scholarly journals Functional Brain Correlates of Upper Limb Spasticity and Its Mitigation following Rehabilitation in Chronic Stroke Survivors

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Svetlana Pundik ◽  
Adam D. Falchook ◽  
Jessica McCabe ◽  
Krisanne Litinas ◽  
Janis J. Daly
Keyword(s):  
Motor Function ◽  
Upper Limb ◽  
Muscle Tone ◽  
Hand Movement ◽  
Chronic Stroke ◽  
Motor Deficits ◽  
Stroke Survivors ◽  
Functional Brain ◽  
Brain Correlates ◽  
Limb Spasticity

Background.Arm spasticity is a challenge in the care of chronic stroke survivors with motor deficits. In order to advance spasticity treatments, a better understanding of the mechanism of spasticity-related neuroplasticity is needed.Objective.To investigate brain function correlates of spasticity in chronic stroke and to identify specific regional functional brain changes related to rehabilitation-induced mitigation of spasticity.Methods.23 stroke survivors (>6 months) were treated with an arm motor learning and spasticity therapy (5 d/wk for 12 weeks). Outcome measures included Modified Ashworth scale, sensory tests, and functional magnetic resonance imaging (fMRI) for wrist and hand movement.Results.First, at baseline, greater spasticity correlated with poorer motor function (P=0.001) and greater sensory deficits (P=0.003). Second, rehabilitation produced improvement in upper limb spasticity and motor function (P<0.0001). Third, at baseline, greater spasticity correlated with higher fMRI activation in the ipsilesional thalamus (rho=0.49,P=0.03). Fourth, following rehabilitation, greater mitigation of spasticity correlated with enhanced fMRI activation in the contralesional primary motor (r=-0.755,P=0.003), premotor (r=−0.565,P=0.04), primary sensory (r=−0.614,P=0.03), and associative sensory (r=−0.597,P=0.03) regions while controlling for changes in motor function.Conclusions.Contralesional motor regions may contribute to restoring control of muscle tone in chronic stroke.

scholarly journals Regional Cerebral Blood Perfusion Changes in Chronic Stroke Survivors as Potential Brain Correlates of The Functional Outcome Following Gamified Home-Based Rehabilitation (IntelliRehab)

2021 ◽  
Author(s):  
Younis Firwana ◽  
Mohd Khairul Izamil Zolkefley ◽  
Hasnetty Zuria Mohamed Hatta ◽  
Christina Rowbin ◽  
Che Mohd Nasril Che Mohd Nassir ◽  
...  
Keyword(s):  
Motor Function ◽  
Upper Limb ◽  
Blood Perfusion ◽  
Chronic Stroke ◽  
Stroke Survivors ◽  
Motor Functions ◽  
Staffing Ratios ◽  
Recovery Potential ◽  
Home Based ◽  
Brain Correlates

Abstract Background: Hospital-based stroke rehabilitation for stroke survivors in developing countries may be limited by staffing ratios and length of stay that could hamper recovery potential. Thus, a home-based, gamified rehabilitation system (i.e. IntelliRehab) was tested for its ability to increase cerebral blood flow (CBF), and the secondary impact of changes on the upper limb motor function and functional outcomes. Objective: To explore the effect of IntelliRehab on CBF in chronic stroke patients and its correlation with the upper limb motor function. Methods: Two-dimensional pulsed Arterial Spin Labelling (2D-pASL) was used to obtain CBF images of stable, chronic stroke subjects (n=8) over 3-months intervention period. CBF alterations were mapped and the detected differences were marked as regions of interest. Motor functions represented by Fugl-Meyer Upper Extremity Assessment (FMA) and Stroke Impact Scale (SIS) were used to assess the primary and secondary outcomes, respectively. Results: Regional CBF were significantly increased in right inferior temporal gyrus and left superior temporal white matter after 1-month (p=0.044) and 3-months (p=0.01) of rehabilitation, respectively. However, regional CBF in left middle fronto-orbital gyrus significantly declined after 1-month of rehabilitation (p=0.012). Moreover, SIS-Q7 and FMA scores significantly increased after 1-month and 3-months of rehabilitation. There were no significant correlations, however, between CBF changes and upper limb motor function. Conclusions: Participants demonstrated improved motor functions, supporting the benefit of using IntelliRehab as a tool for home-based rehabilitation. However, the chronic nature of the stroke in recruited subjects may have limited potential for within-participant improvements.

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

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

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

scholarly journals The effect of the Bobath therapy programme on upper limb and hand function in chronic stroke individuals with moderate to severe deficits

2019 ◽  
Vol 26 (10) ◽  
pp. 1-12
Author(s):  
Thanchanok Pumprasart ◽  
Noppol Pramodhyakul ◽  
Pagamas Piriyaprasarth
Keyword(s):  
Upper Extremity ◽  
Motor Function ◽  
Upper Limb ◽  
Muscle Tone ◽  
Chronic Stroke ◽  
Rank Test ◽  
Limb Function ◽  
Function Test ◽  
Wolf Motor Function Test ◽  
Therapy Programme

