Evaluation of Interventions in Stroke: The Cochrane Stroke Group Experience

AbstractStroke and cognitive impairment are common in older population. They often occur together and their combined effects significantly increase disability in both basic (BADLs) and instrumental (IADLs) activities of daily living. We investigated the individual and combined impacts of stroke and cognitive impairment on BADLs and IADLs. A total of 3331 community-dwelling older adults were enrolled from the Taiwan longitudinal study on aging in 2011. Both BADLs and IADLs were analyzed. Combination of stroke and cognitive impairment increased severity of ADL disabilities, but similar prevalence, similar numbers of summed BADL and IADL tasks with disability, and similar levels of difficulty for each BADL and IADL task were found between the stroke group and cognitive impairment group. The former had more difficult in dressing while the latter had more difficult in using the telephone, transport, and managing finances. A hierarchy of ADLs was also observed in all groups. ADL skill training supplemented with cognitive and physical interventions should focus on secondary prevention of dementia and improve motor functional capacity to reduce loss of ADLs.

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Identifying bidirectional total and non-linear information flow in functional corticomuscular coupling during a dorsiflexion task: a pilot study

Journal of NeuroEngineering and Rehabilitation ◽

10.1186/s12984-021-00872-w ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Tie Liang ◽

Qingyu Zhang ◽

Xiaoguang Liu ◽

Bin Dong ◽

Xiuling Liu ◽

...

Keyword(s):

Time Series ◽

Information Flow ◽

Gamma Band ◽

Motor Dysfunction ◽

Beta Band ◽

Short Time Series ◽

Information Interaction ◽

Stroke Group ◽

Short Time ◽

Maximal Information Coefficient

Abstract Background The key challenge to constructing functional corticomuscular coupling (FCMC) is to accurately identify the direction and strength of the information flow between scalp electroencephalography (EEG) and surface electromyography (SEMG). Traditional TE and TDMI methods have difficulty in identifying the information interaction for short time series as they tend to rely on long and stable data, so we propose a time-delayed maximal information coefficient (TDMIC) method. With this method, we aim to investigate the directional specificity of bidirectional total and nonlinear information flow on FCMC, and to explore the neural mechanisms underlying motor dysfunction in stroke patients. Methods We introduced a time-delayed parameter in the maximal information coefficient to capture the direction of information interaction between two time series. We employed the linear and non-linear system model based on short data to verify the validity of our algorithm. We then used the TDMIC method to study the characteristics of total and nonlinear information flow in FCMC during a dorsiflexion task for healthy controls and stroke patients. Results The simulation results showed that the TDMIC method can better detect the direction of information interaction compared with TE and TDMI methods. For healthy controls, the beta band (14–30 Hz) had higher information flow in FCMC than the gamma band (31–45 Hz). Furthermore, the beta-band total and nonlinear information flow in the descending direction (EEG to EMG) was significantly higher than that in the ascending direction (EMG to EEG), whereas in the gamma band the ascending direction had significantly higher information flow than the descending direction. Additionally, we found that the strong bidirectional information flow mainly acted on Cz, C3, CP3, P3 and CPz. Compared to controls, both the beta-and gamma-band bidirectional total and nonlinear information flows of the stroke group were significantly weaker. There is no significant difference in the direction of beta- and gamma-band information flow in stroke group. Conclusions The proposed method could effectively identify the information interaction between short time series. According to our experiment, the beta band mainly passes downward motor control information while the gamma band features upward sensory feedback information delivery. Our observation demonstrate that the center and contralateral sensorimotor cortex play a major role in lower limb motor control. The study further demonstrates that brain damage caused by stroke disrupts the bidirectional information interaction between cortex and effector muscles in the sensorimotor system, leading to motor dysfunction.

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Facing Loss of Vision: The Response of Adults to Visual Impairment

Journal of Visual Impairment & Blindness ◽

10.1177/0145482x8107500201 ◽

1981 ◽

Vol 75 (2) ◽

pp. 41-45 ◽

Cited By ~ 23

Author(s):

Donna L. Emerson

Keyword(s):

Group Therapy ◽

Group Work ◽

Low Vision ◽

Psychosocial Problems ◽

Short Term ◽

Reactive Depression ◽

Before And After ◽

Group Members ◽

Social Group Work ◽

Group Experience

Short-term group therapy, using social group work, was utilized to treat the psychosocial problems of two groups of elderly low-vision clients and one group of young adult clients with low vision (N = 24). Group members showed psychosocial movement in three phases: shock, reactive depression, and readjustment. Evaluations measured the change in attitudes before and after group therapy. At the end of therapy, 17 persons, compared to none before the therapy, were at the point of self-acceptance and readjustment. Clinical examples illustrate the interplay of intrapsychic and group-experience factors leading to readjustment.

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