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Stroke rehabilitation

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https://www.readbyqxmd.com/read/28634003/spasticity-video-challenge-a-look-at-methods-for-addressing-difficult-cases
#1
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 17, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28633675/acupuncture-treatment-on-the-motor-area-of-the-scalp-for-motor-dysfunction-in-patients-with-ischemic-stroke-study-protocol-for-a-randomized-controlled-trial
#2
Jun Wang, Jian Pei, Dhiaedin Khiati, Qinhui Fu, Xiao Cui, Yi Song, Minghang Yan, Lijun Shi, Yiwen Cai, Yuhong Ma
BACKGROUND: Scalp acupuncture has shown a remarkable treatment efficacy on motor dysfunction in patients with stroke in China, especially the motor area of Jiao's scalp acupuncture, which is the most widely used treatment. However, previous studies have summarized that the clinical curative effect of acupuncture treatment for stroke remains uncertain. Meanwhile, no randomized controlled trials on Jiao's scalp acupuncture have been performed. The aim of this study is to evaluate the efficacy and safety of Jiao's scalp acupuncture for motor dysfunction in ischemic stroke...
June 20, 2017: Trials
https://www.readbyqxmd.com/read/28629270/a-randomized-controlled-trial-of-a-modified-wheelchair-arm-support-to-reduce-shoulder-pain-in-stroke-patients
#3
Ruihuan Pan, Mingchao Zhou, Hao Cai, Youhua Guo, Lechang Zhan, Mei Li, Zhijing Yang, Leying Zhu, Jie Zhan, Hongxia Chen
OBJECTIVE: To evaluate the effect of modified wheelchair arm-support to mitigate hemiplegic shoulder pain and reduce pain frequency in stroke patients. DESIGN: A single-blind randomized controlled trial using computer-generated simple randomization. SETTING: Participants recruited from inpatients at the Guangdong Provincial Hospital of Chinese Medicine. SUBJECTS: A total of 120 patients with stroke were divided into two groups...
June 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28628597/integrating-health-promotion-into-physical-therapy-practice-to-improve-brain-health-and-prevent-alzheimer-disease
#4
Ellen McGough, Neva Kirk-Sanchez, Teresa Liu-Ambrose
BACKGROUND AND PURPOSE: Alzheimer disease is the most common cause of dementia, and brain pathology appears years before symptoms are evident. Primary prevention through health promotion can incorporate lifestyle improvement across the lifespan. Risk factor assessment and identifying markers of disease might also trigger preventive measures needed for high-risk individuals and groups. SUMMARY OF KEY POINTS: Many potential risk factors are modifiable through exercise, and may be responsive to early intervention strategies to reduce the downward slope toward disability...
July 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/28628594/telehealth-wearable-sensors-and-the-internet-will-they-improve-stroke-outcomes-through-increased-intensity-of-therapy-motivation-and-adherence-to-rehabilitation-programs
#5
Jane H Burridge, Alan Chong W Lee, Ruth Turk, Maria Stokes, Jill Whitall, Ravi Vaidyanathan, Phil Clatworthy, Ann-Marie Hughes, Claire Meagher, Enrico Franco, Lucy Yardley
BACKGROUND AND PURPOSE: Stroke, predominantly a condition of older age, is a major cause of acquired disability in the global population and puts an increasing burden on health care resources. Clear evidence for the importance of intensity of therapy in optimizing functional outcomes is found in animal models, supported by neuroimaging and behavioral research, and strengthened by recent meta-analyses from multiple clinical trials. However, providing intensive therapy using conventional treatment paradigms is expensive and sometimes not feasible because of social and environmental factors...
July 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/28628593/consideration-of-dose-and-timing-when-applying-interventions-after-stroke-and-spinal-cord-injury
#6
D Michele Basso, Catherine E Lang
BACKGROUND AND PURPOSE: Nearly 4 decades of investigation into the plasticity of the nervous system suggest that both timing and dose could matter. This article provides a synopsis of our lectures at the IV STEP meeting, which presented a perspective of current data on the issues of timing and dose for adult stroke and spinal cord injury motor rehabilitation. SUMMARY OF KEY POINTS: For stroke, the prevailing evidence suggests that greater amounts of therapy do not result in better outcomes for upper extremity interventions, regardless of timing...
July 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/28628592/genetic-variation-and-neuroplasticity-role-in-rehabilitation-after-stroke
#7
Jill Campbell Stewart, Steven C Cramer
BACKGROUND AND PURPOSE: In many neurologic diagnoses, significant interindividual variability exists in the outcomes of rehabilitation. One factor that may impact response to rehabilitation interventions is genetic variation. Genetic variation refers to the presence of differences in the DNA sequence among individuals in a population. Genetic polymorphisms are variations that occur relatively commonly and, while not disease-causing, can impact the function of biological systems. The purpose of this article is to describe genetic polymorphisms that may impact neuroplasticity, motor learning, and recovery after stroke...
