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Spasticity stroke rehabilitation disability

Kazuya Saita, Takashi Morishita, Koichi Hyakutake, Hiroyuki Fukuda, Etsuji Shiota, Yoshiyuki Sankai, Tooru Inoue
We investigated the combination of robot-assisted rehabilitation (RT) using a single-joint hybrid assistive limb (HAL-SJ) and botulinum toxin A (BTX-A) as therapy for paretic arm with spasticity in post-stroke patients. Participants were seven patients (4 females, 3 males; mean (±SD) age: 60.6±8.4years) who had spastic hemiplegia following chronic stroke. On the day following BTX-A injection, we started RT, which was performed for 20 sessions of 60min each over a two-week period. Clinical outcome measures, including Fugl-Meyer Assessment (FMA), Motor Activity Log (MAL), and Disability Assessment Scale (DAS), and cortical activity were evaluated at baseline, and two weeks, and four months following BTX-A injection...
February 15, 2017: Journal of the Neurological Sciences
Raymond L Rosales, Fran Efendy, Ericka Sa Teleg, Mary Md Delos Santos, Mary Ce Rosales, Marc Ostrea, Michelle J Tanglao, Arlene R Ng
Spasticity is a functionally limiting disorder that commonly occurs following stroke or severe brain injury, and may lead to disability and pain. In tandem with neurorehabilitation, botulinum toxin type A (BoNT-A) is the recommended first-line treatment for spasticity and, to date, the majority of trials have reported BoNT-A use in patients >6months after ictus. The present meta-analysis aimed to evaluate the effects of early BoNT-A injection for post-stroke spasticity on improvements in hypertonicity, disability, function and associated pain...
December 15, 2016: Journal of the Neurological Sciences
Elisabeth Ekstrand, Lars Rylander, Jan Lexell, Christina Brogårdh
BACKGROUND: Despite that disability of the upper extremity is common after stroke, there is limited knowledge how it influences self-perceived ability to perform daily hand activities. The aim of this study was to describe which daily hand activities that persons with mild to moderate impairments of the upper extremity after stroke perceive difficult to perform and to evaluate how several potential factors are associated with the self-perceived performance. METHODS: Seventy-five persons (72 % male) with mild to moderate impairments of the upper extremity after stroke (4 to 116 months) participated...
November 2, 2016: BMC Neurology
Parvin Eftekhar, George Mochizuki, Tilak Dutta, Denyse Richardson, Dina Brooks
Focusing on rehabilitation goals is an effective approach for improving function in individuals with spasticity after stroke. The objectives of this study were to examine and map goals of post-stroke individuals with spasticity using the Goal Attainment Scale (GAS) and International Classification of Functioning, Disability and Health (ICF), and to evaluate the impact of botulinum toxin A (BoNTA) on occupational performance based on the type of rehabilitation goals. Thirty-one patients were recruited from an outpatient spasticity management clinic...
December 2016: Occupational Therapy International
R Garreta-Figuera, A Torrequebrada-Gimenez, En Representacion Del Grupo de Estudio 5e En Representacion Del Grupo de Estudio 5e
INTRODUCTION: Although spasticity is a disabling complication of high incidence, there is a lack of either regional or national epidemiological studies in Spain evaluating its management. AIM: To evaluate the management of spasticity in Spain. PATIENTS AND METHODS: An epidemiological, observational, multicenter, and retrospective study involving 49 rehabilitation services of public and private hospitals was designed. RESULTS: Two hundred and thirty-five patients from 49 centers, with evidence of upper (UL) or lower limb (LL) spasticity with one valid baseline visit and at least one follow-up visit, were included...
October 1, 2016: Revista de Neurologia
Cosimo Costantino, Laura Galuppo, Davide Romiti
BACKGROUND: In recent years, local muscle vibration received considerable attention as a useful method for muscle stimulation in clinical therapy. Some studies described specific vibration training protocol, and few of them were conducted on post-stroke patients. Therefore there is a general uncertainty regarding the vibrations protocol. AIM: The aim of this study was to evaluate the effects of local muscle high frequency mechano-acoustic vibratory treatment on grip muscle strength, muscle tonus, disability and pain in post-stroke individuals with upper limb spasticity...
September 6, 2016: European Journal of Physical and Rehabilitation Medicine
Giovanni Taveggia, Alberto Borboni, Lorena Salvi, Chiara Mulé, Stefania Fogliaresi, Jorge H Villafañe, Roberto Casale
BACKGROUND: A prompt and effective physical and rehabilitation medicine approach is essential to obtain recovery of an impaired limb to prevent tendon shortening, spasticity and pain. Robot-assisted virtual reality intervention has been shown to be more effective than conventional interventions and achieved greater improvement in upper limb function. AIM: The aim of this study was to evaluate the effectiveness of robotic-assisted motion and activity in addition to PRM for the rehabilitation of the upper limb in post-stroke inpatients...
