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Stroke neurorehabilitation

Ayhan Aşkın, Emel Atar, Hikmet Koçyiğit, Aliye Tosun
BACKGROUND: Therapeutic benefits of Kinect-based virtual reality (VR) game training in rehabilitation encourage its use to improve motor function. OBJECTIVE: To assess the effects of Kinect-based VR training on motor recovery of the upper extremity and functional outcomes in patients with chronic stroke. METHODS: In this randomized controlled trial, group A received 20 sessions of physical therapy (PT) + 20 sessions of Kinect-based VR training and group B received only 20 sessions of PT...
March 13, 2018: Somatosensory & Motor Research
Ji Chen, Peter S Lum
BACKGROUND: Robotic devices for neurorehabilitation of movement impairments in persons with stroke have been studied extensively. However, the vast majority of these devices only allow practice of stereotyped components of simulated functional tasks in the clinic. Previously we developed SpringWear, a wearable, spring operated, upper extremity exoskeleton capable of assisting movements during real-life functional activities, potentially in the home. SpringWear assists shoulder flexion, elbow extension and forearm supination/pronation...
March 2, 2018: Journal of Neuroengineering and Rehabilitation
Ildikó Nagy, Dániel Fabó
Neurophysiological methods are gaining ground in the diagnosis and therapy of cerebrovascular disease. While the role of the EEG (electroencephalography) in the diagnosis of post-stroke epilepsy is constant, quantitative EEG para-meters, as new indicators of early efficiency after thrombolysis or in prognosis of patient's condition have proved their effectiveness in several clinical studies. In intensive care units, continuous EEG monitoring of critically ill patients became part of neurointenzive care protocols...
January 30, 2018: Ideggyógyászati Szemle
Ian Daly, Caroline Blanchard, Nicholas P Holmes
OBJECTIVE: Brain-computer interfaces (BCIs) based on motor control have been suggested as tools for stroke rehabilitation. Some initial successes have been achieved with this approach, however the mechanism by which they work is not yet fully understood. One possible part of this mechanism is a, previously suggested, relationship between the strength of the event-related desynchronization (ERD), a neural correlate of motor imagination and execution, and corticospinal excitability. Additionally, a key component of BCIs used in neurorehabilitation is the provision of visual feedback to positively reinforce attempts at motor control...
February 14, 2018: Journal of Neural Engineering
Yoko Takahashi, Toshiyuki Fujiwara, Tomofumi Yamaguchi, Hikaru Matsunaga, Michiyuki Kawakami, Kaoru Honaga, Katsuhiro Mizuno, Meigen Liu
BACKGROUND: Reciprocal inhibition (RI) may be important for recovering locomotion after stroke. Patterned electrical stimulation (PES) can modulate RI in a manner that could be enhanced by voluntary muscle contraction (VC). OBJECTIVE: To investigate whether VC enhances the PES-induced spinal RI in patients with stroke. METHODS: Twelve patients with chronic stroke underwent three 20 min tasks, each on different days: (1) PES (10 pulses, 100 Hz every 2 s) applied to the common peroneal nerve; (2) VC consisting of isometric contraction of the affected-side tibialis anterior muscle; (3) PES combined with VC (PES + VC)...
2018: Restorative Neurology and Neuroscience
Stéphanie Dehem, Maxime Gilliaux, Thierry Lejeune, Emmanuelle Delaunois, Paul Mbonda, Yves Vandermeeren, Christine Detrembleur, Gaëtan Stoquart
The impact of transcranial direct current stimulation (tDCS) is controversial in the neurorehabilitation literature. It has been suggested that tDCS should be combined with other therapy to improve their efficacy. To assess the effectiveness of a single session of upper limb robotic-assisted therapy (RAT) combined with real or sham-tDCS in chronic stroke patients. Twenty-one hemiparetic chronic stroke patients were included in a randomized, controlled, cross-over double-blind study. Each patient underwent two sessions 7 days apart in a randomized order: (a) 20 min of real dual-tDCS associated with RAT (REAL+RAT) and (b) 20 min of sham dual-tDCS associated with RAT (SHAM+RAT)...
