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Shi, Lijuan, Runmin Wang, Jian Zhao, Jing Zhang, and Zhejun Kuang. "Detection of Rehabilitation Training Effect of Upper Limb Movement Disorder Based on MPL-CNN." Sensors 24, no. 4 (2024): 1105. http://dx.doi.org/10.3390/s24041105.
Testo completoAbstract (sommario):
Stroke represents a medical emergency and can lead to the development of movement disorders such as abnormal muscle tone, limited range of motion, or abnormalities in coordination and balance. In order to help stroke patients recover as soon as possible, rehabilitation training methods employ various movement modes such as ordinary movements and joint reactions to induce active reactions in the limbs and gradually restore normal functions. Rehabilitation effect evaluation can help physicians understand the rehabilitation needs of different patients, determine effective treatment methods and strategies, and improve treatment efficiency. In order to achieve real-time and accuracy of action detection, this article uses Mediapipe’s action detection algorithm and proposes a model based on MPL-CNN. Mediapipe can be used to identify key point features of the patient’s upper limbs and simultaneously identify key point features of the hand. In order to detect the effect of rehabilitation training for upper limb movement disorders, LSTM and CNN are combined to form a new LSTM-CNN model, which is used to identify the action features of upper limb rehabilitation training extracted by Medipipe. The MPL-CNN model can effectively identify the accuracy of rehabilitation movements during upper limb rehabilitation training for stroke patients. In order to ensure the scientific validity and unified standards of rehabilitation training movements, this article employs the postures in the Fugl-Meyer Upper Limb Rehabilitation Training Functional Assessment Form (FMA) and establishes an FMA upper limb rehabilitation data set for experimental verification. Experimental results show that in each stage of the Fugl-Meyer upper limb rehabilitation training evaluation effect detection, the MPL-CNN-based method’s recognition accuracy of upper limb rehabilitation training actions reached 95%. At the same time, the average accuracy rate of various upper limb rehabilitation training actions reaches 97.54%. This shows that the model is highly robust across different action categories and proves that the MPL-CNN model is an effective and feasible solution. This method based on MPL-CNN can provide a high-precision detection method for the evaluation of rehabilitation effects of upper limb movement disorders after stroke, helping clinicians in evaluating the patient’s rehabilitation progress and adjusting the rehabilitation plan based on the evaluation results. This will help improve the personalization and precision of rehabilitation treatment and promote patient recovery.
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Mehrholz, Jan. "Upper Limb Stroke Rehabilitation Summer School." neuroreha 10, no. 04 (2018): 197–99. http://dx.doi.org/10.1055/a-0750-6251.
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Davis, Kathy. "Upper limb rehabilitation following a stroke." Primary Health Care 29, no. 6 (2019): 10. http://dx.doi.org/10.7748/phc.29.6.10.s12.
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Aprile, Irene, Marco Germanotta, Arianna Cruciani, et al. "Upper Limb Robotic Rehabilitation After Stroke." Journal of Neurologic Physical Therapy 44, no. 1 (2020): 3–14. http://dx.doi.org/10.1097/npt.0000000000000295.
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Chockalingam, Manigandan, Lenny Thinagaran Vasanthan, Sivakumar Balasubramanian, and Vimal Sriram. "Experiences of patients who had a stroke and rehabilitation professionals with upper limb rehabilitation robots: a qualitative systematic review protocol." BMJ Open 12, no. 9 (2022): e065177. http://dx.doi.org/10.1136/bmjopen-2022-065177.
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IntroductionEmerging evidence suggests that robotic devices for upper limb rehabilitation after a stroke may improve upper limb function. For robotic upper limb rehabilitation in stroke to be successful, patients’ experiences and those of the rehabilitation professionals must be considered. Therefore, this review aims to synthesise the available evidence on experiences of patients after a stroke with rehabilitation robots for upper limb rehabilitation and the experiences of rehabilitation professionals with rehabilitation robots for upper limb stroke rehabilitation.Methods and analysisDatabase search will include MEDLINE (Ovid), EMBASE (Elsevier), Cochrane CENTRAL, PsycINFO, Scopus, Web of Science, IEEE and CINAHL (EBSCOhost). Grey literature from Open Grey, PsyArXiv, bioRxiv, medRxiv and Google Scholar will also be searched. Qualitative studies or results from mixed-method studies that include adult patients after a stroke who use upper limb rehabilitation robots, either supervised by rehabilitation professionals or by patients themselves, at any stage of their rehabilitation and/or stroke professionals who use upper limb rehabilitation robots will be included. Robotic upper limb rehabilitation provided by students, healthcare assistants, technicians, non-professional caregivers, family caregivers, volunteer caregivers or other informal caregivers will be excluded. Articles published in English will be considered regardless of date of publication. Studies will be screened and critically appraised for methodological quality by two independent reviewers. A standardised tool from JBI System for the Unified Management, Assessment and Review of Information for data extraction, the meta-aggregation approach for data synthesis and the ConQual approach for confidence evaluation will be followed.Ethics and disseminationAs this systematic review is based on previously published research, no informed consent or ethical approval is required. It is anticipated that this systematic review will highlight the experiences of patients after a stroke and perceived facilitators and barriers for rehabilitation professionals on this topic, which will be disseminated through peer-reviewed publications and national and international conferences.PROSPERO registration numberCRD42022321402.
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Chin, Lay Fong, Ingrid C. M. Rosbergen, Kathryn S. Hayward, and Sandra G. Brauer. "A self-directed upper limb program during early post-stroke rehabilitation: A qualitative study of the perspective of nurses, therapists and stroke survivors." PLOS ONE 17, no. 2 (2022): e0263413. http://dx.doi.org/10.1371/journal.pone.0263413.
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Introduction This study aimed to explore the perspective of nurses, therapists and stroke survivors on the performance of upper limb self-exercise and use outside therapy during early inpatient stroke rehabilitation. Methods A descriptive qualitative approach was used in focus groups with nurses (n = 21) and therapists (n = 8), as well as in-depth semi-structured interviews with stroke survivors (n = 8) who were undergoing subacute inpatient stroke rehabilitation. Inductive thematic analysis of data was performed according to participant group. Results Nurses and therapists perceived that stroke survivors played a central role in determining the success of a self-directed upper limb program. Nurses perceived that stroke survivors needed a lot of prompting to be motivated to perform self-directed upper limb therapy outside therapy. Therapists perceived that not all stroke survivors would be able to perform self-directed upper limb therapy and deemed it important to consider stroke survivor factors before commencing a program. Although some stroke survivors expressed initial reservations with performing self-practice, many indicated that they would participate in the self-directed upper limb program because they wanted to recover faster. Conclusion A difference between the perspective of nurses/therapists and stroke survivors towards self-directed upper limb performance outside therapy was found. Deeper stroke survivor engagement and a shift in rehabilitation culture to encourage stroke survivor autonomy are important considerations for a self-directed upper limb program. Teamwork amongst healthcare professionals and families is essential to support stroke survivors to participate in a self-directed upper limb program during early inpatient stroke rehabilitation.
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Sidaway, Marta, Julita Głowacka-Popkiewicz, Maciej Krawczyk, and Tomasz Waraksa. "Early upper limb physiotherapy in stroke patients. Questions without answers." Advances in Rehabilitation 31, no. 1 (2017): 37–47. http://dx.doi.org/10.1515/rehab-2015-0060.
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Abstract Stroke is still the most common cause of disability in Poland and in western countries. As many as 80% of patients report reduced upper limb function in the acute phase after stroke. It is estimated that only 5% to 20% of patients experience full functional recovery of an upper limb. In clinical practice, paretic upper limb stimulation after stroke is usually treated as of secondary importance. However, it constantly poses a challenge to physical therapists. The existing procedures do not provide detailed guidelines regarding upper limb rehabilitation model particularly in the first four weeks after stroke. It is hard to predict biological limitations and the effectiveness of upper limb rehabilitation. The aim of this work is to make an attempt at reviewing the knowledge of the current state of early upper limb physiotherapy, its intensity and strategy type as well as neurobiological foundations of the improvement process. Ample scientific evidence confirms that early post-stroke rehabilitation is crucial. There are relatively few foreign (and virtually no Polish) reports related to early upper limb rehabilitation that would take into account the type of exercises and their therapeutic dose. There are still no solid foundations for determining optimal intensity and type of upper limb rehabilitation (including physical and occupational therapy). There is a scarcity of extensive and uniform (in terms of research groups and tools) multicentre investigations aimed at defining an optimal model of upper limb rehabilitation at an early stage after stroke. Thus, a number of questions still remain unanswered.
