Function In Acute Stroke Patients Research Articles

Proportional recovery in mice with cortical stroke.

The proportional Recovery Rule (PRR) has been frequently used to predict recovery of lost motor function in acute stroke patients. However, it still needs to be explored whether the same concept applies to preclinical, i.e. animal models of stroke recovery. To address this question, we investigated behavioral data from 125 adult male C57Bl/6 J mice with photothrombotic strokes in the sensorimotor cortex. Lesion size and location were determined in the first week using in vivo T2-weighted MRI. Motor recovery was evaluated repeatedly over four weeks using the cylinder, grid walk, and rotating beam test. Recovery trajectories were analyzed using a newly formulated Mouse Recovery Rule (MRR), comparing it against the traditional PRR. Initial findings indicated variable recovery patterns, which were separated using a stepwise linear regression approach resulting in two clusters: 47 % PRR and 53 % MRR. No significant correlation was found between recovery patterns and lesion size or location, suggesting that other biological factors drive individual differences in recovery. Of note, in the MRR cluster, animals recovered to 90 % of their initial behavioral state within the first four weeks post-stroke, which is higher than the 70 % recovery usually reported in human PRR studies. This study demonstrates the complexity of translating the PRR to stroke recovery models in mice and underscores the need for species-specific recovery models. Our findings have implications for designing and interpreting therapeutic strategies for stroke recovery in preclinical settings, with the potential to improve the predictive accuracy of stroke recovery assessments.

Effects of High-Quality Comprehensive Nursing Combined with Longxue Tongluo Capsules on Rescue of Nerve Function in Acute Stroke Patients

To assess the effects of high-quality comprehensive nursing in combination with Longxue Tongluo capsules on the rescue effect and nerve function of acute stroke patients, 120 patients admitted to the emergency department of our hospital from January 2020 to December 2021 were separated into a control group and a study group at random. The control group received conventional treatment and routine emergency care. Based on the control group, the study group was given Longxue Tongluo capsules and high-quality comprehensive nursing. The receive-diagnosis time and diagnosing-treatment time of the study group were shorter relative to the control group, and the rescue success rate and total effective rate were higher. The National Institutes of Health Stroke Scale score in the study group presented lower when compared to the control group, and the activity of daily living score in the study group presented higher when compared to the control group. Relative to the control group, the nursing satisfaction of patients in the study group was better. In conclusion, high-quality comprehensive care combined with Longxue Tongluo capsules can promote the rescue effect, improve nerve function, and promote the ability of daily living activities of acute stroke patients.

Retracted: Acute Thrombolytic Therapy Combined with the Green Channel Can Reduce the Thrombolytic Time and Improve Neurological Function in Acute Stroke Patients.

[This retracts the article DOI: 10.1155/2022/1127159.].

Impact of trunk and appendicular skeletal muscle mass on improving swallowing function in acute stroke patients

ObjectivesTo investigate the effect of trunk and appendicular skeletal muscle mass on the swallowing function at discharge in acute stroke patients. Materials and methodsThis retrospective cohort study included patients hospitalized after acute strokes. Skeletal muscle mass was measured by bioelectrical impedance analysis within 5 days of admission. The primary outcome was swallowing function at acute hospital discharge, assessed using the Functional Oral Intake Scale (FOIS). Secondary outcomes were Functional Independence Measure-eating (FIM-eating) scores and length of hospital stay. ResultsData from 231 patients (age 72.2 years; 151 men) were included in the analysis. The median trunk muscle mass index (TMI) was 8.2 and 6.8 kg/m2 in men and women, respectively. The median appendicular skeletal muscle mass index (ASMI) was 7.7 and 5.7 kg/m2 in men and women, respectively. The high TMI group had higher FIM-eating scores at discharge in each sex (p < 0.001). The high ASMI group had higher FOIS (p = 0.039 and 0.048) and FIM-eating scores at discharge (p = 0.046 and 0.047) in men and women, respectively. On multivariate analysis, TMI was independently associated with FIM-eating scores (β = 0.330, p < 0.001); ASMI was independently associated with FOIS (β = 0.229, p = 0.039) and FIM-eating scores (β = 0.111, p = 0.032). ConclusionsSkeletal muscle mass had site-specific impacts on swallowing function and eating activities. This finding may contribute to the design of more individualized rehabilitation programs.

