Post-stroke Hemiplegic Patients Research Articles

Clinical Effect Analysis of Wearable Sensor Technology-Based Gait Function Analysis in Post-Transcranial Magnetic Stimulation Stroke Patients.

(1) Background: This study evaluates the effectiveness of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) in improving gait in post-stroke hemiplegic patients, using wearable sensor technology for objective gait analysis. (2) Methods: A total of 72 stroke patients were randomized into control, sham stimulation, and LF-rTMS groups, with all receiving standard medical treatment. The LF-rTMS group underwent stimulation on the unaffected hemisphere for 6 weeks. Key metrics including the Fugl-Meyer Assessment Lower Extremity (FMA-LE), Berg Balance Scale (BBS), Modified Barthel Index (MBI), and gait parameters were measured before and after treatment. (3) Results: The LF-rTMS group showed significant improvements in the FMA-LE, BBS, MBI, and various gait parameters compared to the control and sham groups (p < 0.05). Specifically, the FMA-LE scores improved by an average of 5 points (from 15 ± 3 to 20 ± 2), the BBS scores increased by 8 points (from 35 ± 5 to 43 ± 4), the MBI scores rose by 10 points (from 50 ± 8 to 60 ± 7), and notable enhancements in gait parameters were observed: the gait cycle time was reduced from 2.05 ± 0.51 s to 1.02 ± 0.11 s, the stride length increased from 0.56 ± 0.04 m to 0.97 ± 0.08 m, and the walking speed improved from 35.95 ± 7.14 cm/s to 75.03 ± 11.36 cm/s (all p < 0.001). No adverse events were reported. The control and sham groups exhibited improvements but were not as significant. (4) Conclusions: LF-rTMS on the unaffected hemisphere significantly enhances lower-limb function, balance, and daily living activities in subacute stroke patients, with the gait parameters showing a notable improvement. Wearable sensor technology proves effective in providing detailed, objective gait analysis, offering valuable insights for clinical applications in stroke rehabilitation.

Longitudinal changes in trunk acceleration and their relationship with gait parameters in post-stroke hemiplegic patients

ObjectiveThe purpose of this study was to examine the longitudinal changes in trunk acceleration, gait speed, and paretic leg motion in patients with post-stroke hemiparesis, the relationships between variables at each time point, and whether initial trunk acceleration and gait parameters were related to gait speed 2 months later. MethodsGait was assessed monthly in patients who could walk under supervision after stroke onset. Gait parameters, including gait speed and trailing limb angle (TLA), were measured. Trunk acceleration was quantified using acceleration root mean square (RMS) and stride regularity (SR) indices. ResultsThis study found statistically significant longitudinal changes in gait speed (p < .001), acceleration RMS of the total axes (p < .001), and SR of the vertical axes (p < .001). Gait speed correlated significantly with the acceleration RMS of the mediolateral (r = −0.815 to −0.901), vertical (r = −0.541 to −0.747), and anteroposterior (r = −0.718 to −0.829) axes, as well as the SR of the vertical axes (r = 0.558 to 0.724) at all time points from T0 to T2. For the TLA, only the acceleration RMS of the mediolateral axis correlated significantly over the entire study period (r = −0.530 to −0.724). In addition, initial TLA correlated significantly with gait speed after 2 months (r = −0.572). ConclusionThis study showed that assessing trunk acceleration helps estimate the improvement in gait status in patients with post-stroke hemiparesis. The magnitude and regularity of trunk acceleration varied longitudinally and were related to gait speed and paretic leg motion at each time point; however, they could not predict future changes in gait speed.

Multidisciplinary team collaboration impact on NGF, BDNF, serum IGF-1, and life quality in patients with hemiplegia after stroke.

This study aimed to study the impact of multidisciplinary team collaboration on NGF, BDNF, serum IGF-1, and life quality in patients with hemiplegia after stroke. For this purpose, 200 post-stroke hemiplegic patients admitted from March 2022 to February 2023 were selected and randomly divided into a control group (100) and an observation group (100). The control group was given routine nursing care, while the observation group was given a multidisciplinary team collaboration model. The neurotroph in [nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1)] and nutritional status [hemoglobin (HGB), serum albumin (ALB), transferrin (TRF)] of patients were compared before and after the intervention on the second day of admission and on the 30th day of intervention. The FUGL Meyer (FM) motor function assessment scale, NIHSS National Institutes of Health Stroke Scale, and the Specialized Quality of Life Scale (SS-QIL) for stroke patients were used to assess limb motor function, balance function, degree of neurological impairment, and life quality. Results showed that before intervention, there was no statistically significant difference in the levels of NGF, BDNF, IGF-1, HGB, ALB, TRF, limb motor function, balance function, neurological deficits, and quality of life scores between the two (P>0.05); After intervention, the levels of NGF, BDNF, IGF-1, HGB, ALB, and TRF in the observation group were significantly higher (P<0.05); The FM and SS-QOL of patients in the observation group were significantly higher (P<0.05); The NIHSS score of patients in the observation group was significantly lower (P<0.05). In conclusion, multidisciplinary team cooperation can significantly improve the level of neurotrophin, reduce the degree of nerve defect, and promote the recovery of limb function, balance function and life quality for stroke patients with hemiplegia.