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Ventura, Sara, Alessia Tessari, Sara Castaldini, et al. "Effectiveness of a Virtual Reality rehabilitation in stroke patients with sensory-motor and proprioception upper limb deficit: A study protocol." PLOS ONE 19, no. 8 (2024): e0307408. http://dx.doi.org/10.1371/journal.pone.0307408.
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Introduction Stroke is the second leading cause of death in Europe. In the case of stroke survival (almost 70%), only 25% of patients recover completely, while the remaining 75% will undergo a rehabilitation phase that varying from months to years. The primary outcomes of a stroke involve motor impairment in the upper limbs, resulting in a partial or complete inability to move the limb on the right or left side, depending on the affected hemisphere. Furthermore, the motor deficit distorts the proprioception of the body and the embodiment ability of the injured limb. This could be rehabilitated through the paradigm of body illusion that modulates the motor rehabilitation. The present protocol aims to investigate the effectiveness of a Virtual Reality system for sensorimotor and proprioception upper limb deficit compared to a traditional upper limb rehabilitation program. Method This study has a randomized and controlled design with control and experimental groups, and 4 measurement times: pre-intervention, immediately after the intervention, and two follow-ups (at 6 and 12 months). The inclusion criteria are: (a) Being 18 to 85 years old, both males and females; (b) Suffering from ischemic or haemorrhagic stroke; (c) The stroke event must have occurred from two to eighteen months before recruitment; (d) Patients must have moderate to severe upper limb motor deficit, and the alteration of sensorimotor and proprioception abilities of the injury upper limb; (e) Patients must understand and sign the written consent for enrolment. The rehabilitation last four weeks with three sessions per week at Bellaria Hospital of Bologna (Italy). The VR protocol uses two types of technology: immersive and non-immersive, and the control group follow the traditional rehabilitation program.
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ABO, Masahiro, Nobuyuki SASAKI, Toru TAKEKAWA, and Wataru KAKUDA. "Rehabilitation for Upper Limb Hemiparesis after Stroke:." Japanese Journal of Rehabilitation Medicine 49, no. 12 (2012): 916–20. http://dx.doi.org/10.2490/jjrmc.49.916.
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Colovic, Hristina, Lidija Dimitrijevic, Vanja Djuric, and Sonja Jankovic. "Upper limb robotic neurorehabilitation after pediatric stroke." Srpski arhiv za celokupno lekarstvo 148, no. 5-6 (2020): 368–71. http://dx.doi.org/10.2298/sarh200104015c.
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Introduction. Pediatric brain stroke is a rare condition, with the incidence of 1.2?13/100,000. The most common consequence is hemiparesis with unilateral hand impairment. There is level 4 evidence that robotics may improve the function of upper limbs. In this paper, we present the effect of combined robotic rehabilitation and kinesitherapy on the distal portion of the arm in the chronic phase of hemiparesis in childhood. Case outline. In a 7.5-year-old girl the treatment with robotic neurorehabilitation was administered in the chronic phase of post-stroke rehabilitation, 18 months after the stroke, involving individualized kinesitherapy for 30 minutes, and virtual reality-based rehabilitation using the robotic Smart Glove for 30 minutes. The rehabilitation protocol was administered for 12 weeks (five times a week). The results of therapeutic evaluation showed that the level 2 of Manual Ability Classification System remained unchanged until the end of treatment, while the grade assigned for the spasticity of flexors in the forearm and fingers was 2 at the treatment onset, 1+ after four weeks of therapy, and 1 after eight and 12 weeks of therapy. Qualitative improvement of arm function through the increase of the overall value of the Quality of Upper Extremity Skills Test was evidenced at each evaluation testing, being the greatest after the first four weeks of rehabilitation (4.83%). Conclusion. The result of our study suggests that combined robotic rehabilitation and kinesitherapy can improve the functional motor performance of the arm involved in the chronic recovery phase after a pediatric stroke.
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Ferreira, Fernanda Márcia Rodrigues Martins, Guilherme de Paula Rúbio, Fabrício Henrique de Lisboa Brandão, et al. "Robotic Orthosis for Upper Limb Rehabilitation." Proceedings 64, no. 1 (2020): 10. http://dx.doi.org/10.3390/iecat2020-08519.
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Individuals with impaired upper limbs have motor limitations that interfere with functionality. An alternative to rehabilitation is robot-assisted therapy, a method that increases the effectiveness of treatment. New robotic actuators have been developed to assist in the rehabilitation of the upper limb. One of them aims to actively perform finger extension and flexion passively, using a servo motor coupled to a rope system. At the elbow, a direct current (DC) motor combined with a gearbox was coupled to a system of pulleys and ropes designed to actively perform flexion and extension movements. To activate the system, an Arduino-NANO® and a mobile application for Android were used. The performance of the prototype was evaluated in four post-stroke volunteers. The ability to perform the proposed movements with the device was observed. Structural reinforcement was necessary, after twisting the elbow support structure, with pronation of the forearm, resulting in increased component weight. This work presented new robotic devices that can assist in the rehabilitation of post-stroke individuals.
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Qassim, Hassan M., and W. Z. Wan Hasan. "A Review on Upper Limb Rehabilitation Robots." Applied Sciences 10, no. 19 (2020): 6976. http://dx.doi.org/10.3390/app10196976.
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Rehabilitation is the process of treating post-stroke consequences. Impaired limbs are considered the common outcomes of stroke, which require a professional therapist to rehabilitate the impaired limbs and restore fully or partially its function. Due to the shortage in the number of therapists and other considerations, researchers have been working on developing robots that have the ability to perform the rehabilitation process. During the last two decades, different robots were invented to help in rehabilitation procedures. This paper explains the types of rehabilitation treatments and robot classifications. In addition, a few examples of well-known rehabilitation robots will be explained in terms of their efficiency and controlling mechanisms.
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Zhang, Kai, Xiaofeng Chen, Fei Liu, Haili Tang, Jing Wang, and Weina Wen. "System Framework of Robotics in Upper Limb Rehabilitation on Poststroke Motor Recovery." Behavioural Neurology 2018 (December 13, 2018): 1–14. http://dx.doi.org/10.1155/2018/6737056.
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Neurological impairments such as stroke cause damage to the functional mobility of survivors and affect their ability to perform activities of daily living. Recently, robotic treatment for upper limb stroke rehabilitation has received significant attention because it can provide high-intensity and repetitive movement therapy. In this review, the current status of upper limb rehabilitation robots is explored. Firstly, an overview of mechanical design of robotics for upper-limb rehabilitation and clinical effects of part robots are provided. Then, the comparisons of human-machine interactions, control strategies, driving modes, and training modes are described. Finally, the development and the possible future directions of the upper limb rehabilitation robot are discussed.
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Kim, Won-Seok, Sungmin Cho, Jeonghun Ku, et al. "Clinical Application of Virtual Reality for Upper Limb Motor Rehabilitation in Stroke: Review of Technologies and Clinical Evidence." Journal of Clinical Medicine 9, no. 10 (2020): 3369. http://dx.doi.org/10.3390/jcm9103369.
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Neurorehabilitation for stroke is important for upper limb motor recovery. Conventional rehabilitation such as occupational therapy has been used, but novel technologies are expected to open new opportunities for better recovery. Virtual reality (VR) is a technology with a set of informatics that provides interactive environments to patients. VR can enhance neuroplasticity and recovery after a stroke by providing more intensive, repetitive, and engaging training due to several advantages, including: (1) tasks with various difficulty levels for rehabilitation, (2) augmented real-time feedback, (3) more immersive and engaging experiences, (4) more standardized rehabilitation, and (5) safe simulation of real-world activities of daily living. In this comprehensive narrative review of the application of VR in motor rehabilitation after stroke, mainly for the upper limbs, we cover: (1) the technologies used in VR rehabilitation, including sensors; (2) the clinical application of and evidence for VR in stroke rehabilitation; and (3) considerations for VR application in stroke rehabilitation. Meta-analyses for upper limb VR rehabilitation after stroke were identified by an online search of Ovid-MEDLINE, Ovid-EMBASE, the Cochrane Library, and KoreaMed. We expect that this review will provide insights into successful clinical applications or trials of VR for motor rehabilitation after stroke.