Background/Aims The Bobath concept has long been used to improve postural control and limb function post-stroke, yet its effect in patients with deficits have not been clearly demonstrated. This study aimed to investigate the effect of the latest Bobath therapy programme on upper limb functions, muscle tone and sensation in chronic stroke individuals with moderate to severe deficits. Methods A pre–post test design was implemented. The participants were chronic stroke individuals (n=26). Home-based intervention based on the Bobath concept was administered 3 days per week for 6 weeks (20 repetitions × 3 sets per task each session). Outcome measures consisted of the Wolf Motor Function Test, Fugl-Meyer Assessment for the upper extremity, Modified Ashworth Scale, and the Revised Nottingham Sensory Assessment. Data were analysed using the Wilcoxon Signed rank test. Results Almost all items of the Wolf Motor Function Test and the Fugl-Meyer Assessment for the upper extremity demonstrated statistically significant differences post-intervention. Finger flexor muscle tone and stereognosis were also significantly improved. Conclusions The 6-week Bobath therapy programme could improve upper limb function and impairments in chronic stroke individuals with moderate to severe deficits. Its effects were also demonstrated in improving muscle tone and cortical sensation.

scholarly journals The Effectiveness of Massage Therapy for Improving Sequelae in Post-Stroke Survivors. A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (9) ◽  
pp. 4424
Author(s):  
Rosa Cabanas-Valdés ◽  
Jordi Calvo-Sanz ◽  
Pol Serra-Llobet ◽  
Joana Alcoba-Kait ◽  
Vanessa González-Rueda ◽  
...  
Keyword(s):  
Systematic Review ◽  
Motor Function ◽  
Upper Limb ◽  
Lower Limb ◽  
Meta Analysis ◽  
Stroke Survivors ◽  
Randomized Controlled Clinical Trials ◽  
Therapeutic Massage ◽  
Limb Spasticity ◽  
Conventional Physiotherapy

Objective: To assess the effect of therapeutic massage for improving sequelae in stroke survivors. Methods: A systematic review of the nine medical databases from January 1961 to December 2020 was carried out. The bibliography was screened to identify randomized controlled clinical trials (RCTs). Two reviewers independently screened references, selected relevant studies, extracted data and assessed the risk of bias using the PEDro scale. The primary outcome was upper and lower limb motor function and spasticity. Results: A total of 3196 studies were identified and 18 RCT were finally included (1989 individuals). A meta-analysis of RCTs in the comparison of Chinese massage (Tuina) plus conventional physiotherapy versus conventional physiotherapy was performed. The mean difference (MD) in the subacute stage on upper limb motor-function using the Fugl Meyer Assessment was 2.75; (95% confidence interval (CI) from 0.97 to 4.53, p = 0.002, I2 = 36%). The MD on upper limb spasticity using modified Ashworth scale was −0.15; (95% CI from −0.24 to −0.06, p < 0.02, I2 = 0%).The MD on lower limb spasticity was −0.59; (95% CI from −0.78 to −0.40, p < 0.001, I2 = 0%) in the endpoint. Conclusions: Therapeutic massage, especially Tuina, in addition to conventional therapy is effective for improving motor function and for reducing spasticity in stroke survivors.

Chronic stroke survivors with upper limb spasticity: linking experience to the ICF

2021 ◽  
pp. 1-13
Author(s):  
Shannon Pike ◽  
Natasha A. Lannin ◽  
Lisa Cameron ◽  
Mithu Palit ◽  
Anne Cusick
Keyword(s):  
Upper Limb ◽  
Chronic Stroke ◽  
Stroke Survivors ◽  
Limb Spasticity

scholarly journals The effects of anxiety and dual-task on upper limb motor control of chronic stroke survivors

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Mahnaz Hejazi-Shirmard ◽  
Laleh Lajevardi ◽  
Mehdi Rassafiani ◽  
Ghorban Taghizadeh
Keyword(s):  
Motor Control ◽  
Upper Limb ◽  
Dual Task ◽  
Chronic Stroke ◽  
Stroke Survivors ◽  
High Anxiety ◽  
Reach And Grasp ◽  
Stroke Group ◽  
Task Conditions ◽  
Hand Opening

Abstract This study was designed to investigate the effects of anxiety and dual-task on reach and grasp motor control in chronic stroke survivors compared with age- and sex-matched healthy subjects (HC). Reach and grasp kinematic data of 68 participants (high-anxiety stroke (HA-stroke), n = 17; low-anxiety stroke (LA-stroke), n = 17; low-anxiety HC, n = 17; and high-anxiety HC, n = 17) were recorded under single- and dual-task conditions. Inefficient reach and grasp of stroke participants, especially HA-stroke were found compared with the control groups under single- and dual-task conditions as evidenced by longer movement time (MT), lower and earlier peak velocity (PV) as well as delayed and smaller hand opening. The effects of dual-task on reach and grasp kinematic measures were similar between HCs and stroke participants (i.e., increased MT, decreased PV that occurred earlier, and delayed and decreased hand opening), with greater effect in stroke groups than HCs, and in HA-stroke group than LA-stroke group. The results indicate that performing a well-learned upper limb movement with concurrent cognitive task leads to decreased efficiency of motor control in chronic stroke survivors compared with HCs. HA-stroke participants were more adversely affected by challenging dual-task conditions, underlying importance of assessing anxiety and designing effective interventions for it in chronic stroke survivors.

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