Facilitating person-centred task-oriented training with a human-centred developed rehabilitation technology in neurorehabilitation

Abstract

Background For persons with central nervous system diseases (PwCNS) a person-centred task- oriented rehabilitation approach seems important to regain or maintain functional ability in daily life activities (ADL). However, rehabilitation services struggle to provide this approach and to provide the optimal rehabilitation time of 6 hours per day. Rehabilitation technology has proven to increase the person’s motivation and adherence to therapy. The use of rehabilitation technology may also be able to increase rehabilitation time without decreasing the quality of therapy or increasing the therapists’ workload. Aim To investigate the effect of additional person-centred task-oriented training with a customised rehabilitation technology on functional performance and ADL in PwCNS and whether individualised goals are more explicitly trained in the intervention group. Methods and materials A multicentre single-blinded randomised controlled trial was performed in PwCNS. The control group received treatment-as-usual. The intervention group received treatment-as-usual and additional training with a customised technology during 6 weeks, 3x/week, 45min/session under supervision of a trained professional. Assessments were performed at baseline, after 3 and 6 weeks of training, and at 6 weeks follow-up. The primary outcome measures were Wolf Motor Function Test, Manual Ability Measure-36 (MAM-36) and Canadian Occupational Performance Measure (COPM). Additionally, the trained and untrained goals of both groups were compared to investigate whether the individualised goals were more explicitly trained in the intervention group. Results Forty-five PwCNS (age 59.07 ± 16.42) performed the full protocol. Both the control and intervention group improved over time on the primary outcome measures, mainly during the 6-week training period. Significant differences between control and intervention group were found regarding MAM-36 after 6 weeks of training in favour of the intervention group. In the control group, the distribution of untrained versus trained COPM goals was about 50%. While in the intervention group, more than 85%

of the COPM goals were implemented in the treatment-as-usual and additional intervention programme. Conclusions Additional training with a customised rehabilitation technology can enhance treatment-as-usual and may facilitate a person-centred task-oriented approach in PwCNS. This intervention might be used to increase therapy time in the future but research into independent use by PwCNS is necessary.