Background: Perioperative stroke is a devastating complication of coronary artery and aortic surgery, resulting in significantly increased mortality and morbidity rates. As such, predicting rehabilitation outcomes after perioperative stroke would be valuable in establishing rehabilitation plans.
Objective: To identify prognostic factors of rehabilitation outcomes in perioperative stroke after surgery of the aorta and coronary arteries.
Methods: This study included patients who experienced perioperative stroke after coronary artery bypass grafting and aortic surgery, and underwent 3-weeks of rehabilitation. Demographic data included age, sex, diagnosis, brain lesions, and Charlson Comorbidity Index (CCI). To identify prognostic factors and the effectiveness of rehabilitation, the Modified Barthel Index (MBI), National Institutes of Health Stroke Scale (NIHSS), Medical Research Council (MRC) sum score, modified Rankin Scale (mRS) score, and Mini-Mental State Examination (MMSE) scores were investigated before and after a three-week rehabilitation period. Spearman rank correlation analyses were performed.
Results: Statistically significant improvements were observed in NIHSS, MBI, and MMSE scores after rehabilitation. Spearman rank correlation analysis revealed a significant correlation between sex, stroke type, and improvement in MRC sum score.
Conclusion: The most crucial factors influencing the prognosis of perioperative stroke occurring after coronary artery or aortic surgery included sex and stroke type.
{"title":"Predictive factors of rehabilitation outcomes of perioperative stroke after surgery of the coronary artery and aorta: A pilot study.","authors":"Soojeong Han, Jeong-Jun Park, Jee Hyun Suh","doi":"10.3233/NRE-240106","DOIUrl":"https://doi.org/10.3233/NRE-240106","url":null,"abstract":"<p><strong>Background: </strong>Perioperative stroke is a devastating complication of coronary artery and aortic surgery, resulting in significantly increased mortality and morbidity rates. As such, predicting rehabilitation outcomes after perioperative stroke would be valuable in establishing rehabilitation plans.</p><p><strong>Objective: </strong>To identify prognostic factors of rehabilitation outcomes in perioperative stroke after surgery of the aorta and coronary arteries.</p><p><strong>Methods: </strong>This study included patients who experienced perioperative stroke after coronary artery bypass grafting and aortic surgery, and underwent 3-weeks of rehabilitation. Demographic data included age, sex, diagnosis, brain lesions, and Charlson Comorbidity Index (CCI). To identify prognostic factors and the effectiveness of rehabilitation, the Modified Barthel Index (MBI), National Institutes of Health Stroke Scale (NIHSS), Medical Research Council (MRC) sum score, modified Rankin Scale (mRS) score, and Mini-Mental State Examination (MMSE) scores were investigated before and after a three-week rehabilitation period. Spearman rank correlation analyses were performed.</p><p><strong>Results: </strong>Statistically significant improvements were observed in NIHSS, MBI, and MMSE scores after rehabilitation. Spearman rank correlation analysis revealed a significant correlation between sex, stroke type, and improvement in MRC sum score.</p><p><strong>Conclusion: </strong>The most crucial factors influencing the prognosis of perioperative stroke occurring after coronary artery or aortic surgery included sex and stroke type.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"55 1","pages":"11-15"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara Vive, Roland Zügner, Roy Tranberg, Lina Bunketorp-Käll
Abstract
BACKGROUND:
Approximately 80% of stroke survivors experience motor impairment of the contralateral limb that severely affects their activities of daily living (ADL).
OBJECTIVE:
To evaluate whether an enriched task-specific training (ETT) program affected the performance and kinetics of sit-to-stand (STS) tasks.
METHODS:
The study was part of an exploratory study with a within-subject, repeated-measure-design, with assessments before and after a three-week-long baseline period, and six months after the intervention. Forty-one participants underwent assessments of strength and endurance measured by the 30-second-chair-stand test (30sCST). The STS-kinetics, including the vertical ground reaction force (GRF) during STS, were analysed in an in-depth-subgroup of three participants, using a single-subject-experimental-design (SSED). For kinetic data, statistical significance was determined with the two-standard deviation band method (TSDB).
