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 Application of the Fugl-Meyer Assessment (FMA) and the Wolf Motor Function Test (WMFT) in the recovery of upper limb function in patients after chronic stroke: a literature review

2013 ◽  
Vol 20 (1) ◽  
pp. 42-49 ◽  
Author(s):  
Cauê Padovani ◽  
Cristhiane Valério Garabello Pires ◽  
Fernanda Pretti Chalet Ferreira ◽  
Gabriela Borin ◽  
Thais Raquel Martins Filippo ◽  
...  
Keyword(s):  
Literature Review ◽  
Motor Function ◽  
Upper Limb ◽  
Chronic Stroke ◽  
Limb Function ◽  
Upper Limb Function ◽  
Function Test ◽  
Wolf Motor Function Test

Influence of task-oriented circuit training on upper limb function among rural community-dwelling survivors of stroke

2020 ◽  
Vol 27 (8) ◽  
pp. 1-8
Author(s):  
Shruti Deshpande ◽  
Sidhiparada Mohapatra ◽  
N Girish
Keyword(s):  
Upper Limb ◽  
Chronic Stroke ◽  
Community Dwelling ◽  
Rank Test ◽  
Circuit Training ◽  
Rehabilitation Centre ◽  
Limb Function ◽  
Upper Limb Rehabilitation ◽  
Upper Limb Function ◽  
Task Oriented

Background Task-oriented circuit training using a Multi-Activities workstation emphasises goal-oriented tasks practiced in a circuit or series in order to learn a new skill. It can be used for upper limb rehabilitation among stroke patients in a community setting, but there is currently very little evidence available regarding its use in this patient group and setting. This study aimed to explore the influence of task-oriented circuit training using a Multi-Activities workstation on upper limb function among community-dwelling individuals with chronic stroke. Methods A pre-test–post-test study was conducted involving 17 community-dwelling individuals with chronic stroke who were attending a stroke rehabilitation centre. Six weeks of task-oriented circuit training was given using a Multi-Activities workstation aimed to improve strength, range of motion and dexterity. Streamlined Wolf Motor Function Test and Chedoke Arm and Hand Activity Inventory were used to measure outcomes. Wilcoxon signed-rank test was used for data analysis. Results A total of 12 sessions of task-oriented circuit training using Multi-Activities workstations did not result in any statistically significant differences in outcome measures. Conclusions Task-oriented circuit training using the Multi-Activities workstation did not improve upper limb function in community-dwelling individuals with chronic stroke.

scholarly journals Assist-as-needed control strategy for upper-limb rehabilitation based on subject’s functional ability

2019 ◽  
Vol 52 (9-10) ◽  
pp. 1354-1361 ◽  
Author(s):  
Shawgi Younis Ahmed Mounis ◽  
Norsinnira Zainul Azlan ◽  
Fatai Sado
Keyword(s):  
Motor Function ◽  
Upper Limb ◽  
Functional Ability ◽  
Measurement Unit ◽  
Robotic Assistance ◽  
Clinical Procedure ◽  
Function Test ◽  
Wolf Motor Function Test ◽  
Movement Ability ◽  
Ability Index

The assist-as-needed technique in robotic rehabilitation is a popular technique that encourages patients’ active participation to promote motor recovery. It has been proven beneficial for patients with functional motor disability. However, its application in robotic therapy has been hindered by a poor estimation method of subjects’ functional or movement ability which is required for setting the appropriate robotic assistance. Moreover, there is also the need for consistency and repeatability of the functional ability estimation in line with the clinical procedure to facilitate a wider clinical adoption. In this study, we propose a new technique of estimation of subject’s functional ability based on the Wolf Motor Function Test. We called this estimation the functional ability index. The functional ability index enables the modulation of robotic assistance and gives a more consistent indication of subjects’ upper-limb movement ability during therapy session. Our baseline controller is an adaptive inertia-related controller, which is integrated with the functional ability index algorithm to provide movement assistance as when needed. Experimental studies are conducted on three hemiplegic patients with different levels of upper-limb impairments. Each patient is requested to perform reaching task of lifting a can from table-to-mouth according to the guidelines stipulated in the Wolf Motor Function Test. Data were collected using two inertial measurement unit sensors installed at the flexion/extension joints, and the functional ability score of each patient was rated by an experienced therapist. Results showed that the proposed functional ability index algorithm can estimate patients’ functional ability level consistently with clinical procedure and can modify generated robotic assistance in accordance with patients’ functional movement ability.

scholarly journals Multicenter Randomized Trial of Robot-Assisted Rehabilitation for Chronic Stroke: Methods and Entry Characteristics for VA ROBOTICS

2009 ◽  
Vol 23 (8) ◽  
pp. 775-783 ◽  
Author(s):  
Albert C. Lo ◽  
Peter Guarino ◽  
Hermano I. Krebs ◽  
Bruce T. Volpe ◽  
Christopher T. Bever ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Motor Function ◽  
Controlled Trial ◽  
Chronic Stroke ◽  
Robot Assisted ◽  
Anterior Circulation ◽  
Multicenter Randomized Controlled Trial ◽  
Index Stroke ◽  
Wolf Motor Function Test ◽  
Upper Extremity Impairment

