scholarly journals Influence of the Passive Stabilization of the Trunk and Upper Limb on Selected Parameters of the Hand Motor Coordination, Grip Strength and Muscle Tension, in Post-Stroke Patients

2021 ◽  
Vol 10 (11) ◽  
pp. 2402
Author(s):  
Anna Olczak ◽  
Aleksandra Truszczyńska-Baszak
Keyword(s):  
Grip Strength ◽  
Upper Extremity ◽  
Upper Limb ◽  
Motor Coordination ◽  
Objective Assessment ◽  
Muscle Tension ◽  
Control Group ◽  
Cerebral Stroke ◽  
Post Stroke ◽  
Passive Stabilization

Objective: Assessment of the influence of a stable trunk and the affected upper limb (dominant or non-dominant) on the parameters of the wrist and hand motor coordination, grip strength and muscle tension in patients in the subacute post-stroke stage compared to healthy subjects. Design: An observational study. Setting: Stroke Rehabilitation Department. Subjects: Thirty-four subjects after ischemic cerebral stroke and control group-32 subjects without neurological deficits, age and body mass/ height matched were included. Main measures: The tone of the multifidus, transverse abdominal and supraspinatus muscles were assessed by Luna EMG device. A HandTutor device were used to measure motor coordination parameters (e.g., range of movement, frequency of movement), and a manual dynamometer for measuring the strength of a hand grip. Subjects were examined in two positions: sitting without back support (non-stabilized) and lying with stabilization of the trunk and the upper limb. Results: Passive stabilization of the trunk and the upper extremity caused a significant improvement in motor coordination of the fingers (p ˂ 0.001) and the wrist (p < 0.001) in patients after stroke. Improved motor coordination of the upper extremity was associated with an increased tone of the supraspinatus muscle. Conclusions: Passive stabilization of the trunk and the upper limb improved the hand and wrist coordination in patients following a stroke. Placing patients in a supine position with the stability of the affected upper limb during rehabilitation exercises may help them to access latent movement patterns lost due to neurological impairment after a stroke.

scholarly journals Post-stroke upper limb spasticity incidence for different cerebral infarction site

Open Medicine ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 227-231 ◽  
Author(s):  
Yi Jin ◽  
Yuan Zhao
Keyword(s):  
Basal Ganglia ◽  
Cerebral Infarction ◽  
Incidence Rate ◽  
Upper Extremity ◽  
Upper Limb ◽  
Internal Capsule ◽  
Post Stroke ◽  
Total Incidence ◽  
Limb Spasticity

AbstractObjectiveThe purpose of this study was to evaluate the incidence rate of post-stroke upper limb spasticity and its correlation with cerebral infarction site.MethodsA total of 498 inpatient and outpatient cases are included in the present study. The post-stroke upper limb spasticity rate of different cerebral infarction site was calculated.ResultsA total of 498 patients with cerebral infarction are enrolled in this study. Of these patients, 91 have dropped out and 407 have completed the study. Of the completed cases, 172 are in the spasm group and 235 are in the non-spasm group. The total incidence of upper limb spasticity is 34.5%. The incidences of upper extremity spasms are 12.5%, 20%, 22.5%, 35%, 40%, and 42.5% in 2 weeks, 1 month, 2 months, 3 months, 6 months, and 12 months, respectively. The incidence of upper extremity spasms increases with time. The incidences of upper limb spasticity are 12.1%, 63.3%, 58.5%, 9.4% and 8.3% when cerebral infarction occurs in the cortical and subcortical mixed areas, basal ganglia and internal capsule, cerebralcortex, brainstem and cerebellum respectively. The incidence of upper limb spasticity varies in different infarction sites (P < 0.05).ConclusionThe post-stroke upper limb spasticity rates were different according to the different cerebral infarction site. Patients with the ganglia and internal capsule infarctions had the highest risk of developing post-stroke upper limb spasticity.

scholarly journals Feasibility, Safety and Efficacy of a Virtual Reality Exergame System to Supplement Upper Extremity Rehabilitation Post-Stroke: A Pilot Randomized Clinical Trial and Proof of Principle