RESULTS:
After the baseline period, a small increase was seen in the 30sCST (from 5.6±4.5 to 6.1±4.9, p = 0.042). A noticeable significant change in the 30sCST was shown after the intervention (from 6.1±4.9 to 8.2±5.4, p < 0.001), maintained at six months. The in-depth kinetic analyses showed that one of three subjects had a significant increase in loading of the affected limb post-intervention.
CONCLUSION:
ETT can produce long-term gains in STS performance. Weight-bearing strategies could be one of several factors that contribute to improvements in STS performance in the chronic phase after stroke.
{"title":"Effects of enriched task-specific training on sit-to-stand tasks in individuals with chronic stroke","authors":"Sara Vive, Roland Zügner, Roy Tranberg, Lina Bunketorp-Käll","doi":"10.3233/nre-230204","DOIUrl":"https://doi.org/10.3233/nre-230204","url":null,"abstract":"<h4><span>Abstract</span></h4><h3><span></span>BACKGROUND:</h3><p>Approximately 80% of stroke survivors experience motor impairment of the contralateral limb that severely affects their activities of daily living (ADL).</p><h3><span></span>OBJECTIVE:</h3><p>To evaluate whether an enriched task-specific training (ETT) program affected the performance and kinetics of sit-to-stand (STS) tasks.</p><h3><span></span>METHODS:</h3><p>The study was part of an exploratory study with a within-subject, repeated-measure-design, with assessments before and after a three-week-long baseline period, and six months after the intervention. Forty-one participants underwent assessments of strength and endurance measured by the 30-second-chair-stand test (30sCST). The STS-kinetics, including the vertical ground reaction force (GRF) during STS, were analysed in an in-depth-subgroup of three participants, using a single-subject-experimental-design (SSED). For kinetic data, statistical significance was determined with the two-standard deviation band method (TSDB).</p><h3><span></span>RESULTS:</h3><p>After the baseline period, a small increase was seen in the 30sCST (from 5.6±4.5 to 6.1±4.9, <i>p</i> = 0.042). A noticeable significant change in the 30sCST was shown after the intervention (from 6.1±4.9 to 8.2±5.4, <i>p</i> < 0.001), maintained at six months. The in-depth kinetic analyses showed that one of three subjects had a significant increase in loading of the affected limb post-intervention.</p><h3><span></span>CONCLUSION:</h3><p>ETT can produce long-term gains in STS performance. Weight-bearing strategies could be one of several factors that contribute to improvements in STS performance in the chronic phase after stroke.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"47 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139065445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amira M. Abd-Elmonem, Hazem A. Ali, Sara S Saad-Eldien, Ahmed Rabiee, W. A. Abd El-nabie
BACKGROUND: Children with spastic diplegia experience tonicity, lack of selective motor control, subnormal postural stability and delayed motor development. Selective dorsal rhizotomy followed by physical therapy is a permanent procedure aimed to alleviate hypertonicity. OBJECTIVE: To explore the efficacy of selective dorsal rhizotomy (SDR) followed by a physical training on gross motor function (GMF), functional balance, walking capacity, selective motor control (SMC) and energy cost of walking (ECW) of ambulant children with spastic diplegia. METHODS: Forty-two children with spastic diplegia aged 5 to 8 years were randomly assigned into the control or SDR-group. Both groups received a designed physical training of progressive functional strength training and standard orthotic management (SOM) 3 times a week for 6 months. GMF, functional balance, ECW, functional capacity and SMC were assessed by gross motor function measure (GMfM-88), pediatric balance scale (PBS), energy expenditure index (EEI), six-minute walking test (6MWT) and selective control assessment of lower extremity (SCALE), respectively. Assessment was carried out before the treatment (baseline), after 6 months (post I) and 1-year follow-up (post II). RESULTS: From baseline to post I and post II assessments, changes of GMF, functional balance, ECW, functional capacity and SMC within the control and SDR groups showed significant improvements (P < 0.001). Moreover, group comparison showed significant differences in favor of the SDR group. CONCLUSION: Integrated physical training followed SDR demonstrated qualitative changes and enhancement in motor function, achieved by spasticity reduction.
