Effects of Group Mirror Therapy on Upper Limb Mobility and Sensory Function in Community-dwelling Patients with Chronic Stroke

2020 ◽  
Vol 10 (2) ◽  
pp. 40-47
Author(s):  
Myung-sook Ko ◽  
◽  
Myung Ja Kong
Keyword(s):  
Upper Limb ◽  
Chronic Stroke ◽  
Community Dwelling ◽  
Sensory Function ◽  
Mirror Therapy

Influence of task-oriented circuit training on upper limb function among rural community-dwelling survivors of stroke

2020 ◽  
Vol 27 (8) ◽  
pp. 1-8
Author(s):  
Shruti Deshpande ◽  
Sidhiparada Mohapatra ◽  
N Girish
Keyword(s):  
Upper Limb ◽  
Chronic Stroke ◽  
Community Dwelling ◽  
Rank Test ◽  
Circuit Training ◽  
Rehabilitation Centre ◽  
Limb Function ◽  
Upper Limb Rehabilitation ◽  
Upper Limb Function ◽  
Task Oriented

Background Task-oriented circuit training using a Multi-Activities workstation emphasises goal-oriented tasks practiced in a circuit or series in order to learn a new skill. It can be used for upper limb rehabilitation among stroke patients in a community setting, but there is currently very little evidence available regarding its use in this patient group and setting. This study aimed to explore the influence of task-oriented circuit training using a Multi-Activities workstation on upper limb function among community-dwelling individuals with chronic stroke. Methods A pre-test–post-test study was conducted involving 17 community-dwelling individuals with chronic stroke who were attending a stroke rehabilitation centre. Six weeks of task-oriented circuit training was given using a Multi-Activities workstation aimed to improve strength, range of motion and dexterity. Streamlined Wolf Motor Function Test and Chedoke Arm and Hand Activity Inventory were used to measure outcomes. Wilcoxon signed-rank test was used for data analysis. Results A total of 12 sessions of task-oriented circuit training using Multi-Activities workstations did not result in any statistically significant differences in outcome measures. Conclusions Task-oriented circuit training using the Multi-Activities workstation did not improve upper limb function in community-dwelling individuals with chronic stroke.

scholarly journals Robotic-based ACTive somatoSENSory (Act.Sens) retraining on upper limb functions with chronic stroke survivors: study protocol for a pilot randomised controlled trial

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ananda Sidarta ◽  
Yu Chin Lim ◽  
Christopher Wee Keong Kuah ◽  
Yong Joo Loh ◽  
Wei Tech Ang
Keyword(s):  
Randomised Controlled Trial ◽  
Study Protocol ◽  
Upper Limb ◽  
Controlled Trial ◽  
Chronic Stroke ◽  
Community Dwelling ◽  
Control Group ◽  
Stroke Survivors ◽  
Pilot Randomised Controlled Trial ◽  
Randomised Controlled

Abstract Background Prior studies have established that senses of the limb position in space (proprioception and kinaesthesia) are important for motor control and learning. Although nearly one-half of stroke patients have impairment in the ability to sense their movements, somatosensory retraining focusing on proprioception and kinaesthesia is often overlooked. Interventions that simultaneously target motor and somatosensory components are thought to be useful for relearning somatosensory functions while increasing mobility of the affected limb. For over a decade, robotic technology has been incorporated in stroke rehabilitation for more controlled therapy intensity, duration, and frequency. This pilot randomised controlled trial introduces a compact robotic-based upper-limb reaching task that retrains proprioception and kinaesthesia concurrently. Methods Thirty first-ever chronic stroke survivors (> 6-month post-stroke) will be randomly assigned to either a treatment or a control group. Over a 5-week period, the treatment group will receive 15 training sessions for about an hour per session. Robot-generated haptic guidance will be provided along the movement path as somatosensory cues while moving. Audio-visual feedback will appear following every successful movement as a reward. For the same duration, the control group will complete similar robotic training but without the vision occluded and robot-generated cues. Baseline, post-day 1, and post-day 30 assessments will be performed, where the last two sessions will be conducted after the last training session. Robotic-based performance indices and clinical assessments of upper limb functions after stroke will be used to acquire primary and secondary outcome measures respectively. This work will provide insights into the feasibility of such robot-assisted training clinically. Discussion The current work presents a study protocol to retrain upper-limb somatosensory and motor functions using robot-based rehabilitation for community-dwelling stroke survivors. The training promotes active use of the affected arm while at the same time enhances somatosensory input through augmented feedback. The outcomes of this study will provide preliminary data and help inform the clinicians on the feasibility and practicality of the proposed exercise. Trial registration ClinicalTrials.gov NCT04490655. Registered 29 July 2020.