2019 ◽  
Vol 17 (1) ◽  
pp. 113 ◽  
Author(s):  
Nahid Norouzi-Gheidari ◽  
Alejandro Hernandez ◽  
Philippe S. Archambault ◽  
Johanne Higgins ◽  
Lise Poissant ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Upper Extremity ◽  
Intervention Group ◽  
Outpatient Rehabilitation ◽  
Control Group ◽  
Stroke Survivors ◽  
Post Intervention ◽  
Serious Adverse Events ◽  
Traditional Therapy ◽  
Post Stroke

(1) Background: Increasing the amount of therapy time has been shown to improve motor function in stroke survivors. However, it is often not possible to increase the amount of therapy time provided in the current one-on-one therapy models. Rehabilitation-based virtual reality exergame systems, such as Jintronix, can be offered to stroke survivors as an adjunct to traditional therapy. The goal of this study was to examine the safety and feasibility of providing additional therapy using an exergame system and assess its preliminary clinical efficacy. (2) Methods: Stroke survivors receiving outpatient rehabilitation services participated in this pilot randomized control trial in which the intervention group received 4 weeks of exergaming sessions in addition to traditional therapy sessions. (3) Results: Nine subjects in the intervention and nine subjects in the control group completed the study. The intervention group had at least two extra sessions per week, with an average duration of 44 min per session and no serious adverse events (falls, dizziness, or pain). The efficacy measures showed statistically meaningful improvements in the activities of daily living measures (i.e., MAL-QOM (motor activity log-quality of movement) and both mobility and physical domains of the SIS (stroke impact scale) with mean difference of 1.0%, 5.5%, and 6.7% between the intervention and control group, respectively) at post-intervention. (4) Conclusion: Using virtual reality exergaming technology as an adjunct to traditional therapy is feasible and safe in post-stroke rehabilitation and may be beneficial to upper extremity functional recovery.

scholarly journals Examining recruitment feasibility and related outcomes in adults post-stroke

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Erin C King ◽  
Megan Doherty ◽  
Daniel Corcos ◽  
Mary Ellen Stoykov
Keyword(s):  
Upper Extremity ◽  
Upper Limb ◽  
Intervention Study ◽  
Evidence Based ◽  
Recruitment Methods ◽  
Post Stroke ◽  
Study Enrollment ◽  
Accrual Rate ◽  
Sample Characteristics ◽  
Is Value

Abstract Background There are limited effective and evidence-based interventions for upper extremity hemiparesis post-stroke. To prepare for an RCT and minimize misuse of resources, there is value in conducting a feasibility study. Objective To examine the feasibility of recruitment and other related outcomes for an intense upper limb intervention. Methodology Feasibility outcomes included retention, adherence, accrual rate, sample characteristics, and identification of productive recruitment methods. Other outcomes included satisfaction with the study, fidelity, and equipoise of both staff and participants. Results Participants were enrolled at a rate of 1.33 per month. The recruitment timeline had to be extended by 4 months, to meet the target of 16 randomized participants. Staggered recruitment was the most successful strategy. We found that following up with individuals who missed initial appointments prior to study enrollment led to decreased adherence. Conclusion It is feasible to recruit and retain post-stroke participants for an intense intervention study. Trial registration NCT02277028

INTEGRATION EXERCISE PROGRAMME FOR CHILDREN WITH LEARNING DIFFICULTIES WHO HAVE PRESERVED VESTIGIAL PRIMITIVE REFLEXES

2017 ◽  
Vol 15 (3) ◽  
pp. 0-0 ◽  
Author(s):  
Celestyna Grzywniak
Keyword(s):  
Motor Development ◽  
Motor Coordination ◽  
Muscle Tension ◽  
Learning Difficulties ◽  
Exercise Programme ◽  
Control Group ◽  
Primitive Reflexes ◽  
Short Period ◽  
Psychology Pedagogy ◽  
Auditory Analysis