The Impact of Upper Limb Functioning on Gait Patterns in Individuals with Post-Stroke Hemiplegia

Hemiplegia resulting from a stroke leads to a distinct gait pattern and dysfunction in the upper limb. The objective of this study was to determine a correlation between the functionality of the upper limb and selected spatiotemporal parameters of gait in patients with hemiplegia following a stroke. The study comprised a sample of 80 outpatients (45 males and 35 females) with post-stroke hemiplegia, with an average age of 60.78 years, selected using a convenient sampling method. To assess the functionality of the affected upper limb, the study employed the QuickDASH questionnaire, which is a shortened version of the Disabilities of the Arm, Shoulder, and Hand questionnaire. Concurrently, the participants were recorded on video while performing the 4-meter walk test (4mWT). The recorded videos were meticulously analyzed using Kinovea software (version 0.8.15) to calculate gait parameters such as comfortable and maximum speeds, stride length and time on the paretic and affected side, number of steps taken to cover the 4m, and cadence. Pearson Correlation analysis was conducted to explore potential associations between these gait parameters and the QuickDASH score, with a significance level of p &lt; 0.05.&#x0D; The findings revealed significant correlations between upper limb functionality and selected gait parameters. Reduced upper limb functionality correlated with decreased comfortable speed (p &lt; 0.05), maximum speed (p &lt; 0.05), and cadence (p &lt; 0.05) during the 4mWT. In contrast, impaired upper limb function linked to prolonged time to complete the 4m distance (p &lt; 0.05), increased steps taken by both affected (p &lt; 0.05) and unaffected (p &lt; 0.05) sides, and extended stride time on both sides (p &lt; 0.05). However, no substantial correlation emerged between upper limb functionality and stride length on either side (p &gt; 0.05).&#x0D; In conclusion, this study emphasizes the correlation between upper limb functionality and specific gait parameters in post-stroke hemiplegic patients. The correlation between upper limb functionality and selected spatiotemporal parameters of gait underscores the necessity for integrated rehabilitation strategies targeting both upper limb and gait training. These findings contribute to a deeper comprehension of the connection between upper limb disability and gait parameters, emphasizing the significance of personalized treatments in order to maximize the restoration of functionality in individuals who have suffered a stroke.

A Case Report on Right Hemiparesis after Left Thalamus Infarction Treated with &lt;italic&gt;Boyanghwanoh-tang-gagam&lt;/italic&gt; and Complex Korean Medicine Treatment

Objectives: This study reports the case of a patient with right hemiparesis after a left thalamic infarction, in which the patient experienced improved clinical symptoms (hemiparesis, constipation) after treatment with a complex Korean medicine treatment.Methods: A 81-year-old male patient diagnosed with acute left thalamic infarction was treated with daily acupuncture and herbal medicine (&lt;i&gt;Boyanghwanoh-tang-gagam&lt;/i&gt;) three times a day. &lt;i&gt;Jowiseunggi-tang&lt;/i&gt; extract granules were administered to treat constipation by adjusting the dosage according to the reported symptoms. The patient’s clinical course was assessed using changes in Modified Barthel Index (MBI) score, Manual Muscle Testing (MMT) grade, and defecation frequency .Results: The patient’s MBI score improved from 35 to 69 and was discharged with the ability to walk under supervision. The MMT grade also improved from 3/4 to 5/5 in the upper/lower extremities. Other clinical symptoms, including constipation, also improved, leading to the discontinuation of magnesium medication.Conclusion: These findings suggest that complex Korean medicine treatments, including herbal medicine and acupuncture, may be an effective treatment for post-stroke hemiplegic patients.

