scholarly journals Scapular Malalignment in Patients with Stroke: A Narrative Review

2021 ◽  
Vol 9 (6) ◽  
pp. 4051-4057
Author(s):  
Eram N Kazi ◽  
◽  
Suvarna S Ganvir ◽  
Keyword(s):  
Range Of Motion ◽  
Upper Limb ◽  
Shoulder Joint ◽  
Daily Living ◽  
Observational Studies ◽  
Chronic Stroke ◽  
Functional Mobility ◽  
Stroke Patients ◽  
Chronic Stage ◽  
Inferior Angle

Background: Scapular Malalignment leads to functional incapacity in stroke patients. This malalignment hampers the functional mobility and stability of shoulder joint in stroke patients due to which there is reduced range of motion and hampers activities of daily living in stroke patients. So, to investigate the extent of scapular malalignment in patients with acute, chronic and sub-acute stroke. Methods: Four databases (PubMed, Google Scholar, Cochrane, Science Direct) were searched to identify eligible studies using the keywords Scapular Malalignment and Stroke. Only observational studies published in last 10 years (2010-2020) were included in this review. Results: Eight Studies, included in the review were conducted on patients with acute, sub-acute and chronic stage. The results showed that there is more of inferior angle tilting seen in patients with stroke and it increases with spasticity and alters functional mobility in patients with stroke. Discussion: All studies were consistent in using the appropriate tools for measurement of scapular malalignment. Literature showed scapular malalignment affects scapular balance angle, functional mobility of hand and range of motion in patients with acute, sub-acute and chronic stroke. Most of the literature includes patients with sub-acute and chronic stroke. There was no conflict of evidence observed among all articles. Conclusion: There is influence of Scapular malalignment on spasticity, duration of stroke, upper limb mobility, and range of motion in stroke patients. Scapular Malalignment is observed in acute, sub-acute and chronic rotation and there is more of inferior angle tilting and rotation of scapula observed. KEY WORDS: Scapular Malalignment, stroke.

scholarly journals The Influence of Primary Motor Cortex Inhibition on Upper Limb Impairment and Function in Chronic Stroke: A Multimodal Study

2019 ◽  
Vol 33 (2) ◽  
pp. 130-140 ◽  
Author(s):  
Ronan A. Mooney ◽  
Suzanne J. Ackerley ◽  
Deshan K. Rajeswaran ◽  
John Cirillo ◽  
P. Alan Barber ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Upper Limb ◽  
Primary Motor Cortex ◽  
Motor Impairment ◽  
Intracortical Inhibition ◽  
Chronic Stroke ◽  
Stroke Patients ◽  
Gaba Concentration ◽  
Chronic Stage ◽  
And Function

Background. Stroke is a leading cause of adult disability owing largely to motor impairment and loss of function. After stroke, there may be abnormalities in γ-aminobutyric acid (GABA)-mediated inhibitory function within primary motor cortex (M1), which may have implications for residual motor impairment and the potential for functional improvements at the chronic stage. Objective. To quantify GABA neurotransmission and concentration within ipsilesional and contralesional M1 and determine if they relate to upper limb impairment and function at the chronic stage of stroke. Methods. Twelve chronic stroke patients and 16 age-similar controls were recruited for the study. Upper limb impairment and function were assessed with the Fugl-Meyer Upper Extremity Scale and Action Research Arm Test. Threshold tracking paired-pulse transcranial magnetic stimulation protocols were used to examine short- and long-interval intracortical inhibition and late cortical disinhibition. Magnetic resonance spectroscopy was used to evaluate GABA concentration. Results. Short-interval intracortical inhibition was similar between patients and controls ( P = .10). Long-interval intracortical inhibition was greater in ipsilesional M1 compared with controls ( P < .001). Patients who did not exhibit late cortical disinhibition in ipsilesional M1 were those with greater upper limb impairment and worse function ( P = .002 and P = .017). GABA concentration was lower within ipsilesional ( P = .009) and contralesional ( P = .021) M1 compared with controls, resulting in an elevated excitation-inhibition ratio for patients. Conclusion. These findings indicate that ipsilesional and contralesional M1 GABAergic inhibition are altered in this small cohort of chronic stroke patients. Further study is warranted to determine how M1 inhibitory networks might be targeted to improve motor function.

