bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extracorporeal Shock Wave Therapy reduces upper limb spasticity and improves motricity in patients with chronic hemiplegia: A case series
Authors: Troncati Franco , Paci Matteo , Myftari Tefta , Lombardi Bruna 
Published: December 2019

Background: Extracorporeal Shock Wave Therapy (ESWT) has been proposed for treatment of abnormal muscle tone only in the last years. The effects on motor impairment are unknown. Objective: To assess the long-term effects of ESWT on muscle tone and motricity in upper limb in patients with chronic hemiplegia. Methods: Twelve patients were selected and treated with two sessions of ESWT. Participants were assessed at baseline, after the treatment, and at 3 and 6 months. Muscle tone of shoulder adductors, elbow, wrist and finger flexors was evaluated at all assessment points using the Modified Ashworth Scale (MAS), while motricity, passive range of motion (PROM) and pain sub-scores of upper extremity part of the Fugl-Meyer scale were used to assess motor recovery. The degree of perceived benefit from treatment was assessed on a visual analogue scale. Results: MAS showed a significant reduction of spasticity and Fugl-Meyer scores improved immediately after treatment. Persistent effects were observed at 3 and 6 months for MAS, and for motricity and PROM subscores of the Fugl-Meyer scale. Clinical improvement was not correlated to the patients' perceived benefit. Conclusions: Two sessions of ESWT seem to have long-term effects in reducing muscle tone and enhancing motor impairment.
Effects of an 1-day education program on physical functioning, activity and quality of life in community living persons with multiple sclerosis
Authors: Feys Peter , Tytgat Katrien , Gijbels Domien , De Groote Luc , Baert Ilse , Van Asch Paul 
Published: December 2019

Background: Persons with MS (pwMS) in the community show reduced physical activity while studies demonstrated beneficial effects of exercise therapy in supervised settings. Objective: This study investigated, in pwMS living in the community, the effects of a 1-day education program about exercises and sports, on physical activity behavior and related outcome measures as self-efficacy, perceived walking ability, fatigue, perceived impact of MS and quality of life. Methods: PwMS attended an education day with theoretical and practical sessions that was organized by the Flemish MS Society and professional exercise experts. Forty-two participants immediately completed questionnaires as well as after three and six months. Overall disability and physical activity level were measured using PDSS (patient determined disease steps) and PASIPD (Physical Activity Scale for Individuals with Physical Disabilities) respectively. Other outcomes were the ESES, MSWS-12, MFIS, MSIS-29 and SF-36. Analyses of variance were performed in groups distinguished by self-reported disability level (PDDS ≤1; n = 24 and PDSS >1; n = 18). Results: Groups differed significantly for perceived walking ability (PDDS,MSWS-12) and physical related-domains of MSIS-29 and SF-36, but not PASIPD. A trend towards significant group*time interaction effect was found for the PASIPD indicating, at 3 and 6 months, increased physical activity in the subgroup PDDS ≤1. For the MSIS-29, a significant time effect was found with reduced impact being largest for the more disabled group at 6 months. No changes were found in other outcome measures. Conclusion: An one-day education program had, depending on perceived disability level, some long-standing effects on physical activity and perceived impact of MS.
Muscle strength is only a weak to moderate predictor of gait performance in persons with late effects of polio
Authors: Flansbjer Ulla-Britt , Brogårdh Christina , Lexell Jan 
Published: December 2019

