Rehabilitation Of Stroke Patients Research Articles

Nature-Based Design in Stroke Rehabilitation Environments: A Scoping Review.

To identify, examine, and map the characteristics of knowledge of nature-based design in stroke rehabilitation facilities, examine how research in this field has been conducted and identify gaps in knowledge. Many stroke survivors have wide ranging impacts, resulting in long hospital stays to undertake rehabilitation. The physical environment can influence brain recovery; however, there is limited evidence to support the design of effective rehabilitation environments. Conversely, the health benefits available from connection with nature are well established. A nature-based design approach may have benefits and implications for the physical environment of inpatient stroke rehabilitation facilities; however, it is unclear what evidence exists in this field. This scoping review followed the JBI methodological guidance for the conduct of scoping reviews, with systematic searches of six databases. Twenty-eight studies were included in the review. Aims and research methods varied widely. Investigations in 19 studies related to gardens and other designed outdoor nature-based environments. Other studies explored natural analogues, nature inside, inside/outside connections, and the natural environment. Findings from the studies were spread across the fields of design, use, exposure to, and engagement in nature-based environments. The characteristics of knowledge underpinning nature-based design in stroke rehabilitation environments are highly diverse, and significant gaps exist in the evidence base. A framework developed during this review for mapping knowledge on the intentions and impacts for spaces and services in this field assisted to identify these gaps and may be applied to other areas of healthcare design research.

Predictors of Spasticity 3-6 Months Post Stroke: A 5-Year Retrospective Cohort Study.

To identify predictors of post stroke spasticity (PSS; modified Ashworth Scale scores, mAS ≥1) at 3-6 months post stroke. A 5-year (2015-2020) retrospective cohort of patients who attended inpatient stroke rehabilitation in Southwestern Ontario, Canada were included. Sociodemographic, clinical, stroke-related, rehabilitation-related, and outcome measure data were extracted from paper charts and electronic databases. Of the 922 individuals attending inpatient stroke rehabilitation, 606 (55.8% males; mean age = 70.9 ± 14.2 years) returned for an outpatient visit. Most patients had a first ever (n = 518; 85.5%), ischemic (n = 470; 77.6%) stroke with hemiplegia (n = 449, 74.1%). A total of 20.3% (N = 122) of patients had developed PSS by 4 months post stroke. A binary logistic regression significantly predicted PSS (χ2(6) = 111.696, p < .0001) with good model fit (χ2(8) = 12.181, p = .143). There were six significant PSS predictors: hemorrhagic stroke (p = .049), younger age (p < .001), family history of stroke (p = .015), Functional Independence Measure admission score (p < .001), use of SSRIs p = .044), and hemiplegia (p < .001). Patients should be monitored closely for PSS after discharge from stroke rehabilitation and throughout the care continuum.

Enabling temporal–spectral decoding in multi-class single-side upper limb classification

This manuscript presents a novel approach for decoding pre-movement patterns from brain signals using a two-stage-training temporal–spectral neural network (TTSNet). The TTSNet employs a combination of filter bank task-related component analysis (FBTRCA) and convolutional neural network (CNN) techniques to enhance the classification of single-upper limb movements in non-invasive brain–computer interfaces (BCIs).In our previous work, we introduced the FBTRCA method which utilized filter banks and spatial filters to handle spectral and spatial information, respectively. However, we observed limitations in the temporal decoding phase, where correlation features failed to effectively utilize temporal information because of misaligned onset and noisy spikes. To address this issue, our proposed method focuses on analyzing multi-channel signals in the temporal–spectral domain. The TTSNet first divides the signals into various filter banks, employing task-related component analysis to reduce dimensionality and eliminate noise, respectively. Subsequently, a CNN is employed to optimize the temporal characteristics of the signals and extract class-related features. Finally, the class-related features from all filter banks are concatenated and classified using the fully connected layer.To evaluate the effectiveness of our proposed method, we conducted experiments on two publicly available datasets. In binary classification tasks, the TTSNet achieved an improved accuracy of 0.7707 ± 0.1168, surpassing the performance of EEGNet (accuracy: 0.7340 ± 0.1246) and FBTRCA (accuracy: 0.7487 ± 0.1250). In multi-class tasks, TTSNet achieved an accuracy of 0.4588 ± 0.0724, exhibiting a 4.27% and 3.95% accuracy increase over EEGNet and FBTRCA, respectively.The findings of this study suggest that the proposed TTSNet method holds promise for detecting limb movements and assisting in the rehabilitation of stroke patients. The classification of single-side limb movements is expected to facilitate the interaction between patients and external environment by increasing the number of control commands in BCIs.

