scholarly journals Investigation of fMRI protocol for evaluation of Gestural Interaction applied to upper-limb motor improvement

2019 ◽  
Vol 10 (1) ◽  
pp. 1
Author(s):  
Alexandre Fonseca Brandao ◽  
Raphael Casseb ◽  
Sara Almeida ◽  
Gilda Assis ◽  
Alline Camargo ◽  
...  
Keyword(s):  
Upper Limb ◽  
Healthy Subjects ◽  
Brain Connectivity ◽  
Training Session ◽  
Resting State Fmri ◽  
Stroke Patients ◽  
Evaluation Protocol ◽  
Gestural Interaction ◽  
Before And After ◽  
Motor Improvement

The use of Virtual Reality (VR) systems for rehabilitation treatment as a complement to conventional therapy has grown in recent years. Upper limbs therapy using VR has already been shown useful for stroke patients. In this work, we present a pilot study aiming to investigate the use of a functional magnetic resonance imaging (fMRI) protocol to analyze brain connectivity changes in subjects undergoing upper limb training through a VR environment. Thirteen healthy subjects underwent resting-state fMRI exams before and after a VR session. Although no significant changes are expected in healthy subjects performing only one training session, this study could pave the way for future studies performed with both stroke patients or athletes performing more sessions. Indeed, no significant changes in motor cortex connectivity were found. Nonetheless, an evaluation protocol for this type of VR rehabilitation procedure was successfully established, to be used in further studies with patients or athletes.

Differences in somatosensory and motor improvement during temporary functional deafferentation in stroke patients and healthy subjects

2013 ◽  
Vol 252 ◽  
pp. 110-116 ◽  
Author(s):  
Elisabeth Sens ◽  
Christin Knorr ◽  
Christoph Preul ◽  
Winfried Meissner ◽  
Otto W. Witte ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Stroke Patients ◽  
Motor Improvement

scholarly journals Longitudinal Brain Functional Connectivity Changes of the Cortical Motor-Related Network in Subcortical Stroke Patients with Acupuncture Treatment

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Yongxin Li ◽  
Ya Wang ◽  
Chenxi Liao ◽  
Wenhua Huang ◽  
Ping Wu
Keyword(s):  
Functional Connectivity ◽  
Western Medicine ◽  
Primary Motor Cortex ◽  
Brain Connectivity ◽  
Effective Means ◽  
Brain Network ◽  
Stroke Patients ◽  
Rehabilitation Therapy ◽  
Cortical Motor ◽  
Before And After

In clinical practice, the effectiveness of the rehabilitation therapy such as acupuncture combining conventional Western medicine (AG) on stroke people’s motor-related brain network and their behaviors has not been systematically studied. In the present study, seventeen adult ischemic patients were collected and divided into two groups: the conventional Western medicine treatment group (CG) and the AG. The neurological deficit scores (NDS) and resting-state functional MRI data were collected before and after treatment. Compared with the CG patients, AG patients exhibited a significant enhancement of the percent changes of NDS from pre- to posttreatment intervention. All patients showed significant changes of functional connectivity (FC) between the pair of cortical motor-related regions. After treatment, both patient groups showed a recovery of brain connectivity to the nearly normal level compared with the controls in these pairs. Moreover, a significant correlation between the percent changes of NDS and the pretreatment FC values of bilateral primary motor cortex (M1) in all patients was found. In conclusion, our results showed that AG therapy can be an effective means for ischemic stroke patients to recover their motor function ability. The FC strengths between bilateral M1 of stroke patients can predict stroke patients’ treatment outcome after rehabilitation therapy.

scholarly journals Can somatosensory electrical stimulation relieve spasticity in post-stroke patients? A TMS pilot study

2018 ◽  
Vol 63 (4) ◽  
pp. 501-506 ◽  
Author(s):  
André Salles Cunha Peres ◽  
Victor Hugo Souza ◽  
João Marcos Yamasaki Catunda ◽  
Kelley Cristine Mazzeto-Betti ◽  
Taiza Elaine Grespan Santos-Pontelli ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Healthy Subjects ◽  
Motor Evoked Potentials ◽  
Wrist Joint ◽  
Single Pulse ◽  
Stroke Patients ◽  
Passive Resistance ◽  
Before And After ◽  
Carry Over ◽  
Carry Over Effect

Abstract Evidence suggests that somatosensory electrical stimulation (SES) may decrease the degree of spasticity from neural drives, although there is no agreement between corticospinal modulation and the level of spasticity. Thus, stroke patients and healthy subjects were submitted to SES (3 Hz) for 30′ on the impaired and dominant forearms, respectively. Motor evoked potentials induced by single-pulse transcranial magnetic stimulation were collected from two forearm muscles before and after SES. The passive resistance of the wrist joint was measured with an isokinetic system. We found no evidence of an acute carry-over effect of SES on the degree of spasticity.

scholarly journals Wrist Actimetry Biomarker Development of Paretic Upper Limb Use in Post Stroke Patients for Ecological Monitoring.