Acute Thrombolytic Therapy Combined with the Green Channel Can Reduce the Thrombolytic Time and Improve Neurological Function in Acute Stroke Patients.

Objective To explore the effect of acute thrombolytic therapy combined with the green channel on the thrombolytic time and neurological function in acute stroke patients. Methods A total of 100 acute stroke patients admitted to our hospital from August 2016 to August 2019 were recruited as the research cohort. In experimental group, 50 patients were administered green channel combined with acute thrombolytic therapy, while the patients in control group were administered general therapy. The thrombolytic times, the muscle strength grades, the FMA scores, the Barthel index levels, the NIHSS and SSS scores, the SAS and SDS scores, the arterial pressure and heart rates, the total effective rates, the incidences of postoperative adverse reactions, and the satisfaction levels were compared between the two groups. Results The thrombolysis times in experimental group were shorter than those in control group. In experimental group, there were more patients with muscle strength grades 4 and 5 (P < 0.05), the FMA and Barthel index levels were higher, the NIHSS and SSS (P < 0.05) and the SAS and SDS scores were lower, the arterial pressure and heart rates were lower (P < 0.05), the incidence of postoperative adverse reactions was lower (P < 0.05), the total efficiency was higher (P < 0.05), and the satisfaction level was higher (P < 0.05). Conclusion Acute thrombolytic therapy combined with the green channel can significantly reduce the thrombolytic time and improve the neurological function in acute stroke patients.

Resolution of diaschisis contributes to early recovery from post-stroke aphasia

Diaschisis is a phenomenon observed in stroke that is defined as neuronal dysfunction in regions spared by the infarction but connected to the lesion site.We combined lesion network mapping and task-based functional MRI in 71 patients with post-stroke aphasia to investigate, whether diaschisis and its resolution contribute to early loss and recovery of language functions. Language activation acquired in the acute, subacute and chronic phase was analyzed in compartments with high and low normative resting-state functional connectivity to the lesion site on an individual basis.Regions with high compared to regions with low lesion connectivity showed a steeper increase in language reactivation from the acute to the subacute phase. This finding is compatible with the assumption of resolution of diaschisis. Additionally, language performance in the subacute phase and improvement from the subacute to the chronic phase significantly correlated with the diaschisis effect and its resolution, respectively, suggesting a behavioral relevance of this effect.We therefore assume that undamaged but functionally connected regions become dysfunctional due to missing input from the lesion contributing to the aphasic deficit. Since these regions are structurally intact, dysfunction resolves over time contributing to the rapid early behavioral improvement observed in aphasic stroke patients. Our results demonstrate that diaschisis and its resolution might be a relevant mechanism of early loss and recovery of language function in acute stroke patients.

Comparison of the Effect of Repetitive Transcranial Magnetic Stimulation by Frequency on Upper Limb Function in Acute Stroke Patients: A Randomized Controlled Trial

This study was conducted to compare the effects of low frequency repetitive transcranial magnetic stimulation (LF-rTMS) and high frequency repetitive transcranial magnetic stimulation (HF-rTMS) on upper limb function in stroke patients with acute stage. A total of 40 subjects were randomly assigned 20 each to the LF(1Hz)-rTMS group and the HF(10Hz)-rTMS group, and all subjects received intervention for 20 minutes a day, 5 times a week, for 2 consecutive weeks. The subjects

COMPARISON OF OUTCOMES AND COGNITIVE FUNCTION IN ACUTE STROKE PATIENTS TREATED AT THE STROKE CORNER OF H. ADAM MALIK GENERAL HOSPITAL MEDAN WITH THOSE TREATED IN WARD OF KESDAM BUKIT BARISAN HOSPITAL MEDAN