The Design of a Speech Recognition-Based Finger Training Rehabilitation Device: Mechanical and System Aspects

Aiming to address the extended diagnosis and recovery period along with low efficiency in traditional stroke patient rehabilitation, this study introduces a speech recognition-based finger rehabilitation training control system. This system enables patients to perform finger exercises while providing feedback on finger angle, speed, and position. Furthermore, it offers rehabilitation physicians valuable data for evaluation and reference in finger rehabilitation. The system is divided into hardware circuitry, a lower computer control system, and a voice recognition human-computer interaction system, all working in conjunction with the finger movement perception system. By applying the Hidden Markov Model (HMM) algorithm to the voice interaction system for pattern matching, the finger rehabilitation system undergoes simulation testing. The results demonstrate that the proposed rehabilitation training system based on speech recognition meets design requirements, ensuring safety, reliability, and substantial application potential in future finger rehabilitation training.

Association between the initial physical activity and functional recovery after 1 month of inpatient rehabilitation for subacute stroke: stratified analysis by nutritional status.

Objectively measured physical activity volume serves as a predictive factor for functional recovery in patients with stroke. Malnutrition, a frequent complication of stroke, may influence the relationship between physical activity and functional recovery. This study aimed to examine the association between physical activity volume and functional recovery in patients with stroke, stratified by their nutritional status. This multicenter prospective observational study included 209 patients with stroke admitted to two Japanese convalescent rehabilitation hospitals. Participants were categorized based on the geriatric nutritional risk index (GNRI) at admission [≥92, high GNRI group ( n = 133); <92, low GNRI group ( n = 76)]. Physical activity levels were measured as the duration of total physical activity (TPA), which is the sum of light-intensity physical activity and moderate-to-vigorous physical activity, using a triaxial accelerometer during the first 7 days after admission. Outcome measures are represented as the relative gain of the motor score on functional independence measure (M-FIM effectiveness) during the first month after admission. The multiple regression analysis, adjusting for age, sex, comorbidity, onset to admission intervals, motor paralysis, initial M-FIM, and cognitive FIM, showed that the duration of TPA in the first 7 days was significantly associated with the M-FIM effectiveness over the first month in both low GNRI [ B = 0.12, 95% confidential intervals (CI) = 0.01; 0.24, P = 0.049] and high GNRI group ( B = 0.11, 95% CI = 0.01; 0.21, P = 0.027). This study demonstrates a positive predictive association between early TPA level and functional recovery in stroke patients, irrespective of their nutritional status.

A hybrid brain-muscle-machine interface for stroke rehabilitation: Usability and functionality validation in a 2-week intensive intervention.

Introduction: The primary constraint of non-invasive brain-machine interfaces (BMIs) in stroke rehabilitation lies in the poor spatial resolution of motor intention related neural activity capture. To address this limitation, hybrid brain-muscle-machine interfaces (hBMIs) have been suggested as superior alternatives. These hybrid interfaces incorporate supplementary input data from muscle signals to enhance the accuracy, smoothness and dexterity of rehabilitation device control. Nevertheless, determining the distribution of control between the brain and muscles is a complex task, particularly when applied to exoskeletons with multiple degrees of freedom (DoFs). Here we present a feasibility, usability and functionality study of a bio-inspired hybrid brain-muscle machine interface to continuously control an upper limb exoskeleton with 7 DoFs. Methods: The system implements a hierarchical control strategy that follows the biologically natural motor command pathway from the brain to the muscles. Additionally, it employs an innovative mirror myoelectric decoder, offering patients a reference model to assist them in relearning healthy muscle activation patterns during training. Furthermore, the multi-DoF exoskeleton enables the practice of coordinated arm and hand movements, which may facilitate the early use of the affected arm in daily life activities. In this pilot trial six chronic and severely paralyzed patients controlled the multi-DoF exoskeleton using their brain and muscle activity. The intervention consisted of 2 weeks of hBMI training of functional tasks with the system followed by physiotherapy. Patients' feedback was collected during and after the trial by means of several feedback questionnaires. Assessment sessions comprised clinical scales and neurophysiological measurements, conducted prior to, immediately following the intervention, and at a 2-week follow-up. Results: Patients' feedback indicates a great adoption of the technology and their confidence in its rehabilitation potential. Half of the patients showed improvements in their arm function and 83% improved their hand function. Furthermore, we found improved patterns of muscle activation as well as increased motor evoked potentials after the intervention. Discussion: This underscores the significant potential of bio-inspired interfaces that engage the entire nervous system, spanning from the brain to the muscles, for the rehabilitation of stroke patients, even those who are severely paralyzed and in the chronic phase.