Improvement of the motor and functional capacity of post-cerebrovascular accident hemiplegics by exercise retraining combined with a varied exercises program

The study aimed to investigate the effect of exercise retraining combined with a program of varied physical exercises on heart rate, training intensity, aerobic capacity, lower limb strength, and body composition of hemiplegic patient’s post-cerebrovascular accident. This was a 12-week follow-up study, of 30 post-stroke hemiplegic patients aged 18 years and over, who were subjected to an effort retraining program, consisting of walking on a treadmill at a progressive speed of 2.7 to 6 km per hour and a slope of 5 to 12% combined with various transfer exercises, going up and down stairs, on an ergometric bike, balance and limb strengthening thighs, Abdo and Buttocks, lasting 60 minutes per session, 3 times a week and from 40 to 75% progressive of the Maximum Heart Rate. We used the paired Student's t-test to compare continuous variables before and after the programs. A significant increase was obtained in 12 weeks of intervention for most of the parameters: +12 (37 vs 49); p &lt; 0.001 for balance, +1.4 meters per second (1.39 vs 2.79). p &lt; 0.001 for walking speed, +4 degrees (11 vs 15); p &lt; 0.001 for step angle, +32 steps per minute (37 vs 69); p &lt; 0.001 for walking cadence; +213 meters (143 vs. 356); p &lt; 0.001 for the distance covered in six minutes, +3 ml/min/Kg (29 vs 32); p &lt; 0.001 for maximum oxygen consumption and +12% (22 vs 34); p &lt; 0.001 for lean body mass. On the other hand, the time of the Time up and go test, of the walk on the descent and ascent, and the fat mass, was significantly reduced: -14 seconds (55 vs 41), p &lt; 0.003; -16 minutes (67 vs. 51); p &lt; 0.001 and -16 minutes (59 vs 43); p &lt; 0.001 and - 5% (41 vs 36); p

Classification of hemiplegia through gait analysis and machine learning methods

Objective: Gait analysis is a method that is used for understanding normal walking and determining the stage of the disease as it affects&#x0D; walking. It is important to objectively determine the stage of the disease in order to decide interventions and treatment strategies. This&#x0D; study aims to determine the Brunnstrom Stage of the hemiplegic patients with an analysis of gait data.&#x0D; Patients and Methods: In the first part of the study, the gait signal data were taken from 28 post-stroke hemiplegic patients and&#x0D; 7 healthy individuals with three-axis accelerometers. In the second part, new gait data were collected from 15 healthy individuals&#x0D; through an accelerometer on the anteroposterior axis.&#x0D; First the accelerometer signals were decomposed to Daubechies 5 (Db5) level six wavelets using MATLAB software. Subsequently,&#x0D; these attributes were classified through several classifier and machine learning algorithms on WEKA and MATLAB software packages&#x0D; to predict the stages of hemiplegia.&#x0D; Results: The highest accuracy rate in the prediction of hemiplegia stage was achieved with the LogitBoost algorithm on WEKA with&#x0D; 91% for 35 samples, and 90% for 50 samples. This performance was followed by the RUSBoosted Trees algorithm on the MATLAB&#x0D; software with an accuracy of 86.1% correct prediction.&#x0D; Conclusion: The Brunnstrom Stage of hemiplegia can be predicted with machine learning algorithms with a good accuracy, helping&#x0D; physicians to classify hemiplegic patients into correct stages, monitor and manage their rehabilitation.

The relationship of respiratory functions and respiratory muscle strength with trunk control, functional capacity, and functional independence in post-stroke hemiplegic patients.

Cardiorespiratory system involvement and early fatigue observed in stroke patients complicate the rehabilitation process and affect their ability to perform daily activities and functional independence. It was aimed to determine the relationship between respiratory functions and respiratory muscle strength with trunk control, functional capacity, and functional independence in hemiplegic patients after stroke. Twenty-five volunteers who were diagnosed with post-stroke hemiplegia were included in the study. Sociodemographic and physical characteristics were recorded. Pulmonary function test (PFT), respiratory muscle strength, Trunk Impairment Scale (TIS), Timed-Up and Go Test (TUG), and Barthel Index (BI) were applied. There was a moderate negative correlation between TUG scores and PFT results (r=0.413-0.502; p=0.011-0.04), except for PEF (%) and FEV1/FVC. Also, there were statistically significant correlation between TIS scores and FEV1(%) (r=0.505; p=0.012), FVC(%) (r=0.449; p=0.024). On the other hand, there was no statistically significant relationship between BI results and any parameter of the PFT (p>0.05). There was no statistically significant correlation between respiratory muscle strength and TUG, TIS, BI (p>0.05). It has been shown that respiratory functions are associated with functional capacity and trunk control. However, it was found that there was no relationship between respiratory muscle strength and functional capacity, trunk control, and functional independence. It is thought that considering these parameters in the assessment of patients will contribute to the creation of individual and effective rehabilitation programs. The respiratory system should be systematically assessed in stroke rehabilitation and considered as part of a holistic approach. NCT05290649 (retrospectively registered) (clinicaltrials.gov).