Background: Stroke is a serious neurological problem that is mostly found in the world, and cognitive impairment is often found in the first few weeks after a stroke, where disturbances in the perception and executive functions are mostly found. Aim: To find out the comparison of outcomes and cognitive function in acute stroke patients treated at the Stroke Corner of H. Adam Malik General Hospital Medan with those treated in the Ward of Kesdam Bukit Barisan Hospital Medan. Methods: This research is descriptive analytic with cross sectional data collection method with primary data source obtained from 44 patients who suffered an acute stroke and was treated at the Stroke Corner of H.Adam Malik General Hospital in Medan and Ward at Kesdam Bukit Barisan Hospital. Then MMSE and CDT were examined to assess cognitive function and NIHSS at initial and day 14 to assess patient outcomes. To assess the comparison of cognitive functions and patient outcomes, a bivariate analysis was performed. Normality test with the Komogrov-Smirnov test, then the Chi Square test was performed and was declared significant if p values &lt;0.05 were obtained. Results: After Chi Square test, it was seen that there were significant differences in cognitive function as measured by MMSE and CDT scores between patients treated at the two hospitals with p value = 0.012 (p &lt;0.05) and p value = 0.004 (p &lt; 0.05), respectively. Then, with the chi square test found significant differences in patient outcomes as measured by the initial NIHSS score and day 14 with p value = 0.018 (p &lt;0.05) and p value = 0.011 (p &lt;0.05), respectively. Conclusions: Significant differences in cognitive function and outcome in acute stroke patients were found between treatment at Stroke Corner H. Adam Malik General Hospital Medan and Ward at Kesdam Bukit Barisan Hospital Medan.

Complications Associated with Osmotic Therapy in Acute Stroke Patients- A Prospective Longitudinal Observational Study

Introduction: Mannitol is one of the most frequently used drugs to treat cerebral oedema resulting from ischemic and haemorrhagic strokes. Mannitol administration is associated with complications such as Acute Kidney Injury (AKI) and electrolyte imbalance. Aim: To study effect of mannitol therapy on electrolyte levels and renal function in acute stroke patients. Materials and Methods: The present prospective longitudinal observational study was carried out from January 2019 till September 2019 in Father Muller Medical College, Mangalore, India. After taking informed consent, patients with acute stroke who received mannitol were recruited into the study. Nature of the stroke, presence of comorbidities and dosage of mannitol given were recorded. Serum electrolytes, Serum urea and creatinine were recorded at admission and on fifth day. Serum urea was measured by enzymatic photometric method using urease and glutamate dehydrogenase and serum creatinine was measured by Jaffe’s kinetic method. Comparison of data among different groups was performed using student t-test, ANOVA test, Mann-whitney test and Pearson test. The p-values &lt;0.05 were taken as statistically significant. Results: Total of 72 patients were included in the study. Mean age was 57.7±14.6 years and male: female ratio was 2.27:1. Of the total study subjects, 16 suffered from diabetes (22.22%), 40 from hypertension (55.55%). Ischemic stroke was seen in 41.66% patients and haemorrhagic stroke was seen in 58.33% of the patients. The dose of mannitol administered to all the patients was less than 1 gram/kg/day (low dose mannitol). Cumulative dose of mannitol was 180±177.3 grams. Serum sodium levels were significantly lower on fifth day compared to admission (p-value 0.030) whereas serum potassium and chloride levels were not significantly changed during therapy. There was statistically significant elevation in serum urea levels from admission to fifth day (p-value &lt;0.001) whereas creatinine levels were not significantly altered. Total cumulative dose was compared to serum electrolyte levels and urea and creatinine at admission and fifth day and no significant changes were found. On analysing comorbidities, electrolyte fluctuations were more common in diabetics and Chronic Kidney Disease (CKD) patients whereas renal function parameters were abnormal in diabetics, CKD and hypertensive patients. None of the patients needed any corrective measures to treat the dyselectrolytemias or altered renal function. Conclusion: Low dose mannitol therapy does not produce any significant electrolyte or renal function abnormality in patients with acute stroke. Careful monitoring may be required while treating patients with additional comorbidities.

