Corresponding Author: Dr. Simon B Thompson, Associate Professor, Psychology Research Centre, Bournemouth University, BH12 5BB - United Kingdom

Transcription

1 Article ID: Thompson Digital Switch: Helping Stroke Patients to Help Themselves by Promoting Proprioception During Therapy. Brief Report and Podcast as a Teaching Aid for Professionals Corresponding Author: Dr. Simon B Thompson, Associate Professor, Psychology Research Centre, Bournemouth University, BH12 5BB - United Kingdom Submitting Author: Dr. Simon B Thompson, Associate Professor, Psychology Research Centre, Bournemouth University, BH12 5BB - United Kingdom Article ID: Article Type: Research articles Submitted on:10-mar-2011, 04:34:40 PM GMT Published on: 11-Mar-2011, 10:26:00 PM GMT Article URL: Subject Categories:NEUROLOGY Keywords:Computerised Therapy, CVA, Diagnosis, Feedback, Neurology, Podcast, Proprioception, Stroke, Switching Device, Thompson Digital Switch How to cite the article:thompson S B. Thompson Digital Switch: Helping Stroke Patients to Help Themselves by Promoting Proprioception During Therapy. Brief Report and Podcast as a Teaching Aid for Professionals. WebmedCentral NEUROLOGY 2011;2(3): Article Video: Source(s) of Funding: Ethical approval - t applicable; Source of funding - ne. Competing Interests: Competing interests - ne. Page 1 of 14

2 Thompson Digital Switch: Helping Stroke Patients to Help Themselves by Promoting Proprioception During Therapy. Brief Report and Podcast as a Teaching Aid for Professionals Author(s): Thompson S B Abstract Stroke affects an estimated 4.6 million people with over new cases each year and people having a second stroke. There is a huge demand on our healthcare services for treating such people. Proprioception is the body?s natural feedback mechanism that becomes disrupted during a stroke because of damaged nerve pathways. Tapping into this phenomenon enables us to re-establish feedback and thus help stroke patients return some of their lost function. The Thompson Digital Switch (TDS) has been used for several decades in assisting occupational therapists and physiotherapists during rehabilitation of stroke patients. Use of the TDS to help other injuries such as leg trauma and deficits following surgery, are presented in a podcast that also informs professionals about the aetiology and prognosis of stroke that can be used as a teaching aid. Introduction The use of cues for improving cognitive deficits following stroke have been followed with great interest by the author. In particular, the use of coloured strips of paper placed in the margin of the page on the patient?s neglected side have resulted in improvement in reading ability by reducing the patient?s tendency to lose their place in the text (Thompson & Morgan, 1996). Cueing for neglect in stroke is no new and is dependent upon using the modality of the cue that matches the task? e.g.? for a visual modality task, a visual cue should be used (Thompson, 1999). Ongoing investigations by the author have focused on the reaction times of the quadriceps muscle group, situated in the upper thigh, especially where incomplete innervation has resulted from a stroke and also following a serious road traffic accident (Illustration 1). Extensive testing in the university and in field tests at various occupational therapy departments (Queen Alexandra Hospital, Cosham; Salisbury District Hospital, Odstock; Royal Naval Hospital, Haslar (Thompson, 1987a,b; 1998), involved?the use of the?quadriceps switch?, used throughout most UK hospitals and in rthern Ireland during the rehabilitation of gunshot injury to the leg muscle, and a fast digital sampler and interpreter of electrical nerve impulses from the movement of leg muscles (Thompson, 2011; Thompson & Coleman, 1987; 1989) (Illustration 2). Computer and electromyography (EMG) was used to measure the muscular electrical nerve activity. Variations in displays and tones were designed and validated in order to optimise on the best type of cue (Illustrations 3-5). The podcast associated with this article (Video 1) presents the demands of a stroke in terms of cognitive and perceptual deficits and aetiology and prognosis. This is intended as a teaching aid for professionals whether occupational or physical therapists, clinical psychologists, nurses or doctors. Conclusions Feedback systems typically had limited application in the early 1960s but later gave clinicians more than just familiarity with this new way of representing?body waves?. The deficits of stroke can be far reaching and it is important to offer explore innovative approaches to assist in rehabilitation. Being realistic about goals during rehabilitation is of paramount importance (Thompson, 2006) but new technologies do provide hope for the future for our valued patients. Podcasts are also a valuable way of presenting information in an interesting and individual format. References 1.Thompson, S. B. N. (1987a). A system for rapidly converting quadriceps contraction to a digital signal for use in microcomputer-oriented muscle therapy and stroke patient assessment schedules. Computers in Biology & Medicine: An International Journal, 17(2), Page 2 of 14

