Neurorehabilitation and neural repair
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Neurorehabil Neural Repair · Jan 2008
Controlled Clinical TrialUsing kinematic analysis to evaluate constraint-induced movement therapy in chronic stroke patients.
This preliminary study aims to verify if the method of kinematic analysis proposed here may be suitable for evaluating the effects of constraint-induced movement therapy (CIMT) in chronic stroke patients and may be of help in the study of the mechanisms underlying functional improvement following CIMT. ⋯ The method of kinematic analysis was sensitive for an assessment of motor recovery induced by CIMT. The kinematic results suggest that the increase in the use of the paretic limb in activities of daily living after the intervention is not only attributable to the patient's increased attention to it and better hand dexterity, but it is also a consequence of the improved speed of movement and better coordination between shoulder and elbow joints.
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Neurorehabil Neural Repair · Jan 2008
A standardized approach to performing the action research arm test.
The study of stroke and its treatment in human subjects requires accurate measurement of behavioral status. Arm motor deficits are among the most common sequelae after stroke. The Action Research Arm Test (ARAT) is a reliable, valid measure of arm motor status after stroke. ⋯ This report therefore includes a manual that provides a highly detailed and standardized approach for assigning ARAT scores. Intrarater reliability and interrater reliability, as well as validity, with this approach were measured and are excellent. The ARAT, when performed in a standardized manner, is a useful tool for assessment of arm motor deficits after stroke.
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Neurorehabil Neural Repair · Jan 2008
Relationship between interhemispheric inhibition and motor cortex excitability in subacute stroke patients.
Studies of stroke patients using functional imaging and transcranial magnetic stimulation (TMS) of the primary motor cortex (M1) demonstrated increased recruitment and abnormally decreased short interval cortical inhibition (SICI) of the M1 contralateral to the lesioned hemisphere (contralesional M1) within the first month after infarction of the M1 or its corticospinal projections. ⋯ In subacute stroke patients, abnormally decreased SICI of a contralesional M1 can only partially be explained by loss of IHI from the lesioned on nonlesioned hemisphere. As decreased SICI of the contralesional M1 did not result in excessive IHI from the nonlesioned on lesioned hemisphere with subsequent suppression of ipsilesional M1 excitability and all patients showed excellent recovery of motor function, decreased SICI of the contralesional M1 may represent an adaptive process supporting recovery.
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Neurorehabil Neural Repair · Nov 2007
Sensorimotor cortical plasticity during recovery following spinal cord injury: a longitudinal fMRI study.
Although the consequences of spinal cord injury (SCI) within the spinal cord and peripheral nervous system have been studied extensively, the influence of SCI on supraspinal structures during recovery remains largely unexplored. ⋯ This study provides the first report of the temporal progression of cortical sensorimotor representational plasticity during recovery following traumatic SCI in humans and suggests an association between movement-related fMRI activation and motor recovery postinjury. These findings have implications on current and future rehabilitative interventions for patients with SCI.
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Neurorehabil Neural Repair · Jul 2007
Randomized Controlled TrialProspective, blinded, randomized crossover study of gait rehabilitation in stroke patients using the Lokomat gait orthosis.
Treadmill training with partial body weight support has been suggested as a useful strategy for gait rehabilitation after stroke. This prospective, blinded, randomized controlled study of gait retraining tested the feasibility and potential efficacy of using an electromechanical-driven gait orthosis (Lokomat) for treadmill training. ⋯ Despite the small number of patients, the present data suggest that the Lokomat robotic assistive device provides innovative possibilities for gait training in stroke rehabilitation while eliminating prolonged repetitive movements in a nonergonomic position on the part of the physical therapist.