EFFICACY OF TENS WITH CONVENTIONAL OCCUPATIONAL THERAPY IN IMPROVING HAND FUNCTION OF STROKE SURVIVORS

BACKGROUND AND AIM Stroke is currently the second leading cause of death and third main cause of disability throughout the world. Around 75% of stroke survivors suffered from upper limb dysfunction with limited functional activities whereas distal parts of upper extremity such as hand and forearm are mostly affected by stroke. Therefore, this study aims to determine the benefits of TENS along with conventional Occupational therapy in the rehabilitation of stroke patients to ascertain the optimal recovery of hand function. METHODOLOGY A Single-blind Randomized Controlled Trial was conducted on 76 individuals with acute phase or one-year history post-stroke. Group-A (n=38) received Low Frequency Transcutaneous Electrical Nerve Stimulation on elbow and wrist extensors (3 Hz, 400 μs)along with conventional Occupational therapy while Group-B (n=38) received conventional Occupational therapy only. Both the groups received intervention for 5 days/week of duration 45 minutes till 3 weeks. RESULTS Group-A showed significant improvement in means scores of FMA-UE and ARAT (p&lt;0.05) in comparison to Group-B which showed moderate improvements in sensorimotor and activity capacity of hand function. CONCLUSION Conventional therapy along with TENS significantly improved the hand function in acute stroke patients as compared to the conventional therapy.

Combination of Exoskeletal Upper Limb Robot and Occupational Therapy Improve Activities of Daily Living Function in Acute Stroke Patients

Purpose: Previous studies have suggested that upper limb rehabilitation using therapeutic robots improves motor function of stroke patients. However, the effect of upper limb robotic rehabilitation on improving functioning in activities of daily living (ADL) remains unclear. The present study aimed to determine whether upper limb rehabilitation using single joint Hybrid Assistive Limb (HAL-SJ) affects ADL function and the use of a hemiparetic arm in ADLs of acute stroke patients. Materials and Methods: Twelve acute stroke patients participated in the study and were randomly divided into group A or group B. The patients in group A followed an A-B-A-B design and those in group B followed a B-A-B-A design. The patients received combination HAL-SJ and occupational therapy during A and conventional occupational therapy during B. Results: Upper limb motor function and ADLs, in particular, dressing the upper body, were improved during combination HAL-SJ and occupational therapy. Interestingly, the use of a hemiparetic arm in daily life evaluated using the motor activity log was also significantly improved during A in group A. Conclusions: Combination HAL-SJ and occupational therapy affects ADL function and real use of a hemiparetic arm in the daily life of acute stroke patients.

Visually-Rated Medial Temporal Lobe Atrophy with Lower Educational History as a Quick Indicator of Amnestic Cognitive Impairment after Stroke.

Time and resource limitations prevent cognitive assessment in acute-to-subacute settings, even in comprehensive stroke centers. To assess cognitive function in acute stroke patients undergoing routine clinical, laboratory, and radiological investigations, with a view to improving post-stroke care and treatment. Sixty-nine patients (72.6±11.1 years; 65% male) were prospectively enrolled within 14 days of acute ischemic stroke. Patients with altered consciousness, aphasia, or dysarthria were excluded. Clinical features including modified Rankin and NIH stroke scales, and vascular risk factors were assessed, as well as neuroimaging parameters by semi-quantitative evaluation of medial temporal lobe atrophy (MTLA) using MRA source images, FLAIR images for white matter changes (Fazekas scores), and T2∗ images for cerebral microbleeds. Neuropsychological screening was conducted using the Montreal Cognitive Assessment (MoCA) test. Univariate and multivariate analyses were used to evaluate the influence of variables on MoCA total and subscale scores. Lower MoCA scores of 22 or less were associated with MTLA [OR (95% CI), 5.3 (1.0-27.5); p = 0.045], education years [OR (95% CI), 0.71 (0.55-0.91); p = 0.007], and modified Rankin scale at discharge [OR (95% CI), 2.4 (1.3-4.5); p = 0.007]. The delayed recall MoCA score was correlated with MTLA (r = - 0.452, p < 0.001), periventricular (r = - 0.273, p = 0.024), and deep (r = - 0.242, p = 0.046), white matter changes. MTLA, together with lower educational history, are quick indicators of amnestic cognitive impairment after stroke. The association between cognitive impairment and physical disability at discharge may signify the importance of earlier cognitive assessment.

