scholarly journals The Efficacy of Interlimb-Coordinated Intervention on Gait and Motor Function Recovery in Patients with Acute Stroke: A Multi-Center Randomized Controlled Trial Study Protocol

2021 ◽  
Vol 11 (11) ◽  
pp. 1495
Author(s):  
Wai-Leung Ambrose Lo ◽  
Dandan Chen ◽  
Jiangli Zhao ◽  
Yan Leng ◽  
Ruihao Bian ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Upper Limb ◽  
Functional Recovery ◽  
Neural Plasticity ◽  
Conventional Therapy ◽  
Controlled Trial ◽  
Functional Improvement ◽  
Secondary Outcome ◽  
Functional Rehabilitation ◽  
Randomized Controlled

Background: The efficacy of interlimb-coordinated training on gait and upper limb functional improvement remains unclear. The latest published randomized controlled trials have supported the potential benefits of interlimb-coordinated training to enhance gait function. Upper limb functional recovery may also benefit from interlimb-coordinated training since most everyday activities require the coordinated use of both hands to complete a task. This study investigates the efficacy of interlimb-coordinated training on gait and upper limb functional recovery over a short-medium term period. Methods: A total of 226 acute stroke patients will be recruited from four centres over four years. Patients will be randomly allocated to either conventional therapy or conventional therapy plus interlimb-coordinated training. Outcomes will be recorded at baseline, after 2 weeks of intervention, and at 3- and 6-months post-intervention. Gait speed is the primary outcome measure. Secondary outcome measures include Fugl–Meyer Assessment of Motor Recovery, Berg Balance Scale, Timed Up and Go test, Action Research Arm Test, electroencephalography, and magnetic resonance imaging. Conclusion: The results of this trial will provide an in-depth understanding of the efficacy of early interlimb-coordinated intervention on gait and upper functional rehabilitation and how it may relate to the neural plasticity process.

scholarly journals A Double-blind Randomized Controlled Trial for the Effects of Dry Needling on Upper Limb Dysfunction in Patients with Stroke

2021 ◽  
Vol 45 (2) ◽  
pp. 115-124
Author(s):  
Zahra Tavakol ◽  
Ardalan Shariat ◽  
Noureddin Nakhostin Ansari ◽  
Shima Ghannadi ◽  
Roshanak Honarpishe ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Range Of Motion ◽  
Outcome Measures ◽  
Upper Limb ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Upper Limbs ◽  
Dry Needling ◽  
Double Blind ◽  
Randomized Controlled

Spasticity is one of the main complications of a stroke. This double-blind, randomized controlled trial aimed to compare the result of three sessions of dry needling (DN) versus sham DN on the affected upper limbs in post-stroke survivors. We recruited 24 patients (age 57.0 ± 9.6 years; male 71%). Patients were randomly allocated to two groups: a DN group and a sham DN group. The primary outcome measures were the Modified Modified Ashworth Scale (MMAS) and the Box and Block Test (BBT). Secondary outcome measures included active and passive wrist range of motion (AROM and PROM). All assessments were measured at baseline, immediately after the last session of the intervention, and one month later. Patients in the DN group had improved upper limb spasticity and passive wrist range of motion compared to control group (P < 0.05). There were no between-group differences in other outcome measures (P > 0.05). Dry needling is a useful method for improving muscle spasticity in the upper limbs of patients with stroke.

scholarly journals Functional rehabilitation of upper limb apraxia in poststroke patients: study protocol for a randomized controlled trial

Trials ◽  
2015 ◽  
Vol 16 (1) ◽  
Author(s):  
Jose Manuel Pérez-Mármol ◽  
Mª Carmen García-Ríos ◽  
Francisco J. Barrero-Hernandez ◽  
Guadalupe Molina-Torres ◽  
Ted Brown ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Study Protocol ◽  
Upper Limb ◽  
Controlled Trial ◽  
Functional Rehabilitation ◽  
Randomized Controlled ◽  
Limb Apraxia

Effectiveness of a functional rehabilitation program for upper limb apraxia in poststroke patients: A randomized controlled trial.

