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Stroke and Rehabilitation

Joe Sarsfield, David Brown, Nasser Sherkat, Caroline Langensiepen, James Lewis, Mohammad Taheri, Christopher McCollin, Cleveland Barnett, Louise Selwood, Penny Standen, Pip Logan, Christopher Simcox, Catherine Killick, Emma Hughes
Encouraging rehabilitation by the use of technology in the home can be a cost-effective strategy, particularly if consumer-level equipment can be used. We present a clinical qualitative and quantitative analysis of the pose estimation algorithms of a typical consumer unit (Xbox One Kinect), to assess its suitability for technology supervised rehabilitation and guide development of future pose estimation algorithms for rehabilitation applications. We focused the analysis on upper-body stroke rehabilitation as a challenging use case...
January 2019: International Journal of Medical Informatics
Adam C Lieber, Estee Hong, David Putrino, Dominic A Nistal, Jonathan S Pan, Christopher P Kellner
While significant research has been performed regarding the use of thrombolytic agents and thrombectomy in the setting of acute stroke, other factors, such as nutritional status of stroke patients, is a less explored topic. The topic of nutrition is critical to the discussion of stroke, as up to half of stroke survivors may be considered malnourished at discharge. Dysphagia, old age, restricted upper limb movement, visuospatial impairment, and depression are all important risk factors for malnutrition in this cohort...
December 7, 2018: Brain Sciences
Sanaz Pornajaf, Michela Goffredo, Maurizio Agosti, Maurizio Massucci, Salvatore Ferro, Marco Franceschini
BACKGROUND: Despite the importance of walking recovery in real life contexts, only 7% of stroke survivors at discharge from neuro-rehabilitation units recover independent walking in the community. However, studies on outcome indicators of walking ability restoration following stroke rarely regard the community ambulation. AIM: To investigate how socio-demographic and sub-acute clinical characteristics of stroke survivors at admission and at discharge may predict a good participation in community walking activity 6 months post-stroke...
December 13, 2018: European Journal of Physical and Rehabilitation Medicine
Mohsen Mazrooyisebdani, Veena A Nair, Po-Ling Loh, Alexander B Remsik, Brittany M Young, Brittany S Moreno, Keith C Dodd, Theresa J Kang, Justin C William, Vivek Prabhakaran
Despite the established effectiveness of the brain-computer interface (BCI) therapy during stroke rehabilitation (Song et al., 2014a, 2015; Young et al., 2014a,b,c, 2015; Remsik et al., 2016), little is understood about the connections between motor network reorganization and functional motor improvements. The aim of this study was to investigate changes in the network reorganization of the motor cortex during BCI therapy. Graph theoretical approaches are used on resting-state functional magnetic resonance imaging (fMRI) data acquired from stroke patients to evaluate these changes...
2018: Frontiers in Neuroscience
Ai Shiraishi, Yoshihiro Yoshimura, Hidetaka Wakabayashi, Yuri Tsuji, Sayuri Shimazu, Seungwon Jeong
BACKGROUND & AIMS: Oral health is an integral part of nutrition and rehabilitation. The purpose of this study was to investigate the impact of impaired oral health status on clinical and functional outcomes in post-acute in-hospital rehabilitation. METHODS: We conducted a prospective cohort study of hospitalized patients undergoing rehabilitation at a 225-bed post-acute rehabilitation hospital in Japan. All newly admitted patients were eligible to enroll during the two-year research period...
November 30, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Mia Ingerslev Loft, Ingrid Poulsen, Bente Martinsen, Lone Lunbak Mathiesen, Helle Klingenberg Iversen, Bente Appel Esbensen
Aim: To assess the feasibility of a nursing educational intervention for inpatient stroke rehabilitation and its acceptability from the nursing staff's perspective. Background: There is currently a lack of interventions that integrate the diversity of nurses' role and functions in stroke rehabilitation and explore their effect on patient outcomes. Design: We used a convergent, parallel, mixed-method design with data interviews and questionnaires...
