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Stroke and Rehabilitation

Stefano Mazzoleni, Vi-Do Tran, Paolo Dario, Federico Posteraro
In this study, the recovery of proximal and distal segments in stroke patients who received distal training alone was investigated. Forty (20 subacute and 20 chronic) stroke patients were recruited to perform wrist robot-assisted rehabilitation training. The upper extremity, shoulder-elbow and wrist subsections of the Fugl-Meyer Assessment Scale were used to assess the motor recovery of distal and proximal segments. In addition, the Modified Ashworth Scale, the Motricity Index and the Box & Block test were used as clinical outcome measures together with kinematic parameters to evaluate the effects of the training...
August 13, 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Li Ding, Xu Wang, Xiaoli Guo, Shugeng Chen, Hewei Wang, Ning Jiang, Jie Jia
Mirror visual feedback (MVF) is used widely for motor recovery after stroke, but an optimal training setup and systematic procedure are lacking. New optimization strategies have been proposed, one of which is a camera technique. We investigated the effects of a camera-based MVF setup on motor function and motor processes upstream for upper-limb rehabilitation. Seventy-nine stroke patients were assigned randomly to the MVF group (MG; N = 38) or conventional group (CG; N = 41), which respectively received camera-based MVF and dosage-equivalent physiotherapy or/and occupational therapy for 1 h/day and 5 days/week for 4 weeks...
August 13, 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Xiao Tang, Xu Zhang, Xiaoping Gao, Xiang Chen, Ping Zhou
The objective of this study was to develop sample entropy (SampEn) as a novel surface electromyogram (EMG) biomarker to quantitatively examine post-stroke neuromuscular alternations. The SampEn method was performed on surface EMG interference patterns recorded from biceps brachii muscles of nine healthy control subjects, fourteen subjects with subacute stroke, and eleven subjects with chronic stroke, respectively. Measurements were collected during isometric contractions of elbow flexion at different constant force levels...
August 8, 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Zoran Vukojevic, Aleksandra Dominovic Kovacevic, Stojan Peric, Sanja Grgic, Bogdan Bjelica, Ivana Basta, Dragana Lavrnic
BACKGROUND: Central poststroke pain (CPSP) is often unrecognized in clinical practice, it may aggravate the rehabilitation process and reduce quality of life. AIM: To determine the frequency and features of CPSP, as well as to make possible associations of CPSP with sociodemographic and clinical features of subjects with stroke. METHOD: In a two-year period 602 patients with previous stroke were consecutively tested. We used three questionnaires for the diagnosis of neuropathic pain (Pain Detect Questionnaire - PD-Q, The Leeds Assessment of Neuropathic Symptoms and Signs - LANSS and Douleur neuropatathique en 4 questions - DN4)...
August 15, 2018: Journal of the Neurological Sciences
Emmanuel S Sogbossi, Charlène Kakpossa, Didier D Niama-Natta, Toussaint G Kpadonou, Charles S Batcho
This study aimed to investigate (i) the validity of self-reported scores of locomotion ability in stroke survivors using the ABILOCO-Benin questionnaire, and (ii) the congruence between online Rasch analysis of the ABILOCO-Benin raw scores and a conversion table set along with the questionnaire development. Thirty-five adult poststroke patients [mean age: 52 (SD: 10) years, 60% men] recruited from the rehabilitation department of National University Hospital of Cotonou (Benin), self-reported their locomotion ability, filling out the ABILOCO-Benin questionnaire [self-reported scores (SRS)]...
August 10, 2018: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
Sebastian H Doeltgen, Lakkari Rigney, Charles Cock, Taher Omari
BACKGROUND: Anodal transcranial direct current stimulation (tDCS) has demonstrated effects on corticobulbar excitability and swallowing function as assessed via clinical rating scales in stroke cohorts. Biomechanical effects of anodal tDCS on swallowing remain largely unexplored. We investigated how anodal tDCS applied over the floor of mouth (FOM) representation on the primary motor cortex affects swallowing biomechanics in healthy participants. METHODS: Anodal and sham tDCS were applied for 20 minutes at 1...
August 13, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Seok Mei Lim, Beatrix Wong, Gail Brenda Cross, Reshma Merchant
An 85-year-old man with a history of aortic valve replacement presented with lower limb cramps. He was initially diagnosed with degenerative disc disease, but was found to have Lactococcus garvieae infective endocarditis with septic embolic strokes causing a central poststroke pain syndrome. Cardiothoracic surgery was deemed too high risk and the patient completed 6 weeks of intravenous antimicrobials as well as prolonged inpatient rehabilitation. Lactococcus garvieae is an aquaculture pathogen which typically affects elderly and immunocompromised patients...
