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The purpose of this paper is to evaluate the physiotherapeutic benefits of bilateral symmetric training (BST) for stroke survivors affected by hemiparesis.

Other studies have investigated symmetric physiotherapy. A key difficulty in previous work is in maintaining mirror-imaged trajectories between the affected and less-affected limbs. This obstacle was overcome in this work by using a two-armed robotic exoskeleton to enforce symmetry. In total, 15 subjects, > 6 months post stroke were, randomly assigned to bilateral symmetric robotic training, unilateral robotic training, and standard physical therapy.

After 12 training sessions (90 minutes/session), the bilateral training group had the greatest intensity of movement training. They also had the greatest improvement in range of motion at the shoulder. The unilateral training group showed the greatest reduction in spasticity.

The rationale for symmetric physiotherapy is that it might promote connections from the undamaged brain hemisphere. The robot generated copious amounts of detailed kinematic data. Even though these data provided insights into the human to machine interface using different training modalities, it proved difficult to draw neurological conclusions. It is recommended that future research along these lines should include measures of neurophysiological change and/or changes in neurological activity.

This research suggests that the advantage of bilateral symmetric movement over other modalities is slight, and that robotic training has comparable results with standard care. If BST is used, care is potentially needed to avoid exacerbation of spasticity. Finally, this research includes a novel quantitative approach for evaluating robotic training.

This study is of value to therapeutic researchers interested in new physiotherapy techniques, roboticists interested in developing rehabilitation devices, or for rehabilitation game designers interested in using virtual reality.

This paper aims to develop a robotic mirror therapy system for lower limb rehabilitation, which is applicable for different patients with individual movement disability levels.

This paper puts forward a novel system that includes a four-degree-of-freedom sitting/lying lower limb rehabilitation robot and a wireless motion data acquisition system based on mirror therapy principle. The magnetorheological (MR) actuators are designed and manufactured, whose characteristics are detected theoretically and experimentally. The passive training control strategy is proposed, and the trajectory tracking experiments verify its feasibility. Also, the active training controller that is adapt to the human motor ability is designed and evaluated by the comparison experiments.

The MR actuators produce continuously variable and compliant torque for robotic joints by adjusting excitation current. The reference limb joint position data collected by the wireless motion data acquisition system can be used as the motion trajectory of the robot to drive the affected limb. The passive training strategy based on proportional-integral control proves to have great trajectory tracking performance through experiments. In the active training mode, by comparing the real-time parameters adjustment in two phases, it is certified that the proposed fuzzy-based regulated impedance controller can adjust assistance torque according to the motor ability of the affected limb.

The system developed in this paper fulfills the needs of robot-assisted mirror therapy for hemiplegic patients.

This paper aims to propose a bilateral robotic system for lower extremity hemiparesis rehabilitation. The hemiplegic patients can complete rehabilitation exercise voluntarily with the assistance of the robot. The reinforcement learning is included in the robot control system, enhancing the muscle activation of the impaired limbs (ILs) efficiently with ensuring the patients’ safety.

A bilateral leader–follower robotic system is constructed for lower extremity hemiparesis rehabilitation, where the leader robot interacts with the healthy limb (HL) and the follow robot is worn by the IL. The therapeutic training is transferred from the HL to the IL with the assistance of the robot, and the IL follows the motion trajectory prescribed by the HL, which is called the mirror therapy. The model reference adaptive impedance control is used for the leader robot, and the reinforcement learning controller is designed for the follower robot. The reinforcement learning aims to increase the muscle activation of the IL and ensure that its motion can be mastered by the HL for safety. An asynchronous algorithm is designed by improving experience relay to run in parallel on multiple robotic platforms to reduce learning time.

Through clinical tests, the lower extremity hemiplegic patients can rehabilitate with high efficiency using the robotic system. Also, the proposed scheme outperforms other state-of-the-art methods in tracking performance, muscle activation, learning efficiency and rehabilitation efficacy.

Using the aimed robotic system, the lower extremity hemiplegic patients with different movement abilities can obtain better rehabilitation efficacy.

Hand impairment post-stroke is a very common and important rehabilitation goal for functional independence. Advanced therapy options such as an app. therapy provides repetitive training, which may be beneficial for improving fine motor function. This study aims to evaluate the effect of app-based therapy compared to conventional hand therapy in improving dexterity in individuals with stroke.