Objective: To assess muscle strength in the knee extensors, knee flexors and ankle dorsiflexors in persons with late effects of polio, and determine how much muscle strength, gender, age and BMI are related to gait performance. Methods: Ninety community-dwelling ambulant persons (47 men and 43 women; mean age 64 years SD 8) with late effects of polio participated. Isokinetic concentric knee extensor and flexor muscle strength was measured at 60°/s and ankle dorsiflexor muscle strength at 30°/s. Gait performance was assessed by the Timed “Up & Go”, the Comfortable and Fast Gait Speed tests, and the 6-Minute Walk test. Results: There were significant correlations between knee extensor and flexor muscle strength and gait performance (p < 0.01), and between ankle dorsiflexor muscle strength and gait performance (p < 0.05), for both lower limbs. Muscle strength in the knee extensors and flexors explained 7% to 37% and 9% to 47%, respectively, of the variance in gait performance. Strength in the ankle dorsiflexors explained 4% to 24%, whereas gender, age and BMI contributed at most an additional 9%. Conclusion: Knee muscle strength, and to some extent ankle dorsiflexor muscle strength, are predictors of gait performance in persons with late effects of polio, but the strength of the relationships indicates that other factors are also important.
Hydrocephalus following severe traumatic brain injury in adults. Incidence, timing, and clinical predictors during rehabilitation
Authors: Kammersgaard Lars Peter , Linnemann Mia , Tibæk Maiken 
Published: December 2019

Objective: To investigate timing and clinical predictors that might predict hydrocephalus emerging during rehabilitation until 1 year following severe traumatic brain injury (TBI). Background: Posttraumatic hydrocephalus (PTH) may lead to clinical deterioration and poor outcome if untreated. However, PTH can be successfully treated if detected. Nevertheless, PTH is easily overlooked during rehabilitation, particularly in severe cases. Method: We prospectively followed all patients (n = 444) in Eastern Denmark (population 2.5 mill) sustaining severe TBI, who required lengthy rehabilitation between 2000 and 2010. All patients with PTH were tracked retrospectively. Demographics, surgery, injury severity, consciousness level, and disability were compared for patients with versus without PTH. Independent predictors of PTH during rehabilitation were identified through multiple logistic regression models. Results: PTH occurred in 14.2% and 3/4 emerged during rehabilitation. Patients with PTH were older, had more severe brain injuries, were more frequently in vegetative state, and needed longer rehabilitation stays. After adjusted analyses, however, only older age and low level of consciousness were independently associated with PTH. Conclusion: Most cases of PTH emerge during rehabilitation. Therefore, attention towards this complication should be present also beyond the acute stage after TBI, particularly among older patients and patients with severe disordered consciousness.
A feasibility study using interactive graphic art feedback to augment acute neurorehabilitation therapy
Authors: Worthen-Chaudhari Lise , Whalen Cara N. , Swendal Catherine , Bockbrader Marcia , Haserodt Sarah , Smith Rashana , Bruce Michael Kelly , Mysiw W. Jerry 
Published: December 2019

Background: Interactive arts technologies, designed to augment the acute neurorehabilitation provided by expert therapists, may overcome existing barriers of access for patients with low motor and cognitive function. Objectives: Develop an application prototype to present movement feedback interactively and creatively. Evaluate feasibility of use within acute neurorehabilitation. Methods: Record demographics and Functional Independent Measure™ scores among inpatients who used the technology during physical, occupational or recreational therapy. Record exercises performed with the technology, longest exercise duration performed (calculated from sensor data), user feedback, and therapist responses to a validated technology assessment questionnaire. Results: Inpatients (n = 21) between the ages of 19 and 86 (mean 57 ± 18; 12 male/9 female) receiving treatment for motor deficits associated with neuropathology used the application in conjunction with occupational, recreational, or physical therapy during 1 to 7 sessions. Patients classified on the Functional Independence Measure™ as requiring 75%+ assistance for cognitive and motor function were able to use the interactive application. Conclusions: Customized interactive arts applications are appropriate for further study as a therapeutic modality. In addition to providing interactivity to individuals with low motor function, interactive arts applications might serve to augment activity-based medicine among inpatients with low problem-solving and memory function.
Muscle synergies with Walkaround® postural support vs. “cane/therapist” assistance
Authors: Miljković Nadica , Milovanović Ivana , Dragin Aleksandra , Konstantinović Ljubica , Popović Dejan B. 
Published: December 2019

