Brain-Machine Interface in Chronic Stroke: Randomized Trial Long-Term Follow-up

Background. Brain-machine interfaces (BMIs) have been recently proposed as a new tool to induce functional recovery in stroke patients. Objective. Here we evaluated long-term effects of BMI training and physiotherapy in motor function of severely paralyzed chronic stroke patients 6 months after intervention. Methods. A total of 30 chronic stroke patients with severe hand paresis from our previous study were invited, and 28 underwent follow-up assessments. BMI training included voluntary desynchronization of ipsilesional EEG-sensorimotor rhythms triggering paretic upper-limb movements via robotic orthoses (experimental group, n = 16) or random orthoses movements (sham group, n = 12). Both groups received identical physiotherapy following BMI sessions and a home-based training program after intervention. Upper-limb motor assessment scores, electromyography (EMG), and functional magnetic resonance imaging (fMRI) were assessed before (Pre), immediately after (Post1), and 6 months after intervention (Post2). Results. The experimental group presented with upper-limb Fugl-Meyer assessment (cFMA) scores significantly higher in Post2 (13.44 ± 1.96) as compared with the Pre session (11.16 ± 1.73; P = .015) and no significant changes between Post1 and Post2 sessions. The Sham group showed no significant changes on cFMA scores. Ashworth scores and EMG activity in both groups increased from Post1 to Post2. Moreover, fMRI-BOLD laterality index showed no significant difference from Pre or Post1 to Post2 sessions. Conclusions. BMI-based rehabilitation promotes long-lasting improvements in motor function of chronic stroke patients with severe paresis and represents a promising strategy in severe stroke neurorehabilitation.

Download Full-text

Training and assessment of upper limb motor function with a robotic exoskeleton in chronic stroke patients

Gait & Posture ◽

10.1016/j.gaitpost.2014.05.055 ◽

2014 ◽

Vol 40 ◽

pp. S27-S28 ◽

Cited By ~ 3

Author(s):

C. Chisari ◽

A. Frisoli ◽

E. Sotgiu ◽

C. Procopio ◽

F. Bertolucci ◽

...

Keyword(s):

Motor Function ◽

Upper Limb ◽

Chronic Stroke ◽

Stroke Patients ◽

Robotic Exoskeleton

Download Full-text

A Comparative Study on the Effect of Task Specific Training on Right Versus Left Chronic Stroke Patients

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17217950 ◽

2020 ◽

Vol 17 (21) ◽

pp. 7950

Author(s):

Reem M. Alwhaibi ◽

Noha F. Mahmoud ◽

Hoda M. Zakaria ◽

Wanees M. Badawy ◽

Mahmoud Y. Elzanaty ◽

...

Keyword(s):

Left Hemisphere ◽

Motor Function ◽

Upper Limb ◽

Right Hemisphere ◽

Service Providers ◽

Post Treatment ◽

Specific Training ◽

Stroke Patients ◽

Significant Difference ◽

Brain Reorganization

Functional impairment of the upper limb (UL) after stroke is a great problem. Finding methods that can improve UL function after stroke is a major concern to all medical service providers. This study was intended to compare the effect of upper limb task specific training (TST) on brain excitability of the affected hemisphere and motor function improvements in patients with left and right stroke. Forty male patients with mild impairment of UL functions were divided into two equal groups; G1 consisted of patients with left hemisphere affection (right side stroke) while G2 consisted of patients with right hemisphere affection (left side stroke). All patients received TST for the affected UL for one hour, three sessions per week for six consecutive weeks. Evaluation was performed twice, pre-, and post-treatment. Outcome measures used were Wolf Motor Function Test (WMFT) and Box and Block Test (BBT) as measures of UL motor function and Quantitative Electroencephalogram (QEEG) of motor and sensory areas of the affected hemisphere as a measure of brain reorganization post-stroke. Both groups showed improvement in motor function of the affected UL measured by WMFT and BBT with reported significant difference between them. G1 showed greater improvement in motor function of the affected UL post-treatment compared to G2. Additionally, there was a significant increase in peak frequency of motor and sensory areas with higher and significant excitability in G1 only. These findings imply that brain reorganization in the left hemisphere responded more to TST compared to the right hemisphere. Based on findings of the current study, we can recommend adding TST to the physical therapy program in stroke patients with left hemisphere lesions.