In total, 39 individuals within the first year of stroke with Brunnstrom stage of hand recovery IV to VI were randomly divided into three groups. All three groups received 60 min of therapy for 21 sessions over a period of 30 days. Group A received conventional hand therapy; Group B received app. therapy, while Group C received conventional therapy along with the app. therapy. All participants were assessed on the Nine-Hole Peg Test and Jebsen–Taylor Hand Function Test at the beginning and after completion of 21 sessions of intervention. Kruskal–Wallis (H) test and Wilcoxon test were used for statistical analysis.

All three groups improved on hand function post-treatment. However, Group C demonstrated significant improvement with 16%–58% increase in hand function performance on outcome measures (p < 0.05).

Findings of the present study demonstrate improvement in dexterity with the app. therapy and combination therapy, in comparison to conventional therapy alone in individuals with stroke.

This experimental study focuses the first time on a structured protocol using an enabling technology adjunct to conventional physical therapy to improve hand function in individuals with stroke, which opens up the further scope in Neurorehabilitation.

The peer review history for this article is available at: https://publons.com/publon/10.1108/ILT-04-2020-0144/

Inspired by the dynamic changes in our daily lives enabled via quantified-self technologies and the urgent need for more studies on the human-computer interaction design mechanisms adopted by these applications, this study explores the value of user affective experience mirroring and examines the empowerment effect of meaningful gamification in a psychological self-help system (PSS) that aids people in work stress relief.

Based on an analysis of the existing systems and theories in relevant fields, we conducted mixed-method research, involving semi-structured interviews, experience sampling experiments and user bio data triangulations, to identify the benefits of user affective experience mirroring and examine the impact of visual impact metaphor–based (VIM) meaningful gamification on PSS users.

For a gamified PSS, users generally perceive VIM as arousing more feelings of enjoyment, empathy, trust and usefulness, empowering them to gain more mastery and control over their emotional well-beings, especially with relieving their occupational stress and upbringing their level of perceived happiness. Overtime, VIM-based meaningful gamification further boosts such value of a PSS.

Weaving together meaningful gamification and psychological empowerment theories, the results emphasized that successful empowerment of user through gamification in PSSs relies heavily on whether a deeper and meaningful affective connection can be established with the users, in short, “meaningful gamification for psychological empowerment”. Such an understanding, as demonstrated in our research framework, also sheds light on the design theories for persuasive technology and human influence tactics during human computer interactions.

The results of the study demonstrate to practitioners how to make the best use of gamification strategies to deeply relate to and resonate with users. Even without complicated game-play design, meaningful gamification mechanisms, such as VIM facilitate the empowerment of users while gaining their appreciation, establishing a deeper connection with them and eventually generating persuasive effects on intended future behavioural outcomes.

The effective management of work-related stress with handy tools such as a VIM-based PSS can be beneficial for many organizations and, to a large extent, the society.

This study proposed and empirically demonstrated the empowerment effect of meaningful gamification for PSS users. In this cross-disciplinary study, theories from different research domains were synthesized to develop a more thorough and multi-faceted understanding of the optimal design strategies for emerging information systems like this VIM-based PSS.

This qualitative study was an exploration on the process of self-reflection on identity. The purpose of this paper is to see how mirrors could be used as a therapeutic tool and a meta-physical bridge to one's inner consciousness.

An intergenerational expressive arts group (n=12) was organized around the question of identity. Following an open-discussion around the topic of identity, participants were asked to decorate a mirror with words, images, and/or symbols while reflecting on the question, “Who am I?” A post-session interview was conducted regarding participant's experiences during the creative process.

The results indicated that mirrors can be used to connect to one's inner thoughts and feelings on the question of identity. Three core themes in the process of self-reflection on identity were revealed which included introspection and self-concern, connection and attachment to something or someone other than self, and taking action to help others.

This study was limited not only in size, but also in cultural diversity and disparity of age range. Although this study was limited, it provided a useful indicator for identifying core themes in the process of self-reflection on identity.

While there have been no studies on the therapeutic use of mirrors as a tool for self-reflection and limited intergenerational studies with pre-adolescent and adolescent students and older adults, results from this study will add to the body of expressive arts literature by providing a new metaphor for mirrors as a therapeutic tool for self-reflection on identity.

To utilize LGBTQ affirmative theory to inform clinical work which affords queer youth with disabilities agency and authorship in their negotiations of sexuality.

