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https://www.readbyqxmd.com/read/28813889/design-of-a-clinically-relevant-upper-limb-exoskeleton-robot-for-stroke-patients-with-spasticity
#1
Dong Jin Lee, Sung Jin Bae, Sung Ho Jang, Pyung Hun Chang
The purpose of this research is to propose a design of a clinically relevant upper-limb (hand, wrist, and elbow) exoskeleton that meets the clinical requirements. At first, the proposed robot was designed to have sufficient torque for passive exercise therapy and spasticity measurement of post-stroke patients with spasticity (grade 3 or lower in Modified Ashworth Scale). Because the therapy of patients with high level spasticity could be laborious for therapists by increased muscle tone, and the patients tend not to get enough rehabilitation treatment...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813809/development-of-elbow-spasticity-model-for-objective-training-of-spasticity-assessment-of-patients-post-stroke
#2
Jeong-Ho Park, Kwang-Jae Lee, Yong-Soon Yoon, Eun-Ji Son, Ji-Sun Oh, Si Hyun Kang, Heesang Kim, Hyung-Soon Park
Reliable assessment is essential for the management of spasticity, one of the most frequent complication of various neurological diseases. For the spasticity assessment, several clinical tools have been developed and widely used in clinics. The most popular one is modified Ashworth scale (MAS). It has a simple protocol, but is subjective and qualitative. To improve its reliability, quantitative measurement and consistent training would be needed. This study presents an elbow spasticity simulator which mimics spastic response of adult post stroke survivors...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813802/movement-therapy-without-moving-first-results-on-isometric-movement-training-for-post-stroke-rehabilitation-of-arm-function
#3
A Melendez-Calderon, E Rodrigues, K Thielbar, J L Patton
This study explores the use of isometric movement training for arm rehabilitation after stroke. The aim of this approach is to enhance movement skill even when the person training is not moving. This is accomplished by deceptively displaying virtual motions, exploiting known cross-modal sensory interactions between vision and proprioception. This approach can be advantageous in situations where actual movement is prohibitive due to weakness, spasticity, instability, or unsafe conditions. We present early insights on usability of and tolerance to this training approach and quantitative results that can power future clinical trials...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28804474/a-longitudinal-electromyography-study-of-complex-movements-in-poststroke-therapy-1-heterogeneous-changes-despite-consistent-improvements-in-clinical-assessments
#4
Negin Hesam-Shariati, Terry Trinh, Angelica G Thompson-Butel, Christine T Shiner, Penelope A McNulty
Poststroke weakness on the more-affected side may arise from reduced corticospinal drive, disuse muscle atrophy, spasticity, and abnormal coordination. This study investigated changes in muscle activation patterns to understand therapy-induced improvements in motor-function in chronic stroke compared to clinical assessments and to identify the effect of motor-function level on muscle activation changes. Electromyography (EMG) was recorded from five upper limb muscles on the more-affected side of 24 patients during early and late therapy sessions of an intensive 14-day program of Wii-based Movement Therapy (WMT) and for a subset of 13 patients at 6-month follow-up...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28751255/modification-of-spastic-stretch-reflexes-at-the-elbow-by-flexion-synergy-expression-in-individuals-with-chronic-hemiparetic-stroke
#5
Jacob G McPherson, Arno H A Stienen, Justin M Drogos, Julius P A Dewald
OBJECTIVE: To systematically characterize the impact of flexion synergy expression on the manifestation of elbow flexor stretch reflexes post-stroke, and to relate these findings to elbow flexor stretch reflexes in individuals without neurological injury. DESIGN: Controlled cohort study. SETTING: Academic medical center. PARTICIPANTS: Ten individuals with chronic hemiparetic stroke and a convenience sample of 10 individuals without neurological or musculoskeletal injury...