Background: The main clinical measures of walking recovery in stroke patients were compared for training assisted by Walkaround® postural support (WPS) and conventional (CON) support by a cane/therapist. Objective: We attributed the differences between the trainings to modified muscular synergies that occurred during assistance by WPS. Methods: We studied the muscle activities of the primary knee and ankle joint movers in the paretic and non-paretic legs of sub-acute stroke patients during assisted walking with WPS and CON. Recorded signals were compared to normative data that were recorded during speed-matched gait trials in healthy subjects. The specific measures were the relative contribution of individual muscles, levels of cocontraction, and the timing of the maximum electromyography (EMG) activity during the walking sessions. Results: We found that, for most patients, the individual contribution of muscles were more similar to the healthy with the WPS assistance. In parallel, the cocontraction of the rectus femoris muscles in both legs was lower (by up to 39 %) during walking assisted by WPS than by cane/therapist gait support); the results from this case series (10 patients) showed that WPS might be the superior training scheme. Conclusions: These findings indicated that assistance by WPS changed the motor control output relative to CON assistance in most patients.
Frequency of domain-specific cognitive impairment in sub-acute and chronic stroke
Authors: Middleton Laura E. , Lam Benjamin , Fahmi Halla , Black Sandra E. , McIlroy William E. , Stuss Donald T. , Danells Cynthia , Ween Jon , Turner Gary R. 
Published: December 2019

Background: Functional contributions of cognitive impairment may vary by domain and severity. Objective: (1) To characterize frequency of cognitive impairment by domain after stroke by severity (mild: −1.5 ≤ z-score < −2; severe: Z ≤ −2) and time (sub-acute: < 90d; chronic: 90d–2yrs); and (2) To assess the association of cognitive impairment with function in chronic stroke. Methods: Cognitive function was characterized among 215 people with sub-acute or chronic stroke (66.8 years, 43.3% female). Z-scores by cognitive domain were determined from normative data. Function was defined as the number of IADLs minimally independent. Results: 76.3% of sub-acute and 67.3% of chronic stroke participants had cognitive impairment in ≥ 1 domain (p-for-difference = 0.09). Severe impairment was most common in psychomotor speed (sub-acute: 53.5%; chronic: 33.7%). Impairment in executive function was common (sub-acute: 39.5%; chronic: 30.7%) but was usually mild. Severe impairment in psychomotor speed, visuospatial function, and language and any impairment in executive function and memory was associated with IADL impairment (p < 0.03). Conclusions: Mild cognitive impairment is common after stroke but is not associated with functional disability. Impairment in psychomotor speed, executive function, and visuospatial function is common and associated with functional impairment so should be a focus of screening and rehabilitation post-stroke.
Motor imagery group practice for gait rehabilitation in individuals with post-stroke hemiparesis: A pilot study
Authors: Dickstein Ruth , Levy Sandra , Shefi Sara , Holtzman Sarit , Peleg Sara , Vatine Jean-Jacques 
Published: December 2019

Background: Stroke is the leading cause of adult disability, with walking impairment being a devastating indicator of chronic post-stroke hemiparesis. Limited resources exist for individual treatments; therefore, the delivery of safe group exercise therapy is highly desired. Objective: To examine whether the application of group-based motor imagery practice to community-dwelling individuals with chronic hemiparesis improves gait. Methods: Sixteen individuals with chronic hemiparesis from two community centers participated in the study, with eight from each center. Four participants in each center received five weeks of the experimental intervention, consisting of group-based motor imagery exercises of gait tasks, followed by five weeks of control treatment of motor imagery exercises for the affected upper extremity. Four other subjects in each center received the same treatments in reverse order. Pre- and post intervention measurements included clinical and biomechanical gait parameters. Results: Comparisons within (pre- vs. post) and between treatments (experimental vs. control) indicated no significant change in any gait variable. Nevertheless, the verbal reports of most participants alluded to satisfaction with the experimental intervention and to an increase in self-confidence. Conclusions: Despite the lack of evidence for the effectiveness of group-based motor imagery practice in improving gait among individuals with chronic hemiparesis, the contrast between the measured outcomes and the positive verbal reports merits further inquiry.
Innovative strength training-induced neuroplasticity and increased muscle size and strength in children with spastic cerebral palsy: An experimenter-blind case study – three-month follow-up
Authors: Lee Dong Ryul , Kim Yun Hee , Kim Dong A. , Lee Jung Ah , Hwang Pil Woo , Lee Min Jin , You Sung (Joshua) Hyun 
Published: December 2019