The authors use a case study to explore the use of queer affirmative theory and peer consultation to guide and evaluate an ongoing clinical case of a young gay man with cerebral palsy as he negotiates his developing sexuality amid powerful messages from media, pornography, friends, and parental influence.

This paper finds that a queer affirmative therapy model which explores themes of intersectionality, and utilizes nuanced views of sexual identity, sexual behavior, and gender identity are useful to practitioners to encourage agency and authorship for queer disabled people in their negotiations of ability, sexuality, identity, and behavior.

This paper provides an alternative approach to nurturing queer identity by (1) creating refuge for emerging sexualities; (2) allowing for difficult dialogues where ability, sexuality, and gender can be pragmatically discussed, performed, and negotiated; (3) tolerating the discomfort of these difficult dialogues and pushing through to nurturing the unique queerness that evolves out of these conversations; and finally (4) encouraging transformation of all participants including client and practitioners. The practitioners discuss their own transformation through the co-created dialog with each other and with the client.

Despite the emergence of NICE guidelines regarding the effectiveness and appropriateness of psychological therapies for the majority of common mental health problems, access to these services is still dramatically underdeveloped and uneven. Estimates of untreated problems such as depression and anxiety in primary care signal the extent of these problems and the scale of investment in new services, if these needs are to be adequately met in the future.The Department of Health's and the Care Services Improvement Partnership's (CSIP) Improving Access to Psychological Therapies (IAPT) programme sets out a framework and a series of co‐ordinated actions, including two national demonstration sites, to begin to address these issues in England.This paper examines the origins and policy drivers that have given rise to the IAPT programme, outlines the progress to date and specifically assesses the implications for the mental health workforce of this programme. Issues addressed include the workforce profiles of existing services, career frameworks for psychological therapists, the capacity of training providers to train new and existing staff in psychological therapies and the challenges implicit in devising a workforce delivery plan to support the IAPT programme.

Many people accessing services, including counselling services, do not speak the official language of the country in which they find themselves. This paper first considers, in general terms, the way that language is used to negotiate relationships and to structure and provide meaning for our experiences, needs, feelings and ideas. This is then related to the use of native language in therapeutic work and the practical issues that this can present for services.The paper then reports on a small‐scale informal piece of research that was conducted in 2009 by Mothertongue multi‐ethnic counselling and listening service with six bilingual and multilingual counsellors, none of whom were native English speakers. The aim was to explore what might be learned from their experience of living with more than one language and then to apply this to the task of communicating in English with non‐English speakers in the therapeutic relationship.Some practical observations and suggestions are included in this paper. These incorporate the themes that emerged from the research such as: attending to clients' linguistic history; the way in which emotions are expressed in different languages; how speaking more than one language impacts on identity formation and the ability to understand across languages and culture; how we convey and construe significance and meaning; how we relate to people's experiences of learning a language. The author of this paper hopes that these findings and observations will stimulate further conversations on this topic.

Equine-assisted therapy (EAT) uses the horse and its environment to achieve therapeutic goals as designed by an allied health professional (Taylor, 2010). The benefits of these interventions affect areas such as motor skills (Bass et al., 2009; Silkwood-Sherer et al., 2012), sensory processing (Ward et al., 2013), learning, social interaction and socioemotional development (Bracher, 2000). It was felt that occupational therapists could offer valuable input in this area. This paper aims to investigate the impact of a specific six-week EAT programme on six participants’ occupational performance.

Mixed methods were used in this pilot study, consisting of a pre- and post-design with two follow-up periods. Participants were aged between 5 and10 years with a diagnosis of a visual impairment, and some had additional diagnoses. The Canadian Occupational Performance Measure (COPM) was administered to parents pre-programme, post-programme and approximately six week after the programme ceased. Additional information from notes that contained children’s and parents’ reports was analysed thematically.

Five of the six children were rated as having clinically significant changes in their occupational performance. Analysis of parents’ and children’s reports on their experience of the programme showed the main themes to be: peer interaction, taking on new challenges, feelings towards EAT and change.

Although there are many practitioners of EAT in Ireland, there is little research, and none was found in relation to the role of occupational therapists within this context. These results indicate that EAT may be effective in assisting some children to reach a variety of goals. This pilot study not only suggests that EAT is worth further research but also begins to explore the role of occupational therapy in this form of intervention.