The association between neuroimaging data and presence of lateropulsion after stroke

ABSTRACT Background Post-stroke lateropulsion is prevalent and has been associated with varied lesion locations, but existing imaging studies are limited by small participant cohorts. Evidence to guide lateropulsion rehabilitation is also limited. Improved understanding of lesion localization associated with lateropulsion post-stroke may inform more targeted intervention approaches. Objectives This study investigated the associations between stroke neuroimaging data and presence of lateropulsion at inpatient rehabilitation admission. Methods This prospective, observational study included participants aged ≥65 years, admitted for inpatient stroke rehabilitation. Using routinely collected clinical neuroimaging data, stroke type, location, and volume were reported, and their association with lateropulsion presence (Four-Point Pusher Score − 4PPS) at admission was explored. Results Of 144 included participants, 82 (56.9%) had lateropulsion (4PPS ≥1). Lateropulsion presence was univariately associated with hemorrhagic stroke (p = 0.002), frontal cortical involvement (OR = 2.17, 95%CI 1.02–6.46), and white matter involvement (OR = 2.45, 95%CI 1.24–4.85), particularly frontal white matter (p = 0.021). Lesions involving the posterior limb of the internal capsule (OR = 2.88, 95% CI 1.14–7.27) and those involving the entire thalamus (OR = 1.0, p = 0.03) were associated with lateropulsion presence. When stratified by stroke type, no specific location was significantly associated with lateropulsion presence in hemorrhagic strokes. Among participants with ischemic stroke, involvement of the pre-central gyrus (OR = 2.45, 95%CI 1.05–5.76), post-central gyrus (OR = 2.76, 95%CI 1.15–6.60), inferior parietal cortex (OR = 3.95, 95%CI 1.43–10.90), and supramarginal gyrus (OR = 3.73, 95%CI 1.25–11.13) were associated with lateropulsion presence. The stroke laterality and size were not significantly associated with lateropulsion presence. Conclusions The findings indicate a role of network disconnection in the post-stroke lateropulsion presence. Future, larger-cohort lesion-network mapping studies are recommended.

A Comprehensive Review: Robot-Assisted Treatments for Gait Rehabilitation in Stroke Patients.

Robot-assisted gait training (RAGT) is at the cutting edge of stroke rehabilitation, offering a groundbreaking method to improve motor recovery and enhance the quality of life for stroke survivors. This review investigates the effectiveness and application of various RAGT systems, including both end-effector and exoskeleton robots, in facilitating gait enhancements. The selection process for this comprehensive analysis involved a meticulous review of the literature from databases such as PubMed, the Cochrane Library, and EMBASE, focusing on studies published between 2018 and 2023. Ultimately, 27 studies met the criteria and were included in the final analysis. The focus of these studies was on the various RAGT systems and their role in promoting gait and balance improvements. The results of these studies conclusively show that patients experience significant positive effects from RAGT, and when combined with other physiotherapy methods, the outcomes are notably superior in enhancing functional ambulation and motor skills. This review emphasizes RAGT's capability to deliver a more customized and effective rehabilitation experience, highlighting the importance of tailoring interventions to meet the specific needs of each patient.