Background: In children with cerebral palsy (CP), the never-learned-to-use (NLTU) effect and underutilization suppress the normal development of cortical plasticity in the paretic limb, which further inhibits its functional use and increases associated muscle weakness. Objective: To highlight the effects of a novel comprehensive hand repetitive intensive strengthening training system on neuroplastic changes associated with upper extremity (UE) muscle strength and motor performance in children with spastic hemiplegic CP. Method: Two children with spastic hemiplegic CP were recruited. Intervention with the comprehensive hand repetitive intensive strengthening training system was provided for 60 min a day, three times a week, for 10 weeks. Neuroplastic changes, muscle size, strength, and associated motor function were measured using functional magnetic resonance imaging (MRI), ultrasound imaging, and standardized motor tests, respectively. Results: The functional MRI data showed that the comprehensive hand repetitive intensive strengthening training intervention produced measurable neuroplastic changes in the neural substrates associated with motor control and learning. These neuroplastic changes were associated with increased muscle size, strength and motor function. Conclusions: These results provide compelling evidence of neuroplastic changes and associated improvements in muscle size and motor function following innovative upper extremity strengthening exercise.
Effect of real-time cortical feedback in motor imagery-based mental practice training
Authors: Bai Ou , Huang Dandan , Fei Ding-Yu , Kunz Richard 
Published: December 2019

Background: Mental practice using motor imagery of limb movement may facilitate motor recovery in persons who have experienced cerebrovascular accident (CVA). However, the lack of a feedback mechanism that can monitor the quality of the motor imagery affects patients' engagement and motivation to participate in the mental practice training program. Objective: This study investigates the effect of novel real-time motor imagery-associated cortical activity feedback on motor imagery-based mental practice training. Methods: Ten healthy volunteers were randomly assigned into intervention and control groups. Both groups participated in a five-visit motor imagery-based mental practice training program managed over a period of two months. The intervention group received mental practice training with real-time feedback of movement-associated cortical activity—beta band (16–28 Hz) event-related desynchronization (ERD) in electroencephalography (EEG), using a novel custom-made brain-computer interface (BCI) system. The control group received the mental practice training program without EEG cortical feedback. Motor excitability was assessed by measuring the frequency power magnitude of the EEG rhythmic activity associated with physical execution of wrist extension before and after the motor imagery-based mental practice training. Results: The EEG frequency power magnitude associated with the physical execution of wrist extension was significantly lower (i.e. more desynchronized) after the mental practice training in the intervention group that received real-time cortical feedback (P < 0.05), whereas no significant difference in EEG frequency power magnitude associated with the physical execution of wrist extension was observed before and after mental practice training in the control group who did not receive feedback. Conclusions: The mental practice training program with motor imagery-associated cortical feedback facilitated motor excitability during the production of voluntary motor control. Motor imagery-based mental practice training with movement-associated cortical activity feedback may provide an effective strategy to facilitate motor recovery in brain injury patients, particularly during the early rehabilitation stage when full participation in physical and occupational therapy programs may not be possible due to excessive motor weakness.
A comparison of hemisphere-specific training pattern in Inter-limb Learning Transfer (ILT) for stroke patients with hemiparesis
Authors: Yoo In-gyu , Jung Min-ye , Yoo Eun-young , Park Ji-hyuk , Kang Dae-hyuk , Lee Jin 
Published: December 2019