scholarly journals Toward wearable supernumerary robotic fingers to compensate missing grasping abilities in hemiparetic upper limb

2017 ◽  
Vol 36 (13-14) ◽  
pp. 1414-1436 ◽  
Author(s):  
Irfan Hussain ◽  
Giovanni Spagnoletti ◽  
Gionata Salvietti ◽  
Domenico Prattichizzo
Keyword(s):  
Upper Limb ◽  
Daily Living ◽  
Chronic Stroke ◽  
Experimental Characterization ◽  
Stroke Patients ◽  
Frontalis Muscle ◽  
Common Principle ◽  
Different Shapes ◽  
Robotic Devices ◽  
Bimanual Tasks

This paper presents the design, analysis, fabrication, experimental characterization, and evaluation of two prototypes of robotic extra fingers that can be used as grasp compensatory devices for a hemiparetic upper limb. The devices are the results of experimental sessions with chronic stroke patients and consultations with clinical experts. Both devices share a common principle of work, which consists in opposing the device to the paretic hand or wrist so to restrain the motion of an object. They can be used by chronic stroke patients to compensate for grasping in several activities of daily living (ADLs) with a particular focus on bimanual tasks. The robotic extra fingers are designed to be extremely portable and wearable. They can be wrapped as bracelets when not being used, to further reduce the encumbrance. Both devices are intrinsically compliant and driven by a single actuator through a tendon system. The motion of the robotic devices can be controlled using an electromyography-based interface embedded in a cap. The interface allows the user to control the device motion by contracting the frontalis muscle. The performance characteristics of the devices have been measured experimentally and the shape adaptability has been confirmed by grasping various objects with different shapes. We tested the devices through qualitative experiments based on ADLs involving five chronic stroke patients. The prototypes successfully enabled the patients to complete various bimanual tasks. Results show that the proposed robotic devices improve the autonomy of patients in ADLs and allow them to complete tasks that were previously impossible to perform.

scholarly journals Examination of Kinect’s Torso PCA Model for Planar Activities Assessment after Stroke

2019 ◽  
Vol 8 (12S2) ◽  
pp. 476-482
Keyword(s):  
Motion Capture ◽  
Upper Limb ◽  
Daily Living ◽  
Hand Movement ◽  
Three Dimensional ◽  
Principal Component ◽  
Stroke Patients ◽  
Joint Coordination ◽  
Arm Transport ◽  
Statistical Results

Compensatory movement after stroke occurred when inter-joint coordination between arm and forearm for the purpose of arm transport becomes limited due to the weaknesses of the upper limb after stroke. This limitation causes an inefficiency of hand movement to perform the activity of daily living (ADL). Previous work has shown the possibility of using Kinect to assess torso compensation in typical assessment of upper limb movement in a stroke-simulated setting using a Torso Principal Component Analysis (PCA) Model. This research extends the study into evaluating Torso PCA Model in terms of orientation angles of the torso in three dimensional when performing planar activities namely circle tracing and point-topoint tracing. The orientation angles were compared to the outcome of the measurement from a standard motion capture system and Kinect’s intrinsic chest orientation angles. Based on the statistical results, Torso PCA model is concurrently valid with the clinically accepted measures of torso orientation and can be used further to analyze torso compensation in stroke patients.

Upper limb robot-assisted therapy in subacute and chronic stroke patients using an innovative end-effector haptic device: A pilot study

2018 ◽  
Vol 42 (1) ◽  
pp. 43-52 ◽  
Author(s):  
S. Mazzoleni ◽  
E. Battini ◽  
R. Crecchi ◽  
P. Dario ◽  
F. Posteraro
Keyword(s):  
Pilot Study ◽  
Upper Limb ◽  
Chronic Stroke ◽  
Haptic Device ◽  
Stroke Patients ◽  
Robot Assisted ◽  
End Effector

Decoding Upper Limb Movement Attempt From EEG Measurements of the Contralesional Motor Cortex in Chronic Stroke Patients

2017 ◽  
Vol 64 (1) ◽  
pp. 99-111 ◽  
Author(s):  
Javier M. Antelis ◽  
Luis Montesano ◽  
Ander Ramos-Murguialday ◽  
Niels Birbaumer ◽  
Javier Minguez
Keyword(s):  
Motor Cortex ◽  
Upper Limb ◽  
Limb Movement ◽  
Chronic Stroke ◽  
Stroke Patients
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