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Stroke physical therapy

M Luz Sánchez-Sánchez, Maria-Arántzazu Ruescas-Nicolau, José-Antonio Pérez-Miralles, Elena Marqués-Sulé, Gemma-Victoria Espí-López
BACKGROUND: In chronic stroke, feasible physical therapy (PT) programs are needed to promote function throughout life. OBJECTIVE: This randomized controlled pilot trial investigated the feasibility and effect of a PT program composed of strengthening exercises with elastic bands and bimanual functional training, with clearly defined doses based on the rate of perceived exertion (Borg scale), to counteract inactivity in chronic stroke. METHODS: Fifteen subjects > 6 month post-stroke were randomized to three-month of UE function training (UE group), or to lower extremity function training (LE group)...
October 19, 2016: Topics in Stroke Rehabilitation
Hiromi Rakugi
European guidelines (ESH-ESC2013) for the elderly have discussed well about treatment blood pressure (BP) levels and targeting BP levels. In general, elderly patients with systolic BP (SBP) ≥160 mmHg including individuals older than 80 years in good physical and mental conditions are recommended reducing SBP to between 150 and 140 mmHg. Furthermore, fit elderly patients <80 years old are recommended to consider antihypertensive treatment at SBP values ≥140 mmHg with a target SBP <140 mmHg. On the other hand, frail elderly patients are recommended to leave decisions on antihypertensive therapy to the treating physician, and based on monitoring of the clinical effects of treatment...
September 2016: Journal of Hypertension
Kyoung-Sim Jung, Jin-Hwa Jung, Tae-Sung In, Hwi-Young Cho
This study investigated the effects of weight-shifting exercise (WSE) combined with transcutaneous electrical nerve stimulation (TENS), applied to the erector spinae and external oblique (EO) muscles, on muscle activity and trunk control in patients with hemiparetic stroke. Sixty patients with stroke were recruited to this study and randomly distributed into three treatment groups: (1) WSE + TENS, (2) WSE + placebo TENS, and (3) control. All participants underwent 30 sessions of training (30 minutes five times per week for 6 weeks) and received 1 hour of conventional physical therapy five times per week for 6 weeks...
October 17, 2016: Occupational Therapy International
V A Bronnikov, V B Smychek, Yu A Mavlikaeva, Yu I Kravtsov, K A Sklyannaya, O A Plotnikova, A V Vil'deman
AIM: To compare the efficacy of complex rehabilitation in patients receiving robotic kinesiotherapy and conventional physical therapy. MATERIAL AND METHODS: In total 68 patients were examined, including 37 patients receiving traditional kinesiotherapy and sessions on the robotic complex 'Locomat' and 31 patients of the control group who received conventional physical therapy. RESULTS AND CONCLUSION: There were statistical between-group differences in the indices of mobility, physical capabilities, strength and muscle tone in paretic extremities as well as the overall improvement of daily activity...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Oh Young Bang, Eun Hee Kim, Jae Min Cha, Gyeong Joon Moon
Stroke is one of the leading causes of death and physical disability among adults. It has been 15 years since clinical trials of stem cell therapy in patients with stroke have been conducted using adult stem cells like mesenchymal stem cells and bone marrow mononuclear cells. Results of randomized controlled trials showed that adult stem cell therapy was safe but its efficacy was modest, underscoring the need for new stem cell therapy strategies. The primary limitations of current stem cell therapies include (a) the limited source of engraftable stem cells, (b) the presence of optimal time window for stem cell therapies, (c) inherited limitation of stem cells in terms of growth, trophic support, and differentiation potential, and (d) possible transplanted cell-mediated adverse effects, such as tumor formation...
September 2016: Journal of Stroke
Danielle Levac, Stephanie M N Glegg, Heidi Sveistrup, Heather Colquhoun, Patricia A Miller, Hillel Finestone, Vincent DePaul, Jocelyn E Harris, Diana Velikonja
BACKGROUND: Despite increasing evidence for the effectiveness of virtual reality (VR)-based therapy in stroke rehabilitation, few knowledge translation (KT) resources exist to support clinical integration. KT interventions addressing known barriers and facilitators to VR use are required. When environmental barriers to VR integration are less amenable to change, KT interventions can target modifiable barriers related to therapist knowledge and skills. METHODS: A multi-faceted KT intervention was designed and implemented to support physical and occupational therapists in two stroke rehabilitation units in acquiring proficiency with use of the Interactive Exercise Rehabilitation System (IREX; GestureTek)...
October 6, 2016: BMC Health Services Research
Andoret van Wyk, Carina A Eksteen, Piet J Becker, Barbara M Heinze
INTRODUCTION: Visual impairment, specifically eye movement disorders and vestibular dysfunction may have a negative influence on the functional recovery in post-stroke patients. This type of sensory dysfunction may further be associated with poor functional outcome in patients' post-stroke. METHODS: In phase 1, a cross-sectional survey (n = 100) will be conducted to determine the prevalence of eye movement disorders and vestibular dysfunction in patients who sustained a stroke...