2021 ◽  
Author(s):  
María Encarnación Aguilar-Ferrándiz ◽  
Sonia Toledano-Moreno ◽  
María Carmen García-Ríos ◽  
Rosa María Tapia-Haro ◽  
Francisco Javier Barrero-Hernández ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Upper Limb ◽  
Controlled Trial ◽  
Rehabilitation Program ◽  
Functional Rehabilitation ◽  
Randomized Controlled ◽  
Limb Apraxia

scholarly journals Electrical somatosensory stimulation followed by motor training of the paretic upper limb in acute stroke: study protocol for a randomized controlled trial

Trials ◽  
2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Emma Ghaziani ◽  
Christian Couppé ◽  
Cecilie Henkel ◽  
Volkert Siersma ◽  
Mette Søndergaard ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Acute Stroke ◽  
Study Protocol ◽  
Upper Limb ◽  
Controlled Trial ◽  
Motor Training ◽  
Somatosensory Stimulation ◽  
Randomized Controlled ◽  
Stroke Study

scholarly journals Effects of Wearable Ankle Robotics for Stair and Over-ground Training on Sub-acute Stroke: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Ling Fung Yeung ◽  
Cathy CY Lau ◽  
Charles WK Lai ◽  
Yannie OY Soo ◽  
Man Lok Chan ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Acute Stroke ◽  
Usual Care ◽  
Effect Size ◽  
Walking Speed ◽  
Controlled Trial ◽  
Gait Training ◽  
Functional Improvement ◽  
Robot Assisted ◽  
Randomized Controlled

Abstract Background: Wearable ankle robotics could potentially facilitate intensive repetitive task-specific gait training on stair environment for stroke rehabilitation. A lightweight (0.5kg) and portable exoskeleton ankle robot was designed to facilitate over-ground and stair training either providing active assistance to move paretic ankle augmenting residual motor function (power-assisted ankle robot, PAAR), or passively support dropped foot by lock/release ankle joint for foot clearance in swing phase (swing-controlled ankle robot, SCAR).In this two-center randomized controlled trial, we hypothesized that robot-assisted gait training using either PAAR or SCAR in stair environment are more effective to enhance gait recovery and promote independency in early stroke, than conventional training.Methods: Sub-acute stroke survivors (within two months after stroke onset) received hospital usual care plus 20-session robot-assisted training (at least twice weekly, 30-minute per session) on over-ground and stair environments, wearing PAAR (n=14) or SCAR (n=16), as compared to control group receiving conventional training only (CT, n=17). PAAR provided 2.5Nm-4.2Nm torque which was calibratedin each training session to adjust for any progression of functional changes throughout the intervention. Clinical assessments were performed before and after the 20-session intervention, including functional ambulatory categoryas primary outcome measure, along with Berg balance scale and timed 10-metre walk test.Results: After the 20-session interventions, all three groups showed statistically significant and clinically meaningful within-group functional improvement in all outcome measures (p<0.005). Between-group comparison showed SCAR had greater improvement in functional ambulatory category(mean difference +0.6, medium effect size 0.610) with more than 56% independent walkers after training, as compared to only 29% for CT. Analysis of covariance results showed PAAR had greater improvement in walking speed than SCAR (mean difference +0.15m/s, large effect size 0.752), which was in line with the higher cadence and speed when wearing the robot during the 20-session robot-assisted training over-ground and on stairs.Conclusions: Robot-assisted stair training would lead to greater functional improvement in gait independency and walking speed than conventional training in usual care. The active powered ankle assistance might facilitate users to walk more and faster with their paretic leg during stair and over-ground walking.Trial Registration:ClinicalTrials.gov NCT03184259. Registered on 12 June 2017.

scholarly journals Effects of wearable ankle robotics for stair and over-ground training on sub-acute stroke: a randomized controlled trial

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Ling-Fung Yeung ◽  
Cathy C. Y. Lau ◽  
Charles W. K. Lai ◽  
Yannie O. Y. Soo ◽  
Man-Lok Chan ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Acute Stroke ◽  
Effect Size ◽  
Walking Speed ◽  
Controlled Trial ◽  
Gait Training ◽  
Mean Difference ◽  
Functional Improvement ◽  
Robot Assisted ◽  
Randomized Controlled

