scholarly journals Combined Brain and Peripheral Nerve Stimulation in Chronic Stroke Patients With Moderate to Severe Motor Impairment

2017 ◽  
Vol 21 (2) ◽  
pp. 176-183 ◽  
Author(s):  
Isabella S. Menezes ◽  
Leonardo G. Cohen ◽  
Eduardo A. Mello ◽  
André G. Machado ◽  
Paul Hunter Peckham ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Motor Impairment ◽  
Chronic Stroke ◽  
Peripheral Nerve Stimulation ◽  
Stroke Patients ◽  
Severe Motor ◽  
Severe Motor Impairment

scholarly journals Effects of Combined Peripheral Nerve Stimulation and Brain Polarization on Performance of a Motor Sequence Task After Chronic Stroke

Stroke ◽  
2009 ◽  
Vol 40 (5) ◽  
pp. 1764-1771 ◽  
Author(s):  
Pablo Celnik ◽  
Nam-Jong Paik ◽  
Yves Vandermeeren ◽  
Michael Dimyan ◽  
Leonardo G. Cohen
Keyword(s):  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Chronic Stroke ◽  
Peripheral Nerve Stimulation ◽  
Motor Sequence

scholarly journals Model for prompt and effective classification of motion recovery after stroke considering muscle strength and coordination factors

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Álvaro Costa-García ◽  
Ken-ichi Ozaki ◽  
Hiroshi Yamasaki ◽  
Matti Itkonen ◽  
Fady Alnajjar S. ◽  
...  
Keyword(s):  
Brain Damage ◽  
Motor Impairment ◽  
Muscle Coordination ◽  
Motor Impairments ◽  
Stroke Patients ◽  
Neural Adaptations ◽  
Two Factors ◽  
Severe Motor ◽  
Motor Strength ◽  
Severe Motor Impairment

Abstract Background Muscle synergies are now widely discussed as a method for evaluating the existence of redundant neural networks that can be activated to enhance stroke rehabilitation. However, this approach was initially conceived to study muscle coordination during learned motions in healthy individuals. After brain damage, there are several neural adaptations that contribute to the recovery of motor strength, with muscle coordination being one of them. In this study, a model is proposed that assesses motion based on surface electromyography (sEMG) according to two main factors closely related to the neural adaptations underlying motor recovery: (1) the correct coordination of the muscles involved in a particular motion and (2) the ability to tune the effective strength of each muscle through muscle fiber contractions. These two factors are hypothesized to be affected differently by brain damage. Therefore, their independent evaluation will play an important role in understanding the origin of stroke-related motor impairments. Results The model proposed was validated by analyzing sEMG data from 18 stroke patients with different paralysis levels and 30 healthy subjects. While the factors necessary to describe motion were stable across heathy subjects, there was an increasing disassociation for stroke patients with severe motor impairment. Conclusions The clear dissociation between the coordination of muscles and the tuning of their strength demonstrates the importance of evaluating these factors in order to choose appropriate rehabilitation therapies. The model described in this research provides an efficient approach to promptly evaluate these factors through the use of two intuitive indexes.

scholarly journals Brain State-Dependent Peripheral Nerve Stimulation for Plasticity Induction in Stroke Patients

2018 ◽  
pp. 1066-1070
Author(s):  
Andrew J. T. Stevenson ◽  
Helle R. M. Jørgensen ◽  
Kåre E. Severinsen ◽  
Susan Aliakbaryhosseinabadi ◽  
Ning Jiang ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Peripheral Nerve Stimulation ◽  
Brain State ◽  
Stroke Patients ◽  
State Dependent

scholarly journals Cerebrolysin Combined with Rehabilitation Enhances Motor Recovery and Prevents Neural Network Degeneration in Ischemic Stroke Patients with Severe Motor Deficits

2021 ◽  
Vol 11 (6) ◽  
pp. 545
Author(s):  
Won Hyuk Chang ◽  
Jungsoo Lee ◽  
Yong-Il Shin ◽  
Myoung-Hwan Ko ◽  
Deog Young Kim ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Diffusion Tensor ◽  
Motor Impairment ◽  
Motor Recovery ◽  
Stroke Onset ◽  
Stroke Patients ◽  
Rehabilitation Therapy ◽  
Severe Motor ◽  
Severe Motor Impairment ◽  
Over Time

The objective of this study was to evaluate whether Cerebrolysin combined with rehabilitation therapy supports additional motor recovery in stroke patients with severe motor impairment. This study analyzed the combined data from the two phase IV prospective, multicenter, randomized, double-blind, placebo-controlled trials. Stroke patients were included within seven days after stroke onset and were randomized to receive a 21-day treatment course of either Cerebrolysin or placebo with standardized rehabilitation therapy. Assessments were performed at baseline, immediately after the treatment course, and 90 days after stroke onset. The plasticity of the motor system was assessed by diffusion tensor imaging and resting state fMRI. In total, 110 stroke patients were included for the full analysis set (Cerebrolysin n = 59, placebo n = 51). Both groups showed significant motor recovery over time. Repeated-measures analysis of varianceshowed a significant interaction between time and type of intervention as measured by the Fugl–Meyer Assessment (p < 0.05). The Cerebrolysin group demonstrated less degenerative changes in the major motor-related white matter tracts over time than the placebo group. In conclusion, Cerebrolysin treatment as an add-on to a rehabilitation program is a promising pharmacologic approach that is worth considering in order to enhance motor recovery in ischemic stroke patients with severe motor impairment.

scholarly journals The Probability of Choosing Both Hands Depends on an Interaction Between Motor Capacity and Limb-Specific Control in Chronic Stroke

2020 ◽  
Author(s):  
Rini Varghese ◽  
Jason J Kutch ◽  
Nicolas Schweighofer ◽  
Carolee J Winstein
Keyword(s):  
Primary Outcome ◽  
Motor Impairment ◽  
Chronic Stroke ◽  
Task Demands ◽  
Functional Activities ◽  
Photo Album ◽  
Severe Motor ◽  
Severe Motor Impairment ◽  
Specific Control ◽  
Bimanual Tasks

A goal of rehabilitation after stroke is to promote pre-stroke levels of arm use for everyday, frequently bimanual, functional activities. We reasoned that, after a stroke, the choice to use one or both hands for bimanual tasks might depend not only on residual motor capacity but also the specialized demands imposed by the task on the paretic hand. To capture spontaneous, task-specific choices, we covertly observed 50 pre-stroke right-handed chronic stroke survivors (25 left hemisphere damage, LHD) and recorded their hand use strategies for two pairs of bimanual tasks with distinct demands: one with greater precision requirements (photo-album tasks), and another with greater stabilization requirements (letter-envelope tasks). The primary outcome was the choice to use one or both hands. Logistic regression was used to test the hypothesis that the probability of choosing a bimanual strategy would be greater in those with less severe motor impairment and those with LHD. When collapsed across the four subtasks, we found support for this hypothesis. However, notably, the influence of these factors on bimanual choice varied based on task demands. For the photo-album task, the probability of a bimanual strategy was greater for those with LHD compared to RHD, regardless of the degree of motor impairment. For the letter-envelope task, we found a significant interaction between impairment and side of lesion in determining the likelihood of choosing both hands. Therefore, the manner in which side of lesion moderates the effect of impairment on hand use depends on the task.

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