Short-term Efficacy of Hand-Arm Bimanual Intensive Training on Upper Arm Function in Acute Stroke Patients: A Randomized Controlled Trial.

Rehabilitation training during the acute phase of stroke (<48 h) markedly improves impaired upper-limb movement. Hand-arm bimanual intensive training (HABIT) represents an intervention that promotes improvements in upper extremity function in children with cerebral palsy. This study repurposed HABIT in acute stroke patients and assessed recovery of upper extremity function when compared with a conventional rehabilitation program (CRP). In a randomized trial, 128 patients with acute stroke were assigned to the HABIT or the CRP groups. The primary endpoint was clinical motor functional assessment that was guided by the Fugl-Meyer motor assessment (FMA) and outcomes of the action research arm test (ARAT). The secondary endpoint was an improved neurophysiological evaluation according to the motor-evoked potential amplitude (AMP), resting motion threshold (RMT), and central motor conduction time (CMCT) scores over the 2-week course of therapy. In both groups, scores were evaluated at baseline, 1 week from commencing therapy, and post-therapy. After 2 weeks, the HABIT group showed improved scores as compared the CRP group for FMA (51.7 ± 6.44 vs. 43.5 ± 5.6, P < 0.001), ARAT (34.5 ± 6.2 vs. 33.3 ± 6.3, P = 0.022), and AMP (1.1 ± 0.1 vs. 1.0 ± 0.1, P < 0.001). However, CMCT (8.6 ± 1.0 vs. 9.1 ± 0.6, P = 0.054) and RMT (55.3 ± 4.2 vs. 57.5 ± 4.1, P = 0.088) were similar when comparing between groups. HABIT significantly improved motor functional and neuro-physiological outcomes in patients with acute stroke, which suggested that HABIT might represent an improved therapeutic strategy as compared CRP.

Effects of expiratory muscle strength training on swallowing function in acute stroke patients with dysphagia.

[Purpose] This study was conducted to identify the effects of expiratory muscle strength training on swallowing function in acute stroke patients with dysphagia. [Subjects and Methods] A total of 18 stroke patients with dysphagia were enrolled in the study. All participants were randomly assigned to either an experimental group (n=9) or a control group (n=9). All participants performed traditional-swallowing rehabilitation therapy in 30-minute sessions five times a week for four weeks; however, only the experimental group received expiratory muscle strength training. [Results] Both groups showed significant improvements after mediation. When compared with the control group, the functional dysphagia scale, vallecular residue, and penetration-aspiration scale were significantly improved in the experimental group. [Conclusion] Expiratory muscle strength training is an effective intervention for impaired swallowing function in acute strike patients with dysphagia.

Motor cortex activation during motor imagery of the upper limbs in stroke patients

