Virtual Reality effect on upper limb Motor function paretic in post stroke

2015 ◽  
Vol 23 (04) ◽  
pp. 493-498 ◽  
Author(s):  
Maria Luiza Galvão ◽  
Príscila Gouvêa ◽  
Gabriela Ocamoto ◽  
Adriana Silva ◽  
Luciana Reis ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Motor Function ◽  
Upper Limb ◽  
Post Stroke ◽  
Reality Effect

scholarly journals Effectiveness of a combined transcranial direct current stimulation and virtual reality-based intervention on upper limb function in chronic individuals post-stroke with persistent severe hemiparesis: a randomized controlled trial

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Roberto Llorens ◽  
María Antonia Fuentes ◽  
Adrián Borrego ◽  
Jorge Latorre ◽  
Mariano Alcañiz ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Physical Therapy ◽  
Motor Function ◽  
Upper Limb ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Sensorimotor Function ◽  
Meaningful Improvement ◽  
Direct Current Stimulation ◽  
Post Stroke

Abstract Background Functional impairments derived from the non-use of severely affected upper limb after stroke have been proposed to be mitigated by action observation and imagination-based techniques, whose effectiveness is enhanced when combined with transcranial direct current stimulation (tDCS). Preliminary studies in mildly impaired individuals in the acute phase post-stroke show intensified effects when action is facilitated by tDCS and mediated by virtual reality (VR) but the effectiveness in cases of severe impairment and chronic stroke is unknown. This study investigated the effectiveness of a combined tDCS and VR-based intervention in the sensorimotor function of chronic individuals post-stroke with persistent severe hemiparesis compared to conventional physical therapy. Methods Twenty-nine participants were randomized into an experimental group, who received 30 minutes of the combined tDCS and VR-based therapy and 30 minutes of conventional physical therapy, or a control group, who exclusively received conventional physical therapy focusing on passive and active assistive range of motion exercises. The sensorimotor function of all participants was assessed before and after 25 one-hour sessions, administered three to five times a week, using the upper extremity subscale of the Fugl-Meyer Assessment, the time and ability subscales of the Wolf Motor Function Test, and the Nottingham Sensory Assessment. Results A clinically meaningful improvement of the upper limb motor function was consistently revealed in all motor measures after the experimental intervention, but not after conventional physical therapy. Similar limited effects were detected in the sensory function in both groups. Conclusion The combined tDCS and VR-based paradigm provided not only greater but also clinically meaningful improvement in the motor function (and similar sensory effects) in comparison to conventional physical therapy.

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

2015 ◽  
Vol 37 (5) ◽  
pp. 434-440 ◽  
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

scholarly journals Virtual reality applied to the lower limb motor function in post-stroke individuals

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
Marcos Paulo Braz de Oliveira ◽  
Daiane Marques Ferreira ◽  
Josie Resende Torres da Silva ◽  
Andreia Maria Silva ◽  
Daniel Ferreira Moreira Lobato ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Motor Function ◽  
Lower Limb ◽  
Post Stroke

Efficacy of motor imagery additional to motor-based therapy in the recovery of motor function of the upper limb in post-stroke individuals: a systematic review

2019 ◽  
Vol 26 (7) ◽  
pp. 548-553 ◽  
Author(s):  
Tácia Cotinguiba Machado ◽  
Adriani Andrade Carregosa ◽  
Matheus S. Santos ◽  
Nildo Manoel da Silva Ribeiro ◽  
Ailton Melo
Keyword(s):  
Systematic Review ◽  
Motor Function ◽  
Motor Imagery ◽  
Upper Limb ◽  
Post Stroke ◽  
Recovery Of Motor Function

scholarly journals β-Oscillations Reflect Recovery of the Paretic Upper Limb in Subacute Stroke