2018: IDCases
Gustaf Magaard, Per Wester, Richard Levi, Peter Lindvall, Emma Gustafsson, Arzhang Nazemroaya Sedeh, Malin Lönnqvist, Stina Berggren, Kristin Nyman, Xiaolei Hu
BACKGROUND: Unmet rehabilitation needs are common among stroke survivors. We aimed to evaluate whether a comprehensive graphic "Rehab-Compass," a novel combination of structured patient-reported outcome measures, was feasible and useful in facilitating a capture of patients' rehabilitation needs in clinical practice. METHODS: A new graphic overview of broad unmet rehabilitation needs covers deficits in functioning, daily activity, participation, and quality of life...
August 7, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Shannon L MacDonald, Pamela L Joseph, Ida J Cavaliere, Mark Theodore Bayley, Alexander Lo
Ontario physicians are legally obligated to report patients who may be medically unfit to drive to the Ministry of Transportation of Ontario (MTO). Currently at Toronto Rehabilitation Institute (TRI), there are no standardised processes for MTO reporting, resulting in inconsistent communication regarding driving with patients and between healthcare providers, redundant assessments and ultimately reduced patient satisfaction. TRI received 10 patient complaints regarding the driving reporting process in the 5 years prior to this project and a large number of patients were not being reported appropriately...
2018: BMJ Open Quality
Chalak Berzingi, Vinay Badhwar, Fahad Alqahtani, Sami Aljohani, Zakeih Chaker, Mohamad Alkhouli
Background: Early experience with transcatheter mitral valve replacement (TMVR) highlighted several investigational challenges related to this novel therapy. Conclusive randomised clinical trials in the field may, therefore, be years ahead. In the interim, contemporary outcomes of isolated surgical bioprosthetic mitral valve replacement (MVR) can be used as a benchmark for the emerging TMVR therapies. Methods: We used the nationwide inpatient sample to examine recent trends and outcomes of surgical bioprosthetic MVR for mitral regurgitation (isolated and combined)...
2018: Open Heart
Nico Milantoni, Natale Di Bella, Kariné Chahbazian
BACKGROUND Although rehabilitation for balance disorders is commonly undertaken following a stroke, hearing dysfunction is rarely investigated, even though hearing loss affects the ability to maintain balance. This report presents a case of restoration of balance and unilateral hearing using an alternating and filtering auditory training (AFAT) protocol in a patient with subarachnoid hemorrhage (SAH) and shunt-treated hydrocephalus. CASE REPORT A 54-year-old woman with a five-month history of SAH due to a ruptured aneurysm in the anterior communicating artery and hydrocephalus treated with a shunt was admitted to our unit for neurorehabilitation...
August 10, 2018: American Journal of Case Reports
Tao Wang, Dao-Rui Yu, Jing Huang, Qiang Liu, Dan-Xin Wang, Nan Luo, Hao Jia, Hao-Fei Fan, Qi-Bing Liu
BACKGROUND: Despite the intense efforts devoted to preventing and treating cerebral ischemia, some individuals will continue to have completed infarctions. Failure of prevention or intervention does not, however, preclude therapeutic approaches to enhance recovery. Our study aims to explore the effect of multimodal rehabilitation program on the motor function recovery of rats with ischemic stroke. METHODS: Rat models of ischemic stroke were established using clean-grade adult male Sprague-Dawley rats...
August 6, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Joji Hagii, Norifumi Metoki, Shin Saito, Ayaka Fujita, Hiroshi Shiroto, Satoko Sasaki, Koki Takahashi, Hiroyasu Hitomi, Yoshiko Baba, Satoshi Seino, Takaatu Kamada, Takamitsu Uchizawa, Manabu Iwata, Shigeo Matsumoto, Minoru Yasujima, Hirofumi Tomita
BACKGROUND: The relationship between body mass index (BMI) and the severity of cardioembolic stroke (CES) remains poorly understood. METHOD: A total of 419 consecutive CES patients with nonvalvular atrial fibrillation (NVAF), and with a modified Rankin Scale (mRS) score of 0 or 1 before onset admitted within 48 hours after onset to the Hirosaki Stroke and Rehabilitation Center were studied. The patients were divided into three groups, low BMI (L-BMI; n = 36, BMI < 18...
August 6, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Diyang Lyu, Xuanxin Lyu, Yong Zhang, Yi Ren, Fan Yang, Li Zhou, Yihuai Zou, Zongheng Li
Background: Stroke is a major cause of poor health and has numerous complications. Tai Chi (TC) may have positive effects on the rehabilitation of stroke survivors, but recent clinical findings have not been included in previously published reviews. Objectives: We conducted this systematic review and meta-analysis to determine the effectiveness of all types of TC vs. conventional rehabilitation therapy for all aspects of stroke survivors' rehabilitation that have been studied. Method: We searched seven electronic literature databases (three in English, four in Chinese) and one clinical registry platform using established strategies to identify randomized controlled trials performed up to October 2017...
