Control In Stroke Patients Research Articles

Effect of Kinesio Taping on Spasticity and Postural Control in Stroke Patients with Hemiplegic Foot

Effect of Kinesio Taping on Spasticity and Postural Control in Stroke Patients with Hemiplegic Foot

Effects of home-based telemedicine and mHealth interventions on blood pressure in stroke patients: a systematic evaluation and meta-analysis of randomized controlled trials

BackgroundStroke is a common cerebrovascular disease. Elevated blood pressure is the most significant manageable factor for both initial and recurrent strokes. Despite the potential benefits of telemedicine and mobile health technology (mHealth) in managing blood pressure among stroke patients, there remains skepticism. ObjectivesThis systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to assess the effectiveness of telemedicine and mHealth interventions in managing blood pressure in stroke patients. MethodsWe identified randomized controlled trials (RCTs) evaluating telemedicine and mHealth technology interventions for blood pressure in patients with stroke or transient ischemic attack (TIA) from the inception date of each database up to January 2, 2024 by systematic searches of the PubMed, EMBASE, Web of Science, and Cochrane Library databases. The Cochrane Risk of Bias tool (ROB 2.0) was used to evaluate study quality. Sources of heterogeneity were explored through Meta-regression, subgroup analyses, sensitivity analyses and publication bias assessment. Meta-analysis was performed using R 4.2.2 statistical software. ResultsA total of 13 randomized controlled trials with 3803 participants were included. The meta-analysis found that telemedicine and mHealth improved control of both systolic [MD = -4.37, 95 % CI (-5.50, -3.24), I2 = 43 %, P<0.00001] and diastolic blood pressures [MD = -1.72, 95 % CI (-2.45, -0.98), I2 = 0 %, P<0.00001] in stroke patients compared to the conventional care group. Stroke patients who received telemedicine and mHealth interventions showed improved medication adherence than usual care [SMD=0.52, 95 % CI (0.03, 1.00), I2 = 90 %, P<0.00001]. Meta-regression and subgroup analyses identified several key factors influencing systolic and diastolic blood pressure control in stroke patients, including whether stroke patients have hypertension, the specific forms of telemedicine and mHealth interventions employed, the duration of these interventions, and the frequency of intervention intervals. ConclusionsOverall, telemedicine and mHealth reduced stroke patients' systolic blood pressure by an average of 4.37 mm Hg and diastolic blood pressure by an average of 1.72 mm Hg and improved medication adherence compared with usual care. As an emerging medical model, telemedicine and mHealth intervention create a good prospect for the management of blood pressure in stroke patients in the future.

The Role of Anatomic Connectivity in Inhibitory Control Revealed by Combining Connectome-based Lesion-symptom Mapping with Event-related Potentials.

Inhibitory control refers to the ability to suppress cognitive or motor processes. Current neurocognitive models indicate that this function mainly involves the anterior cingulate cortex and the inferior frontal cortex. However, how the communication between these areas influence inhibitory control performance and their functional response remains unknown. We addressed this question by injecting behavioral and electrophysiological markers of inhibitory control recorded during a Go/NoGo task as the 'symptoms' in a connectome-based lesion-symptom mapping approach in a sample of 96 first unilateral stroke patients. This approach enablesus to identify the white matter tracts whose disruption by the lesions causally influences brain functional activity during inhibitory control. We found a central role of left frontotemporal and frontobasal intrahemispheric connections, as well as of the connections between the left temporoparietal and right temporal areas in inhibitory control performance. We also found that connections between the left temporal and right superior parietal areas modulate the conflict-related N2 event-related potential component and between the left temporal parietal area and right temporal and occipital areas for the inhibition P3 component. Our study supports the role of a distributed bilateral network in inhibitory control and reveals that combining lesion-symptom mapping approaches with functional indices of cognitive processes could shed new light on post-stroke functional reorganization. It may further help to refine the interpretation of classical electrophysiological markers of executive control in stroke patients.

Evidence of synergy coordination patterns of upper-limb motor control in stroke patients with mild and moderate impairment.