Application of Neural Rehabilitation Manipulator Training in Upper Limb Rehabilitation of Stroke Patients with Hemiplegia

Objective: To analyze the application of neural rehabilitation manipulator training in upper limb rehabilitation of stroke patients with hemiplegia. Methods: 94 patients with hemiplegia after stroke were selected from January 2021 to January 2023. The patients were randomly divided into a control group and an observation group, with 47 cases in each group. The control group received routine rehabilitation training while the observation group received neural rehabilitation manipulator training. The upper limb and nerve function, daily task performance ability, quality of life, and rehabilitation training satisfaction were compared between the two groups. Results: There was no significant difference in upper limb and nerve function between the two groups before training, P &gt; 0.05. After training, the observation group had 51.45 ± 8.75 points in ARAT and 52.59 ± 8.48 points in FMA-UE, which were higher than those in the control group with 43.81 ± 6.67 points and 45.51 ± 7.31 points respectively, P &lt; 0.05. The observation group had 5.71 ± 1.53 points in NIHSS, which was lower than those in the control group with 8.04 ± 2.39 points, P &lt; 0.05. In terms of daily task performance ability and quality of life, there was no significant difference between the two groups before training, P &gt; 0.05. After training, the observation group had 78.54 ± 10.63 scores in MBI and 171.93 ± 19.12 scores in SS-QOL, which were higher than those in the control group with 70.51 ± 9.25 scores and 160.13 ± 18.42 scores respectively, P &lt; 0.05. In terms of satisfaction, the total satisfaction rate of the observation group was 93.62%, which was higher than that of the control group with 74.47%, P &lt; 0.05. Conclusion: The application of neural rehabilitation manipulator training in the upper limb rehabilitation of stroke patients with hemiplegia can significantly improve the upper limb function of patients, relieve nerve defects, improve daily task performance ability and quality of life, and increase patient satisfaction with rehabilitation training.

Comparison between Home-Based Exercise and Hospital-Based Supervised Exercise in the Early Rehabilitation of Stroke Patients

Introduction: Stroke is one of the leading causes of death and disability worldwide and more so in underdeveloped countries like Bangladesh, where health support systems including rehabilitation not expectedly available. Early initiation of rehabilitation procedures can enable a greater return of neurological function and improve long-term outcomes and quality of life. In this study, we aimed to compare the effects of home-based exercise and hospital-based supervised exercise in the early rehabilitation of stroke patients. Methods: This was a prospective observational study and was conducted in the Department of Physical Medicine and Rehabilitation, Dhaka Medical College Hospital, Dhaka, Bangladesh during the period from January, 2014 to June, 2014. In our study, we included 250 patients, and the patients were divided into two groups – Group A (Patients who got home-based exercise) and Group B (Patients who got hospital-based exercise). Result: We found the mean age of the patients of Group A &amp; Group B was 56.75± 9.45 and 55.46± 10.58 years respectively. Among the patients, 41% were female,59% were male and 168 (67.2%) patients had been suffering from ischemic stroke and 82 (32.8%) patients from hemorrhagic stroke. The most common risk factors were HTN, dyslipidemia, and obesity. Mean FIM gain in Group A was 37.97 ± 17.52 and in Group B was 48.56 ± 21.22 which was significantly higher than that of Group A patients. Conclusion: In our study, we found that hospital-based supervised exercise is superior to home-based exercise within 4 weeks of stroke in early rehabilitation of stroke patients.

The impact of reminiscent music therapy and robot-assisted rehabilitation on older stroke patients: a protocol for a randomized controlled trial.

Stroke is the main disease that causes the burden of neurological disease, leading to upper limb dysfunction and affecting their self-care abilities. Robot-assisted rehabilitation therapy has been gradually used in the rehabilitation of upper limb function after stroke. However, it would be beneficial to explore auxiliary interventions such as reminiscent music therapy, a combination of music and reminiscent, to relieve negative emotions and post-stroke fatigue and improve rehabilitation outcomes. This protocol aims to evaluate the effectiveness of reminiscent music therapy combined with robot-assisted rehabilitation in older stroke patients. This trial is a single-blind, three-arm randomized controlled trial. Older stroke patients with upper limb dysfunction will be recruited. Participants will be randomly assigned to receive usual rehabilitation treatment and care, usual rehabilitation treatment and care plus robot-assisted rehabilitation and reminiscent music therapy, or usual rehabilitation treatment and care plus robot-assisted rehabilitation. Robot-assisted rehabilitation will be conducted by rehabilitation doctors five times per week for 3 weeks. In experimental group 1, a reminiscent song list will be played for patients. The primary outcome is activities of daily living. All outcomes will be evaluated at baseline and in the week immediately post-intervention. We are conducting the first randomized controlled trial on the effects of reminiscent music therapy combined with robot-assisted rehabilitation in older stroke patients. It is expected that this study, if proven effective in improving the activities of daily living in older stroke patients with upper limb dysfunction, will provide evidence-based rehabilitation strategies for medical staff.Clinical Trial Registration: ChiCTR2200063738.