July 24, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28736326/tone-inhibiting-insoles-enhance-the-reciprocal-inhibition-of-ankle-plantarflexors-of-post-stroke-hemiparetic-subjects-an-electromyographic-study
#6
Nobushige Takahashi, Hidetoshi Takahashi, Osamu Takahashi, Ryosuke Ushijima, Rie Umebayashi, Junji Nishikawa, Yasutomo Okajima
BACKGROUND: Spasticity is a common sequela of upper motor neuron pathology, such as cerebrovascular diseases and cerebral palsy. Intervention for spasticity of the ankle plantarflexors in physical therapy may include tone-inhibiting casting and/or orthoses for the ankle and foot. However, the physiological mechanism of tone reduction by such orthoses remains unclarified. OBJECTIVE: To investigate the electrophysiologic effects of tone-inhibiting insoles in stroke subjects with hemiparesis by measuring changes in reciprocal Ia inhibition (RI) in the ankle plantarflexor...
July 20, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28726023/benefits-and-risks-of-non-approved-injection-regimens-for-botulinum-toxins-in-spasticity
#7
Andrea Santamato, Francesco Panza
Spasticity with muscle paresis and loss of dexterity is a common feature of upper motor neuron syndrome due to injuries or the pyramidal tract in several neurological conditions. Botulinum toxin type A has been considered the gold standard treatment for spasticity and movement disorders, with efficacy, reversibility, and low prevalence of complications. During the last 30 years, thousands of studies of its use have been performed, but few guidelines are available. Therefore, there is great variability in both the doses and intervals of administration and the approaches taken by clinicians with considerable experience in spasticity and movement disorder treatment...
July 19, 2017: Drugs
https://www.readbyqxmd.com/read/28713101/-extracorporeal-shock-waves-esw-as-an-alternative-treatment-method-for-improving-the-limb-muscles-spasticity-after-cerebral-stroke-a-systematic-review-of-the-literature
#8
Robert Dymarek, Kuba Ptaszkowski, Lucyna Słupska, Małgorzata Paprocka-Borowicz, Jakub Taradaj, Tomasz Halski, Joanna Rosińczuk
Extracorporeal shock wave (ESW) is a physical factor, of which the clinical use is observed in a wide range of disorders, particularly musculoskeletal dysfunctions. Recently, one can observe that the list of indications for ESW treatment is continuously growing and adapting the increasingly different systemic diseases in terms of etiology and pathomechanism. Nevertheless, it should be remembered that the potential biological mechanisms of ESW stimulation conditioning advantageous and desirable therapeutic effects are not clearly explained...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28696373/rehabilitation-plus-onabotulinumtoxina-improves-motor-function-over-onabotulinumtoxina-alone-in-post-stroke-upper-limb-spasticity-a-single-blind-randomized-trial
#9
Deidre Devier, JoAnn Harnar, Leandro Lopez, Allison Brashear, Glenn Graham
BACKGROUND: OnabotulinumtoxinA (BoNT-A) can temporarily decrease spasticity following stroke, but whether there is an associated improvement in upper limb function is less clear. This study measured the benefit of adding weekly rehabilitation to a background of BoNT-A treatments for chronic upper limb spasticity following stroke. METHODS: This was a multi-center clinical trial. Thirty-one patients with post-stroke upper limb spasticity were treated with BoNT-A. They were then randomly assigned to 24 weeks of weekly upper limb rehabilitation or no rehabilitation...
July 11, 2017: Toxins
https://www.readbyqxmd.com/read/28676142/the-italian-real-life-post-stroke-spasticity-survey-unmet-needs-in-the-management-of-spasticity-with-botulinum-toxin-type-a
#10
A Picelli, A Baricich, C Cisari, Stefano Paolucci, Nicola Smania, Giorgio Sandrini
The present national survey seeking to identify unmet needs in the management of spasticity with botulinum toxin type A focused on the use of OnabotulinumoxinA, since this is the brand with the widest range of licensed indications in Italy. Physicians from twenty-four Italian neurorehabilitation units compiled a questionnaire about "real-life" post-stroke spasticity management. OnabotulinumtoxinA was reported to be used in the following average doses: upper limb 316.7 ± 79.1 units; lower limb 327.8 ± 152...
