Motor Recovery and Cortical Reorganization After Mirror Therapy in Chronic Stroke Patients

2010 ◽  
Vol 25 (3) ◽  
pp. 223-233 ◽  
Author(s):  
Marian E. Michielsen ◽  
Ruud W. Selles ◽  
Jos N. van der Geest ◽  
Martine Eckhardt ◽  
Gunes Yavuzer ◽  
...  
Keyword(s):  
Chronic Stroke ◽  
Motor Recovery ◽  
Cortical Reorganization ◽  
Mirror Therapy ◽  
Stroke Patients

scholarly journals 2190 Longitudinal changes in EEG power envelope connectivity are proportional to motor recovery in chronic stroke patients

2018 ◽  
Vol 2 (S1) ◽  
pp. 17-17
Author(s):  
Joseph B. Humphries ◽  
David T. Bundy ◽  
Eric C. Leuthardt ◽  
Thy N. Huskey
Keyword(s):  
Motor Cortex ◽  
Motor Imagery ◽  
Stroke Rehabilitation ◽  
Brain Computer Interface ◽  
Chronic Stroke ◽  
Motor Recovery ◽  
Stroke Recovery ◽  
Computer Interface ◽  
Beta Band ◽  
Stroke Patients

OBJECTIVES/SPECIFIC AIMS: The objective of this study is to determine the degree to which the use of a contralesionally-controlled brain-computer interface for stroke rehabilitation drives change in interhemispheric motor cortical activity. METHODS/STUDY POPULATION: Ten chronic stroke patients were trained in the use of a brain-computer interface device for stroke recovery. Patients perform motor imagery to control the opening and closing of a motorized hand orthosis. This device was sent home with patients for 12 weeks, and patients were asked to use the device 1 hour per day, 5 days per week. The Action Research Arm Test (ARAT) was performed at 2-week intervals to assess motor function improvement. Before the active motor imagery task, patients were asked to quietly rest for 90 seconds before the task to calibrate recording equipment. EEG signals were acquired from 2 electrodes—one each centered over left and right primary motor cortex. Signals were preprocessed with a 60 Hz notch filter for environmental noise and referenced to the common average. Power envelopes for 1 Hz frequency bands (1–30 Hz) were calculated through Gabor wavelet convolution. Correlations between electrodes were then calculated for each frequency envelope on the first and last 5 runs, thus generating one correlation value per subject, per run. The chosen runs approximately correspond to the first and last week of device usage. These correlations were Fisher Z-transformed for comparison. The first and last 5 run correlations were averaged separately to estimate baseline and final correlation values. A difference was then calculated between these averages to determine correlation change for each frequency. The relationship between beta-band correlation changes (13–30 Hz) and the change in ARAT score was determined by calculating a Pearson correlation. RESULTS/ANTICIPATED RESULTS: Beta-band inter-electrode correlations tended to decrease more in patients achieving greater motor recovery (Pearson’s r=−0.68, p=0.031). A similar but less dramatic effect was observed with alpha-band (8–12 Hz) correlation changes (Pearson’s r=−0.42, p=0.22). DISCUSSION/SIGNIFICANCE OF IMPACT: The negative correlation between inter-electrode power envelope correlations in the beta frequency band and motor recovery indicates that activity in the motor cortex on each hemisphere may become more independent during recovery. The role of the unaffected hemisphere in stroke recovery is currently under debate; there is conflicting evidence regarding whether it supports or inhibits the lesioned hemisphere. These findings may support the notion of interhemispheric inhibition, as we observe less in common between activity in the 2 hemispheres in patients successfully achieving recovery. Future neuroimaging studies with greater spatial resolution than available with EEG will shed further light on changes in interhemispheric communication that occur during stroke rehabilitation.