Objectives: Previous studies showed that the central nervous system (CNS) controls movements by recruiting a low-dimensional set of modules, usually referred to as muscle synergies. Stroke alters the structure and recruitment patterns of muscle synergies, leading to abnormal motor performances. Some studies have shown that muscle synergies can be used as biomarkers for assessing motor function. However, coordination patterns of muscle synergies in post-stroke patients need more investigation to characterize how they are modified in functional movements. Methods: Thirteen mild-to-moderate stroke patients and twenty age-matched healthy subjects were recruited to perform two upper-limb movements, hand-to-mouth movement and reaching movement. Muscle synergies were extracted with nonnegative matrix factorization. We identified a set of reference synergies (i.e., averaged across healthy subjects) and typical synergies (i.e., averaged across stroke subjects) from the healthy group and stroke group respectively, and extracted affected synergies from each patient. Synergy similarity between groups was computed and analyzed. Synergy reconstruction analysis was performed to verify synergy coordination patterns in post-stroke patients. Results: On average, three synergies were extracted from both the healthy and stroke groups, while the mild impairment group had a significantly higher number of synergies than the healthy group. The similarity analysis showed that synergy structure was more consistent in the healthy group, and stroke instead altered synergy structure and induced more variability. Synergy reconstruction analysis at group and individual levels showed that muscle synergies of patients often showed a combination of healthy reference synergies in the analyzed movements. Finally, this study associated four synergy coordination patterns with patients: merging (equilibrium and disequilibrium), sharing (equilibrium and disequilibrium), losing, and preservation. The preservation was mainly represented in the mild impairment group, and the moderate impairment group showed more merging and sharing. Conclusion: This study concludes that stroke shows more synergy variability compared to the healthy group and the alterations of muscle synergies can be described as a combination of reference synergies by four synergy coordination patterns. These findings deepen the understanding of the underlying neurophysiological mechanisms and possible motor control strategies adopted by the CNS in post-stroke patients.

Effect of a visual dual task on postural stability-A comparative study using linear and nonlinear methods.

The dual-task experimental paradigm is used to study the attentional demands of postural control. Postural control is impaired in poststroke patients, and dual-task balance studies address the visual needs of postural control in stroke patients. A nonlinear approach can help us understand the overall behavior of the dynamic system. A total of 20 chronic stroke patients and 20 healthy subjects with similar age, height, and weight participated in this study. The stability and complexity of postural control were assessed using linear and nonlinear methods. All data and parameters (center of pressure [COP] velocity, anteroposterior and mediolateral directions displacement, length of COP path, and phase plane) were analyzed using the Kolmogorov-Smirnov test. When postural control was examined based on linear analysis, the results showed that the main effect of the group was not significant, but the main impact of position was significant for all parameters of the COP variation (p < 0.05). Examination of postural control based on nonlinear analysis also showed that the main effect of the group was not significant, and the main effect of status was significant only for the parameters of approximate entropy in both directions and short-term Lyapunov view in the anterior-posterior direction (p < 0.05). According to the results of this study, the assessment of postural control and gait performance in poststroke patients, as well as the dual tasks they have to perform in daily life, is crucial for their independence in activities of daily living.

The effect of three dimensional printing hinged ankle foot orthosis for equinovarus control in stroke patients

