Therapy In Rehabilitation Of Stroke Patients Research Articles

Active Rehabilitation Gloves Based on Brain-Computer Interfaces and Deep Learning

Cerebral stroke is the second leading cause of death and the third leading cause of death and disability in the world, and more than half of these patients have hand dysfunction, making hand rehabilitation an urgent challenge. In this study, a system for hand rehabilitation therapy for stroke patients was designed using novel human-computer interaction technology. The system combines a brain-computer interface, a deep learning algorithm and a rehabilitation glove, and designs an electroencephalogram (EEG) signal acquisition card and a rehabilitation glove to realise the application of motor imagery therapy to the active rehabilitation of patients' hands. On the brain-computer interface-based motor imagery experiments, the Long Short Term Memory (LSTM) recurrent neural network algorithm designed in this study achieves an average accuracy of 95.78% for the classification accuracy of mental tasks in seven motor imagery modes, which is important for the active rehabilitation of patients with hand function based on motor imagery-driven rehabilitation.

Abstract WMP14: Status And Influencing Factors Of Rehabilitation Exercise Compliance In Young And Middle-aged Patients With Hemorrhagic Stroke Based On The Hapa Model: A Multi-center Cross-sectional Survey

Background and Purpose: Exercise rehabilitation is the preferred rehabilitation therapy for stroke patients, but exercise compliance of patients is generally low. The study aimed to investigate and analyze the status and influencing factors of rehabilitation exercise compliance in young and middle-aged patients with hemorrhagic stroke. Methods: Convenience sampling method was adopted to select 397 young and middle-aged hemorrhagic stroke patients from three hospitals in central, eastern and northern China from July 2021 to January 2022 in accordance with the geographical classification standards of the National Bureau of Statistics and multi-center research cooperation. According to the Health Action Process Approach(HAPA), the general data survey scale, stroke functional exercise compliance Scale, exercise self-efficacy scale, exercise plan scale, stroke health belief scale and self-care ability scale were used for cross-sectional investigation. Results: The total score of exercise compliance in young and middle-aged stroke patients was (43.46±9.58), and the average compliance rate was 77.60%, which was in the middle level. Multivariate regression analysis showed that total score of exercise self-efficacy, total score of exercise program, perceived susceptibility, perceived severity, perceived benefit, perceived obstacle, health motivation and self-efficacy were the influencing factors of exercise compliance in young and middle-aged stroke patients ( P < 0.05). Conclusions: According to the HAPA model, clinical medical staff should accurately evaluate the rehabilitation exercise stage of patients, and formulate and implement stroke rehabilitation exercise strategies according to the actual situation of patients and various possible influencing factors, so as to improve the exercise compliance of patients, improve their functional status, and further improve their quality of life.

Predicting Individual Treatment Response to rTMS for Motor Recovery After Stroke: A Review and the CanStim Perspective.

BackgroundRehabilitation is critical for reducing stroke-related disability and improving quality-of-life post-stroke. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation technique used as stand-alone or adjunct treatment to physiotherapy, may be of benefit for motor recovery in subgroups of stroke patients. The Canadian Platform for Trials in Non-Invasive Brain Stimulation (CanStim) seeks to advance the use of these techniques to improve post-stroke recovery through clinical trials and pre-clinical studies using standardized research protocols. Here, we review existing clinical trials for demographic, clinical, and neurobiological factors which may predict treatment response to identify knowledge gaps which need to be addressed before implementing these parameters for patient stratification in clinical trial protocols.ObjectiveTo provide a review of clinical rTMS trials of stroke recovery identifying factors associated with rTMS response in stroke patients with motor deficits and develop research perspectives for pre-clinical and clinical studies.MethodsA literature search was performed in PubMed, using the Boolean search terms stroke AND repetitive transcranial magnetic stimulation OR rTMS AND motor for studies investigating the use of rTMS for motor recovery in stroke patients at any recovery phase. A total of 1,676 articles were screened by two blinded raters, with 26 papers identified for inclusion in this review.ResultsMultiple possible factors associated with rTMS response were identified, including stroke location, cortical thickness, brain-derived neurotrophic factor (BDNF) genotype, initial stroke severity, and several imaging and clinical factors associated with a relatively preserved functional motor network of the ipsilesional hemisphere. Age, sex, and time post-stroke were generally not related to rTMS response. Factors associated with greater response were identified in studies of both excitatory ipsilesional and inhibitory contralesional rTMS. Heterogeneous study designs and contradictory data exemplify the need for greater protocol standardization and high-quality controlled trials.ConclusionClinical, brain structural and neurobiological factors have been identified as potential predictors for rTMS response in stroke patients with motor impairment. These factors can inform the design of future clinical trials, before being considered for optimization of individual rehabilitation therapy for stroke patients. Pre-clinical models for stroke recovery, specifically developed in a clinical context, may accelerate this process.