{"title":"Effect of physical training on motor function of ambulant children with diplegia after selective dorsal rhizotomy: A randomized controlled study","authors":"Amira M. Abd-Elmonem, Hazem A. Ali, Sara S Saad-Eldien, Ahmed Rabiee, W. A. Abd El-nabie","doi":"10.3233/nre-230098","DOIUrl":"https://doi.org/10.3233/nre-230098","url":null,"abstract":"BACKGROUND: Children with spastic diplegia experience tonicity, lack of selective motor control, subnormal postural stability and delayed motor development. Selective dorsal rhizotomy followed by physical therapy is a permanent procedure aimed to alleviate hypertonicity. OBJECTIVE: To explore the efficacy of selective dorsal rhizotomy (SDR) followed by a physical training on gross motor function (GMF), functional balance, walking capacity, selective motor control (SMC) and energy cost of walking (ECW) of ambulant children with spastic diplegia. METHODS: Forty-two children with spastic diplegia aged 5 to 8 years were randomly assigned into the control or SDR-group. Both groups received a designed physical training of progressive functional strength training and standard orthotic management (SOM) 3 times a week for 6 months. GMF, functional balance, ECW, functional capacity and SMC were assessed by gross motor function measure (GMfM-88), pediatric balance scale (PBS), energy expenditure index (EEI), six-minute walking test (6MWT) and selective control assessment of lower extremity (SCALE), respectively. Assessment was carried out before the treatment (baseline), after 6 months (post I) and 1-year follow-up (post II). RESULTS: From baseline to post I and post II assessments, changes of GMF, functional balance, ECW, functional capacity and SMC within the control and SDR groups showed significant improvements (P < 0.001). Moreover, group comparison showed significant differences in favor of the SDR group. CONCLUSION: Integrated physical training followed SDR demonstrated qualitative changes and enhancement in motor function, achieved by spasticity reduction.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"38 24","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138946807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Effective trunk control is an essential component of sitting and standing balance, and is a key requirement for movement of the head and limbs, and for carrying out functional tasks. A stroke can result in impaired trunk control, affected by stroke-related deficits in balance, muscle function, coordination and position sense. Recovery of trunk control is recognised as a key goal of stroke rehabilitation. OBJECTIVE: To evaluate the effectiveness of trunk training interventions in people with stroke. METHODS: A summary of the Cochrane Review by Thijs et al. (2023), with comments from a rehabilitation perspective. RESULTS: 68 studies (2585 participants) were included in the Cochrane review. Trunk training was not found to have any benefit on measures of ADL, when compared to other dose-matched therapies, but did improve trunk function and other outcomes. Trunk training was more beneficial than non-dose-matched therapies for measures of ADL, trunk function, and other outcomes. The certainty of these findings is very low. CONCLUSION: Evidence supports the use of trunk training as part of stroke rehabilitation. However certainty in these findings is very low due to volume, quality and heterogeneity of the evidence.