BackgroundHemiplegic stroke patients often suffered from equinovarus foot which result in plantar pressure overload over lateral sole. 3D printing is a promising technique utilized in orthosis fabrication, and the effects on plantar pressure remains unclear. The aim in this study focus on the effect of 3D printed ankle foot orthosis, by measuring plantar parameters. MethodsTen patients with first-ever unilateral stroke were enrolled in this study. All patients performed 10-m walk test in 3 conditions, including ambulation with 3D printed hinged ankle foot orthosis, anterior ankle foot orthosis, and bare foot. The plantar contact area, maximum force, and peak pressure were collected and evaluate using Pedar X in-sole system. Plantar parameters symmetric analysis was conducted to assess the similarity between hemiplegic leg and unaffected leg. We used Quebec User Evaluation of Satisfaction with Assistive Technology questionnaire to survey patients' subjective satisfaction. FindingsWalking with 3D printed ankle foot orthosis revealed significant increase in medial midfoot peak pressure compared to bare foot walking. Plantar parameters symmetric analysis illustrated more even medial midfoot contact area compared to bare foot walking. In satisfaction survey, walking with 3D printed ankle foot orthosis outweighs anterior ankle foot orthosis in fitting and durableness. InterpretationDynamic plantar pressure measurement is useful for evaluation of equinovarus deformity in hemiplegic stroke patients. Wearing 3D printed ankle foot orthosis increase plantar pressure in medial midfoot area. And medial midfoot contact area is also more symmetry.

A Rehabilitation Protocol for Stroke Patients using Virtual Reality

Rehabilitation training for stroke patients is mostly based on face-to-face contact. This affects the routine training during the coronavirus disease outbreak in many hospitals worldwide, including Oman. Perhaps, this problem can be overcome using a virtual reality system. This protocol study aims to compare the outcome measures of the two groups of stroke patients (virtual reality intervention vs. conventional control) on these two modes of rehabilitation training. A randomized controlled trial with pre-/post-study of 42 stroke patients (21 control vs. 21 intervention) with upper limb motor impairments, aged 18-65 years old, newly admitted to the rehabilitation clinic in Oman, will be recruited. Basic demographic data and three major outcome assessments will be collected pre-/post-period. Baseline assessment (pre) on admission to the stroke rehabilitation program and after completion (post). Participants will be assessed by Barthel Index, Action Research Arm scale, and time spent per session with costs involved by the workforce in training. Repeated measures general linear model will examine the within, between, and interaction effects while adjusted by demographic data. All analyses will use IBM SPSS software, and a statistical significance level of p&lt;0.05 will be employed. This research protocol aims to evaluate the feasibility and effectiveness of VR in improving motor control in stroke patients with upper limb weakness by comparing a low-cost VR platform with face-to-face training. If the proposed training protocol is helpful and easy to use, it could become a reliable tool to assist healthcare professionals for stroke patients during their rehabilitation training. This protocol will contribute to the theoretical discussion of integrating high-tech equipment with healthcare theory for stroke patients with learning disabilities. Also, adopting a virtual reality system could aid if a sudden pandemic outbreak. It could continue offering its services while maintaining a high standard of care for stroke sufferers.

Understanding them to understand ourselves: The importance of NHP research for translational neuroscience.

Studying higher brain function presents fundamental scientific challenges but has great potential for impactful translation to the clinic, supporting the needs of many patients suffering from conditions that relate to neuronal dysfunction. For many key questions relevant to human neurological conditions and clinical interventions, non-human primates (NHPs) remain the only suitable model organism and the only effective way to study the relationship between brain structure and function with the knowledge and tools currently available. Here we present three exemplary studies of current research yielding important findings that are directly translational to human clinical patients but which would be impossible without NHP studies. Our first example shows how studies of the NHP prefrontal cortex are leading to clinically relevant advances and potential new treatments for human neuropsychiatric disorders such as depression and anxiety. Our second example looks at the relevance of NHP research to our understanding of visual pathways and the visual cortex, leading to visual prostheses that offer treatments for otherwise blind patients. Finally, we consider recent advances in treatments leading to improved recovery of movement and motor control in stroke patients, resulting from our improved understanding of brain stem parallel pathways involved in movement in NHPs. The case for using NHPs in neuroscience research, and the direct benefits to human patients, is strong but has rarely been set out directly. This paper reviews three very different areas of neuroscience research, expressly highlighting the unique insights offered to each by NHP studies and their direct applicability to human clinical conditions.

Decoding Multi-Class EEG Signals of Hand Movement Using Multivariate Empirical Mode Decomposition and Convolutional Neural Network.