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Poveda-García, Ana, Carmen Moret-Tatay, and Miguel Gómez-Martínez. "The Association between Mental Motor Imagery and Real Movement in Stroke." Healthcare 9, no. 11 (2021): 1568. http://dx.doi.org/10.3390/healthcare9111568.
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Background: Stroke is the main cause of disability in adults; the most common and long-term sequela is upper-limb hemiparesis. Many studies support the idea that mental motor imagery, which is related to the visualization of movement patterns, activates the same areas of the cortex as if the movement occurred. Objectives: This study aims to examine the capacity to elaborate mental motor images, as well as its relationship to loss of movement in the upper limbs after a stroke. Method: An observational study, in a sample of 39 adults who suffered a stroke, was carried out. The upper limb movement and functionality, cognitive disorders, the ability to visualize mental images, and activities of daily living were examined. Results: The results depicted a statistically significant correlation between the ability to visualize upper limb mental motor images with movement, functionality, and strength. In addition, a correlation between visual–spatial skills and mental visualization of motor ability and upper limb movement was found. Conclusions: These results suggest that the rehabilitation approach focused on the improvement of mental motor imagery could be of interest for the upper limb rehabilitation of movement and functionality.
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Hyakutake, Koichi, Takashi Morishita, Kazuya Saita, et al. "Effects of Home-Based Robotic Therapy Involving the Single-Joint Hybrid Assistive Limb Robotic Suit in the Chronic Phase of Stroke: A Pilot Study." BioMed Research International 2019 (March 18, 2019): 1–9. http://dx.doi.org/10.1155/2019/5462694.
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Introduction. Robotic therapy has drawn attention in the rehabilitation field including home-based rehabilitation. A previous study has reported that home-based therapy could be more effective for increasing upper limb activity than facility-based therapy. The single-joint hybrid assistive limb (HAL-SJ) is an exoskeleton robot developed according to the interactive biofeedback theory, and several studies have shown its effectiveness for upper limb function in stroke patients. A study of home-based robotic therapy has shown to enhance rehabilitation effectiveness for stroke patient with a paretic upper limb. However, home-based therapy involving a HAL-SJ in stroke patients with paretic upper limbs has not been investigated. The present study aimed to investigate paretic upper limb activity and function with home-based robotic therapy involving a HAL-SJ in stroke patients. Materials and Methods. A home-based robotic therapy program involving a HAL-SJ was performed for 30 min per session followed by standard therapy for 30 min per session, 2 times a week, for 4 weeks (i.e., completion of all 8 sessions involved 8 h of rehabilitation), at home. After the intervention, patients were followed up by telephone and home visits for 8 weeks. The paretic upper limb activity and function were assessed using the Motor Activity Log (MAL; amount of use (AOU)), arm triaxial accelerometry (laterality index (LI)), the Fugl–Meyer assessment (FMA), and the action research arm test (ARAT), at baseline and week 4 and week 12 after the start of training. Results. The study included 10 stroke patients (5 men; mean age, 61.1 ± 7.1 years). The AOU scores and LI significantly improved at week 4 after the start of training (p<0.05). However, no significant changes were observed in the LI at week 12 (p=0.161) and the FMA scores at both week 4 and week 12 (p=0.059 and p=0.083, respectively). The ARAT scores significantly improved at both week 4 and week 12 (p<0.05). Conclusion. Home-based robotic therapy combined with conventional therapy could be a valuable approach for increasing paretic upper limb activity and maintaining paretic upper limb function in the chronic phase of stroke.
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Fearnhead, L., C. J. Eales, and V. U. Fritz. "Arm function after stroke - can we make a difference?" South African Journal of Physiotherapy 55, no. 2 (1999): 4–7. http://dx.doi.org/10.4102/sajp.v55i2.559.
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Impairment of upper limb function is a significant cause of functional disability after stroke. Based on a review of the literature this paper defines upper limb function and highlights some of the relevant recent developments in neuropathology. The effects of changes in sensation, muscle recruitment and tone are described. Reliable and valid outcome measures of upper limb impairment and disability are listed. The principles of rehabilitation are described in terms of timing of rehabilitation, sensory reeducation, motor control and functional use. Questions are raised regarding the need for counselling for the loss of fine discriminative hand function and for research into this behavioural aspect of upper limb rehabilitation.
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Phan, Huu Lam, Thi Huong Le, Jung Min Lim, Chang Ho Hwang, and Kyo-in Koo. "Effectiveness of Augmented Reality in Stroke Rehabilitation: A Meta-Analysis." Applied Sciences 12, no. 4 (2022): 1848. http://dx.doi.org/10.3390/app12041848.
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Augmented reality (AR)-based rehabilitation shows potential to improve upper and lower limb function after stroke. This study aims to review the effect of AR technology in the recovery of the upper and lower limb function in stroke patients. Published randomized controlled trials and observational investigations with adult stroke patients were retrieved from five electronic databases to analyze the effect of the AR systems in improving motor function and balance and gait function for stroke patients. The treatment effect was estimated by standardized mean difference (SMD) and 95% confidence interval (CI) using a random effect model for motor function outcomes at the body structure and function, body activity and participation level of the International Classification of Functioning, and balance and gait outcomes. In total, 13 investigations (9 for the upper limb and 4 for the lower limb) were identified. AR demonstrated a significant influence on the upper limb function (SMD = 0.657; 95% CI, 0.287 to 1.026; p = 0.000) and the lower limb function (SMD = 0.52; 95% CI, 0.039 to 1.001; p = 0.034). The present analysis suggests that AR applications could offer options for increasing treatment intensity and promoting motor recovery after a stroke. This approach can be used with the conventional rehabilitation methods as a new intervention for recovering upper and lower limb function.
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Soares, Nayron Medeiros, Gabriela Magalhães Pereira, Renata Italiano da Nóbrega Figueiredo, Gleydson Silva Morais, and Sandy Gonzaga De Melo. "Terapia baseada em realidade virtual usando o Leap Motion Controller para reabilitação do membro superior após acidente vascular cerebral." Scientia Medica 27, no. 2 (2017): 25935. http://dx.doi.org/10.15448/1980-6108.2017.2.25935.
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*** Virtual reality therapy using the Leap Motion Controller for post-stroke upper limb rehabilitation ***AIMS: To evaluate the applicability of a virtual reality-based motion sensor for post-stroke upper limb rehabilitation.CASES DESCRIPTION: Three post-stroke patients were subjected to virtual reality training for rehabilitation of their upper limbs using the Leap Motion Controller technology and the game Playground 3D® for 3 consecutive days. On the first and last days, the Box and Blocks test, the De Melo Eye-Hand Coordination Test, and transcranial magnetic stimulation were applied. On the last day, the patients were evaluated with the Experience Evaluation Form. After the proposed training, a lower motor threshold was observed in both cerebral hemispheres, as well as better performance in the tests that evaluated hand and eye-hand coordination skills. The proposed therapy was well received by the patients.CONCLUSIONS: No adverse effects were observed, and promising and precise results were obtained for the virtual reality-based training using the Leap Motion Controller and Playground 3D®. The training allowed patients to have an active role in the rehabilitation of stroke-induced upper limb sequelae.
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Zhang, Mingliang, Jing Chen, Zongquan Ling, et al. "Quantitative Evaluation System of Upper Limb Motor Function of Stroke Patients Based on Desktop Rehabilitation Robot." Sensors 22, no. 3 (2022): 1170. http://dx.doi.org/10.3390/s22031170.
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Rehabilitation training and movement evaluation after stroke have become a research hotspot as stroke has become a very common and harmful disease. However, traditional rehabilitation training and evaluation are mainly conducted under the guidance of rehabilitation doctors. The evaluation process is time-consuming and the evaluation results are greatly influenced by doctors. In this study, a desktop upper limb rehabilitation robot was designed and a quantitative evaluation system of upper limb motor function for stroke patients was proposed. The kinematics and dynamics data of stroke patients during active training were collected by sensors. Combined with the scores of patients’ upper limb motor function by rehabilitation doctors using the Wolf Motor Function Test (WMFT) scale, three different quantitative evaluation models of upper limb motor function based on Back Propagation Neural Network (BPNN), K-Nearest Neighbors (KNN), and Support Vector Regression (SVR) algorithms were established. To verify the effectiveness of the quantitative evaluation system, 10 healthy subjects and 21 stroke patients were recruited for experiments. The experimental results show that the BPNN model has the best evaluation performance among the three quantitative evaluation models. The scoring accuracy of the BPNN model reached up to 87.1%. Moreover, there was a significant correlation between the models′ scores and the doctors′ scores. The proposed system can help doctors to quantitatively evaluate the upper limb motor function of stroke patients and accurately master the rehabilitation progress of patients.
