individuals aging with disability and their caregivers by evaluating transfer performance of caregiving dyads using their own AT/EM interventions; (2) observe and delineate categorical differences in unmet needs for environmental supports for care recipient/caregiver dyads with different functional abilities; (3) identify the salient factors of the AT/EM that either act as barriers or facilitators to successful transfer performance based on the different needs and abilities of care recipients and their caregivers; (4) develop design criteria for the subsequent development of effective AT/EM solutions for assisted transfers by individuals aging with disabilities and their spousal caregivers; and (5) develop and execute a knowledge translation plan to disseminate study findings to appropriate stakeholders.
3D printing-enhanced assistive technology interventions to facilitate independence in activities of daily living among older adults with disabilities
Department: Occupational Therapy
Title: 3D printing-enhanced assistive technology interventions to facilitate independence in activities of daily living among older adults with disabilities
Agency: Intramural Non-Tenure Track
Project Period: 01/01/2022 – 12/31/2022
ABSTRACT
Assistive technologies (AT) are crucial for maintaining independent living and participation of older adults. Occupational therapists (OTs) often need to modify, refine, repurpose, or jury rig existing off-the-shelf AT to further customize it to meet the specific needs and abilities of their clients 1-4. While such AT adaptions are helpful 5.6, these practices typically involve hacking and makeshift methods using practical and often improvised materials at hand that lack durability and or esthetics for long-term utilization 6. In contrast, digital fabrication and rapid prototyping technologies, such as 3D printing, have the potential to empower and support OTs in designing more durable, esthetic, and highly customized AT solutions4,7,8.
To support a client-centered use of 3D printing for AT customization, the purpose of this project is to establish feasibility of a 3D printing-enhanced AT intervention to facilitate ADL functioning among older adults with disabilities. To do so, we will engage in a participatory AT co-development process with older adults with hand impairments receiving services at Meals on Wheels. After a goal suited for 3D printing intervention is established, they will be provided an off the shelf AT solution which, as necessary, will be modified using 3D printing. Effect of the intervention will be measured (immediately after intervention and 3 months post intervention) by self-report of 1) functional ability, 2) level of difficulty during task performance, and 3) satisfaction experienced with task performance. Facilitators and barriers during implementation will be noted to understand factors that impact the success of the intervention. The nature of modifications made will be noted to inform the design requirements of an OT-friendly 3D modeling platform that will help OTs customize AT in practice.
The output of the study will provide the basis for a development proposal to the National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR). In addition to generating evidence for feasibility of this approach, the study will inform the development of 1) a manualized 3D printing-enhanced AT intervention and 2) design requirements for an OT-friendly 3D modeling platform which allows customization of AT via a simple interface.
Veronica Rowe
Occupational Therapy
Addressing socioeconomic disparities in post-stroke disability through the development of an accessible, new tool
Claire Honeycutt PHD, Arizona State University, PD/PI
Pamela Bosch, Northern Arizona University, Co-Investigator
Veronica Rowe, Georgia State University, Co-Investigator
Agency: Arizona State University / National Institutes of Health
NICHD Exploratory/Developmental Research Grant (R21) - 1 R21 HD105180-01
Title: Addressing socioeconomic disparities in post-stroke disability through the development of an accessible, new tool
Project Period: 04/26/2021 - 03/31/2023
Abstract:
Individuals with low socioeconomic status (SES) are more likely to have a stroke, more disabled at 3 months, and less likely to be independently ambulatory. Individuals with low SES struggle to adhere to physician guidelines because of 1) increased disability leaves patients ineligible or unable to tolerate therapy, and 2) poor access to quality care i.e., lack of transportation to therapy. To reduce post-stroke disparity in low SES groups, we need to invest in development of novel tools that make therapy more accessible. For the past 5 years, the PI has been developing Startle Adjuvant Rehabilitation Therapy (START), a tele-enabled, low-cost treatment to improve upper-extremity therapy outcomes in individuals with stroke – in particular individuals with severe-to-moderate stroke. START is the application of a startling, acoustic stimulus (via headphones) which increases the intensity of practice, particularly in severe patient populations. START is adjuvant, meaning it does not replace clinical practice but instead enhances current evidence-based treatments.
Objective: we seek to determine if START can be used to enhance functionally relevant movement of the upper extremity.
