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Rehabilitation of stroke

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https://www.readbyqxmd.com/read/28820348/where-to-now-avert-answered-an-important-question-but-raised-many-more
#1
Mark T Bayley, Audrey Bowen, Coralie English, Robert Teasell, Janice J Eng
A Very Early Rehabilitation Trial (AVERT) was a Phase 3 randomized trial with over 2100 subjects post stroke that had unexpected results with better outcomes for usual care than those receiving very early mobilization. This review of published stroke clinical practice guidelines highlights that recommendations for mobilization have changed after publication of AVERT but also that developers have struggled to provide recommendations for appropriate dose, duration and intensity of mobilization in the acute post stroke period with available analyses from AVERT and other literature...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28819157/a-preliminary-investigation-of-the-association-of-sleep-with-inflammation-and-oxidative-stress-biomarkers-and-functional-outcomes-after-stroke-rehabilitation
#2
Ting-Ting Yeh, Yu-Wei Hsieh, Ching-Yi Wu, Jong-Shyan Wang, Keh-Chung Lin, Chia-Ling Chen
This study examined the association of sleep with inflammation and oxidative stress biomarkers, and with functional outcomes, after stroke rehabilitation. The rehabilitation effects on biomarkers and functional outcomes were also evaluated. Twenty subacute stroke survivors received 4 weeks of upper limb rehabilitation. Baseline inflammatory (i.e., soluble intercellular adhesion molecule-1, sICAM-1) and oxidative stress biomarkers (i.e., glutathione peroxidase, GPx and malondialdehyde, MDA) were assessed, as were sleep outcomes...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28818006/the-role-of-the-bdnf-val66met-polymorphism-in-recovery-of-aphasia-after-stroke
#3
Riemke G A de Boer, Kerstin Spielmann, Majanka H Heijenbrok-Kal, Rick van der Vliet, Gerard M Ribbers, W Mieke E van de Sandt-Koenderman
BACKGROUND: Brain-derived neurotrophic factor (BDNF) is assumed to play a role in mediating neuroplasticity after stroke. Carriers of the function-limiting Val66Met (rs6265) single nucleotide polymorphism (SNP) may have a downregulation in BDNF secretion, which may lead to a poorer prognosis after stroke compared to noncarriers in motor learning and motor function recovery. The present study investigates whether this polymorphism may also affect the recovery of poststroke aphasia (ie, language impairment)...
August 1, 2017: Neurorehabilitation and Neural Repair
https://www.readbyqxmd.com/read/28816511/virtual-reality-and-active-videogame-based-practice-learning-needs-and-preferences-a-cross-canada-survey-of-physical-therapists-and-occupational-therapists
#4
Danielle Levac, Stephanie Glegg, Heather Colquhoun, Patricia Miller, Farzad Noubary
OBJECTIVE: Describe the clinical use of virtual reality (VR)/active videogaming (AVG) by physical therapists (PTs) and occupational therapists (OTs) in Canada, identify usage barriers and facilitators, evaluate factors that predict intention to use VR/AVGs, and determine therapists' learning needs. DESIGN: Cross-sectional survey. MATERIALS AND METHODS: Online survey of therapists in Canada who were members of 1 of 26 professional PT or OT colleges or associations using the Assessing Determinants Of Prospective Take-up of Virtual Reality (ADOPT-VR2) Instrument...
August 2017: Games for Health
https://www.readbyqxmd.com/read/28815562/treadmill-training-and-body-weight-support-for-walking-after-stroke
#5
REVIEW
Jan Mehrholz, Simone Thomas, Bernhard Elsner
BACKGROUND: Treadmill training, with or without body weight support using a harness, is used in rehabilitation and might help to improve walking after stroke. This is an update of the Cochrane review first published in 2003 and updated in 2005 and 2014. OBJECTIVES: To determine if treadmill training and body weight support, individually or in combination, improve walking ability, quality of life, activities of daily living, dependency or death, and institutionalisation or death, compared with other physiotherapy gait-training interventions after stroke...