Effects of change in walking speed on time-distance parameters in post-stroke hemiplegic gait.

In stroke patients, the assessment of gait ability over time is important. For quantitative gait assessment using measuring devices, the walking speed condition for measurement is generally based on the patient's preferred walking speed or the maximum walking speed at the time of measurement. However, because walking speed often increases during the convalescent stage, understanding the effects of change in walking speed on gait when comparing the course of recovery is necessary. Although several previous studies have reported the effects of change in walking speed on gait in stroke patients, the time-distance parameters described in these reports may not be generalizable because of the small case numbers. Therefore, we measured treadmill gait at the preferred walking speed (PWS) and 1.3 times the PWS (130% PWS) in 43 post-stroke hemiplegic patients and analyzed the effects of change in walking speed on time-distance parameters. Forty-three patients with hemiplegia after a first stroke, who were able to walk on a treadmill under supervision, were recruited as subjects. Using a three-dimensional motion analysis system, treadmill gait was assessed under two conditions: PWS and 130% PWS. The primary outcome measures were the time-distance parameters, which were compared between the PWS and 130% PWS conditions. Cadence, stride length, and step length of the affected and unaffected lower limbs increased significantly at 130% PWS compared with at PWS. In terms of actual time, single stance time and initial and terminal double stance time in both affected and unaffected limbs decreased significantly at 130% PWS. In terms of relative time (% of the gait cycle), compared with PWS, relative single stance time increased significantly, whereas relative initial and terminal double stance times decreased significantly at 130% PWS in both the affected and unaffected limbs. This study on treadmill gait in patients with hemiplegia after a first stroke confirmed the effects of change in walking speed on time-distance parameters. Our results will help in the interpretation of time-distance parameters measured under different walking speed conditions.

Preliminary Assessment of a Flexible Multi-Sensor Wearable System Based on Fiber Bragg Gratings for Respiratory Monitoring of Hemiplegic Patients.

Respiratory diseases are common in post-stroke hemiplegic patients and represent a major social problem as they worsen the quality of life and reduce the life span. As a consequence, being able to monitor respiratory parameters such as the respiratory rate (RR) and assess the presence of respiratory asynchronies could be of paramount importance to define hemiplegics’ health status. Moreover, RR is a useful parameter to investigate the level of fatigue and distress that these patients undergo during rehabilitation processes. Although motion capture systems and flowmeters are the leading instruments for respiratory pattern evaluation, smart wearable systems are gaining ever more acceptance since they allow continuous monitoring by detecting chest wall breathing displacements, ensuring reduced costs and no need for dedicated spaces. Among other sensing technologies, fiber Bragg grating (FBG) sensors have emerged thanks to their high sensitivity to strain, lightness, and multiplexing capability. In this work, a wearable system composed of four flexible dumbbell-shaped sensing modules is proposed for respiratory monitoring in hemiplegic patients. The system is light and easy to wear and can be adapted to any anthropometry thanks to the modular anchoring system. Its feasibility assessment in RR evaluation was performed on seven hemiplegic volunteers in eupnea and tachypnea breathing conditions. In addition, an explorative investigation was conducted to assess the system’s ability to detect asynchronies between torso compartments. The good results suggest that this device could be a useful instrument to support clinicians and operators in hemiplegic patients’ management.

Kinect-Based Assessment of Lower Limbs during Gait in Post-Stroke Hemiplegic Patients: A Narrative Review.

The aim of this review was to present an overview of the state of the art in the use of the Microsoft Kinect camera to assess gait in post-stroke individuals through an analysis of the available literature. In recent years, several studies have explored the potentiality, accuracy, and effectiveness of this 3D optical sensor as an easy-to-use and non-invasive clinical measurement tool for the assessment of gait parameters in several pathologies. Focusing on stroke individuals, some of the available studies aimed to directly assess and characterize their gait patterns. In contrast, other studies focused on the validation of Kinect-based measurements with respect to a gold-standard reference (i.e., optoelectronic systems). However, the nonhomogeneous characteristics of the participants, of the measures, of the methodologies, and of the purposes of the studies make it difficult to adequately compare the results. This leads to uncertainties about the strengths and weaknesses of this technology in this pathological state. The final purpose of this narrative review was to describe and summarize the main features of the available works on gait in the post-stroke population, highlighting similarities and differences in the methodological approach and primary findings, thus facilitating comparisons of the studies as much as possible.