January 2019: Nursing Open
Aki Rintala, Ville Päivärinne, Sanna Hakala, Jaana Paltamaa, Ari Heinonen, Juha Karvanen, Tuulikki Sjögren
OBJECTIVE: To study the effectiveness of technology-based distance physical rehabilitation interventions on physical functioning in stroke. DATA SOURCES: A systematic literature search was conducted in six databases from January 2000 to May 2018. STUDY SELECTION: Inclusion criteria applied PICOS (Patient, Intervention, Comparison, Outcome, Study design) framework as follows: (P) stroke; (I) technology-based distance physical rehabilitation interventions; (C) any comparison without the use of technology; (O) physical functioning; (S) randomized controlled trials (RCTs)...
December 6, 2018: Archives of Physical Medicine and Rehabilitation
Jiao-Jiao Peng, Rong Sha, Ming-Xing Li, Lu-Ting Chen, Xiao-Hua Han, Feng Guo, Hong Chen, Xiao-Lin Huang
Stem cells hold great promise as a regenerative therapy for ischemic stroke by improving functional outcomes in animal models. However, there are some limitations regarding the cell transplantation, including low rate of survival and differentiation. Repetitive transcranial magnetic stimulation (rTMS) has been widely used in clinical trials as post-stroke rehabilitation in ischemic stroke and has shown to alleviate functional deficits following stroke. The present study was designed to evaluate the therapeutic effects and mechanisms of combined human neural stem cells (hNSCs) with rTMS in a middle cerebral artery occlusion (MCAO) rat model...
December 4, 2018: Experimental Neurology
Lydia G Brough, Steven A Kautz, Mark G Bowden, Chris M Gregory, Richard R Neptune
Stroke is the leading cause of long-term disability and individuals post-stroke often experience impaired walking ability. The plantarflexor (PF) muscles are critical to walking through their contributions to the ground reaction forces and body segment energetics. Previous studies have shown muscle activity during walking can be grouped into co-excited muscle sets, or modules. Improper co-activation, or merging of modules, is a common impairment in individuals post-stroke. The purpose of this study was to determine the influence of merged PF modules on walking performance in individuals post stroke by examining balance control, body support and propulsion, and walking symmetry...
November 15, 2018: Journal of Biomechanics
Winifried Backhaus, Hanna Braass, Christian Gerloff, Friedhelm C Hummel
Acquisition and reacquisition of skills is a main pillar of functional recovery after stroke. Nighttime sleep has a positive influence on motor learning in healthy individuals, whereas the effect of daytime sleep on neuro-rehabilitative training and relearning of the trained skills is often neglected. The aim of this study was to investigate the relationship between daytime sleep (napping) and the ability to learn a new visuomotor task in chronic stroke patients. The main hypothesis was that sleep enhances motor memory consolidation after training resulting in better motor performance after a period of daytime sleep...
2018: Frontiers in Neurology
Ana Lúcia Faria, Maria Salomé Pinho, Sergi Bermúdez I Badia
BACKGROUND: Cognitive impairments after stroke are not always given sufficient attention despite the critical limitations they impose on activities of daily living (ADLs). Although there is substantial evidence on cognitive rehabilitation benefits, its implementation is limited because of time and human resource's demands. Moreover, many cognitive rehabilitation interventions lack a robust theoretical framework in the selection of paper-and-pencil tasks by the clinicians. In this endeavor, it would be useful to have a tool that could generate standardized paper-and-pencil tasks, parameterized according to patients' needs...
December 6, 2018: JMIR Rehabilitation and Assistive Technologies
Katsuhiro Mizuno, Takayuki Abe, Junichi Ushiba, Michiyuki Kawakami, Tomomi Ohwa, Kazuto Hagimura, Miho Ogura, Kohei Okuyama, Toshiyuki Fujiwara, Meigen Liu
BACKGROUND: We developed a brain-machine interface (BMI) system for poststroke patients with severe hemiplegia to detect event-related desynchronization (ERD) on scalp electroencephalogram (EEG) and to operate a motor-driven hand orthosis combined with neuromuscular electrical stimulation. ERD arises when the excitability of the ipsi-lesional sensorimotor cortex increases. OBJECTIVE: The aim of this study was to evaluate our hypothesis that motor training using this BMI system could improve severe hemiparesis that is resistant to improvement by conventional rehabilitation...
