Activities Of Daily Living In Stroke Patients Research Articles

The effect of family-supportive therapy on the burden of caregivers and Activities of Daily Living among stroke patients

The role of family members in providing care for stroke patients at home is associated with heightened stress and burden on caregivers. Therefore, this study aimed to analyze the effect of family-supportive therapy on the burden of caregivers and Activities of Daily Living (ADL) among stroke patients.A quasi-experimental method was used with a pre-test and post-test control group. The intervention of family-supportive therapy was given to the treatment group, while the control group received home visits. Samples of 40 caregivers in two primary health care centers in Surabaya were recruited using a multi-stage sampling method. The variables were the burden of caregivers and ADL of stroke patients, while Zarit Burden's Interview Schedule and Katz Index of Independence in ADL were used as instruments. Data analysis was carried out using a Paired t-test and a Manova test.The results showed that the burden of caregivers in the treatment group decreased, but there was a re-increase after 2 weeks of therapy, and the burden in the control group also decreased. ADL of stroke patients in the treatment group increased and tended to persist up to 2 weeks after therapy, while the value in the control group decreased. Furthermore, family-supportive therapy did not have a significant effect on the burden of caregivers (p-value 0.12) and ADL (p-value 0.21). To address this challenge, modifying services through the implementation of community health programs, individual health efforts for stroke patients in the hospital and at home, group services for families providing primary health care, and home visits could be a comprehensive effort.The study found that family-supportive therapy and health education through home visits reduced caregiver burden.

Effect of Sit-to-Stand Training on Balance, Muscle Strength, and Activities of Daily Living in Patients with Stroke: A Randomised Controlled Trial

Introduction: Patients who have had a stroke often experience issues with static balance while sitting and standing. Additionally, they may encounter problems with dynamic balance, particularly when transitioning between sitting and standing positions, leading to reduced postural stability in both static and dynamic standing. This also contributes to weakness in the affected lower limb and decreased engagement in Activities of Daily Living (ADL). Nevertheless, few studies have investigated the impact of sit-to-stand training on balance, muscle strength, and ADL in stroke patients. Aim: To assess the impact of sit-to-stand training on balance, muscle strength, and ADL in patients who have had a stroke. Materials and Methods: This trial was an experimental, parallel, and assessor-blinded allocation with a computer-generated randomisation sequence. Sixty-six stroke patients (33 in each group) were enrolled from the inpatient Department of Medicine and the neurosurgery ward of Justice KS Hegde Charitable Hospital in Deralakatte, Mangaluru, Karnataka, India based on specific selection criteria. The trial was conducted from March 2022 to March 2023. Inclusion criteria included patients who had experienced a stroke involving the Anterior Cerebral Artery (ACA) and Middle Cerebral Artery (MCA), encompassing both ischaemic and haemorrhagic types of stroke, aged between 35-60 years, and including both male and female stroke patients who were able to effectively communicate and comprehend instructions. Other criteria included a Mini-Mental State Examination (MMSE) score greater than or equal to 23, the ability to independently have a transition from a supine position to a seated position, and a minimum score on the trunk impairment scale. In the experimental group, participants received sit-to-stand training for 45 minutes over five days, while the control group received conventional physical therapy, including tandem walking, single leg stance, double leg stance, early mobilisation, position and balance training exercises for 45 minutes over five days. The primary outcomes used for balance assessment were the Berg Balance Scale (BBS), and for ADL, the Barthel Index (BI) Scale was used, with muscle strength being measured using a push and pull dynamometer. The independent sample t-test was used to compare between groups, and within-group comparisons were conducted using the paired t-test. A p-value <0.05 was considered significant. Results: Significant differences (p-value=0.044) were observed in BBS score and muscle strength between the groups during both the pretest (Day-1) and post-test (Week-1). The BI exhibited a significant difference (p-value=0.016) during the post-test (Week-1) only. Additionally, a significant difference (p-value<0.001) was found in muscle strength, specifically in the Hip Extensors (HE) between the groups. Conclusion: The results of the current study showed a statistically significant difference in muscle strength of the HE. However, no significant difference was observed in BI and BBS between the groups. No side-effects or harms were reported, indicating that the approach is safe and feasible for stroke patients.