Greater Cortical Thickness Is Associated With Enhanced Sensory Function After Arm Rehabilitation in Chronic Stroke

2018 ◽  
Vol 32 (6-7) ◽  
pp. 590-601 ◽  
Author(s):  
Svetlana Pundik ◽  
Aleka Scoco ◽  
Margaret Skelly ◽  
Jessica P. McCabe ◽  
Janis J. Daly
Keyword(s):  
Cortical Thickness ◽  
Upper Limb ◽  
Posterior Parietal Cortex ◽  
Occipital Cortex ◽  
Chronic Stroke ◽  
Sensory Function ◽  
Response To Treatment ◽  
Complex Nature ◽  
Sensory Recovery ◽  
Sensory Acuity

Objective. Somatosensory function is critical to normal motor control. After stroke, dysfunction of the sensory systems prevents normal motor function and degrades quality of life. Structural neuroplasticity underpinnings of sensory recovery after stroke are not fully understood. The objective of this study was to identify changes in bilateral cortical thickness (CT) that may drive recovery of sensory acuity. Methods. Chronic stroke survivors (n = 20) were treated with 12 weeks of rehabilitation. Measures were sensory acuity (monofilament), Fugl-Meyer upper limb and CT change. Permutation-based general linear regression modeling identified cortical regions in which change in CT was associated with change in sensory acuity. Results. For the ipsilesional hemisphere in response to treatment, CT increase was significantly associated with sensory improvement in the area encompassing the occipital pole, lateral occipital cortex (inferior and superior divisions), intracalcarine cortex, cuneal cortex, precuneus cortex, inferior temporal gyrus, occipital fusiform gyrus, supracalcarine cortex, and temporal occipital fusiform cortex. For the contralesional hemisphere, increased CT was associated with improved sensory acuity within the posterior parietal cortex that included supramarginal and angular gyri. Following upper limb therapy, monofilament test score changed from 45.0 ± 13.3 to 42.6 ± 12.9 mm ( P = .063) and Fugl-Meyer score changed from 22.1 ± 7.8 to 32.3 ± 10.1 ( P < .001). Conclusions. Rehabilitation in the chronic stage after stroke produced structural brain changes that were strongly associated with enhanced sensory acuity. Improved sensory perception was associated with increased CT in bilateral high-order association sensory cortices reflecting the complex nature of sensory function and recovery in response to rehabilitation.

scholarly journals Multi-sensory feedback therapy combined with task-oriented training on the hemiparetic upper limb in chronic stroke: study protocol for a pilot randomized controlled trial

2020 ◽  
Author(s):  
Jiali Lin ◽  
Jieying He ◽  
Beibei Shu ◽  
Jie Jia
Keyword(s):  
Upper Limb ◽  
Functional Recovery ◽  
Sensory Feedback ◽  
Therapy Group ◽  
Controlled Trial ◽  
Training Group ◽  
Chronic Stroke ◽  
Sensory Function ◽  
Double Blind ◽  
Task Oriented

Abstract Background An important reason for the difficulty in recovering sensorimotor dysfunction of the upper extremity in chronic stroke survivors, is the lack of sensory function, such as tactile and proprioception feedback. In clinical practice, single sensory training is only for the restoration of sensory function. Increasing evidence suggests that use of task-oriented training (TOT) is a useful approach to hand motor rehabilitation. However, neither approach is optimal since both methods are trained only for specific functional recovery. Our hypothesis is that multi-sensory feedback therapy (MSFT) combined with TOT has the potential to provide stimulating tasks to restore both sensory and motor functions. The objective of the trial is to investigate whether novel MSFT is more effective in improving arm sensorimotor function in chronic stroke phase than single TOT.Methods/Design: The study will be conducted as a multicenter, randomized, double blind controlled trial. Participants (n = 90) will be randomised into three groups to compare the effect of the multi-sensory feedback therapy group against task-oriented training group and conventional group. Participants will receive treatment at the same intensity (60 min, 5 days a week, 4 weeks, 20 hours total). Primary outcome measures for assessment of sensory function are the Semmes Weinstein monofilaments examination (SWME),two-point discrimination test (2PD) test. Secondary measures are the Action Research Arm Test (ARAT)༌Nine-Hole Peg Test (NHPT), Wolf Motor Function Test (WMFT), Box and Blocks Test (BBT), Modified Barthel Index (MBI), Instrumental activities of daily living (IADL) and Generalized Anxiety Disorder 7-Item Scale (GAD-7). Outcome mearsures will be evaluated at baseline, post treatment, and two months follow-up. All assessments will be conducted by trained assessors blinded to treatment allocation.Discussion This study will determine the acceptability and efficacy of the intervention on the hemiparetic upper limb, it may be promising tools for sensorimotor functional recovery after stroke.