Longitudinal Impact of Community-Based Rehabilitation Programs on Functional Recovery After Stroke: A Scoping Review

The purpose of this scoping review is to guide the effects of long-term application of CBRP in stroke patients and to help make recommendations for developing treatment protocols for therapeutic application. The study examined relevant literature published between 2009 and 2020 using searches of 4 scientific databases. CBRP may have long-term effects on the functional effectiveness of stroke patients. In particular, long-term effects on walking ability and level of daily living activities have been identified. However, disease-related health conditions and quality of life were less effective in the long run. The effect decreased over time, but the long-term effect was maintained. Long-term intervention after discharge has proven to make a significant difference in the outcome of the goal. Given the potential therapeutic benefits of this process, the results of this review highlight the lack of further research to establish the effectiveness of this form of community-based long-term rehabilitation therapy for stroke patients.

EFFECTIVITY OF NINTENDO WII AS REHABILITATION THERAPY IN POST STROKE PATIENTS: A SYSTEMATIC REVIEW

Post stroke patients need medical rehabilitation to live an independent life. Nintendo Wii technology presents an alternative choice that is quite safe, feasible, and has a high potential in rehabilitating & restoring motor function in post stroke patients. Although it has been widely used as adjunct therapy in stroke rehabilitation facilities throughout the world, only a few acknowledge its effectivity in post-stroke patients. This study aims to conduct a systematic review in order to identify and assess the results used in evaluating Nintendo Wii technology as rehabilitation therapy for stroke patients. Thus, the study used for this research is systematic review. Materials included in this study are research/studies found in NCBI, PubMed, Cochrane and other relevant online databases. From this research, it is found that Virtual Reality (VR) such as Nintendo Wii considered as an additional rehabilitation therapy that provides a significant improvement in various aspects of exercise therapy, such as; balance; walking ability; statistical and dynamic strengths; motivation as well as socialization; and recovery of physical function in stroke patients. Nintendo Wii can also be used safely in stroke patients and there have been no reports of side effects from this therapy.

Dual-Wavelength Laser Speckle Contrast Imaging (dwLSCI) Improves Chronic Measurement of Superficial Blood Flow in Hands

Laser speckle contrast imaging (LSCI) has been widely used to determine blood flow and perfusion in biological tissues. The physical model of traditional LSCI ignores the effects of scattering property distribution in relation to speckle correlation time τc and blood flow v, which further results in biased estimation. In this study, we developed a dual-wavelength laser speckle contrast imaging (dwLSCI) method and a portable device for imaging the blood flow and tissue perfusion in human hands. Experimental data showed that dwLSCI could retrieve the vein vasculatures under the surface skin, and it further provided accurate measurements of vein blood flow signals, tissue perfusion signals, and fingertip perfusion signals, which assist with assessments of rehabilitation therapy for stroke patients. Fingertip perfusion signals demonstrated better performance in early assessments, while vein blood flow signals assisted the Fugl–Meyer Assessment Scale (FMA) and the Wolf Motor Function Test (WMFT) behavior assessments. As a general noninvasive imaging method, dwLSCI can be applied in clinical studies related to hand functions combined with behavior assessments.