Brain-computer interface (BCI) is a technology that connects the human brain and external devices. Many studies have shown the possibility of using it to restore motor control in stroke patients. One specific challenge of such BCI is that the classification accuracy is not high enough for multi-class movements. In this study, by using Multivariate Empirical Mode Decomposition (MEMD) and Convolutional Neural Network (CNN), a novel algorithm (MECN) was proposed to decode EEG signals for four kinds of hand movements. Firstly, the MEMD was used to decompose the movement-related electroencephalogram (EEG) signals to obtain the multivariate intrinsic empirical functions (MIMFs). Then, the optimal MIMFs fusion was performed based on sequential forward selection algorithm. Finally, the selected MIMFs were input to the CNN model for discriminating four kinds of hand movements. The average classification accuracy of thirteen subjects over the six-fold cross-validation reached 81.14% for 2s-data before the movement onset and 81.08% for 2s-data after the movement onset. The MECN method achieved statistically significant improvement on the state-of-the-art methods. The results showed that the algorithm proposed in this study can effectively decode four kinds of hand movements based on EEG signals.

Effect of Abdominal Draw-in Maneuver Using Breathing on Transversus Abdominis Thickness and Trunk Control in Stroke Patients

Effect of Abdominal Draw-in Maneuver Using Breathing on Transversus Abdominis Thickness and Trunk Control in Stroke Patients

Effects of Proprioceptive Neuromuscular Facilitation (PNF) Techniques on Bed Mobility, Transfer and Early Trunk Control in Acute Stroke Patients

Aims: The aim of this study was to observe the effects of Proprioceptive neuromuscular facilitation (PNF) Techniques to improve bed mobility, transfer and early trunk control in Stroke patients.&#x0D; Study Design: Assessor blinded Randomized Control Trail.&#x0D; Place and Duration of the Study: Physiotherapy department of Shalamar hospital Lahore, Pakistan from March 2019 to September 2020.&#x0D; Methodology: A total of 50 acute stroke patients with severity level NIHSS&gt;21 were recruited and randomly allocated into 2 groups (males: 29, females: 21; age range: 50 to 65) after obtaining written informed consent. Patients were assessed at baseline 0 week and after 6 week of post treatment on Trunk impairment scale (TIS) and ICU mobility scale.&#x0D; Results: It showed that PNF base trunk control exercises exhibited significant improvement in Trunk impairment scale(TIS) in Group A as compared with Group B at post-test, 18.44±3.176 vs 16.12±2.35 (p=0.004) respectively. ICU Mobility scale significantly improves at post-test in Group A as compared to Group B, 7.52 ±2.583 vs 5.84±1.434 (p=0.007) respectively.&#x0D; Conclusion: This study concluded that PNF based trunk exercise showed more improvement in Group A (Trunk stability exercises using PNF techniques) when compared with conventional training.

The Effectivity of Anodal Transcranial Direct Current Stimulation in Enhancing Wrist Extensor Muscle Activation After Stroke: A Randomized Trial

Background: Disability in stroke patients is frequently due to upper limb motor dysfunction, in which wrist extension control plays a major role. Beneficial effects of anodal transcranial direct current stimulation (tDCS) on motor recovery after stroke have been previously reported, but data regarding its effect on wrist extensor muscle activity is limited. Objective: To investigate whether anodal tDCS has an effect on wrist extensor activation in post-stroke patients. Methods: Ten patients suffering from first ischemic stroke were randomized to either an experimental group (anodal tDCS + occupational therapy) or a control group (occupational therapy only). Anodal tDCS over ipsilesional primary motor cortex (M1) was delivered with 2 mA intensity for 20 minutes. Evaluations of wrist extensor muscle activation during isometric contraction using surface electromyography were performed before and after five days of intervention. Results: Within-group comparison in the experimental and control groups; and between-group comparison showed no significant difference in wrist extension control before and after intervention (p = 0.446, p = 0.764, and p = 0,917, respectively). Conclusions: Five sessions of anodal tDCS showed no significant effect on wrist extensor activation in post-stroke patients. Further studies with a larger sample size and a longer period of intervention are necessary to clarify the effects of tDCS on wrist extension control in stroke patients.