April 2017: Functional Neurology
https://www.readbyqxmd.com/read/28666805/change-in-coefficient-of-fatigability-following-rapid-repetitive-movement-training-in-post-stroke-spastic-paresis-a-prospective-open-label-observational-study
#11
Michele Vecchio, Jean-Michel Gracies, Francesco Panza, Francesca Fortunato, Giovanna Vitaliti, Giulia Malaguarnera, Nicoletta Cinone, Raffaele Beatrice, Maurizio Ranieri, Andrea Santamato
BACKGROUND: In post-stroke patients, the possibility of performing an active ankle dorsiflexion movement is favorable for the recovery of gait. Moreover, the fatigue due to repetitive active ankle dorsiflexion could reduce the speed gait. We assessed the change in coefficient of fatigability of active ankle dorsiflexion after a home-based self-rehabilitative procedure in post-stroke patients. METHODS: In a prospective open-label observational study conducted in 2 university hospitals, a home-based self-rehabilitation treatment comprising two 12-minute sessions per day (3 times per week for 3 months) was performed by 10 outpatients with post-stroke lower limb impairment...
June 27, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28665375/-the-comprehensive-step-by-step-rehabilitation-of-the-patients-after-acute-disturbances-of-the-cerebral-circulation
#12
N F Miryutova, V A Chistyakova, V A Vorob'eva, A A Zaitsev
AIM: The objective of the present study was to evaluate the therapeutic effectiveness of the comprehensive one- and two-stage rehabilitation including the application of mirror therapy and orthetics on an individual basis. MATERIAL AND METHODS: The study included 125 patients (66 men and 59 women) at the medium age of 57 (52; 63) years who had undergone the acute disorders of cerebral circulation (the diagnosis was verified based on the results of CT or MRI of the brain)...
2017: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
https://www.readbyqxmd.com/read/28652065/effects-of-transcranial-direct-current-stimulation-with-sensory-modulation-on-stroke-motor-rehabilitation-a-randomized-controlled-trial
#13
Chia-Lin Koh, Jau-Hong Lin, Jiann-Shing Jeng, Sheau-Ling Huang, Ching-Lin Hsieh
OBJECTIVE: To test whether a multi-strategy intervention enhanced recovery immediately and longitudinally in patients with severe to moderate upper extremity (UE) paresis. DESIGN: Double-blind randomized controlled trial with placebo control. SETTING: An outpatient department of a local medical center. PARTICIPANTS: People (n = 25) with chronic stroke were randomly assigned to 2 groups. Participants in the transcranial direct current stimulation with sensory modulation (tDCS-SM) and in the control group were 55...
June 23, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28634003/spasticity-video-challenge-a-look-at-methods-for-addressing-difficult-cases
#14
Katharine E Alter, Mark Gormley, Atul T Patel
As seen in this CME online activity (available at http://courses.elseviercme.com/spasticity/662e), treatment of patients with spasticity due to upper motor neuron syndromes, including traumatic brain injury, stroke, and cerebral palsy, is multifaceted, involving chemodenervation, systemic medications, surgical therapy, rehabilitation efforts, and home care. Optimal care begins with the recognition that each patient's impairments are unique and must be assessed carefully to determine the impact of muscle overactivity, loss of dexterity, and weakness on passive and active function in the context of the patients' goals...
June 19, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28629806/prevalence-of-bleeding-complications-following-ultrasound-guided-botulinum-toxin-injections-in-patients-on-anticoagulation-or-antiplatelet-therapy
#15
Jeffrey LaVallee, Regan Royer, Geoffrey Smith
BACKGROUND: Patients on anticoagulation or antiplatelet therapy may be at higher risk for bleeding complications following intramuscular chemodenervation injections. Musculoskeletal ultrasound may be able to reduce the risk of bleeding complications by providing real-time visualization of vascular structures and postinjection monitoring. Limited data exist addressing the risk of bleeding complications following ultrasound-guided botulinum neurotoxin intramuscular chemodenervation procedures in the setting of anticoagulation or antiplatelet therapy...