Post-Stroke Rehabilitation: Importance of Neuroplasticity and Sensorimotor Integration Processes

Questions of the neurorehabilitation of strokes patients are addressed. The importance of the phenomenon of neuroplasticity, which underlies recovery processes after brain lesions, is emphasized. Particular attention is paid to the question of sensorimotor integration in health and CNS pathology, as well as to the role of afferentation in the processes underlying the recovery of motor impairments. The principles of rehabilitation therapy for stroke patients are discussed.

Exercise intensity criteria for routine rehabilitation therapy for stroke patients.

[Purpose] The aim of this study was to observe the relationships among heart rate, rate of perceived exertion, and oxygen consumption in stroke patients and the effectiveness of improving aerobic capacity during routine rehabilitation therapy. [Subjects and Methods] Thirty-six stroke patients participated in the study. A K4b2 pulmonary function device was used to record heart rate (beats per minute), oxygen consumption (Equation Section (Next)ml·min−1·kg−1), and rate of perceived exertion. Results were recorded after completing the following activities continuously: (1) silent sitting, (2) sit-to-stand transfers, (3) hip extension while standing against a wall, (4) weight loading on the affected leg, (5) upward and downward leg movements on a stall bar, (6) walking up and down a flight of stairs, and (7) a 60-meter walk. Correlation analyses were performed to demonstrate the relationship of oxygen consumption with HR and RPE. [Results] Moderate correlation was found between HR and oxygen consumption, and low correlation was found between rate of perceived exertion and oxygen consumption. The routine rehabilitation therapy could reduce the accumulation of lactate. [Conclusion] HR is a better index than rate of perceived exertion in evaluating exercise intensity in stroke patients. The routine rehabilitation therapy can improve the aerobic capacity of stroke patients.

Hand usage and inter-limb coordination parameters for the bimanual rapid visuomotor task to quantify sensorimotor dysfunction of participants with stroke

Clinical assessment provides a foundation for all aspects of patient care, assisting diagnosis, prognosis and overall patient care. Stroke can impact a broad range of sensory, motor and cognitive functions, but existing assessment tools tend to be largely subjective in nature and use relatively course rating systems. Thus, in practice the majority of stroke patients follow the same general rehabilitation program, which may not necessarily be optimal for each individual case. The major goal of this research is to develop advanced technologies that provide objective and accurate measurements of stroke-caused impairments and aid clinicians in the planning of individual rehabilitation therapy for stroke patients. The key technology in this research is a KINARM (Kinesiological Instrument for Normal and Altered Reaching Movements) robot that allows for the collection of quantitative measurements of upper limb movements of a subject performing a particular task [1]. The apparatus permits planar movements of the upper limb in concert with a 2D virtual reality system that displays hand position and targets in the horizontal workspace. This abstract presents a technique for the evaluation of stroke impairment using statistical and time series analysis of the data collected with the KINARM robot. The data were collected from 154 stroke (91 left- and 63 right-affected) and 262 control participants. Each subject completed a bimanual object hit task. In this task participants are instructed to use their right and left hands (represented as green paddles) to hit red balls that move towards the participant. At the beginning of the task, only one ball is displayed and moves relatively slowly, but the number and speed of the balls progressively increases. In addition to completing this object hit task, each stroke participant underwent a standardized clinical stroke assessment. The data were analyzed and different parameters were extracted that characterize task performance, hand usage motion and ability to multitask. Some of the collected data, such as hand trajectories and hand speed, was represented as time series. Time series and special statistical analyses were performed to develop parameters that quantify whether a specific stroke participant is significantly different from healthy controls. The parameters, taken individually, identified between 14% - 67% of right-side affected and 24% - 88% of the left-affected stroke participants as different from controls. In addition, the parameters allowed to differentiate between spatial and motor deficits in stroke participants. Patients with visuospatial neglect (n = 34) showed greater deficits for some parameters then other stroke participants. Finally, the parameters had significant correlations with collected clinical scores (Functional Independence Measure (FIM), Montreal Cognitive Assessment (MoCA) and Behavioural Inattention Test (BIT)).