Background. Chronic upper extremity impairment due to stroke has significant medical, psychosocial, and financial consequences, but few studies have examined the effectiveness of rehabilitation therapy during the chronic stroke period. Objective. To test the safety and efficacy of the MIT-Manus robotic device for chronic upper extremity impairment following stroke. Methods. The VA Cooperative Studies Program initiated a multicenter, randomized, controlled trial in November 2006 (VA ROBOTICS). Participants with upper extremity impairment ≥6 months poststroke were randomized to robot-assisted therapy (RT), intensive comparison therapy (ICT), or usual care (UC). RT and ICT consisted of three 1-hour treatment sessions per week for 12 weeks. The primary outcome was change in the Fugl-Meyer Assessment upper extremity motor function score at 12 weeks relative to baseline. Secondary outcomes included the Wolf Motor Function Test and the Stroke Impact Scale. Results. A total of 127 participants were randomized: 49 to RT, 50 to ICT, and 28 to UC. The majority of participants were male (96%), with a mean age of 65 years. The primary stroke type was ischemic (85%), and 58% of strokes occurred in the anterior circulation. Twenty percent of the participants reported a stroke in addition to their index stroke. The average time from the index stroke to enrollment was 56 months (range, 6 months to 24 years). The mean Fugl-Meyer score at entry was 18.9. Conclusions. VA ROBOTICS demonstrates the feasibility of conducting multicenter clinical trials to rigorously test new rehabilitative devices before their introduction to clinical practice. The results are expected in early 2010.

scholarly journals Can the Wolf Motor Function Test be Streamlined?

2009 ◽  
Vol 23 (5) ◽  
pp. 422-428 ◽  
Author(s):  
Kimberly Bogard ◽  
Steven Wolf ◽  
Qin Zhang ◽  
Paul Thompson ◽  
David Morris ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Motor Function ◽  
Movement Therapy ◽  
Change Score ◽  
Functional Level ◽  
Regression Methods ◽  
Constraint Induced Movement Therapy ◽  
Gender Concordance ◽  
Function Test ◽  
Wolf Motor Function Test

Background. To assess upper extremity (UE) capabilities following stroke, the Wolf Motor Function Test (WMFT) measures time to complete 15 UE tasks and 2 strength tasks, but takes 30 to 45 minutes for the clinician to complete. Objective. In an effort to streamline the WMFT, this study evaluated the association between the magnitude of improvement on any timed task of the WMFT and the change score on all other tasks among participants in the Extremity Constraint Induced Therapy Evaluation (EXCITE) trial. Methods. This association was evaluated using regression methods according to chronicity and controlling for key covariates (functional level, gender, concordance) for log mean WMFT scores. Results. After controlling for covariates, 6 tasks (hand to table [front], hand to box [front], reach and retrieve, lift can, lift pencil, and fold towel) influenced the overall WMFT score for survivors meeting EXCITE criteria and treated within 3 to 9 months poststroke. Six different tasks (extend elbow weight, hand to box [front], lift can, lift pencil, turn key in lock, and fold towel) influenced the overall WMFT score for those receiving constraint-induced movement therapy (CIMT) 1 year later. The importance of certain tasks relative to others may best represent overall UE function, but this streamlining enables the clinician to prioritize these tasks in the evaluation. Conclusions. The delineation of those tasks depends on the time poststroke from enrollment to CIMT. This study demonstrates that the WMFT can be streamlined from 17 to 6 tasks.

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.

Rasch Validation of the Streamlined Wolf Motor Function Test in People With Chronic Stroke and Subacute Stroke

2012 ◽  
Vol 92 (8) ◽  
pp. 1017-1026 ◽  
Author(s):  
Hui-fang Chen ◽  
Ching-yi Wu ◽  
Keh-chung Lin ◽  
Hsieh-ching Chen ◽  
Carl P-C. Chen ◽  
...  
Keyword(s):  
Construct Validity ◽  
Motor Function ◽  
Item Difficulty ◽  
Short Form ◽  
Chronic Stroke ◽  
Test Structure ◽  
Validity And Reliability ◽  
Subacute Stroke ◽  
Function Test ◽  
Wolf Motor Function Test

Background The construct validity and reliability of the short form of the Wolf Motor Function Test (S-WMFT) in people with subacute stroke and chronic stroke (S-WMFT subacute stroke and chronic stroke versions) have not been investigated. Objective The purpose of this study was to investigate the dimensionality, item difficulty hierarchy, differential item functioning (DIF), and reliability of the S-WMFT subacute stroke and chronic stroke versions in people with mild to moderate upper-extremity (UE) dysfunction. Design This was a secondary study in which data collected from randomized controlled trials were used. Methods Data were collected at baseline from 97 people with chronic stroke (&gt;12 months after stroke) and 75 people with subacute stroke (3–9 months after stroke) at 3 medical centers in Taiwan. Test structure, hierarchical properties, DIF, and reliability were assessed with Rasch analysis. Results The test structure for both versions was unidimensional. No DIF relevant to sex, age, or stroke location (hemispheric laterality) was detected. The tasks of moving a hand to a box and moving a hand to a table in the S-WMFT for subacute stroke showed a significantly high correlation. The reliability coefficients for both versions were approximately .90. Limitations The findings were limited to people with stroke and mild to moderate impairment of UE function. Conclusions The S-WMFT subacute stroke and chronic stroke versions are useful tools for assessing UE function in different subgroups of people with stroke and show evidence of construct validity and reliability. A high correlation between the tasks of moving a hand to a box and moving a hand to a table in the S-WMFT for subacute stroke suggests that the removal of 1 of these 2 items is warranted.

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