Download Full-text

Improvement of Hand Motor Function after Radial Shock Wave Therapy in Chronic Stroke Patients

Indonesian Journal of Physical Medicine & Rehabilitation ◽

10.36803/2621-7678.07(1).01 ◽

2018 ◽

pp. 2-12

Author(s):

M Kamaluddin ◽

Erna Setiawati ◽

Tanti Ajoe Kesoema

Keyword(s):

Shock Wave ◽

Motor Function ◽

Controlled Trial ◽

Hand Function ◽

Chronic Stroke ◽

Control Group ◽

Shock Wave Therapy ◽

Stroke Patients ◽

And Control ◽

Experimental Group

Introduction: The Radial Shock Wave Therapy (RSWT) expected could improve spasticity and hand function in chronic stroke patients. This study aimed to find out the improvement of hand function after RSWT as an additional therapy in chronic stroke patients. Methods: Design study was a randomized controlled trial. The patients were assigned randomly to the experimental group (Infrared, Stretching, and RSWT) and control group (Infrared and Stretching) for six weeks. Hand motor function was measured using Fugl-Meyer Motor Assesment (FMA) before and after intervention. Conclusion: There were improvement of wrist and hand FMA scores in the experimental as well as control group Results: Median of wrist FMA scores in the experimental and control group before intervention were 2 and 3 respectively whereas median of wrist FMA scores in the experimental and control group after intervention were 5 and 4 respectively. Median of hand FMA scores in the experimental and control group before intervention were 4 and 4 respectively whereas median of hand FMA scores in the control and experimental group after intervention were 6 and 5 respectively. The scores of wrist- hand FMA in the control and experimental group after intervention were increased P = 0.001P < 0.001 (wrist) and P = 0.001 P < 0.001 (hand) respectively. However, difference increased of wrist and hand FMA scores in the experimental group after intervention were more significant. Keywords: Spasticity, Hand Function, Stroke, Radial Shock Therapy, Fugl-Meyer Motor Assesment

Download Full-text

Improvement of Hand Motor Function after Radial Shock Wave Therapy in Chronic Stroke Patients

Indonesian Journal of Physical Medicine & Rehabilitation ◽

10.36803/2019.ikfr.07(1).01 ◽

2019 ◽

pp. 2-12

Author(s):

M. Kamaluddin K ◽

Erna Setiawati ◽

Tanti Ajoe Kesoema

Keyword(s):

Shock Wave ◽

Motor Function ◽

Hand Function ◽

Chronic Stroke ◽

Control Group ◽

Shock Wave Therapy ◽

Stroke Patients ◽

Before And After ◽

And Control ◽

Experimental Group

IIntroduction: The Radial Shock Wave Therapy (RSWT) expected could improve spasticity and hand function in chronic stroke patients. This study aimed to find out the improvement of hand function after RSWT as an additional therapy in chronic stroke patients. Methods: Design study was a randomized controlled trial, in December 2018. The patients were assigned randomly to the experimental group (Infrared, Stretching, and RSWT) and control group (Infrared and Stretching) for six weeks. Hand motor function was measured using Fugl-Meyer Motor Assesment (FMA) before and after intervention. Results: The median values of wrist FMA scores in the experimental and control group before and after intervention were 2 vs 5 (p=0.001) and 3 vs 4 (p<0.001) respectively. The median values of hand FMA scores in the experimental and control group before and intervention were 4 vs 6 (p=0,.001) and 4 vs 5 (p<0.001). However, the delta between before and after intervention was higher in experimental group. Conclusion: The improvement of wrist and hand FMA scores after added treatment by RSWT was tend to higher.Keywords: Spasticity, Hand Function, Stroke, Radial Shock Therapy, Fugl-Meyer Motor Assesment