2018: Frontiers in Physiology
Cuiling Shen, Fang Liu, Liqun Yao, Zhongyuan Li, Li Qiu, Suzhu Fang
OBJECTIVE: To estimate the effectiveness of MOTOmed® movement therapy in increasing mobility and activities of daily living in stroke patients with hemiplegia. DESIGN: Systematic review. DATA SOURCES: English- and Chinese-language articles published from the start of database coverage through 20 June 2018 were retrieved from the Embase, Web of Science, PubMed, OVID, Cochrane Central Register of Controlled Trials, Cochrane Systematic Reviews, Wanfang, Chinese National Knowledge Infrastructure, VIP, and Chinese Biomedicine databases...
August 8, 2018: Clinical Rehabilitation
Ellen N Sutter, Anna E Mattlage, Marghuretta D Bland, Kendra M Cherry-Allen, Elinor Harrison, Swati M Surkar, Jeffrey M Gidday, Ling Chen, Tamara Hershey, Jin-Moo Lee, Catherine E Lang
Remote limb ischemic conditioning (RLIC) is a clinically feasible method of promoting tissue protection against subsequent ischemic insult. Recent findings from our lab demonstrated that RLIC robustly enhances motor learning in young, healthy humans. The next step is to determine which individuals would receive maximum benefit from RLIC before applying these findings to clinical rehabilitation populations such as stroke. Numerous factors, such as age, sex, body mass index (BMI), and cardiovascular comorbidities may influence the response...
August 7, 2018: Translational Stroke Research
Robert J Zhou, Hossein M Hondori, Maryam Khademi, Jessica M Cassidy, Katherine M Wu, Derek Z Yang, Nikhita Kathuria, Fareshte R Erani, Lucy Dodakian, Alison McKenzie, Cristina V Lopes, Walt Scacchi, Ramesh Srinivasan, Steven C Cramer
The heterogeneity of stroke prompts the need for predictors of individual treatment response to rehabilitation therapies. We previously studied healthy subjects with EEG and identified a frontoparietal circuit in which activity predicted training-related gains in visuomotor tracking. Here we asked whether activity in this same frontoparietal circuit also predicts training-related gains in visuomotor tracking in patients with chronic hemiparetic stroke. Subjects ( n = 12) underwent dense-array EEG recording at rest, then received 8 sessions of visuomotor tracking training delivered via home-based telehealth methods...
2018: Frontiers in Neurology
Kendra M Cherry-Allen, Matthew A Statton, Pablo A Celnik, Amy J Bastian
BACKGROUND: Gait impairments after stroke arise from dysfunction of one or several features of the walking pattern. Traditional rehabilitation practice focuses on improving one component at a time, which may leave certain features unaddressed or prolong rehabilitation time. Recent work shows that neurologically intact adults can learn multiple movement components simultaneously. OBJECTIVE: To determine whether a dual-learning paradigm, incorporating 2 distinct motor tasks, can simultaneously improve 2 impaired components of the gait pattern in people posttroke...
August 7, 2018: Neurorehabilitation and Neural Repair
Elizabeth M Byrd, Rita J Jablonski, David E Vance
BACKGROUND: Anosognosia for hemiplegia (AHP) after stroke is a complex cognitive behavioral disorder that removes awareness of one-sided paralysis (hemiplegia). As a result, stroke survivors afflicted with AHP may be more likely to have unrealistic expectations for stroke rehabilitation, display unsafe behaviors and experience falls, and ultimately suffer the physical and psychological consequences of frequent falling. OBJECTIVE: The purpose of this article is to describe AHP by discussing anosognosia within the context of contemporary theoretical understandings, examining current imaging evidence of the disorder, and summarizing emerging interventions designed to reinstate self-awareness in anosognosic patients...
August 6, 2018: Rehabilitation Nursing: the Official Journal of the Association of Rehabilitation Nurses
Maijke Van Bloemendaal, Walter Bout, Sicco A Bus, Frans Nollet, Alexander Ch Geurts, Anita Beelen
OBJECTIVE: To evaluate construct validity and reproducibility of the Functional Gait Assessment (FGA) for measuring walking balance capacity in persons after stroke. DESIGN: Cross-sectional study. SETTING: Inpatient and outpatient rehabilitation center. SUBJECTS: Fifty-two persons post-stroke (median (25% and 75% percentiles)) time post-stroke 6 (5-10) weeks) with independent walking ability (mean gait speed 1.1 ± ...
August 7, 2018: Clinical Rehabilitation
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