Bilateral upper limb robot-assisted rehabilitation improves upper limb motor function in stroke patients: a study based on quantitative EEG

BackgroundUpper limb dysfunction after stroke seriously affects quality of life. Bilateral training has proven helpful in recovery of upper limb motor function in these patients. However, studies evaluating the effectiveness of bilateral upper limb robot-assisted training on improving motor function and quality of life in stroke patients are lacking. Quantitative electroencephalography (EEG) is non-invasive, simple, and monitors cerebral cortical activity, which can be used to evaluate the effectiveness of interventions. In this study, EEG was used to evaluate the effect of end-drive bilateral upper extremity robot-assisted training on upper extremity functional recovery in stroke patients.Methods24 stroke patients with hemiplegia were randomly divided into a conventional training (CT, n = 12) group or a bilateral upper limb robot-assisted training (BRT, n = 12) group. All patients received 60 min of routine rehabilitation treatment including rolling, transferring, sitting, standing, walking, etc., per day, 6 days a week, for three consecutive weeks. The BRT group added 30 min of bilateral upper limb robot-assisted training per day, while the CT group added 30 min of upper limb training (routine occupational therapy) per day, 6 days a week, for 3 weeks. The primary outcome index to evaluate upper limb motor function was the Fugl-Meyer functional score upper limb component (FMA-UE), with the secondary outcome of activities of daily living (ADL), assessed by the modified Barthel index (MBI) score. Quantitative EEG was used to evaluate functional brain connectivity as well as alpha and beta power current source densities of the brain.ResultsSignificant (p < 0.05) within-group differences were found in FMA-UE and MBI scores for both groups after treatment. A between-group comparison indicated the MBI score of the BRT group was significantly different from that of the CT group, whereas the FMA-UE score was not significantly different from that of the CT group after treatment. The differences of FMA-UE and MBI scores before and after treatment in the BRT group were significantly different as compared to the CT group. In addition, beta rhythm power spectrum energy was higher in the BRT group than in the CT group after treatment. Functional connectivity in the BRT group, under alpha and beta rhythms, was significantly increased in both the bilateral frontal and limbic lobes as compared to the CT group.ConclusionsBRT outperformed CT in improving ADL in stroke patients within three months, and BRT facilitates the recovery of upper limb function by enhancing functional connectivity of the bilateral cerebral hemispheres.

Effectiveness of Oriental Massage on Daily Living Activities of Stroke Patients: A Systematic Review and Meta-Analysis

INTRODUCTION Oriental massage can improve activities of daily living (ADL) and health outcomes in other chronic illness populations, yet similar studies are lacking in stroke populations. This study aimed to examine the effectiveness of oriental massage on ADL in patients with stroke. METHODS This study was a systematic literature review and meta-analysis and searched the primary research studies published electronically in Thai and English through five databases: ThaiJO, Thai National Research Repository (TNRR), PubMed, Science Direct, and Google Scholar. We analyzed data using RevMan version 5.4 by forest plot graphs. The confidence interval was calculated at the 95% level, and the heterogeneity was tested by Cochran’s Q and I2. RESULTS We identified seven relevant studies that performed ADL on stroke patients after receiving Thai or Chinese massage therapy interventions. We found that Thai and Chinese massage were applied together, emphasizing pressing, rolling, squeezing, gripping, bending, and pulling and herbal compress, which can increase blood flow and reduce muscle spasms. These findings suggest that the duration of massage at 3-weeks and 6-weeks follow-ups can be restored and improve the ability to perform ADL in stroke patients.

Effects of Uni- vs. Bilateral Upper Limb Robot-Assisted Rehabilitation on Motor Function, Activities of Daily Living, and Electromyography in Hemiplegic Stroke: A Single-Blinded Three-Arm Randomized Controlled Trial.

