Upper limbs cranking for post-stroke rehabilitation: a pilot study on healthy subjects

Author(s):  
Elisa Digo ◽  
Stefano Pastorelli ◽  
Taian Vieira ◽  
Alberto Botter ◽  
Laura Gastaldi
2021 ◽  
Author(s):  
Yuchen Xu ◽  
Wai Sang Poon ◽  
Yongping Zheng ◽  
Shaomin Zhang ◽  
Xiaoling Hu

Medicina ◽  
2019 ◽  
Vol 55 (4) ◽  
pp. 98 ◽  
Author(s):  
Adomavičienė ◽  
Daunoravičienė ◽  
Kubilius ◽  
Varžaitytė ◽  
Raistenskis

Background: New technologies to improve post-stroke rehabilitation outcomes are of great interest and have a positive impact on functional, motor, and cognitive recovery. Identifying the most effective rehabilitation intervention is a recognized priority for stroke research and provides an opportunity to achieve a more desirable effect. Objective: The objective is to verify the effect of new technologies on motor outcomes of the upper limbs, functional state, and cognitive functions in post-stroke rehabilitation. Methods: Forty two post-stroke patients (8.69 ± 4.27 weeks after stroke onset) were involved in the experimental study during inpatient rehabilitation. Patients were randomly divided into two groups: conventional programs were combined with the Armeo Spring robot-assisted trainer (Armeo group; n = 17) and the Kinect-based system (Kinect group; n = 25). The duration of sessions with the new technological devices was 45 min/day (10 sessions in total). Functional recovery was compared among groups using the Functional Independence Measure (FIM), and upper limbs’ motor function recovery was compared using the Fugl–Meyer Assessment Upper Extremity (FMA-UE), Modified Ashworth Scale (MAS), Hand grip strength (dynamometry), Hand Tapping test (HTT), Box and Block Test (BBT), and kinematic measures (active Range Of Motion (ROM)), while cognitive functions were assessed by the MMSE (Mini-Mental State Examination), ACE-R (Addenbrooke’s Cognitive Examination-Revised), and HAD (Hospital Anxiety and Depression Scale) scores. Results: Functional independence did not show meaningful differences in scores between technologies (p > 0.05), though abilities of self-care were significantly higher after Kinect-based training (p < 0.05). The upper limbs’ kinematics demonstrated higher functional recovery after robot training: decreased muscle tone, improved shoulder and elbow ROMs, hand dexterity, and grip strength (p < 0.05). Besides, virtual reality games involve more arm rotation and performing wider movements. Both new technologies caused an increase in overall global cognitive changes, but visual constructive abilities (attention, memory, visuospatial abilities, and complex commands) were statistically higher after robotic therapy. Furthermore, decreased anxiety level was observed after virtual reality therapy (p < 0.05). Conclusions: Our study displays that even a short-term, two-week training program with new technologies had a positive effect and significantly recovered post-strokes functional level in self-care, upper limb motor ability (dexterity and movements, grip strength, kinematic data), visual constructive abilities (attention, memory, visuospatial abilities, and complex commands) and decreased anxiety level.


2021 ◽  
Vol 25 (3) ◽  
Author(s):  
Zuzanna Olszewska ◽  
Elżbieta Mirek ◽  
Kinga Opoka-Kubica ◽  
Szymon Pasiut Szymon Pasiut ◽  
Magdalena Filip

Introduction: Stroke is a serious health problem in the modern population. Spasticity is one of the consequences of stroke and affects about 30% of people. Increased muscle tone affects postural control disorders. Due to the specificity of spasticity, therapy in post-stroke patients is a challenge for neurological physiotherapy. Therefore, it requires the development of appropriate management standards . Study aim: The aim of the study was to evaluate the effectiveness of 3 combination therapy cycles based on botulinum toxin injection and physiotherapy for muscle tone, muscle strength and postural stability in post-stroke patients qualified for the spasticity treatment programme of the lower and upper limbs. Material and methods: The pilot study involved 12 patients (6 from the lower limb and 6 from the upper limb programme). The 1-year combination therapy programmes included 3 botulinum toxin injections and 3 weeks of physiotherapy after each injection. Clinical evaluation was conducted before and after the 1-year observation cycle. The results were evaluated using: MAS (Modified Ashworth Scale), MRC (Medical Research Council Scale) and posture stability test on a balance platform (BiodexSD). Results: A decrease was observed in muscle tone of the lower and upper limbs, as well as an increase in muscular strength of the upper limb. However, there were no noted statistical significance of the studied parameters. Conclusions: Physiotherapy in combination with the botulinum toxin is an important element of improvement in post-stroke patients. However, further research is needed to explicitly confirm its effectiveness.