2016: Frontiers in Neurology
Sari Numminen, Anna-Maija Korpijaakko-Huuhka, Anna-Kaisa Parkkila, Teija Kulkas, Heikki Numminen, Prasun Dastidar, Mervi Jehkonen
OBJECTIVE: This prospective follow-up study aimed to identify sociodemographic and clinical factors that may affect the quality of life (QoL) of patients with acute ischemic stroke during a 6-month follow-up. PATIENTS AND METHODS: In the acute phase, sociodemographic and clinical data were collected using the National Institute of Health Stroke Scale, Barthel Index, and modified Rankin Scale. QoL was assessed with the Stroke and Aphasia Quality of Life Scale-39 6 months after stroke...
September 30, 2016: Folia Phoniatrica et Logopaedica
Egle Cekanaviciute, Marion S Buckwalter
Astrocytes regulate neuroinflammatory responses after stroke and in other neurological diseases. Although not all astrocytic responses reduce inflammation, their predominant function is to protect the brain by driving the system back to homeostasis after injury. They receive multidimensional signals within the central nervous system and between the brain and the systemic circulation. Processing this information allows astrocytes to regulate synapse formation and maintenance, cerebral blood flow, and blood-brain barrier integrity...
September 27, 2016: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
Alain Yelnik, Cedric Andriantsifanetra, Peggy Reinert, Mathilde Evrard, Hélène Marneff, Marie Wanepain, Margaux Barbie, Johann Beaudreuil, Jean Pascal Devailly, Eric Vicaut
OBJECTIVE: Active and intensive physical therapy (PT) facilitates motor recovery when provided at a subacute stage after stroke. The efficiency of very early intensive PT (within the 2 first weeks) has been much less investigated. Early intensive rehabilitation might be beneficial for neural plasticity but also detrimental by worsening the cerebral ischemia. The AVERT study (Bernhardt 2015) showed negative effect of high dose of very early mobilisation. MATERIAL/PATIENTS AND METHODS: Patients have been recruited in this multicentre randomized controlled trial (9 stroke units with PRM teams) to compare "soft" (20 min/day apart from respiratory needs) versus "intensive" PT (idem+45 minutes of intensive exercises/day), initiated within the 72 first hours after a first hemispheric stroke...
September 2016: Annals of Physical and Rehabilitation Medicine
Marie Orentin, Victorine Quintaine, Alain Yelnik, Marylène Jousse, Leila Tlili, Anna Bernard, Maryse Guillemette
OBJECTIVE: Music therapy enhances awareness of sound perception and musical sensorial experience often highly impaired following a stroke, confirmed by music's neurosciences. The study aims to verify its reception and utility in a Physical Medicine and Rehabilitation (PMR) service with professional team and patients. MATERIAL/PATIENTS AND METHODS: Eleven hospitalized patients were included after stoke (without regular instrumental practice, speech disorder, severe hearing loss nor psychiatric history)...
September 2016: Annals of Physical and Rehabilitation Medicine
Aurélie Duruflé, Claire Le-Meur, Marie-Pierre Reillon, Claire Lozach, Benoit Nicolas
Many mobile teams were created over the past decade in various medical specialties including physical medicine and rehabilitation (MPR). The Pôle Saint-Helier has created a mobile team of rehabilitation-reintegration (EM2R) in December 2012 with support from the Regional Health Agency of Brittany. It operates on the health territory No. 5 of Brittany near people experiencing neurological disability. Its main mission is to implement the necessary devices to facilitate the home return of people hospitalized after a neurological event or maintaining to home people with neurological disorders...
September 2016: Annals of Physical and Rehabilitation Medicine
Yann Le Déan, Benjamin Brissebrat, Evelyne Castel-Lacanal, Xavier De Boissezon, Philippe Marque
OBJECTIVE: Central neuropathic pain is common among neurological patients. Drug therapy has high pharmacoresistance and some GABAergic agents can be detrimental to the recovery process. Alternative therapies include neuromodulation techniques, such as repetitive transcranial magnetic stimulation (rTMS) and motor imagery techniques with mirror therapy. The objective of this study was to evaluate their effectiveness in clinical practice on central neuropathic pain. MATERIAL/PATIENTS AND METHODS: Thirty-two patients followed in the Physical Medicine and Rehabilitation department of Rangueil University Hospital were included...
