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Stroke neurorehabilitation

U Horn, M Grothe, M Lotze
Several biomarkers have been identified which enable a considerable prediction of hand-motor outcome after cerebral damage already in the subacute stage after stroke. We here review the value of MRI biomarkers in the evaluation of corticospinal integrity and functional recruitment of motor resources. Many of the functional imaging parameters are not feasible early after stroke or for patients with high impairment and low compliance. Whereas functional connectivity parameters have demonstrated varying results on their predictive value for hand-motor outcome, corticospinal integrity evaluation using structural imaging showed robust and high predictive power for patients with different levels of impairment...
2016: Neural Plasticity
Sonja E Findlater, Sean P Dukelow
Proprioception is an important aspect of function that is often impaired in the upper extremity following stroke. Unfortunately, neurorehabilitation has few evidence based treatment options for those with proprioceptive deficits. The authors consider potential reasons for this disparity. In doing so, typical assessments and proprioceptive intervention studies are discussed. Relevant evidence from the field of neuroscience is examined. Such evidence may be used to guide the development of targeted interventions for upper extremity proprioceptive deficits after stroke...
October 11, 2016: Journal of Motor Behavior
Terry Trinh, Christine T Shiner, Angelica G Thompson-Butel, Penelope A McNulty
PURPOSE: Post-stroke hemiparesis may manifest as asymmetric gait, poor balance, and inefficient movement patterns. We investigated improvements in lower-limb muscle activation and function during Wii-based Movement Therapy (WMT), a rehabilitation program specifically targeting upper-limb motor-function. METHODS: Electromyography (EMG) was recorded bilaterally from tibialis anterior (TA) in 20 stroke patients during a 14-day WMT program. EMG amplitude and burst duration were analyzed during stereotypical movement sequences of WMT activities...
October 9, 2016: Disability and Rehabilitation
Paul Rinne, Michael Mace, Tagore Nakornchai, Karl Zimmerman, Susannah Fayer, Pankaj Sharma, Jean-Luc Liardon, Etienne Burdet, Paul Bentley
Motor-training software on tablets or smartphones (Apps) offer a low-cost, widely-available solution to supplement arm physiotherapy after stroke. We assessed the proportions of hemiplegic stroke patients who, with their plegic hand, could meaningfully engage with mobile-gaming devices using a range of standard control-methods, as well as by using a novel wireless grip-controller, adapted for neurodisability. We screened all newly-diagnosed hemiplegic stroke patients presenting to a stroke centre over 6 months...
2016: PloS One
Simon Butet, Clément Provost, Marylène Jousse, Leila Tlili, Victorine Quintaine, Isabelle Bonan, Alain Yelnik
OBJECTIVE: The positive effects on motor cortical excitability of stimulating proprioception with tendon vibration therapy have previously been reported in healthy individuals and in chronic stroke patient (Marconi et al., 2008 and 2011). The aim of this study is to evaluate the feasibility of a protocol of tendon vibration therapy in a neurorehabilitation service, with a view to proceeding to an efficacy study. MATERIAL/PATIENTS AND METHODS: We performed a prospective, single-centre study, including 11 patients, 8 men, mean age 61,7±10,6, with upper limb motor deficit secondary to a first stroke (5 ischaemic)...
September 2016: Annals of Physical and Rehabilitation Medicine
Michelle Ploughman, Liam P Kelly
PURPOSE OF REVIEW: Converging evidence from animal models of stroke and clinical trials suggests that aerobic exercise has effects across multiple targets. RECENT FINDINGS: The subacute phase is characterized by a period of heightened neuroplasticity when aerobic exercise has the potential to optimize recovery. In animals, low intensity aerobic exercise shrinks lesion size and reduces cell death and inflammation, beginning 24 h poststroke. Also in animals, aerobic exercise upregulates brain-derived neurotrophic factor near the lesion and improves learning...
September 21, 2016: Current Opinion in Neurology
Luis D Lledó, Jorge A Díez, Arturo Bertomeu-Motos, Santiago Ezquerro, Francisco J Badesa, José M Sabater-Navarro, Nicolás García-Aracil
Post-stroke neurorehabilitation based on virtual therapies are performed completing repetitive exercises shown in visual electronic devices, whose content represents imaginary or daily life tasks. Currently, there are two ways of visualization of these task. 3D virtual environments are used to get a three dimensional space that represents the real world with a high level of detail, whose realism is determinated by the resolucion and fidelity of the objects of the task. Furthermore, 2D virtual environments are used to represent the tasks with a low degree of realism using techniques of bidimensional graphics...
