Judith Deutsch | Rutgers University - Biomedical and Health sciences (original) (raw)

Papers by Judith Deutsch

Journal of neurologic physical therapy : JNPT, 2013

A virtual reality (VR) augmented cycling kit (VRACK) was developed to address motor control and f... more A virtual reality (VR) augmented cycling kit (VRACK) was developed to address motor control and fitness deficits of individuals with chronic stroke. In this article, we report on the safety, feasibility, and efficacy of using the VR augmented cycling kit to improve cardiorespiratory (CR) fitness of individuals in the chronic phase poststroke. Four individuals with chronic stroke (47-65 years old and ≥3 years poststroke), with residual lower extremity impairments (Fugl-Meyer 24-26/34), who were limited community ambulators (gait speed range 0.56-1.1 m/s) participated in this study. Safety was defined as the absence of adverse events. Feasibility was measured using attendance, total exercise time, and "involvement" measured with the presence questionnaire (PQ). Efficacy of CR fitness was evaluated using a submaximal bicycle ergometer test before and after an 8-week training program. The intervention was safe and feasible with participants having 1 adverse event, 100% adheren...

2011 International Conference on Virtual Rehabilitation, 2011

ABSTRACT Off-the-shelf interactive video games are used in the rehabilitation of individuals post... more ABSTRACT Off-the-shelf interactive video games are used in the rehabilitation of individuals post-stroke. However, the potential benefits of using the games for aerobic training have not been tested. The purpose of this preliminary study was to determine feasibility of measuring energy expenditure during interactive video gaming by individuals post-stroke and to characterize the energy demands of specific games. We used indirect calorimetry to measure energy expenditure of one healthy and two post- stroke individuals under four conditions: rest, Wii Fit™ Long Run, Penguin, and Wii Sports™ Boxing. We found that measuring interactive video gaming of people post-stroke was feasible and required mild to moderate exercise activity.

Games for Health Journal, 2015

This article asked and answered the question of whether there was evidence to support the use of ... more This article asked and answered the question of whether there was evidence to support the use of videogames for promotion of wellness and fitness for people poststroke and those with cerebral palsy (CP). A literature search of PubMed, CINAHL, and PEDro using a population, intervention, and outcome (PIO) approach and the key words &amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;stroke (or CP) AND video games (and synonyms) AND energy expenditure (EE) (and synonyms)&amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; was conducted. It yielded two relevant references for people poststroke and five references for people with CP. The literature extraction and synthesis by the categories of the PIO indicated that most studies used only the population of interest, except two that compared the EE with that of healthy controls. The main finding is that both people poststroke (moderate severity) and people with CP (mild severity) can achieve moderate EE playing Wii(™) (Nintendo, Kyoto, Japan), PlayStation(®) (Sony, Tokyo, Japan), and Kinect(™) (Microsoft, Redmond, WA) games. Adults with CP of mild severity played the videogames at vigorous levels, whereas those with severe CP played them at low levels. There appears to be an interaction between development and severity that influences the exercise intensity measured by EE. The findings suggests that videogames are a gateway for wellness promotion.

Journal of neurologic physical therapy : JNPT, 2014

Energy variables, such as metabolic cost (MC) and energy expenditure (EE), are important characte... more Energy variables, such as metabolic cost (MC) and energy expenditure (EE), are important characteristics of motor activities that can influence daily activity and have implications for health. In individuals poststroke, these variables have previously been described only for walking. Our goal was to characterize the MC and EE of typical motor activities among individuals in the chronic phase poststroke and compare them with those of able-bodied individuals. Eleven individuals with poststroke and 8 able-bodied individuals participated in this study. Four activities were tested: sit-to-walk-to-sit, walking over an obstacle course, walking at a comfortable speed, and reaching for an object while in a standing position. Each activity was performed repeatedly for 8 minutes, while oxygen consumption was recorded. The MC of the activities was calculated by dividing the mean oxygen consumption by walking speed or the number of repetitions. The EE was represented by metabolic equivalents. Th...

Proceedings of the 2nd …, 2003

Usability studies are an essential and iterative component of technology development and ease its... more Usability studies are an essential and iterative component of technology development and ease its transfer from the laboratory to the clinic. Although such studies are standard methodology in today's graphical user interface/windows world of applications, new technologies strain ...

