wildwilly
01-25-2008, 10:08 AM
Phys Ther. 2008 Jan 10 [Epub ahead of print]
A Four-Week, Task-Specific Neuroprosthesis Program for a Person With No Active Wrist or Finger Movement Because of Chronic Stroke.
Dunning K, Berberich A, Albers B, Mortellite K, Levine PG, Hill Hermann VA, Page SJ.
Department of Rehabilitation Sciences, College of Allied Health Sciences, University of Cincinnati Academic Medical Center, 3202 Eden Ave, Cincinnati, OH 45220-0394 (USA), and Director of Clinical Research, Drake Center, Cincinnati, Ohio.
BACKGROUND AND PURPOSE:/b> This case report describes a task-specific training protocol incorporating functional electrical stimulation for a person who had chronic stroke and who initially exhibited no active wrist or finger movement. CASE DESCRIPTION: /b> A 63-year-old man with hemiparesis caused by an ischemic stroke 7 years before the intervention described here received task-specific training incorporating an electrical stimulation neuroprosthesis 3 hours per day, 5 days per week, for 4 weeks. Testing was conducted before and after the intervention and again 6 weeks later with stroke-specific outcome measures. OUTCOMES: /b> Increases in function and quality of life were observed after the intervention. DISCUSSION:/b> An intervention incorporating task-specific training with functional electrical stimulation appears to have increased function and quality of life in a person with chronic stroke. This type of intervention might provide a pathway by which people with similar impairments would become eligible for more advanced treatment regimens, such as modified constraint-induced therapy.
http://www.ncbi.nlm.nih.gov/pubmed/18187493?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVDocSum
Clin Rehabil. 2008 Feb;22(2):112-24.
A study of constraint-induced movement therapy in subacute stroke patients in Hong Kong.
Myint JM, Yuen GF, Yu TK, Kng CP, Wong AM, Chow KK, Li HC, Chun Por Wong .
Department of Geriatrics, Ruttonjee Tang Shiu Kin Hospitals, Hong Kong. jmyint@graduate.hku.hk.
Objective: To investigate the beneficial effect of constraint-induced movement therapy in improving the function of hemiplegic upper extremity in the early subacute stroke patients.Design: A prospective, single-blinded, randomized controlled study comparing the effectiveness of constraint-induced movement therapy or control treatment at post intervention and 12 weeks follow-up.Subjects: The inclusion criteria were 2-16 weeks after stroke, hemiparesis of the affected limb, minimal function of >/=20 degrees wrist extension and >/=10 degrees extension of all digits and Mini-Mental State Examination score >/=17.Interventions: The intervention group underwent a programme of 10 days upper extremity training (4 hours per day) with the unaffected limb being restrained ina shoulder sling and the control group received an equivalent duration of conventional rehabilitation therapy.Main measures: Functional level for hemiparetic upper extremity, Motor Activity Log, Action Research Arm Test and modified Barthel Index.Results: There were 23 and 20 subjects respectively in the constraint-induced movement therapy and control groups. Significant improvements were seen at post intervention and 12 weeks after constraint-induced movement therapy in functional level for hemiparetic upper extremity (P= 0.001), and in the ;amount of use' (P= 0.001) and ;how well' (P= 0.021) subscales of the Motor Activity Log. The total Action Research Arm Test score, grasp (P= 0.004), grip (P= 0.004), pinch (P= 0.032) and gross (P= 0.006) components showed significant improvement over the control group at post intervention. The grip component (P=0.019) and the total Action Research Arm Test score (P= 0.009) were superior to the control group at 12 weeks.Conclusion: Significant improvement in hand function could be achieved with constraint-induced movement therapy in subacute stroke patients, which was maintained up to 12 week follow-up.
http://www.ncbi.nlm.nih.gov/pubmed/18212033?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVDocSum
Curr Opin Neurol. 2008 Feb;21(1):76-82.
Neuroplasticity and brain repair after stroke.
Cramer SC, Riley JD.
Departments of Neurology and Anatomy & Neurobiology, University of California, Irvine, California, USA.
PURPOSE OF REVIEW: This review considers recent insights into the neurobiology of repair after stroke in animals and humans, the range of emerging therapies to promote repair and recovery after the acute phase of stroke, and issues related to optimizing trials of such therapies. RECENT FINDINGS: Animal studies continue to shed light on the molecular, vascular, glial, neuronal, behavioral, and environmental events that are important to the spontaneous behavioral recovery that is observed during the weeks after a stroke. Animal and human studies are examining a wide range of potential interventions that may favorably modify outcome, including small molecules, growth factors, cell-based approaches, electromagnetic stimulation, a range of devices and robots, and intense physiotherapy methods, including constraint-induced movement therapy. Optimal prescription of these restorative therapies in human patients with stroke requires further study, including defining potential roles for functional neuroimaging. SUMMARY: A wide range of therapies shows promise for improving poststroke brain repair. Insights into the neurobiology of brain repair after stroke in animals and in humans continue to accrue. This information might prove useful in designing and implementing clinical trials that aim to measure the clinical effects of restorative therapies after stroke.
http://www.ncbi.nlm.nih.gov/pubmed/18180655?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVDocSum
Phys Ther. 2008 Jan 3 [Epub ahead of print]
Modified Constraint-Induced Therapy in Chronic Stroke: Results of a Single-Blinded Randomized Controlled Trial.