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Meireles, Cecília Vieira, Suelen Félix Ferreira, Patrick Roberto Avelino, and Kênia Kiefer Parreiras de Menezes. "Effects of virtual reality training in the upper limb motor coordination of individuals post- stroke: a systematic review with meta-analysis." Fisioterapia e Pesquisa 29, no. 1 (2022): 11–21. http://dx.doi.org/10.1590/1809-2950/19039029012022en.
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ABSTRACT After a stroke, 75% of people are affected in their upper limbs, remaining with sequelae at these limbs. Results from recent clinical trials have been contradictory regarding the effectiveness of Virtual Reality (VR) therapy in rehabilitating upper limb motor coordination in this population. This study aimed to perform a systematic literature review with meta-analysis to investigate the effects of VR training on upper limb motor coordination in patients post-stroke. Searches were performed in the electronic databases PubMed, LILACS, SciELO, PEDro, in addition to manual searches. The whole process was performed by two independent raters. The methodological quality of the studies was assessed by the PEDro scale. In total, we selected 18 studies, out of which only 13 were included in the meta-analysis. In general, VR training was effective in improving upper limb motor coordination (SMD 0.32; 95% CI 0.08-0.56; I2=42%; p<0.01). When subgroup analysis assessed control group type, VR training was superior than no intervention (SMD 0.36; 95% CI: 0.06-0.66; p<0.05). However, when compared to other interventions, we found no significant difference (SMD 0.26; 95% CI: −0.12-0.64; p=0.18). Overall, VR training is effective in improving upper limb motor coordination in post-stroke individuals compared to no intervention. However, it shows no superiority when compared to other types of intervention used in the rehabilitation of upper limb motor coordination in these patients.
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Gular, Kumar, Viswanathan Sivasubramanian, Ravi Shankar Reddy, Jaya Shanker Tedla, and Snehil Dixit. "The Mediating Effect of Age, Gender, and Post-Stroke Duration on the Association between Trunk and Upper Limb Recovery in Subacute Stroke Population: A Cross-Sectional Study with Mediation Analysis." International Journal of Environmental Research and Public Health 19, no. 23 (2022): 15644. http://dx.doi.org/10.3390/ijerph192315644.
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Background: The trunk acts as proximal support with which limbs execute smooth and purposeful movement. Furthermore, as upper extremity functions are an integral component of daily living activities, exploring the association between trunk and upper extremity recovery will guide therapists in developing appropriate rehabilitation goals and interventions. The objectives of this study were to (1) assess the association between trunk and upper extremity recovery in the subacute stroke population and (2) assess the effect of trunk control on upper extremity impairment and function with age, gender, and duration of stroke as mediators using mediation analysis in subacute stroke individuals. Methods: This cross-sectional study included 54 subacute stroke participants with a mean age of 58.37 ± 6.11 years. The trunk impairment scale (TIS) assessed the trunk’s stability, mobility, and coordination. The level of upper extremity impairment was evaluated using the Fugl-Meyer Assessment scale (FMA). The quality and quantity of upper limb motor functions were measured using the Wolf motor function test (WMFT). Results: The TIS exhibited moderate positive correlations with the FMA-UE, WMFT-time scale (TS), and WMFT-functional ability scale (FAS) at p < 0.001. The mediation analysis reported a profound mediation effect of post-stroke duration on the association of trunk and upper limb recovery. Conclusions: The study results substantiated that trunk control significantly correlates with upper limb impairment and the quality and quantity of its use in the subacute stroke population. Post-stroke duration proved to mediate the association between trunk and upper limb recovery. Therefore, the assessment and intervention of trunk and upper extremity motor control considering the post-stroke duration is vital and should be incorporated in stroke rehabilitation aiming at functional independence.
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Trinh Bao, Tram, and Lien Nguyen Thi Kim. "Effects of using Virtual Reality simulation devices on upper limb rehabilitation for ischemic stroke patients with hemiplegia." Journal of Health and Development Studies 05, no. 06 (2021): 47–54. http://dx.doi.org/10.38148/jhds.0506skpt21-049.
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Objective: Evaluate effects of Virtual reality-based training on rehabilitation for upper limb function of hemiplegic patients due to ischemic stroke. Methods: The interventional study with the control group to evaluate effects of combining virtual reality simulation devices into upper limb function recovery programs in 20 ischemic stroke inpatients of the intervention group and 20 inpatients of the control group at the Center Rehabilitation of Bach Mai hospital and the Nation Geriatric hospital from August 2020 to August 2021. Main findings: After 2 weeks and 4 week of treatment, the intervention group has the upper limb function on the FMA-UE scale increased respectively 13,5 points (20,5%) and 20 points (30,3%), and ARAT improved 9,5 points (16,7%) and 14,8 points (26%), respectively, which were significantly higher the control group. Conclusions: Virtual reality- based training combined with standard therapy might be more effective than conventional rehabilitation in improving upper extremity function in stroke survivors. Key words: ischemic stroke, upper limb function, virtual reality simulation devices.
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Carey, Leeanne M., Liana S. Cahill, Jannette M. Blennerhassett, et al. "A Network of Sites and Upskilled Therapists to Deliver Best-Practice Stroke Rehabilitation of the Arm: Protocol for a Knowledge Translation Study." Healthcare 11, no. 23 (2023): 3080. http://dx.doi.org/10.3390/healthcare11233080.
Testo completoAbstract (sommario):
Implementation of evidence-informed rehabilitation of the upper limb is variable, and outcomes for stroke survivors are often suboptimal. We established a national partnership of clinicians, survivors of stroke, researchers, healthcare organizations, and policy makers to facilitate change. The objectives of this study are to increase access to best-evidence rehabilitation of the upper limb and improve outcomes for stroke survivors. This prospective pragmatic, knowledge translation study involves four new specialist therapy centers to deliver best-evidence upper-limb sensory rehabilitation (known as SENSe therapy) for survivors of stroke in the community. A knowledge-transfer intervention will be used to upskill therapists and guide implementation. Specialist centers will deliver SENSe therapy, an effective and recommended therapy, to stroke survivors in the community. Outcomes include number of successful deliveries of SENSe therapy by credentialled therapists; improved somatosensory function for stroke survivors; improved performance in self-selected activities, arm use, and quality of life; treatment fidelity and confidence to deliver therapy; and for future implementation, expert therapist effect and cost-effectiveness. In summary, we will determine the effect of a national partnership to increase access to evidence-based upper-limb sensory rehabilitation following stroke. If effective, this knowledge-transfer intervention could be used to optimize the delivery of other complex, evidence-based rehabilitation interventions.
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Minzatanu, Diana, Nadinne Alexandra Roman, Adina Ionelia Manaila, et al. "Virtual Reality Associated with Functional Electrical Stimulation for Upper Extremity in Post-Stroke Rehabilitation: A Systematic Review." Applied Sciences 14, no. 18 (2024): 8248. http://dx.doi.org/10.3390/app14188248.
Testo completoAbstract (sommario):
Background: This systematic literature review aims to explore the impact of rehabilitation in post-stroke patients, particularly highlighting the roles of virtual reality (VR) technology and functional electrical stimulation (FES). Methods: To ensure all relevant studies were included, a thorough search was conducted in PubMed and Web of Science databases using keywords such as ‘post-stroke’, ‘FES’, ‘functional electrical stimulation’, ‘virtual reality’, and ‘VR’. Studies on rehabilitating upper limb function through VR and FES in post-stroke patients were included, regardless of publication year. Studies had to compare this combination therapy with conventional methods and report outcomes related to upper limb coordination, functional mobility, and daily activities. Studies not meeting these criteria were excluded. The selection process involved screening titles, abstracts, and full texts by four independent reviewers. The quality and risk of bias of the included studies were assessed using the PEDro scale and Robvis tool. Results: The review included four studies involving 135 post-stroke patients. Two articles examined the effectiveness of an approach involving virtual reality, robotic therapy, and functional electrical stimulation in rehabilitating upper limbs in post-stroke patients, showing significant improvements in motor function and quality of life. The other two studies explored the effects of rehabilitation therapy using virtual reality combined with functional electrical stimulation on upper limb function in stroke patients, finding that combined therapy (FES with VR) was superior to functional electrical stimulation or robotic therapy. Discussion: The review was limited by the small number of studies and participants, which may affect the generalizability of the results. Variations in intervention protocols and outcome measures across studies posed challenges in synthesis. Integrating these technologies brings benefits and increases the potential for personalizing and optimizing the rehabilitation process, enhancing patient engagement and satisfaction, and promoting a holistic approach to post-stroke management. Future research should focus on larger, more standardized trials to confirm these findings and optimize intervention protocols.