Preliminary data: Individuals with severe-to-moderate disability from a stroke completed a remotely delivered, 3-day training of object manipulation with START. Box and Blocks, which was targeted during training, demonstrated a large increase under START (+47.1%) compared to Control (+3.3%). Modified functional reach was also increased under START (+8.9%) compared to Control (+1.1%). Impairment also decreased under START (Upper-Extremity-Fugl-Meyer: +8.6%) resulting in subject-reported increase in arm function both in quantity (Motor Activity Log: +26.2%) and quality (+20.2%). These results indicate that START can be deployed remotely and may prove a valuable, adjuvant tool to enhance functional upper extremity movement. We propose to perform a Phase 1 clinical trial on a larger cohort of 58 subjects, with a longer, 5-day training with the goal of establishing that START can 1) enhance functional movement of the upper extremity and 2) generate sustainable changes that impact quality of life.
Impact: This proposal is significant because it tests a tool that has the potential to directly target the causes leading to disparity of care for individuals with low SES. A third (34%) of 6.5 million people in the U.S. with stroke are on Medicaid or uninsured. Our best evidence based therapies (e.g., high-intensity, CIMT) and our emerging rehabilitation technologies (e.g., TMS, robotics) are inaccessible to our minority and low SES populations. START addresses disparity because it 1) targets individuals with severe disability, which disproportionally affects low SES and minority groups, and 2) is tele-enabled eliminating transportation which 60% of individuals with low SES report as a barrier to care. If successful, this study will set the stage for larger trials to establish 1) the effectiveness of START to be incorporated into traditional therapy and as well as patient compliance, adherence, and tolerance – particularly in low SES groups.
Dr. Veronica Rowe, co-investigator, will contribute to the study by facilitating telehealth delivery, establishing interrater reliability of outcome measures through training, monitoring performance, and adjudicating conflicts in outcome measures results. Dr. Rowe will assist with data collection, compiling, cleaning, and assuring quality of outcome measures as well as other RCT duties as needed.
TRANScranial direct current stimulation for Post-stroke motor Recover - a phase II sTudy (TRANSPORT 2)
Title: TRANScranial direct current stimulation for Post-stroke motor Recover - a phase II sTudy (TRANSPORT 2)
Project Period: 08/01/2020 - 07/31/2022
Agency/Program: Duke University
Award #: A033729
Transcranial Direct Current Stimulation Current For Post-stroke Motor Recovery - A Phase Ii
Study (TRANSPORT2)
Authors: Wuwei Feng, Duke Univ, Durham, NC; Gottfried Schlaug, Baystate Health, Boston, MA;
Caitlyn Meinzer, Medical Univ of South Carolina, Charleston, SC; Pratik Y Chhatbar, Duke Univ,
Durham, NC; Christy Cassarly, Catherine Dillon, Wenle Zhao, Medical Univ of South Carolina,
Charleston, SC; Kristina Balderson, Duke Univ, Durham, NC; Jamey S Frasure, Univ of Cincinnati,
Cincinnati, OH; Veronica T Rowe, Georgia State University, Atlanta, GA; Stacy L Fritz, Univ of South
Carolina, Columbia, SC; Steven L Wolf, Emory Univ, Atlanta, GA; Joseph P Broderick, Univ of Cincinnati, OH
Abstract:
Background: Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation tool that holds promise for stroke recovery and has been demonstrated to be safe and tolerable up to 4 mA in a recent Phase I trial in stroke population. Hypothesis: There is an initial overall treatment effect of tDCS in post-stroke motor recovery as measured by the Fugl-Meyer Upper Extremity (FM-UE) motor impairment scale. Design: Multi-center, double-blinded, randomized sham-controlled Phase 2 trial involving 129 subjects (43 per arm) to either modified Constraint Induced Movement Therapy (mCIMT) only (sham), mCIMT+2 mA tDCS, or mCIMT+4 mA tDCS. Eligibility: Participants aged 18-80 years with first ever unihemispheric ischemic stroke occurring within 30-180 days; pre-stroke modified Rankin Scale ≤2; stable motor impairment defined as: >10° of active wrist extension, >10° of thumb abduction/extension, and > 10° of extension in at least 2 additional digits; Unilateral limb weakness with a FM-UE motor score of ≤ 54 (out of 66); and an absolute difference of FM-UE motor scores between the two baseline assessments of ≤ 2 points. Intervention: Participants receive 10 sessions (5 days/week) of active mCIMT for 120 minutes where the first 30 minutes are combined with tDCS intervention (or sham where only 30 seconds of tDCS ramp was applied). Outcomes: Primary: FM-UE; Secondary: Wolf Motor Function Test (WMFT) time and Stroke Impact Scale (SIS) hand domain; Assessments occur at day 0, 15, 45 and 105. Analysis: Analysis of Variance and generalized linear models will be used to compare treatment groups at day 15 (primary) and over time (secondary). A Go, No-Go approach will be used to determine proceeding to Phase III trial, taking into account safety, tolerability, feasibility and efficacy. Clinical Trial NCT03826030.
