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Objective: The objective of this study was to assess the feasibility of delivering Art skill-based Rehabilitation Training (ART), a novel upper limb motor training program, to patients with stroke as an adjunct to standard care in an inpatient setting. Design: Feasibility study. Setting: Inpatient stroke rehabilitation unit at a university hospital. Participants: Thirty-eight patients admitted to a stroke rehabilitation unit with upper limb motor impairment were enrolled in the ART program facilitated by trained non-healthcare professionals between December 2017 and June 2021. Intervention: The ART program included nine, one-hour sessions of supervised tracing and freehand drawing tasks completed with both hands. This program was intended to be delivered at a frequency of three times per week over a duration of 3 weeks or for the length of inpatient stay. Main outcome measures: Feasibility outcomes included ART program adherence, acceptability, and safety. Results: Thirty-two (84%) participants with subacute stroke completed the ART program and 30 (79%) were included in the study analysis. Participants completed 93–100% of the ART tasks in a median [IQR] of 8 [6–10] ART sessions over a median [IQR] duration of 15 [7–19] days. ART program facilitators effectively provided upper limb assistance to patients with more severe upper limb impairments. Adherence and acceptability were high and no study-related adverse events occurred. Conclusion: The ART program was feasible to deliver and highly acceptable to patients with stroke. Further research is warranted to explore the impact of ART on upper limb sensorimotor function and use. [ABSTRACT FROM AUTHOR]

Introduction: Survivors of critical illness frequently exhibit acute and chronic neurological complications. The underlying aetiology of this dysfunction remains unknown but may be associated with cerebral ischaemia. This study will use near-infrared spectroscopy to non-invasively quantify regional cerebral oxygenation (rSO 2 ) to assess the association between poor rSO 2 during the first 72 hours of critical illness with delirium severity, as well as long-term sensorimotor and cognitive impairment among intensive care unit (ICU) survivors. Further, the physiological determinants of rSO 2 will be examined., Methods and Analysis: This multicentre prospective observational study will consider adult patients (≥18 years old) eligible for enrolment if within 24 hours of ICU admission, they require mechanical ventilation and/or vasopressor support. For 72 hours, rSO 2 will be continuously recorded, while vital signs (eg, heart rate) and peripheral oxygenation saturation will be concurrently captured with data monitoring software. Arterial and central venous gases will be sampled every 12 hours for the 72 hours recording period and will include: pH, PaO2, PaCO2, and haemoglobin concentration. Participants will be screened daily for delirium with the confusion assessment method (CAM)-ICU, whereas the brief-CAM will be used on the ward. At 3 and 12 months post-ICU discharge, neurological function will be assessed with the Repeatable Battery for the Assessment of Neuropsychological Status and KINARM sensorimotor and cognitive robot-based behavioural tasks., Ethics and Dissemination: The study protocol has been approved in Ontario by a central research ethics board (Clinical Trials Ontario); non-Ontario sites will obtain local ethics approval. The study will be conducted under the guidance of the Canadian Critical Care Trials Group (CCCTG) and the results of this study will be presented at national meetings of the CCCTG for internal peer review. Results will also be presented at national/international scientific conferences. On completion, the study findings will be submitted for publication in peer-reviewed journals., Trial Registration Number: NCT03141619., Competing Interests: Competing interests: JM is the scientific director of the Canadian Frailty Network. SHS is the cofounder of BKIN Technologies, the manufacturer of the KINARM device. IB receives a stipend from the Trillium Gift of Life Network to support his role as a Regional Medical Lead. NO received funding from the Academic Medical Organization of Southwestern Ontario. MS receives a stipend from the Trillium Gift of Life Network to support his role as a Hospital Donation Physician. DG is funded through a Health-Professional Investigator Award from the Michael Smith Foundation for Health Research. JGB receives a stipend from the Trillium Gift of Life Network to support his role as a Regional Medical Lead., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: To investigate the use of a robotic assessment tool to quantify sensorimotor, visuospatial attention, and executive function impairments in individuals with traumatic brain injury (TBI)., Setting: Foothills Hospital (Calgary, Canada)., Participants: Twenty-three subjects with first-time TBI in the subacute to chronic phase participated in this study. Normative data were collected from 275 to 494 neurologically intact control subjects for each robotic task., Design: A prospective observational case series. Subjects with TBI completed brief clinical cognitive and motor assessments followed by robotic assessments of upper limb reaching, position sense, bimanual motor ability, attention, and visuospatial skills. Scores of subjects with TBI were compared with normative data., Main Measures: Robotic task performance was computed for each subject on each task, as well as performance on specific task parameters. Clinical assessments included the Montreal Cognitive Assessment, Fugl-Meyer upper extremity assessment, and Purdue Peg Board., Results: Subjects with TBI demonstrated a variety of deficits on robotic tasks. The proportion of TBI subjects who were significantly different from controls ranged from 36% (dominant arm reaching) to 60% (bimanual object hitting task)., Conclusion: Robotic measures allowed us to quantify a range of impairments specific to each subject, and offer an objective tool with which to examine these abilities after TBI.