scholarly journals Size Doesn't Matter: Cortical Stroke Lesion Volume Is Not Associated With Upper Extremity Motor Impairment and Function in Mild, Chronic Hemiparesis

2013 ◽  
Vol 94 (5) ◽  
pp. 817-821 ◽  
Author(s):  
Stephen J. Page ◽  
Lynne V. Gauthier ◽  
Susan White
Keyword(s):  
Upper Extremity ◽  
Motor Impairment ◽  
Lesion Volume ◽  
Cortical Stroke ◽  
Stroke Lesion ◽  
And Function ◽  
Upper Extremity Motor Impairment

Virtual Reality Training for Upper Extremity in Subacute Stroke (VIRTUES)

Neurology ◽  
2017 ◽  
Vol 89 (24) ◽  
pp. 2413-2421 ◽  
Author(s):  
Iris Brunner ◽  
Jan Sture Skouen ◽  
Håkon Hofstad ◽  
Jörg Aßmus ◽  
Frank Becker ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Upper Extremity ◽  
Outcome Measures ◽  
Motor Impairment ◽  
Phase Iii ◽  
Secondary Outcome ◽  
Subacute Phase ◽  
Vr Training ◽  
Upper Extremity Motor Impairment

Objective:To compare the effectiveness of upper extremity virtual reality rehabilitation training (VR) to time-matched conventional training (CT) in the subacute phase after stroke.Methods:In this randomized, controlled, single-blind phase III multicenter trial, 120 participants with upper extremity motor impairment within 12 weeks after stroke were consecutively included at 5 rehabilitation institutions. Participants were randomized to either VR or CT as an adjunct to standard rehabilitation and stratified according to mild to moderate or severe hand paresis, defined as ≥20 degrees wrist and 10 degrees finger extension or less, respectively. The training comprised a minimum of sixteen 60-minute sessions over 4 weeks. The primary outcome measure was the Action Research Arm Test (ARAT); secondary outcome measures were the Box and Blocks Test and Functional Independence Measure. Patients were assessed at baseline, after intervention, and at the 3-month follow-up.Results:Mean time from stroke onset for the VR group was 35 (SD 21) days and for the CT group was 34 (SD 19) days. There were no between-group differences for any of the outcome measures. Improvement of upper extremity motor function assessed with ARAT was similar at the postintervention (p = 0.714) and follow-up (p = 0.777) assessments. Patients in VR improved 12 (SD 11) points from baseline to the postintervention assessment and 17 (SD 13) points from baseline to follow-up, while patients in CT improved 13 (SD 10) and 17 (SD 13) points, respectively. Improvement was also similar for our subgroup analysis with mild to moderate and severe upper extremity paresis.Conclusions:Additional upper extremity VR training was not superior but equally as effective as additional CT in the subacute phase after stroke. VR may constitute a motivating training alternative as a supplement to standard rehabilitation.ClinicalTrials.gov identifier:NCT02079103.Classification of evidence:This study provides Class I evidence that for patients with upper extremity motor impairment after stroke, compared to conventional training, VR training did not lead to significant differences in upper extremity function improvement.

scholarly journals Cortical disconnection of the ipsilesional primary motor cortex is associated with gait speed and upper extremity motor impairment in chronic left hemispheric stroke

2017 ◽  
Vol 39 (1) ◽  
pp. 120-132 ◽  
Author(s):  
Denise M. Peters ◽  
Julius Fridriksson ◽  
Jill C. Stewart ◽  
Jessica D. Richardson ◽  
Chris Rorden ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Upper Extremity ◽  
Gait Speed ◽  
Primary Motor Cortex ◽  
Motor Impairment ◽  
Hemispheric Stroke ◽  
Upper Extremity Motor Impairment