2021 ◽  
Author(s):  
Gilles Dusfour ◽  
Denis Mottet ◽  
Makii Muthalib ◽  
Isabelle Laffont ◽  
Karima K.A. Bakhti
Keyword(s):  
Home Environment ◽  
Upper Limb ◽  
Healthy Subjects ◽  
Limiting Factors ◽  
Cumulative Probability ◽  
Limiting Factor ◽  
Upper Limbs ◽  
Stroke Patients ◽  
Post Stroke ◽  
Paretic Side

Abstract Background In post-stroke patients it is unclear which wrist actimetry biomarkers to use to estimate the degree of upper limb hemiparesis. The objective of this study was to develop a general and objective framework for monitoring hemiparetic patients in their home environment via different biomarkers based on 7 days of actimetry data. A secondary objective was to use all of these biomarkers to better understand the mechanism for potential non-use of the paretic upper limb. Methods Accelerometers were worn continuously for a period of 7 days on both wrists of 10 post-stroke hemiparetic patients as well as 6 healthy subjects. Various wrist actimetry biomarkers were calculated, including the Jerk ratio 50 (JR50, cumulative probability that the Jerk Ratio is between 0 and 0.5), absolute and relative amounts of functional use of movements of the upper limbs (FuncUse and FuncUseR) and absolute and relative velocities of the upper limbs during functional use (VUL and VULR). For each biomarker, the values of stroke and healthy groups were compared. The correlations between all the biomarkers were studied. Results We studied 10 participants with mild-to-moderate chronic hemiparesis and 6 healthy control participants. FuncUse and VUL of the paretic upper limb of stroke patients were significantly lower than in the non-dominant upper limb of healthy subjects. Similarly, FuncUseR (paretic/non-paretic vs non-dominant/dominant), JR and VULR are significantly lower in stroke patients than in healthy subjects. FuncUseR, VULR and JR50 seem to be complementary biomarkers for monitoring patient strokes. Conclusion The stroke patients do not seem to compensate for the decrease in functional movement on the paretic side by an increase on the non-paretic side. The speed of execution of functional movements on the paretic side could be the limiting factor to a normal use of the paretic upper limb. A thorough clinical study is needed to identify the limiting factors. In conclusion, this study for the first time has shown actimetry is a robust and non-obtrusive lightweight technology for continuously acquiring objective upper limb data of paretic arm use/ non-use over an extended period in a home environment for monitoring stroke patients.

scholarly journals Brain-Computer Interface Coupled to a Robotic Hand Orthosis for Stroke Patients’ Neurorehabilitation: A Crossover Feasibility Study

2021 ◽  
Vol 15 ◽  
Author(s):  
Jessica Cantillo-Negrete ◽  
Ruben I. Carino-Escobar ◽  
Paul Carrillo-Mora ◽  
Marlene A. Rodriguez-Barragan ◽  
Claudia Hernandez-Arenas ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Upper Limb ◽  
Conventional Therapy ◽  
Stroke Rehabilitation ◽  
Motor Evoked Potentials ◽  
Random Order ◽  
Robotic Hand ◽  
Stroke Patients ◽  
Significant Difference ◽  
Before And After