The effects of dynamic core-postural chain stabilization on respiratory function, fatigue and activities of daily living in subacute stroke patients: A randomized control trial.

Neurodevelopmental treatment (NDT) and dynamic core-postural chain stabilization (DCS)- based exercise is effective for improving core stability and postural control in stroke patients. However, no study has reported respiratory function, increased fatigue and ADL function in subacute stroke patients by training using NDT and DCS exercises. To compare the effects of DCS and NDT exercises on respiratory function, fatigue and activities of daily living in individuals with hemiparetic stroke. Thirty-one participants with hemiparetic stroke (17 male, 14 female; mean age 60.4±14.58 years; post-stroke duration, 7.2±2.2 weeks) participated in this study. The participants were randomly allocated into DCS (n = 16) and NDT (n = 15). Respiratory function was determined using forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP). The fatigue severity scale (FSS) and functional independent measure (FIM) were used to evaluate fatigue severity and activities of daily living (ADL). Analysis of covariance (ANCOVA) was used to evaluate post-test differences in the DCS and NDT exercise groups. ANCOVA revealed the superior effects of DCS in respiratory function, as well as clinical FSS and FIM tests, compared with those of NDT (p < 0.05). The results suggest that DCS training was more effective than NDT training at improving respiratory function, fatigue severity and ADL via balanced co-activation of the diaphragm and increased diaphragm movement in individuals with hemiparetic stroke.

Effects of dynamic core-postural chain stabilization on diaphragm movement, abdominal muscle thickness, and postural control in patients with subacute stroke: A randomized control trial.

Neurodevelopmental treatment (NDT) and Dynamic neuromuscular stabilization (DNS)-based exercise is effective for improving core stability and postural control in stroke patients. To compare the effects of DNS and conventional NDT exercises on diaphragm movement, abdominal muscle thickness, and postural control in stroke patients. The participants were randomly allocated into DNS (n = 16) and NDT (n = 15) for 30 minutes each per day, 3 days a week for 4 weeks. Diaphragm movement and abdominal muscle thickness were determined using ultrasonography. The trunk impairment scale (TIS) and Berg Balance Scale (BBS) were used to measure postural control. The functional ambulation category (FAC) was used to evaluate gait ability. Analysis of covariance (ANCOVA) was used to evaluate post-test differences in the DNS and NDT exercise groups. ANCOVA revealed the superior effects of DNS in diaphragm movement and abdominal muscle thickness (transversus abdominis, internal oblique), as well as clinical BBS and FAC tests, compared with those of NDT (p < 0.05). This novel clinical trial suggests that DNS training was more effective than NDT training in improving postural movement control and gait ability via a balanced co-activation of the diaphragm and TrA/IO in stroke patients.

Quantitative Static and Dynamic Assessment of Balance Control in Stroke Patients.

In patients with stroke, damage to the central nervous system (CNS) can affect the postural stability and increase the risk of falling. Therefore, accurately assessing the balance is important to understand the type, extent, and causes of balance deficit, and to identify individualized interventions. Clinical assessment methods for balance function can be broadly divided into observation, scale assessment, and balance instrument testing. Here, a clinical protocol is presented for static and dynamic balance assessment in stroke patients, which includes three semiquantitative balance function scale assessments (i.e., Berg Balance Scale, Timed Up and Go Test, and Fugl-Meyer Assessment) and three quantitative instrumental balance evaluation (i.e., Stability Assessment Module, Proprioceptive Assessment Module, and Limit of Stability Module). It is recommended that clinicians consider the use of both classic clinical balance scales and instrumental balance measurements when assessing stroke patients to improve the accuracy of assessments, leading to a better individualized treatment plan.

Remote Management of Poststroke Patients With a Smartphone-Based Management System Integrated in Clinical Care: Prospective, Nonrandomized, Interventional Study.