June 16, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28629415/kaps-kinematic-assessment-of-passive-stretch-a-tool-to-assess-elbow-flexor-and-extensor-spasticity-after-stroke-using-a-robotic-exoskeleton
#16
Andrew Centen, Catherine R Lowrey, Stephen H Scott, Ting-Ting Yeh, George Mochizuki
BACKGROUND: Spasticity is a common sequela of stroke. Traditional assessment methods include relatively coarse scales that may not capture all characteristics of elevated muscle tone. Thus, the aim of this study was to develop a tool to quantitatively assess post-stroke spasticity in the upper extremity. METHODS: Ninety-six healthy individuals and 46 individuals with stroke participated in this study. The kinematic assessment of passive stretch (KAPS) protocol consisted of passive elbow stretch in flexion and extension across an 80° range in 5 movement durations...
June 19, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/28625615/efficacy-and-safety-of-abobotulinumtoxina-dysport-for-the-treatment-of-hemiparesis-in-adults-with-upper-limb-spasticity-previously-treated-with-botulinum-toxin-subanalysis-from-a-phase-3-randomized-controlled-trial
#17
Christina Marciniak, Peter McAllister, Heather Walker, Allison Brashear, Steven Edgley, Thierry Deltombe, Svetlana Khatkova, Marta Banach, Fatma Gul, Claire Vilain, Philippe Picaut, Anne-Sophie Grandoulier, Jean-Michel Gracies
OBJECTIVE: To assess the efficacy and safety of abobotulinumtoxinA in adults with upper limb spasticity previously treated with botulinum toxin A (BoNT-A). DESIGN: A post hoc analysis from a Phase 3, prospective, double-blind, randomized, placebo-controlled study (NCT01313299). SETTING: A total of 34 neurology or rehabilitation clinics in 9 countries. PARTICIPANTS: Adults aged 18-80 years with hemiparesis, ≥6 months after stroke or traumatic brain injury...
June 16, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28613178/biomechanical-reactions-of-exoskeleton-neurorehabilitation-robots-in-spastic-elbows-and-wrists
#18
Hyung Seok Nam, Sukgyu Koh, Yoon Jae Kim, Jaewon Beom, Woo Hyung Lee, Shi-Uk Lee, Sungwan Kim
Spasticity is an important factor in designing wearable and lightweight exoskeleton neurorehabilitation robots. The proposed study evaluates biomechanical reactions of an exoskeleton robot to spasticity and establishes relevant guidelines for robot design. A two-axis exoskeleton robot is used to evaluate a group of 20 patients post-stroke with spastic elbow and/or wrist joints. All subjects are given isokinetic movements at various angular velocities within the capable range of motion for both joints. The resistance torque and corresponding angular position at each joint are recorded continuously...
June 9, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28566161/long-term-safety-of-repeated-high-doses-of-incobotulinumtoxina-injections-for-the-treatment-of-upper-and-lower-limb-spasticity-after-stroke
#19
Andrea Santamato, Francesco Panza, Domenico Intiso, Alessio Baricich, Alessandro Picelli, Nicola Smania, Francesca Fortunato, Davide Seripa, Pietro Fiore, Maurizio Ranieri
Current guidelines suggested a dosage up to 600units (U) of botulinum toxin type A (BoNT-A) (onabotulinumtoxinA or incobotulinumtoxinA) in reducing spastic hypertonia with low prevalence of complications, although a growing body of evidence showed efficacy with the use of high doses (>800U). The available evidence mainly referred to a single set of injections evaluating the efficacy and safety of the neurotoxin 30days after the treatment. In a prospective, non-randomized, open-label study, we studied the safety of repeated higher doses of incobotulinumtoxinA in post-stroke upper and lower limb spasticity...
July 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28553200/phase-ii-clinical-validation-of-a-powered-exoskeleton-for-the-treatment-of-elbow-spasticity
#20
Simona Crea, Marco Cempini, Stefano Mazzoleni, Maria Chiara Carrozza, Federico Posteraro, Nicola Vitiello
Introduction: Spasticity is a typical motor disorder in patients affected by stroke. Typically post-stroke rehabilitation consists of repetition of mobilization exercises on impaired limbs, aimed to reduce muscle hypertonia and mitigate spastic reflexes. It is currently strongly debated if the treatment's effectiveness improves with the timeliness of its adoption; in particular, starting intensive rehabilitation as close as possible to the stroke event may counteract the growth and postpone the onset of spasticity...
2017: Frontiers in Neuroscience
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