To evaluate if bilateral or unilateral upper limb robot-assisted rehabilitation training using a new three-dimensional end-effector robot that targets shoulder and elbow flexion and abduction is superior to conventional therapy with regard to upper extremity motor function recovery and neuromuscular improvement in stroke patients. Randomized, controlled, parallel, assessor-blinded, three-arm clinical trial. Southeast University Zhongda Hospital Nanjing, Jiangsu, China. Seventy patients with hemiplegic stroke were randomly assigned to conventional training (Control, n = 23) or unilateral (URT, n = 23), or bilateral robotic training (BRT, n = 24). The conventional group received routine rehabilitation, 60 min/day, 6 days/week, for 3 weeks. For URT and BRT upper limb robot-assisted rehabilitation training was added. This was 60 min/day, 6 days/week, for 3 weeks. The primary outcome was upper limb motor function assessed with Fugl-Meyer-Upper Extremity Scale (FMA-UE). Secondary outcomes were activities of daily living (ADL) assessed with the Modified Barthel Index (MBI), Motor Evoked Potential (MEP) to assess corticospinal tract connectivity, Root Mean Square (RMS) value, and integrate Electromyography (iEMG) value recorded by surface electromyography to evaluate muscle contraction function. The primary outcome indicator FMA-UE (least square mean (LSMEAN): 31.40, 95% confidence interval (95% CI): 27.74-35.07) and the secondary outcome indicator MBI (LSMEAN: 69.95, 95% CI: 66.69-73.21) were significantly improved in BRT as opposed to control (FMA-UE, LSMEAN: 24.79, 95% CI: 22.23-27.35; MBI, LSMEAN: 62.75, 95% CI: 59.42-66.09); and unilateral (FMA-UE, LSMEAN: 25.97, 95% CI: 23.57-28.36; MBI, LSMEAN: 64.34, 95% CI: 61.01-67.68). BRT also showed greater improvement in the anterior deltoid bundle with regard to muscle contraction function indicated by RMS (LSMEAN: 257.79, 95% CI: 211.45-304.12) and iEMG (LSMEAN: 202.01, 95% CI: 167.09-236.94), as compared to the controls (RMS, LSMEAN: 170.77, 95% CI: 148.97-192.58; iEMG, LSMEAN: 132.09, 95% CI: 114.51-149.68), and URT (RMS, LSMEAN: 179.05, 95% CI: 156.03-202.07; iEMG, LSMEAN: 130.38, 95% CI: 107.50-153.26). There was no statistically significant difference between URT and conventional training for any outcome. There was no significant difference in MEP extraction rate after treatment between groups (p = 0.54 for URT, p = 0.08 for BRT). A 60 min daily training for upper extremities using a three-dimensional end-effector targeting elbow and shoulder adding conventional rehabilitation appears to promote upper limb function and ADL in stroke patients only if delivered bilaterally. URT does not seem to result in better outcomes than conventional rehabilitation. Electrophysiological results suggest that training using a bilateral upper limb robot increases the recruitment of motor neurons rather than improving the conduction function of the corticospinal tract.

Factor Analysis Related to the Change in Activities of Daily Living Performance of Stroke Patients.

This study is aimed at investigating the factors influencing the change (improvement) in the performance of activities of daily living (ADL) in stroke patients. This study utilized data collected from 123 stroke patients at admission and discharge from a local rehabilitation hospital in South Korea between 2019 and 2022. We analyzed the correlations between ADL (Korean version of the Modified Barthel Index) and spasticity (Modified Ashworth Scale), muscle strength (Manual Muscle Test), gait ability (Functional Ambulation Category), cognitive function (Korean version of Mini Mental Status Examination), upper extremity function (Manual Function Test), and balance function (Berg Balance Scale). In addition, to identify the factors influencing the change in ADL in line with the 3 months of rehabilitation, a multiple regression analysis was performed. The results of the correlation analysis showed that balance function (r = 0.925, p < 0.01) and gait ability (r = 0.921, p < 0.01) had strong positive correlations with ADL. Multiple regression analysis (F = 34.547, p ≤ 0.001, adj.R2 = 0.466) indicated that changes in the upper extremity (β = 0.494, p ≤ 0.001), cognitive (β = 0.197, p = 0.008), and balance (β = 0.163, p = 0.029) functions influenced changes in ADL. Our results found that the recovery of upper extremity function along with the improvement of cognitive and balance functions had a significant effect on the improvement of independence in ADL in stroke patients.

Effect of Repetitive Task Training to Improve Sit to Stand Performance and Activities of Daily Living Skills in Patients with Stroke

Introduction: Stroke is an acute neurological dysfunction and the second leading single cause of death,with 5·8 million fatal cases per year, 40% of which are in people younger than 70 years, with problems involuntary movement, sensation, language, emotional and intellectual functioning. Task oriented approachpractice of Repetitive Task Training (RTT) is a treatment in which you repeat a series of specific movementsover and over again, exercises are categorized as either blocked practice or random practice.Aims and Objectives: To find out the effects of repetitive task training to improve sit to stand performanceand Activities of Daily Living (ADL) skills in stroke patients. To evaluate sit to stand performance and ADLperformance and to train Repetitive task training activities.Materials and Methods: The raw scores of pre intervention and post intervention of Modified AshworthScale (MAS) and Functional Independence Measure (FIM) were added and summed up into final scores.Within experimental and control groups were analyzed using Wilcoxon Sign Ranks Test. Mann–Whitney UTest was performed for knowing the significance between the groups.Conclusion: The results of this study suggest that sit to stand activities which is based on activity interventionis strongly grounded in repetitive task training is a promising intervention for improving sit stand activityperformance of ADL in stroke patients.