August 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28814838/post-acute-care-for-stroke-a-retrospective-cohort-study-in-taiwan
#6
Chung-Liang Lai, Ming-Miau Tsai, Jia-Yuan Luo, Wan-Chun Liao, Pi-Shan Hsu, Han-Yu Chen
BACKGROUND: Stroke often causes functional decline in patients. Therefore, after the acute phase, many patients require post-acute care (PAC) to maximize their functional progress, reduce disability, and make it possible for them to return to their home and community. PAC can be provided in different settings. Taiwan's National Health Insurance (NHI) proposed a PAC pilot program, effective since 2014, for stroke patients that allowed patients with the potential for functional improvement to receive PAC rehabilitation in regional or community hospitals...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28814056/design-of-a-lightweight-tethered-torque-controlled-knee-exoskeleton
#7
Kirby Ann Witte, Andreas M Fatschel, Steven H Collins
Lower-limb exoskeletons show promise for improving gait rehabilitation for those with chronic gait abnormalities due to injury, stroke or other illness. We designed and built a tethered knee exoskeleton with a strong lightweight frame and comfortable, four-point contact with the leg. The device is structurally compliant in select directions, instrumented to measure joint angle and applied torque, and is lightweight (0.76 kg). The exoskeleton is actuated by two off-board motors. Closed loop torque control is achieved using classical proportional feedback control with damping injection in conjunction with iterative learning...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28814049/wearable-sensing-for-rehabilitation-after-stroke-bimanual-jerk-asymmetry-encodes-unique-information-about-the-variability-of-upper-extremity-recovery
#8
Diogo S de Lucena, Oliver Stoller, Justin B Rowe, Vicky Chan, David J Reinkensmeyer
Wearable sensing is a new tool for quantifying upper extremity (UE) rehabilitation after stroke. However, it is unclear whether it provides information beyond what is available through standard clinical assessments. To investigate this question, people with a chronic stroke (n=9) wore accelerometers on both wrists for 9 hours on a single day during their daily activities. We used principal components analysis (PCA) to characterize how novel kinematic measures of jerk and acceleration asymmetry, along with conventional measures of limb use asymmetry and clinical function, explained the behavioral variance of UE recovery across participants...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28814040/training-wrist-extensor-function-and-detecting-unwanted-movement-strategies-in-an-emg-controlled-visuomotor-task
#9
Mingxing Lyu, Charles Lambelet, Daniel Woolley, Xue Zhang, Weihai Chen, Xilun Ding, Roger Gassert, Nicole Wenderoth
Stroke patients often suffer from severe upper limb paresis. Rehabilitation treatment typically targets motor impairments as early as possible, however, muscular contractions, particularly in the wrist and fingers, are often too weak to produce overt movements, making the initial phase of rehabilitation training difficult. Here we propose a new training tool whereby electromyographic (EMG) activity is measured in the wrist extensors and serves as a proxy of voluntary corticomotor drive. We used the Myo armband to develop a proportional EMG controller which allowed volunteers to perform a simple visuomotor task by modulating wrist extensor activity...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28814039/evaluating-wearable-multimodal-sensor-insoles-for-motion-pattern-measurements-in-stroke-rehabilitation-a-pilot-study
#10
V David, M Forjan, J Martinek, S Kotzian, H Jagos, D Rafolt
The majority of stroke patients experience deficits in motoric functions, especially in gait and mobility. They need rehabilitation to regain walking independence, which is a major goal of rehabilitation after stroke. To document and assess the rehabilitation progress, instrumented motion analysis and clinical assessments are commonly used. In a clinical pilot study the applicability of an instrumented insole system in stroke rehabilitation is evaluated. Motion parameter of 35 stroke patients were gathered with the system while completing 90 s level walking and Timed Up & Go test at the beginning and end of four weeks inpatient rehabilitation...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28814016/applying-a-soft-robotic-glove-as-assistive-device-and-training-tool-with-games-to-support-hand-function-after-stroke-preliminary-results-on-feasibility-and-potential-clinical-impact
#11
Gerdienke B Prange-Lasonder, Bob Radder, Anke I R Kottink, Alejandro Melendez-Calderon, Jaap H Buurke, Johan S Rietman
Recent technological developments regarding wearable soft-robotic devices extend beyond the current application of rehabilitation robotics and enable unobtrusive support of the arms and hands during daily activities. In this light, the HandinMind (HiM) system was developed, comprising a soft-robotic, grip supporting glove with an added computer gaming environment. The present study aims to gain first insight into the feasibility of clinical application of the HiM system and its potential impact. In order to do so, both the direct influence of the HiM system on hand function as assistive device and its therapeutic potential, of either assistive or therapeutic use, were explored...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28814003/a-springs-actuated-finger-exoskeleton-from-mechanical-design-to-spring-variables-evaluation
#12
Roberto Bortoletto, Ashley N Mello, Davide Piovesan
In the context of post-stroke patients, suffering of hemiparesis of the hand, robot-aided neuro-motor rehabilitation allows for intensive rehabilitation treatments and quantitative evaluation of patients' progresses. This work presents the design and evaluation of a spring actuated finger exoskeleton. In particular, the spring variables and the interaction forces between the assembly and the hand were investigated, in order to assess the effectiveness of the proposed exoskeleton.