{"title":"Is trunk training effective at improving ability in activities of daily living and function of people who have had a stroke? A Cochrane Review summary with commentary","authors":"Alex Todhunter‐Brown","doi":"10.3233/nre-236007","DOIUrl":"https://doi.org/10.3233/nre-236007","url":null,"abstract":"BACKGROUND: Effective trunk control is an essential component of sitting and standing balance, and is a key requirement for movement of the head and limbs, and for carrying out functional tasks. A stroke can result in impaired trunk control, affected by stroke-related deficits in balance, muscle function, coordination and position sense. Recovery of trunk control is recognised as a key goal of stroke rehabilitation. OBJECTIVE: To evaluate the effectiveness of trunk training interventions in people with stroke. METHODS: A summary of the Cochrane Review by Thijs et al. (2023), with comments from a rehabilitation perspective. RESULTS: 68 studies (2585 participants) were included in the Cochrane review. Trunk training was not found to have any benefit on measures of ADL, when compared to other dose-matched therapies, but did improve trunk function and other outcomes. Trunk training was more beneficial than non-dose-matched therapies for measures of ADL, trunk function, and other outcomes. The certainty of these findings is very low. CONCLUSION: Evidence supports the use of trunk training as part of stroke rehabilitation. However certainty in these findings is very low due to volume, quality and heterogeneity of the evidence.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"11 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138944797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yulong Xie, JuanHong Pan, Jia Chen, Di Zhang, Song Jin
BACKGROUND: Upper limb motor dysfunction after stroke is an important factor affecting patients’ motor function and daily life. Acupuncture and repetitive transcranial magnetic stimulation are effective methods for stroke rehabilitation. However, a systematic and comprehensive overview of the combined efficacy of the two is lacking. OBJECTIVE: Through a systematic review and meta-analysis of randomized controlled trials, this study aimed to assess the effectiveness of acupuncture combined with repetitive transcranial magnetic stimulation on upper extremity motor function in post-stroke patients. METHODS: The relevant randomized controlled trials on acupuncture combined with repetitive transcranial magnetic stimulation in the treatment of upper limb motor disorders after stroke were searched in PubMed, Embase, Cochrane Library, Web of Science CNKI, VIP, Wanfang, and CBM databases. After screening clinical trials that met the inclusion criteria, data extraction was conducted independently by two investigators. Meta-analysis was performed using RevMan 5.4 software. RESULTS: After the screening, 18 articles were included, with a total of 1083 subjects. The results of meta-analysis showed that combination therapy could effectively improve the patients’ upper limb motor function (MD = 7.77, 95%CI [6.32, 9.22], P < 0.05), ability of daily living (MD = 8.53, 95%CI [6.28, 10.79], P < 0.05), and hemiplegic shoulder pain (MD = – 1.72, 95%CI [– 2.26, – 1.18], P < 0.05). Meanwhile, for neurophysiological indexes, combined treatment could significantly shorten the latency of motor evoked potential and central motor conduction time (MD = – 1.42, 95%CI [– 2.14, – 0.71], P < 0.05); (MD = – 0.47, 95%CI [– 0.66, – 0.29], P < 0.05), and also could increase the amplitude of motor evoked potential (SMD = 0.71, 95%CI [0.28, 1.14], P < 0.05). CONCLUSION: According to the results of the meta-analysis, we can conclude that acupuncture combined with repeated transcranial magnetic stimulation can significantly improve the upper limb motor function and daily living ability of stroke patients.
{"title":"Acupuncture combined with repeated transcranial magnetic stimulation for upper limb motor function after stroke: A systematic review and meta-analysis","authors":"Yulong Xie, JuanHong Pan, Jia Chen, Di Zhang, Song Jin","doi":"10.3233/nre-230144","DOIUrl":"https://doi.org/10.3233/nre-230144","url":null,"abstract":"BACKGROUND: Upper limb motor dysfunction after stroke is an important factor affecting patients’ motor function and daily life. Acupuncture and repetitive transcranial magnetic stimulation are effective methods for stroke rehabilitation. However, a systematic and comprehensive overview of the combined efficacy of the two is lacking. OBJECTIVE: Through a systematic review and meta-analysis of randomized controlled trials, this study aimed to assess the effectiveness of acupuncture combined with repetitive transcranial magnetic stimulation on upper extremity motor function in post-stroke patients. METHODS: The relevant randomized controlled trials on acupuncture combined with repetitive transcranial magnetic stimulation in the treatment of upper limb motor disorders after stroke were searched