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Topics in Stroke Rehabilitation

Takashi Takebayashi, Kohei Marumoto, Kayoko Takahashi, Kazuhisa Domen
Background No previous studies have determined how the post-stroke integrity of non-corticospinal neural pathways relates to the efficacy of constraint-induced movement therapy (CIMT). Objectives We aimed to clarify the relationship between several non-corticospinal neural pathway integrities and the short- and long-term benefits of CIMT. Methods This was a pilot cohort study (UMIN registration number: R00027136UMIN000023566), for which we enrolled 13 patients with chronic stroke and hemiparesis who had undergone CIMT...
November 13, 2017: Topics in Stroke Rehabilitation
Charalambos C Charalambous, Erin E Helm, Kristin A Lau, Susanne M Morton, Darcy S Reisman
BACKGROUND: People post-stroke can learn a novel locomotor task but require more practice to do so. Implementing an approach that can enhance locomotor learning may therefore improve post-stroke locomotor recovery. In healthy adults, an acute high-intensity exercise bout before or after a motor task may improve motor learning and has thus been suggested as a method that could be used to improve motor learning in neurorehabilitation. However, it is unclear whether an acute high-intensity exercise bout, which stroke survivors can feasibly complete in neurorehabilitation session, would generate comparable results...
November 5, 2017: Topics in Stroke Rehabilitation
Maxence Compagnat, Jean Yves Salle, Stephane Mandigout, Justine Lacroix, Nicolas Vuillerme, Jean Christophe Daviet
Background The Borg Scale for the rating of perceived exertion (RPE) is recommended to measure the intensity of physical exercise during stroke rehabilitation, but its reliability in activities of daily living is not explored. Objective To evaluate the correlation between the RPE using the Borg Scale (6-20) and the intensity of effort as measured by the Total Energy Expenditure per minute (TEE.min(-1)) in a post-stroke population for two tasks: walking at spontaneous comfortable speed and walking up and down stairs...
November 5, 2017: Topics in Stroke Rehabilitation
Marianne E Klinke, Haukur Hjaltason, Guðný Berg F Ra Tryggvadóttir, Helga Jónsdóttir
Background Stroke patients with severe symptoms of hemispatial neglect (HN) are known to experience a weaker recovery than those less affected from the outset. Correct identification of HN is therefore important throughout the course of rehabilitation. Objectives To explore: (i) the course of clinical symptoms in stroke patients with moderate/severe HN from acute setting to home, (ii) changes in sensitivity of diagnostic tasks over time, and (iii) agreement between the researcher's and patients' HN assessments...
November 4, 2017: Topics in Stroke Rehabilitation
A N Ali, J Howe, A Majid, J Redgrave, S Pownall, A H Abdelhafiz
Introduction Stroke-associated pneumonia (SAP) is common, however, data on the economic impact of SAP are scarce. This study aimed to prospectively evaluate the impact of SAP on acute stroke care costs in a UK setting. Methods Prospective cohort study of 213 consecutive patients with stroke (196 ischemic, 17 hemorrhagic) was admitted to a UK hospital over 1 year. Socio demographic and clinical characteristics were recorded along with all treatments and rehabilitation activity. Patients were classified as having SAP if they fulfilled criteria for "probable" or "definite" respiratory tract infection according to the Centres for Disease Control and Prevention definition, within the first seven days following stroke...
November 4, 2017: Topics in Stroke Rehabilitation
Bulmaro A Valdés, H F Machiel Van der Loos
Background Compensatory movements are commonly employed by stroke survivors, and their use can have negative effects on motor recovery. Current practices to reduce them rely on strapping a person to a chair. The use of technology to substitute or supplement this methodology has not being thoroughly investigated. Objective To compare the use of Scores + Visual + Force and Visual + Force feedback for reducing trunk compensation. Methods Fourteen hemiparetic stroke survivors performed bimanual reaching movements while receiving feedback on trunk compensation...
October 27, 2017: Topics in Stroke Rehabilitation
Viviane Aparecida Carvalho de Morais, Marina Ferreira da Silva Tourino, Ana Carolina de Souza Almeida, Thaís Bueno Dias Albuquerque, Roberta Castro Linhares, Paulo Pereira Christo, Patrícia Massara Martinelli, Paula Luciana Scalzo
Background Aerobic exercise, even for short durations, may promote an increase in serum concentrations of brain-derived neurotrophic factor (BDNF). However, it is necessary to determine the optimal exercise types and intensities to increase BDNF levels. Objectives This aim of this study was investigate the effects of mild and moderate intensity acute aerobic exercise on serum BDNF levels in patients in the chronic post-stroke phase. Methods The participants answered a socio-demographic questionnaire, cognitive assessment (Mini Mental State Examination), assessment of depressive symptoms (Hamilton Depression Scale), fatigue (Fatigue Severity Scale) and functional capacity (6-minute walk test)...
