Motor Function In Hemiplegic Patients Research Articles

Effects of motor imagery-based brain-computer interface-controlled electrical stimulation on lower limb function in hemiplegic patients in the acute phase of stroke: a randomized controlled study.

Lower limb motor dysfunction is one of the most serious consequences of stroke; however, there is insufficient evidence for optimal rehabilitation strategies. Improving lower limb motor function through effective rehabilitation strategies is a top priority for stroke patients. Neuroplasticity is a key factor in the recovery of motor function. The extent to which neuroplasticity-based rehabilitation therapy using brain-computer interface (BCI) is effective in treating lower limb motor dysfunction in acute ischemic stroke patients has not been extensively investigated. This study aimed to assess the impact of BCI rehabilitation on lower limb motor dysfunction in individuals with acute ischemic stroke by evaluating motor function, walking ability, and daily living activities. This study was conducted in a randomized controlled trial, involving 64 patients with acute ischemic stroke who experienced lower limb motor dysfunction. All patients were divided into two groups, with 32 patients assigned to the control group was given conventional rehabilitation once a day for 70 min, 5 times a week for 2 weeks, and the experimental group (n = 32) was given BCI rehabilitation on top of the conventional rehabilitation for 1 h a day, 30 min of therapy in the morning and an additional 30 min in the afternoon, for a total of 20 sessions over a two-week period. The primary outcome was lower extremity motor function, which was assessed using the lower extremity portion of the Fugl-Meyer Rating Scale (FMA-LE), and the secondary endpoints were the Functional Ambulation Scale (FAC), and the Modified Barthel index (MBI). After 20 sessions of treatment, both groups improved in motor function, walking function, and activities of daily living, and the improvements in FMA-LE scores (p < 0.001), FAC (p = 0.031), and MBI (p < 0.001) were more pronounced in the experimental group compared with the control group. Conventional rehabilitation therapy combined with BCI rehabilitation therapy can improve the lower limb motor function of hemiplegic patients with stroke, enhance the patient's ability to perform activities of daily living, and promote the improvement of walking function, this is an effective rehabilitation policy to promote recovery from lower extremity motor function disorders.

Effectiveness of Conventional Exercise on Motor Functions among Patients with Hemiparesis Admitted in Selected Hospital

Background : Hemiparesis is the weakness or inability to move one side of the body, making daily activities difficult. Motor activity (from daily activity) - All activities produced by stimulation of motor neurons, including activity in the gland, as well as activity of body and muscle complaints (American Psychiatric Association). Aim: Effectiveness of conventional exercise on motor functions among patients with hemiparesis admitted in selected hospital, Salem, Tamilnadu. Design: The research design used for the present study was Quasi – experimental design. Participants: 30 hemiplegic patients who met the inclusion criteria were selected by purposive sampling technique. Selection criteria: INCLUSION CRITERIA: patients with hemiparesis =&gt; Age group 40 and 70 years, Illness for the duration of less than 2 years,present during the period of data collection, have normal cognitive function,willing to participate in the study, able to understand Tamil or English. Results: The results showed that the average motor test score of the hemiplegic patients in the control group was 24.45 ± 1.42, and the average score of the experimental group was 18.21 ± 1.85. Result: Regular exercise appears to be effective in improving motor function in patients with hemiplegia. Paired t test and unpaired t test showed that regular exercise had an effect on motor function in hemiplegic patients. Conclusion: According to the results of the study, daily exercise appears to be effective in improving motor function in patients with hemiplegia, regardless of demographic differences.

Verification of Criterion-Related Validity for Developing a Markerless Hand Tracking Device.

Physicians, physical therapists, and occupational therapists have traditionally assessed hand motor function in hemiplegic patients but often struggle to evaluate complex hand movements. To address this issue, in 2019, we developed Fahrenheit, a device and algorithm that uses infrared camera image processing to estimate hand paralysis. However, due to Fahrenheit's dependency on specialized equipment, we conceived a simpler solution: developing a smartphone app that integrates MediaPipe. The objective of this study was to measure hand movements in stroke patients using both MediaPipe and Fahrenheit and to assess their criterion-related validity. The analysis revealed moderate-to-high correlations between the two methods. Consistent results were also observed in the peak angle and velocity comparisons across the severity stages. Because Fahrenheit determines finger recovery status based on these measures, it has the potential to transfer this function to MediaPipe. This study highlighted the potential use of MediaPipe in paralysis estimation applications.

B-FMEA-TRIZ model for scheme decision in conceptual product design: A study on upper-limb hemiplegia rehabilitation exoskeleton

Upper-limb rehabilitation devices are essential in restoring and improving the motor function of hemiplegic patients. However, developing a product design that meets the needs of users is challenging. Current design tools and methods suffer from limitations such as a single model, poor synergy between integrated models, and subjective bias in analysing user needs and translating them into product attributes. To address these issues, this study proposes a new structural design decision-making model based on Behaviour Analysis (B), Failure Mode Effect Analysis (FMEA), and Teoriya Resheniya Izobreatatelskikh Zadatch (TRIZ theory). The model was developed and applied to design an upper-limb rehabilitation exoskeleton for hemiplegia. In this paper, an empirical investigation was conducted in several rehabilitation hospitals in Xuzhou City and used user journey mapping to identify potential failure points in the behaviour process. Then, the fault models were ranked according to the Fuzzy Risk Priority Number (FRPN) calculated by FMEA and used TRIZ theory to determine principles for resolving contradictions and generating creative design solutions for the product. By integrating B, FMEA, and TRIZ theory, it eliminated subjective bias in product design, improved the design decision-making process, and provided new methods and ideas for designing assistive rehabilitation devices and similar products. The framework of the proposed approach can be used in other contexts to develop effective and precise product designs that meet the needs of users.

Quantitative assessment of thenar to evaluate hand function after stroke by Bayes discriminant

BackgroundThe incidence rate of stroke or cerebrovascular accidents ranks first in China. More than 85% of stroke patients have residual upper limb motor dysfunction, especially hand dysfunction. Normalizing the rehabilitation evaluation process and standard quantitative evaluation method is a complex and key point in rehabilitation therapy. The study aimed to establish a function model based on the Bayes discriminant by measuring the thenar stiffness with shear wave elastography (SWE) to quantitatively evaluate the hand motor function of hemiplegic patients after stroke.MethodsThis study collected 60 patients diagnosed with hemiplegia after stroke from October 2021 to October 2022. Therapists used the Brunnstrom assessment (BA)scale to divide the patients into the stage. All the patients underwent the measurement of SWE examination of abductor pollicis brevis (APB), opponens pollicis (OP), flexor pollicis long tendon (FPLT), and flexor pollicis brevis (FPB) by two sonographers. The SWE change rate of four parts of the thenar area was calculated prospectively with the non-hemiplegic side as the reference, the function equation was established by the Bayes discriminant method, and the evaluation model was fitted according to the acquired training set data. Lastly, the model was verified by self-validation, cross-validation, and external data validation methods. The classification performance was evaluated regarding the area under the ROC curve (AUC), sensitivity, and specificity.ResultsThe median SWE values of the hemiplegic side of patients were lower than those of the non-hemiplegic side. According to the BA stage and SWER of APB, OP, FPLT, and FPB, our study established the Bayes discriminative model and validated it via self-validation and cross-validation methods. Then, the discriminant equation was used to validate 18 patients prospectively, the diagnostic coincidence rate was about 78.8%, and the misjudgment rate was approximately 21.2%. The AUC of the discriminant model for diagnosing BA stage I-VI was 0.928(95% CI: 0.839-1.0),0.858(95% CI: 0.748–0.969),1.0(95% CI: 1.0–1.0), 0.777(95% CI: 0.599–0.954),0.785(95% CI: 0.593–0.977) and 0.985(95% CI: 0.959-1.0), respectively.ConclusionThis Bayes discriminant model built by measuring thenar stiffness was of diagnostic value and can provide an objective basis for evaluating clinical rehabilitation.

The effects of dynamic motion instability system training on motor function and balance after stroke: A randomized trial.

The balance and postural control of humans is related to the coordination of dynamic perception and movement. Multiple senses, such as vision, vestibular sense, proprioception, and/or a single sensory disorder, would lead to its integration disorder and induce imbalance and abnormal gait. The present study aimed to determine the effects of dynamic motion instability system training (DMIST) on the balance and motor function of hemiplegic patients after stroke. In this assessor-blinded, randomized controlled trial, the participants allocated to the intervention group (n = 20) received 30 minutes of conventional treatment and 20 minutes of DMIST training. Participants randomized to the control group (n = 20) received the same dose of conventional therapy and 20 minutes of general balance training. Rehabilitation was performed 5 times per week for 8 weeks. The primary outcome was the Fugl-Meyer assessment for the lower extremity (FMA-LE), and the secondary outcomes were the Berg balance scale (BBS) and gait function. Data were collected at baseline and immediately after the intervention. After 8 weeks (t1), both groups showed significant post-intervention improvements in BBS, FMA-LE, gait speed and stride length (P < 0.05); there were significant positive correlations between the increase in FMA-LE and gait speed and stride length. Compared with the control group, the DMIST group showed significant post-intervention improvements in FMA-LE, gait speed and stride length (P < 0.05). However, no significant differences between the groups were found over time with respect to BBS (P > 0.05). The experiences of patients with DMIST were positive, and no serious adverse events were related to the interventions. Supervised DMIST could be highly effective in treating lower-limb motor function in patients with stroke. Frequent (weekly) and medium-term (8 weeks) dynamic motion instability-guided interventions might be highly effective in enhancing motor function, and subsequently improving gait in stroke patients.

Mechanical digit sensory stimulation: a randomized control trial on neurological and motor recovery in acute stroke.

Mechanical digit sensory stimulation (MDSS) is a novel therapy designed to accelerate the recovery of upper limb (including hand) function in patients with hemiplegia following a stroke. The primary goal of this study was to investigate the effect of MDSS on patients with acute ischemic stroke (AIS). Sixty-one inpatients with AIS were randomly divided into conventional rehabilitation group (RG) and stimulation group (SG), and the latter group received MDSS therapy. A healthy group consisting of 30 healthy adults was also included. The interleukin-17A (IL-17A), vascular endothelial growth factor A (VEGF-A), and tumor necrosis factor-alpha (TNF-α) plasma levels were measured in all subjects. The neurological and motor functions of patients were evaluated using the National Institutes of Health Stroke Scale (NIHSS), Mini-Mental State Examination (MMSE), Fugel-Meyer Assessment (FMA), and Modified Barthel Index (MBI). After 12 days of intervention, the IL-17A, TNF-α, and NIHSS levels were significantly decreased, while the VEGF-A, MMSE, FMA, and MBI levels were significantly increased in both disease groups. No significant difference was observed between both disease groups after intervention. The levels of IL-17A and TNF-α were positively correlated with NIHSS but negatively correlated with MMSE, FMA, and MBI. The VEGF-A levels were negatively correlated with NIHSS but positively correlated with MMSE, FMA, and MBI. Both MDSS and conventional rehabilitation significantly reduce the production of IL-17A and TNF-α, increase the VEGF-A levels, and effectively improve cognition and motor function of hemiplegic patients with AIS, and the effects of MDSS and conventional rehabilitation are comparable.

Therapeutic Effectiveness of Mirror Therapy Combined with Music Therapy on Upper Limb Motor Function in Hemiplegic Patients with Stroke

Therapeutic Effectiveness of Mirror Therapy Combined with Music Therapy on Upper Limb Motor Function in Hemiplegic Patients with Stroke

INFLUÊNCIAS DA ENFERMAGEM NA RECUPERAÇÃO DA FUNÇÃO MOTORA EM PACIENTES COM HEMIPLEGIA PÓS-AVE

ABSTRACT Introduction: The motor function of the lower limbs is of great importance for the recovery of hemiplegics post stroke. Objective: Study the influence of nursing during motor rehabilitation on the recovery of lower limb motor function in patients with hemiplegia after stroke. Methods: In this study, the 28 patients were treated with nursing intervention for motor rehabilitation in the experimental group, while the control group was treated only with a conventional rehabilitation program, and the results were compared before and after the experiment. Results: After eight weeks of the experiment, the FMA-LE scale score in the experimental group increased from 19.65 to 30.51; the TUGT assessment score increased from 38.45s to 28.61s; the FAC rating test was upgraded from 1.86 to 2.98. The maximum weight percentage on the hemiplegic side increased from 27.54±10.14% to 79.51±7.52%; the fastest 5m return speed increased from 0.22±0.03m/s to 0.54±0.07m/s. The improvement effect was less evident in the control group. Conclusion: Rehabilitation nursing promotes a positive effect on improving lower limb motor function in hemiplegic patients. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

A novel functional electrical stimulation-control system for restoring motor function of post-stroke hemiplegic patients.