Presence: Teleoperators and Virtual Environments, 2005

Studies in Health Technology and Informatics, Feb 1, 2000

A novel ankle rehabilitation device is being developed for home use, allowing remote monitoring b... more A novel ankle rehabilitation device is being developed for home use, allowing remote monitoring by therapists. The system will allow patients to perform a variety of exercises while interacting with a virtual environment (VE). These game-like VEs created with WorldToolKit run on a host PC that controls the movement and output forces of the device via an RS232 connection. Patients will develop strength, flexibility, coordination, and balance as they interact with the VEs. The device will also perform diagnostic functions, measuring the ankle's range of motion, force exertion capabilities and coordination. The host PC transparently records patient progress for remote evaluation by therapists via our existing telerehabilitation system. The "Rutgers Ankle" Orthopedic Rehabilitation Interface uses double-acting pneumatic cylinders, linear potentiometers, and a 6 degree-of-freedom (DOF) force sensor. The controller contains a Pentium single-board computer and pneumatic control valves. Based on the Stewart platform, the device can move and supply forces and torques in 6 DOFs. A proof-of-concept trial conducted at the University of Medicine and Dentistry of New Jersey (UMDNJ) provided therapist and patient feedback. The system measured the range of motion and maximum force output of a group of four patients (male and female). Future medical trials are required to establish clinical efficacy in rehabilitation.

Physical Therapy Reviews, Sep 30, 2009

Journal of Neurologic Physical Therapy, Sep 1, 2004

Neurorehabilitation and Neural Repair, 2016

Gait is influenced by higher order cognitive and cortical control mechanisms. Functional near inf... more Gait is influenced by higher order cognitive and cortical control mechanisms. Functional near infrared spectroscopy (fNIRS) has been used to examine frontal activation during walking in healthy older adults, reporting increased oxygenated hemoglobin (HbO2) levels during dual task walking (DT), compared with usual walking. To investigate the role of the frontal lobe during DT and obstacle negotiation, in healthy older adults and patients with Parkinson&amp;#39;s disease (PD). Thirty-eight healthy older adults (mean age 70.4 ± 0.9 years) and 68 patients with PD (mean age 71.7 ± 1.1 years,) performed 3 walking tasks: (a) usual walking, (b) DT walking, and (c) obstacles negotiation, with fNIRS and accelerometers. Linear-mix models were used to detect changes between groups and within tasks. Patients with PD had higher activation during usual walking (P &amp;lt; .030). During DT, HbO2 increased only in healthy older adults (P &amp;lt; .001). During obstacle negotiation, HbO2 increased in patients with PD (P = .001) and tended to increase in healthy older adults (P = .053). Higher DT and obstacle cost (P &amp;lt; .003) and worse cognitive performance were observed in patients with PD (P = .001). A different pattern of frontal activation during walking was observed between groups. The higher activation during usual walking in patients with PD suggests that the prefrontal cortex plays an important role already during simple walking. However, higher activation relative to baseline during obstacle negotiation and not during DT in the patients with PD demonstrates that prefrontal activation depends on the nature of the task. These findings may have important implications for rehabilitation of gait in patients with PD.

Journal of Neurologic Physical Therapy, Dec 1, 2004

Studies in Health Technology and Informatics, Feb 1, 2009

Int J Rehabil Res, 2006

The aim of this series of pilot case studies was to examine the feasibility of enhancing the walk... more The aim of this series of pilot case studies was to examine the feasibility of enhancing the walking of individuals with post-stroke hemiparesis through the imagery practice of gait activities at home. Four persons with chronic hemiparesis received imagery gait practice, 3 days a week for 6 weeks. The intervention addressed gait impairments of the affected lower limb and task-specific gait training. Pre-intervention, mid-term, post-intervention and follow-up evaluations were performed. At 6 weeks from the beginning of treatment, the participants increased walking speed, stride length, cadence and single-support time on the affected lower limb, while decreasing double-support time. The findings appear to justify the institution of a larger-scale study in order to better delineate the contribution of motor imagery practice to gait performance in individuals with post-stroke hemiparesis.

Collegium Antropologicum, Jun 1, 2013

Restorative Neurology and Neuroscience, Feb 1, 2004

Development and application of virtual reality (VR) systems for rehabilitation is an iterative pr... more Development and application of virtual reality (VR) systems for rehabilitation is an iterative process produced by collaboration of an inter-disciplinary team of engineers, neuroscientists and clinician-scientists. In this paper the use of virtual reality technology for the rehabilitation of individuals post-stroke is described. The development of the hardware is based on principles of motor control. Development of the software uses findings from the enrichment and motor plasticity and training literatures as well as principles of motor learning. Virtual environments are created to afford individuals post-stroke opportunities to practice tasks for which they require rehabilitation. These tasks, related to hand function and gait, are trained both at the impairment and functional level. The training engages users to allow for the repetitive intensive practice required for behavioral motor plasticity. Results from a series of upper and lower extremity studies indicate that use of VR technology to augment rehabilitation of individuals post-stroke merits further study.

Journal of Neurologic Physical Therapy, 2004

ABSTRACT