Task Oriented Training Activities Post Stroke Will Produce Measurable Alterations in Brain Plasticity Concurrent with Skill Improvement

2021 ◽  
pp. 1-14
Author(s):  
Somchanok Rungseethanakul ◽  
Jarugool Tretriluxana ◽  
Pagamas Piriyaprasarth ◽  
Narawut Pakaprot ◽  
Khanitha Jitaree ◽  
...  
Keyword(s):  
Brain Plasticity ◽  
Post Stroke ◽  
Training Activities ◽  
Skill Improvement ◽  
Task Oriented

Sequentially applied myoelectrically controlled FES in a task-oriented approach and robotic therapy for the recovery of upper limb in post-stroke patients: A randomized controlled pilot study

2020 ◽  
pp. 1-11
Author(s):  
Gloria Perini ◽  
Rita Bertoni ◽  
Rune Thorsen ◽  
Ilaria Carpinella ◽  
Tiziana Lencioni ◽  
...  
Keyword(s):  
Upper Limb ◽  
Standard Care ◽  
Experimental Treatment ◽  
Stroke Patients ◽  
Rehabilitation Care ◽  
Post Stroke ◽  
Robotic Therapy ◽  
Arm Rehabilitation ◽  
Point Increase ◽  
Task Oriented

BACKGROUND: Functional recovery of the plegic upper limb in post-stroke patients may be enhanced by sequentially applying a myoelectrically controlled FES (MeCFES), which allows the patient to voluntarily control the muscle contraction during a functional movement and robotic therapy which allows many repetitions of movements. OBJECTIVE: Evaluate the efficacy of MeCFES followed by robotic therapy compared to standard care arm rehabilitation for post-stroke patients. METHODS: Eighteen stroke subjects (onset ⩾ 3 months, age 60.1 ± 15.5) were recruited and randomized to receive an experimental combination of MeCFES during task-oriented reaching followed by robot therapy (MRG) or same intensity conventional rehabilitation care (CG) aimed at the recovery of the upper limb (20 sessions/45 minutes). Change was evaluated through Fugl-Meyer upperextremity (FMA-UE), Reaching Performance Scale and Box and Block Test. RESULTS: The experimental treatment resulted in higher improvement on the FMA-UE compared with CG (P= 0.04), with a 10 point increase following intervention. Effect sizes were moderate in favor of the MRG group on FMA-UE, FMA-UE proximal and RPS (0.37–0.56). CONCLUSIONS: Preliminary findings indicate that a combination of MeCFES and robotic treatment may be more effective than standard care for recovery of the plegic arm in persons > 3 months after stroke. The mix of motor learning techniques may be important for successful rehabilitation of arm function.

scholarly journals Feasibility of a specific task-oriented training versus its combination with manual therapy on balance and mobility in people post stroke at the chronic stage: study protocol for a pilot randomised controlled trial

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kristina Traxler ◽  
Franz Schinabeck ◽  
Eva Baum ◽  
Edith Klotz ◽  
Barbara Seebacher
Keyword(s):  
Randomised Controlled Trial ◽  
Ankle Joint ◽  
Manual Therapy ◽  
Controlled Trial ◽  
Daily Activities ◽  
Control Group ◽  
Chronic Stage ◽  
Post Stroke ◽  
Randomised Controlled ◽  
Task Oriented