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813985/emg-pattern-classification-to-control-a-hand-orthosis-for-functional-grasp-assistance-after-stroke
#13
Cassie Meeker, Sangwoo Park, Lauri Bishop, Joel Stein, Matei Ciocarlie
Wearable orthoses can function both as assistive devices, which allow the user to live independently, and as rehabilitation devices, which allow the user to regain use of an impaired limb. To be fully wearable, such devices must have intuitive controls, and to improve quality of life, the device should enable the user to perform Activities of Daily Living. In this context, we explore the feasibility of using electromyography (EMG) signals to control a wearable exotendon device to enable pick and place tasks...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813961/identifying-the-effects-of-using-integrated-haptic-feedback-for-gait-rehabilitation-of-stroke-patients
#14
Muhammad Raheel Afzal, Sanghun Pyo, Min-Kyun Oh, Young Sook Park, Jungwon Yoon
This paper evaluates the prospects of using a novel Integrated Haptic Feedback (IHF) system. IHF can provide over-ground gait training regimens for post-stroke ambulatory subjects. IHF system combines the use of a portable cane for kinesthetic feedback and a wearable vibrotactor array for tactile feedback. Continuous somatosensory input is aiforded to the users at the handle of cane; it serves the purpose of balance assurance at higher gait speeds. Besides, restricted use of upper limb for weight-bearing inspires the users to involve the paretic lower limbs more actively...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813946/a-user-centered-design-approach-in-the-development-of-rehabilitation-devices-after-stroke
#15
Natalie Jankowski, Laura Schonijahn, Adina Kreitlow, Elsa Gotze, Michael Wahl
Involving users in iterative development processes is to be shown to increase the quality of health care devices and to prevent refusal. Successful use can only be achieved provided that the devices are accepted by its users. In this study potentials of user satisfaction surveys in the development of stroke rehabilitation devices are presented. The two arm-training devices Reha-Slide (RS) and Bi-Manu-Track (BMT) are assessed for patient satisfaction. The aim is to detect the satisfaction with the current state of certain aspects of the devices to obtain incentives for technical optimisation...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813943/conjunctive-rehabilitation-of-multiple-cognitive-domains-for-chronic-stroke-patients-in-virtual-reality
#16
Martina Maier, Nuria Leiva Banuelos, Belen Rubio Ballester, Esther Duarte, Paul F M J Verschure
Classically, cognitive deficits have been studied and treated in isolation from each other. A stroke patient is classified as being memory impaired, having executive dysfunction or showing attentional deficits after which a dedicated rehabilitation therapy is given. Studies seldom looked at the relationship between these different cognitive domains and syndromes, although, there is evidence that they might share common neuronal substrates and do not occur in isolation. Here, we propose a novel rehabilitation method in virtual reality to treat cognitive deficits in conjunction and report the preliminary results of an ongoing randomized controlled clinical trial...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813936/using-upper-limb-kinematics-to-assess-cognitive-deficits-in-people-living-with-both-hiv-and-stroke
#17
Kevin D Bui, Roshan Rai, Michelle J Johnson
In this study, we aim to explore ways to objectively assess cognitive deficits in the stroke and HIV/stroke populations, where cognitive and motor impairments can be hard to separate. Using an upper limb rehabilitation robot called the Haptic TheraDrive, we collect performance error scores and motor learning data on the impaired and unimpaired limb during a trajectory tracking task. We compare these data to clinical cognitive scores. The preliminary results suggest a possible relationship between unimpaired upper limb performance error and visuospatial/executive function cognitive domains, but more work needs to be done to further investigate this...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813935/influence-of-artifacts-on-movement-intention-decoding-from-eeg-activity-in-severely-paralyzed-stroke-patients
#18
Eduardo Lopez-Larraz, Carlos Bibian, Niels Birbaumer, Ander Ramos-Murguialday
Brain-machine interfaces (BMI) can be used to control robotic and prosthetic devices for rehabilitation of motor disorders, such as stroke. The calibration of these BMI systems is of paramount importance in order to establish a precise contingent link between the brain activity related to movement intention and the peripheral feedback. However, electroencephalographic (EEG) activity, commonly used to build non-invasive BMIs, can be easily contaminated by artifacts of electrical or physiological origin. The way these interferences can affect the performance of movement intention decoders has not been deeply studied, especially when dealing with severely paralyzed patients, which often generate more artifacts by compensatory movements...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813934/a-hybrid-brain-machine-interface-based-on-eeg-and-emg-activity-for-the-motor-rehabilitation-of-stroke-patients
#19
Andrea Sarasola-Sanz, Nerea Irastorza-Landa, Eduardo Lopez-Larraz, Carlos Bibian, Florian Helmhold, Doris Broetz, Niels Birbaumer, Ander Ramos-Murguialday
Including supplementary information from the brain or other body parts in the control of brain-machine interfaces (BMIs) has been recently proposed and investigated. Such enriched interfaces are referred to as hybrid BMIs (hBMIs) and have been proven to be more robust and accurate than regular BMIs for assistive and rehabilitative applications. Electromyographic (EMG) activity is one of the most widely utilized biosignals in hBMIs, as it provides a quite direct measurement of the motion intention of the user...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813931/making-neurorehabilitation-fun-multiplayer-training-via-damping-forces-balancing-differences-in-skill-levels
#20
Kilian Baur, Peter Wolf, Robert Riener, Jaime E Duarte
Multiplayer environments are thought to increase the training intensity in robot-aided rehabilitation therapy after stroke. We developed a haptic-based environment to investigate the dynamics of two-player training performing time-constrained reaching movements using the ARMin rehabilitation robot. We implemented a challenge level adaptation algorithm that controlled a virtual damping coefficient to reach a desired success rate. We tested the algorithm's effectiveness in regulating the success rate during game play in a simulation with computer-controlled players, in a feasibility study with six unimpaired players, and in a single session with one stroke patient...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
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