Download Full-text

A neurorehabilitation therapy based on a brain machine interface (BMI) for the motor function restoration of the upper limb in chronic stroke patients.

http://isrctn.com/ ◽

10.1186/isrctn10150672 ◽

2015 ◽

Author(s):

Ander Ramos-Murguialday

Keyword(s):

Motor Function ◽

Upper Limb ◽

Chronic Stroke ◽

Brain Machine Interface ◽

Stroke Patients ◽

Machine Interface

Download Full-text

A Long-Term Follow-Up Programme for Maintenance of Motor Function after Stroke: Protocol of the life after Stroke—The LAST Study

Stroke Research and Treatment ◽

10.1155/2012/392101 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Torunn Askim ◽

Birgitta Langhammer ◽

Hege Ihle-Hansen ◽

Jon Magnussen ◽

Torgeir Engstad ◽

...

Keyword(s):

Motor Function ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Stroke Severity ◽

Stroke Patients ◽

Long Term Follow Up ◽

Randomised Controlled

Background. There are no evidence-based strategies that have been shown to be superior in maintaining motor function for months to years after the stroke. The LAST study therefore intends to assess the effect of a long-term follow-up program for stroke patients compared to standard care on function, disability and health.Design. This is a prospective, multi-site randomised controlled trial, with blinded assessment 18 months after inclusion. A total of 390 patients will be recruited and randomised to a control group, receiving usual care, or to an intervention group 10 to 16 weeks after onset of stroke. Patients will be stratified according to stroke severity, age above 80, and recruitment site. The intervention group will receive monthly coaching on physical activity by a physiotherapist for 18 consecutive months after inclusion.Outcomes. The primary outcome is motor function (Motor Assessment Scale) 18 months after inclusion. Secondary outcomes are: dependency, balance, endurance, health-related quality of life, fatigue, anxiety and depression, cognitive function, burden on caregivers, and health costs. Adverse events and compliance to the intervention will be registered consecutively during follow-up.

Download Full-text

Improvement of Hand Motor Function after Radial Shock Wave Therapy in Chronic Stroke Patients

Indonesian Journal of Physical Medicine & Rehabilitation ◽

10.36803/ijpmr.v7i01.115 ◽

2018 ◽

Vol 7 (01) ◽

pp. 2

Author(s):

M. Kamaluddin K ◽

Erna Setiawati ◽

Tanti Ajoe Kesoema

Keyword(s):

Shock Wave ◽

Motor Function ◽

Hand Function ◽

Chronic Stroke ◽

Control Group ◽

Shock Wave Therapy ◽

Stroke Patients ◽

Before And After ◽

And Control ◽

Experimental Group

Download Full-text

COMPARISON OF MIRROR THERAPY AND MOTOR RELEARNING PROGRAM IN IMPROVING THE UPPER LIMB MOTOR FUNCTION OF PATIENTS WITH STROKE

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i4.6249 ◽

2021 ◽

Vol 71 (4) ◽

pp. 1364-67

Author(s):

Rabia Rauf ◽

Abdul Rashad ◽

Alisha Noreen ◽

Rabia Intikhab ◽

Tehreem Anis Suleman ◽

...

Keyword(s):

Motor Function ◽

Upper Limb ◽

Group Analysis ◽

Mirror Therapy ◽

Stroke Patients ◽

Significant Difference ◽

Registration Number ◽

Group A ◽

Group B ◽

Post Assessment

Objective: To compare the effectiveness of mirror therapy and motor relearning program for improving the upper limb motor function in stroke patients. Study Design: A randomized control trial with registration number IRCT20200316046791N1 (IRCT). Place and Duration of Study: Al-Noor Hospital and Al Jannat Medicare, Rahim Yar Khan Pakistan, from Jan to Jul 2020. Methodology: Sample size consisted of 30 patients recruited by convenient sampling. Patients were randomized into two groups. Both groups received 5 sessions a week for 6 weeks. Group A received Motor Relearning Program while the treatment of group B was Mirror Therapy. Motor part of Fugl Meyer Assessment was used as an outcome measure. Non parametric Friedman test was used for within group analysis, while for between group analyses Karuskal-Wallis test was used. Results: The total participants who suffer from left hemiplegia were 22 whereas the patients having right hemiplegia were 8. The mean age of participants in both groups was 53.80 ± 7.6 group A median (interquartile range) at pre-assessment was 5.00 (3) at mid-assessment median=15.00 (4) while at post assessment median was 25.00 (6). Group B median at baseline was 6.00 (4), at mid-assessment median=14.00 (9), post assessment median was 17.00 (13). Mid and post assessment comparison showed both treatments improved the motor function. Statistically the results were non-significant (p>0.005). Both treatments improved the motor function in stroke patients. Conclusion: There is no significant difference between the effectiveness of Mirror Therapy and Motor relearning program in improving the upper limb motor function of stroke patients.

Download Full-text

Long-term Effectiveness and Adoption of a Cellphone Augmented Reality System for Stroke Rehabilitation: Randomized Controlled Trial (Preprint)

10.2196/preprints.30184 ◽

2021 ◽

Author(s):

Jie Jia ◽

Chong Li ◽

Xinyu Song ◽

Shugeng Chen ◽

Chuankai Wang ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Motor Function ◽

Controlled Trial ◽

Control Group ◽

Stroke Patients ◽

Randomized Controlled ◽

Augmented Reality System ◽

Home Based ◽

Experimental Group

BACKGROUND A serious game-based Cellphone Augmented Reality System (CARS) was developed for rehabilitation of stroke patients, which is portable, convenient, and suitable for self-training. OBJECTIVE The present research aimed to study the effectiveness of CARS in improving upper limb motor function and cognition function of stroke patients via conducting a long-term randomized controlled trial and analyze the patient’s acceptance of the proposed system. METHODS A randomized, double-blind, controlled trial was performed with 30 post-stroke, sub-acute phase patients. All patients in both the experimental group (n=15) and the control group (n=15) performed a 1-hour session of therapy each day, 5 days per week, for 2 weeks. Patients in the experimental group received 30 minutes of rehabilitation training with CARS and 30 minutes of conventional occupational therapy (OT) each session, while patients in the control group received conventional OT for the full 1 hour each session. The Fugl-Meyer Assessment-Upper Extremity subscale (FMA-UE), Action Research Arm Test (ARAT), Manual Muscle Test (MMT), Brunnstrom Stage (BS), and Barthel Index (BI) were used to assess motor function, and the Mini-Mental State Examination (MMSE), Add VS Sub (AVS), and Stroop Game (SG) were used to assess cognitive function before and after the 2-week treatment period. In addition, the User Satisfaction Evaluation Questionnaire (USEQ) was used to reflect the patients’ acceptance of the system in the experimental group after the final intervention. RESULTS All the assessment scores of the experimental group and control group were significantly improved after intervention (p＜0.05). The experimental group’s score of FMA-UE and ARAT increased by 11.47 and 5.86 respectively after intervention, which were both significantly higher than the increase of the control group (p＜0.01). Similarly, the score of AVS and SG in the experimental group increased by 7.53 and 6.83 respectively after the intervention, which was also higher than the control group (p＜0.01). The evaluation of the adoption of this system has three sub-dimensions. In terms of accessibility, the patients reported a mean score of 4.27±0.704 for the enjoyment of their experience with the system, 4.33±0.816 for success to use the system, 4.67±0.617 for the ability to control the system. In terms of comfort, the patients reported 4.40±0.737 for clear information provided by the system, 4.40±0.632 for comfort. In terms of acceptability, the patients reported 4.27±0.884 for usefulness in their rehabilitation, 4.67±0.617 for agreeing with CARS as a suitable tool for home-based rehabilitation. CONCLUSIONS CARS and conventional OT together-based rehabilitation were more effective in improving both upper limb motor function and cognition function as compared with conventional OT. Due to the low cost, and ease of use, CARS is also potentially suitable for home-based rehabilitation. CLINICALTRIAL The Chinese Clinical Trial Registry (ChiCTR1800017568).

Download Full-text