Abstract Background Large studies have shown that stroke is among the most relevant causes of acquired adult disability. Walking and balance impairment in stroke survivors often contribute to a restriction in daily activities and social participation. Task-oriented training (TOT) is an effective treatment strategy and manual therapy (MT) is used successfully to enhance ankle joint flexibility in this population. No study, however, has compared TOT against its combination with MT in a randomised controlled trial. Aims of this pilot study are therefore to explore the feasibility of a full-scale RCT using predefined feasibility criteria. Secondary aims are to explore the preliminary effects of specific TOT with a combined specific TOT-MT versus a control group in people post stroke. Methods This is a protocol of a 4-week prospective randomised controlled parallel pilot trial in people post stroke at the chronic stage with limited upper ankle joint mobility and an impairment in balance and mobility. At a German outpatient therapy centre using 1:1:1 allocation, 36 patients will be randomised into one of three groups: 15-min talocrural joint MT plus 30-min specific TOT (group A), 45-min specific TOT (group B), and controls (group C). Training will be goal-oriented including tasks that are based on daily activities and increased in difficulty utilising predefined progression criteria based on patients’ skill levels. Interventions will be provided face-to-face 2 times per week, for 4 weeks, in addition to 20-min concurrent x4 weekly home-based training sessions. Data will be collected by blinded assessors at baseline, post-intervention and 4-week follow-up. The primary outcome will be feasibility assessed by recruitment, retention and adherence rates, compliance, adverse events, falls and the acceptability of the intervention. Secondary outcomes will be walking speed, single and dual tasking functional mobility, ankle range of motion, disability and health-related quality of life. Discussion Feasibility provided, results from this study will be used to calculate the sample size of a larger randomised controlled trial to investigate the effects of specific TOT and specific TOT-MT compared to a post stroke control group. Trial registration German Clinical Trials Register, DRKS00023068. Registered on 21.09.2020, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023068.

scholarly journals Effects of a specific task-oriented training versus its combination with manual therapy on balance and mobility in people post stroke at the chronic stage: study protocol for a pilot randomised controlled trial

2020 ◽  
Author(s):  
Kristina Traxler ◽  
Franz Schinabeck ◽  
Eva Baum ◽  
Edith Klotz ◽  
Barbara Seebacher
Keyword(s):  
Randomised Controlled Trial ◽  
Ankle Joint ◽  
Manual Therapy ◽  
Controlled Trial ◽  
Daily Activities ◽  
Control Group ◽  
Chronic Stage ◽  
Post Stroke ◽  
Randomised Controlled ◽  
Task Oriented

Abstract Background: Large studies have shown that stroke is among the most relevant causes of acquired adult disability. Walking and balance impairment in stroke survivors often contribute to a restriction in daily activities and social participation. Task-oriented training (TOT) is an effective treatment strategy and manual therapy (MT) is used successfully to enhance ankle joint flexibility in this population. No study, however, has compared TOT against its combination with MT in a randomised controlled trial. Aims of this pilot study are therefore to explore the feasibility of a full-scale RCT and the preliminary effects of specific TOT with a combined specific TOT-MT versus a control group in people post stroke.Methods: This is a protocol of a 4-week prospective randomised controlled parallel pilot trial in people post stroke at the chronic stage with limited upper ankle joint mobility and an impairment in balance and mobility. At a German outpatient therapy centre using 1:1:1 allocation, 36 patients will be randomised into one of three groups: 15-minute talocrural joint MT plus 30-minute specific TOT (Group A); 45-minute specific TOT (Group B); controls (Group C). Training will be goal-oriented including tasks that are based on daily activities and increased in difficulty ulilising predefined progression criteria. Interventions will be provided face-to-face 2 times per week, for 4 weeks, in addition to 20-minute concurrent x4 weekly homebased training sessions. Data will be collected by blinded assessors at baseline, post-intervention and 4-week follow-up. The primary outcome will be feasibility assessed by recruitment, retention and adherence rates, compliance, adverse events, falls and the acceptability of the intervention. Secondary outcomes will be walking speed, single and dual tasking functional mobility, ankle range of motion, disability and health-related quality of life.Discussion: Results from this study will inform a larger randomised controlled trial to investigate the effects of specific TOT and specific TOT-MT compared to a post stroke control group. We hope that the study findings help to enhance stroke rehabilitation.Trial registration: German Clinical Trials Register, DRKS00023068. Registered on 21.09.2020, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023068.