2021 ◽  
Author(s):  
Gilles Dusfour ◽  
Denis Mottet ◽  
Makii Muthalib ◽  
Isabelle Laffont ◽  
Karima K.A. Bakhti

Abstract Background In post-stroke patients it is unclear which wrist actimetry biomarkers to use to estimate the degree of upper limb hemiparesis. The objective of this study was to develop a general and objective framework for monitoring hemiparetic patients in their home environment via different biomarkers based on 7 days of actimetry data. A secondary objective was to use all of these biomarkers to better understand the mechanism for potential non-use of the paretic upper limb. Methods Accelerometers were worn continuously for a period of 7 days on both wrists of 10 post-stroke hemiparetic patients as well as 6 healthy subjects. Various wrist actimetry biomarkers were calculated, including the Jerk ratio 50 (JR50, cumulative probability that the Jerk Ratio is between 0 and 0.5), absolute and relative amounts of functional use of movements of the upper limbs (FuncUse and FuncUseR) and absolute and relative velocities of the upper limbs during functional use (VUL and VULR). For each biomarker, the values of stroke and healthy groups were compared. The correlations between all the biomarkers were studied. Results We studied 10 participants with mild-to-moderate chronic hemiparesis and 6 healthy control participants. FuncUse and VUL of the paretic upper limb of stroke patients were significantly lower than in the non-dominant upper limb of healthy subjects. Similarly, FuncUseR (paretic/non-paretic vs non-dominant/dominant), JR and VULR are significantly lower in stroke patients than in healthy subjects. FuncUseR, VULR and JR50 seem to be complementary biomarkers for monitoring patient strokes. Conclusion The stroke patients do not seem to compensate for the decrease in functional movement on the paretic side by an increase on the non-paretic side. The speed of execution of functional movements on the paretic side could be the limiting factor to a normal use of the paretic upper limb. A thorough clinical study is needed to identify the limiting factors. In conclusion, this study for the first time has shown actimetry is a robust and non-obtrusive lightweight technology for continuously acquiring objective upper limb data of paretic arm use/ non-use over an extended period in a home environment for monitoring stroke patients.


Author(s):  
Jenifer Miehlbradt ◽  
Camilla Pierella ◽  
Nawal Kinany ◽  
Martina Coscia ◽  
Elvira Pirondini ◽  
...  

2021 ◽  
pp. jnnp-2021-326948
Author(s):  
Belén Rubio Ballester ◽  
Nick S Ward ◽  
Fran Brander ◽  
Martina Maier ◽  
Kate Kelly ◽  
...  

2021 ◽  
pp. 1-10
Author(s):  
Douglas Rafael da Rosa Pinheiro ◽  
Maria Eduarda Parcianello Cabeleira ◽  
Luigi Antonio da Campo ◽  
Laís Andrielli Ferreira Gattino ◽  
Kellen Sábio de Souza ◽  
...  

BACKGROUND: Studies demonstrate the benefits of upper limbs cycle ergometer (ULCE) in subacute and chronic stroke subjects, but the literature still needs to explore the acute phase of the disease. OBJECTIVE: Verify the effects of ULCE on muscular strength, trunk control and independence of post-stroke subjects in hospital acute phase. METHODS: In this randomized clinical trial participants were allocated into two groups. The control group (CG) performed two daily sessions of conventional physiotherapy, while the intervention group (IG) had one daily session of conventional physiotherapy and one of ULCE. The interventions were carried out for 20 minutes for five days. Both groups were assessed before and after the treatment for upper limbs strength by manual dynamometer, trunk control by Trunk Impairment Scale and level of independence by the Modified Rankin Scale. RESULTS: Twenty subjects with mean ages of 63.5±4.5 were enrolled. There was a significant intra-group difference of palmar grip, shoulder abductors, elbow flexor and wrist extensor strength, trunk control and functional independence only in IG. Inter-group difference for all variables showed superiority in IG. CONCLUSIONS: ULCE is an effective device for increasing muscle strength, trunk control and consequently improving the independence of post-stroke subjects in the acute hospital phase.


2014 ◽  
Vol 125 ◽  
pp. S145
Author(s):  
R. Chieffo ◽  
F. Ferrari ◽  
P. Battista ◽  
E. Houdayer ◽  
A. Nuara ◽  
...  

2013 ◽  
Vol 27 (2) ◽  
pp. 31-38 ◽  
Author(s):  
Marta Sidaway ◽  
Edyta Czernicka ◽  
Arkadiusz Sosnowski

StreszczenieNeuroplastyczność jest zjawiskiem powszechnym w działaniu układu nerwowego, a samoistne i spontaniczne zdrowienie jest normą we wczesnym okresie poudarowym. Zmiany plastyczne leżą u podstaw przywracania funkcji po uszkodzeniu mózgu. Reprezentacje czuciowe i ruchowe pól korowych mogą być modyfikowane przez dopływ bodźców ze środowiska. Odpowiednio dobrane strategie postępowania fizjoterapeutycznego mają wpływ na spontaniczną neuroplastyczność. Przedstawiono podstawowe założenia działań terapeutycznych mających korzystny wpływ, na omawiane zjawisko reorganizacji układu nerwowego oraz uczenia się kontekstualnego, szczególnie w odniesieniu do zagadnienia Terapii Ruchem Wymuszonym Koniecznością. Opisano protokół Tauba dotyczący tej terapii oraz stanowiący jej podwalinę zespół wyuczonego nieużywania. Przybliżono zagadnienie shapingu i praktyki zadaniowej (ćwiczeń zadaniowych). Głównym celem opisywanej terapii jest przywrócenie spontanicznego i automatycznego wykorzystania kończyny niedowładnej w czynnościach dnia codziennego.Na zjawisko plastyczności istotny wpływ mają: wzbogacone środowisko, odległość czasu od zachorowania, liczba powtórzeń zadań ruchowych oraz znajomość wykonywanych czynności co potwierdzają dowody naukowe.Prawidłowo prowadzona terapia pozwala przenieść osiągnięte umiejętności poza ściany kliniki i przyczynia się do funkcjonalnej niezależności pacjentów.


Sign in / Sign up

Export Citation Format

Share Document