Page SJ, Levine P, Leonard A, Szaflarski JP, Kissela BM.
Departments of Rehabilitation Sciences, Physical Medicine and Rehabilitation, and Neurosciences; a member of the Greater Cincinnati/Northern Kentucky Stroke Team; and a Scholar at The Institute for the Study of Health, all at the University of Cincinnati Academic Medical Center, Cincinnati, Ohio. Dr Page also is Director of the Neuromotor Recovery and Rehabilitation Laboratory at Drake Center, Cincinnati, Ohio. Mailing address: 3202 Eden Ave, Suite 310, Cincinnati, OH 45267-0394 (USA).
BACKGROUND AND PURPOSE:/b> This single-blinded randomized controlled trial compared the efficacy of a reimbursable, outpatient, modified constraint-induced therapy (mCIT) protocol (half-hour therapy sessions occurring 3 days per week in which subjects used the more affected arm combined with less affected arm restriction 5 days per week for 5 hours; both of these regimens were administered during a 10-week period) with that of a time-matched exercise program for the more affected arm or a no-treatment control regimen. SUBJECTS:/b> Thirty-five subjects with chronic stroke participated in the study. METHODS:/b> The Action Research Arm Test (ARAT), Fugl-Meyer Assessment of Motor Recovery After Stroke (FM), and Motor Activity Log (MAL) were administered to the subjects. RESULTS: /b> After intervention, significant differences were observed on the ARAT and MAL Amount of Use and Quality of Movement scales, all in favor of the mCIT group. DISCUSSION AND CONCLUSION:/b> The data affirm previous findings suggesting that this reimbursable, outpatient protocol increases more affected arm use and function. Magnitude of changes was consistent with those reported in more intense protocols, such as constraint-induced therapy.
http://www.ncbi.nlm.nih.gov/pubmed/18174447?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVDocSum
A Four-Week, Task-Specific Neuroprosthesis Program for a Person With No Active Wrist or Finger Movement Because of Chronic Stroke.
Dunning K, Berberich A, Albers B, Mortellite K, Levine PG, Hill Hermann VA, Page SJ.
Department of Rehabilitation Sciences, College of Allied Health Sciences, University of Cincinnati Academic Medical Center, 3202 Eden Ave, Cincinnati, OH 45220-0394 (USA), and Director of Clinical Research, Drake Center, Cincinnati, Ohio.
BACKGROUND AND PURPOSE:/b> This case report describes a task-specific training protocol incorporating functional electrical stimulation for a person who had chronic stroke and who initially exhibited no active wrist or finger movement. CASE DESCRIPTION: /b> A 63-year-old man with hemiparesis caused by an ischemic stroke 7 years before the intervention described here received task-specific training incorporating an electrical stimulation neuroprosthesis 3 hours per day, 5 days per week, for 4 weeks. Testing was conducted before and after the intervention and again 6 weeks later with stroke-specific outcome measures. OUTCOMES: /b> Increases in function and quality of life were observed after the intervention. DISCUSSION:/b> An intervention incorporating task-specific training with functional electrical stimulation appears to have increased function and quality of life in a person with chronic stroke. This type of intervention might provide a pathway by which people with similar impairments would become eligible for more advanced treatment regimens, such as modified constraint-induced therapy.
http://www.ncbi.nlm.nih.gov/pubmed/18187493?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVDocSum
Clin Rehabil. 2008 Feb;22(2):112-24.
A study of constraint-induced movement therapy in subacute stroke patients in Hong Kong.
Myint JM, Yuen GF, Yu TK, Kng CP, Wong AM, Chow KK, Li HC, Chun Por Wong .
Department of Geriatrics, Ruttonjee Tang Shiu Kin Hospitals, Hong Kong. jmyint@graduate.hku.hk.