October 27, 2017: Topics in Stroke Rehabilitation
Takayuki Watabe, Hisayoshi Suzuki, Yusuke Konuki, Keiichiro Aoki, Jun Nagashima, Rikitaro Sako
Purpose To use a mixed method design to evaluate how clinicians judge falls in stroke patients as a beneficial event, and to identify patient-specific characteristics associated with beneficial falls. Methods The definition of beneficial falls was based on interviews with six experienced clinicians in stroke rehabilitation. Interview data were analyzed using the grounded theory approach, with outcomes used to develop a checklist to judge falls as beneficial. We subsequently used the checklist to identify falls sustained by patients in our rehabilitation unit as beneficial events...
October 26, 2017: Topics in Stroke Rehabilitation
José Fonseca, Ana Raposo, Isabel Pavão Martins
Objectives This study assessed cognitive performance of subjects with aphasia during the acute stage of stroke and evaluated how such performance relates to recovery at 3 months. Materials & methods Patients with aphasia following a left hemisphere stroke were evaluated during the first (baseline) and the fourth-month post onset. Assessment comprised non-verbal tests of attention/processing speed (Symbol Search, Cancelation Task), executive functioning (Matrix Reasoning, Tower of Hanoi, Clock Drawing, Motor Initiative), semantic (Camel and Cactus Test), episodic and immediate memory (Memory for Faces Test, 5 Objects Memory Test, and Spatial Span...
October 26, 2017: Topics in Stroke Rehabilitation
Ji-Eun Cho, Hwang-Jae Lee, Min-Kyu Kim, Wan-Hee Lee
BACKGROUND: The changes effected by the inspiratory muscle training (IMT) on the structure of inspiratory muscles such as on the diaphragm, in patients with stroke, is unclear. OBJECTIVE: To investigate the effect of IMT on inspiratory function, diaphragm thickness, walking endurance, and fatigue in patients with stroke. METHODS: A total of 30 patients with stroke were randomized to either the experimental group or the control group. The experimental group (n = 15) underwent inspiratory muscle training with resistance adjusted to 30% of maximal inspiratory pressure, 90 breaths a day, 5 times a week for 6 weeks...
October 24, 2017: Topics in Stroke Rehabilitation
Virginia Marie Grant, Alison Gibson, Nora Shields
Background Somatosensory stimulation may have a positive impact on recovery of motor function by maintaining cortical representation of the hand and acting to prime the motor system for movement. Objective Determine the efficacy of somatosensory stimulation on upper limb motor function after stroke. Methods Five electronic databases (MEDLINE, CINAHL, Embase, PEDro and OT Seeker) were searched from inception to October 2016. Included studies were English-language randomized controlled trials where a sensory intervention was applied below the elbow to improve upper limb motor control of adults after stroke...
October 20, 2017: Topics in Stroke Rehabilitation
Palmira Bernocchi, Chiara Mulè, Fabio Vanoglio, Giovanni Taveggia, Alberto Luisa, Simonetta Scalvini
OBJECTIVE: To evaluate the feasibility and safety of home rehabilitation of the hand using a robotic glove, and, in addition, its effectiveness, in hemiplegic patients after stroke. METHODS: In this non-randomized pilot study, 21 hemiplegic stroke patients (Ashworth spasticity index ≤ 3) were prescribed, after in-hospital rehabilitation, a 2-month home-program of intensive hand training using the Gloreha Lite glove that provides computer-controlled passive mobilization of the fingers...
October 16, 2017: Topics in Stroke Rehabilitation
Kodai Miyara, Shuji Matsumoto, Tomohiro Uema, Tomokazu Noma, Keiko Ikeda, Akihiko Ohwatashi, Ryoji Kiyama, Megumi Shimodozono
BACKGROUND: Several reports have focused on the effects of whole body vibration (WBV) on spasticity with differing results. Most studies used modified Ashworth scale (MAS) for qualitative measurements, but the effect was small. OBJECTIVE: To investigate the effect of WBV on spasticity in hemiplegic legs of patients with stroke using F-wave parameters. METHODS: Sixteen patients with stroke (mean age, 54.7 ± 13.5 years: time after stroke, 28...