Predictive Validity of the Johns Hopkins Fall Risk Assessment Tool for Older Patients in Stroke Rehabilitation.

The aim of this retrospective, cross-sectional, observational study was to assess the frequency of falls and evaluate the predictive validity of the Johns Hopkins Fall Risk Assessment Tool (JHFRAT) among patients aged ≥65 years, transferred to the rehabilitation ward of a university hospital. The predictive ability was assessed using receiver operating characteristic curve analysis, and the optimal threshold was established using the Youden index. We analyzed the overall cohort (N = 175) with subacute stroke and the subgroup with a low unaffected handgrip strength (HGS; men: <28 kg, women: <18 kg). Overall, 135/175 patients (77.1%) had a low HGS. The fall rate was 6.9% overall and 5.9% for patients with a low HGS. The JHFRAT predictive value was higher for patients with a low HGS than that for the overall cohort, but acceptable in both. The optimal cutoff score for the overall cohort was 11 (sensitivity, 67%; specificity, 68%), whereas that for the subgroup was 12 (sensitivity, 75%; specificity: 72%). These results are expected to aid nurses working in rehabilitation wards in more effectively utilizing JHFRAT outcomes for post-stroke older patients with a low HGS and contribute to the development of more appropriate fall prevention strategies for high-risk patients in the future.

Targeted language training combined with transcranial direct current therapy for Wernicke aphasia in the sequelae stage: A case report

ObjectiveTo observe the effects of combining targeted language training with transcranial direct current stimulation (tDCS) on speech rehabilitation in senile stroke patients with Wernicke's aphasia in the sequelae stage. MethodsA patient with Wernicke's aphasia caused by stroke, 15 months prior, was successively treated with regimen A (targeted language training), regimen B (L-Wernicke area tDCS + targeted language training), and regimen C (R-Wernicke area tDCS + targeted language training) for a total of 3 weeks, with a 2-day washout period between each regimen. The accuracy of spontaneous speech, auditory word-picture matching, visual word-picture matching, retelling, graph-reading writing, and graph-reading naming items was evaluated and compared before treatment and 3 weeks after treatment with regimens A, B, and C. ResultsAfter 3 weeks of the regimen A treatment, there was no significant improvement in each evaluation item. After 3 weeks of treatment with regimen B, the patient's spontaneous speech slightly improved, but the expression remained meaningless. Visual word-graph matching was slightly improved, but auditory word-graph matching was not. After 3 weeks of treatment with regimen C, the spontaneous speech of the patient's increased significantly, and the correct rates of auditory word-graph matching, visual word-graph matching, retelling, and picture reading and writing were significantly improved compared with those before treatment and after 3 weeks of treatment with regimens A and B (P < 0.05). ConclusionsTargeted language training combined with tDCS stimulation of the non-dominant Wernicke's area can improve spontaneous speech, auditory word-picture matching, visual word-picture matching, retelling, and picture reading and writing ability in elderly patients with Wernicke's aphasia after stroke, thus promoting speech rehabilitation.

The Relationship between Function, Stroke Severity and Perception of Health at Follow-up in Stroke Rehabilitation Patients

The Relationship between Function, Stroke Severity and Perception of Health at Follow-up in Stroke Rehabilitation Patients

Improvements of mid-thigh circumferences following robotic rehabilitation in hemiparetic stroke patients.