Brain-Computer Interfaces (BCI) coupled to robotic assistive devices have shown promise for the rehabilitation of stroke patients. However, little has been reported that compares the clinical and physiological effects of a BCI intervention for upper limb stroke rehabilitation with those of conventional therapy. This study assesses the feasibility of an intervention with a BCI based on electroencephalography (EEG) coupled to a robotic hand orthosis for upper limb stroke rehabilitation and compares its outcomes to conventional therapy. Seven subacute and three chronic stroke patients (M = 59.9 ± 12.8) with severe upper limb impairment were recruited in a crossover feasibility study to receive 1 month of BCI therapy and 1 month of conventional therapy in random order. The outcome measures were comprised of: Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), motor evoked potentials elicited by transcranial magnetic stimulation (TMS), hand dynamometry, and EEG. Additionally, BCI performance and user experience were measured. All measurements were acquired before and after each intervention. FMA-UE and ARAT after BCI (23.1 ± 16; 8.4 ± 10) and after conventional therapy (21.9 ± 15; 8.7 ± 11) were significantly higher (p < 0.017) compared to baseline (17.5 ± 15; 4.3 ± 6) but were similar between therapies (p > 0.017). Via TMS, corticospinal tract integrity could be assessed in the affected hemisphere of three patients at baseline, in five after BCI, and four after conventional therapy. While no significant difference (p > 0.05) was found in patients’ affected hand strength, it was higher after the BCI therapy. EEG cortical activations were significantly higher over motor and non-motor regions after both therapies (p < 0.017). System performance increased across BCI sessions, from 54 (50, 70%) to 72% (56, 83%). Patients reported moderate mental workloads and excellent usability with the BCI. Outcome measurements implied that a BCI intervention using a robotic hand orthosis as feedback has the potential to elicit neuroplasticity-related mechanisms, similar to those observed during conventional therapy, even in a group of severely impaired stroke patients. Therefore, the proposed BCI system could be a suitable therapy option and will be further assessed in clinical trials.

scholarly journals Effect of Sensory Loss on Improvements of Upper-Limb Paralysis Through Robot-Assisted Training: A Preliminary Case Series Study

2019 ◽  
Vol 9 (18) ◽  
pp. 3925 ◽  
Author(s):  
Hiroyuki Miyasaka ◽  
Kotaro Takeda ◽  
Hitoshi Ohnishi ◽  
Abbas Orand ◽  
Shigeru Sonoda
Keyword(s):  
Upper Limb ◽  
Case Series ◽  
Sensory Loss ◽  
Stroke Patients ◽  
Robot Assisted ◽  
Motor Paralysis ◽  
Tendon Reflex ◽  
Case Series Study ◽  
Before And After ◽  
Series Study

Sensory disorder is a factor preventing recovery from motor paralysis after stroke. Although several robot-assisted exercises for the hemiplegic upper limb of stroke patients have been proposed, few studies have examined improvement in function in stroke patients with sensory disorder using robot-assisted training. In this study, the efficacies of robot training for the hemiplegic upper limb of three stroke patients with complete sensory loss were compared with those of 19 patients without complete sensory loss. Robot training to assist reach motion was performed in 10 sessions over a 2-week period for 5 days per week at 1 h per day. Before and after the training, the total Fugl–Meyer Assessment score excluding coordination and tendon reflex (FMA-total) and the FMA shoulder and elbow score excluding tendon reflex (FMA-S/E) were evaluated. Reach and path errors (RE and PE) during the reach motion were also evaluated by the arm-training robot. In most cases, both the FMA-total and the FMA-S/E scores improved. Cases with complete sensory loss showed worse RE and PE scores. Our results suggest that motor paralysis is improved by robot training. However, improvement may be varied according to the presence or absence of somatic sensory feedback.

scholarly journals The Value of Real-Time Shear Wave Elastography before and after Rehabilitation of Upper Limb Spasm in Stroke Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Jun Liu ◽  
Huijuan Pan ◽  
Yong Bao ◽  
Yanna Zhao ◽  
Li Huang ◽  
...  
Keyword(s):  
Shear Wave ◽  
Upper Limb ◽  
Biceps Brachii ◽  
Shear Wave Elastography ◽  
Stroke Patients ◽  
Rehabilitation Treatment ◽  
Modified Ashworth Scale ◽  
Significant Difference ◽  
Before And After ◽  
Ashworth Scale

