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

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.

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

Neurorehabilitation and Neural Repair ◽

10.1177/1545968319827573 ◽

2019 ◽

Vol 33 (3) ◽

pp. 188-198 ◽

Cited By ~ 15

Author(s):

Ander Ramos-Murguialday ◽

Marco R. Curado ◽

Doris Broetz ◽

Özge Yilmaz ◽

Fabricio L. Brasil ◽

...

Keyword(s):

Motor Function ◽

Upper Limb ◽

Sham Group ◽

Chronic Stroke ◽

Emg Activity ◽

Stroke Patients ◽

Significant Difference ◽

Experimental Group

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.

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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.

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Effects of short-term upper limb robot-assisted therapy on the rehabilitation of sub-acute stroke patients

Technology and Health Care ◽

10.3233/thc-202127 ◽

2020 ◽

pp. 1-9

Author(s):

Shangrong Jiang ◽

Hong You ◽

Weijing Zhao ◽

Min Zhang

Keyword(s):

Activities Of Daily Living ◽

Acute Stroke ◽

Motor Function ◽

Upper Limb ◽

Daily Living ◽

Muscle Tone ◽

Stroke Patients ◽

Robot Assisted ◽

Short Term ◽

Significant Difference

BACKGROUND: Robot-assisted therapy (RT) has become a promising stroke rehabilitation intervention. OBJECTIVE: To examine the effects of short-term upper limb RT on the rehabilitation of sub-acute stroke patients. METHODS: Subjects were randomly assigned to the RT group (n= 23) or conventional rehabilitation (CR) group (n= 22). All subjects received conventional rehabilitation therapy for 30 minutes twice a day, for 2 weeks. In addition, the RT group received RT for 30 minutes twice a day, for 2 weeks. The outcomes before treatment (T0) and at 2 weeks (T1) and 1 month follow-up (T2) were evaluated in the patients using the upper limb motor function test of the Fugl-Meyer assessment (FMA) the Motricity Index (MI), the Modified Ashworth Scale (MAS), the Functional Independence Measure (FIM), and the Barthel Index (BI). RESULTS: There were significant improvements in motor function scales (P< 0.001 for FMA and MI) and activities of daily living (P< 0.001 for FIM and BI) but without muscle tone (MAS, P> 0.05) in the RT and CR groups. Compared to the CR group, the RT group showed improvements in motor function and activities of daily living (P< 0.05 for FMA, MI, FIM, BI) at T1 and T2. There was no significant difference between the two groups in muscle tone (MAS, P> 0.05). CONCLUSIONS: RT may be a useful tool for sub-acute stroke patients’ rehabilitation.

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The Relation between Perceptual and Language Deficits in Stroke Patients

British Journal of Occupational Therapy ◽

10.1177/030802268905200102 ◽

1989 ◽

Vol 52 (1) ◽

pp. 8-10 ◽

Cited By ~ 4

Author(s):

A Smith ◽

N B Lincoln

Keyword(s):

Left Hemisphere ◽

Language Impairment ◽

Right Hemisphere ◽

Poor Performance ◽

Stroke Patients ◽

The Poor ◽

Language Tests ◽

Significant Difference ◽

Language Problems ◽

The Relationship

The study investigates the relationship between the performance of stroke patients on tests of perception and language. It has been suggested that stroke patients with left hemisphere damage may perform poorly on tests of visual perception due to language problems affecting their understanding of the task. Results indicated that there was no significant difference between stroke patients with right hemisphere, dysphasic left hemisphere and non-dysphasic left hemisphere damage on perceptual tests. Few significant correlations were found between scores on the perceptual tests and scores on the language tests, suggesting that the poor performance of dysphasic patients cannot be explained by language impairment alone.

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Impact of Somatosensory Training on Neural and Functional Recovery of Lower Extremity in Patients with Chronic Stroke: A Single Blind Controlled Randomized Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020583 ◽

2021 ◽

Vol 18 (2) ◽

pp. 583

Author(s):

Reem M. Alwhaibi ◽

Noha F. Mahmoud ◽

Mye A. Basheer ◽

Hoda M. Zakaria ◽

Mahmoud Y. Elzanaty ◽

...

Keyword(s):

Physical Therapy ◽

Lower Extremity ◽

Functional Recovery ◽

Intervention Group ◽

Chronic Stroke ◽

Post Treatment ◽

Control Group ◽

Stroke Patients ◽

Significant Difference ◽

Group Post

Recovery of lower extremity (LE) function in chronic stroke patients is considered a barrier to community reintegration. An adequate training program is required to improve neural and functional performance of the affected LE in chronic stroke patients. The current study aimed to evaluate the effect of somatosensory rehabilitation on neural and functional recovery of LE in stroke patients. Thirty male and female patients were recruited and randomized to equal groups: control group (GI) and intervention group (GII). All patients were matched for age, duration of stroke, and degree of motor impairment of the affected LE. Both groups received standard program of physical therapy in addition to somatosensory rehabilitation for GII. The duration of treatment for both groups was eight consecutive weeks. Outcome measures used were Functional Independent Measure (FIM) and Quantitative Electroencephalography (QEEG), obtained pre- and post-treatment. A significant improvement was found in the FIM scores of the intervention group (GII), as compared to the control group (GI) (p < 0.001). Additionally, QEEG scores improved within the intervention group post-treatment. QEEG scores did not improve within the control group post-treatment, except for “Cz-AR”, compared to pretreatment, with no significant difference between groups. Adding somatosensory training to standard physical therapy program results in better improvement of neuromuscular control of LE function in chronic stroke patients.