September 2016: Annals of Physical and Rehabilitation Medicine
Roberto Colombo, Fabrizio Pisano, Carmen Delconte, Alessandra Mazzone, Giuseppe Grioni, Marisa Castagna, Giacomo Bazzini, Chiara Imarisio, Giorgio Maggioni, Caterina Pistarini
BACKGROUND: Several robotic devices have been proposed for upper limb rehabilitation, but they differ in terms of application fields and the technical solutions implemented. AIM: To compare the effectiveness of three different robotic devices for shoulder-elbow rehabilitation in reducing motor impairment and improving motor performance in post-stroke patients. DESIGN: Retrospective multi-center study. SETTING: Inpatient rehabilitation hospital...
September 27, 2016: European Journal of Physical and Rehabilitation Medicine
Tingting Chen, Ninghua Liu, Jinxuan Liu, Xiaoying Zhang, Zhen Huang, Yuhui Zang, Jiangning Chen, Lei Dong, Junfeng Zhang, Zhi Ding
OBJECTIVE: The skin is an important immunological barrier of the body as well as an optimal route for vaccine administration. Gua Sha, which involves press-stroke treatment of the skin, is an effective folk therapy, widely accepted in East Asia, for various symptoms; however, the mechanisms underlying its therapeutic effects have not been clarified. We investigated the influence of Gua Sha on the immunological features of the skin. METHODS: Gua Sha was performed on BALB/c mice and the effects were evaluated using anatomical, histological, and cytometric methods as well as cytokine determination locally and systemically...
2016: PeerJ
Arlene A Schmid, Marieke Van Puymbroeck, Jennifer D Portz, Karen E Atler, Christine A Fruhauf
OBJECTIVE: To examine the feasibility and benefits of the Merging Yoga and Occupational Therapy (MY-OT) intervention. DESIGN: This is the primary analysis of a non-controlled pretest-posttest pilot study to understand the feasibility and impact of MY-OT on balance, balance self-efficacy, and fall risk factor management in people with chronic stroke. SETTING: University research laboratory. PARTICIPANTS: People with chronic stroke were included in the study if they: had sustained a fall or had fear of falling, were able to stand, and hand impaired balance and were at risk for falls (≤46 on the Berg Balance Scale (BBS))...
October 2016: Complementary Therapies in Medicine
Jin Hwan Lee, Zheng Z Wei, Wenyuan Cao, Soonmi Won, Xiaohuan Gu, Megan Winter, Thomas A Dix, Ling Wei, Shan Ping Yu
Stroke is a leading threat to human life and health in the US and around the globe, while very few effective treatments are available for stroke patients. Preclinical and clinical studies have shown that therapeutic hypothermia (TH) is a potential treatment for stroke. Using novel neurotensin receptor 1 (NTR1) agonists, we have demonstrated pharmacologically induced hypothermia and protective effects against brain damages after ischemic stroke, hemorrhage stroke, and traumatic brain injury (TBI) in rodent models...
September 19, 2016: Neurobiology of Disease
Hiromi Rakugi
European guidelines (ESH-ESC2013) for the elderly have discussed well about treatment blood pressure (BP) levels and targeting BP levels. In general, elderly patients with systolic BP (SBP) ≥160 mmHg including individuals older than 80 years in good physical and mental conditions are recommended reducing SBP to between 150 and 140 mmHg. Furthermore, fit elderly patients <80 years old are recommended to consider antihypertensive treatment at SBP values ≥140 mmHg with a target SBP <140 mmHg. On the other hand, frail elderly patients are recommended to leave decisions on antihypertensive therapy to the treating physician, and based on monitoring of the clinical effects of treatment...
September 2016: Journal of Hypertension
Karla Bustamante Valles, Sandra Montes, Maria de Jesus Madrigal, Adan Burciaga, María Elena Martínez, Michelle J Johnson
BACKGROUND: Stroke rehabilitation in low- and middle-income countries, such as Mexico, is often hampered by lack of clinical resources and funding. To provide a cost-effective solution for comprehensive post-stroke rehabilitation that can alleviate the need for one-on-one physical or occupational therapy, in lower and upper extremities, we proposed and implemented a technology-assisted rehabilitation gymnasium in Chihuahua, Mexico. The Gymnasium for Robotic Rehabilitation (Robot Gym) consisted of low- and high-tech systems for upper and lower limb rehabilitation...
2016: Journal of Neuroengineering and Rehabilitation
Dae-Hyouk Bang, Young-Lan Son
[Purpose] To investigate the effects of intensive aerobic exercise on respiratory capacity and walking ability in chronic stroke patients. [Subjects and Methods] The subjects were randomly assigned to an experimental group (n=6) or a control group (n=6). Patients in the experimental group received intensive aerobic exercise for 30 minutes and traditional physical therapy once a day, five days a week, for four weeks. The control group received aerobic exercise for 30 minutes and traditional physical therapy for 30 minutes a day, five days a week, for four weeks...
August 2016: Journal of Physical Therapy Science
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