Background: Stroke patients have major problems with impaired upper-extremity function. Unfortunately, many patients do not experience a full recovery from movement deficits in the upper extremities. Objectives: The purpose of this study was to compare the effectiveness of inter-limb learning transfer (ILT) to the contralateral upper limb after both hemisphere-specific and -unspecific ipsilateral upper limb training for stroke patients with hemiparesis. Methods: Twenty-four stroke patients with hemiparesis participated. The hemisphere-specific training group performed reaching movements in a customized training setting in which non-dominant limb training participants began from a single starting location and proceeded to one of three target locations (1S3T condition); the dominant limb training participants started from one of three starting locations and proceeded to a single target location (3S1T condition). The hemisphere-unspecific training group performed these movements starting under reverse-start and target conditions. Results: The non-dominant to dominant limb transfer, the hemisphere-specific training group performance time decreased significantly as compared with the pre-training session (p < 0.05). Also, the isolation contraction ratio was decreased significantly from that of the pre-training session in the biceps brachii muscles and increased significantly in the upper trapezius muscles (p < 0.05). And, dominant to non-dominant limb transfer in the hemisphere-specific training group significantly increased RMS amplitudes from the pre-training session in the biceps brachii and triceps muscles (p < 0.05). Also, the isolation contraction ratio was increased significantly from that of the pre-training session in the biceps brachii muscles and decreased significantly in the upper trapezius muscles (p < 0.05). However, the hemisphere-unspecific training group showed no significant differences in inter-limb learning transfer (ILT). Conclusion: The transfer of hemisphere-specific training from one arm to the other had a more positive influence on functional recovery than did hemisphere-unspecific training for patients with stroke and hemiparesis.
Effect of electrical stimulation to long head of biceps in reducing gleno humeral subluxation after stroke
Authors: Manigandan J. Bala , Ganesh G. Shankar , Pattnaik Monalisa , Mohanty Patitapaban 
Published: December 2019

Background: Glenohumeral subluxation is the most frequent complication in post stroke hemiplegia and its reduction has been considered an important goal. Though it has been demonstrated that cyclical electrical stimulation of posterior deltoid and supraspinatus muscles can reduce subluxation, the role of biceps has not been given due consideration. Objective: The purpose of this study was to determine whether electrical stimulation to the long head of biceps could more effectively reduce gleno humeral subluxation. Methods: 24 patients were selected and consecutively assigned to group 1 (electrical stimulation to supraspinatus & posterior deltoid) and group II (electrical stimulation to supraspinatus, posterior deltoid & long head of the biceps) along with routine physiotherapy and occupational therapy for a period of 5 weeks. All patients were assessed for shoulder subluxation, pain and shoulder active abduction range of motion at the time of recruitment to study and after 5 weeks of therapy. Results: Both the groups showed significant improvement in parameters measured. Tukey's post hoc analysis showed the results were more significant in Group II. Conclusions: Electrical stimulation to biceps along with the supraspinatus and posterior deltoid can more effectively reduce shoulder subluxation.
The effects of speed-dependent treadmill training and rhythmic auditory-cued overground walking on balance function, fall incidence, and quality of life in individuals with idiopathic Parkinson's disease: A randomized controlled trial
Authors: Harro C.C. , Shoemaker M.J. , Frey O. , Gamble A.C. , Harring K.B. , Karl K.L. , McDonald J.D. , Murray C.J. , VanDyke J.M. , Tomassi E.M. , VanHaitsma R.J. 
Published: December 2019

Objectives: The purpose of this single-blinded, randomized controlled study was to examine and compare the immediate and retention effects of progressive speed-dependent treadmill training (SDTT) and rhythmic auditory-cued (RAC) training on balance function, fall incidence, and quality of life (QOL) in individuals with PD. Methods: Twenty participants (mean age 66.1 yrs) with idiopathic PD were randomized into either SDTT (n = 10) or RAC (n = 10) progressive, interval-based locomotor training for 6 weeks. Measures included the Berg Balance Scale (BBS), Rapid Step-Up Test (RST), Activities-specific Balance Confidence Scale, Parkinson's Disease Questionnaire-39 (PDQ), and the NeuroCom Sensory Organization Test (SOT), Motor Control Test, and Limits of Stability (LOS). Fall incidence was assessed prospectively post-training based on six monthly self-report fall calendars. Results: Significant gains in balance measures were observed post-training in BBS, RST and SOT for the RAC group and in RST, SOT and LOS for the SDTT group. Gains were retained at 3 months post-training in all measures for RAC group, but only the RST for the SDTT group. No clear trend in reduction in fall frequency was evident. Conclusion: Externally-cued locomotor training paradigms with progressive speed challenges produced significant improvements in dynamic balance function in persons with PD, with stronger retention of gains in RAC group.