Hemiparesis is one of the most common consequences of stroke. Advanced rehabilitation techniques are essential for restoring motor function in hemiplegic patients. Functional electrical stimulation applied to the affected limb based on myoelectric signal from the unaffected limb is a promising therapy for hemiplegia. In this study, we developed a prototype system for evaluating this novel functional electrical stimulation-control strategy. Based on surface electromyography and a vector machine model, a self-administered, multi-movement, force-modulation functional electrical stimulation-prototype system for hemiplegia was implemented. This paper discusses the hardware design, the algorithm of the system, and key points of the self-oscillation-prone system. The experimental results demonstrate the feasibility of the prototype system for further clinical trials, which is being conducted to evaluate the efficacy of the proposed rehabilitation technique.

Effects of rehabilitation robot for lower-limb on motor function in hemiplegic patients after stroke

To explore the effects of rehabilitation robot for lower-limb on motor function in hemiplegic patients after stroke. Forty-eight hemiplegic patients were divided randomly into treatment (n = 24) and control (n = 24) group. The neuro-facilitation technique was applied for both groups. But the treatment group had also rehabilitation robot for lower-limb training of 10 - 20 min/d, 6 d/week for 8 weeks. All patients were assessed with the Fugl-Meyer lower limb (FMA), 10 m maximum walking speed (MWS), function ambulation category (FAC) classification and the modified Barthel index (MBI)at the time of beginning and 8 weeks later. Prior to intervention, no significant differences in any parameter existed between two groups. Eight weeks later, all assessment scores of FMA (25.7 ± 3.5), MWS (52 ± 16), FAC (4.3 ± 1.4) and MBI (82 + 17) were significantly better in the treatment group than those FMA (22.8 ± 3.7), MWS (40 ± 17), FAC (3.4 ± 1.3) and MBI (72 ± 14) in the control group. The application of rehabilitation robot for lower-limb may markedly improve the motor function of lower limb, walking ability and activity of daily living.

Validation of the Effect of Aquatic Exercise Program Designed to Improve Motor Function of Hemiplegic Patients

Validation of the Effect of Aquatic Exercise Program Designed to Improve Motor Function of Hemiplegic Patients

Visuo-motor learning with combination of different rates of motor imagery and physical practice

Sports psychology suggests that mental rehearsal facilitates physical practice in athletes and clinical rehabilitation attempts to use mental rehearsal to restore motor function in hemiplegic patients. Our aim was to examine whether mental rehearsal is equivalent to physical learning, and to determine the optimal proportions of real execution and rehearsal. Subjects were asked to grasp an object and insert it into an adapted slot. One group (G0) practiced the task only by physical execution (240 trials); three groups imagined performing the task in different rates of trials (25%, G25; 50%, G50; 75%, G75), and physically executed movements for the remaining trials; a fourth, control group imagined a visual rotation task in 75% of the trials and then performed the same motor task as the others groups. Movement time (MT) was compared for the first and last physical trials, together with other key trials, across groups. All groups learned, suggesting that mental rehearsal is equivalent to physical motor learning. More importantly, when subjects rehearsed the task for large numbers of trials (G50 and G75), the MT of the first executed trial was significantly shorter than the first executed trial in the physical group (G0), indicating that mental practice is better than no practice at all. Comparison of the first executed trial in G25, G50 and G75 with the corresponding trials in G0 (61, 121 and 181 trials), showed equivalence between mental and physical practice. At the end of training, the performance was much better with high rates of mental practice (G50/G75) compared to physical practice alone (G0), especially when the task was difficult. These findings confirm that mental rehearsal can be beneficial for motor learning and suggest that imagery might be used to supplement or partly replace physical practice in clinical rehabilitation.