Function In Stroke Survivors Research Articles

Evaluating the impact of transcranial electrical stimulation on post-stroke dysphagia: a systematic review and meta-analysis.

To conduct a systematic review and meta-analysis to assess the impact of transcranial electrical stimulation (TES), proposed as a potential therapy for post-stroke dysphagia, on swallowing function in stroke survivors. The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for relevant studies on TES for post-stroke dysphagia. Search results were reviewed following PRISMA guidelines, and the following data were extracted from included studies: study characteristics, demographics, and outcomes. Bias was assessed using the Cochrane tool. Heterogeneity and effect sizes were analysed using I2 statistics and appropriate effects models. The study protocol was registered with PROSPERO (registration No. CRD42024578243). Six randomized controlled trials met the inclusion criteria (I2 = 0.0%). The meta-analysis indicated a significant improvement in dysphagia with TES (standardized mean difference [SMD] 0.43, 95% confidence interval [CI] 0.13, 0.73). Subgroup analysis suggested that low-intensity TES was effective (SMD 0.46, 95% CI 0.09, 0.82), whereas high-intensity TES showed no significant improvement (SMD 0.37, 95% CI -0.17, 0.91). No publication bias was detected. TES may improve swallowing in stroke patients, with potential benefits from low-intensity protocols.

StrokeCog-R: Protocol for a Pilot Randomised Controlled Trial Of A Novel Cognitive Rehabilitation Intervention For Post-Stroke Cognitive Impairment

Abstract Background Post-stroke cognitive impairment (PSCI) affects 50% of patients six months post-stroke and is associated with increased disability, reduced quality of life, diminished independence, and a higher risk of long-term care and dementia. Addressing cognitive impairment is crucial to maximise patient recovery, facilitate the return to pre-stroke activities, and optimise secondary prevention efforts. However, cognitive rehabilitation is underrepresented in standard stroke rehabilitation protocols. This pilot randomised controlled trial (RCT) aims to evaluate a novel cognitive rehabilitation intervention, StrokeCog-R, designed to enhance cognitive function in stroke survivors with PSCI. The primary aims are to assess the feasibility of patient recruitment and retention and to determine the statistical power needed for a definitive trial. A secondary aim is to evaluate the efficacy and acceptability of the intervention for individuals with mild-to-moderate PSCI. Methods Sixty-four consecutive stroke patients with mild-to-moderate PSCI will be recruited and randomly assigned to either the intervention group (StrokeCog-R) or the control group (usual care). The intervention involves five weeks of group-based cognitive rehabilitation using “Rehearsal-Based” and “Compensatory-Based” strategies, supplemented with tailored home activities. Cognitive function, self-efficacy, and caregiver psychological wellbeing will be assessed pre- and post-intervention (or control) and at a four-month follow-up. Intervention acceptability will be documented through focus groups following each intervention. Recruitment is ongoing, and the first intervention group has concluded. Results Recruitment and retention rates, the feasibility of randomisation, patient acceptability, and resource utilisation will be evaluated. Additionally, the effectiveness of various communication techniques for retaining participants between the intervention period and the four-month follow-up will be assessed. These data will inform recruitment strategies and the determination of necessary effect sizes to power a definitive trial. Conclusion This study will provide critical insights for a definitive trial, potentially making a substantial contribution to the evidence base for cognitive rehabilitation in stroke patients.

Integrating Machine Learning with Robotic Rehabilitation May Support Prediction of Recovery of the Upper Limb Motor Function in Stroke Survivors.

Motor impairment is a common issue in stroke patients, often affecting the upper limbs. To this standpoint, robotic neurorehabilitation has shown to be highly effective for motor function recovery. Notably, Machine learning (ML) may be a powerful technique able to identify the optimal kind and intensity of rehabilitation treatments to maximize the outcomes. This retrospective observational research aims to assess the efficacy of robotic devices in facilitating the functional rehabilitation of upper limbs in stroke patients through ML models. Specifically, clinical scales, such as the Fugl-Meyer Assessment (A-D) (FMA), the Frenchay Arm Test (FAT), and the Barthel Index (BI), were used to assess the patients' condition before and after robotic therapy. The values of these scales were predicted based on the patients' clinical and demographic data obtained before the treatment. The findings showed that ML models have high accuracy in predicting the FMA, FAT, and BI, with R-squared (R2) values of 0.79, 0.57, and 0.74, respectively. The findings of this study suggest that integrating ML into robotic therapy may have the capacity to establish a personalized and streamlined clinical practice, leading to significant improvements in patients' quality of life and the long-term sustainability of the healthcare system.

The effect of body weight-supported Tai Chi Yunshou on upper limb motor function in stroke survivors based on neurobiomechanical analysis: a four-arm, parallel-group, assessors-blind randomized controlled trial protocol.

A series of functional disorders commonly occur after stroke, of which upper limb dysfunction is the most difficult to recover. The upper limb rehabilitation effect of Tai Chi Yunshou(TCY) in the later stage of stroke has been confirmed by research. Body weight support-Tai Chi Yunshou (BWS-TCY) is based on TCY exercise and robotic exoskeletons offers most flexibility in deweighting and control strategy. This study is aimed to explore the effect of BWS-TCY on upper limb motor function in stroke based on neurobiomechanics. A single-blind randomized controlled trial will be conducted on 36 stroke survivors who will be randomly assigned to three groups: experimental group, control group A and control group B. In addition, 12 healthy elderly people will be recruited into the healthy control group. Those in the experimental group will receive 20 min of CRT and 20 min of BWS-TCY training, while participants in the control group A will receive 20 min of CRT and 20 min of Robot-assisted training. Participants in the control group B will undergo 40 min of Conventional rehabilitation training (CRT) daily. All interventions will take place 5 days a week for 12 weeks, with a 12-week follow-up period. No intervention will be carried out for the healthy control group. Upper limb function will be assessed before and after the intervention using various rating scales (Fugl-Meyer Assessment, Wolf Motor Function Test, etc.), as well as neurobiomechanical analyses (surface electromyography, functional near-infrared brain function analysis system, and Xsens maneuver Capture System). Additionally, 10 healthy elderly individuals will be recruited for neurobiomechanical analysis, and the results will be compared with those of stroke survivors. The results of this study will offer initial evidence on the effectiveness and feasibility of BWS-TCY as an early intervention for stroke rehabilitation. Positive findings from this study could contribute to the development of guidelines for the use of BWS-TCY in the early stages of stroke. This study has been approved by the Research Ethics Committees of the seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (Study ID: 2022-7th-HIRB-022). The results of the study will be published in a peer-reviewed journal and presented at scientific conferences. https://clinicaltrials.gov/, ChiCTR 2200063150.

Combined robot-assisted therapy virtual reality for upper limb rehabilitation in stroke survivors: a systematic review of randomized controlled trials.

Upper limb impairments are among the most common consequences following a stroke. Recently, robot-assisted therapy (RT) and virtual reality (VR) have been used to improve upper limb function in stroke survivors. This review aims to investigate the effects of combined RT and VR on upper limb function in stroke survivors and to provide recommendations for researchers and clinicians in the medical field. We searched PubMed, SCOPUS, REHABDATA, PEDro, EMBASE, and Web of Science from inception to March 28, 2024. Randomized controlled trials (RCTs) involving stroke survivors that compared combined RT and VR interventions with either passive (i.e., sham, rest) or active (i.e., traditional therapy, VR, RT) interventions and assessed outcomes related to upper limb function (e.g., strength, muscle tone, or overall function) were included. The Cochrane Collaboration tool was used to evaluate the methodological quality of the included studies. Six studies were included in this review. In total, 201 patients with stroke (mean age 57.84years) were involved in this review. Four studies were considered 'high quality', while two were considered as 'moderate quality' on the Cochrane Collaboration tool. The findings showed inconsistent results for the effects of combined RT and VR interventions on upper limb function poststroke. In conclusion, there are potential effects of combined RT and VR interventions on improving upper limb function, but further research is needed to confirm these findings, understand the underlying mechanisms, and assess the consistency and generalizability of the results.

Development and Validation of a Bedside Scale for Assessing Upper Limb Function Following Stroke: A Methodological Study.

Background Numerous tools are available for evaluation of upper limb (UL) functions among stroke survivors. Despite the excellent psychometric properties, many require considerable amount of time, are resource-intensive, and often impractical for bedside evaluation. Objectives To develop and concurrently validate a simple, resource-efficient, and time-efficient bedside tool for evaluating UL function in stroke survivors. Methods Relevant literature review was carried out to conceptualize and define the theoretical framework of day-to-day UL movement tasks. Subsequently, an item pool of 18 UL movements was developed. A mini-Delphi method was employed to verify content validity. During the iterative rounds, 18-items were revised and refined to a 12-items scale. The final bedside upper limb evaluation tool (BUFET) scale underwent concurrent validation by correlating the scores with Wolf Motor Function Test (WMFT) scores using Spearman’s correlation coefficient. Internal consistency was evaluated through Cronbach’s alpha. Results Concurrent validity and internal consistency of the scale were supported by a high correlation coefficient (r = 0.937; p<0.001) with WMFT and high Cronbach’s alpha (0.948). Conclusions Newly developed BUFET was found to be a valid and reliable bedside tool in the evaluation of upper limb functions and can be administered in a resource and time-efficient manner.

Effects of Maitland mobilization technique on upper extremity function in stroke survivors with spasticity: An experimental study.

The recovery of upper limb function is of great significance for stroke patients to regain their self-care ability, yet it is still a difficult point in clinical practice of neurological rehabilitation. This study aimed to investigate the effect of Maitland joint mobilization technique on the recovery of upper extremity function in patients with spasticity after stroke. From August to December 2023, 71 patients with upper extremity flexor spasm after stroke were recruited and randomly divided into experimental group (n = 35) and control group (n = 36). The control group was given conventional rehabilitation treatment, while the experimental group was treated with Maitland mobilization technique treatment of upper extremity joints on the basis of the control group. The experiment lasted for 8 weeks. Participants of the 2 groups were observed for Fugl-Meyer motor assessment-upper extremity (FMA-UE), box and block test (BBT) and Brunnstrom stage, modified Ashworth scale (MAS), and functional independence measure (FIM) at pre- and post-8 weeks study. There was no significant difference in gender distribution, hemiplegic side, diagnosis, past history, age, duration, body mass index, and mini-mental state examination between the 2 groups (P > .05). After 8 weeks of intervention, both groups showed significant improvement in FMA-UE, Brunnstrom stage, BBT, FIM, and MAS of the shoulder (P < .05); however, there was no significant change in MAS of the elbow, wrist, and finger joints (P > .05). The posttreatment values showed a significant improvement in FMA-UE, BBT, and FIM in the experimental group compared to the control group. Comparing the changes in pretreatment and posttreatment, FMA-UE, BBT, and FIM in the experimental group were significantly improved compared with those in the control group (P < .05). Maitland joint mobilization can improve the motor function of upper extremity and the spasticity of shoulder joint complex in patients with stroke.

Reliability and validity of a graphical computerized adaptive test Longshi scale for rapid assessment of activities of daily living in stroke survivors

Stroke survivors frequently experience difficulties in daily activities, such as bathing, feeding, and mobility. This study aimed to evaluate the reliability and validity of a computer-adaptive test-Longshi scale (CAT-LS) for assessing activities of daily living (ADL) in stroke survivors. This cross-sectional study collected data using an electronic application. The ADL function of stroke survivors in rehabilitation departments of hospitals was assessed using both the CAT-LS and BI. Correlations between the CAT-LS and Barthel index (BI) and concurrent validity were evaluated using Pearson’s correlation test and multiple linear regression. Interrater reliability was evaluated using the intraclass correlation coefficient based on a two-way random effect. The internal consistency of the CAT-LS was assessed using Cronbach’s coefficient (α) and corrected item-total correlations. Overall, 103 medical institutions in China were used in this study. In total, 7151 patients with stroke were included in this study. The CAT-LS classified patients into three ADL groups (bedridden, domestic, and community) with significantly different BI scores (P < 0.05). The CAT-LS results obtained using the decision-tree scoring model were consistent with the scores for each BI item. A strong correlation was observed between CAT-LS and BI (Pearson’s r: 0.6–0.894, P < 0.001). The CAT-LS demonstrated good internal consistency (Cronbach’s α, 0.803–0.894) and interrater reliability (ICC, 0.928–0.979). CAT-LS is time-efficient and requires < 1 min to administer. The CAT-LS is a reliable and valid tool for assessing ADL function in stroke survivors and can provide rapid and accurate assessments that reduce the burden on healthcare professionals. Further validation of this tool in other populations and settings is necessary.Study registration number: No.: ChiCTR2000034067; http://www.chictr.org.cn/showproj.aspx?proj=54770.

Ankle-foot orthosis in stroke survivors: status of the issue

This paper presents an analysis of information regarding the peculiarity of ankle joint orthosis in cerebral stroke survivors. Gait research methods used to assess gait changes in patients who had suffered a cerebral stroke were briefly reviewed. The three most common patterns of gait impairment after a stroke, namely, stiff-knee gait, “dropped foot,” and gait with knee joint hyperextension, were described. A brief review of the main functional types of ankle joint orthoses, namely, static and dynamic, considering their strengths and weaknesses, was presented. Changes in temporal, spatial, and kinematic parameters of gait in cerebral stroke survivors using orthoses were reported. Changes in gait parameters when using ankle joint orthoses depending on the initial pattern of gait disturbance were assessed. The effect of orthotics on the angles of flexion in the ankle, knee, and hip joints at various gait phases as well as their effect on the speed, rhythm, and length of the step were described. Data on the effect of ankle orthosis on patient’s ability to maintain balance were also presented. The effects of orthosis on gait biomechanics and balance function in stroke survivors are debatable. Thus, our findings in this study allow us to raise the question regarding the optimal timing of the use of ankle joint orthoses during the recovery period of a stroke. Possible reasons for these ambiguous results were considered. The necessity for further research into the effectiveness of ankle–foot orthoses regarding various pathological gait patterns in stroke survivors is justified.

Does repetitive transcranial magnetic stimulation induce long-lasting neuroplastic changes to improve detrusor muscle function in stroke survivors with neurogenic overactive bladder?

Neurogenic overactive bladder (OAB) is purported to result from damage to the central inhibitory pathways in the brain and spinal cord or peripheral afferent terminal sensitization in the bladder, which unmasks the primitive voiding reflex. Excitation of the pontine micturition center activates descending neural pathways to the spinal cord, resulting in sequential detrusor contraction and urethral relaxation. Damage to the central nervous system mechanism may disrupt normal micturition control, leading to involuntary micturition with concomitant detrusor overactivity.Low-frequency repetitive transcranial magnetic stimulation (rTMS), causing long-term depression of neuronal synaptic transmission, results in presynaptic neuron stimulation within several milliseconds after postsynaptic neuron stimulation. Low-frequency rTMS of the primary motor cortex may induce cortical inhibition via suppression of neural overactivity in descending projections, thereby reversing lower urinary tract symptoms by increasing pelvic floor tonicity and enhancing bladder capacity and bladder filling. Given the role of low-frequency rTMS in improving detrusor overactivity, we hypothesized that low-frequency active rTMS would inhibit cortical excitability and induce long-lasting neuroplastic changes to improve detrusor muscle function in stroke survivors with neurogenic OAB.

Effects of Circuit Class Training Versus Individual, Task Specific Training on Upper Extremity Function in Chronic Stroke Patients

Background: Stroke is a leading contributor to disability globally, emphasizing the need for effective rehabilitation techniques. Circuit class training (CCT) and individual, task-specific training (ITST) have emerged as potential approaches for enhancing upper extremity function in stroke survivors. Comparative analyses of their efficacy, especially among chronic stroke patients, are scant. Objective: This study aimed to evaluate and compare the impacts of CCT and ITST on upper extremity spasticity, motor function, and quality of life in individuals with chronic stroke. Methods: In a randomized controlled trial, 36 chronic stroke patients were allocated to either CCT or ITST groups. Participants were aged 45-70 years, had experienced a single stroke episode, and were at least 6 months post-stroke, with specific inclusion criteria regarding spasticity and motor function levels. The interventions were delivered for 1.5 hours daily, five days a week, over eight weeks. Outcomes were measured using the Modified Ashworth Scale (MAS) for spasticity, Functional Independence Measure for Upper Extremity (FMA-UE) for motor function, and Stroke-Specific Quality of Life (SS-QOL) scale for quality of life, analyzed using SPSS version 25. Results: Post-intervention, both CCT and ITST participants exhibited significant improvements in their outcomes. MAS scores showed a reduction in spasticity, with average improvements not significantly differing between the groups. FMA-UE scores increased by an average of 10 points in both groups, indicating enhanced motor function without a significant difference between the groups (p &gt; 0.05). SS-QOL scores improved by an average of 20 points in each group, reflecting better quality of life, with no significant intergroup difference observed. Conclusion: The study concludes that CCT and ITST are equally effective in ameliorating upper extremity spasticity, motor function, and quality of life among chronic stroke patients. The selection between CCT and ITST can thus be personalized based on patient preferences, available resources, and logistical considerations, maintaining rehabilitation efficacy.

Combined noninvasive brain stimulation virtual reality for upper limb rehabilitation poststroke: A systematic review of randomized controlled trials.

Upper limb impairments are common consequences of stroke. Noninvasive brain stimulation (NIBS) and virtual reality (VR) play crucial roles in improving upper limb function poststroke. This review aims to evaluate the effects of combined NIBS and VR interventions on upper limb function post-stroke and to provide recommendations for future studies in the rehabilitation field. PubMed, MEDLINE, PEDro, SCOPUS, REHABDATA, EMBASE, and Web of Science were searched from inception to November 2023. Randomized controlled trials (RCTs) encompassed patients with a confirmed stroke diagnosis, administrated combined NIBS and VR compared with passive (i.e., rest) or active (conventional therapy), and included at least one outcome assessing upper limb function (i.e., strength, spasticity, function) were selected. The quality of the included studies was assessed using the Cochrane Collaboration tool. Seven studies met the eligibility criteria. In total, 303 stroke survivors (Mean age: 61.74 years) were included in this review. According to the Cochrane Collaboration tool, five studies were classified as "high quality," while two were categorized as "moderate quality". There are mixed findings for the effects of combined NIBS and VR on upper limb function in stroke survivors. The evidence for the effects of combined transcranial direct current stimulation and VR on upper limb function post-stroke is promising. However, the evidence regarding the effects of combined repetitive transcranial magnetic stimulation and VR on upper limb function is limited. Further randomized controlled trials with long-term follow-up are strongly warranted.

The facilitators and barriers to home-based robotic rehabilitation in India: a pilot feasibility study

IntroductionRobot-assisted rehabilitation has emerged as a promising approach for enhancing motor function in stroke survivors. However, the feasibility and effectiveness of home-based robotic training in this population are underexplored, especially in low/middle-income countries.MethodsThis feasibility study aimed to address this gap by examining the feasibility and effectiveness of independent home-based training using PLUTO, a robotic device for hand training. A total of 7 chronic stroke survivors were recruited, with 5 completing the study.ResultsThe results revealed high engagement and adherence to the home-based training program, with participants averaging 1659.8 min of training over 24.8 days. The PLUTO system demonstrated excellent usability and elicited positive user perceptions. Significant improvements were observed in functional outcomes, as evidenced by a noteworthy increase in Fugl-Meyer Assessment scores (mean increase of 6.2 points, exceeding the minimal clinically important difference (MCID) of 5.35 points). Furthermore, participants showed improvements in the ABILHAND measure (mean improvement of 1.24 logits, surpassing the MCID of 0.2 logits) and the Barthel Index (mean increase of 8.8 points).ConclusionThese findings demonstrate the feasibility and effectiveness of home-based robotic rehabilitation for chronic stroke survivors. This has implications for expanding access to rehabilitation services in low- and middle-income countries, enhancing patient engagement and adherence, and improving functional outcomes. Larger controlled studies are warranted to evaluate the effectiveness of home-based robotic rehabilitation programs.

Effects of Kinesiotaping on upper limb function and daily activities in subacute or chronic stroke survivors: A randomized control study.

Impaired upper limb function in stroke survivors is characterized by muscle weakness, increased muscle tone, contracture, or impaired motor control. We aimed to evaluate the effectiveness of Kinesio-taping application for functional recovery on the affected arm and forearm during rehabilitation. Forty-one patients eligible for this study were randomly assigned to either the Kinesio-taping group (n = 21), receiving Kinesio-taping intervention and conventional therapy, or control group (n = 20), receiving sham Kinesio-taping intervention and conventional therapy. The whole intervention lasted for 3 weeks. Fugl-Meyer assessment of the upper extremity, Barthel Index, the Stroke Impact Scale, and modified Ashworth scale were measured at 3 time points: baseline, post-treatment (3rd week), and follow-up (6th week). In the Kinesio-taping group, there were significant differences in the upper extremity (p = 0.003), wrist (p = 0.000) and hand (p = 0.000) parts of the Fugl-Meyer assessment of the upper extremity between the three assessment times. On the other hand, the Barthel Index showed significant differences in both groups after therapy. Combining conventional rehabilitation with Kinesio-taping intervention may improve functional motor performance of both the proximal and distal parts of the affected upper extremity in stroke survivors, with potential benefits for activity of daily living.

Effectiveness of virtual reality-based rehabilitation on the upper extremity motor function of stroke patients: A protocol for systematic review and meta-analysis.

Upper extremity deficits (UED) is a common and impactful complication among stroke survivors. Virtual reality (VR)-based rehabilitation holds potential for enhancing rehabilitation intensity and engagement by stimulating tasks. While several clinical studies have examined the effectiveness and safety of VR-based rehabilitation, there is a need for further research to improve consistency in outcomes. The study will incorporate randomized controlled trials (RCTs) concerning the effects of VR-based rehabilitation on upper extremity (UE) function in stroke survivors. A comprehensive search of databases including PubMed, Embase, Cochrane Library, Web of Science, Scopus, Cinahl, China National Knowledge Infrastructure (CNKI), Wan-fang, and Chinese Biology Medicine Database will be performed from inception to the start of the study. Primary outcomes will focus on upper limb motor function assessments such as the Fugl-Meyer Upper Extremity (FMUE), Box and Block Test (BBT), Wolf Motor Function Test (WMFT), and Action Research Arm Test (ARAT). Secondary outcomes related to activities of daily living will include the Barthel Index (BI) and Functional Independence Measure (FIM). Research selection, data extraction, and quality assessment will be independently conducted by two researchers. The recently revised Cochrane risk of bias tool will be employed to evaluate study quality. Meta-regression and subgroup analyses will be utilized to identify effective therapy delivery modes and patterns. The assessment, development, and evaluation of recommendations approach will be applied to achieve a robust conclusion. This study provides a rigorous synthesis to evaluate optimal parameters-specifically intensity and duration-for VR-based rehabilitation interventions aimed at enhancing UE function in stroke survivors. Our secondary objective is to assess the impact of these parameters on rehabilitation outcomes. We anticipate an accurate, transparent, and standardized review process that will yield evidence-based recommendations for integrating VR technology into treating upper extremity dysfunction in stroke patients, offering clinicians effective strategies to enhance upper limb function.

Is the difference real, is the difference relevant: the minimal detectable and clinically important changes in the Montreal Cognitive Assessment

Background and aimsThe Montreal Cognitive Assessment (MoCA) is a widely used instrument for assessing cognitive function in stroke survivors. To interpret changes in MoCA scores accurately, it is crucial to consider the minimal detectable change (MDC) and minimal clinically important difference (MCID). The aim was to establish the MDC and MCID of the MoCA within 6 months after stroke. MethodsThis cohort study analysed data from the EFFECTS trial. The MoCA was administered at baseline and at 6-month follow-up. The MDC was calculated as the upper limit of the 95 % confidence interval of the standard error of the MoCA mean. The MCID was determined using anchor-based and distribution methods. The visual analogue recovery scale of the Stroke Impact Scale (SIS [primary anchor]) and Euro Quality of Life-5 Dimensions index (EQ-5D [confirmatory anchor]) were used as anchors. The distribution-based method, the Cohen benchmark effect size was chosen. ResultsIn total, 1131 (mean age [SD], 71 [10.6] years) participants were included. The mean (SD) MoCA scores at admission and 6-month follow-up were 22 (5.2) and 25 (4.2), respectively. The MDC of the MoCA was 5.1 points. The anchor method yielded the MCIDs 2 and 1.6 points for SIS and EQ-5D, respectively. Using the distribution method, the MCID for the MoCA was 1 point. ConclusionsEven a small change in MoCA scores can be important for stroke survivors; however, larger differences are required to ensure that any difference in MoCA values is a true change and is not related to the inherent variation in the test. Due to small sample sizes, the results of the anchor analysis need to be interpreted with caution.

Effects of Baduanjin on balance and walking function in stroke survivors

OBJECTIVE: This study was designed to systematically assess the impacts of the Baduanjin exercise on the balance and walking ability of stroke survivors. METHODS: A search for relevant randomized controlled trials was carried out in three Chinese and English electronic databases. RESULTS: Eight randomized controlled trials were included in this study. By analyzing the results of the eight trials, it was found that Baduanjin exercise could significantly help stroke survivors balance in later rehabilitation. Additionally, Baduanjin exercise can effectively improve the ability of daily living and cognitive function, thus improving living quality. CONCLUSION: The findings suggest that Baduanjin may be a beneficial rehabilitation technique for improving balance, motor, trunk and neurological function, activities of daily living and overall living quality in stroke survivors. However, the results pertaining to improvements in walking function associated with Baduanjin remain inconclusive. Further high quality RCTs are needed to validate these findings.

The Effectiveness of Constraint-Induced Movement Therapy versus Traditional Occupational Therapy on Upper Limb Function after Stroke

Background: Stroke significantly impacts upper limb function, necessitating effective rehabilitation strategies. Constraint-Induced Movement Therapy (CIMT) and Traditional Occupational Therapy (OT) are widely used, yet their comparative effectiveness in improving upper limb function remains to be fully established. Objective: The aim was to compare the effectiveness of CIMT and traditional OT in enhancing upper limb function in stroke survivors. The comparison was based on changes in the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) and the Stroke Impact Scale (SIS). Methods: This randomized clinical trial involved 40 adult stroke survivors, who were assigned to either CIMT (n=20) or traditional OT (n=20). Assessments using FMA-UE and SIS were conducted before and after the intervention. Data analysis was conducted using SPSS 22.0, included within-group and between-group comparisons using repeated-measures ANOVA and paired t-tests. Results: Both CIMT and traditional OT groups showed significant improvements in FMA-UE and SIS scores. The CIMT group's FMA-UE scores improved from a mean of 43.26 to 47.36 (p=0.006), and SIS scores from 43.99 to 49.03 (p=0.009). The traditional OT group displayed more substantial improvements, with FMA-UE scores increasing from 42.71 to 48.89 (p=0.001), and SIS scores from 44.31 to 50.04 (p=0.007). Between-group analysis revealed no significant differences at baseline, but post-intervention, traditional OT showed significantly better outcomes compared to CIMT. Conclusion: Both CIMT and traditional OT are effective in improving upper limb function and reducing stroke impact. Traditional OT, however, demonstrated a slightly greater improvement. These findings underscore the importance of incorporating diverse therapeutic approaches in stroke rehabilitation, tailored to individual patient needs.

A novel scoring approach for the Wolf Motor Function Test in stroke survivors using motion-sensing technology and machine learning: A preliminary study

Background and objectiveHuman-administered clinical scales, such as the Functional Ability Scale of the Wolf Motor Function Test (WMFT-FAS), are widely utilized to evaluate upper-limb motor function in stroke survivors. However, these scales are generally subjective and labor-intensive. To end this, we proposed a novel scoring approach for the motor function assessment. MethodsThe proposed novel scoring approach mainly contained one Microsoft Kinect v2, one customized motion tracking system, and one customized intelligent scoring system. Specifically, the Kinect v2 was used to capture stroke survivors’ functional movements, the motion tracking system was developed for recording the gathered movement data, and the intelligent scoring system (kernel: feed-forward neural network, FFNN) was developed to evaluate movement quality and provide corresponding WMFT-FAS scores. Several methods have been applied to enhance the approach's usability, such as singular spectrum analysis and multi-ReliefF method. ResultsSixteen stroke survivors and ten healthy subjects were recruited for validation. Inspiring results of the proposed approach were achieved when compared with the clinical scores provided by a physiotherapist: 0.924 ± 0.027 for accuracy, 0.875 ± 0.063 for F1-score, 0.915 ± 0.051 for sensitivity, 0.969 ± 0.013 for specificity, 0.952 ± 0.038 for AUC, 0.098 ± 0.037 for mean absolute error, and 0.214 ± 0.078 for root mean squared error. ConclusionsThe results indicate that the proposed novel scoring approach can provide objective and accurate assessment scores, which can help physiotherapists make individualized treatment decisions.

Holistic Approach In Stroke Patients: A Clinical Trial

Objective: This study aimed to explore the holistic relationship between personality types, coping attitudes, physical functioning, and cognitive levels in individuals diagnosed with stroke. Material and Methods: The research employed a single-group design and included 25 stroke patients. The participants, comprising 7 females and 12 males with a mean age of 54.211±8.979 years, underwent a comprehensive assessment. Physical function was assessed using the Berg Balance Scale and Timed Up and Go Tests, and cognitive levels were measured with the Montreal Cognitive Assessment Scale, coping strategies were evaluated through the COPE-R Coping Attitudes Evaluation Scale, and personality types were determined using the Enneagram Scale. Results: A significant correlation was identified between the Montreal Cognitive Assessment, Timed Up and Go, and Berg Balance Scales (p&lt;0.05). However, no significant correlation was observed between COPE-R Coping Attitudes and Enneagram scales (p=0.503). Conclusion: This study underscores the interplay between cognitive and physical functioning in stroke survivors, highlighting the potential impact of cognitive levels on physical capabilities. Surprisingly, coping attitudes and personality types did not significantly influence cognitive or physical function.