February 7, 2018: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
Melanie Cogne, Marie-Helene Violleau, Evelyne Klinger, Pierre-Alain Joseph
BACKGROUND: Topographical disorientation is frequent among patients after a stroke and can be well explored with virtual environments (VEs). VEs also allow for the addition of stimuli. A previous study did not find any effect of non-contextual auditory stimuli on navigational performance in the Virtual Action Planning-Supermarket (VAP-S) simulating a medium-sized 3D supermarket. However, the perceptual or cognitive load of the sounds used was not high. OBJECTIVE: We investigated how non-contextual auditory stimuli with high load affect navigational performance in the VAP-S for patients who have had a stroke and any correlation between this performance and dysexecutive disorders...
January 30, 2018: Annals of Physical and Rehabilitation Medicine
Chung-Yao Chen, Chia-Ling Chen, Yao-Hung Yang, Chien-Hui Ho, Wen-Chun Tseng
Poststroke depression is independently associated with poor health outcomes, such as increased mortality, disability, anxiety, and lower quality of life. Identifying the potential biomarkers and detailed mechanisms of poststroke depression may improve the effectiveness of therapeutic intervention. In this cross-sectional study, the authors recruited patients with subacute ischemic stroke who were consecutively admitted for neurorehabilitation. Depression was assessed with the Patient Health Questionnaire-9 (PHQ-9), with a cutoff based on a summed-items score of 10...
January 25, 2018: Journal of Neuropsychiatry and Clinical Neurosciences
A Stan, C Birle, A Blesneag, M Iancu
Background - Stroke represents one of the most important causes of permanent physical or mental disability. A number of recent advances in recovery have reinforced the idea that pharmacological intervention combined with a specific rehabilitation therapy can reduce disability after stroke. Objective - The aim of this trial was to demonstrate the hypothesis that the association of pharmacological treatment with Cerebrolysin to early physical therapy can significantly stimulate the endogenous processes underlying the recovery after an ischemic stroke...
October 2017: Journal of Medicine and Life
Liana S Cahill, Natasha A Lannin, Yvonne Y K Mak-Yuen, Megan L Turville, Leeanne M Carey
BACKGROUND: The treatment of somatosensory loss in the upper limb after stroke has been historically overshadowed by therapy focused on motor recovery. A double-blind randomized controlled trial has demonstrated the effectiveness of SENSe (Study of the Effectiveness of Neurorehabilitation on Sensation) therapy to retrain somatosensory discrimination after stroke. Given the acknowledged prevalence of upper limb sensory loss after stroke and the evidence-practice gap that exists in this area, effort is required to translate the published research to clinical practice...
January 23, 2018: BMC Health Services Research
Kazuya Saita, Takashi Morishita, Hisatomi Arima, Koichi Hyakutake, Toshiyasu Ogata, Kenji Yagi, Etsuji Shiota, Tooru Inoue
INTRODUCTION: Robot-assisted rehabilitation has been increasingly drawing attention in the field of neurorehabilitation. The hybrid assistive limb (HAL) is an exoskeleton robot developed based on the "interactive biofeedback" theory, and several studies have shown its efficacy for patients with stroke. We aimed to investigate the mechanisms of the facilitative effect of neurorehabilitation using a single-joint HAL (HAL-SJ) and functional near-infrared spectroscopy (fNIRS). MATERIALS AND METHODS: Subacute stroke patients admitted to our hospital were assessed in this study for HAL eligibility...
2018: PloS One
Stefan Thomas Kotzian, Angela Schwarzinger, Sandra Haider, Bernd Saletu, Josef Spatt, Michael Timothy Saletu
INTRODUCTION: Meta-analyses report that more than 50% of patients who had a stroke suffer from moderate to severe sleep apnoea (SA), with adherence rates to positive airway pressure (PAP) therapy of only 30%. The primary objective of this study is to determine whether PAP adherence in patients who had a stroke with obstructive sleep apnoea (OSA) can be improved by a PAP training strategy during inhospital rehabilitation combined with a telemedicine monitoring system after discharge. Further objectives are (1) to compare the validity of a non-attended level-III polygraphy with that of a level-II polysomnography (PSG) in the diagnosis of SA, (2) to compare the validity of an apnoea-hypopnoea index (AHI) yielded by the PAP device with that obtained during PSG, (3) to determine changes in nocturnal systolic blood pressure (BP) due to PAP therapy with the pulse transit time (PTT) method and (4) to assess the impact of telemonitored PAP therapy on neurorehabilitation outcome parameters...
January 9, 2018: BMJ Open
Estelle Raffin, Friedhelm C Hummel
More than 1.5 million people suffer a stroke in Europe per year and more than 70% of stroke survivors experience limited functional recovery of their upper limb, resulting in diminished quality of life. Therefore, interventions to address upper-limb impairment are a priority for stroke survivors and clinicians. While a significant body of evidence supports the use of conventional treatments, such as intensive motor training or constraint-induced movement therapy, the limited and heterogeneous improvements they allow are, for most patients, usually not sufficient to return to full autonomy...
November 1, 2017: Neuroscientist: a Review Journal Bringing Neurobiology, Neurology and Psychiatry
Carolee Winstein
Over the past decade, ATTEND is one of only a handful of moderate to large-scale nonpharmacologic stroke recovery trials with a focus on rehabilitation. While unique in some respects, its test of superiority for the experimental intervention returned negative/neutral results, with no differences in outcome between the experimental intervention and an appropriate control group - a result not uncommon to the majority of moderate to large stroke rehabilitation intervention trials (i.e. six out of eight conducted in the past decade)...
February 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Michał Starosta, Joanna Kostka, Justyna Redlicka, Elżbieta Miller
PURPOSE: The aim of this study was to determine the muscles with the lowest strength in non-affected (non-A) and affected upper limb (A), to assess differences between men and women and to correlate these values with age in patients after stroke. METHODS: Sixty patients (40 male, 20 female), hospitalized in Neurorehabilitation Ward, 1-2 weeks after stroke, were included in the study. Their age ranged from 50 to 80 years with a mean (sd) of 65.5 (18.7) years. Muscle force values from upper limb muscles were measured using the MicroFet 2 hand-held dynamometer...
2017: Acta of Bioengineering and Biomechanics
Monike Barros Camargos, Andressa da Silva Palmeira, Emerson Fachin-Martins
Post-stroke hemiparesis causes compensated postures, which can modify the footedness established before the impairment. Recently, a paresis severity-modulated dominance hypothesis stated that measures to detect footedness become crucial to float new ideas for neurorehabilitation strategies. The Waterloo Footedness Questionnaire-Revised (WFQ-R) represents the most acceptable measure but it had not yet been cross-culturally adapted for Portuguese spoken in Brazil. Our aim was to cross-culturally adapt the WFQ-R to Brazilian Portuguese, verifying its reliability...
October 2017: Arquivos de Neuro-psiquiatria
Takashi Takebayashi, Kayoko Takahashi, Misa Moriwaki, Tomosaburo Sakamoto, Kazuhisa Domen
In this study, we investigated the effects of dual-hemisphere transcranial direct current stimulation (dual-tDCS) of both the affected (anodal tDCS) and non-affected (cathodal tDCS) primary motor cortex, combined with peripheral neuromuscular electrical stimulation (PNMES), on the effectiveness of constraint-induced movement therapy (CIMT) as a neurorehabilitation intervention in chronic stroke. We conducted a randomized controlled trial of feasibility, with a single blind assessor, with patients recruited from three outpatient clinics...
2017: Frontiers in Neurology
Daniel Perez-Marcos, Odile Chevalley, Thomas Schmidlin, Gangadhar Garipelli, Andrea Serino, Philippe Vuadens, Tej Tadi, Olaf Blanke, José D R Millán
BACKGROUND: Technology-mediated neurorehabilitation is suggested to enhance training intensity and therefore functional gains. Here, we used a novel virtual reality (VR) system for task-specific upper extremity training after stroke. The system offers interactive exercises integrating motor priming techniques and embodied visuomotor feedback. In this pilot study, we examined (i) rehabilitation dose and training intensity, (ii) functional improvements, and (iii) safety and tolerance when exposed to intensive VR rehabilitation...
November 17, 2017: Journal of Neuroengineering and Rehabilitation
Zhi-Wen Zhou, Qi-Dong Yang, Qing-Ping Tang, Jie Yang, Rong-Jing Guo, Wen Jiang
Neurorehabilitation training is a therapeutic intervention for the loss of neural function induced by focal cerebral ischemia, however, the effect varies depending on the neurorehabilitation exercises. Willed movement (WM) training is defined as task‑oriented training, which increases enthusiasm of patients to accomplish a specific task. The current study was performed to the evaluate effect of WM training on neurorehabilitation following focal cerebral ischemia, and further investigate the influence on neural plasticity‑associated signaling pathway...
January 2018: Molecular Medicine Reports
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
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