3 ? 2.Thompson, S. B. N. (1987b). A microcomputer-feedback system for improving control of incompletely innervated leg muscle in adult cerebrovascular accident patients. British Journal of Occupational Therapy, 5 (5), Thompson, S. B. N. (1998). Working in stroke rehabilitation: trends for clinical neuropsychology for the next century. Journal of Cognitive Rehabilitation, 16(3), Thompson, S. B. N. (1999). Rehabilitation of cognitive and emotional problems. In R. Fawcus (Ed.), Stroke rehabilitation: a collaborative approach (pp ). Oxford, Blackwell. 5.Thompson, S. B. N. (2006). Dementia and memory: A handbook for students and professionals. Aldershot: Ashgate. 6.Thompson, S. B. N., Psychology of trauma: clinical reviews, case histories, research. Portsmouth: Blackwell-Harvard-Academic. 7.Thompson, S. B. N., & Coleman, M. J. (1987). A quantitative assessment of neuromuscular function for use with unilateral cerebrovascular accident patients. International Journal of Rehabilitation Research, 10(3), Thompson, S. B. N., & Coleman, M. J. (1989). An interative microcomputer-system for the assessment and prognosis of stroke patients. Journal of Microcomputer Applications, 12(1), Thompson, S. B. N., & Morgan, M. (1996). Occupational therapy for stroke rehabilitation. 2nd reprint. London: Chapman & Hall. Page 3 of 14

4 Illustrations Illustration 1 Using the apparatus for rehabilitation of skiing injuries Page 4 of 14

5 Illustration 2 Set-up incorporating the Thompson Digital Switch interface unit Page 5 of 14

6 Illustration 3 Bridge open (muscles relax) Page 6 of 14

7 Illustration 4 Bridge closed (muscles contract) - lorry moves across screen Page 7 of 14

8 Illustration 5 Audible tones (blue) and patients responses (green) Page 8 of 14

9 Disclaimer This article has been downloaded from WebmedCentral. With our unique author driven post publication peer review, contents posted on this web portal do not undergo any prepublication peer or editorial review. It is completely the responsibility of the authors to ensure not only scientific and ethical standards of the manuscript but also its grammatical accuracy. Authors must ensure that they obtain all the necessary permissions before submitting any information that requires obtaining a consent or approval from a third party. Authors should also ensure not to submit any information which they do not have the copyright of or of which they have transferred the copyrights to a third party. Contents on WebmedCentral are purely for biomedical researchers and scientists. They are not meant to cater to the needs of an individual patient. The web portal or any content(s) therein is neither designed to support, nor replace, the relationship that exists between a patient/site visitor and his/her physician. Your use of the WebmedCentral site and its contents is entirely at your own risk. We do not take any responsibility for any harm that you may suffer or inflict on a third person by following the contents of this website. Page 9 of 14

10 Reviews Review 1 Review Title: Thompson Digital Switch:... Posted by Mr. Brian Thompson on 09 Jul :40:57 PM GMT 1 Is the subject of the article within the scope of the subject category? 2 Are the interpretations / conclusions sound and justified by the data? 3 Is this a new and original contribution? 4 Does this paper exemplify an awareness of other research on the topic? 5 Are structure and length satisfactory? 6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? 7 Can you suggest any reductions in the paper, or deletions of parts? 8 Is the quality of the diction satisfactory? 9 Are the illustrations and tables necessary and acceptable? 10 Are the references adequate and are they all necessary? 11 Are the keywords and abstract or summary informative? Rating: 9 Comment: Potential savings in rehabilitation which could benifit patients and care workers Competing interests: none Invited by the author to make a review on this article? : Experience and credentials in the specific area of science: Assisting in rehabilitation. Publications in the same or a related area of science: How to cite: Thompson B.Thompson Digital Switch:...[Review of the article 'Thompson Digital Switch: Helping Stroke Patients to Help Themselves by Promoting Proprioception During Therapy. Brief Report and Podcast as a Teaching Aid for Professionals ' by ].WebmedCentral 1970;2(7):REVIEW_REF_NUM851 Page 10 of 14