ABSTRACT Objective: The objective of this study was to analyze the functional brain activation in acute stroke patients during motor execution (ME) and motor imagery (MI) and to discuss the association between damaged brain structure and impaired brain function in stroke patients. Methods: The functional magnetic resonance imaging technique was used to observe activation of the brain during ME/MI of the upper limbs in 12 acute stroke patients (with the left brain damage) and 12 healthy controls. Results: During ME, the stroke patients appeared to be activated more strongly than the healthy controls in the ipsilateral primary motor areas. The MI of the affected hand in the stroke patients was not significantly different from that of the healthy hand. The nonmotor areas, the angular gyrus, and the fusiform gyrus were also activated during ME/MI. Conclusion: Structural damage in the brain is associated with the activation of brain function in acute stroke patients. Ipsilateral inhibition is reduced in stroke patients during ME and the damaged brain needs to recruit more brain areas to complete the desired action due to motion difficulties resulting from brain damage. The participation of nonmotor brain areas in ME/MI indicates that cortical reorganization may contribute to the restoration of motor function following stroke. MI can be used to improve injured brain areas, helping with the rehabilitation of stroke patients.

The effects of very early mirror therapy on functional improvement of the upper extremity in acute stroke patients.

[Purpose] The aim of the study was to evaluate the effects of a very early mirror therapy program on functional improvement of the upper extremity in acute stroke patients. [Subjects] Eight stroke patients who were treated in an acute neurology unit were included in the study. [Methods] The patients were assigned alternatively to either the mirror therapy group receiving mirror therapy and neurodevelopmental treatment or the neurodevelopmental treatment only group. The primary outcome measures were the upper extremity motor subscale of the Fugl-Meyer Assessment, Motricity Index upper extremity score, and the Stroke Upper Limb Capacity Scale. Somatosensory assessment with the Ayres Southern California Sensory Integration Test, and the Barthel Index were used as secondary outcome measures. [Results] No statistically significant improvements were found for any measures in either group after the treatment. In terms of minimally clinically important differences, there were improvements in Fugl-Meyer Assessment and Barthel Index in both mirror therapy and neurodevelopmental treatment groups. [Conclusion] The results of this pilot study revealed that very early mirror therapy has no additional effect on functional improvement of upper extremity function in acute stroke patients. Multicenter trials are needed to determine the results of early application of mirror therapy in stroke rehabilitation.

Recovery of hand function with robot-assisted therapy in acute stroke patients: a randomized-controlled trial.

In the last few years, not many studies on the use of robot-assisted therapy to recover hand function in acute stroke patients have been carried out. This randomized-controlled observer trial is aimed at evaluating the effects of intensive robot-assisted hand therapy compared with intensive occupational therapy in the early recovery phases after stroke with a 3-month follow-up. Twenty acute stroke patients at their first-ever stroke were enrolled and randomized into two groups. The experimental treatment was performed using the Amadeo Robotic System. Control treatment, instead, was carried out using occupational therapy executed by a trained physiotherapist. All participants received 20 sessions of treatment for 4 consecutive weeks (5 days/week). The following clinical scales, Fugl-Meyer Scale (FM), Medical Research Council Scale for Muscle Strength (hand flexor and extensor muscles) (MRC), Motricity Index (MI) and modified Ashworth Scale for wrist and hand muscles (MAS), were performed at baseline (T0), after 20 sessions (end of treatment) (T1) and at the 3-month follow-up (T2). The Barthel Index was assessed only at T0 and T1. Evidence of a significant improvement was shown by the Friedman test for the FM [experimental group (EG): P=0.0039, control group (CG): P<0.0001], Box and Block Test (EG: P=0.0185, CG: P=0.0086), MI (EG: P<0.0001, CG: P=0.0303) and MRC (EG: P<0.0001, CG: P=0.001) scales. These results provide further support to the generalized therapeutic impact of intensive robot-assisted treatment on hand recovery functions in individuals with acute stroke. The robotic rehabilitation treatment may contribute toward the recovery of hand motor function in acute stroke patients. The positive results obtained through the safe and reliable robotic rehabilitation treatment reinforce the recommendation to extend it to a larger clinical practice.