Background: The main goal of the research was to determine the usefulness of the Integration exercise programme stimulating development in children with learning difficulties who have preserved vestigial primitive reflexes. Their symptoms included weak motor and visual-motor coordination, lowered visual and auditory analysis and synthesis which resulted in difficulties in reading and writing, disrupted emotional development, psychomotor hyperactivity, weak concentration and other symptoms. Material/ Methods: 104 children with learning difficulties and other accompanying symptoms took part in the experiment. The children were trained in the shape of the Integration exercise programme at school under a therapist’s supervision and additionally at home under parental supervision. The children who went through the whole programme were qualified to the experimental group and those who resigned from the programme after a short period of time – to the control group. A pre-test and a post-test, before and after completion of the Integration exercise programme, was used to evaluate the results. Results: It was found that the Integration exercise programme is useful in therapy involving facilitation of development in children with learning difficulties, who exhibit various symptoms. Almost all the obtained results were statistically significant. The Integration exercise programme is particularly effective in the case of children exhibiting a whole set of symptoms along with learning difficulties, problems with concentration, weak emotion control, weak motor development, abnormal muscle tension, weak motor coordination. Conclusions:The Integration exercise programme widens the range of methods stimulating development and the range of possibilities to apply the therapy practiced in psychology, pedagogy and physiotherapy.

Declines in physical function from androgen deprivation therapy (ADT) in men with nonmetastatic prostate cancer: A matched cohort study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9526-9526
Author(s):  
H. Breunis ◽  
N. Timilshina ◽  
G. Tomlinson ◽  
G. Naglie ◽  
I. Tannock ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cohort Study ◽  
Physical Function ◽  
Grip Strength ◽  
Upper Extremity ◽  
Control Group ◽  
Healthy Controls ◽  
Matched Cohort ◽  
Control Groups ◽  
Sf 36

9526 Background: Although prolonged use of ADT is hypothesized to adversely affect physical function, few studies have examined this relationship longitudinally using objective measures of physical function. Methods: Men age 50+ with non-metastatic prostate cancer (PC) starting continuous ADT were enrolled in this prospective longitudinal matched cohort study. Physical function was assessed with the six-minute walk test (6MWT), grip strength, and the Timed Up and Go (TUG) test, representing endurance, upper extremity strength, and lower extremity strength, respectively. Self-reported physical function was measured with the Medical Outcomes Study SF-36. Assessments were done at baseline, 3 months, 6 months, and 12 months. Two control groups, matched on age, education, and baseline function were also enrolled. One control group had PC but did not receive ADT, and the other group did not have PC. Linear mixed effects regression models were fitted adjusting for baseline covariates. Results: 85 patients on ADT, 86 PC controls, and 86 healthy controls were enrolled. All 3 groups were similar in age (mean age 69.1 y, range 50–87) and physical function (all ANOVA p>0.05). The 6MWT distance improved in both control groups (p=0.05 and 0.05 for PC and healthy controls, respectively) but remained stable in the ADT group (p=0.96)). Grip strength declined in the ADT group (p=0.04), remained stable in the PC control group (p=0.31), and improved in the healthy control group (p=0.008). TUG scores remained stable over time and across groups (p>0.10). SF-36 physical function declined in the ADT group (p<0.001) but increased in both control groups (p<0.001). Negative effects on outcomes were noted within 3–6 months of starting ADT and were larger with older age. Conclusions: Endurance, upper extremity strength, and self-reported physical function are affected within 3–6 months of starting ADT, particularly in older men. Declines persist at 12 months after adjustment for baseline function and covariates. Exercise intervention studies to counteract these losses are warranted. No significant financial relationships to disclose.

scholarly journals The Effect of High-Frequency Repetitive Transcranial Magnetic Stimulation on Functional Indices of Affected Upper Limb in Patients with Subacute Stroke

2018 ◽  
Author(s):  
F Moslemi Haghighi ◽  
A Kordi Yoosefinejad ◽  
M Razeghi ◽  
A H Shariat ◽  
Z Bagheri ◽  
...  
Keyword(s):  
Grip Strength ◽  
Upper Limb ◽  
High Frequency ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Pinch Strength ◽  
Control Group ◽  
Subacute Phase ◽  
Functional Indices ◽  
Experimental Group