December 6, 2018: JMIR Research Protocols
A M Barrett, Olga Boukrina, Soha Saleh
Emerging research suggests spatial neglect after right stroke is linked to dysfunctional attention and motor networks. Advanced functional connectivity analysis clarified brain network recovery, however we need to know how networks participate in adaptive motor performance. We need to verify network changes associated with validated functional measures and spatial-motor performance in spatial neglect, especially in patients with large brain lesions and significant disability. This study tested whether disability-relevant spatial neglect associates with different patterns of resting state functional connectivity between motor, dorsal and ventral attention networks (MN, DAN and VAN)...
December 3, 2018: Brain and Cognition
Danilo Avola, Luigi Cinque, Gian Luca Foresti, Marco Raoul Marini
Strokes, surgeries, or degenerative diseases can impair motor abilities and balance. Long-term rehabilitation is often the only way to recover, as completely as possible, these lost skills. To be effective, this type of rehabilitation should follow three main rules. First, rehabilitation exercises should be able to keep patient's motivation high. Second, each exercise should be customizable depending on patient's needs. Third, patient's performance should be evaluated objectively, i.e., by measuring patient's movements with respect to an optimal reference model...
December 3, 2018: Journal of Biomedical Informatics
Jonas Schröder, Steven Truijen, Tamaya Van Criekinge, Wim Saeys
BACKGROUND: Pre-clinical evidence suggests a period early after stroke during which the brain is most receptive to rehabilitation, if it is provided as high-dose motor training. OBJECTIVE: To evaluate the feasibility of repetitive gait training within the first 3 months post-stroke and the effects on gait-specific outcomes. METHODS: PubMed, Web of Science, Cochrane Library, Rehab Data and PEDro databases were searched systematically. Randomized controlled trials were included to descriptively analyse the feasibility and quantitatively investigate the effectiveness of repetitive gait training compared with conventional therapy...
December 4, 2018: Journal of Rehabilitation Medicine
Jae Min Lee, Yong Sauk Hau, Jae Chan Park, Min Cheol Chang
No abstract text is available yet for this article.
December 3, 2018: American Journal of Physical Medicine & Rehabilitation
Sophie O'Keefe, Mandy Stanley, Kerry Adam, Natasha A Lannin
Purpose Addressing return to work early after neurological impairment from stroke or moderate and severe traumatic brain injury may improve likelihood of returning to employment, yet little is known about how best to organize work interventions for delivery in the inpatient hospital setting. The purpose of this scoping review was to identify knowledge gaps and inform program development in hospital-based work interventions. Method We searched MEDLINE, CINAHL, OTSeeker and Embase for English-language articles published from database inception until March 2018...
December 4, 2018: Journal of Occupational Rehabilitation
Karen Borschmann, Kathryn S Hayward, Audrey Raffelt, Leonid Churilov, Sharon Kramer, Julie Bernhardt
Background: The ineffectiveness of most complex stroke recovery trials may be explained by inadequate intervention design. The primary aim of this review was to explore the rationales given for interventions and dose in stroke rehabilitation randomised controlled trials (RCTs). Methods: We searched the Cochrane Stroke Group library for RCTs that met the following criteria: (1) training based intervention; (2) >50% participants who were stroke survivors; (3) full peer-reviewed text; (4) English language...
2018: Stroke Research and Treatment
Danielle Munford, Hilary Gunn
PURPOSE: To explore the perceptions and experiences of people with stroke living in the community with regard to the perceived causes, impact and solutions to minimise falls. METHODS: A qualitative research approach underpinned by a constructivist paradigm utilising a phenomenological methodology. Twelve people with stroke participated in focus groups; the data were analysed using thematic analysis. RESULTS: Three themes and one foundation theme were identified...
December 4, 2018: Disability and Rehabilitation
Richard G Carson, Michelle L Rankin
There has been an explosion of interest in methods that may promote neural plasticity by indirectly stimulating tissue in damaged brains using transient magnetic fields or weak electrical currents. A major limitation of these approaches is that the induced variations in brain activity tend to be diffuse. Thus far it has proved extremely difficult to target pathways from the brain to specific muscles. This is a particular challenge for applications in rehabilitation. Stroke survivors often exhibit abnormal patterns of muscle activation, including diminished specificity and high levels of co-contraction...
2018: Frontiers in Psychology
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