December 2016: European Journal of Physical and Rehabilitation Medicine
Fabio Vanoglio, Palmira Bernocchi, Chiara Mulè, Francesca Garofali, Chiara Mora, Giovanni Taveggia, Simonetta Scalvini, Alberto Luisa
OBJECTIVE: The purpose of the study was to evaluate the feasibility and efficacy of robot-assisted hand rehabilitation in improving arm function abilities in sub-acute hemiplegic patients. DESIGN: Randomized controlled pilot study. SETTING: Inpatient rehabilitation centers. PARTICIPANTS: Thirty hemiplegic stroke patients (Ashworth spasticity index <3) were recruited and randomly divided into a Treatment group (TG) and Control group (CG)...
April 7, 2016: Clinical Rehabilitation
Rocco Salvatore Calabrò, Margherita Russo, Antonino Naro, Demetrio Milardi, Tina Balletta, Antonino Leo, Serena Filoni, Placido Bramanti
BACKGROUND: The Armeo Power, a rehabilitation exoskeleton that allows early treatment of motor disabilities, provides intelligent arm support in a large 3-dimensional work space, thus enabling patients to perform intensive, repetitive, and goal-oriented exercises. This device could efficiently induce new connections and facilitate plasticity phenomena potentiation. Knowledge of the potential brain plasticity reservoir after brain damage constitutes a prerequisite for an optimal rehabilitation strategy...
February 20, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Maryam Rastgoo, Sofia Naghdi, Noureddin Nakhostin Ansari, Gholamreza Olyaei, Shohreh Jalaei, Bijan Forogh, Hamidreza Najari
PURPOSE: To investigate the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) on lower extremity (LE) spasticity, motor function and motor neurone excitability in chronic stroke patients. METHOD: This study was a randomised sham-controlled cross-over trial with 1-week follow-up. A total of 20 post-stroke patients were randomised to receive active (n = 10) or sham (n = 10) rTMS. Fourteen of them (7 in each group) crossed over to the sham or active rTMS after a washout period of 1 month...
September 2016: Disability and Rehabilitation
Sami S Alabdulwahab, Fuzail Ahmad, Harpreet Singh
Background. Stroke is a leading cause for long-term disability that often compromises the sensorimotor and gait function accompanied by spasticity. Gait abnormalities persist through the chronic stages of the condition and only a small percentage of these persons are able to walk functionally in the community. Material and Method. Patients with chronic stroke were recruited from outpatient rehabilitation unit at Department of Neurology & Neurosurgery, All India Institute of Medical Sciences, having a history of first stroke at least six months before recruitment, with unilateral motor deficits affecting gait...
2015: Rehabilitation Research and Practice
Davide Corbetta, Valeria Sirtori, Greta Castellini, Lorenzo Moja, Roberto Gatti
BACKGROUND: In people who have had a stroke, upper limb paresis affects many activities of daily life. Reducing disability is therefore a major aim of rehabilitative interventions. Despite preserving or recovering movement ability after stroke, sometimes people do not fully realise this ability in their everyday activities. Constraint-induced movement therapy (CIMT) is an approach to stroke rehabilitation that involves the forced use and massed practice of the affected arm by restraining the unaffected arm...
October 8, 2015: Cochrane Database of Systematic Reviews
Jean-Michel Gracies, Allison Brashear, Robert Jech, Peter McAllister, Marta Banach, Peter Valkovic, Heather Walker, Christina Marciniak, Thierry Deltombe, Alexander Skoromets, Svetlana Khatkova, Steven Edgley, Fatma Gul, France Catus, Beatrice Bois De Fer, Claire Vilain, Philippe Picaut
BACKGROUND: Resistance from antagonistic muscle groups might be a crucial factor reducing function in chronic hemiparesis. The resistance due to spastic co-contraction might be reduced by botulinum toxin injections. We assessed the effects of abobotulinumtoxinA injection in the upper limb muscles on muscle tone, spasticity, active movement, and function. METHODS: In this randomised, placebo-controlled, double-blind study, we enrolled adults (aged 18-80 years) at least 6 months after stroke or brain trauma from 34 neurology or rehabilitation clinics in Europe and the USA...