Sensorimotor Responses in Post-Stroke Hemiplegic Patients Modulated by Acupuncture at Yanglingquan (GB34): A fMRI Study Using Intersubject Functional Correlation (ISFC) Analysis.

Motor dysfunction is common in patients with stroke. Acupuncture has become an acceptable alternative method for stroke rehabilitation. Previous studies have shown various functional connectivity changes activated by acupuncture. We introduced intersubject correlation (ISC) and intersubject functional correlation (ISFC) analyses into the functional magnetic resonance imaging (fMRI) for ischemic stroke to seek a common activation and suppression pattern triggered by acupuncture. In this study, 63 ischemic stroke patients with motor dysfunction and 42 normal controls were analyzed. Three functional scans were conducted during the resting state, motor task, and acupuncture at Yanglingquan (GB34) task. Twenty-two sensory, motor, and movement-imagination cortices in the bilateral hemispheres were selected as the region of interest (ROI). We performed ISC and ISFC analyses among these ROIs in three fMRI runs on patients and controls. Subgroup analyses by course or severity were also conducted. The results showed that acupuncture at GB34 triggered ISFC among upper limb motor, upper limb/hand/face, lower limb, tongue/larynx sensory, and movement imagination regions in the patient group. Subgroup ISC and ISFC analyses showed that patients tended to have increasing responses in the early stage of stroke (within 1 month) and decreasing responses afterward (1–3 months). Patients with mild clinical functional damage (NIHSS 2–4) tended to generate more responses via acupuncture than those with moderate damage (NIHSS 5–15). Our findings may help understand the clinical effects and modulatory features of acupuncture based on the group-level post-stroke neuroplasticity.

Time-Varying Effective Connectivity for Describing the Dynamic Brain Networks of Post-stroke Rehabilitation.

Hemiplegia is a common motor dysfunction caused by a stroke. However, the dynamic network mechanism of brain processing information in post-stroke hemiplegic patients has not been revealed when performing motor imagery (MI) tasks. We acquire electroencephalography (EEG) data from healthy subjects and post-stroke hemiplegic patients and use the Fugl-Meyer assessment (FMA) to assess the degree of motor function damage in stroke patients. Time-varying MI networks are constructed using the adaptive directed transfer function (ADTF) method to explore the dynamic network mechanism of MI in post-stroke hemiplegic patients. Finally, correlation analysis has been conducted to study potential relationships between global efficiency and FMA scores. The performance of our proposed method has shown that the brain network pattern of stroke patients does not significantly change from laterality to bilateral symmetry when performing MI recognition. The main change is that the contralateral motor areas of the brain damage and the effective connection between the frontal lobe and the non-motor areas are enhanced, to compensate for motor dysfunction in stroke patients. We also find that there is a correlation between FMA scores and global efficiency. These findings help us better understand the dynamic brain network of patients with post-stroke when processing MI information. The network properties may provide a reliable biomarker for the objective evaluation of the functional rehabilitation diagnosis of stroke patients.

A Wearable System Composed of FBG-Based Soft Sensors for Trunk Compensatory Movements Detection in Post-Stroke Hemiplegic Patients.

In this study, a novel wearable system for the identification of compensatory trunk movements (CTMs) in post-stroke hemiplegic patients is presented. The device is composed of seven soft sensing elements (SSEs) based on fiber Bragg grating (FBG) technology. Each SSE consists of a single FBG encapsulated into a flexible matrix to enhance the sensor’s robustness and improve its compliance with the human body. The FBG’s small size, light weight, multiplexing capability, and biocompatibility make the proposed wearable system suitable for multi-point measurements without any movement restriction. Firstly, its manufacturing process is presented, together with the SSEs’ mechanical characterization to strain. Results of the metrological characterization showed a linear response of each SSE in the operating range. Then, the feasibility assessment of the proposed system is described. In particular, the device’s capability of detecting CTMs was assessed on 10 healthy volunteers and eight hemiplegic patients while performing three tasks which are representative of typical everyday life actions. The wearable system showed good potential in detecting CTMs. This promising result may foster the use of the proposed device on post-stroke patients, aiming at assessing the proper course of the rehabilitation process both in clinical and domestic settings. Moreover, its use may aid in defining tailored strategies to improve post-stoke patients’ motor recovery and quality of life.