BackgroundAdvances in mobile health (mHealth) have enabled systematic and continuous management of patients with chronic diseases.ObjectiveWe developed a smartphone-based mHealth system and aimed to evaluate its effects on health behavior management and risk factor control in stroke patients.MethodsWith a multifaceted stroke aftercare management system that included exercise, medication, and educational materials, we performed a 12-week single-arm intervention among eligible poststroke patients in the stroke clinic from September to December 2016. The intervention consisted of (1) regular blood pressure (BP), blood glucose, and physical activity measurements; (2) stroke education; (3) an exercise program; (4) a medication program; and (5) feedback on reviewing of records by clinicians. Clinical assessments consisted of the stroke awareness score, Beck Depression Inventory-II (BDI), EuroQol-5 Dimensions (EQ-5D), and BP at visit 1 (baseline), visit 2 (4 weeks), and visit 3 (12 weeks). Temporal differences in the parameters over 12 weeks were investigated with repeated-measures analysis of variance. Changes in medication adherence at visit 1-2 (from visit 1 to visit 2) and visit 2-3 (from visit 2 to visit 3) were compared. System satisfaction was evaluated with a self-questionnaire using a 5-point Likert scale at visit 3.ResultsThe study was approved by the Institutional Review Board in September 2016, and participants were enrolled from September to December 2016. Among the 110 patients enrolled for the study, 99 were included in our analyses. The mean stroke awareness score (baseline: 59.6 [SD 18.1]; 4 weeks: 67.6 [SD 16.0], P<.001; 12 weeks: 74.7 [SD 14.0], P<.001) and BDI score (baseline: 12.7 [SD 10.1]; 4 weeks: 11.2 [SD 10.2], P=.01; 12 weeks: 10.7 [SD 10.2], P<.001) showed gradual improvement; however, no significant differences were found in the mean EQ-5D score (baseline: 0.66 [SD 0.33]; 4 weeks: 0.69 [SD 0.34], P=.01; 12 weeks: 0.69 [SD 0.34], P<.001). Twenty-six patients who had uncontrolled BP at baseline had −13.92 mmHg (P=.001) and −6.19 mmHg (P<.001) reductions on average in systolic and diastolic BP, respectively, without any antihypertensive medication change. Medication compliance was better at visit 2-3 (60.9% [SD 37.2%]) than at visit 1-2 (47.8% [SD 38.7%], P<.001).ConclusionsAwareness of stroke, depression, and BP was enhanced when using the smartphone-based mHealth system. Emerging mHealth techniques have potential as new nonpharmacological secondary prevention methods because of their ubiquitous access, near real-time responsiveness, and comparatively lower cost.

Glycemic Control of Stroke Patients and Their Outcomes in a Comprehensive Stroke Center at a Tertiary Care Hospital: A Retrospective Cohort

Background: Diabetes mellitus is one of the major modifiable risk factors for having a stroke and those who present with a stroke are found to have hyperglycemia. The association between hyperglycemia and stroke has been found in an increasing number of studies. Evidence indicates that persistent in-hospital hyperglycemia during the first 24 hours after acute ischemic stroke (AIS) is associated with worse outcomes than normoglycemia. We conducted a retrospective chart review to see the glycemic control of stroke patients and their hospital outcome over a 3-month period as part of a pre-evaluation assessment to develop a hyperglycemia protocol in the stroke unit. Methods: Institutional review board approval was obtained for this study. A total of 142 patients with acute stroke admitted in the Comprehensive Stroke Center at Jersey Shore University Medical Center over a 3-month period were included in this study. Demographic characteristics, comorbidities, glycemic patterns at admission and throughout the hospital stay, types of stroke, length of stay, NIH (National Institutes of Health) stroke scale on admission and discharge, discharge disposition and outcome were reviewed retrospectively. Statistical analysis was performed by SPSS and a nova with tukey as post-hoc analysis. For the graph, we used prism and for the regression analysis, stat disk was used. Results: Average age of the patients was 73 years, with male predominance (54%). Average BMI of the patients was 28.2. Most of the patients had an ischemic stroke (73%). Major comorbidities were hypertension (88%), dyslipidemia (66%), and diabetes (36%). About 8 of 143 (6%) patients were newly diagnosed with diabetes. Average Hba1C was 6.5. For a detailed statistical analysis, we divided patients into three groups by their blood glucose levels ranging from 80-140 mg/dl in group 1, 140-180 mg/dl in group 2, and more than 180 mg /dl in group 3. Then, we compared the length of stay (LOS), NIH scale admission/discharge, types of stroke and discharge disposition within the three groups. This study showed that the NIH stroke scale on admission in group 3 (blood glucose >180mg/dl) was higher compared to group 1 (blood glucose 80-140 mg/dl), with a p value of <0.01. Length of stay was more in group 3 compared to group 1 and 2, with a P value < 0.08. Conclusion: Although this study limited by smaller patient groups, but it concludes that higher blood glucose level associated with higher NIH stroke scale at admission and during discharge and have increased length of stay which is consistent with other similar studies