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Kitsos, Gemma H., Isobel J. Hubbard, Alex R. Kitsos, and Mark W. Parsons. "The Ipsilesional Upper Limb Can Be Affected following Stroke." Scientific World Journal 2013 (2013): 1–7. http://dx.doi.org/10.1155/2013/684860.
Testo completoAbstract (sommario):
Objective. Neurological dysfunction commonly occurs in the upper limb contralateral to the hemisphere of the brain in which stroke occurs; however, the impact of stroke on function of the ipsilesional upper limb is not well understood. This study aims to systematically review the literature relating to the function of the ipsilesional upper limb following stroke and answer the following research question: Is the ipsilesional upper limb affected by stroke?Data Source. A systematic review was carried out in Medline, Embase, and PubMed.Review Methods. All studies investigating the ipsilesional upper limb following stroke were included and analysed for important characteristics. Outcomes were extracted and summarised.Results. This review captured 27 articles that met the inclusion criteria. All studies provided evidence that the ipsilesional upper limb can be affected following stroke.Conclusion. These findings demonstrate that clinicians should consider ipsilesional upper limb deficits in rehabilitation and address this reduced functional capacity. Furthermore, the ipsilesional upper limb should not be used as a “control” measure of recovery for the contralateral upper limb.
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Pregnolato, Giorgia, Daniele Rimini, Francesca Baldan, et al. "Clinical Features to Predict the Use of a sEMG Wearable Device (REMO®) for Hand Motor Training of Stroke Patients: A Cross-Sectional Cohort Study." International Journal of Environmental Research and Public Health 20, no. 6 (2023): 5082. http://dx.doi.org/10.3390/ijerph20065082.
Testo completoAbstract (sommario):
After stroke, upper limb motor impairment is one of the most common consequences that compromises the level of the autonomy of patients. In a neurorehabilitation setting, the implementation of wearable sensors provides new possibilities for enhancing hand motor recovery. In our study, we tested an innovative wearable (REMO®) that detected the residual surface-electromyography of forearm muscles to control a rehabilitative PC interface. The aim of this study was to define the clinical features of stroke survivors able to perform ten, five, or no hand movements for rehabilitation training. 117 stroke patients were tested: 65% of patients were able to control ten movements, 19% of patients could control nine to one movement, and 16% could control no movements. Results indicated that mild upper limb motor impairment (Fugl-Meyer Upper Extremity ≥ 18 points) predicted the control of ten movements and no flexor carpi muscle spasticity predicted the control of five movements. Finally, severe impairment of upper limb motor function (Fugl-Meyer Upper Extremity > 10 points) combined with no pain and no restrictions of upper limb joints predicted the control of at least one movement. In conclusion, the residual motor function, pain and joints restriction, and spasticity at the upper limb are the most important clinical features to use for a wearable REMO® for hand rehabilitation training.
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Ali, Muhammad, Muhammad Bilal, Muhammad Akram, and Mohsin Rizwan. "Hybrid Position and Force Control for Upper Limb Rehabilitation of Stroke Patient." American Journal of Mechanical and Industrial Engineering 9, no. 2 (2024): 28–42. http://dx.doi.org/10.11648/j.ajmie.20240902.12.
Testo completoAbstract (sommario):
This paper presents hybrid position and force control (HPFC) methodology for position and as well as force tracking for upper limb rehabilitation of stroke patients. Stroke is a leading cause of disability in humans. Traditional rehabilitative therapies help regain motor function and ameliorate impairment, but they depend on the therapist’s experience and require many therapists, which is cost-prohibitive. Most robotic tasks with high severity such as rehabilitation, demands an effective force as well as position control scheme to ensure the safe physical contact between the robot and its environment in this case the patient. Some rehabilitation robots have been developed to help stroke survivors recover motor function. In past robots used for upper-limb rehabilitation employed general control schemes such as proportional integral derivative. To overcome the problem of force tracking in rehabilitation, robots require modern control techniques. To mimic the human upper-limb, and universality of application, an end-effector based robot is used for this study. To ensure the convergence of position and force errors to zero extensive simulations are performed. Two of assistant modes passive and active assistive rehabilitation are considered. Most common rehabilitation trajectories horizontal reaching, and vertical reaching are selected as robot’s motion for both passive and active assistive activities. The mathematical model of robots’ kinematics, dynamics, alongside the proposed control scheme has been discussed in detail.
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Cacchio, Angelo, Elisabetta De Blasis, Vincenzo De Blasis, Valter Santilli, and Giorgio Spacca. "Mirror Therapy in Complex Regional Pain Syndrome Type 1 of the Upper Limb in Stroke Patients." Neurorehabilitation and Neural Repair 23, no. 8 (2009): 792–99. http://dx.doi.org/10.1177/1545968309335977.
Testo completoAbstract (sommario):
Background. Complex regional pain syndrome type 1 (CRPSt1) of the upper limb is a painful and debilitating condition, frequent after stroke, and interferes with the rehabilitative process and outcome. However, treatments used for CRPSt1 of the upper limb are limited. Objective. This randomized controlled study was conducted to compare the effectiveness on pain and upper limb function of mirror therapy on CRPSt1 of upper limb in patients with acute stroke. Methods. Of 208 patients with first episode of unilateral stroke admitted to the authors’ rehabilitation center, 48 patients with CRPSt1 of the affected upper limb were enrolled in a randomized controlled study, with a 6-month follow-up, and assigned to either a mirror therapy group or placebo control group. The primary end points were a reduction in the visual analogue scale score of pain at rest, on movement, and brush-induced tactile allodynia. The secondary end points were improvement in motor function as assessed by the Wolf Motor Function Test and Motor Activity Log. Results. The mean scores of both the primary and secondary end points significantly improved in the mirror group ( P < .001). No statistically significant improvement was observed in any of the control group values ( P > .001). Moreover, statistically significant differences after treatment ( P < .001) and at the 6-month follow-up were found between the 2 groups. Conclusions. The results indicate that mirror therapy effectively reduces pain and enhances upper limb motor function in stroke patients with upper limb CRPSt1.
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Park, Si-Woon, Jae-Hyung Kim, and Yun-Jung Yang. "Mental practice for upper limb rehabilitation after stroke." International Journal of Rehabilitation Research 41, no. 3 (2018): 197–203. http://dx.doi.org/10.1097/mrr.0000000000000298.
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Raghavan, Preeti. "Upper Limb Motor Impairment After Stroke." Physical Medicine and Rehabilitation Clinics of North America 26, no. 4 (2015): 599–610. http://dx.doi.org/10.1016/j.pmr.2015.06.008.
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Hara, Takatoshi, Ryo Momosaki, Masachika Niimi, Naoki Yamada, Hiroyoshi Hara, and Masahiro Abo. "Botulinum Toxin Therapy Combined with Rehabilitation for Stroke: A Systematic Review of Effect on Motor Function." Toxins 11, no. 12 (2019): 707. http://dx.doi.org/10.3390/toxins11120707.
Testo completoAbstract (sommario):
Aim: The purpose of this study was to examine the effectiveness of botulinum toxin A (BoNT-A) therapy combined with rehabilitation on motor function in post-stroke patients. Methods: The following sources up to December 31, 2018, were searched from inception for articles in English: Pubmed, Scopus, CINAHL, Embase, PsycINFO, and CENTRAL. Trials using injections of BoNT-A for upper and lower limb rehabilitation were examined. We excluded studies that were not performed for rehabilitation or were not evaluated for motor function. Results: Twenty-six studies were included. In addition to rehabilitation, nine studies used adjuvant treatment to improve spasticity or improve motor function. In the upper limbs, two of 14 articles indicated that significant improvement in upper limb motor function was observed compared to the control group. In the lower limbs, seven of 14 articles indicated that significant improvement in lower limb motor function was observed compared to the control group. Conclusions: The effect of combined with rehabilitation is limited after stroke, and there is not sufficient evidence, but results suggest that BoNT-A may help to improve motor function. In future studies, the establishment of optimal rehabilitation and evaluation times of BoNT-A treatment will be necessary for improving motor function and spasticity.