in PubMed, Embase, Cochrane Library, Web of Science CNKI, VIP, Wanfang, and CBM databases. After screening clinical trials that met the inclusion criteria, data extraction was conducted independently by two investigators. Meta-analysis was performed using RevMan 5.4 software. RESULTS: After the screening, 18 articles were included, with a total of 1083 subjects. The results of meta-analysis showed that combination therapy could effectively improve the patients’ upper limb motor function (MD = 7.77, 95%CI [6.32, 9.22], P < 0.05), ability of daily living (MD = 8.53, 95%CI [6.28, 10.79], P < 0.05), and hemiplegic shoulder pain (MD = – 1.72, 95%CI [– 2.26, – 1.18], P < 0.05). Meanwhile, for neurophysiological indexes, combined treatment could significantly shorten the latency of motor evoked potential and central motor conduction time (MD = – 1.42, 95%CI [– 2.14, – 0.71], P < 0.05); (MD = – 0.47, 95%CI [– 0.66, – 0.29], P < 0.05), and also could increase the amplitude of motor evoked potential (SMD = 0.71, 95%CI [0.28, 1.14], P < 0.05). CONCLUSION: According to the results of the meta-analysis, we can conclude that acupuncture combined with repeated transcranial magnetic stimulation can significantly improve the upper limb motor function and daily living ability of stroke patients.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"42 43","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138946453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jenna Tosto-Mancuso, Gabriela Rozanski, Nehal Patel, E. Breyman, Sophie Dewil, O. Jumreornvong, D. Putrino, Laura Tabacof, M. Escalón, M. Cortes
BACKGROUND: Advanced technologies are increasingly used to address impaired mobility after neurological insults, with growing evidence of their benefits for various populations. However, certain robotic devices have not been extensively investigated in specific conditions, limiting knowledge about optimal application for healthcare. OBJECTIVE: To compare effectiveness of conventional gait training with exoskeleton-assisted walking for non-traumatic brain injury during early stage rehabilitation. METHODS: Clinical evaluation data at admission and discharge were obtained in a retrospective case-control design. Patients received standard of care physical therapy either using Ekso GT or not. Within- or between-group statistical tests were performed to determine change over time and interventional differences. RESULTS: This study analyzed forty-nine individuals (33% female), 20 controls and 29 Ekso participants who were equivalent at baseline. Both groups improved in Functional Independence Measure scores and ambulation ability (p < .00001 and p < .001, respectively). Control subjects demonstrated significantly different distance walked and assistance level values at discharge from those who were treated with the exoskeleton (p < .01). CONCLUSION: Robotic locomotion is non-inferior for subacute functional recovery after non-traumatic brain injury. Conventional therapy produced larger gait performance gains during hospitalization. Further research is needed to understand specific factors influencing efficacy and the long-term implications after rehabilitation.
{"title":"Retrospective case-control study to compare exoskeleton-assisted walking with standard care in subacute non-traumatic brain injury patients","authors":"Jenna Tosto-Mancuso, Gabriela Rozanski, Nehal Patel, E. Breyman, Sophie Dewil, O. Jumreornvong, D. Putrino, Laura Tabacof, M. Escalón, M. Cortes","doi":"10.3233/nre-230168","DOIUrl":"https://doi.org/10.3233/nre-230168","url":null,"abstract":"BACKGROUND: Advanced technologies are increasingly used to address impaired mobility after neurological insults, with growing evidence of their benefits for various populations. However, certain robotic devices have not been extensively investigated in specific conditions, limiting knowledge about optimal application for healthcare. OBJECTIVE: To compare effectiveness of conventional gait training with exoskeleton-assisted walking for non-traumatic brain injury during early stage rehabilitation. METHODS: Clinical evaluation data at admission and discharge were obtained in a retrospective case-control design. Patients received standard of care physical therapy either using Ekso GT or not. Within- or between-group statistical tests were performed to determine change over time and interventional differences. RESULTS: This study analyzed forty-nine individuals (33% female), 20 controls and 29 Ekso participants who were equivalent at baseline. Both groups improved in Functional Independence Measure scores and ambulation ability (p < .00001 and p < .001, respectively). Control subjects demonstrated significantly different distance walked and assistance level values at discharge from those who were treated with the exoskeleton (p < .01). CONCLUSION: Robotic locomotion is non-inferior for subacute functional recovery after non-traumatic brain injury. Conventional therapy produced larger gait performance gains during hospitalization. Further research is needed to understand specific factors influencing efficacy and the long-term implications after rehabilitation.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"80 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138945440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ming Zhang, Feilong Zhu, Fan Jia, Yu Wu, Bin Wang, Ling Gao, Fengming Chu, Wei Tang