July 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/28628537/needs-of-stroke-survivors-as-perceived-by-their-caregivers-a-scoping-review
#8
Shilpa Krishnan, Monique R Pappadis, Susan C Weller, Marsja Stearnes, Amit Kumar, Kenneth J Ottenbacher, Timothy A Reistetter
OBJECTIVE: Caregivers usually are not involved while planning the stroke survivor's medical and rehabilitation goals and interventions. This review aimed to identify the needs of stroke survivors as perceived by their caregivers. DESIGN: A literature search from 2003 to 2014 was conducted using Medline, CINAHL, PsychINFO, and Google Scholar. Sixty-six studies were included. Most studies excluded did not encompass caregivers' perspectives. Four reviewers screened the titles, abstracts, and full texts of the articles for inclusion...
July 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28628535/community-based-rehabilitation-to-improve-stroke-survivors-rehabilitation-participation-and-functional-recovery
#9
Xiaojuan Ru, Hong Dai, Bin Jiang, Ninghua Li, Xingquan Zhao, Zhen Hong, Li He, Wenzhi Wang
OBJECTIVE: The aim of this study was to evaluate the effectiveness of a community-based rehabilitation appropriate technique (CRAT) intervention program in increasing rehabilitation participation and improving functional recovery of stroke survivors. DESIGN: This study followed a quasi-experimental design. In each of 5 centers servicing approximately 50,000 individuals, 2 communities were designated as either the intervention or control community. A CRAT intervention program, including 2-year rehabilitation education and 3-month CRAT treatment, was regularly implemented in the intervention communities, whereas there was no special intervention in the control community...
July 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28627938/-i-ve-got-somebody-there-someone-cares-what-support-is-most-valued-following-a-stroke
#10
Sarah Northcott, Katerina Hilari
PURPOSE: There is often a need for increased support following a stroke. This study explored what types of support are provided by different network members and what support functions are most valued. METHODS: Adults with first stroke were recruited from a stroke unit and participated in in-depth interviews 8-15 months poststroke. Framework Analysis was used to build thematic and explanatory accounts of the data. RESULTS: Twenty-nine participants took part...
June 19, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28627862/feasibility-and-efficacy-of-wearable-devices-for-upper-limb-rehabilitation-in-patients-with-chronic-stroke-a-randomized-controlled-pilot-study
#11
Li-Fong Lin, Yi-Jia Lin, Zi-Hao Lin, Li-Yun Chuang, Wei-Chun Hsu, Yuan-Hsiang Lin
BACKGROUND: Wearable devices based on inertial measurement units through wireless sensor networks have many applications such as real-time motion monitoring and functional outcome assessment of stroke rehabilitation. However, additional investigations are warranted to validate their clinical value, particularly in detecting the synergy patterns of movements after stroke. AIM: To explore the feasibility and efficacy of wearable devices for upper limb rehabilitation in patients with chronic stroke and to compare the intervention effects (e...
June 19, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28626427/distinctive-steady-state-heart-rate-and-blood-pressure-responses-to-passive-robotic-leg-exercise-during-head-up-tilt-a-pilot-study-in-neurological-patients
#12
Amirehsan Sarabadani Tafreshi, Robert Riener, Verena Klamroth-Marganska
Introduction: Robot-assisted tilt table therapy was proposed for early rehabilitation and mobilization of patients after diseases such as stroke. A robot-assisted tilt table with integrated passive robotic leg exercise (PE) mechanism has the potential to prevent orthostatic hypotension usually provoked by verticalization. In a previous study with rather young healthy subjects [average age: 25.1 ± 2.6 years (standard deviation)], we found that PE effect on the cardiovascular system depends on the verticalization angle of the robot-assisted tilt table...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28626331/the-effects-of-training-using-emg-biofeedback-on-stroke-patients-upper-extremity-functions
#13
Ju-Hong Kim
[Purpose] While electromyography (EMG) biofeedback has been recently used in diverse therapeutic interventions for stroke patients, research on its effects has been lacking. Most existing studies are confined to functions of the lower extremities, and research on upper extremity functional recovery using EMG biofeedback training is limited. Therefore, this study examined the effects of training using EMG biofeedback on stroke patients' upper extremity functions. [Subjects and Methods] The subjects of this study included 30 hemiplegia patients whose disease duration was longer than six months...