2016: Frontiers in Aging Neuroscience
Harika Dasari, Bharath Wootla, Arthur E Warrington, Moses Rodriguez
We provide an overview of rehabilitation in neurological diseases. A large amount of literature available on neurorehabilitation is based from the rehabilitative work on stroke and spinal cord injuries. After a brief description of rehabilitation, the potential application of neurorehabilitation in neurodegenerative diseases specifically multiple sclerosis (MS) is summarized. Since MS causes a wide variety of symptoms, the rehabilitation in MS patients may benefit from an interdisciplinary approach that encloses physiotherapy, cognitive rehabilitation, psychological therapy, occupational therapy, and other methods to improve fatigue...
August 2016: International Journal of Physical Medicine & Rehabilitation
Heather T Peters, Lorie Richards, Brittani A Basobas, Julie M Faieta, Stephen J Page
Stroke remains a leading cause of disability, with survivors experiencing long-term decrements in independence and quality of life. Occupational therapists (OTs) employ numerous neurorehabilitative treatment approaches to remediate impairments that are impeding performance. OTs also use physical agent modalities to facilitate increased participation and success in therapy. One such modality is transcranial direct current stimulation (tDCS), a form a noninvasive brain stimulation that can be overlaid onto task practice and delivers a constant, low intensity current into the brain...
September 3, 2016: Journal of Motor Behavior
A Riccio, F Pichiorri, F Schettini, J Toppi, M Risetti, R Formisano, M Molinari, L Astolfi, F Cincotti, D Mattia
Communication and control of the external environment can be provided via brain-computer interfaces (BCIs) to replace a lost function in persons with severe diseases and little or no chance of recovery of motor abilities (ie, amyotrophic lateral sclerosis, brainstem stroke). BCIs allow to intentionally modulate brain activity, to train specific brain functions, and to control prosthetic devices, and thus, this technology can also improve the outcome of rehabilitation programs in persons who have suffered from a central nervous system injury (ie, stroke leading to motor or cognitive impairment)...
2016: Progress in Brain Research
J Ushiba, S R Soekadar
Noninvasive brain-machine interfaces (BMIs) are typically associated with neuroprosthetic applications or communication aids developed to assist in daily life after loss of motor function, eg, in severe paralysis. However, BMI technology has recently been found to be a powerful tool to promote neural plasticity facilitating motor recovery after brain damage, eg, due to stroke or trauma. In such BMI paradigms, motor cortical output and input are simultaneously activated, for instance by translating motor cortical activity associated with the attempt to move the paralyzed fingers into actual exoskeleton-driven finger movements, resulting in contingent visual and somatosensory feedback...
2016: Progress in Brain Research
Stefano Paolucci, Andrea Martinuzzi, Giorgio Scivoletto, Nicola Smania, Claudio Solaro, Irene Aprile, Michela Armando, Roberto Bergamaschi, Eliana Berra, Giulia Berto, Elena Carraro, Monica Cella, Marialuisa Gandolfi, Marcella Masciullo, Marco Molinari, Emanuela Pagliano, Cristiano Pecchioli, Laura Roncari, Monica Torre, Erika Trabucco, Gabriella Vallies, Paolo Zerbinati, Stefano Tamburin
Pain is a common and disabling symptom in patients with stroke, multiple sclerosis (MS), cerebral palsy (CP), spinal cord injury (SCI) and other conditions associated with spasticity, but data on its prevalence, and natural history, as well as guidelines on its assessment and treatment in the field of neurorehabilitation, are largely lacking. The Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) searched and evaluated current evidence on the frequency, evolution, predictors, assessment, and pharmacological and non-pharmacological treatment of pain in patients with stroke, MS, CP, SCI and other conditions associated with spasticity...
August 31, 2016: European Journal of Physical and Rehabilitation Medicine
Daniele Munari, Anna Pedrinolla, Nicola Smania, Alessandro Picelli, Marialuisa Gandolfi, Leopold Saltuari, Federico Schena
BACKGROUND: Stroke is a major cause of death and long-term disability across the globe. Previous studies have demonstrated the trainability of stroke survivors and documented beneficial effects of aerobic exercises on cardiovascular fitness and gait ability. AIM: The main aim of this study was to compare the effects of a high-intensity treadmill training (HITT) against low-intensity treadmill training (LITT) on gait ability, quality of life, cardiorespiratory fitness and cost of walking in chronic stroke subjects...
August 30, 2016: European Journal of Physical and Rehabilitation Medicine
Marco Tramontano, Giovanni Morone, Andrea Curcio, Giulia Temperoni, Alessandra Medici, Daniela Morelli, Carlo Caltagirone, Stefano Paolucci, Marco Iosa
BACKGROUND: Dual task paradigm is common mechanism of daily life, it is often used for investigating the effect on cognitive processing of motor behavior. AIM: In the present study we investigate the dual task interference during walking on upright gait stability. DESIGN: cross-sectional study. SETTING: Inpatient neurorehabilitation unit and children neurorehabilitation unit. POPULATION: Eighty-five subjects were enrolled, divided into five groups: healthy young, healthy elderly, children with typical development, children with cerebral palsy and adults with stroke in subacute phase...