October 2015: Lancet Neurology
Domenico Intiso, Mario Basciani, Andrea Santamato, Marta Intiso, Filomena Di Rienzo
Pain is a natural protective mechanism and has a warning function signaling imminent or actual tissue damage. Neuropathic pain (NP) results from a dysfunction and derangement in the transmission and signal processing along the nervous system and it is a recognized disease in itself. The prevalence of NP is estimated to be between 6.9% and 10% in the general population. This condition can complicate the recovery from stroke, multiple sclerosis, spinal cord lesions, and several neuropathies promoting persistent disability and poor quality of life...
July 2015: Toxins
S V Kotov, L G Turbina, P D Bobrov, A A Frolov, O G Pavlova, M E Kurganskaia, E V Biriukova
Objective. To investigate the possibility of using a bioengineering system, which includes an electroencephalograph and a personal computer with a software for synchronous data transmission, recognition and classification of EEG signals, development of directions for intended actions in real time in the combination with the hand exoskeleton (the bioengineering system "brain-computer interface + exoskeleton"), in motor rehabilitation of post stroke patients with paresis of the upper extremity. Material and methods...
2014: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
D R Khasanova, N V Agafonova, G Kh Starostina
OBJECTIVE: Muscle tone disorders, including poststroke spasticity, is a frequent cause of disability. We studied the efficacy and safety of tizalud (tizanidine) in patients with arm poststroke spasticity. MATERIAL AND METHODS: Forty-four patients were treated with tizalud and botulotoxin A in different doses in complex with rehabilitation measures or without them. RESULTS AND CONCLUSION: The marked improvement (the decrease in spasticity, increase in muscle power and pain syndrome intensity) was noted in patients treated with the combination of tizalud and botulotoxin A...
2014: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Birgitte Boeskov, Line Tornehøj Carver, Anders von Essen-Leise, Marius Henriksen
BACKGROUND: Stroke is an important cause of severe disability and impaired motor function. Treatment modalities that improve motor function in patients with stroke are needed. The objective of this study was to investigate the effect of kinesthetic taping of the anterior thigh and knee on maximal walking speed and clinical indices of spasticity in patients with stroke. METHODS: Thirty-two patients (9 women) receiving rehabilitation after stroke (average, 50 days since stroke) who had impaired walking ability were recruited...
November 2014: Topics in Stroke Rehabilitation
Jörg Wissel, Molly Verrier, David M Simpson, David Charles, Pia Guinto, Spyros Papapetropoulos, Katharina S Sunnerhagen
OBJECTIVE: The complexities of post-stroke spasticity (PSS), and the resultant difficulties in treating the disability, present a significant challenge to patients, stroke rehabilitation teams, and caregivers. Reducing the severity of spasticity and its long-term complications may be facilitated by early intervention, making identification of stroke patients at high risk for developing spasticity essential. Factors that predict which patients are at risk for the development of PSS are identified...
January 2015: PM & R: the Journal of Injury, Function, and Rehabilitation
Thanitta Thanakiatpinyo, Supakij Suwannatrai, Ueamphon Suwannatrai, Phanitanong Khumkaew, Dokmai Wiwattamongkol, Manmas Vannabhum, Somluck Pianmanakit, Vilai Kuptniratsaikul
PURPOSE: To study the efficacy of traditional Thai massage (TTM) versus conventional physical therapy (PT) programs in treating muscle spasticity, functional ability, anxiety, depression, and quality of life (QoL) in Thai stroke patients. METHODS: This randomized controlled trial with a blinded assessor was carried out at the Department of Rehabilitation Medicine, Siriraj Hospital (Bangkok, Thailand). The study included 50 stroke (onset ≥ 3 months) outpatients experiencing spasticity at the elbow or knee muscles at a grade of ≥ 1+ on the modified Ashworth Scale who were ≥ 50 years old and able to communicate...
2014: Clinical Interventions in Aging
Marlene Cristina Neves Rosa, Alda Marques, Sara Demain, Cheryl D Metcalf
PURPOSE: To characterise the global functioning post-stroke in patients with normal knee posture (NKP) and abnormal knee posture (AKP) during loading-response. METHODS: 35 people, 6 months post-stroke. with NKP and AKP were identified and assessed using clinical measures classified into the corresponding International Classification of Functioning, Disability and Health (ICF) domains: weight function (body mass index); muscle power (knee isometric strength); muscle tone (Modified Ashworth Scale); voluntary motor control (Leg sub-score of Fugl-Meyer scale); walking short distances (5-meter walk test; Timed-Up and Go test); walking on different surfaces (Functional Ambulation Categories); moving around (Falls Efficacy Scale); moving using equipment (walking aids) and global assessment of function (WHODAS II)...
2015: Disability and Rehabilitation
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