Upper-limb motor and sensory function in patients with hip fracture: Comparison with community-dwelling older adults

2017 ◽  
Vol 30 (6) ◽  
pp. 1231-1236
Author(s):  
Hiroyuki Hayashi ◽  
Daiki Nakashima ◽  
Hiroka Matsuoka ◽  
Midori Iwai ◽  
Shugo Nakamura ◽  
...  
Keyword(s):  
Older Adults ◽  
Hip Fracture ◽  
Upper Limb ◽  
Community Dwelling ◽  
Sensory Function ◽  
Community Dwelling Older Adults

scholarly journals Mirror Therapy Rehabilitation in Stroke: A Scoping Review of Upper Limb Recovery and Brain Activities

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Nurulhuda Jaafar ◽  
Ahmad Zamir Che Daud ◽  
Nor Faridah Ahmad Roslan ◽  
Wahidah Mansor
Keyword(s):  
Upper Limb ◽  
Scoping Review ◽  
Brain Activity ◽  
Chronic Stroke ◽  
The Body ◽  
International Classification Of Functioning ◽  
Functional Domain ◽  
Mirror Therapy ◽  
Positive Effects ◽  
Upper Limb Function

Background. Mirror therapy (MT) has been used as a treatment for various neurological disorders. Recent application of electroencephalogram (EEG) to the MT study allows researchers to gain insight into the changes in brain activity during the therapy. Objective. This scoping review is aimed at mapping existing evidence and identifying knowledge gaps about the effects of MT on upper limb recovery and its application for individuals with chronic stroke. Methods and Materials. A scoping review through a systematic literature search was conducted using PubMed, CINAHL, PsycINFO, and Scopus databases. Twenty articles published between 2010 and 2020 met the inclusion criteria. The efficacy of MT on upper limb recovery and brain activity during MT were discussed according to the International Classification of Functioning, Disability and Health (ICF). Results. A majority of the studies indicated positive effects of MT on upper limb recovery from the body structure/functional domain. All studies used EEG to indicate brain activation during MT. Conclusion. MT is a promising intervention for improving upper limb function for individuals with chronic stroke. This review also highlights the need to incorporate EEG into the MT study to capture brain activity and understand the mechanism underlying the therapy.

Revisiting Poststroke Upper Limb Stratification: Resilience in a Larger Cohort

2021 ◽  
pp. 154596832199204
Author(s):  
Benjamin J. Varley ◽  
Christine T. Shiner ◽  
Liam Johnson ◽  
Penelope A. McNulty ◽  
Angelica G. Thompson-Butel
Keyword(s):  
Clinical Practice ◽  
Motor Function ◽  
Upper Limb ◽  
Hierarchical Cluster ◽  
Community Dwelling ◽  
Stratification Method ◽  
Wolf Motor Function Test ◽  
Block Test ◽  
Time Restriction ◽  
Post Hoc

Background Upper limb (UL) impairment in stroke survivors is both multifactorial and heterogeneous. Stratification of motor function helps identify the most sensitive and appropriate assessments, which in turn aids the design of effective and individualized rehabilitation strategies. We previously developed a stratification method combining the Grooved Pegboard Test (GPT) and Box and Block Test (BBT) to stratify poststroke UL motor function. Objective To investigate the resilience of the stratification method in a larger cohort and establish its appropriateness for clinical practice by investigating limitations of the GPT completion time. Methods Post hoc analysis of motor function for 96 community-dwelling participants with stroke (n = 68 male, 28 female, age 60.8 ± 14 years, 24.4 ± 36.6 months poststroke) was performed using the Wolf Motor Function Test (WMFT), Fugl-Meyer Assessment (F-M), BBT, and GPT. Hypothesis-free and hypothesis-based hierarchical cluster analyses were conducted to determine the resilience of the stratification method. Results The hypothesis-based analysis identified the same functional groupings as the hypothesis-free analysis: low (n = 32), moderate (n = 26), and high motor function (n = 38), with 3 exceptions. Thirty-three of the 38 participants with fine manual dexterity completed the GPT in ≤5 minutes. The remaining 5 participants took 6 to 25 minutes to place all 25 pegs but used alternative movement strategies to complete the test. The GPT time restriction changed the functional profile of the moderate and high motor function groups leading to more misclassifications. Conclusion The stratification method unambiguously classifies participants by UL motor function. While the inclusion of a 5-minute cutoff time for the GPT is preferred for clinical practice, it is not recommended for stratification purposes.

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