Background: Repetitive transcranial magnetic stimulation (rTMS) is a novel technique that may improve recovery in patients with stoke, but the role of rTMS as an applied and practical treatment modality for stroke rehabilitation has not been established yet.Objective: This study was conducted to determine the effects of a rehabilitation program (RP) in conjunction with rTMS on functional indices of the paretic upper limb in the subacute phase of stroke.Material and Methods: Twenty patients in the subacute phase of stroke were randomly assigned into two groups: The high frequency rTMS (HF-rTMS) in conjunction with RP (experimental group), and the RP group (control group). The experimental group received 10 sessions of 20 Hz rTMS on the affected primary motor cortex and the other group received 10 sessions of RP. In experimental group, RP for the paretic hand was conducted following rTMS session. Box and block test (BBT), Fugl-Meyer Motor Assessment for upper limb (FMA-UL), grip strength and pinch strength were used to assess motor function before the first session and after  the last session of treatment.Results: Significant improvement in BBT, FMA-UL, grip strength and pinch strength was observed in both groups. Improvement of BBT and grip strength was significantly greater in the experimental group rather than the control group (p<0.05). FMA-UL score and the pinch strength were greater in the experimental group, although the differences were not statistically significant. Conclusion: HF-rTMS in conjunction with RP is effective to improve the function of upper limb. It seems HF-rTMS is a novel feasible and safe technique for hemiparesis patients in the subacute phase of stroke.

scholarly journals Effects of Neuromuscular Electrical Stimulation on Hemiplegic Upper Limb of Stroke Survivors: A Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Author(s):  
Wenyue Zhang ◽  
Shuye Pei ◽  
Juan Huang ◽  
Yao Tang ◽  
Huaidong Hu
Keyword(s):  
Electrical Stimulation ◽  
Randomized Controlled Trials ◽  
Upper Extremity ◽  
Upper Limb ◽  
Meta Analysis ◽  
Neuromuscular Electrical Stimulation ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled

Abstract Background: Whether NMES helps the recovery of upper limb function in patients with hemiparesis has not been confirmed. We conducted this meta-analysis to examine the effectiveness of neuromuscular electrical stimulation (NMES) for upper limb hemiparesis after stroke.Methods: Data sources such as Pubmed, Embase and Cochrane library databases were searched for all relevant studies that were carried out before December 1, 2018.We selected the randomized controlled trials (RCTs) which included chronic and acute stroke patients with upper extremity dysfunction. Then the intervention group which applied NMES was compared with a control group without NMES. Results: A total of 16 RCTs involving 691 patients were discerned from 248 searched articles. According to the forest plot ,NMES had a significant benefit on FMA-ue scale(SMD=0.44,95%CI 0.13 to 0.74,P=0.006).Also, NMES was positive for ARAT(SMD=0.31,95%CI 0.05 to 0.58,P=0.019)and MAL-AOU(SMD=0.59,95%CI 0.15 to1.04,P=0.009),but not for wrist MAS(SMD=-0.12,95%CI -0.43 to 0.19,P=0.434) or BI(SMD=0.51,95%CI -0.65 to 1.66,P=0.392).Conclusion: NMES application has beneficial impacts on upper extremity motor function in patients with stroke. This study suggests that NMES ought to be applied as a beneficial rehabilitation means in improving the upper function.

scholarly journals Midazolam Sedation Induces Upper Limb Coordination Deficits That Are Reversed by Flumazenil in Patients with Eloquent Area Gliomas

2019 ◽  
Vol 131 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Nan Lin ◽  
Ruquan Han ◽  
Xuan Hui ◽  
Kaiying Zhang ◽  
Adrian W. Gelb
Keyword(s):  
Upper Limb ◽  
Motor Coordination ◽  
Motor Dysfunction ◽  
Task Completion ◽  
Control Group ◽  
Dominant Hand ◽  
Nondominant Hand ◽  
Eloquent Area ◽  
Before And After ◽  
Contralateral Hand