October 16, 2017: Topics in Stroke Rehabilitation
Henk Arwert, Selma Schut, Jelis Boiten, Thea Vliet Vlieland, Jorit Meesters
OBJECTIVE: To comprehensively describe hand function and associated factors among stroke survivors by means of the Michigan Hand Outcomes Questionnaire (MHQ; 6 domains; score 0-100, worst-best). METHODS: In this cross-sectional study, stroke patients were invited to complete a set of questionnaires on hand function, socio-demographic characteristics, mental functioning, daily activities, quality of life, and caregiver strain. Stroke characteristics were collected retrospectively from medical records...
October 12, 2017: Topics in Stroke Rehabilitation
Alison Blane, Torbjörn Falkmer, Hoe C Lee, Tania Dukic Willstrand
Background Safe driving is a complex activity that requires calibration. This means the driver can accurately assess the level of task demand required for task completion and can accurately evaluate their driving capability. There is much debate on the calibration ability of post-stroke drivers. Objectives The aim of this study was to assess the cognition, self-rated performance, and estimation of task demand in a driving simulator with post-stroke drivers and controls. Methods A between-groups study design was employed, which included a post-stroke driver group and a group of similarly aged older control drivers...
October 12, 2017: Topics in Stroke Rehabilitation
Kamal Narayan Arya, Shanta Pandian, Vinod Puri
Background Shoulder subluxation is a common post-stroke complication affecting up to 80% of the stroke subjects. The pathomechanics at the skeletal level does not provide the structural base for the neural-motor recovery. The management of subluxed shoulder has always been a challenge, complicating the motor and functional recovery. Objective To review the available studies of rehabilitation interventions for reduction of subluxed shoulder and to explore the evidence for impact of subluxation on motor recovery...
October 11, 2017: Topics in Stroke Rehabilitation
Catherine J VanDerwerker, Ryan E Ross, Katy H Stimpson, Aaron E Embry, Stacey E Aaron, Brian Cence, Mark S George, Chris M Gregory
Objective and importance Residual effects of stroke include well-documented functional limitations and high prevalence of depression. Repetitive transcranial magnetic stimulation (rTMS) and aerobic exercise (AEx) are established techniques that improve depressive symptoms, but a combination of the two has yet to be reported. The purpose of this case series is to examine the safety, feasibility, and impact of combined rTMS and AEx on post-stroke depression and functional mobility. Clinical presentation Three participants with a history of stroke and at least mild depressive symptoms (Patient Health Questionare-9 ≥5)...
October 6, 2017: Topics in Stroke Rehabilitation
Ji-Eun Cho, Ki Hun Cho, Jun Sang Yoo, Su Jin Lee, Wan-Hee Lee
Background A dual-probe personal computer-based muscle viewer (DPC-BMW) is advantageous in that it is relatively lightweight and easy to apply. Objective To investigate the reliability and validity of the DPC-BMW in comparison with those of a portable ultrasonography (P-US) device for measuring the pennation angle of the medial gastrocnemius (MG) muscle at rest and during contraction. Methods Twenty-four patients who had a stroke (18 men and 6 women) participated in this study. Using the DPC-BMW and P-US device, the pennation angle of the MG muscle on the affected side was randomly measured...
October 5, 2017: Topics in Stroke Rehabilitation
Claire Marsal, Jean-Michel Gracies, Catherine Dean, Serge Mesure, Nicolas Bayle
Purpose To investigate the beliefs of physiotherapy students (ST), professionals (PT) and physicians (MD) about engaging patients with post-stroke hemiparesis into Guided Self-Rehabilitation Contracts (GSC), to increase their exercise intensity and responsibility level. Method A survey examining beliefs about post-stroke rehabilitation was completed by first (n = 95), second (n = 105), and third (n = 48) year STs; PTs (n = 129) and MDs (n = 65) in France. Results The belief about whether a patient may exercise alone varied between the professional groups with more STs and MDs finding it acceptable: 62% of PTs vs...
September 28, 2017: Topics in Stroke Rehabilitation
Danbi Lee, Heidi Fischer, Sarah Zera, Rosetta Robertson, Joy Hammel
Background People with stroke often find discharge from rehabilitation distressing because they do not feel prepared to participate in life roles as they want. A self-management approach can facilitate improvement in confidence and ability to manage post-stroke community living and participation after transitioning into the community. Objective To evaluate the feasibility and effectiveness of the Improving Participation After Stroke Self-management program - Rehab version (IPASS-R) in a day rehabilitation setting...
September 28, 2017: Topics in Stroke Rehabilitation
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