Abstract Background Wearable ankle robotics could potentially facilitate intensive repetitive task-specific gait training on stair environment for stroke rehabilitation. A lightweight (0.5 kg) and portable exoskeleton ankle robot was designed to facilitate over-ground and stair training either providing active assistance to move paretic ankle augmenting residual motor function (power-assisted ankle robot, PAAR), or passively support dropped foot by lock/release ankle joint for foot clearance in swing phase (swing-controlled ankle robot, SCAR). In this two-center randomized controlled trial, we hypothesized that conventional training integrated with robot-assisted gait training using either PAAR or SCAR in stair environment are more effective to enhance gait recovery and promote independency in early stroke, than conventional training alone. Methods Sub-acute stroke survivors (within 2 months after stroke onset) received conventional training integrated with 20-session robot-assisted training (at least twice weekly, 30-min per session) on over-ground and stair environments, wearing PAAR (n = 14) or SCAR (n = 16), as compared to control group receiving conventional training only (CT, n = 17). Clinical assessments were performed before and after the 20-session intervention, including functional ambulatory category as primary outcome measure, along with Berg balance scale and timed 10-m walk test. Results After the 20-session interventions, all three groups showed statistically significant and clinically meaningful within-group functional improvement in all outcome measures (p < 0.005). Between-group comparison showed SCAR had greater improvement in functional ambulatory category (mean difference + 0.6, medium effect size 0.610) with more than 56% independent walkers after training, as compared to only 29% for CT. Analysis of covariance results showed PAAR had greater improvement in walking speed than SCAR (mean difference + 0.15 m/s, large effect size 0.752), which was in line with the higher cadence and speed when wearing the robot during the 20-session robot-assisted training over-ground and on stairs. Conclusions Robot-assisted stair training would lead to greater functional improvement in gait independency and walking speed than conventional training in usual care. The active powered ankle assistance might facilitate users to walk more and faster with their paretic leg during stair and over-ground walking. Trial registration: ClinicalTrials.gov NCT03184259. Registered on 12 June 2017.

scholarly journals Effects of Number of Repetitions and Number of Hours of Shaping Practice during Constraint-Induced Movement Therapy: A Randomized Controlled Trial

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Auwal Abdullahi
Keyword(s):  
Randomized Controlled Trial ◽  
Motor Function ◽  
Upper Limb ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Movement Therapy ◽  
Secondary Outcome ◽  
Randomized Controlled ◽  
Constraint Induced Movement Therapy ◽  
Significant Difference

Background. Constraint-induced movement therapy (CIMT) is effective in improving motor outcomes after stroke. However, its existing protocols are resource-intensive and difficult to implement. The aim of this study is to design an easier CIMT protocol using number of repetitions of shaping practice. Method. The study design was randomized controlled trial. Participants within 4 weeks after stroke were recruited at Murtala Muhammad Specialist Hospital. They were randomly assigned to groups A, B, C, and D. Group A received 3 hours of traditional therapy. Groups B, C, and D received modified CIMT consisting of 3 hours of shaping practice per session, 300 repetitions of shaping practice in 3 sessions, and 600 repetitions of shaping practice in 3 sessions per day, respectively, and constraint for 90% of the waking hours. All treatment protocols were administered 5 times per week for 4 weeks. The primary outcome was measured using upper limb Fugl-Meyer assessment, while the secondary outcome was measured using motor activity log, Wolf Motor Function Test, and upper limb self-efficacy test at baseline, 2 weeks, and 4 weeks after intervention. Result. There were 48 participants 4 weeks after intervention. The result showed that there was no significant difference between groups at baseline (p>0.05). Within-group improvements attained minimal clinically important difference (MCID) in modified CIMT and 300 repetitions and 600 repetitions groups. Conclusion. Number of repetitions of shaping practice significantly improved motor function, real-world arm use, and upper limb self-efficacy after stroke. Therefore, it seems to be a simple alternative for the use of number of hours. Trial Registration. This trial is registered with Pan African Clinical Trial Registry (registration number: PACTR201610001828172) (date of registration: 21/10/2016).

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