PENGARUH AKUPRESUR TERHADAP PENINGKATAN KEKUATAN OTOT DAN ACTIVITIES OF DAILY LIVING (ADL) PADA PASIEN STROKE NON HEMORAGIK DI UNIT STROKE RSUD A. WAHAB SJAHRANIE SAMARINDA

Stroke is a disease caused by the interruption of blood supply to the brain. WHO (World Health Organization) stated 15 million people world wide suffer a stroke each year. As many as 5 million people are death sand 5 million people have permanent disability. Stroke Foundation of Indonesia (Yastroki) noted that Indonesia ranks first in Asia with the majority of stroke patients and become leading causes of death in Indonesia. Stroke affects extremity dysfunction such decreased muscle strength which will contribute to the decline ability of Activities of daily living (ADL). There are several the rapies that have been done to over come muscle weakness and limitations of the ADL such as range of movement exercises, positioning, and acupressure is one form of therapy that can be done to restore extremity function. This study aims to determine the effect of acupressure intervention on limb muscle strength and Activities Of Daily Living (ADL) In Stroke Patients. Quantitative Study of quasi-experiment pre-post test design involved 113 respondents into two groups: the intervention group with 88 respondents and the control group with 25 respondents.The result showed male respondents (51.3%), aged 45-59 years (58.4%), and the first attack (85%). After the intervention of 7 day sine ach ofthe respondents, found significant differences increase muscle strength and ADL before the after intervention: right limbmuscle strength(p =0.000); left limbstrength (p =0.000); and ADL (p =0.000). Respondent characteristics that influence muscle strength and ADL were age and frequency of stroke (P &lt;0.05), where as no influence of gender (p&gt; 0.05). The conclusions of this study that acupressureis an effective therapy on increase muscle strength and ADL of stroke patients. This research recommended acupressure as a complementary therapy to improve muscle strength andADLof stroke patients.

Effects of Anodal Transcranial Direct Current Stimulation on Somatosensory Recovery After Stroke

The aim of this study was to evaluate the effect of anodal transcranial direct current stimulation over the primary somatosensory cortex on the recovery of somatosensation, motor function, and the activities of daily living in patients with subacute stroke. This study was a prospective, randomized sham controlled, double-blinded study. Patients with subacute stroke having somatosensory deficits (N = 24) were enrolled and assigned randomly to the anodal and sham stimulation groups. Patients received 10 consecutive anodal or sham transcranial direct current stimulations over the primary somatosensory cortex on the side of the stroke lesion. Before and after each stimulation session, Nottingham sensory assessments, Semmes Weinstein monofilaments examination, and manual function tests were performed, and modified Brunnstrom classification, modified Barthel index, and functional ambulation categories were assessed. Although there was no clear significant difference between the two groups, when the changes from baseline to posttreatment evaluation were compared between the groups, a partially significant improvement was observed in the anodal stimulation group compared with the sham stimulation group. Interestingly, the tactile sensation of the unaffected side also improved. Moreover, the greater improvement in activities of daily living function was observed in the anodal stimulation group too. Anodal transcranial direct current stimulation over the primary somatosensory cortex may be a useful adjuvant therapy for the recovery of somatosensation and activities of daily living function in patients with sensory deficits after stroke.

Six-Week Nordic Treadmill Training Compared with Treadmill Training on Balance, Gait, and Activities of Daily Living for Stroke Patients: A Randomized Controlled Trial

Recently, stroke rehabilitation training programs have contained elements of sporting activities. Arm swing is a particularly important factor in gait; accordingly, the use of the Nordic walking exercise has been advocated in the literature. Our objective is to compare the effects of Nordic treadmill training (NTT) and treadmill training (TT) on balance, gait, and activities of daily living (ADL) in stroke patients. Thirty stroke patients were randomly allocated to NTT and TT groups. NTT and TT were performed for 30 minutes each day, 5 times per week for 6 weeks. The Berg Balance Scale, the timed up and go test, and the tetra-ataxiometric posturography tests were used to assess balance; the 10-meter walk test, 6-minute walk test, and modified Barthel Index were used to measure balance, gait, and ADL. After 6 weeks of training, balance, gait, and ADL improved significantly in both groups, but NTT was associated with greater improvements compared to TT for all 3 measures. This study is the first to assess the effects of NTT on balance, gait, and ADL in stroke patients. The data indicate that NTT represents an effective adjunctive treatment to TT in this population.