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Qu, Qingming, Yingnan Lin, Zhijie He, et al. "The Effect of Applying Robot-Assisted Task-Oriented Training Using Human-Robot Collaborative Interaction Force Control Technology on Upper Limb Function in Stroke Patients: Preliminary Findings." BioMed Research International 2021 (July 28, 2021): 1–8. http://dx.doi.org/10.1155/2021/9916492.
Testo completoAbstract (sommario):
Stroke is one of the leading causes of death and the primary cause of acquired disability worldwide. Many stroke survivors have difficulty using their upper limbs, which have important functional roles in the performance of daily life activities. Consequently, the independence and quality of life of most stroke patients are reduced. Robot-assisted therapy is an effective intervention for improving the upper limb function of individuals with stroke. Human-robot collaborative interaction force control technology is critical for improving the flexibility and followability of the robot’s motion, thereby improving rehabilitation training outcomes. However, there are few reports on the effect of robot-assisted rehabilitative training on upper limb function. We applied this technology using a robot to assist patients with task-oriented training. Posttreatment changes in Fugl-Meyer and modified Barthel index (MBI) scores were assessed to determine whether this technology could improve the upper limb function of stroke patients. One healthy adult and five stroke patients, respectively, participated in functional and clinical experiments. The MBI and Fugl-Meyer scores of the five patients in the clinical experiments showed significant improvements after the intervention. The experimental results indicate that human-robot collaborative interaction force control technology is valuable for improving robots’ properties and patients’ recovery. This trial was registered in the Chinese clinical trial registry (ChiCTR2000038676).
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Harris, Jocelyn E., Janice J. Eng, William C. Miller, and Andrew S. Dawson. "The Role of Caregiver Involvement in Upper-Limb Treatment in Individuals With Subacute Stroke." Physical Therapy 90, no. 9 (2010): 1302–10. http://dx.doi.org/10.2522/ptj.20090349.
Testo completoAbstract (sommario):
Background Initial severity of upper-limb motor impairment and exercise intensity are important predictors of improved upper-limb function during stroke rehabilitation. Initial severity of motor impairment, however, is not modifiable by rehabilitation, and increased one-on-one treatment is not always feasible. Alternative methods to increase intensity and improve upper-limb function are needed. Objective The purpose of this study was to examine caregiver involvement in upper-limb treatment as a method to improve upper-limb function. Design This study was a secondary analysis of a multi-site randomized controlled trial for upper-limb recovery during subacute inpatient stroke rehabilitation. Methods Data from 50 individuals with subacute stroke who were randomly assigned to the experimental group (upper-limb exercise) were used for the analysis. Outcome variables were measured at baseline and at completion of the 4-week intervention. Group comparisons between participants with caregiver support and participants without caregiver support were done using an analysis of variance. Using the Fugl-Meyer Upper-Limb Motor Impairment Scale and time spent in treatment (intensity) as covariates, a multivariate regression analysis was performed to determine the additive value of caregiver support on upper-limb function, as measured by change scores on the Chedoke Arm and Hand Activity Inventory and the Motor Activity Log. Results Group comparisons revealed that participants with caregiver support had improved upper-limb function compared with those without caregiver support and were more likely to increase the amount of time spent doing exercise. The multiple regression analysis showed that Fugl-Meyer score, treatment intensity, and caregiver support were significant predictors of upper-limb improvement (R2=.240–.292). In the regression models, caregiver support accounted for 5% to 9% of upper-limb improvement. Limitations Support was coded as a dichotomous variable, and thus the degree of support or qualitative nature of support was not captured. Conclusions Involvement of caregivers was a determinant of improved upper-limb function over and above initial severity of motor impairment and exercise intensity. Further research is needed to determine the optimal qualitative and quantitative elements of caregiver involvement in stroke rehabilitation in order to maximize results.
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Germanotta, Marco, Laura Cortellini, Sabina Insalaco, and Irene Aprile. "Effects of Upper Limb Robot-Assisted Rehabilitation Compared with Conventional Therapy in Patients with Stroke: Preliminary Results on a Daily Task Assessed Using Motion Analysis." Sensors 23, no. 6 (2023): 3089. http://dx.doi.org/10.3390/s23063089.
Testo completoAbstract (sommario):
Robotic rehabilitation of the upper limb has demonstrated promising results in terms of the improvement of arm function in post-stroke patients. The current literature suggests that robot-assisted therapy (RAT) is comparable to traditional approaches when clinical scales are used as outcome measures. Instead, the effects of RAT on the capacity to execute a daily life task with the affected upper limb are unknown, as measured using kinematic indices. Through kinematic analysis of a drinking task, we examined the improvement in upper limb performance between patients following a robotic or conventional 30-session rehabilitation intervention. In particular, we analyzed data from nineteen patients with subacute stroke (less than six months following stroke), nine of whom treated with a set of four robotic and sensor-based devices and ten with a traditional approach. According to our findings, the patients increased their movement efficiency and smoothness regardless of the rehabilitative approach. After the treatment (either robotic or conventional), no differences were found in terms of movement accuracy, planning, speed, or spatial posture. This research seems to demonstrate that the two investigated approaches have a comparable impact and may give insight into the design of rehabilitation therapy.
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Song, Yo-Han, and Hyun-Min Lee. "Effect of Immersive Virtual Reality-Based Bilateral Arm Training in Patients with Chronic Stroke." Brain Sciences 11, no. 8 (2021): 1032. http://dx.doi.org/10.3390/brainsci11081032.
Testo completoAbstract (sommario):
Virtual reality (VR)-based therapies are widely used in stroke rehabilitation. Although various studies have used VR techniques for bilateral upper limb training, most have been only semi-immersive and have only been performed in an artificial environment. This study developed VR content and protocols based on activities of daily living to provide immersive VR-based bilateral arm training (VRBAT) for upper limb rehabilitation in stroke patients. Twelve patients with chronic stroke were randomized to a VRBAT group or a normal bilateral arm training (NBAT) group and attended 30-min training sessions five times a week for four weeks. At the end of the training, there was a significant difference in upper limb function in both groups (p < 0.05) and in the upper limb function sensory test for proprioception in the NBAT group (p < 0.05). There was no significant between-group difference in upper limb muscle activity after training. The relative alpha and beta power values for electroencephalographic measurements were significantly improved in both groups. These findings indicate that both VRBAT and NBAT are effective interventions for improving upper limb function and electroencephalographic activity in patients with chronic stroke.
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Khat’kova, S. E., E. A. Nikolaev, O. A. Pogorel’tseva, O. G. Pavlova, V. Y. Roschin, and V. V. Kotlyarov. "Motor rehabilitation of the spastic paresis and proprioceptive disorders of the upper limb after focal CNS lesion (case report)." Russian Medical Inquiry 5, no. 10 (2021): 674–82. http://dx.doi.org/10.32364/2587-6821-2021-5-10-674-682.
Testo completoAbstract (sommario):
Motor disorders (i.e., spastic paresis of the upper limb) are among the most common complications of a stroke. Motor deficiency (muscle weakness/paresis), increased muscle tone, proprioceptive loss, and lesions of muscles, joints, and surrounding tissues develop in the limb. As a result, its functional rehabilitation is a challenging, long-term, and labor-intensive process. This paper addresses factors that directly affect the functional recovery of the upper limb after stroke. The authors emphasize the importance of timely diagnosis of all lesions using assessment scales, optimal rehabilitation programs, including techniques to recover sensitivity and muscle tone, and current rehabilitation techniques with biofeedback. This rehabilitation allows for adapting patients (particularly younger patients of working age) to society and daily life. This case report describes a 22-year-old man with cerebral infarction in the right temporoparietal in whom relevant diagnostic tools and personalized rehabilitation programs provided an excellent functional outcome. These methods are crucial for motor rehabilitation of patients with spastic paresis of the upper limb and proprioceptive disorders after focal CNS lesion. KEYWORDS: stroke, paresis, spasticity, prognosis, proprioception, rehabilitation, botulinum toxin therapy, biofeedback. FOR CITATION: Khat’kova S.E., Nikolaev E.A., Pogorel’tseva O.A. et al. Motor rehabilitation of the spastic paresis and proprioceptive disorders of the upper limb after focal CNS lesion (case report). Russian Medical Inquiry. 2021;5(10):674–682 (in Russ.). DOI: 10.32364/2587-6821- 2021-5-10-674-682.