2020 ◽  
Vol 34 (5) ◽  
pp. 450-462 ◽  
Author(s):  
Chih-Wei Tang ◽  
Fu-Jung Hsiao ◽  
Po-Lei Lee ◽  
Yun-An Tsai ◽  
Ya-Fang Hsu ◽  
...  
Keyword(s):  
Motor Function ◽  
Upper Limb ◽  
Primary Motor Cortex ◽  
Hand Movement ◽  
Stroke Recovery ◽  
Stroke Survivors ◽  
Healthy Controls ◽  
Functional Changes ◽  
Post Stroke ◽  
Subacute Stroke

Background. Recovery of upper limb function post-stroke can be partly predicted by initial motor function, but the mechanisms underpinning these improvements have yet to be determined. Here, we sought to identify neural correlates of post-stroke recovery using longitudinal magnetoencephalography (MEG) assessments in subacute stroke survivors. Methods. First-ever, subcortical ischemic stroke survivors with unilateral mild to moderate hand paresis were evaluated at 3, 5, and 12 weeks after stroke using a finger-lifting task in the MEG. Cortical activity patterns in the β-band (16-30 Hz) were compared with matched healthy controls. Results. All stroke survivors (n=22; 17 males) had improvements in action research arm test (ARAT) and Fugl-Meyer upper extremity (FM-UE) scores between 3 and 12 weeks. At 3 weeks post-stroke the peak amplitudes of the movement-related ipsilesional β-band event-related desynchronization (β-ERD) and synchronization (β-ERS) in primary motor cortex (M1) were significantly lower than the healthy controls (p<0.001) and were correlated with both the FM-UE and ARAT scores (r=0.51-0.69, p<0.017). The decreased β-ERS peak amplitudes were observed both in paretic and non-paretic hand movement particularly at 3 weeks post-stroke, suggesting a generalized disinhibition status. The peak amplitudes of ipsilesional β-ERS at week 3 post-stroke correlated with the FM-UE score at 12 weeks (r=0.54, p=0.03) but no longer significant when controlling for the FM-UE score at 3 weeks post-stroke. Conclusions. Although early β-band activity does not independently predict outcome at 3 months after stroke, it mirrors functional changes, giving a potential insight into the mechanisms underpinning recovery of motor function in subacute stroke.

scholarly journals Augmented Efficacy of Intermittent Theta Burst Stimulation on the Virtual Reality-based Cycling Training for Upper Limb Function in Patients With Stroke

2020 ◽  
Author(s):  
Yu-Hsin Chen ◽  
Chia-Ling Chen ◽  
Ying-Zu Huang ◽  
Hsieh-Ching Chen ◽  
Chung-Yao Chen ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Upper Extremity ◽  
Motor Function ◽  
Upper Limb ◽  
Manual Dexterity ◽  
Therapeutic Effects ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Theta Burst ◽  
Cycling Training

Abstract Background: Virtual reality and arm cycling have been reported as effective treatment to improve upper limb motor recovery in patients with stroke. Intermittent theta burst stimulation (iTBS) can increase ipsilesional cortical excitability, and has been increasingly used in patients with stroke. However, few studies examined the augmented effect of iTBS on neurorehabilitation program. In this study, we investigated the augmented effect of iTBS on virtual reality-based cycling training (VCT) for upper limb motor function in patients with stroke.Methods: In this randomized controlled trial, 23 patients with stroke were recruited. Each patient received either 15 sessions of iTBS or sham stimulation in addition to VCT on the same day. Outcome measures, including Modified Ashworth Scale Upper Extremity (MAS-UE), Fugl-Meyer Assessment Upper Extremity (FMA-UE) for body function, Action Research Arm Test (ARAT), Nine Hole Peg Test (NHPT), Box and Block Test (BBT) and Motor Activity Log (MAL) for activity and Stroke Impact Scale (SIS) for participation were assessed before and after the intervention. Paired t test was performed to evaluate the effectiveness after the intervention and analysis of covariance (ANCOVA) was conducted to compare the therapeutic effects between two groups.Results: At post-treatment, both groups showed significant improvement in FMA-UE and ARAT, while only the iTBS group demonstrated significant improvement in MAS-UE, BBT, NHPT, MAL and SIS. ANCOVA revealed that the iTBS group presented greater improvement than the sham group significantly in MAS-UE, NHPT and SIS, and with borderline significance in ARAT, BBT and MAL. There was no significant difference in FMA-UE between groups.Conclusions: Intermittent TBS showed augmented efficacy on VCT for reducing spasticity, improving gross motor function and manual dexterity, and increasing participation in daily life in stroke patients. This study provided an integrated innovative intervention, which may be a promising therapy to improve upper limb motor function recovery, especially manual dexterity, in stroke rehabilitation. However, this study has a small sample size, and thus a further larger-scale study is warranted to confirm the treatment efficacy.Trial registration: This trial was registered under ClinicalTrials.gov ID No. NCT03350087, retrospectively registered, on November 22, 2017.

