Because hand and cognitive functions decline in the elderly, intervention programs addressing these problems are necessary. In recent years, creating rehabilitation programs using technology has gained popularity. The aim of this study is to examine the effects of technology-based rehabilitation using LMC (Light Mood Enhancer) and dual upper extremity tasks on joint position sense, grip strength, functionality, and executive functions in elderly individuals; and to compare these effects with those of an exercise program performed solely with an LMC device and a control group consisting of a hand rehabilitation program performed with a physiotherapist. The research is a randomized controlled trial and will consist of 3 groups. After randomization, individuals' joint position sense, gross and fine grip strength, functionality, and executive functions will be evaluated. Evaluations will be performed twice, at the beginning and end of the 8-week program.
Impairment of hand muscle function reduces quality of life and independence in daily living activities in the geriatric population. In recent years, technology-based rehabilitation applications have been used in hand rehabilitation programs because, in addition to their effects similar to conventional rehabilitation, they increase patient motivation and compliance with rehabilitation. Studies have also shown that dual-task training has positive effects on upper extremity functions. In the literature, rehabilitation programs and dual-task training to improve hand functions in the elderly are applied separately. However, a study combining technology-based hand rehabilitation programs with dual-task training to increase cognitive level in elderly individuals has not been previously encountered. The unique value of our study and its difference from the existing literature is that the intervention group includes dual-task training as a cognitive task along with the Leap Motion Controller (LMC) and assessment of joint position sense. The aim of this study is to examine the effects of technology-based rehabilitation using LMC and dual-task training targeting the upper extremities on joint position sense, grip strength, functionality, and executive functions in elderly individuals; and to compare these effects with the effects of an exercise program performed only with the LMC device and a hand rehabilitation program performed with a physiotherapist as a control group. The main goal of this project is to improve the hand skills of elderly individuals through a technology-based rehabilitation program and dual-task training, enabling them to continue their daily lives independently. In the study, 75 elderly individuals will be randomly divided into three groups. The first group will receive hand exercises via computer using LMC (Leap Motion Conntroller) and dual-task training during these exercises. These exercises and training will be conducted twice a week for eight weeks under the supervision of a physiotherapist. The second group will receive only hand exercises via LMC under the supervision of a physiotherapist. The third group, the control group, will receive a conventional hand rehabilitation program (stretching and strengthening) under the supervision of a physiotherapist. The program will be applied to all three groups for 45 minutes a day, twice a week, for eight weeks. Following randomization, individuals' joint position sense (using inclinometer), gross and fine grip strength (using dynamometer and pinchmeter), functionality (using Jebsen hand function, Purdue pegbord, 9 hole peg test), and executive functions (using stroop test) will be evaluated. Evaluations will be conducted twice, at the beginning and end of the eight-week program.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
66
Elderly individuals in this group will play the games mentioned above for 45 minutes a day, 2 days a week, for 8 weeks, using only their hands via a computer with an LMC device, under the supervision of a physiotherapist. The procedure will be the same as for the other group, as described above. The intervention will be carried out with ball games for the first 4 weeks, and helicopter and airplane games will be added in the following 4 weeks. The elderly individual will play these games with both their dominant and non-dominant hands. The playing time will be equal for both hands. The elderly individuals will be able to take as many breaks as they wish during the games. The number of repetitions of the games will be increased each week according to the elderly individual's progress.
A rehabilitation program consisting of stretching and strengthening exercises will be applied to individuals under the guidance of a physiotherapist experienced in geriatric rehabilitation. The program will include hand flexion, extension, radial and ulnar deviation, and finger movements. Therabands and resistance bands will be used for strengthening. The number of repetitions of the exercises will be increased each week. The rehabilitation program will be applied for 45 minutes a day, 2 days a week, for 8 weeks.
Hand exercises will be conducted with the guidance of a physiotherapist using the Leap Motion Controller (LMC). These exercises will be performed twice a week for eight weeks, with each session lasting 45 minutes. While the elderly are playing games on a computer using their hands via the LMC device, dual-task training will be provided by physiotherapists. The dual-task training will be implemented as follows: In the first week, while the elderly are performing hand exercises via the LMC, they will be given one verbal, one arithmetic, and one auditory task. In subsequent weeks, the number of verbal, arithmetic, and auditory tasks will be increased by one task each week. Thus, the training will be gradually made more challenging. In addition, the dual-task training can be individualized according to the elderly's initial cognitive level and progress. Technology-based hand exercises will be performed with games specific to the LMC.
Akdeniz University
Antalya, Konyaaltı, Turkey (Türkiye)
Joint sense position
Wrist joint position sense of individuals will be assessed using a digital inclinometer. In this method, the individual will be actively guided to the desired position by the physiotherapist, held in that position for 5 seconds, and asked to remember the position. The individual will then be asked to return their wrist to that position. Wrist position sense assessment will be based on the principle of actively repeating the predetermined target angle. All axes of movement of the wrist in flexion, extension, radial deviation, and ulnar deviation directions will be evaluated. The target angles used in the assessment will be determined as 30° for flexion and extension, 10° for radial deviation, and 15° for ulnar deviation. The angle of the participant's wrist in all axes of movement will be noted, and the absolute difference between this angle and the target angle will be recorded as the "Joint Position Sense Error Amount"
Time frame: Just before the treatment begins and at the end of the 8th week
Hand function
The Nine-Hole Peg Test (9HPT) is a standardized, timed, quantitative assessment of fine manual dexterity. The test requires placing 9 pegs into holes on a board one-by-one and then removing them, using one hand at a time, to measure hand-eye coordination and finger speed. Less time means better performance.
Time frame: Just before the treatment begins and at the end of the 8th week
Hand function
Jebsen hand function tes will be used for hand function. It is a standardized, clinician-administered assessment designed to measure fine motor, gross motor, and weighted hand function using simulated activities of daily living (ADLs). Special equipment and a stopwatch are provided for the tests. Separate times are recorded for each task given for scoring purposes. It consists of seven timed subtests performed on both hands-starting with the non-dominant hand-to evaluate speed rather than movement quality, with higher times indicating lower function.
Time frame: Just before the treatment begins and at the end of the 8th week
Grip strength
Dynamometer and pinchmeter will be used for gross and fine grip strength. The measurement will be repeated three times. A 15-second break will be given after each measurement. Finally, the average of the three measurements will be recorded.
Time frame: Just before the treatment begins and at the end of the 8th week
Hand function
The Purdue Pegboard Test is a standardized, 5-10 minute assessment used to measure fine and gross motor dexterity of the hands, fingers, and arms. It requires individuals to place small metal pins, collars, and washers into holes on a vertical board using the right hand, left hand, and both hands simultaneously, commonly applied in rehabilitation and hiring for manual labor. The more pins that are installed within the specified time, the better the performance.
Time frame: Just before the treatment begins and at the end of the 8th week
Stroop test
This test will be used to assess the executive functions of older adults. The test consists of a word, a color, and a color word attempt sheet, and five separate tests as follows: 1. Saying color names from a card written in black, 2. Saying color names from a card written in different colors, 3. Saying the colors of circles shown on a card with colored circles, 4. Saying the colors of words on a card with neutral words written in color, and 5. Saying the color names shown on a card with color names written using different colors. A stopwatch will be used to record the time during the test.
Time frame: Just before the treatment begins and at the end of the 8th week
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