Effects of neurofeedback and computer-assisted cognitive rehabilitation on relative brain wave ratios and activities of daily living of stroke patients: a randomized control trial.

[Purpose] This study investigated the effects of neurofeedback (NFB) and computer-assisted cognitive rehabilitation (CACR) on the relative brain wave ratios and activities of daily living (ADL) of stroke patients. [Subjects and Methods] Forty-four participants were randomly allocated to the NFB (n=14), CACR (n=14), or control (CON) (n=16) groups. Two expert therapists provided the NFB, CACR, and CON groups with traditional rehabilitation therapy in 30-minute sessions, 5 times a week, for 6 weeks. NFB training was provided only to the NFB group and CACR training was provided only to the CACR group. The CON group received traditional rehabilitation therapy only. Before and after 6 weeks of intervention, brain wave and ADL evaluations were performed, and the results were analyzed. [Results] The relative ratio of beta waves, only showed a significant increase in the frontal and parietal areas of the NFB group. Significant changes in ADL were shown by all three groups after the intervention. However, there were no significant differences between the NFB and CACR groups and the CON group. [Conclusion] Our results suggest that CACR and NFB are effective at improving cognitive function and ADL of stroke patients.

Effects of aquatic PNF lower extremity patterns on balance and ADL of stroke patients.

[Purpose] This study investigated the effect of aquatic proprioceptive neuromuscular facilitation (PNF) patterns in the lower extremity on balance and activities of daily living (ADL) in stroke patients. [Subjects] Twenty poststroke participants were randomly assigned to an experimental group (n = 10) or a control group (n = 10). The experimental group performed lower extremity patterns in an aquatic environment, and the control group performed lower extremity patterns on the ground. Both exercises were conducted for 30 minutes/day, 5 days/week for 6 weeks. Balance was measured with the Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), Functional Reach Test (FRT), and One Leg Stand Test (OLST). Activities of daily living were measured with the Functional Independence Measure (FIM). A paired t-test was used to measure pre- and post-experiment differences, and an independent t-test was used to measure between-group differences. [Results] The experimental and control groups showed significant differences for all pre- and post-experiment variables. In the between-group comparison, the experimental group was significantly difference from the control group. [Conclusion] These results indicate that performing aquatic proprioceptive neuromuscular facilitation patterns in the lower extremity enhances balance and ADL in stroke patients.

Effects of horse-riding exercise on balance, gait, and activities of daily living in stroke patients.

[Purpose] This study aimed to investigate the effects of horse-riding exercise on balance, gait, and activities of daily living (ADLs) in stroke patients. [Subjects] Among 20 participants with stroke, 10 were randomly assigned to the experimental group, and 10 were randomly assigned to the control group. The experimental group participated in horse-riding exercise for 30 minutes per day, 5 days a week for 6 weeks. Balance was tested with the Berg Balance Scale (BBS). Gait was measured using the 10-Meter Walk Test (10MWT). ADLs were tested with the Modified Barthel Index (MBI). Differences between pre- and post-experiment values within the two groups were compared using paired t-tests. Between-group differences were compared using independent t-tests. [Results] The experimental group showed significant improvements in balance, gait, and ADLs following horse-riding exercise. Additionally, the experimental group showed significant differences in balance, gait, and ADLs compared with in the control group. [Conclusion] These results support that horse-riding exercise enhances balance, gait, and ADLs in stroke patients. This study supports the need for further research on horse-riding exercise programs.

