Chronic stroke survivors with upper limb spasticity: linking experience to the ICF

2021 ◽  
pp. 1-13
Author(s):  
Shannon Pike ◽  
Natasha A. Lannin ◽  
Lisa Cameron ◽  
Mithu Palit ◽  
Anne Cusick
Keyword(s):  
Upper Limb ◽  
Chronic Stroke ◽  
Stroke Survivors ◽  
Limb Spasticity

scholarly journals Functional Brain Correlates of Upper Limb Spasticity and Its Mitigation following Rehabilitation in Chronic Stroke Survivors

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Svetlana Pundik ◽  
Adam D. Falchook ◽  
Jessica McCabe ◽  
Krisanne Litinas ◽  
Janis J. Daly
Keyword(s):  
Motor Function ◽  
Upper Limb ◽  
Muscle Tone ◽  
Hand Movement ◽  
Chronic Stroke ◽  
Motor Deficits ◽  
Stroke Survivors ◽  
Functional Brain ◽  
Brain Correlates ◽  
Limb Spasticity

Background.Arm spasticity is a challenge in the care of chronic stroke survivors with motor deficits. In order to advance spasticity treatments, a better understanding of the mechanism of spasticity-related neuroplasticity is needed.Objective.To investigate brain function correlates of spasticity in chronic stroke and to identify specific regional functional brain changes related to rehabilitation-induced mitigation of spasticity.Methods.23 stroke survivors (>6 months) were treated with an arm motor learning and spasticity therapy (5 d/wk for 12 weeks). Outcome measures included Modified Ashworth scale, sensory tests, and functional magnetic resonance imaging (fMRI) for wrist and hand movement.Results.First, at baseline, greater spasticity correlated with poorer motor function (P=0.001) and greater sensory deficits (P=0.003). Second, rehabilitation produced improvement in upper limb spasticity and motor function (P<0.0001). Third, at baseline, greater spasticity correlated with higher fMRI activation in the ipsilesional thalamus (rho=0.49,P=0.03). Fourth, following rehabilitation, greater mitigation of spasticity correlated with enhanced fMRI activation in the contralesional primary motor (r=-0.755,P=0.003), premotor (r=−0.565,P=0.04), primary sensory (r=−0.614,P=0.03), and associative sensory (r=−0.597,P=0.03) regions while controlling for changes in motor function.Conclusions.Contralesional motor regions may contribute to restoring control of muscle tone in chronic stroke.

scholarly journals The effects of anxiety and dual-task on upper limb motor control of chronic stroke survivors

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Mahnaz Hejazi-Shirmard ◽  
Laleh Lajevardi ◽  
Mehdi Rassafiani ◽  
Ghorban Taghizadeh
Keyword(s):  
Motor Control ◽  
Upper Limb ◽  
Dual Task ◽  
Chronic Stroke ◽  
Stroke Survivors ◽  
High Anxiety ◽  
Reach And Grasp ◽  
Stroke Group ◽  
Task Conditions ◽  
Hand Opening

Abstract This study was designed to investigate the effects of anxiety and dual-task on reach and grasp motor control in chronic stroke survivors compared with age- and sex-matched healthy subjects (HC). Reach and grasp kinematic data of 68 participants (high-anxiety stroke (HA-stroke), n = 17; low-anxiety stroke (LA-stroke), n = 17; low-anxiety HC, n = 17; and high-anxiety HC, n = 17) were recorded under single- and dual-task conditions. Inefficient reach and grasp of stroke participants, especially HA-stroke were found compared with the control groups under single- and dual-task conditions as evidenced by longer movement time (MT), lower and earlier peak velocity (PV) as well as delayed and smaller hand opening. The effects of dual-task on reach and grasp kinematic measures were similar between HCs and stroke participants (i.e., increased MT, decreased PV that occurred earlier, and delayed and decreased hand opening), with greater effect in stroke groups than HCs, and in HA-stroke group than LA-stroke group. The results indicate that performing a well-learned upper limb movement with concurrent cognitive task leads to decreased efficiency of motor control in chronic stroke survivors compared with HCs. HA-stroke participants were more adversely affected by challenging dual-task conditions, underlying importance of assessing anxiety and designing effective interventions for it in chronic stroke survivors.

scholarly journals Corticospinal Excitability as a Predictor of Functional Gains at the Affected Upper Limb Following Robotic Training in Chronic Stroke Survivors

2014 ◽  
Vol 28 (9) ◽  
pp. 819-827 ◽  
Author(s):  
Marie-Hélène Milot ◽  
Steven J. Spencer ◽  
Vicky Chan ◽  
James P. Allington ◽  
Julius Klein ◽  
...  
Keyword(s):  
Upper Limb ◽  
Chronic Stroke ◽  
Corticospinal Excitability ◽  
Stroke Survivors ◽  
Robotic Training ◽  
Functional Gains

Effect of Shock Wave Therapy on Upper Limb Spasticity in Chronic Stroke

2010 ◽  
Vol 3 (2) ◽  
pp. 94
Author(s):  
Sang Hyun Kim ◽  
Hyun Seok ◽  
Sunwoo Kim
Keyword(s):  
Shock Wave ◽  
Upper Limb ◽  
Chronic Stroke ◽  
Shock Wave Therapy ◽  
Limb Spasticity

scholarly journals A Novel Wearable Device for Motor Recovery of Hand Function in Chronic Stroke Survivors

2020 ◽  
Vol 34 (7) ◽  
pp. 600-608
Author(s):  
Supriyo Choudhury ◽  
Ravi Singh ◽  
A. Shobhana ◽  
Dwaipayan Sen ◽  
Sidharth Shankar Anand ◽  
...  
Keyword(s):  
Upper Limb ◽  
Hand Function ◽  
Chronic Stroke ◽  
Wearable Device ◽  
Stroke Survivors ◽  
Limb Function ◽  
Median Baseline ◽  
Healthy Humans ◽  
Upper Limb Function ◽  
Wearable Electronic Device

Background. In monkey, reticulospinal connections to hand and forearm muscles are spontaneously strengthened following corticospinal lesions, likely contributing to recovery of function. In healthy humans, pairing auditory clicks with electrical stimulation of a muscle induces plastic changes in motor pathways (probably including the reticulospinal tract), with features reminiscent of spike-timing dependent plasticity. In this study, we tested whether pairing clicks with muscle stimulation could improve hand function in chronic stroke survivors. Methods. Clicks were delivered via a miniature earpiece; transcutaneous electrical stimuli at motor threshold targeted forearm extensor muscles. A wearable electronic device (WD) allowed patients to receive stimulation at home while performing normal daily activities. A total of 95 patients >6 months poststroke were randomized to 3 groups: WD with shock paired 12 ms before click; WD with clicks and shocks delivered independently; standard care. Those allocated to the device used it for at least 4 h/d, every day for 4 weeks. Upper-limb function was assessed at baseline and weeks 2, 4, and 8 using the Action Research Arm Test (ARAT), which has 4 subdomains (Grasp, Grip, Pinch, and Gross). Results. Severity across the 3 groups was comparable at baseline. Only the paired stimulation group showed significant improvement in total ARAT (median baseline: 7.5; week 8: 11.5; P = .019) and the Grasp subscore (median baseline: 1; week 8: 4; P = .004). Conclusion. A wearable device delivering paired clicks and shocks over 4 weeks can produce a small but significant improvement in upper-limb function in stroke survivors.

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