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Midazolam has been found to exacerbate or unmask limb motor dysfunction in patients with brain tumors. This study aimed to determine whether the exacerbated upper limb motor-sensory deficits are mediated through benzodiazepine sites by demonstrating reversibility by flumazenil in patients with gliomas in eloquent areas. Methods This was an interventional, parallel assignment, nonrandomized trial. Study subjects were admitted in the operating room. Patients with supratentorial eloquent area gliomas and volunteers of similar age without neurologic disease were sedated with midazolam, but still responsive and cooperative. Motor and sensory functions for upper extremities were evaluated by the Nine-Hole Peg Test before and after midazolam, as well as after flumazenil reversal. Results Thirty-two cases were included: 15 in the glioma group and 17 in the control group. The total dose of midazolam and flumazenil were comparable between the groups. In the glioma group, the times to task completion after midazolam in the contralateral hand (P = 0.001) and ipsilateral hand (P = 0.002) were 26.5 (95% CI, 11.3 to 41.7) and 13.7 (95% CI, 5.0 to 22.4) seconds slower than baseline, respectively. After flumazenil reversal, the contralateral hand (P = 0.99) and ipsilateral hand (P = 0.187) performed 1.2 (95% CI, −3.3 to 5.8) and 1.5 (95% CI, −0.5 to 3.5) seconds slower than baseline, respectively. In the control group, the dominant (P &lt; 0.001) and nondominant hand (P = 0.006) were 2.9 (95% CI, 1.4 to 4.3) and 1.7 (95% CI, 0.5 to 2.9) seconds slower than baseline, respectively. After flumazenil, the dominant hand (P = 0.99) and nondominant hand (P = 0.019) performed 0.2 (95% CI, −0.7 to 1.0) and 1.3 (95% CI, −0.2 to 2.4) seconds faster than baseline, respectively. Conclusions In patients with eloquent area gliomas, mild sedation with midazolam induced motor coordination deficits in upper limbs. This deficit was almost completely reversed by the benzodiazepine antagonist flumazenil, suggesting that this is a reversible abnormality linked to occupation of the receptor by midazolam.

Study of Effectiveness of Shoulder Elbow Wrist Hand Orthosis in the Management of Glenohumeral Subluxation in Post-stroke Hemiplegic Patients

2016 ◽  
Vol 27 (3) ◽  
pp. 78-86
Author(s):  
G. Sonachand Sharma ◽  
Alex T Touthang ◽  
Y. Nandabir Singh ◽  
Ak. Joy ◽  
Bimol Singh ◽  
...  
Keyword(s):  
Upper Limb ◽  
Rehabilitation Programme ◽  
Randomised Control Trial ◽  
Control Group ◽  
Medical Sciences ◽  
Physical Medicine ◽  
X Ray ◽  
Post Stroke ◽  
Physical Medicine And Rehabilitation ◽  
Regional Institute

Abstract Objective Study of effectiveness of shoulder elbow wrist hand orthosis in the management of glenohumeral subluxation in post-stroke hemiplegic patients. Methods Design: Randomised control trial. Setting Department of Physical Medicine and Rehabilitation, Regional Institute of Medical Sciences (RIMS), Imphal. Participants Post-stroke hemiplegic patients (n=120) having glenohumeral subluxation (GHS) as confirmed by x-ray. Duration One and half years (August 2010 to January 2012). Intervention Control group (n=60) received routine rehabilitation programme for hemiplegic practice in the Department of PMR, RIMS while the experiment group (n=60) received shoulder elbow wrist hand orthosis in addition to rehabilitation programme. Outcomes Grade of glenohumeral subluxation using x-ray. Results Experiment group showed reduction in the glenohumeral subluxation which is statistically significant when compared to control group (p<0.001). Conclusions Use of upper limb orthosis in addition to routine rehabilitation programme can effectively reduce glenohumeral subluxation in post-stroke hemiplegic patients.

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