Five-day course of paired associative stimulation fails to improve motor function in stroke patients

We aimed to explore whether motor function and activities of daily life (ADL) could be improved with the application of visual deprivation in two patients with Pusher syndrome complicated by hemispatial neglect after right basal ganglia stroke. We assessed two stroke patients suffering from severe motor disturbances, both tilting heavily to the left, with diagnoses of Pusher syndrome and left hemispatial neglect. Vision in the left eye was deprived using patches during clinical rehabilitation. Motor function promotion was confirmed using the Burke Lateropulsion Scale (BLS), Fugl–Meyer Balance Scale (FMBS), and Holden grade (HG), while the Barthel index (BI) assessed ADL immediately and 1 week after intervention. Both patients regained standing balance immediately using visual deprivation, as well as walking ability, although both scored 0 on the FMBS and HG. After 1 week of treatment, one patient increased to 11 and 3 on the FMBS and HG, respectively, while the BLS score decreased from 12 to 2, and the ADL increased from 23 to 70. The other patient demonstrated increases to 10 and 3 on the FMBS and HG, respectively, with the BLS decreasing from 13 to 3, and the ADL increasing from 25 to 60. Therefore, in the rehabilitation treatment of Pusher syndrome complicated by hemispatial neglect due to basal ganglia stroke, visual deprivation can significantly improve motor function and shorten the treatment course.

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Abstract 9 feasibility of cortical stimulation to improve motor function in stroke patients. Richard L. Harvey, MD (Rehabil Inst Chicago, Chicago, IL); Mark Huang, MD; Robert M. Levy, MD; Sean Ruland, DO; Rima M. Dafer, MD; Martin E. Weinand, MD; et al, e-mail: [email protected]

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2004.07.009 ◽

2004 ◽

Vol 85 (9) ◽

pp. e2

Keyword(s):

Motor Function ◽

Cortical Stimulation ◽

Stroke Patients ◽

Improve Motor Function ◽

E Mail

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MIRROR THERAPY IN STROKE REHABILITATION

JURNAL BIOMEDIK (JBM) ◽

10.35790/jbm.6.2.2014.5548 ◽

2014 ◽

Vol 6 (2) ◽

Cited By ~ 1

Author(s):

Lidwina S. Sengkey ◽

Paola Pandeiroth

Keyword(s):

Motor Function ◽

Daily Living ◽

Stroke Rehabilitation ◽

Internal Capsule ◽

Mirror Therapy ◽

Stroke Patients ◽

Beneficial Effects ◽

Improve Motor Function ◽

Set Up ◽

The Brain

Abstract: Paralysis in stroke is mainly caused by damage of any kind in internal capsule. Recovering of these damages require neuroplasticity which involves parts of the brain survivors. One kind of therapies that has some beneficial effects on neuroplasticity is mirror therapy. This therapy is used to improve motor function after stroke. Mirror therapy is easy to set up and requires very little training without taxing the patient. Data obtained from several studies show that besides it is simple and cheap, this mirror therapy might have a significant effect on motor function and improve activities of daily living as an adjunct to the rehabilitation for stroke patients. This review aims to demonstrate the benefits of mirror therapy in stroke rehabilitation. Keywords: exercise therapy, mirror therapy, rehabilitation, stroke Abstrak: Paralisis pada stroke terutama terjadi karena kerusakan di kapsula interna. Kerusakan ini memerlukan neuroplastisitas yang melibatkan sejumlah bagian otak yang selamat untuk memulihkannya. Salah satu terapi yang bermanfaat terhadap neuroplastisitas yaitu terapi cermin. Terapi ini digunakan untuk memperbaiki fungsi motorik pasca stroke. Terapi cermin mudah dilakukan dan hanya membutuhkan latihan yang sangat singkat tanpa membebani pasien. Data yang diperoleh dari beberapa penelitian memperlihatkan bahwa terapi cermin merupakan terapi yang sederhana, murah, dan efektif dalam memperbaiki fungsi motorik (baik ekstremitas atas maupun bawah) dan aktivitas kehidupan sehari-hari, sebagai tambahan untuk rehabilitasi yang umumnya dilakukan pada pasien dengan stroke. Telaah ini bertujuan untuk menunjukkan keuntungan terapi cermin pada rehabilitasi stroke. Kata kunci: terapi latihan, terapi cermin, rehabilitasi, stroke

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Effect of Functional Electrical Stimulation on Improving Upper Extremity Motor Function in Stroke Patients Revealed by fMRI: a Controlled Study

Rehabilitation Medicine ◽

10.3724/sp.j.1329.2015.03001 ◽

2015 ◽

Vol 25 (3) ◽

pp. 1

Author(s):

Fangfang ZHENG ◽

Huihua LIU ◽

Tiebin YAN ◽

Xiaokun JIN ◽

Xiaohui DUAN ◽

...

Keyword(s):

Electrical Stimulation ◽

Upper Extremity ◽

Motor Function ◽

Functional Electrical Stimulation ◽

Controlled Study ◽

Stroke Patients

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Abstract T P123: Non-invasive Brain Stimulation for Motor Function of Chronic Stroke Patients

Stroke ◽

10.1161/str.45.suppl_1.tp123 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Eunhee Park ◽

Tae Gun Kwon ◽

Won Hyuk Chang ◽

Yun-Hee Kim

Keyword(s):

Motor Function ◽

Brain Stimulation ◽

Movement Time ◽

Motor Task ◽

Chronic Stroke ◽

Stroke Patients ◽

Dual Mode ◽

Simultaneous Application ◽

Corticomotor Excitability ◽

Cathodal Tdcs

Objective: The purpose of this study was to investigate the effect of dual-mode noninvasive brain stimulation (NBS) by combining transcranial direct current stimulation (tDCS) over the unaffected primary motor cortex (uM1) and high-frequency repetitive transcranial magnetic stimulation (rTMS) over the affected M1 (aM1) on motor functions and corticomotor excitability in chronic stroke patients. Methods: Seventeen chronic stroke patients (12 men; mean age 58.7 years; 12 infarctions and 5 hemorrhages) participated in this double blinded random-order crossover study. All participants received three randomly arranged, dual-mode stimulations with 24 hours of washout period; Condition 1, simultaneous application of 10 Hz rTMS over the aM1 and cathodal tDCS over the uM1; Condition 2, simultaneous application of 10 Hz rTMS over the M1a and anodal tDCS over the uM1; Condition 3, 10 Hz rTMS over the aM1 and sham tDCS over the uM1. Corticomotor excitability using motor evoked potential (MEP) amplitude and hand motor functions using the sequential motor task were assessed before and after stimulation. Results: MEP amplitude was significantly increased after condition 1 and 3, respectively (p<0.05). The changes of MEP amplitude were significantly higher in condition 1 than condition 2 (p<0.05). In sequential motor task, the movement time was significantly decreased after condition 1 and 3, respectively (p<0.05). The change of movement time was significantly larger in condition 1 than the other conditions (p<0.05). Conclusions: Simultaneous stimulation of cathodal tDCS over the uM1 produced enhancement of 10 Hz rTMS effect over the aM1 in patients with stroke. These results suggest the dual-mode NBS as a method of enhancing motor function probably by inducing interhemispheric interaction of bilateral primary motor cortices in chronic stroke patients (Supported by the National Research Foundation of Korea grant (No.2011-0016960) and a KOSEF grant (M10644000022-06N4400-02210)).

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