Robot-assisted therapy for upper extremity motor impairment after stroke: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Jingyi Wu ◽  
Hao Cheng ◽  
Jiaqi Zhang ◽  
Shanli Yang ◽  
Sufang Cai
Keyword(s):  
Randomized Controlled Trials ◽  
Upper Extremity ◽  
Meta Analysis ◽  
Motor Impairment ◽  
Controlled Trials ◽  
Robot Assisted ◽  
Randomized Controlled ◽  
Small Effect Size ◽  
Evidence Database ◽  
Upper Extremity Motor Impairment

Abstract Objective The purpose of this study was to review the effects of robot-assisted therapy (RT) for improving poststroke upper extremity motor impairment. Methods The PubMed, EMBASE, Medline, and Web of Science databases were searched from inception to April 8, 2020. Randomized controlled trials that were conducted to evaluate the effects of RT on upper extremity motor impairment poststroke and that used Fugl-Meyer Assessment Upper Extremity (FMA-UE) scores as an outcome were included. Two authors independently screened articles, extracted data, and assessed the methodological quality of the included studies using the Physiotherapy Evidence Database (PEDro) scale. A random-effects meta-analysis was performed to pool the effect sizes across the studies. Results Forty-one randomized controlled trials with 1916 stroke patients were included. Compared with dose-matched conventional rehabilitation, RT significantly improved the FMA-UE scores of the patients with stroke, with a small effect size (Hedges g = 0.25; 95% CI = 0.11 to 0.38; I2 = 45.9%). The subgroup analysis revealed that the effects of unilateral RT, but not that of bilateral RT, was superior to conventional rehabilitation (Hedges g = 0.32; 95% CI = 0.15 to 0.50; I2 = 55.9%). Regarding the type of robot devices, the effects of the end effector device (Hedges g = 0.22; 95% CI = 0.09 to −0.36; I2 = 35.4%), but not the exoskeleton device, were superior to conventional rehabilitation. Regarding the stroke stage, the between-group difference (ie, RT vs convention rehabilitation) was significant only for people with late subacute or chronic stroke (Hedges g = 0.33; 95% CI = 0.16 to 0.50; I2 = 34.2%). Conclusion RT might be superior to conventional rehabilitation in improving upper extremity motor impairment in people after stroke with notable upper extremity hemiplegia and limited potential for spontaneous recovery.

scholarly journals FUNCTIONAL UTILITY OF WEARING A MYOELECTRIC ORTHOSIS FOR UPPER EXTREMITY PARALYSIS DUE TO SPINAL CORD INJURY

2018 ◽  
Author(s):  
Lauren Wengerd
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Upper Extremity ◽  
Motor Impairment ◽  
Neurological Impairment ◽  
The United States ◽  
Cervical Lesions ◽  
National Assembly ◽  
Cord Injury ◽  
Upper Extremity Motor Impairment

INTRODUCTION Spinal cord injury (SCI) remains a leading cause of long-term disability in the United States with the majority of injuries resulting in incomplete quadriplegia due to cervical lesions.1 This leads to significant neurological impairment including upper extremity (UE) weakness and decreased independence with self-care activities of daily living (ADLs). Previous work demonstrated that using a myoelectric elbow-wrist-hand orthosis as a therapeutic adjunct to a multi-week rehabilitation regimen resulted in decreased UE motor impairment and increased function in stroke survivors with moderate UE hemiparesis.2 The purpose of this case study was to determine if wearing a myoelectric elbow-wrist-hand orthosis reduces upper extremity motor impairment and increases functional ability in an individual with chronic, incomplete spinal cord injury and resultant quadriplegia. Abstract PDF  Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/32021/24439 How to cite: Wengerd L. FUNCTIONAL UTILITY OF WEARING A MYOELECTRIC ORTHOSIS FOR UPPER EXTREMITY PARALYSIS DUE TO SPINAL CORD INJURY. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, POSTER PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32021 Abstracts were Peer-reviewed by the American Orthotic Prosthetic Association (AOPA) 101st National Assembly Scientific Committee.  http://www.aopanet.org/

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