Cutoff Knee Extensor Strength as a Determinant for Walking Independence in Post-stroke Hemiplegic Patients in Convalescent Rehabilitation Wards

Cutoff Knee Extensor Strength as a Determinant for Walking Independence in Post-stroke Hemiplegic Patients in Convalescent Rehabilitation Wards

Trunk Movement Characteristics of Post-stroke Hemiplegic Patients at Gait Initiation

Trunk Movement Characteristics of Post-stroke Hemiplegic Patients at Gait Initiation

The time-varying networks of the wrist extension in post-stroke hemiplegic patients.

The online version contains supplementary material available at 10.1007/s11571-021-09738-2.

Functional Muscle Network in Post-stroke Patients during Quiet Standing.

The overall muscle activation of post-stroke patients during standing has not been well understood. Functional muscle network provides a tool to quantify the functional synchronization across a large number of muscles. In order to investigating the functional muscle network of stroke survivors during quiet standing, we recruited 8 post-stroke hemiplegic patients and required them to stand still for 30 s with eyes open and closed. Surface electromyography signals were recorded from 16 muscles in abdomen, buttocks and lower limbs. The functional muscle networks of paretic side and healthy side were built by multiplex recurrence network approach. The topological characteristics of functional muscle network was quantified by parameters of multiplex network and weighted network. The results showed that the dynamical similarities of muscles on paretic side were reduced, and the dynamical connections of muscles on paretic side were weakened. Without visual feedback, the muscles activated in a more similar mode. The stroke led to lower synchronization of the muscle activation, and decreased efficiency of information transmission between muscles. When subjects stood with eyes closed, the muscles activated in a more deterministic pattern. The research opens new horizons to detect the overall muscle activation when stroke patients stand quietly, and can provide a theoretical basis for understanding the motor dysfunction caused by stroke.

EFFECT OF VIBRATION STIMULUS ON SPASTICITY IN POST STROKE HEMIPLEGIC PATIENTS

Physical treatment such as vibration has been proposed as possible non-pharmacological way to control spasticity. The aim of the study was 1) can a selective vibration of the lower limb Dorsiexors of foot and quadriceps, reduce the spasticity of the plantar exors and hamstrings muscle; 2) is vibrations association with physiotherapy better than physiotherapy alone in reducing spasticity. This was a Pre Post study design wherein all the patients were taken from OPD in Govt. Medical College &amp; Hospital, Sector 32 Chandigarh, India. Atotal of Sixty post stroke hemiplegic patients were taken for the study. Method. (VIB + PT) group A received physiotherapy plus vibration by means of a hand held vibrator applied over the belly of the Dorsiexors of leg and belly of Quadriceps muscle of the spastic side (contact surface 2 cm2; frequency 100 Hz; amplitude 2 mm; mean pressure 250 mBar). Control group B received conventional physiotherapy treatment alone. Both groups had 45 minutes of physiotherapy including Bobath therapy, muscle lengthening stretching exercises for 5 days a week for 2 weeks.Main Outcome Measure was Spasticity measurement by Modied Ashworth scale for both the groups before starting treatment and after the end of 2 weeks. Results: Fisher's exact test showed a statistically non signicant improvements in the (VIB + PT) group (p≥0.05) compared to in the (PT) group after 2 weeks of treatment for the Modied Ashworth scale. AlthoughStuart Maxwell Test showed that there was a statistically signicant difference within Group A i.e. Vibration plus Conventional physiotherapy with (p≤0.05) Conclusion. 1) 100 Hz vibration applied to the Dorsiexors of foot and Quadriceps muscle of a spastic lower limb in association with physiotherapy is able to reduce the spasticity of the exor agonist i.e. plantar exors and hamstrings 2) this association is not better than physiotherapy alone in controlling spasticity. Clinical Rehabilitation Impact :100 Hz antagonist muscle vibration, a non-pharmacological treatment, can help physiotherapy to reduce exors spasticity in the rehabilitation of lower limb spasticity.

DNN-Based FES Control for Gait Rehabilitation of Hemiplegic Patients

In this study, we proposed a novel machine-learning-based functional electrical stimulation (FES) control algorithm to enhance gait rehabilitation in post-stroke hemiplegic patients. The electrical stimulation of the muscles on the paretic side was controlled via deep neural networks, which were trained using muscle activity data from healthy people during gait. The performance of the developed system in comparison with that of a conventional FES control method was tested with healthy human subjects.