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Zhang, Chao, Ji Zou, Zhongjing Ma, Qian Wu, Zhaogang Sheng, and Zhen Yan. "Upper Limb Action Identification Based on Physiological Signals and Its Application in Limb Rehabilitation Training." Traitement du Signal 38, no. 6 (2021): 1887–94. http://dx.doi.org/10.18280/ts.380633.
Testo completoAbstract (sommario):
pper limb motor dysfunction brings huge pain and burden to patients with brain trauma, stroke, and cerebral palsy, as well as their relatives. Physiological signals are closely related to the recovery of patients with limb dysfunction. The joint analysis of two key physiological signals, namely, surface electromyographic (sEMG) signal and acceleration signal, enables the scientific and effective evaluation of upper limb rehabilitation. However, the existing indices of upper limb rehabilitation are incomplete, and the current evaluation approaches are not sufficiently objective or quantifiable. To solve the problems, this paper explores upper limb action identification based on physiological signals, and tries to apply the approach to limb rehabilitation training. Specifically, the upper limb action features during limb rehabilitation training were extracted and identified by time-domain feature method, frequency-domain feature method, time-frequency domain feature method, and entropy feature method. Then, the evaluation flow of upper limb rehabilitation, plus the relevant evaluation indices, were given. Experimental results demonstrate the effectiveness of the proposed composite feature identification of upper limb actions, and the proposed evaluation method for limb rehabilitation.
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Furlan, Leonardo, Adriana Bastos Conforto, Leonardo G. Cohen, and Annette Sterr. "Upper Limb Immobilisation: A Neural Plasticity Model with Relevance to Poststroke Motor Rehabilitation." Neural Plasticity 2016 (2016): 1–17. http://dx.doi.org/10.1155/2016/8176217.
Testo completoAbstract (sommario):
Advances in our understanding of the neural plasticity that occurs after hemiparetic stroke have contributed to the formulation of theories of poststroke motor recovery. These theories, in turn, have underpinned contemporary motor rehabilitation strategies for treating motor deficits after stroke, such as upper limb hemiparesis. However, a relative drawback has been that, in general, these strategies are most compatible with the recovery profiles of relatively high-functioning stroke survivors and therefore do not easily translate into benefit to those individuals sustaining low-functioning upper limb hemiparesis, who otherwise have poorer residual function. For these individuals, alternative motor rehabilitation strategies are currently needed. In this paper, we will review upper limb immobilisation studies that have been conducted with healthy adult humans and animals. Then, we will discuss how the findings from these studies could inspire the creation of a neural plasticity model that is likely to be of particular relevance to the context of motor rehabilitation after stroke. For instance, as will be elaborated, such model could contribute to the development of alternative motor rehabilitation strategies for treating poststroke upper limb hemiparesis. The implications of the findings from those immobilisation studies for contemporary motor rehabilitation strategies will also be discussed and perspectives for future research in this arena will be provided as well.
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Dixon, Joel. "Predicting Upper Limb Recovery After Stroke." Neurology Report 23, no. 2 (1999): 74–75. http://dx.doi.org/10.1097/01253086-199923020-00016.
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Coscia, Martina, Maximilian J. Wessel, Ujwal Chaudary, et al. "Neurotechnology-aided interventions for upper limb motor rehabilitation in severe chronic stroke." Brain 142, no. 8 (2019): 2182–97. http://dx.doi.org/10.1093/brain/awz181.
Testo completoAbstract (sommario):
AbstractUpper limb motor deficits in severe stroke survivors often remain unresolved over extended time periods. Novel neurotechnologies have the potential to significantly support upper limb motor restoration in severely impaired stroke individuals. Here, we review recent controlled clinical studies and reviews focusing on the mechanisms of action and effectiveness of single and combined technology-aided interventions for upper limb motor rehabilitation after stroke, including robotics, muscular electrical stimulation, brain stimulation and brain computer/machine interfaces. We aim at identifying possible guidance for the optimal use of these new technologies to enhance upper limb motor recovery especially in severe chronic stroke patients. We found that the current literature does not provide enough evidence to support strict guidelines, because of the variability of the procedures for each intervention and of the heterogeneity of the stroke population. The present results confirm that neurotechnology-aided upper limb rehabilitation is promising for severe chronic stroke patients, but the combination of interventions often lacks understanding of single intervention mechanisms of action, which may not reflect the summation of single intervention’s effectiveness. Stroke rehabilitation is a long and complex process, and one single intervention administrated in a short time interval cannot have a large impact for motor recovery, especially in severely impaired patients. To design personalized interventions combining or proposing different interventions in sequence, it is necessary to have an excellent understanding of the mechanisms determining the effectiveness of a single treatment in this heterogeneous population of stroke patients. We encourage the identification of objective biomarkers for stroke recovery for patients’ stratification and to tailor treatments. Furthermore, the advantage of longitudinal personalized trial designs compared to classical double-blind placebo-controlled clinical trials as the basis for precise personalized stroke rehabilitation medicine is discussed. Finally, we also promote the necessary conceptual change from ‘one-suits-all’ treatments within in-patient clinical rehabilitation set-ups towards personalized home-based treatment strategies, by adopting novel technologies merging rehabilitation and motor assistance, including implantable ones.
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Gövercin, Mehmet, Isabelle M. Missala, Michael Marschollek, and Elisabeth Steinhagen-Thiessen. "Virtual Rehabilitation and Telerehabilitation for the Upper Limb." GeroPsych 23, no. 2 (2010): 79–90. http://dx.doi.org/10.1024/1662-9647/a000011.
Testo completoAbstract (sommario):
This paper provides a systematic overview of clinical trials investigating the effectiveness and usefulness of virtual rehabilitation (VR) and telerehabilitation (TR) for upper-limb recovery post stroke. Twenty-seven out of 116 hits showed positive results for outcome measurements. Whereas one randomized controlled trial (n = 81) showed no difference in outcome after VR, another (n = 10) yielded positive results in clinical outcome. Although general recommendations cannot be given, VR and TR approaches are feasible for upper-limb rehabilitation post stroke. Immersive VR approaches were shown to be effective compared to control groups. While nonimmersive VR did not prove to be effective, evidence from noncontrolled trials revealed that nonimmersive VR may prove to be effective compared to standard care.
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Azimova, N. М., Sh А. Shirmatov, and Sh B. Shokhyusupov. "FEATURES OF REHABILITATION OF MOTOR DISORDERS IN STROKE." UZBEK MEDICAL JOURNAL Special issue, no. 2 (2021): 5–8. http://dx.doi.org/10.26739/2181-0664-2021-si-2-1.
Testo completoAbstract (sommario):
Motor disorders are the most frequent and severe consequences of impaired cerebral circulation. Our study included 50 patients (24 women and 26 men) aged 50 to 74 years who had suffered an ischemic stroke. The main group included 25 patients with ischemic stroke who received transcranial micropolarization sessions together with standard pharmacotherapy. They showed an improvement in the motor function of the affected upper limb to a greater extent than in the comparison group
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Azimova, N. М., Sh А. Shirmatov, and Sh B. Shokhyusupov. "FEATURES OF REHABILITATION OF MOTOR DISORDERS IN STROKE." UZBEK MEDICAL JOURNAL Special issue, no. 2 (2021): 5–8. http://dx.doi.org/10.26739/2181-0664-2021-si-2-1.
Testo completoAbstract (sommario):
Motor disorders are the most frequent and severe consequences of impaired cerebral circulation. Our study included 50 patients (24 women and 26 men) aged 50 to 74 years who had suffered an ischemic stroke. The main group included 25 patients with ischemic stroke who received transcranial micropolarization sessions together with standard pharmacotherapy. They showed an improvement in the motor function of the affected upper limb to a greater extent than in the comparison group
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Tam, Pui Kit, Nicodemus Edrick Oey, Ning Tang, Guhan Ramamurthy, and Effie Chew. "Facilitating Corticomotor Excitability of the Contralesional Hemisphere Using Non-Invasive Brain Stimulation to Improve Upper Limb Motor Recovery from Stroke—A Scoping Review." Journal of Clinical Medicine 13, no. 15 (2024): 4420. http://dx.doi.org/10.3390/jcm13154420.