BACKGROUND: The recovery of upper limb function is crucial to the daily life activities of stroke patients. Brain-computer interface technology may have potential benefits in treating upper limb dysfunction. OBJECTIVE: To systematically evaluate the efficacy of brain-computer interfaces (BCI) in the rehabilitation of upper limb motor function in stroke patients. METHODS: Six databases up to July 2023 were reviewed according to the PRSIMA guidelines. Randomized controlled trials of BCI-based upper limb functional rehabilitation for stroke patients were selected for meta-analysis by pooling standardized mean difference (SMD) to summarize the evidence. The Cochrane risk of bias tool was used to assess the methodological quality of the included studies. RESULTS: Twenty-five studies were included. The studies showed that BCI had a small effect on the improvement of upper limb function after the intervention. In terms of total duration of training, < 12 hours of training may result in better rehabilitation, but training duration greater than 12 hours suggests a non significant therapeutic effect of BCI training. CONCLUSION: This meta-analysis suggests that BCI has a slight efficacy in improving upper limb function and has favorable long-term outcomes. In terms of total duration of training, < 12 hours of training may lead to better rehabilitation.
{"title":"Efficacy of brain-computer interfaces on upper extremity motor function rehabilitation after stroke: A systematic review and meta-analysis","authors":"Ming Zhang, Feilong Zhu, Fan Jia, Yu Wu, Bin Wang, Ling Gao, Fengming Chu, Wei Tang","doi":"10.3233/nre-230215","DOIUrl":"https://doi.org/10.3233/nre-230215","url":null,"abstract":"BACKGROUND: The recovery of upper limb function is crucial to the daily life activities of stroke patients. Brain-computer interface technology may have potential benefits in treating upper limb dysfunction. OBJECTIVE: To systematically evaluate the efficacy of brain-computer interfaces (BCI) in the rehabilitation of upper limb motor function in stroke patients. METHODS: Six databases up to July 2023 were reviewed according to the PRSIMA guidelines. Randomized controlled trials of BCI-based upper limb functional rehabilitation for stroke patients were selected for meta-analysis by pooling standardized mean difference (SMD) to summarize the evidence. The Cochrane risk of bias tool was used to assess the methodological quality of the included studies. RESULTS: Twenty-five studies were included. The studies showed that BCI had a small effect on the improvement of upper limb function after the intervention. In terms of total duration of training, < 12 hours of training may result in better rehabilitation, but training duration greater than 12 hours suggests a non significant therapeutic effect of BCI training. CONCLUSION: This meta-analysis suggests that BCI has a slight efficacy in improving upper limb function and has favorable long-term outcomes. In terms of total duration of training, < 12 hours of training may lead to better rehabilitation.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"20 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138945860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: White matter hyperintensity (WMH) is reported to have a potential prevalence in healthy people and is a predictor of walking disability. However, WMH has not been adequately considered as a predictor of independent walking after stroke. OBJECTIVE: To investigate the effects of WMH severity on walking function in patients with acute stroke. METHODS: The retrospective cohort study included 422 patients with acute stroke. The WMH severity from magnetic resonance images was evaluated using the Fazekas scale. Age, type of stroke, Fazekas scale, Brunnstrom motor recovery stage, Motricity Index, and Mini-Mental State Examination were used as independent variables. Multivariable logistic regression analysis was conducted on the factors of independent walking at discharge and 6 months after onset, respectively. RESULTS: Multivariable analysis revealed that the Fazekas scale is not a predictive factor of independent walking at discharge (odds ratio [OR] = 0.89, 95% confidence intervals [CI] = 0.65–1.22), but at 6 months (OR = 0.54, 95% CI = 0.34–0.86). CONCLUSION: The WMH severity was a predictive factor of independent walking in patients with acute stroke after 6 months. WMH is a factor that should be considered to improve the accuracy of predicting long-term walking function in patients with stroke.