Patterns in default-mode network connectivity for determining outcomes in cognitive function in acute stroke patients

ObjectTo investigate whether resting-state functional connectivity (FC) differed in the default mode network (DMN) in stroke patients with and without post-stroke cognitive impairment (PSCI vs. Non-PSCI) and to explore the relationship between DMN connectivity and the cognitive performance in stroke patients. MethodsWe totally enrolled twenty healthy controls and 18 stroke patients. The stroke patients were divided into two subgroups on the basis of the cognitive assays. Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) scores were recorded 10days and 3months after the stroke. Independent component analysis was used to isolate the DMN. One-way analysis of variance was performed to detect different FC among groups. Pearson correlation analyses were conducted to determine the relationships between FC strength and the MoCA and MMSE scores. ResultsCompared to healthy controls, both Non-PSCI patients and PSCI patients showed significantly decreased FC in the posterior cingulate cortex/precuneus (PCC/PCu), as well as increased FC in the medial prefrontal cortex (MPFC) and left hippocampus. However, Non-PSCI patients showed more significantly increased FC in the MPFC and hippocampus than PSCI patients did. The FC in the PCC/PCu was related to the MoCA score measured at a 10-day follow-up, and the FC in the left hippocampus predicted the MoCA score measured at 3months follow-up. ConclusionsOur findings may be helpful for facilitating further understanding of the potential mechanism underlying PSCI, and suggests that resting-state DMN connectivity could serve as neuroimaging biomarkers for future interventional studies.

The Mirror Therapy Program Enhances Upper-Limb Motor Recovery and Motor Function in Acute Stroke Patients

The purpose of this study was to evaluate the effects of the mirror therapy program on upper-limb motor recovery and motor function in patients with acute stroke. Twenty-six patients who had an acute stroke within 6 mos of study commencement were assigned to the experimental group (n = 13) or the control group (n = 13). Both experimental and control group members participated in a standard rehabilitation program, but only the experimental group members additionally participated in mirror therapy program, for 25 mins twice a day, five times a week, for 4 wks. The Fugl-Meyer Assessment, Brunnstrom motor recovery stage, and Manual Function Test were used to assess changes in upper-limb motor recovery and motor function after intervention. In upper-limb motor recovery, the scores of Fugl-Meyer Assessment (by shoulder/elbow/forearm items, 9.54 vs. 4.61; wrist items, 2.76 vs. 1.07; hand items, 4.43 vs. 1.46, respectively) and Brunnstrom stages for upper limb and hand (by 1.77 vs. 0.69 and 1.92 vs. 0.50, respectively) were improved more in the experimental group than in the control group (P < 0.05). In upper-limb motor function, the Manual Function Test score (by shoulder item, 5.00 vs. 2.23; hand item, 5.07 vs. 0.46, respectively) was significantly increased in the experimental group compared with the control group (P < 0.01). No significant differences were found between the groups for the coordination items in Fugl-Meyer Assessment. This study confirms that mirror therapy program is an effective intervention for upper-limb motor recovery and motor function improvement in acute stroke patients. Additional research on mirror therapy program components, intensity, application time, and duration could result in it being used as a standardized form of hand rehabilitation in clinics and homes.

A randomized controlled trial of Cognitive Sensory Motor Training Therapy on the recovery of arm function in acute stroke patients

Objective: The aim of this study was to evaluate the effectiveness of Cognitive Sensory Motor Training Therapy (Perfetti’s method) vis-à-vis conventional occupational therapy in the recovery of arm function after acute stroke. Design: Prospective randomized controlled trial. Setting: Two rehabilitation centers in Bangkok, Thailand. Subjects: Forty first-time acute stroke patients without severe cognitive or language impairment. Intervention: All subjects were randomly divided into two groups; one was treated using Perfetti’s method and the other using conventional occupational therapy. Each group underwent therapy for 30 minutes, five times a week for four weeks. Main measures: The primary variable was arm function as assessed by the Action Research Arm Test; secondary variables were the extended Barthel Index and the box and block test score. Results: The intention-to-treat analysis revealed no statistically significant differences between the two groups at the end of treatment for any variable. Conclusions: There was no evidence of a difference between Cognitive Sensory Motor Training Therapy of Perfetti’s method and conventional occupational therapy with respect to the restoration of hand and arm function after a stroke.