Knowledge Translation of Remotely Delivered Task Oriented Training for Stroke Rehabilitation (reTOTE - Remote Task Oriented Training and Evaluation)
(reTOTE - Remote Task Oriented Training and Evaluation)
PI: Veronica Rowe
Project Period: 01/01/2022 - 12/31/2022
Agency: Augusta University
Knowledge translation is an essential step for successful clinical implementation of contemporary evidence-based approaches in any clinical practice and stroke rehabilitation is not an exception. This study of translational research addresses the problem of evidence not reaching consumers which is highly significant given the large number of strokes that happen not only in Georgia, but in the US. In addition, the current gap in knowledge translation of evidence into practice results in slowed and arduous recovery due to ineffective treatment protocol. Not only are enormous amount of dollars being spent in the research and recovery process, but also the magnitude of burden of care is extremely significant, especially during this time of social distancing due to COVID-19. Therefore, it is imperative that as science develops innovative interventions for stroke rehabilitation, such as Task-Oriented Training (TOT), research must also be done to identify the processes to translate the science into actual therapeutic practice, such as the use of telerehabilitation. Educating occupational and physical therapists about research evidence underlying TOT and facilitating the knowledge-to-action process through telerehabilitation can address barriers and hasten the implementation of research into clinical practice.
This pilot study will utilize a case series design to determine effectiveness and feasibility of an educational program delivered to occupational and physical therapists in Georgia who work in the clinical areas of stroke rehabilitation, and provide preliminary results on the effectiveness of reTOTE delivered to stroke survivor participants.Twelve therapists will participate in a Knowledge Translation (KT) program for evidence-based TOT. To translate knowledge and bridge the “know-do” gap, the co-PIs will provide in person instruction at Georgia State University and at Augusta University to occupational and physical therapists from various settings of stroke rehabilitation (acute care, inpatient rehabilitation, outpatient rehabilitation, and home health) on the evidence based components of TOT to be delivered via telerehabilitation to clients who have hemiparesis after stroke. The TOT educational program will include evidence based research from aspects of experience-dependent plasticity, Constraint Induced Movement Therapy (CIMT) from the ExCITE trial, the Acquired Skill Acquisition Protocol (ASAP) from the ICARE trial, the Occupational Performance in Occupational Therapy (CO-OP) model, and studies on Task Oriented Training and Evaluation at Home (TOTE Home). The knowledge-to-action process will be utilized to identify facilitators and overcome barriers to implementing TOT via tele-rehabilitation. Guidance from the “myself as the instructor” model will assist therapists with the implementation of knowledge gained. Emphasis will be placed on the safe delivery of TOT remotely via HIPPA compliant video conferencing over the internet.
Therapists will remotely deliver a TOT program via telerehabilitation (reTOTE) to improve upper extremity function, confidence in balance and to increase quality of life in participants following stroke. As an essential part of the Knowledge Translation process, each therapist will practice the delivery of TOT with one client remotely via HIPPA compliant video conferencing over the internet with remote consultation from Co-PIs. The reTOTE delivery will occur with therapist and stroke survivor communication for 1 hour, 2-3 times per week for 10 weeks and the stroke survivor practicing TOT activities independently, which is similar to methods in other studies on TOT. Preliminary data collection and analysis will be conducted to determine feasibility and effectiveness with pre-test, post-test, and follow-up assessments of both therapists who participated in the Knowledge Translation program and the stroke survivors who received the reTOTE program.
Understanding the mechanisms of action observation as a rehabilitation intervention for stroke
Title: Understanding the mechanisms of action observation as a rehabilitation intervention for stroke
Agency: University Research Services and Administration / Research Initiation Grant
Project Period: 07/01/2021 –12/31/2022
ABSTRACT
Someone in the United States has a stroke every 40 seconds. Almost 70% of people who have a stroke experience the loss of arm and hand movement which ultimately decreases daily function and contributes to poor quality of life. Thus, there is a great need for rehabilitation in the stroke population. One way to help a stroke survivor learn how to use their arm and hand again is to have them watch and replicate “normal” arm and hand movements. This type of intervention is called action observation (AO) and has emerged as a potentially powerful therapeutic tool to improve stroke rehabilitation for the weakened arm and hand. AO involves the patient’s visual observation of video recorded intact body movements with the intent to perform the same task with their weakened arm and hand. There is behavioral evidence in stroke survivors that movement skills usually gained through physical practice can also be acquired through observation of the skill alone. In preliminary research performed in Dr. Lewis Wheaton’s lab at Georgia Tech (collaborator and mentor), AO has been successfully implemented for persons with arm and hand amputations learning how to use their prostheses. AO training in patients with amputations revealed that their movement is improved when they focus their eye gaze on specific aspects of the movement in the video that may maximally benefit the patient. It is unknown if these eye gaze patterns may serve as the mechanism behind AO and differ among those with mild or moderate movement impairments due to stroke. In this study, we seek to identify if experience with AO in stroke survivors with varying levels of impairment has a similar emergence of eye gaze patterns found in people with amputations. We hypothesize that AO augments visuomotor strategies to help support improved movement and enhance rehabilitation strategies in stroke survivors with mild and moderate impairments. The goal of this work is to utilize eye gaze tracking approaches to understand this phenomenon. In addition, we will identify the feasibility of implementing and assessing AO on eye gaze in stroke survivors. The stroke research experience of Dr. Veronica Rowe will merge well with Dr. Wheaton’s lab to help directly inform larger future studies on the mechanisms and outcomes of AO therapy for the surviving stroke population.