scholarly journals Robotic Assisted Upper Limb Training Post Stroke: A Randomized Control Trial Using Combinatory Approach Toward Reducing Workforce Demands

2021 ◽  
Vol 12 ◽  
Author(s):  
Aamani Budhota ◽  
Karen S. G. Chua ◽  
Asif Hussain ◽  
Simone Kager ◽  
Adèle Cherpin ◽  
...  
Keyword(s):  
Motor Function ◽  
Upper Limb ◽  
Conventional Therapy ◽  
Randomized Control Trial ◽  
Potential Method ◽  
Clinical Trial Registration ◽  
Upper Limb Rehabilitation ◽  
Post Stroke ◽  
Robotic Therapy ◽  
Randomized Control

Post stroke upper limb rehabilitation is a challenging problem with poor outcomes as 40% of survivors have functionally useless upper limbs. Robot-aided therapy (RAT) is a potential method to alleviate the effort of intensive, task-specific, repetitive upper limb exercises for both patients and therapists. The present study aims to investigate how a time matched combinatory training scheme that incorporates conventional and RAT, using H-Man, compares with conventional training toward reducing workforce demands. In a randomized control trial (NCT02188628, www.clinicaltrials.gov), 44 subacute to chronic stroke survivors with first-ever clinical stroke and predominant arm motor function deficits were recruited and randomized into two groups of 22 subjects: Robotic Therapy (RT) and Conventional Therapy (CT). Both groups received 18 sessions of 90 min; three sessions per week over 6 weeks. In each session, participants of the CT group received 90 min of 1:1 therapist-supervised conventional therapy while participants of the RT group underwent combinatory training which consisted of 60 min of minimally-supervised H-Man therapy followed by 30 min of conventional therapy. The clinical outcomes [Fugl-Meyer (FMA), Action Research Arm Test and, Grip Strength] and the quantitative measures (smoothness, time efficiency, and task error, derived from two robotic assessment tasks) were independently evaluated prior to therapy intervention (week 0), at mid-training (week 3), at the end of training (week 6), and post therapy (week 12 and 24). Significant differences within group were observed at the end of training for all clinical scales compared with baseline [mean and standard deviation of FMA score changes between baseline and week 6; RT: Δ4.41 (3.46) and CT: Δ3.0 (4.0); p &lt; 0.01]. FMA gains were retained 18 weeks post-training [week 24; RT: Δ5.38 (4.67) and week 24 CT: Δ4.50 (5.35); p &lt; 0.01]. The RT group clinical scores improved similarly when compared to CT group with no significant inter-group at all time points although the conventional therapy time was reduced to one third in RT group. There were no training-related adverse side effects. In conclusion, time matched combinatory training incorporating H-Man RAT produced similar outcomes compared to conventional therapy alone. Hence, this study supports a combinatory approach to improve motor function in post-stroke arm paresis.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT02188628.

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