11 Review 2 Review Title: Thompson Digital Switch: Helping Stroke Patients to Help Themselves by Promoting Proprioception During Therapy. Brief Report and Podcast as a Teaching Aid for Professionals Posted by Ms. Holly Chinnery on 18 May :53:57 AM GMT 1 Is the subject of the article within the scope of the subject category? 2 Are the interpretations / conclusions sound and justified by the data? 3 Is this a new and original contribution? 4 Does this paper exemplify an awareness of other research on the topic? 5 Are structure and length satisfactory? 6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? 7 Can you suggest any reductions in the paper, or deletions of parts? 8 Is the quality of the diction satisfactory? 9 Are the illustrations and tables necessary and acceptable? 10 Are the references adequate and are they all necessary? 11 Are the keywords and abstract or summary informative? Rating: 9 Comment: Thought provoking read Invited by the author to make a review on this article? : Experience and credentials in the specific area of science: Clinical Researcher Publications in the same or a related area of science: How to cite: Chinnery H.Thompson Digital Switch: Helping Stroke Patients to Help Themselves by Promoting Proprioception During Therapy. Brief Report and Podcast as a Teaching Aid for Professionals[Review of the article 'Thompson Digital Switch: Helping Stroke Patients to Help Themselves by Promoting Proprioception During Therapy. Brief Report and Podcast as a Teaching Aid for Professionals ' by ].WebmedCentral 1970;2(5):REVIEW_REF_NUM766 Page 11 of 14

12 Review 3 Review Title: Thompson Digital Switch: Helping Stroke Patients to Help Themselves by Promoting Proprioception During Therapy. Brief Report and Podcast as a Teaching Aid for Professionals Posted by Ms. Natalie Jones on 13 Apr :46:59 PM GMT 1 Is the subject of the article within the scope of the subject category? 2 Are the interpretations / conclusions sound and justified by the data? 3 Is this a new and original contribution? 4 Does this paper exemplify an awareness of other research on the topic? 5 Are structure and length satisfactory? 6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? 7 Can you suggest any reductions in the paper, or deletions of parts? 8 Is the quality of the diction satisfactory? 9 Are the illustrations and tables necessary and acceptable? 10 Are the references adequate and are they all necessary? 11 Are the keywords and abstract or summary informative? Rating: 9 Comment: I found this fascinating and intriguing; Dr Thompson is renowned in this field and I know this advance complements current physiotherapy practice in stroke today Invited by the author to make a review on this article? : Experience and credentials in the specific area of science: Assistance in rehabilitation settings Publications in the same or a related area of science: How to cite: Jones N.Thompson Digital Switch: Helping Stroke Patients to Help Themselves by Promoting Proprioception During Therapy. Brief Report and Podcast as a Teaching Aid for Professionals[Review of the article 'Thompson Digital Switch: Helping Stroke Patients to Help Themselves by Promoting Proprioception During Therapy. Brief Report and Podcast as a Teaching Aid for Professionals ' by ].WebmedCentral 1970;2(4):REVIEW_REF_NUM673 Page 12 of 14

13 Review 4 Review Title: Is it a research article? Posted by Prof. Prasunpriya Nayak on 13 Mar :23:36 AM GMT 1 Is the subject of the article within the scope of the subject category? 2 Are the interpretations / conclusions sound and justified by the data? 3 Is this a new and original contribution? 4 Does this paper exemplify an awareness of other research on the topic? 5 Are structure and length satisfactory? 6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? 7 Can you suggest any reductions in the paper, or deletions of parts? 8 Is the quality of the diction satisfactory? 9 Are the illustrations and tables necessary and acceptable? 10 Are the references adequate and are they all necessary? 11 Are the keywords and abstract or summary informative? Rating: 2 Comment: The article addressed an important area and question of neurology. However, the structure and the way is presented is far from qualifying as a research article. Extensive use of the setup has been reproted. The observations / results are not included in the article. Competing interests: ne Invited by the author to make a review on this article? : Experience and credentials in the specific area of science: Teaching neurophysiology Publications in the same or a related area of science: How to cite: Nayak P.Is it a research article?[review of the article 'Thompson Digital Switch: Helping Stroke Patients to Help Themselves by Promoting Proprioception During Therapy. Brief Report and Podcast as a Teaching Aid for Professionals ' by ].WebmedCentral 1970;2(3):REVIEW_REF_NUM582 Page 13 of 14

14 Disclaimer This article has been downloaded from WebmedCentral. With our unique author driven post publication peer review, contents posted on this web portal do not undergo any prepublication peer or editorial review. It is completely the responsibility of the authors to ensure not only scientific and ethical standards of the manuscript but also its grammatical accuracy. Authors must ensure that they obtain all the necessary permissions before submitting any information that requires obtaining a consent or approval from a third party. Authors should also ensure not to submit any information which they do not have the copyright of or of which they have transferred the copyrights to a third party. Contents on WebmedCentral are purely for biomedical researchers and scientists. They are not meant to cater to the needs of an individual patient. The web portal or any content(s) therein is neither designed to support, nor replace, the relationship that exists between a patient/site visitor and his/her physician. Your use of the WebmedCentral site and its contents is entirely at your own risk. We do not take any responsibility for any harm that you may suffer or inflict on a third person by following the contents of this website. Page 14 of 14