August 30, 2016: European Journal of Physical and Rehabilitation Medicine
Ruiying Qiu, Yuan Gao, Dongzhe Hou, Yajing Wang, Changshen Yu, Wanjun Wang, Shoufeng Liu, Chunlin Gao, Xiaoguang Tong, Jialing Wu
BACKGROUND: High-sensitivity C-reactive protein (hs-CRP) is not only a marker of inflammation but also a prognostic factor for ischemic stroke. The objective of our study was to investigative the association between hs-CRP levels and outcomes of patients with small-artery occlusion (SAO). METHODS: We selected 718 participants diagnosed with SAO (according to Trial of Org 10172 in Acute Stroke Treatment classification) using the stroke registry of the Department of Neurorehabilitation of Tianjin HuanHu Hospital...
2016: Frontiers in Aging Neuroscience
Florian Grimm, Armin Walter, Martin Spüler, Georgios Naros, Wolfgang Rosenstiel, Alireza Gharabaghi
Brain-machine interface-controlled (BMI) neurofeedback training aims to modulate cortical physiology and is applied during neurorehabilitation to increase the responsiveness of the brain to subsequent physiotherapy. In a parallel line of research, robotic exoskeletons are used in goal-oriented rehabilitation exercises for patients with severe motor impairment to extend their range of motion (ROM) and the intensity of training. Furthermore, neuromuscular electrical stimulation (NMES) is applied in neurologically impaired patients to restore muscle strength by closing the sensorimotor loop...
2016: Frontiers in Neuroscience
Bokkyu Kim, Carolee Winstein
Background There is growing interest to establish recovery biomarkers, especially neurological biomarkers, in order to develop new therapies and prediction models for the promotion of stroke rehabilitation and recovery. However, there is no consensus among the neurorehabilitation community about which biomarker(s) have the highest predictive value for motor recovery. Objective To review the evidence and determine which neurological biomarker(s) meet the high evidence quality criteria for use in predicting motor recovery...
August 8, 2016: Neurorehabilitation and Neural Repair
Athanasios Vourvopoulos, Sergi Bermúdez I Badia
BACKGROUND: The use of Brain-Computer Interface (BCI) technology in neurorehabilitation provides new strategies to overcome stroke-related motor limitations. Recent studies demonstrated the brain's capacity for functional and structural plasticity through BCI. However, it is not fully clear how we can take full advantage of the neurobiological mechanisms underlying recovery and how to maximize restoration through BCI. In this study we investigate the role of multimodal virtual reality (VR) simulations and motor priming (MP) in an upper limb motor-imagery BCI task in order to maximize the engagement of sensory-motor networks in a broad range of patients who can benefit from virtual rehabilitation training...
2016: Journal of Neuroengineering and Rehabilitation
Meike Holleman, Martie Vink, Rinske Nijland, Ben Schmand
The objective of the study was to examine the effects of a comprehensive neuropsychological rehabilitation programme (Intensive NeuroRehabilitation, INR) on the emotional and behavioural consequences of acquired brain injury (ABI). The participants were 75 adult patients suffering from ABI (33 traumatic brain injury, 14 stroke, 10 tumour, 6 hypoxia, 12 other), all of whom were admitted to the INR treatment programme. The main outcome measures were: general psychological well-being (Symptom-Checklist-90), depression and anxiety (Beck Depression Inventory-II, Hospital Anxiety and Depression Scale, State Trait Anxiety Inventory), and quality of life (Quality of Life in Brain Injury)...
August 3, 2016: Neuropsychological Rehabilitation
Yuan Gao, Lihong Jiang, Hui Wang, Changshen Yu, Wanjun Wang, Shoufeng Liu, Chunlin Gao, Xiaoguang Tong, Jinhuan Wang, Yi Jin, Jialing Wu
INTRODUCTION: Abnormal glucose metabolism is an independent risk factor for poor outcome following acute ischemic stroke. However, the relationship between initial hemoglobin A1c level and functional outcome (defined by modified Rankin Scale scores) following small-artery occlusion, a subtype of ischemic stroke, is unknown. The aim of the present study was to evaluate this association among patients diagnosed with small-artery occlusion. MATERIALS AND METHODS: Data on 793 patients diagnosed with small-artery occlusion from October 25, 2012 to June 30, 2015 were collected from the stroke registry of the Department of Neurorehabilitation of HuanHu Hospital...
2016: PloS One
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