Validity and variability of center of pressure measures to quantify trunk control in stroke patients during quiet sitting and reaching tasks

BackgroundIn the immediate period following stroke, sitting balance is one of the most important predictors of functional recovery at discharge after rehabilitation. Thus, sitting balance determines the content of the early phase of stroke rehabilitation and an appropriate measurement tool is important. Research QuestionThe aim of this study is to investigate the concurrent validity of center of pressure (CoP) excursions of patients seated on a force plate, as well as to examine the daily variability of trunk control after stroke. MethodsTwenty stroke patients at an inpatient rehabilitation clinic underwent two assessment sessions, on average eight hours apart. Each session comprised two trials: quiet sitting for 30 s; extended reaching in forward, backward, left and right directions. The Trunk Impairment Scale (TIS) was measured during the first session. CoP excursions were measured to determine the outcomes of sway area and sway velocity during stable sitting and the maximal excursions in frontal and sagittal planes during the reaching tasks. ResultsHigh Spearman’s correlations (0.72, 0.79) were found between the TIS and the frontal and sagittal excursions. However, only low correlations between the TIS and the sway area and sway velocity were observed. Within sessions, all CoP outcomes showed high ICCs (0.73–1.00). Between sessions, high ICCs (0.86-0.93) were found except for sway velocity (ICC 0.51). Sway velocity increased significantly between sessions. SignificanceFrontal and sagittal CoP excursions during reaching tasks appear to be valid measurement parameters to evaluate trunk control in patients after stroke. Only small variability was observed and no significant differences between consecutive days.

Effects of robotic intervention associated with conventional therapy on gait speed and resistance and trunk control in stroke patients

Objective: To verify the effects of gait and robotic stair training with G-EO System, associated with conventional rehabilitation, on gait speed and endurance and trunk control of stroke participants. Methods: Retrospective study with 28 participants in the chronic phase of the disease. G-EO System was used for gait and stair robotic intervention. 20-session protocol of 20 minutes associated with conventional multidisciplinary therapy. The 10-meter Walk Test (10mWT), 6-minute Walk Test (6MWT) and Trunk Impairment Scale (TIS) tools were used. P values &lt;0.05 were considered statistically significant with Wilcoxon test before and after intervention. Results: Significant differences found in the tests. TIS presented initial mean value of 14.29 (± 5.30) and final value of 17.04 (± 4.49), with p = 0.00044. 10mWT presented average initial velocity of 0.498 m/s (± 0.27) and final velocity of 0.597 m/s (± 0.32), p = 0.00008. 6mWT presented mean initial value of 155.89m (± 85.96) and final value of 195.39m (± 109.78), p = 0.00152. Conclusion: Gait and stair robotic therapy, associated with conventional therapy, was effective in promoting increased speed, endurance aptitude for greater gait distances and trunk control in individuals with chronic stroke after stroke.

Validity and variability of center of pressure measures to quantify trunk control in stroke patients during sitting and reaching tasks

Validity and variability of center of pressure measures to quantify trunk control in stroke patients during sitting and reaching tasks