Objective. Our goal was to evaluate the efficacy of muscle spasm before and after rehabilitation by comparing shear wave propagation velocity (SWV) and Young’s modulus (YM) in the normal and spastic biceps brachii in stroke patients. Methods. A study of 60 stroke patients with upper limb spasm was performed; these patients were admitted from April 2018 to September 2019. The modified Ashworth scale (MAS) scores of the spastic biceps brachii before and after rehabilitation treatment were compared. SWV and YM on the spastic and normal biceps brachii before rehabilitation treatment, SWV and YM on the spastic and normal biceps brachii after rehabilitation treatment, and SWV and YM on the spastic biceps brachii before and after rehabilitation treatment were compared. Whether SWV and YM on the spastic biceps brachii are related to MAS was compared. Results. There was a statistically significant difference in SWV and YM between the normal and spastic biceps brachii before (P<0.01) and after (P<0.05) the rehabilitation treatment. There was no statistically significant difference in SWV and YM in the normal biceps brachii before and after the rehabilitation treatment (P>0.05). There was a statistically significant difference in SWV and YM in the spastic biceps brachii before and after the rehabilitation treatment (P<0.01). SWV and FM of the spastic biceps brachii are correlated with MAS before and after rehabilitation treatment, and the correlation coefficient for SWV was 0.563 and 0.605 for YM (P<0.05). Conclusion. SWE can be used as a means of assessment before and after rehabilitation treatment.

scholarly journals Acupuncture Modulates the Functional Connectivity of the Default Mode Network in Stroke Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Yong Zhang ◽  
Kuangshi Li ◽  
Yi Ren ◽  
Fangyuan Cui ◽  
Zijing Xie ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Default Mode Network ◽  
Resting State Fmri ◽  
Brain Regions ◽  
Stroke Patients ◽  
Default Mode ◽  
Function Recovery ◽  
Abundant Evidence ◽  
Before And After ◽  
Hemispheric Infarction

Abundant evidence from previous fMRI studies on acupuncture has revealed significant modulatory effects at widespread brain regions. However, few reports on the modulation to the default mode network (DMN) of stroke patients have been investigated in the field of acupuncture. To study the modulatory effects of acupuncture on the DMN of stroke patients, eight right hemispheric infarction and stable ischemic stroke patients and ten healthy subjects were recruited to undergo resting state fMRI scanning before and after acupuncture stimulation. Functional connectivity analysis was applied with the bilateral posterior cingulate cortices chosen as the seed regions. The main finding demonstrated that the interregional interactions between the ACC and PCC especially enhanced after acupuncture at GB34 in stroke patients, compared with healthy controls. The results indicated that the possible mechanisms of the modulatory effects of acupuncture on the DMN of stroke patients could be interpreted in terms of cognitive ability and motor function recovery.

scholarly journals EEG predicts upper limb motor improvement after robotic rehabilitation in chronic stroke patients

2018 ◽  
Vol 61 ◽  
pp. e200-e201
Author(s):  
F. Bertolucci ◽  
G. Lamola ◽  
C. Fanciullacci ◽  
F. Artoni ◽  
A. Panarese ◽  
...  
Keyword(s):  
Upper Limb ◽  
Chronic Stroke ◽  
Robotic Rehabilitation ◽  
Stroke Patients ◽  
Motor Improvement

scholarly journals Modulating Brain Connectivity by Simultaneous Dual-Mode Stimulation over Bilateral Primary Motor Cortices in Subacute Stroke Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Jungsoo Lee ◽  
Eunhee Park ◽  
Ahee Lee ◽  
Won Hyuk Chang ◽  
Dae-Shik Kim ◽  
...  
Keyword(s):  
Motor Function ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Brain Connectivity ◽  
Resting State Fmri ◽  
Control Group ◽  
Stroke Patients ◽  
Dual Mode ◽  
Subacute Stroke ◽  
Interhemispheric Connectivity ◽  
Stimulation Group

Repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) has been used for the modulation of stroke patients’ motor function. Recently, more challenging approaches have been studied. In this study, simultaneous stimulation using both rTMS and tDCS (dual-mode stimulation) over bilateral primary motor cortices (M1s) was investigated to compare its modulatory effects with single rTMS stimulation over the ipsilesional M1 in subacute stroke patients. Twenty-four patients participated; 12 participants were assigned to the dual-mode stimulation group while the other 12 participants were assigned to the rTMS-only group. We assessed each patient’s motor function using the Fugl-Meyer assessment score and acquired their resting-state fMRI data at two times: prior to stimulation and 2 months after stimulation. Twelve healthy subjects were also recruited as the control group. The interhemispheric connectivity of the contralesional M1, interhemispheric connectivity between bilateral hemispheres, and global efficiency of the motor network noticeably increased in the dual-mode stimulation group compared to the rTMS-only group. Contrary to the dual-mode stimulation group, there was no significant change in the rTMS-only group. These data suggested that simultaneous dual-mode stimulation contributed to the recovery of interhemispheric interaction than rTMS only in subacute stroke patients. This trial is registered with NCT03279640.

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