Objective: To investigate the beneficial effect of constraint-induced movement therapy in improving the function of hemiplegic upper extremity in the early subacute stroke patients.Design: A prospective, single-blinded, randomized controlled study comparing the effectiveness of constraint-induced movement therapy or control treatment at post intervention and 12 weeks follow-up.Subjects: The inclusion criteria were 2-16 weeks after stroke, hemiparesis of the affected limb, minimal function of >/=20 degrees wrist extension and >/=10 degrees extension of all digits and Mini-Mental State Examination score >/=17.Interventions: The intervention group underwent a programme of 10 days upper extremity training (4 hours per day) with the unaffected limb being restrained ina shoulder sling and the control group received an equivalent duration of conventional rehabilitation therapy.Main measures: Functional level for hemiparetic upper extremity, Motor Activity Log, Action Research Arm Test and modified Barthel Index.Results: There were 23 and 20 subjects respectively in the constraint-induced movement therapy and control groups. Significant improvements were seen at post intervention and 12 weeks after constraint-induced movement therapy in functional level for hemiparetic upper extremity (P= 0.001), and in the ;amount of use' (P= 0.001) and ;how well' (P= 0.021) subscales of the Motor Activity Log. The total Action Research Arm Test score, grasp (P= 0.004), grip (P= 0.004), pinch (P= 0.032) and gross (P= 0.006) components showed significant improvement over the control group at post intervention. The grip component (P=0.019) and the total Action Research Arm Test score (P= 0.009) were superior to the control group at 12 weeks.Conclusion: Significant improvement in hand function could be achieved with constraint-induced movement therapy in subacute stroke patients, which was maintained up to 12 week follow-up.
http://www.ncbi.nlm.nih.gov/pubmed/18212033?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVDocSum
Curr Opin Neurol. 2008 Feb;21(1):76-82.
Neuroplasticity and brain repair after stroke.
Cramer SC, Riley JD.
Departments of Neurology and Anatomy & Neurobiology, University of California, Irvine, California, USA.
PURPOSE OF REVIEW: This review considers recent insights into the neurobiology of repair after stroke in animals and humans, the range of emerging therapies to promote repair and recovery after the acute phase of stroke, and issues related to optimizing trials of such therapies. RECENT FINDINGS: Animal studies continue to shed light on the molecular, vascular, glial, neuronal, behavioral, and environmental events that are important to the spontaneous behavioral recovery that is observed during the weeks after a stroke. Animal and human studies are examining a wide range of potential interventions that may favorably modify outcome, including small molecules, growth factors, cell-based approaches, electromagnetic stimulation, a range of devices and robots, and intense physiotherapy methods, including constraint-induced movement therapy. Optimal prescription of these restorative therapies in human patients with stroke requires further study, including defining potential roles for functional neuroimaging. SUMMARY: A wide range of therapies shows promise for improving poststroke brain repair. Insights into the neurobiology of brain repair after stroke in animals and in humans continue to accrue. This information might prove useful in designing and implementing clinical trials that aim to measure the clinical effects of restorative therapies after stroke.
http://www.ncbi.nlm.nih.gov/pubmed/18180655?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVDocSum
Phys Ther. 2008 Jan 3 [Epub ahead of print]
Modified Constraint-Induced Therapy in Chronic Stroke: Results of a Single-Blinded Randomized Controlled Trial.
Page SJ, Levine P, Leonard A, Szaflarski JP, Kissela BM.
Departments of Rehabilitation Sciences, Physical Medicine and Rehabilitation, and Neurosciences; a member of the Greater Cincinnati/Northern Kentucky Stroke Team; and a Scholar at The Institute for the Study of Health, all at the University of Cincinnati Academic Medical Center, Cincinnati, Ohio. Dr Page also is Director of the Neuromotor Recovery and Rehabilitation Laboratory at Drake Center, Cincinnati, Ohio. Mailing address: 3202 Eden Ave, Suite 310, Cincinnati, OH 45267-0394 (USA).
BACKGROUND AND PURPOSE:/b> This single-blinded randomized controlled trial compared the efficacy of a reimbursable, outpatient, modified constraint-induced therapy (mCIT) protocol (half-hour therapy sessions occurring 3 days per week in which subjects used the more affected arm combined with less affected arm restriction 5 days per week for 5 hours; both of these regimens were administered during a 10-week period) with that of a time-matched exercise program for the more affected arm or a no-treatment control regimen. SUBJECTS:/b> Thirty-five subjects with chronic stroke participated in the study. METHODS:/b> The Action Research Arm Test (ARAT), Fugl-Meyer Assessment of Motor Recovery After Stroke (FM), and Motor Activity Log (MAL) were administered to the subjects. RESULTS: /b> After intervention, significant differences were observed on the ARAT and MAL Amount of Use and Quality of Movement scales, all in favor of the mCIT group. DISCUSSION AND CONCLUSION:/b> The data affirm previous findings suggesting that this reimbursable, outpatient protocol increases more affected arm use and function. Magnitude of changes was consistent with those reported in more intense protocols, such as constraint-induced therapy.
http://www.ncbi.nlm.nih.gov/pubmed/18174447?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVDocSum