Function In Stroke Patients Research Articles

Effect of Tai Chi Yunshou training on the balance and motor functions of stroke patients: a systematic review and meta-analysis of randomized controlled trials.

There is insufficient evidence on the effect of Tai Chi Yunshou on improving balance and motor function in stroke survivors. Therefore, this systematic review and meta-analysis aimed to evaluate the effect of Tai Chi Yunshou on improving balance and motor function in stroke patients through a comprehensive literature search. English and Chinese databases were searched from inception to February 10, 2023, to collect randomized controlled trials (RCTs) investigating the effects of Tai Chi Yunshou on balance and motor function in stroke survivors. Two reviewers independently selected studies meeting eligibility criteria, extracted required data, and assessed the risk of bias using methods recommended by the Cochrane Reviewers' Handbook. Primary outcomes were balance function and motor function, while secondary outcomes included walking gait and activities of daily living. Review Manager software (version 5.4.1) was used for data analysis. Among the 1,400 identified records, 12 eligible randomized controlled trials were finally included, with a total of 966 subjects. The results of the meta-analysis showed that the balance function of the experimental group and the control group was assessed using the Berg Balance Scale (MD = 4.87, p < 0.001, I2 = 90, 95% CI = 4.46-5.28). The motor function assessment of the experimental group and the control group used the Fugl-Meyer Motor Assessment (SMD = 1.11, p < 0.001, I2 = 94, 95% CI = 0.94-1.28) and Simple Test of Extremity Function (MD = 10.28, p < 0.001, I2 = 0, 95% CI = 7.89-12.68). Walking ability was measured using the Time-Up and Go Test (MD = -3.22, p < 0.001, I2 = 83, 95% CI = -3.71--2.73). Activities of daily living were measured using the Modified Bathel Index (MD = 4.61, p < 0.001, I2 = 81, 95% CI = 3.61-5.61). Initial evidence seems to show that Tai Chi Yunshou training can improve the balance and motor function of stroke survivors and further improve walking ability and daily living ability, and the rehabilitation effect may be better than that of conventional rehabilitation training. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=376969, identifier [CRD42022376969].

Response to Asirvatham (2023): Effects of Robot-Assisted Rehabilitation on Hand Function of People With Stroke.

In Thajus Asirvatham’s letter to the editor, one concern expressed was that, in our 2021 study (Lee et al., 2021), sensory function should have been highlighted as much as motor function. In this response, we add some discussion about sensory function.Sensorimotor function is significantly correlated with Fugl-Meyer Assessment–Upper Extremity (FMA–UE; Duncan et al., 1983) scores, which could affect the interlimb coordination and accuracy of limb positioning during movement. The sensory function did not show significant improvement in our study, which may be due to the motor-focused training that we used. Sensorimotor-focused training should be considered.We argue that the discussion of sensorimotor function was partially presented in the article. In our study, sensorimotor function was significantly associated with FMA–UE scores (Nordin et al., 2014), which may affect interlimb coordination and accuracy of limb positioning during movement. The results of our study showed no statistically significant improvement in sensory function in stroke patients with sensory impairment after robotic therapy. Previous studies have shown considerable improvements in proprioceptive acuity using rehabilitation robots with vibro-tactile feedback (Elangovan et al., 2019). The training in our study improved the use of proprioceptive input, resulting in better perceptual judgments of passive motion. Our program focused on motor training, but on the basis of the Semmes–Weinstein hand monofilament and the modified Nottingham Sensory Assessment (University of Nottingham, 2007), this may not have been beneficial for sensory function. Sensorimotor-focused training can be considered in future research. The second concern Asirvatham expressed was related to performance- or function-based assessment, such as the Action Research Arm Test (ARAT; McDonnell, 2008) or the Jebsen–Taylor Hand Function Test (JTT; Jebsen et al., 1969). We agree that, rather than using self-report or impairment-based measures to assess hand function, performance- or function-based assessments, such as the ARAT or the JTT, could be used. In our study, the Box and Block Test (Chen et al., 2009) and grip strength meter were functional assessments, and these tools were readily available in our clinical setting. The use of the ARAT and JTT will be considered in future studies.We thank Asirvatham for the insightful comments about our study, and we appreciate the attention we have received from other readers. Some suggestions have been made about adjustments that we need to make in future studies, and we appreciate the opportunity to respond.

Fuzzy Adaptive Passive Control Strategy Design for Upper-Limb End-Effector Rehabilitation Robot.

Robot-assisted rehabilitation therapy has been proven to effectively improve upper-limb motor function in stroke patients. However, most current rehabilitation robotic controllers will provide too much assistance force and focus only on the patient's position tracking performance while ignoring the patient's interactive force situation, resulting in the inability to accurately assess the patient's true motor intention and difficulty stimulating the patient's initiative, thus negatively affecting the patient's rehabilitation outcome. Therefore, this paper proposes a fuzzy adaptive passive (FAP) control strategy based on subjects' task performance and impulse. To ensure the safety of subjects, a passive controller based on the potential field is designed to guide and assist patients in their movements, and the stability of the controller is demonstrated in a passive formalism. Then, using the subject's task performance and impulse as evaluation indicators, fuzzy logic rules were designed and used as an evaluation algorithm to quantitively assess the subject's motor ability and to adaptively modify the stiffness coefficient of the potential field and thus change the magnitude of the assistance force to stimulate the subject's initiative. Through experiments, this control strategy has been shown to not only improve the subject's initiative during the training process and ensure their safety during training but also enhance the subject's motor learning ability.

Short-term and long-term predictors of balance function in stroke patients: a 6-month follow-up study.

We aimed to determine early predictors of balance function (Berg Balance Scale, BBS) at 3 and 6 months after stroke using clinical, neurophysiological, and neuroimaging variables. Seventy-nine patients with hemiparesis after a stroke were included. Demographics, stroke characteristics, and clinical variables [Mini-Mental State Examination, BBS, strength in the hemiparetic hip, knee, and ankle muscles, and Fugl-Meyer Assessment Lower Extremity (FMA-LE)] were evaluated 2 weeks post-stroke, on average. Somatosensory-evoked potentials (SEP) from both tibial nerves and diffusion tensor imaging data were collected respectively within 3 weeks and 4 weeks post-onset to calculate the SEP amplitude ratio and the laterality index of fractional anisotropy of the corticospinal tract. In multiple linear regression analysis, younger age, higher FMA-LE score, and stronger hemiparetic hip extensors were independent predictors of higher BBS at 3 months post-stroke (adjusted R2 = 0.563, P < 0.001). At 6 months post-stroke, significant predictors of higher BBS were younger age, higher FMA-LE, stronger hemiparetic hip extensors, and larger SEP amplitude ratio (adjusted R2 = 0.552, P < 0.001), although the incremental contribution of the latter was rather small ( R2 = 0.019). We conclude that age and the initial motor impairment of the affected lower limb can inform the state of balance function at 3 and 6 months after stroke.

다이나믹 테이핑 적용 상태에서의 신경발달물리치료가 발 처짐 증상을 가진 뇌졸중 환자의 정적 및 동적 균형, 보행 기능에 미치는 장기 효과

The purpose of this study was to investigate the effects of Neuro Development Treatment (NDT) treatment using dynamic taping of static and dynamic balance and gait function in stroke patients with foot drop. In this study, a total of 21 stroke patients with foot drop were randomly assigned to NDT treatment with dynamic taping training group and NDT treatment with sham taping training control group. Limit of Stability (LoS) and Berg Balance Test (BBS) were used to evaluate static and dynamic balance and gait function. To evaluate walking ability, 10Meter-Walking Test (10MWT) and Time Up and Go Test (TUG) tests were conducted. The intervention was performed five times a week for four weeks. Each session lasted 60 minutes twice a day. The experimental group received NDT treatment after attaching dynamic tape to tibialis anterior and peroneus longus, and the control group was provided with NDT treatment after attaching the sham tape. The results of this study confirmed that NDT treatment with dynamic taping was effective in improving static and dynamic balance and gait in stroke patients with foot drop and can be used as an effective interventional method in physical therapy to improve balance and gait in such patients.

The effects of combined high-frequency repetitive transcranial magnetic stimulation and cervical nerve root magnetic stimulation on upper extremity motor recovery following stroke.

Upper limb motor impairments after stroke cause patients partial or total loss of the capability of performing daily living, working, and social activities, which significantly affects the quality of life (QoL) of patients and brings a heavy burden to their families and society. As a non-invasive neuromodulation technique, transcranial magnetic stimulation (TMS) can act not only on the cerebral cortex, but also on peripheral nerves, nerve roots, and muscle tissues. Previous studies have shown that magnetic stimulation on the cerebral cortex and peripheral tissues has a positive effect on the recovery of upper limb motor function after stroke, however, few studies have reported the combination of the two. This study was to investigate whether high frequency repetitive transcranial magnetic stimulation (HF-rTMS) combined with cervical nerve root magnetic stimulation more effectively ameliorates upper limb motor function in stroke patients. We hypothesized that the combination of the two can achieve a synergistic effect and further promotes functional recovery. Sixty patients with stroke were randomly divided into four groups and received real or sham rTMS stimulation and cervical nerve root magnetic stimulation consecutively before other therapies, once daily over five fractions per week for a total of 15 times. We evaluated the upper limb motor function and activities of daily living of the patients at the time of pre-treatment, post-treatment, and 3-month follow up. All patients completed study procedures without any adverse effects. The upper limb motor function and activities of daily living improved in patients of each group were improved after treatment (post 1) and 3 months after treatment (post 2). Combination treatment was significantly better than single treatments alone or sham. Both rTMS and cervical nerve root magnetic stimulation effectively promoted upper limb motor recovery in patients with stroke. The protocol combining the two is more beneficial for motor improvement and patients can easily tolerate it. https://www.chictr.org.cn/, identifier ChiCTR2100048558.

The relationship between the prefrontal cortex and limb motor function in stroke: A study based on resting-state functional near-infrared spectroscopy

BackgroundWith the ageing of the world population, the incidence of stroke has been increasing annually, becoming a public health problem affecting adult health. Limb motor dysfunction is one of the common complications of stroke and an important factor in disability. Therefore, restoring limb function is an important task in current rehabilitation. Accurate assessment of motor function in stroke patients is the basis for formulating effective rehabilitation strategies. With the development of neuroimaging technology, scholars have begun to study objective evaluation methods for limb motor dysfunction in stroke to determine reliable neural biomarkers to accurately identify brain functional activity and its relationship with limb motor function. The prefrontal cortex (PFC) plays an important role in motor control and in response to motor state changes. Our previous study found that the PFC network characteristics of stroke patients are related to their motor function status and the topological properties of the PFC network under resting state can predict the motor function of stroke patients to some extent. Therefore, this study used functional near-infrared spectroscopy (fNIRS) to evaluate prefrontal neuroplasticity markers and the relationships between such neural markers and limb motor function in stroke patients with limb motor dysfunction, which could be helpful to further clarify the relationship between brain neuroplasticity and cerebral haemodynamics. At the same time, through accurate and objective means of evaluation, it could be helpful for clinicians to formulate and optimize individualized rehabilitation treatment plans and accurately determine the rehabilitation efficacy and prognosis. MethodsThis study recruited 17 S patients with limb motor dysfunction and 9 healthy subjects. fNIRS was used to collect 22 channels of cerebral blood oxygen signals in the PFC in the resting state. The differences in prefrontal oxygenated haemoglobin (HbO) and deoxygenated haemoglobin (HbR) concentrations were analysed between stroke patients and healthy subjects, and the lateralization index (LI) of HbO in stroke patients was also calculated. Pearson’s correlation analysis was performed between the LI and the scores of the Fugl-Meyer Assessment Scale (FMA) of motor function in stroke patients. ResultsThe results found that the prefrontal HbO concentration was significantly decreased in stroke patients with limb motor dysfunction compared with healthy subjects, and there was a significant, positive correlation between the LI of the PFC and FMA scores in stroke patients. ConclusionThese study results showed that stroke can cause cerebral haemodynamic changes in the PFC, and the functional imbalance of the left and right PFC in the resting state is correlated with the severity of limb motor dysfunction. Furthermore, we emphasize that the cerebral haemodynamic activity reflected by fNIRS could be used as a reliable neural biomarker for assessing limb motor dysfunction in stroke.

Effect of rTMS intervention on upper limb motor function after stroke: A study based on fNIRS.

Stroke is a disease with a high fatality rate worldwide and a major cause of long-term disability. In the rehabilitation of limb motor function after stroke, the rehabilitation of upper limb function takes a long time and the recovery progress is slow, which seriously affects the patients' self-care ability in daily life. Repeated transcranial magnetic stimulation (rTMS) has been increasingly used to improve limb dysfunction in patients with stroke. However, a standardized reference for selecting a magnetic stimulation regimen is not available. Whether to increase the inhibition of the contralateral hemispheric motor cortex remains controversial. This study has evaluated the effects of different rTMS stimulation programs on upper limb function and corresponding brain functional network characteristics of patients with stroke and sought a new objective standard based on changes in brain network parameters to guide accurate rTMS stimulation programs. Thirty-six patients with stroke were selected and divided into control group and treatment group by number table method, with 18 patients in each group, and 3 patients in the control group were turned out and lost due to changes in disease condition. The treatment group was divided into two groups. TMS1 group was given 1 Hz magnetic stimulation in the M1 region of the contralesional hemisphere +10 Hz magnetic stimulation in the M1 region of the affected hemisphere, and the TMS2 group was given 10 Hz magnetic stimulation in the M1 region of the affected hemisphere. The control group was given false stimulation. The treatment course was once a day for 5 days a week for 4 weeks. The Fugl-Meyer Assessment for upper extremity (FMA-UE) sand near-infrared brain function were collected before treatment, 2 weeks after treatment, and 4 weeks after treatment, and the brain function network was constructed. Changes in brain oxygenated hemoglobin concentration and brain network parameters were analyzed with the recovery of motor function (i.e., increased FMA score). Meanwhile, according to the average increment of brain network parameters, the rTMS stimulation group was divided into two groups with good efficacy and poor efficacy. Network parameters of the two groups before and after rTMS treatment were analyzed statistically. (1) Before treatment, there was no statistical difference in Fugl-Meyer score between the control group and the magnetic stimulation group (p = 0.178).Compared with before treatment, Fugl-Meyer scores of 2 and 4 weeks after treatment were significantly increased in both groups (p <0.001), and FMA scores of 4 weeks after treatment were significantly improved compared with 2 weeks after treatment (p < 0.001). FMA scores increased faster in the magnetic stimulation group at 2 and 4 weeks compared with the control group at the same time point (p <0.001).TMS1 and TMS2 were compared at the same time point, FMA score in TMS2 group increased more significantly after 4 weeks of treatment (p = 0.010). (2) Before treatment, HbO2 content in healthy sensory motor cortex (SMC) area of magnetic stimulation group and control group was higher than that in other region of interest (ROI) area, but there was no significant difference in ROI between the two groups. After 4 weeks of treatment, the HbO2 content in the healthy SMC area was significantly decreased (p < 0.001), while the HbO2 content in the affected SMC area was significantly increased, and the change was more significant in the magnetic stimulation group (p < 0.001). (3) In-depth study found that with the recovery of motor function (FMA upper limb score increase ≥4 points) after magnetic stimulation intervention, brain network parameters were significantly improved. The mean increment of network parameters in TMS1 group and TMS2 group was significantly different (χ 2 = 5.844, p = 0.016). TMS2 group was more advantageous than TMS1 group in improving the mean increment of brain network parameters. (1) The rTMS treatment is beneficial to the recovery of upper limb motor function in stroke patients, and can significantly improve the intensity of brain network connection and reduce the island area. The island area refers to an isolated activated brain area that cannot transmit excitation to other related brain areas. (2) When the node degree of M1_Healthy region less than 0.52, it is suggested to perform promotion therapy only in the affected hemisphere. While the node degree greater than 0.52, and much larger than that in the M1_affected region. it is suggested that both inhibition in the contralesional hemisphere and high-frequency excitatory magnetic stimulation in the affected hemisphere can be performed. (3) In different brain functional network connection states, corresponding adjustment should be made to the treatment plan of rTMS to achieve optimal therapeutic effect and precise rehabilitation treatment.

The relationship of trunk control with balance, upper extremity and lower extremity functions in stroke patients

The center of the body is the trunk. For distal extremity movements, balance, and functional tasks, proximal trunk control is crucial. The aim of the study is to examine the relationship of trunk control with balance, upper extremity and lower extremity functions in stroke patients. Thirty-six stroke patients were included in this cross-sectional descriptive study. Trunk control was assessed using the Trunk Impairment Scale (TIS), Berg Balance Scale (BBS) was used for balance evaluation, Fugl-Meyer Lower Extremity Scale (FML) was used for lower extremity function evaluation, Fugl-Meyer Upper Extremity Scale (FMU) was used for upper extremity function evaluation. The mean age of the included stroke patients was 62±11 years. There was a moderate negative correlation between TIS and BBS (r=-0.610, p&lt;0.01). A moderate negative correlation was found between TIS and FML (r=-0.520, p=0.001). A low negative correlation was found between TIS and FMU (r=-0.372, p=0.025). Trunk control affects balance, lower extremity and upper extremity function. In the treatment of stroke patients, exercise approaches for trunk control should be added to rehabilitation programs in addition to basic neurophysiological approaches.

Effect of CPAP on cognitive function in stroke patients with obstructive sleep apnoea: a meta-analysis of randomised controlled trials

ObjectiveTo investigate the effect of continuous positive airway pressure (CPAP) treatment on cognitive function in stroke patients with obstructive sleep apnoea (OSA) by exploring randomised controlled trials (RCTs).MethodsPublished RCTs that...

Effects of Taping on Lower Limb Function in Stroke Patients: A Literature Review

BACKGROUND: Stroke is one of the leading causes of morbidity and mortality globally and is caused due todefective blood supply to an area of the brain, resulting from a hemorrhage or an infarction, leading to severe braindamage. Depending upon the area involved, the patient may exhibit loss of sensory or motor function, affectingbalance and gait; impaired cognition; visual and verbal deficits; and social problems. A stroke can occur at anyage, but the majority of the affected patients are above 60 years of age, which further contributes to impairedbalance and difficulty in performing activities of daily living. Rehabilitative measures include exercises along withadjuncts, such as taping, to promote function in the affected extremity. Thereby, this literature review assesses theeffect of taping on lower-limb function in stroke patients.METHODS: A thorough search was carried out through online databases such as PEDro, PUBMED, and GoogleScholar for the purpose of this literature review. Relevant articles were studied thoroughly, and the observationshave been presented in this paper.CONCLUSION: Taping is an effective rehabilitative approach for improving lower extremity function in patientswith stroke. Further studies can increase the magnitude of this intervention.

Evaluation of the relationship of balance and posture with speech functions in stroke patients

Aim: Balance disorders, postural dysfunctions, and speech disorders are common after stroke. This study aims to investigate whether there is a connection between language and speech function and posture and balance in paralyzed patients and to which speech area function the connection is related.Methods: Eighteen stroke patients with speech impairment and no cognitive impairment were included in the study. Balance and postures of stroke patients were evaluated using the Berg Balance Test (BBT) and Postural Assessment Scale for Stroke Patients (PASS-T), while their quality of life was evaluated using the Stroke and Aphasia Quality of Life-39 Test (SAQOL-39). Patients’ speech functions were evaluated using the Gülhane Aphasia Test-2 (GAT-2), voice-related assessments were made with the Voice-Related Quality of Life Scale (V-RQOL), and objective voice analysis.Results: The mean age of the participants was 59.10±14.72 years, the mean score of the Mini-Mental Test was 26.16±2.00. According to statistical analysis, there was a significant relationship between BBT score and GAT-2 (r: 0.552, p=0.017), and BBT score and SAQOL-39 mean score (r: 0.589, p=0.010), there was no significant relationship between BBT and V-RQOL (r: -0.075, p=0.768). While there was a significant relationship between PASS-T (r: 0.499, p=0.035) and SAQOL-39, no significant relationship was found with GAT-2 (r: 0.388, p=0.112). In addition, a significant correlation was found between the SAQOL-39 mean score and the GAT-2 total score (r: 0,606, p=0.008).Conclusion: It was observed that there is a significant relationship between balance functions and speech function and quality of life, and patients with good balance have better functional independence and speech functions. However, it was found that posture did not change speech function. Due to the importance of evaluation in treatment, it is thought that the evaluation of stroke patients who will receive speech and language therapy in terms of balance and postural functions will contribute to the speech functions of patients.

Impact of early urinary catheter removal on successful voiding and physical function in stroke patients

Impact of early urinary catheter removal on successful voiding and physical function in stroke patients

Motor and Cognitive Modulation of a Single Session of Transcutaneous Auricular Vagus Nerve Stimulation in Post Stroke Patients: A Pilot Study.

Objective: The aim of the present study is to explore whether a single session of transcutaneous Vagus Nerve Stimulation (tVNS) can enhance the ipsilesional, and contralesional upper limb motor functions as well as cognitive functions in stroke patients. The effects of the stimulation were evaluated through two different tasks: the box and blocks test (BB), indexing manual dexterity, and the Go/No-go task, a visuomotor paradigm used to assess both motor readiness and response inhibition. Tests were administered without tVNS, during tVNS and during sham tVNS. Results: The BB showed a statistical difference for both contralesional side (p = 0.05) between Basal-Real condition (p = 0.042) and ipsilesional side (p = 0.001) between Basal-Real (p = 0.008) and for Real-Sham (p = 0.005). Any statistical difference was found for the mean latencies in the three conditions of the Go/No-go test. Conclusion: A single session of tVNS seems to improve upper limb motor functions but not cognitive functions in post-stroke patients, despite a positive trend was detected.

The Impact of Virtual Reality on Upper Extremity Function In Stroke Patients: A Pilot Study

The Impact of Virtual Reality on Upper Extremity Function In Stroke Patients: A Pilot Study

The Impact of Mental Practice on Motor Function in Patients With Stroke: A Systematic Review and Meta-analysis.

Mental practice (MP), the cognitive rehearsal of physical activities without overt movements, has recently emerged as a promising rehabilitation method for patients with stroke. This paper presents a systematic review and meta-analysis critically evaluating the existing evidence to offer a comprehensive estimate of the overall effect of MP on motor function in stroke patients. A systematic search of 3 international databases (PubMed, Embase, and the Cochrane Library) was conducted for randomized controlled trials. We finally selected 31 randomized clinical trials and conducted meta-analysis to determine the effectiveness of MP on motor recovery of upper extremity, upper extremity function, activities of daily living, and gait velocity in stroke patients. The results of the systematic reviews showed that MP combined with conventional therapy has a positive impact on improving upper extremity motor function, with a moderate quality of evidence. However, the beneficial effect of MP on gait velocity was not demonstrated. It is recommended to treat with MP in addition to conventional rehabilitation therapy to improve the motor outcome of stroke depending on the patient's condition (Recommendation level: Conditional Recommend Evidence certainty: Moderate).

The Effects of Virtual Reality Mirror Therapy on Movement-Related Cortical Potentials and Upper Extremity Function in Stroke Patients

The purpose of this study lies in finding out of the effects of virtual reality mirror therapy (VRMT) on excitability of the cerebral cortex and upper extremity function in stroke patients. The subjects were diagnosed as stroke according to criteria to select the research targets. The experimental group (n=12) was applied on general physical therapy included VRMT for 5 times per week in 6 weeks. Bereitschafts potential (BP) and motor potential (MP) of movement-related cortical potential (MRCPs) was applied for evaluation of excitability of the cerebral cortex, the upper extremity function of experimental group was assessed using Fugl-Meyer assessment (FMA), box and block test (BBT). Results were measured at periods of pre-intervention, post-intervention. The BP mean amplitude showed statistically significant decrease. The MP peak amplitude showed statistically significant increase except for C4. FMA, BBT score showed statistically significant increase. These results were show that VRMT increase excitability of the cerebral cortex and upper extremity function. Accordingly, VRMT would usefully be applicable treatment to improve upper extremity functional recovery in the stroke patients.

Effect of Rhythmic Auditory Stimulation against Mirror Therapy on Hand Function in Stroke Patients

Objective: Stroke affects the upper limb function keeping the patient dependent for daily activities. Rhythmic auditory stimulation is proved to be beneficial in upper limb functions, although Mirror therapy and Conventional therapy has their own beneficial effects in stroke. The study aimed at comparing the effect of rhythmic auditory stimulation against mirror therapy and conventional therapy. Method: Sixty participants were taken for the study divided into three groups, 20 in each. Interventions were planned with Group A for Conventional therapy, Group B for Rhythmic Auditory Stimulation and Group C as Mirror therapy. Hand grip was measured by Hand held Dynamometer and Hand function by using Action Research Arm Test. Treatment was given for 20 minutes in a day, for 5 sessions a week extending for 4 weeks. Findings: The results obtained after the analysis showed a significant difference in ARAT scores among three groups: Control (34.808.27), RAS (40.607.12) and Mirror therapy (33.507.86) with mean post-test scores (F=4.7400, p=0.0120) and change from pre-test to post-test (F=67.2790, p=0.0001). A significant difference was observed among three groups: Control (21.286.82), RAS (27.616.94) and Mirror therapy (23.39 5.47) with mean post-test scores (F=5.0040, P=0.0100) and pretest posttest score for hand grip (F=59.6750, P=0.0001). Novelty: Mirror therapy and rhythmic auditory stimulation influences the visual and the auditory system respectively. The novelty of this study is being exhibited in identifying the effective intervention that can influence the neuroplasticity of the brain in the learning process. Conclusion: Both RAS and mirror therapy programme have been found to improve hand functions and grip in paretic arms; hence they can be used as an add-on intervention alongside convention therapy to help hemi paretic patients regain upper extremity function. Keywords: Rhythmic Auditory stimulation; Mirror box; Paretic arm; Hand function and Hand grip

Application of Multi-Dimensional Intelligent Visual Quantitative Assessment System to Evaluate Hand Function Rehabilitation in Stroke Patients.

Hand dysfunction is one of the main symptoms of stroke patients, but there is still a lack of accurate hand function assessment systems. This study focused on the application of the multi-dimensional intelligent visual quantitative assessment system (MDIVQAS) in the rehabilitation assessment of hand function in stroke patients and evaluate hand function rehabilitation in stroke patients. Eighty-two patients with stroke and unilateral hand dysfunction were evaluated by MDIVQAS. Cronbach's Alpha coefficient was used to assess the internal consistency of MDIVQAS; the F-test is used to assess the differences in MDIVQAS for multiple repeated measures. Spearman's analysis was used to identify correlations of MDIVQAS with other assessment systems. t-tests were used to identify differences in outcomes assessed with MDIVQAS in patients before and after treatment. p &lt; 0.05 were considered significant. (1) Cronbach's Alpha coefficient of MDIVQAS in evaluating hand's function &gt; 0.9. (2) There was no significant difference between the other repeated measurements, except for thumb rotation in MDIVQAS. (3) MDIVQAS had a significant correlation with other assessment systems (r &gt; 0.5, p &lt; 0.01). (4) There were significant differences in the evaluation of hand function in patients before and after treatment using MDIVQAS. The MDIVQAS system has good reliability and validity in the evaluation of stroke hand function, and it can also better evaluate the treatment effect.

Psychometric properties of the Action Research Arm Test using decision rules for skipping items in hemiparetic patients after stroke: a retrospective study

Purpose Important properties have been studied using the Action Research Arm Test (ARAT) in patients with stroke. However, whether the ARAT subtests constitute a Guttman scale (i.e., items hierarchically ordered according to difficulty) remains unclear. Guttman scales can define decision rules for skipping items in patients with low endurance. This study investigated the psychometric properties of the ARAT when applying decision rules for post-stroke hemiparetic patients. Methods A retrospective, single-institution study was conducted between 2020 and 2021. Datasets of 30 patients with stroke-induced hemiparesis were collected from a previous study which employed the ARAT without decision rules, Fugl-Meyer assessment (FMA), Box and Block Test (BBT), and Motor Activity Log (MAL). The ARAT was rescored with decision rules for this study, and inter-rater reliability/agreement, parallel forms reliability, and construct validity were assessed. Results Parallel forms reliability (Spearman’s rho) was 0.99 (95% CI, 0.99–0.99) for both raters. The lower 95% CI limits of the sum and individual item scores in the reliability analysis exceeded the planned value (0.8). Construct validity values exceeded the planned value (0.8) for FMA, BBT, and MAL. Conclusion Decision rules can be used to skip ARAT items when assessing upper extremity motor function in stroke patients. IMPLICATIONS FOR REHABILITATION The Action Research Arm Test with decision rules for skipping items was valid and reliable for measuring upper extremity motor function in hemiparetic patients after stroke. The decision rules may reduce the burden of both patients and evaluators by decreasing the number of Action Research Arm Test items to be administrated.