June 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28625615/efficacy-and-safety-of-abobotulinumtoxina-dysport%C3%A2-for-the-treatment-of-hemiparesis-in-adults-with-upper-limb-spasticity-previously-treated-with-botulinum-toxin-sub-analysis-from-a-phase-3-randomized-controlled-trial
#14
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 SETTING: 34 neurology or rehabilitation clinics in nine countries. PARTICIPANTS: Adults aged 18-80 years with hemiparesis, ≥6 months after stroke or traumatic brain injury. This analysis focused on a subgroup of subjects with previous onabotulinumtoxinA or incobotulinumtoxinA treatment (n=105 of 243 in the total trial population) in the affected limb...
June 15, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28625085/enjoyable-company-in-sharing-stroke-experiences-lifestyle-groups-after-stroke
#15
Anne Lund, Mali Melhus, Unni Sveen
BACKGROUND: Even people with mild to moderate stroke will experience changes in their abilities to perform everyday occupations. Group interventions may be appropriate in late-stage rehabilitation. The aim of this study was to explore how the participants involved themselves in person-centered lifestyle groups after stroke in Norway. METHOD: Semi-structured interviews were performed with six older adults with mild-to-moderate stroke who had participated in lifestyle groups over a period of nine months...
June 19, 2017: Scandinavian Journal of Occupational Therapy
https://www.readbyqxmd.com/read/28625084/objectively-assessed-physical-activity-and-associated-factors-of-sedentary-behavior-among-survivors-of-stroke-living-in-cape-town-south-africa
#16
Conran Joseph, David Conradsson, Maria Hagströmer, Isa Lawal, Anthea Rhoda
PURPOSE: To investigate objectively measured physical activity in stroke survivors living in low-income areas of Cape Town, South Africa, specifically to: (a) describe the volume of daily physical activity and time spent in different intensity levels and (b) investigate the association of factors covering the International Classification of Functioning, Disability and Health with sedentary behavior. MATERIALS AND METHODS: A cross-sectional design was used, where forty-five ambulatory community-dwelling stroke survivors participated...
June 18, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28623892/improving-transitions-in-acute-stroke-patients-discharged-to-home-the-michigan-stroke-transitions-trial-mistt-protocol
#17
Mathew J Reeves, Anne K Hughes, Amanda T Woodward, Paul P Freddolino, Constantinos K Coursaris, Sarah J Swierenga, Lee H Schwamm, Michele C Fritz
BACKGROUND: For some stroke patients and caregivers, navigating the transition between hospital discharge and returning home is associated with substantial psychosocial and health-related challenges. Currently, no evidence-based standard of care exists that addresses the concerns of stroke patients and caregivers during the transition period. Objectives of the Michigan Stroke Transitions Trial (MISTT) are to test the impact of a social worker home-based case management program, as well as an online information and support resource, on patient and caregiver outcomes after returning home...
June 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28620998/a-survey-of-speech-language-therapy-provision-for-people-with-post-stroke-dysarthria-in-the-uk
#18
Nick Miller, Steven Bloch
BACKGROUND: A large number of people who experience a stroke are affected by dysarthria. This may be in isolation or in association with aphasia and/or dysphagia. Despite evidence highlighting the psychological and social impact of having post-stroke dysarthria and a number of clinical guidelines that make recommendations for appropriate management, little is known currently about UK service delivery issues relating to speech and language therapy (SLT) assessment and treatment for this group...
June 16, 2017: International Journal of Language & Communication Disorders
https://www.readbyqxmd.com/read/28619985/long-term-improvements-after-multimodal-rehabilitation-in-late-phase-after-stroke-a-randomized-controlled-trial
#19
Lina Bunketorp-Käll, Åsa Lundgren-Nilsson, Hans Samuelsson, Tulen Pekny, Karin Blomvé, Marcela Pekna, Milos Pekny, Christian Blomstrand, Michael Nilsson
BACKGROUND AND PURPOSE: Treatments that improve function in late phase after stroke are urgently needed. We assessed whether multimodal interventions based on rhythm-and-music therapy or horse-riding therapy could lead to increased perceived recovery and functional improvement in a mixed population of individuals in late phase after stroke. METHODS: Participants were assigned to rhythm-and-music therapy, horse-riding therapy, or control using concealed randomization, stratified with respect to sex and stroke laterality...
June 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28619447/similar-movements-are-associated-with-drastically-different-muscle-contraction-velocities
#20
Daniel A Hagen, Francisco J Valero-Cuevas
We investigated how kinematic redundancy interacts with the neurophysiological control mechanisms required for smooth and accurate, rapid limb movements. Biomechanically speaking, tendon excursions are over-determined because the rotation of few joints determines the lengths and velocities of many muscles. But how different are the muscle velocity profiles induced by various, equally valid hand trajectories? We used an 18-muscle sagittal-plane arm model to calculate 100,000 feasible shoulder, elbow, and wrist joint rotations that produced valid basketball free throws with different hand trajectories, but identical initial and final hand positions and velocities...
May 31, 2017: Journal of Biomechanics
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