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Music-supported therapy (MST) in improving post-stroke patients' upper-limb motor function: a randomised controlled pilot study

Neurological Research ◽

10.1179/1743132815y.0000000034 ◽

2015 ◽

Vol 37 (5) ◽

pp. 434-440 ◽

Cited By ~ 17

Author(s):

Yanna Tong ◽

Brian Forreider ◽

Xinting Sun ◽

Xiaokun Geng ◽

Weidong Zhang ◽

...

Keyword(s):

Pilot Study ◽

Motor Function ◽

Upper Limb ◽

Stroke Patients ◽

Post Stroke ◽

Randomised Controlled

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Effects of bilateral arm training on upper extremity function in right and left hemispheric stroke

Journal of the Pakistan Medical Association ◽

10.47391/jpma.593 ◽

2020 ◽

pp. 1-9

Author(s):

Humera Ambreen ◽

Hina Tariq ◽

Imran Amjad

Keyword(s):

Upper Extremity ◽

Motor Function ◽

Recovery Of Function ◽

Hand Function ◽

Group Analysis ◽

Stroke Patients ◽

Hemispheric Stroke ◽

Beneficial Effects ◽

Significant Difference ◽

Bilateral Arm Training

Abstract Objective: This experimental study on 24 stroke patients aimed at evaluating and comparing the effects of bilateral arm training on upper extremity (UE) motor function between right and left hemispheric chronic stroke patients. Methods: Both groups received the same intervention involving 5 functional tasks for 1 hour, 3 days per week, for a total of 6 weeks. Fugl-Meyer Assessment-Upper Extremity and Wolf-Motor Function Test were applied as outcome measures at baseline and after 6 weeks of training to assess the recovery of function in the affected area. Results: Intra-group analysis showed no significant improvement in the wrist and hand function in the left hemispheric stroke (LHS) (p>0.05), while right hemispheric stroke (RHS) patients did not improve significantly in the coordination/speed domain (p>0.05). Inter-group analysis showed no significant difference between right and left hemispheric stroke patients (p>0.05). Conclusion: Bilateral arm training showed beneficial effects in improving UE function in both RHS and LHS patients. Distal UE function in LHS and coordination and speed of movement in RHS patients did not show any significant improvement. Key Words: Stroke, Upper extremity, Recovery of function, Bilateral arm training. Continuous...

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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

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Effects of Excitatory Transcranial Magnetic Stimulation of the Anterior Intraparietal Area in Chronic Stroke Patients

10.20944/preprints201803.0018.v1 ◽

2018 ◽

Author(s):

Ronaldo Luis da Silva ◽

Angela Maria Costa de Souza ◽

Francielly Ferreira Santos ◽

Sueli Toshie Inoue ◽

Johanne Higgins ◽

...

Keyword(s):

Transcranial Magnetic Stimulation ◽

Motor Function ◽

Upper Limb ◽

Lower Limb ◽

Magnetic Stimulation ◽

Sensory Function ◽

Stroke Patients ◽

Chronic Patients ◽

Upper Limb Function ◽

Stimulation Of

1) Objective: to evaluate the effects of excitatory transcranial magnetic stimulation of the anterior intraparietal area in chronic patients with a frontal lesion and parietal sparing due to stroke on the impaired upper (UL) and lower limb (LL) as measured by Fugl-Meyer Assessment (FMA). 2) Methods: three patients (P1: 49.83/2.75, P2: 53.17/3.83, P3:63.33/3.08 years-old at stroke/years post-stroke, respectively) received two weeks (five days/ week) of rTMS at 10 Hz of the left anterior intraparietal area (AIP). A patient was treated in similar conditions with a sham coil (56.58/4.33) No complimentary therapy was delivered during the study. Patients were evaluated before, after- and two-months post-treatment (A1, A2 and A3, respectively). 3) Results: We found increased scores for lower limb in motor function subsection for P1 and P3 and in sensory function for P2 by A2 that remained at A3. We also found an increased score for upper limb motor function for P2 and P3, but the score decreased by A3 for P2. P3 score for upper limb ROM increased by A3 compared to A1 and A2. 4) Conclusion: AIP excitatory rTMS increased the FMA scores for lower and upper limb function, showing a broader effect when compared to M1 stimulation.

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