Stroke has emerged as the leading cause of disability globally. The provision of long-term rehabilitation to stroke survivors poses a health care burden to many countries. Robotic devices have created a major turning point in stroke rehabilitation program. Currently, the anthropometric evidence to support the benefit of robotic rehabilitation (RR) among stroke patients is scarce. Therefore, the aim of this study was to evaluate the impact of RR on the mid-thigh circumferences of the paretic limbs in stroke patients. Twenty stroke patients from conventional rehabilitation (CR) (n=10) and RR (n=10) groups were recruited through a purposive sampling method. Patients in the CR group received a two-hour session of a five-day-a-week home-based CR program for 4weeks. Patients in the RR group received a five-day-a-week of an hour combined physiotherapy and occupational therapy session and a one-hour robotic therapy session using the HAL® Cyberdyne lower-limb, for 4weeks. The mid-thigh circumferences of both limbs were measured on day 1 (baseline), week 2 and week 4 of rehabilitation program. The results revealed no statistically significant difference in the mid-thigh circumferences between the paretic (F1.05,9.44=1.96, p=0.20), and the normal (F1.05,9.44=1.96, p=0.20) sides in the CR group (n=10). For the comparison between the paretic and normal sides in the RR group (n=10), the paretic mid-thigh circumferences revealed significant time effect results (F2,18=11.91, p=0.001), which were due to changes between baseline and week 2, and baseline and week 4 measurements. Interestingly, the normal mid-thigh circumferences also revealed a significant time effect (F2,18=6.56, p=0.007), which is due to changes between baseline and week 4. One-way analysis of variance was employed to compare the mean average between groups due to the difference in the baseline measurements of the mid-thigh circumferences between the paretic side of the CR and the RR groups. With this adjustment, the average means mid-thigh circumferences after 4weeks of therapy were shown to be significantly different between the CR and RR groups (F1,18=12.49, p=0.02). Significant increments in the mid-thigh circumferences following RR were seen in the paretic limbs of stroke patients. Hence, this study may provide some insights into further potential research related to the benefits of RR in stroke patients.

Optimizing Rehabilitation Outcomes for Stroke Survivors: The Impact of Speed and Slope Adjustments in Anti-Gravity Treadmill Training.

Background and Objectives: This study explored the efficacy of customized anti-gravity treadmill (AGT) training, with adjustments in speed and incline, on rehabilitation outcomes for stroke patients, focusing on knee extensor muscle strength, joint angle, balance ability, and activities of daily living (ADLs). Materials and Methods: In this study, 30 individuals diagnosed with a stroke were divided into three groups. Experimental group 1 (EG1) underwent training without changes to speed and incline, experimental group 2 (EG2) received training with an increased incline, and experimental group 3 (EG3) underwent training with increased speed. Initially, all participants received AGT training under uniform conditions for two weeks. Subsequently, from the third to the sixth week, each group underwent their specified training intervention. Evaluations were conducted before the intervention and six weeks post-intervention using a manual muscle strength tester for knee strength, TETRAX for balance ability, Dartfish software for analyzing knee angle, and the Korean version of the Modified Barthel Index (K-MBI) for assessing activities of daily living. Results: Within-group comparisons revealed that AGT training led to enhancements in muscle strength, balance ability, joint angle, and ADLs across all participant groups. Between-group analyses indicated that EG2, which underwent increased incline training, demonstrated significant improvements in muscle strength and balance ability over EG1. EG3 not only showed significant enhancements in muscle strength, joint angle, and ADLs when compared to EG1 but also surpassed EG2 in terms of knee strength improvement. Conclusions: In conclusion, the application of customized AGT training positively impacts the rehabilitation of stroke patients, underscoring the importance of selecting a treatment method tailored to the specific needs of each patient.

Rehabilitation effect of core muscle training combined with functional electrical stimulation on lower limb motor and balance functions in stroke patients.

Studies have shown that core muscle training can accelerate the recovery of motor function in stroke patients. However, there are no relevant reports to show the effect of core muscle training combined with functional electrical stimulation (FES) on the rehabilitation of stroke patients. This study aimed to observe the efficacy of core muscle training combined with FES on motor and balance functions of lower limbs in stroke patients. This study selected and divided 120 stroke patients with hemiplegia admitted to our hospital into the control and observation groups. Patients in the control group just received core muscle training; while patients in the observation group were treated by core muscle training combined with FES. Both groups were treated for 8 weeks. Subsequently, the clinical data and information of all patients were collected and counted. Muscle strength changes were observed by detecting paralytic dorsiflexor (pDF), plantar flexor (pPF), knee extensor (pKE), and knee flexor (pKF) before and after treatment. Motor and balance abilities of both groups were scored through the 10-meter walking test (10 MWT), Berg balance scale (BBS), functional ambulation category (FAC) scale, timed up and go (TUG) test, and lower extremity motricity index (MI-Lower). No significant difference was found in clinical data between the two groups. The intensity of pDF, pPF, pKE, and pKF significantly increased in both groups after treatment, and the intensity of these parameters was higher in the observation group relative to the control group. Additionally, 10 MWT and TUG test scores of patients in the observation group were notably decreased while the BBS and MI-Lower scores were significantly increased after treatment compared with those in the control group. Core muscle training combined with FES can significantly improve the rehabilitation effect of lower limb motor and balance functions in stroke patients.