Cortical reorganization associated with motor recovery in hemiparetic stroke patients

Neuroreport ◽  
2003 ◽  
Vol 14 (10) ◽  
pp. 1305-1310 ◽  
Author(s):  
Sung Ho Jang ◽  
Yun-Hee Kim ◽  
Sang-Hyun Cho ◽  
Yongmin Chang ◽  
Zee In Lee ◽  
...  
Keyword(s):  
Motor Recovery ◽  
Cortical Reorganization ◽  
Stroke Patients ◽  
Hemiparetic Stroke

CLINICAL USE OF FUNCTIONAL ELECTRICAL STIMULATION FOR CORRECTION OF FOOT DROP: A COMPARISON BETWEEN SUBACUTE AND CHRONIC STROKE PATIENTS

2011 ◽  
Vol 11 (05) ◽  
pp. 1165-1177 ◽  
Author(s):  
SUKANTA K. SABUT ◽  
CHHANDA SIKDAR ◽  
RATNESH KUMAR ◽  
MANJUNATHA MAHADEVAPPA
Keyword(s):  
Electrical Stimulation ◽  
Lower Extremity ◽  
Functional Electrical Stimulation ◽  
Rehabilitation Program ◽  
Chronic Stroke ◽  
Motor Recovery ◽  
Calf Muscle ◽  
Foot Drop ◽  
Stroke Patients ◽  
Muscle Spasticity

Functional electrical stimulation (FES) allows active exercises for correction of foot drop in stroke patients. Our objective is to evaluate and compare the effects of FES therapy in walking ability, calf muscle spasticity, and lower-extremity motor recovery between subacute and chronic stroke patients. Twenty consecutive hemiplegic patients having foot drop were assigned either to subacute or chronic group. Both group subjects were treated with conventional rehabilitation program combined with FES therapy for 12 weeks. All subjects received the electrical stimulation to the peroneal nerve of paretic limb for 15–30 min while walking.After being treated with FES-based rehabilitation program, subacute subjects showed a mean increase in walking speed of 31.3% and chronic subjects of 19.1% and the physiological cost index (PCI), with a reduction of 66.7% in subacute subjects and 46.4% in chronic subjects between the beginning and end of the trial. Improvement was also measured in gait parameters such as cadence, step and stride lengths, ankle joint range of motion (ROM), calf muscle spasticity, and lower-extremity motor recovery assessed by Fugl-Meyer score in both group subjects, but subacute subjects improved better compared with chronic subjects. In conclusion, early and intensive interventions of FES therapy combine with conventional rehabilitation program could significantly improve the waking ability and recovery of lower-extremity motor functions in stroke survivors.

Cerebellar Theta-Burst Stimulation Combined With Physiotherapy in Subacute and Chronic Stroke Patients: A Pilot Randomized Controlled Trial

2020 ◽  
Vol 35 (1) ◽  
pp. 23-32
Author(s):  
Ling-Yi Liao ◽  
Yun-Juan Xie ◽  
Yi Chen ◽  
Qiang Gao
Keyword(s):  
Sham Group ◽  
Low Cost ◽  
Controlled Trial ◽  
Chronic Stroke ◽  
Motor Recovery ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Stroke Patients ◽  
Clinical Trial Registry ◽  
Theta Burst

Background Intermittent theta-burst stimulation (iTBS) has been suggested to improve poststroke rehabilitation. The cerebellum is considered crucial for motor control. However, the effects of cerebellar iTBS with routine physical therapy on balance and motor recovery in subacute and chronic stroke patients have not been explored. Objective To measure the short-term effects of cerebellar iTBS with physiotherapy on the balance and functional outcomes in subacute and chronic stroke patients with hemiparesis. Methods Thirty hemiparetic patients were recruited for this randomized, double-blinded, sham-controlled trial, and randomized into either the treatment or sham group. Both groups participated in physiotherapy 5 times per week for 2 weeks, and cerebellar iTBS or sham iTBS was performed daily, immediately before physiotherapy. The primary outcome was the Berg balance scale (BBS) score. Secondary outcomes included the trunk impairment scale (TIS) score, Fugl-Meyer assessment scale score for lower extremities (FMA-LE), Barthel index (BI), and corticospinal excitability, as measured by transcranial magnetic stimulation. The outcomes were measured before and 1 week and 2 weeks after the intervention. Results Compared with those at baseline, significant increases were identified in all clinical scores (BBS, TIS, FMA-LE, and BI) in both groups after the 2-week intervention. The BBS and TIS scores improved more in the iTBS group than in the sham group. Conclusions Cerebellar iTBS with physiotherapy promotes balance and motor recovery in poststroke patients. Therefore, this method can be used in low-cost, fast, and efficient protocols for stroke rehabilitation (Chinese Clinical Trial Registry: ChiCTR1900026450).

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