{"title":"White matter hyperintensity predicts independent walking function at 6 months after stroke: A retrospective cohort study","authors":"Masahiro Nomoto, Kazuhiro Miyata, Yutaka Kohno","doi":"10.3233/nre-230225","DOIUrl":"https://doi.org/10.3233/nre-230225","url":null,"abstract":"BACKGROUND: White matter hyperintensity (WMH) is reported to have a potential prevalence in healthy people and is a predictor of walking disability. However, WMH has not been adequately considered as a predictor of independent walking after stroke. OBJECTIVE: To investigate the effects of WMH severity on walking function in patients with acute stroke. METHODS: The retrospective cohort study included 422 patients with acute stroke. The WMH severity from magnetic resonance images was evaluated using the Fazekas scale. Age, type of stroke, Fazekas scale, Brunnstrom motor recovery stage, Motricity Index, and Mini-Mental State Examination were used as independent variables. Multivariable logistic regression analysis was conducted on the factors of independent walking at discharge and 6 months after onset, respectively. RESULTS: Multivariable analysis revealed that the Fazekas scale is not a predictive factor of independent walking at discharge (odds ratio [OR] = 0.89, 95% confidence intervals [CI] = 0.65–1.22), but at 6 months (OR = 0.54, 95% CI = 0.34–0.86). CONCLUSION: The WMH severity was a predictive factor of independent walking in patients with acute stroke after 6 months. WMH is a factor that should be considered to improve the accuracy of predicting long-term walking function in patients with stroke.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"56 21","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138946236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica P Conklin, Katherine L. McCauley, Jackie Breitenstein, Lyndsey Edelman, Russell K. Gore, Tracey Wallace
BACKGROUND: The COVID-19 pandemic necessitated the implementation of telehealth and hybrid service delivery models and provided an opportunity to study the impact of this care model in military populations with history of traumatic brain injury (TBI). OBJECTIVE: To present telehealth service utilization rates across rehabilitation specialties, treatment outcome indicators, and patient satisfaction outcomes from a retrospective clinical sample. METHODS: The study sample consists of 34 patients who underwent telehealth/hybrid Intensive Outpatient Programming (IOP) at a major rehabilitation hospital. Retrospective chart review and clinical data extraction were performed. A historical cohort receiving in-person care was used as a comparison group. Statistical analyses included partial correlations, mixed method analysis of variance (ANOVA), and independent sample t-tests. RESULTS: Medical, behavioral health, physical, occupational, and speech-language therapy providers exhibited similar rates of telehealth service delivery (35 to 41% of all sessions). No significant association was found between percent telehealth sessions and the global treatment outcome indicator. Comparison of treatment effects across cohorts revealed similar benefits of IOP. No between-group differences were noted in satisfaction ratings. CONCLUSION: The comparable treatment-related gains and reports of positive patient experience support the use of a telehealth and hybrid delivery model for military service members and veterans with TBI.