Efficacy of brain-computer interfaces on upper extremity motor function rehabilitation after stroke: A systematic review and meta-analysis.

The recovery of upper limb function is crucial to the daily life activities of stroke patients. Brain-computer interface technology may have potential benefits in treating upper limb dysfunction. To systematically evaluate the efficacy of brain-computer interfaces (BCI) in the rehabilitation of upper limb motor function in stroke patients. Six databases up to July 2023 were reviewed according to the PRSIMA guidelines. Randomized controlled trials of BCI-based upper limb functional rehabilitation for stroke patients were selected for meta-analysis by pooling standardized mean difference (SMD) to summarize the evidence. The Cochrane risk of bias tool was used to assess the methodological quality of the included studies. Twenty-five studies were included. The studies showed that BCI had a small effect on the improvement of upper limb function after the intervention. In terms of total duration of training, < 12 hours of training may result in better rehabilitation, but training duration greater than 12 hours suggests a non significant therapeutic effect of BCI training. This meta-analysis suggests that BCI has a slight efficacy in improving upper limb function and has favorable long-term outcomes. In terms of total duration of training, < 12 hours of training may lead to better rehabilitation.

ANALYSIS OF EFFECTS OF MIND-BODY ACTIVATION STRATEGIES IN PROMOTING REHABILITATION OF ELDERLY STROKE PATIENTS — REINTEGRATION BASED ON THE ICF COMPREHENSIVE FUNCTIONAL FRAMEWORK

The objective of this study was to fully implement the comprehensive rehabilitation concept based on the International Classification of Functioning, Disability and Health (ICF) and integrate Mind-body Activation strategies into the holistic rehabilitation and supportive treatment of elderly patients with post-stroke hemiparesis. The aim was to assess the potential of promoting overall recovery in elderly stroke patients and explore a novel approach to stroke rehabilitation that emphasizes the integration of mind and body. A total of 103 elderly patients with post-stroke hemiplegia receiving rehabilitation treatment were selected and randomly assigned to the control group and experimental group. In the control group, 52 patients received intervention with routine rehabilitation exercise training, while in the experimental group, 51 patients adopted the Mind-body Activation strategy combined with routine rehabilitation exercise training to achieve physical and mental integration through techniques such as warm-up exercises and music therapy. Both groups were evaluated before and after the intervention in terms of walking function, balance function, daily living ability, and cognitive ability. The results showed that after the intervention for 3 months, the Holden walking functional grading, Berg scale score, Barthel scale score and MMSE score of patients in both groups were significantly higher than those before the intervention ([Formula: see text]). Additionally, the above four indicators of patients in the experimental group were significantly higher than those in the control group ([Formula: see text]). The Mind-body Activation strategy incorporated into routine rehabilitation exercise training can effectively enhance the walking function, balance function, daily living ability and cognitive ability of elderly stroke patients with hemiplegia. The Mind-body Activation strategy is a feasible and effective new rehabilitation method of hemiplegia after stroke, which is conducive to promoting the comprehensive rehabilitation of elderly stroke patients.

Adaptive Time-Frequency Segment Optimization for Motor Imagery Classification.

Motor imagery (MI)-based brain-computer interface (BCI) has emerged as a crucial method for rehabilitating stroke patients. However, the variability in the time-frequency distribution of MI-electroencephalography (EEG) among individuals limits the generalizability of algorithms that rely on non-customized time-frequency segments. In this study, we propose a novel method for optimizing time-frequency segments of MI-EEG using the sparrow search algorithm (SSA). Additionally, we apply a correlation-based channel selection (CCS) method that considers the correlation coefficient of features between each pair of EEG channels. Subsequently, we utilize a regularized common spatial pattern method to extract effective features. Finally, a support vector machine is employed for signal classification. The results on three BCI datasets confirmed that our algorithm achieved better accuracy (99.11% vs. 94.00% for BCI Competition III Dataset IIIa, 87.70% vs. 81.10% for Chinese Academy of Medical Sciences dataset, and 87.94% vs. 81.97% for BCI Competition IV Dataset 1) compared to algorithms with non-customized time-frequency segments. Our proposed algorithm enables adaptive optimization of EEG time-frequency segments, which is crucial for the development of clinically effective motor rehabilitation.