Testo completoAbstract (sommario):
Upper limb weakness following stroke poses a significant global psychosocial and economic burden. Non-invasive brain stimulation (NIBS) is a potential adjunctive treatment in rehabilitation. However, traditional approaches to rebalance interhemispheric inhibition may not be effective for all patients. The supportive role of the contralesional hemisphere in recovery of upper limb motor function has been supported by animal and clinical studies, particularly for those with severe strokes. This review aims to provide an overview of the facilitation role of the contralesional hemisphere for post-stroke motor recovery. While more studies are required to predict responses and inform the choice of NIBS approach, contralesional facilitation may offer new hope for patients in whom traditional rehabilitation and NIBS approaches have failed.
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Vanoglio, Fabio, Laura Comini, Marta Gaiani, Gian Pietro Bonometti, Alberto Luisa, and Palmira Bernocchi. "A Sensor-Based Upper Limb Treatment in Hemiplegic Patients: Results from a Randomized Pilot Study." Sensors 24, no. 8 (2024): 2574. http://dx.doi.org/10.3390/s24082574.
Testo completoAbstract (sommario):
In post-stroke patients, the disabling motor deficit mainly affects the upper limb. The focus of rehabilitation is improving upper limb function and reducing long-term disability. This study aims to evaluate the feasibility of using the Gloreha Aria (R-Lead), a sensor-based upper limb in-hospital rehabilitation, compared with conventional physiotherapist-led training in subacute hemiplegic patients. Twenty-one patients were recruited and randomised 1:1 to a sensor-based group (treatment group TG) or a conventional group (control group, CG). All patients performed 30 sessions of 30 min each of dedicated upper limb rehabilitation. The Fugl–Meyer Assessment for Upper Extremity (FMA-UE) was the primary evaluation., both as a motor score and as individual items. Secondary evaluations were Functional Independence Measure; global disability assessed with the Modified Barthel Index; Motor Evaluation Scale for UE in stroke; power grip; and arm, shoulder, and hand disability. All the enrolled patients, 10 in the TG and 11 in the CG, completed all hand rehabilitation sessions during their hospital stay without experiencing any adverse events. FMA-UE scores in upper limb motor function improved in both groups [delta change CG (11.8 ± 9.2) vs. TG (12.7 ± 8.6)]. The score at T1 for FMA joint pain (21.8 vs. 24 best score) suggests the use of the Gloreha Aria (R-Lead) as feasible in improving arm function abilities in post-stroke patients.
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Thomson, Katie, Alex Pollock, Carol Bugge, and Marian C. Brady. "Commercial gaming devices for stroke upper limb rehabilitation: The stroke survivor experience." Journal of Rehabilitation and Assistive Technologies Engineering 7 (January 2020): 205566832091538. http://dx.doi.org/10.1177/2055668320915381.
Testo completoAbstract (sommario):
Introduction Approximately 30% of stroke survivors experience an upper limb impairment, which impacts on participation and quality of life. Gaming devices (Nintendo Wii) are being incorporated into rehabilitation to improve function. We explored the stroke survivor experience of gaming as an upper limb intervention. Methods Semi-structured, individual interviews with stroke survivors living within the UK were completed. Interviews were audio-recorded, transcribed verbatim and analysed using Framework methods. Transcripts were coded and summarised into thematic charts. Thematic charts were refined during analysis until the final framework emerged. Results We captured experiences of 12 stroke survivors who used Nintendo Wii. Gaming devices were found to be acceptable for all ages but varying levels of enthusiasm existed. Enthusiastic players described gaming as having a positive impact on their motivation to engage in rehabilitation. For some, this became a leisure activity, encouraging self-practice. Non-enthusiastic players preferred sports to gaming. Conclusion An in-depth account of stroke survivor experiences of gaming within upper limb rehabilitation has been captured. Suitability of gaming should be assessed individually and stroke survivor abilities and preference for interventions should be taken into consideration. There was no indication that older stroke survivors or those with no previous experience of gaming were less likely to enjoy the activity.
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Iosa, M., G. Morone, A. Fusco, et al. "Seven Capital Devices for the Future of Stroke Rehabilitation." Stroke Research and Treatment 2012 (2012): 1–9. http://dx.doi.org/10.1155/2012/187965.
Testo completoAbstract (sommario):
Stroke is the leading cause of long-term disability for adults in industrialized societies. Rehabilitation’s efforts are tended to avoid long-term impairments, but, actually, the rehabilitative outcomes are still poor. Novel tools based on new technologies have been developed to improve the motor recovery. In this paper, we have taken into account seven promising technologies that can improve rehabilitation of patients with stroke in the early future: (1) robotic devices for lower and upper limb recovery, (2) brain computer interfaces, (3) noninvasive brain stimulators, (4) neuroprostheses, (5) wearable devices for quantitative human movement analysis, (6) virtual reality, and (7) tablet-pc used for neurorehabilitation.
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Sethy, Damayanti, Surjeet Sahoo, Srikant Sahoo, and Kshanaprava Mohakud. "Effect of movement-based priming combined with task specific training on upper limb recovery in patients after stroke." Journal of Associated Medical Sciences 57, no. 1 (2024): 77–86. http://dx.doi.org/10.12982/jams.2024.009.
Testo completoAbstract (sommario):
Background: Rehabilitation of upper limb impairments and functional deficits is a top goal in stroke rehabilitation. Alternative therapeutic methods may be developed to facilitate upper limb recovery. Priming prepares the brain for better action. When some therapies accompany Priming, it results in a change in behaviour at the performance level by improving the effect of Neuro-Rehabilitation Therapies and enhancing change in the neural process. Objectives: To investigate the efficacy of movement-based priming combined with task-specific training on upper limb recovery in patients after stroke. Materials and methods: Twenty-four subjects in the early phase of stroke, attending the Department of Neurology in a tertiary care hospital of Bhubaneswar, Odisha participated in a single-blind randomized controlled trial. 24 subjects after stroke were recruited to the study and randomly allocated to a control group receiving task-specific training only (TST) and an experimental group receiving Movement-Based Priming with task-specific training (MBP+TST). The control group received only task-specific training for 45 minutes per session three days a week for six weeks, while the experimental group received 15 minutes of priming and 30 minutes of task-specific training. Fugl-Mayer Assessment of upper extremity (FMA-UE)was used to measure upper extremity motor recovery, and the Motor Activity Log (MAL) was used to measure the use of arm and hand during activities of daily living at baseline and after six weeks of therapy. Results: Both the TST group and the MBP+TST group had significantly improved their capacity to move and use their upper limbs functionally (p<0.001). FMA-UE and MAL scores improved more favorably in the MBP+TST group than in the TST group (p<0.001). Conclusion: Priming in combination with task-specific training results in better upper limb recovery than task-specific training alone.
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Li, Rui, Jingyi Lu, Meiqi Wang, et al. "Ultrasound-Guided Median Nerve Electrical Stimulation to Promote Upper Limb Function Recovery after Stroke." Evidence-Based Complementary and Alternative Medicine 2022 (July 14, 2022): 1–10. http://dx.doi.org/10.1155/2022/3590057.
Testo completoAbstract (sommario):
Peripheral electrical nerve stimulation enhances hand function during stroke rehabilitation. Here, we proposed a percutaneous direct median nerve stimulation guided by ultrasound (ultrasound‐guided median nerve electrical stimulation, UG-MNES) and evaluated its feasibility and effectiveness in the treatment of stroke patients with upper limb extremity impairments. Sixty-three stroke patients (2-3 months of onset) were randomly divided into control and UG-MNES groups. Both groups received routine rehabilitation and the UG-MNES group received an additional ultrasound-guided electrical stimulation of the median nerve at 2 Hz, 0.2 ms pulse-width for 20 minutes with gradual intensity enhancement. The Fugl-Meyer Assessment for upper extremity motor function (FMA-UE) was used as the primary outcome. The secondary outcomes were the Functional Test for the Hemiplegic Upper Extremity (FTHUE-HK), Hand Function Rating Scale, Brunnstrom Stages, and Barthel Index scores for motor and daily functions. All the participants completed the trial without any side effects or adverse events during the intervention. After 4 weeks of intervention, the functions of the upper limbs on the hemiplegic side in both groups achieved significant recovery. Compared to the control group, all evaluation indices used in this trial were improved significantly in the UG-MNES group after 2 and 4 weeks of intervention; particularly, the first intervention of UG-MNES immediately improved all the assessment items significantly. In conclusion, the UG-MNES is a safe and feasible treatment for stroke patients with upper limb extremity impairments and could significantly improve the motor function of the affected upper limb, especially in the first intervention. The UG-MNES could be an effective alternative intervention for stroke with upper limb extremity impairments.