Abstract WP156: Therapy-related Structural Plasticity Of Temporal White Matter Is Related To Naming Recovery In Aphasia

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Emilie McKinnon ◽  
Russell Glenn ◽  
Ashley Wabnitz ◽  
Jens Jensen ◽  
Joseph Helpern ◽  
...  
Keyword(s):  
Language Production ◽  
Speech Therapy ◽  
Clinical Performance ◽  
Brain Plasticity ◽  
Mean Diffusivity ◽  
Contralateral Side ◽  
Post Stroke ◽  
Aphasia Therapy ◽  
The Usa ◽  
Semantic Errors

Stroke is the leading cause of adult disability in the USA and aphasia is a common consequence of dominant-hemispheric strokes. It is unclear why some recover with speech therapy, while others persist with debilitating deficits. One theory suggests that therapy-related brain plasticity provides the anatomical substrate for improvements in language. In this longitudinal study, we assessed the integrity of the ipsi- and contralateral inferior longitudinal fasciculus (ILF) using diffusional kurtosis MRI (DKI), and examined its relationship with aphasia-therapy related changes in semantic errors. 8 subjects (age = 52.0±7.2y; 62% male; MRI time post-stroke = 50.25±29.8m) with chronic post-stroke aphasia received Language Action Therapy for a period of 3 weeks. Structural images (T1 & T2) and DKI (30 directions, b= [1000, 2000 s/mm 2 ]) were acquired. We applied an innovative form of tractography using Diffusion Kurtosis Estimator and a WM mask as a seeding region. Lastly, we optimized the automated fiber quantification software to acquire along-tract diffusion measurements resulting in 100 nodal mean kurtosis (MK), mean diffusivity (MD) and fractional anisotropy (FA) measurements along major tracts. Compared to the contralateral side, the ipsilateral ILF shows diffusion characteristics often found in damaged neuronal tissue: high MD, low FA, and low MK (figure1). The variability is larger on the ipsilateral side, and lowest MK correlated significantly with an increase in semantic errors (r=-0.84, p<0.05). None of the associations with FA and MD reached significance. Additionally, a therapy related reduction in semantic errors was associated with a longitudinal increase in MK (r=-0.89, p<0.05). In conclusion, ILF integrity captured using MK relates to clinical performance with lower MK predicting worse semantic language production, whereas therapy related increases in microstructural complexity (higher MK) were associated with a decrease in semantic errors.

scholarly journals Arm rehabilitation in post stroke subjects: A randomized controlled trial on the efficacy of myoelectrically driven FES applied in a task-oriented approach

PLoS ONE ◽  
2017 ◽  
Vol 12 (12) ◽  
pp. e0188642 ◽  
Author(s):  
Johanna Jonsdottir ◽  
Rune Thorsen ◽  
Irene Aprile ◽  
Silvia Galeri ◽  
Giovanna Spannocchi ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Post Stroke ◽  
Randomized Controlled ◽  
Arm Rehabilitation ◽  
Task Oriented ◽  
Oriented Approach

scholarly journals Application of Technologies Robotic Rehabilitation in Children with Upper Limb Injury

2021 ◽  
Vol 1 (4) ◽  
pp. 1-5
Author(s):  
Dr. Madhu Yadav* ◽  
Keyword(s):  
Brain Plasticity ◽  
Quantitative Information ◽  
The Other ◽  
Advanced Technology ◽  
Hand Movements ◽  
Robotic Rehabilitation ◽  
Limb Injury ◽  
Reach And Grasp ◽  
Opening And Closing ◽  
Task Oriented

Robotic and advanced technology rehabilitation is useful for people with difficulties and deficits in arm and hand movements, walking problems and balance disorders. Robotic technologies are being introduced in the rehabilitation field to support the activity of specialists, doctors and physiotherapists; the future and the challenge of rehabilitation lies precisely in the development of robotics. Robot assists the therapist in administering the most appropriate motor therapy with precision and repeatability modulates the difficulty of the exercise. It allows repetitive task-oriented activities with augmentative feedback capable of inducing brain plasticity. It acquires quantitative information on movement and evaluates the services performed he first, “Arm and Hand”, is used to help the opening and closing movements of the hand. After entering it by hand and forearm, gently guides the patient's shoulder and elbow movements to reach and grasp objects. “Wrist”, on the other hand, interacts with the movements of the wrist and integrates functionally with the “Hand” module.

Sign in / Sign up

Export Citation Format

Share Document