{"title":"Implementation of telehealth and hybrid service delivery of interdisciplinary rehabilitation for military populations with traumatic brain injury","authors":"Jessica P Conklin, Katherine L. McCauley, Jackie Breitenstein, Lyndsey Edelman, Russell K. Gore, Tracey Wallace","doi":"10.3233/nre-230154","DOIUrl":"https://doi.org/10.3233/nre-230154","url":null,"abstract":"BACKGROUND: The COVID-19 pandemic necessitated the implementation of telehealth and hybrid service delivery models and provided an opportunity to study the impact of this care model in military populations with history of traumatic brain injury (TBI). OBJECTIVE: To present telehealth service utilization rates across rehabilitation specialties, treatment outcome indicators, and patient satisfaction outcomes from a retrospective clinical sample. METHODS: The study sample consists of 34 patients who underwent telehealth/hybrid Intensive Outpatient Programming (IOP) at a major rehabilitation hospital. Retrospective chart review and clinical data extraction were performed. A historical cohort receiving in-person care was used as a comparison group. Statistical analyses included partial correlations, mixed method analysis of variance (ANOVA), and independent sample t-tests. RESULTS: Medical, behavioral health, physical, occupational, and speech-language therapy providers exhibited similar rates of telehealth service delivery (35 to 41% of all sessions). No significant association was found between percent telehealth sessions and the global treatment outcome indicator. Comparison of treatment effects across cohorts revealed similar benefits of IOP. No between-group differences were noted in satisfaction ratings. CONCLUSION: The comparable treatment-related gains and reports of positive patient experience support the use of a telehealth and hybrid delivery model for military service members and veterans with TBI.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"19 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138946973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Post-stroke fatigue can manifest as both physical and mental fatigue. The Fatigue Scale for Motor and Cognitive Functions (FSMC) evaluates fatigue on the motor and cognitive domains separately, however, the psychometric properties of this measure in stroke have not been reported. OBJECTIVE: To determine the internal consistency, test-retest reliability, and concurrent validity of the FSMC in chronic stroke. METHODS: Thirty-four participants with chronic stroke (55.26±12.27 years of age; 59.53±89.21 months post-stroke) completed the FSMC on two separate visits. Internal consistency and reliability of the FSMC were examined using Cronbach’s alpha and two-way mixed effects intraclass correlation coefficients (ICC), respectively. Correlation between the FSMC and the Fatigue Severity Scale and Visual Analog Scale-Fatigue was used to assess concurrent validity. RESULTS: Internal consistency was excellent (Cronbach’s alpha > 0.9) and reliability was moderate to good (ICC = 0.72–0.81) for all FSMC scores. The FSMC demonstrated moderate to good concurrent validity with the Fatigue Severity Scale (ρ= 0.66–0.72) but only fair concurrent validity with the Visual Analog Scale-Fatigue (ρ= 0.37–0.44). CONCLUSION: The FSMC is a valid and reliable measure of post-stroke fatigue and may be a useful tool to examine physical fatigue and cognitive fatigue in chronic stroke.
{"title":"Validating the Fatigue Scale for Motor and Cognitive Function (FSMC) in chronic stroke","authors":"Hui-Ting Goh, Jill Stewart, Kevin Becker","doi":"10.3233/nre-230189","DOIUrl":"https://doi.org/10.3233/nre-230189","url":null,"abstract":"BACKGROUND: Post-stroke fatigue can manifest as both physical and mental fatigue. The Fatigue Scale for Motor and Cognitive Functions (FSMC) evaluates fatigue on the motor and cognitive domains separately, however, the psychometric properties of this measure in stroke have not been reported. OBJECTIVE: To determine the internal consistency, test-retest reliability, and concurrent validity of the FSMC in chronic stroke. METHODS: Thirty-four participants with chronic stroke (55.26±12.27 years of age; 59.53±89.21 months post-stroke) completed the FSMC on two separate visits. Internal consistency and reliability of the FSMC were examined using Cronbach’s alpha and two-way mixed effects intraclass correlation coefficients (ICC), respectively. Correlation between the FSMC and the Fatigue Severity Scale and Visual Analog Scale-Fatigue was used to assess concurrent validity. RESULTS: Internal consistency was excellent (Cronbach’s alpha > 0.9) and reliability was moderate to good (ICC = 0.72–0.81) for all FSMC scores. The FSMC demonstrated moderate to good concurrent validity with the Fatigue Severity Scale (ρ= 0.66–0.72) but only fair concurrent validity with the Visual Analog Scale-Fatigue (ρ= 0.37–0.44). CONCLUSION: The FSMC is a valid and reliable measure of post-stroke fatigue and may be a useful tool to examine physical fatigue and cognitive fatigue in chronic stroke.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"39 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138949797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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