Balance self-efficacy in relation to balance and activities of daily living in community residents with stroke

Purpose: This study attempts to determine a causal relationship among balance self-efficacy, balance, and activities of daily living (ADL) in community residents with stroke. Method: A cross-sectional descriptive correlation study was conducted with a convenience sample comprising 105 stroke patients living in the community. Data were collected using self-reporting questionnaires, including the Activities-specific Balance Confidence (ABC) scale and the Korean version of the Modified Barthel Index (K-MBI). The Berg Balance Scale was used to measure balance ability. A path model was tested to investigate the causal relations between variables, using the AMOS 17.0 statistical program to analyze the models, to obtain maximum-likelihood estimates of model parameters and to provide goodness-of-fit indices. Results: The proposed path model showed good fit indices. The direct path was significant between balance self-efficacy and balance (0.583), between balance and ADL (0.455). The indirect path was significant between balance self-efficacy and ADL (0.015). Conclusion: Our results support the link between balance efficacy, balance, and ADL in stroke patients. The proposed conceptual model was a good fit for the data and provided a plausible framework for understanding the relationship among these factors in stroke patients. Our model may also guide the intervention of functional rehabilitation for stroke patients.Implications for RehabilitationBalance self-efficacy, a psychological factor, should not be overlooked in attempting to improve functional outcomes in stroke survivors because balance self-efficacy impact ADL through the mediation of balance abilityIt would be appropriate to assess the balance efficacy as well as balance ability for maximizing performing tasks such as ADLs for individual with strokeInterventions that use a combination of balance training and balance self-efficacy enhancement could be the most effective for improving ADL in the case of community-dwelling stroke patients

Relationship between Barthel Index scores during the acute phase of rehabilitation and subsequent ADL in stroke patients

The Barthel Index (BI) cannot be used to measure initial stroke severity or by extension, to stratify patients by severity in acute stroke trials because most patients are bedbound in the first few hours after stroke, either by their deficit or by medical directive. Our objectives were to clarify the threshold of acute BI for use in the prediction of subsequent independence in activities of daily living (ADL) and to assist in the definition of acute stroke rehabilitation goals. Subjects comprised 78 patients out of 191 inpatients admitted with acute stroke at our hospital during 2006-2007. The BI ADL score was divided into 2 ranges (BI> or =60 and < or =40), in a process similar to previous studies. During the acute period (from onset to approximately 3 weeks), all patients with a BI> or =40 could improve their ADL in 6 months. Patients with a BI< or =40 exhibited two ADL recovery outcomes (improved and no change) at 6 months. We also found that the skill level of basic activities related to standing was significant indicator of BI improvement (P<0.001). BI scores determined at approximately 3 weeks were reliable predictors of ADL disabilities at 6 months.

Multicentre Trials: Planning and Achieving TOTAL

This article provides an overview for those conducting multicentre rehabilitation trials. It aims to highlight potential problems and difficulties which may not be obvious initially. TOTAL (Trial of Occupational Therapy and Leisure) was a multicentre rehabilitation trial. The aim was to test whether a leisure-based intervention was more effective than activities of daily living (ADL) based therapy at improving the mood, leisure participation and independence in ADL of stroke patients. During the study period, 466 patients were recruited from five centres in the United Kingdom. Postal assessments were sent out at 6 and 12 months after discharge to evaluate mood, leisure independence and ADL performance. The possible difficulties in recruiting centres are presented. The problems encountered were staff shortages, insufficient numbers of patients, concern over aspects of the protocol and funding issues. Day-to-day problems in running the trial and how these may be resolved are also discussed, such as access to the trial coordinator, finance, the need for written agreements and regular communication with each centre. While the complexity of conducting a multicentre trial should not be underestimated, preparation, good planning and an awareness of potential problems makes it a feasible proposition.

Recovery of Diminished Mealtime-Associated Anticipatory Behavior by Aniracetam in Aged Rats

Disease- or age-related neuropsychiatric symptoms and cognitive and chronobiological impairments greatly aggravate the activities of daily living (ADL) in patients. The present study evaluates the effects of aniracetam on a decline in mealtime-associated anticipatory behavior in aged rats, as an animal model of temporally regulated behaviors or habitual daily activities. Aged rats showed a lower but typical nocturnal motor activity rhythm than young rats when the animals were fed ad lib. Mealtime-associated anticipatory behavior emerged in young rats when the rats were fed at a fixed time for 6 days, but the activity in aged rats was diminished. Repeated administration of aniracetam (100 mg/kg PO) or physostigmine (0.1 mg/kg SC) for 7 days ameliorated the impaired anticipatory behavior in aged rats. Nefiracetam (10 mg/kg PO) was ineffective. All compounds tested had no effect on appetite or motor ability. These results indicate that aging disturbs the timing or temporal regulation of anticipatory behavior, probably resulting from dysfunction in a food-entrainable oscillator linked to central cholinergic systems. The restoration of the time-keeping ability by aniracetam may be mediated by the facilitation of reticulothalamic cholinergic neurotransmission, and the action may lead to the improvement of declined ADL in stroke patients.