Remote Delivery of a Standardized Stroke Rehabilitation Assessment
Title: Remote Delivery of a Standardized Stroke Rehabilitation Assessment
Project Period: 01/01/2021 – 06/30/2023
Agency/Program: The Lewis College Tenure-Track/Tenured Faculty Intramural Grant Award
Remote Delivery of a Standardized Stroke Rehabilitation Assessment
The demand for telerehabilitation has increased dramatically requiring a shift towards online therapy assessments and treatment. For stroke rehabilitation, the Fugl-Meyer Assessment (FMA) is one of the most well-known and frequently used standardized measures of arm and hand movement. Its use is highly recommended by multiple professional disciplines to monitor stroke recovery throughout the continuum of care. There are currently no published protocols available for the remote delivery of the FMA. The objective of the proposed research is to establish the feasibility, reliability, and validity for the remote delivery of the FMA (reFMA) to assess stroke survivor upper extremity function. An instructional protocol to deliver the reFMA has been created by the investigators and contains specific instructions including information needed for scheduling and setup of the remote assessment, instructions for the therapist with specific items modified for remote delivery, and instructions for the stroke survivor and their carepartner. Feasibility testing of the reFMA protocol will include 9 participants (3 triads of therapists, stroke survivors, and carepartners) who will administer and receive the FMA remotely using the instructional protocol and provide feedback and suggestions for refinement. The process will develop with an iterative design so that changes to improve the protocol will be made after each utilization of the reFMA. Pilot testing for reliability and validity of the delivery of reFMA will then occur with the FMA being administered to 12 stroke survivor participants remotely and in person. Validity will be measured to see how the remote delivery of the FMA compares to the in person delivery of the Fugl-Meyer. Reliability will be measured between the 2 therapists’ ratings of the remote delivery of the FMA. The ability to deliver the FMA remotely would be of current benefit during these times of social distancing, and in the future for those unable to access rehabilitation facilities. Pending feasibility outcomes will contribute to future, larger grants involving the establishment of similar protocols for other outcome measures.
Jon Sanford
Occupational Therapy
Technologies to Support Aging-in-Place for People with Long-term Disabilities
Agency: GA Tech/DHHS
Project Period: 01/01/2022 – 09/30/2023
Award Number: AWD-102707-G2
The Rehabilitation Engineering Research Center on Technologies to Support Aging-in-Place for People with Long-Term Disabilities(RERC TechSAge) is a $4.6 million, 5-year grant supported by the National Institute on Disability, Independent living, and Rehabilitation Research (NIDILRR), which is housed within the Administration for Community Living, Department of Health and Human Services. TechSAge, which is a partnership among GA Tech, University of Illinois Urbana Champaign and GA State, is one of 20 RERC’s funded by NIDILRR, all of which conduct a variety of research, development, and training projects focused on different rehabilitation issues. Now in the 4th year of it’s second 5-year cycle, the TechSAge is to support and empower people with chronic conditions and long-term vision, hearing, and mobility impairments to age-in-place through increasing knowledge about, availability of, and access to effective design and technologies that enable them to sustain independence; maintain health; engage safely in basic activities at home and in the community, and fully participate in society. Specific areas of focus include: identifying users’ needs for, and use of, assistive and smart technologies to overcome limitations in daily activities; understanding the effectiveness of technology-based interventions (e.g., voice-activated software applications and an evidence-based, home exercise program) to support independence, health and safety; development and deployment of new technologies to enhance the safety and support in performing daily activities in the home and community; and training of students in a range of professions to conduct advanced rehabilitation engineering research and develop new technologies to improve the health and participation individuals with long-term disabilities. You can learn more about TechSAge at www.TechSAge.gatech.edu.
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Occupational Therapy
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Academic Advisor III
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404-413-1007