共查询到20条相似文献,搜索用时 15 毫秒
1.
Johanna VG Robertson Thomas Hoellinger Påvel Lindberg Djamel Bensmail Sylvain Hanneton Agnès Roby-Brami 《Journal of neuroengineering and rehabilitation》2009,6(1):45-11
Background
Following stroke, patients frequently demonstrate loss of motor control and function and altered kinematic parameters of reaching movements. Feedback is an essential component of rehabilitation and auditory feedback of kinematic parameters may be a useful tool for rehabilitation of reaching movements at the impairment level. The aim of this study was to investigate the effect of 2 types of auditory feedback on the kinematics of reaching movements in hemiparetic stroke patients and to compare differences between patients with right (RHD) and left hemisphere damage (LHD). 相似文献2.
Background
Abnormal synergy is one of the major motor deficits in stroke patients. Abnormal muscle synergies, in conjunction with weakness and spasticity, interfere with voluntary movements and restrict the range of motion. This study aimed to quantify abnormal synergies in the affected upper limbs of chronic stroke patients by using a neuro-rehabilitation robot.Methods
Twelve chronic stroke patients and eight age-matched control subjects were recruited to perform rectilinear tracking movements in four horizontal directions (back–forth, two oblique directions at 45°, and right–left). Kinematic, kinetic and electromyogram data were recorded and used to develop two biomechanical indices and one electromyogram assessment index based on principal component analysis.Findings
Significant differences between upper limbs of control subjects and the affected side of stroke patients were observed in all three assessment indices. Higher correlation between the elbow joint angle and the forearm pronation/supination torque, higher variation of the forearm torque, and abnormal co-contraction of the elbow and shoulder muscles were observed in the affected limbs of stroke patients. The difference was more prominent in the right–left direction and the oblique direction contra-proximal to ipsi-distal.Interpretation
The proposed assessment indices could be employed to quantify the abnormal synergies in stroke patients. Rectilinear tracking along the right–left direction and the oblique direction of contra-proximal to ipsi-distal is more suitable for assessing abnormal synergies. 相似文献3.
Stefan Hesse H Kuhlmann J Wilk C Tomelleri Stephen GB Kirker 《Journal of neuroengineering and rehabilitation》2008,5(1):1-6
Background
The functional outcome after stroke is improved by more intensive or sustained therapy. When the affected hand has no functional movement, therapy is mainly passive movements. A novel device for repeating controlled passive movements of paralysed fingers has been developed, which will allow therapists to concentrate on more complicated tasks. A powered cam shaft moves the four fingers in a physiological range of movement.Methods
After refining the training protocol in 2 chronic patients, 8 sub-acute stroke patients were randomised to receive additional therapy with the Finger Trainer for 20 min every work day for four weeks, or the same duration of bimanual group therapy, in addition to their usual rehabilitation.Results
In the chronic patients, there was a sustained reduction in finger and wrist spasticity, but there was no improvement in active movements. In the subacute patients, mean distal Fugl-Meyer score (0–30) increased in the control group from 1.25 to 2.75 (ns) and 0.75 to 6.75 in the treatment group (p < .05). Median Modified Ashworth score increased 0/5 to 2/5 in the control group, but not in the treatment group, 0 to 0. Only one patient, in the treatment group, regained function of the affected hand. No side effects occurred.Conclusion
Treatment with the Finger Trainer was well tolerated in sub-acute & chronic stroke patients, whose abnormal muscle tone improved. In sub-acute stroke patients, the Finger Trainer group showed small improvements in active movement and avoided the increase in tone seen in the control group. This series was too small to demonstrate any effect on functional outcome however. 相似文献4.
Nathan Neckel Marlena Pelliccio Diane Nichols Joseph Hidler 《Journal of neuroengineering and rehabilitation》2006,3(1):17-11
Background
The presence of abnormal muscle activation patterns is a well documented factor limiting the motor rehabilitation of patients following stroke. These abnormal muscle activation patterns, or synergies, have previously been quantified in the upper limbs. Presented here are the lower limb joint torque patterns measured in a standing position of sixteen chronic hemiparetic stroke subjects and sixteen age matched controls used to examine differences in strength and coordination between the two groups. 相似文献5.
Elena Vergaro Maura Casadio Valentina Squeri Psiche Giannoni Pietro Morasso Vittorio Sanguineti 《Journal of neuroengineering and rehabilitation》2010,7(1):13
Background
Although robot therapy is progressively becoming an accepted method of treatment for stroke survivors, few studies have investigated how to adapt the robot/subject interaction forces in an automatic way. The paper is a feasibility study of a novel self-adaptive robot controller to be applied with continuous tracking movements. 相似文献6.
Lorenzo Masia Maura Casadio Psiche Giannoni Giulio Sandini Pietro Morasso 《Journal of neuroengineering and rehabilitation》2009,6(1):44-11
Background
In the last two decades robot training in neuromotor rehabilitation was mainly focused on shoulder-elbow movements. Few devices were designed and clinically tested for training coordinated movements of the wrist, which are crucial for achieving even the basic level of motor competence that is necessary for carrying out ADLs (activities of daily life). Moreover, most systems of robot therapy use point-to-point reaching movements which tend to emphasize the pathological tendency of stroke patients to break down goal-directed movements into a number of jerky sub-movements. For this reason we designed a wrist robot with a range of motion comparable to that of normal subjects and implemented a self-adapting training protocol for tracking smoothly moving targets in order to facilitate the emergence of smoothness in the motor control patterns and maximize the recovery of the normal RoM (range of motion) of the different DoFs (degrees of Freedom). 相似文献7.
Background
While upper-extremity movement in individuals with neurological disorders such as stroke and spinal cord injury (SCI) has been studied for many years, the effects of spasticity on arm movement have been poorly quantified. The present study is designed to characterize the nature of impaired arm movements associated with spasticity in these two clinical populations. By comparing impaired voluntary movements between these two groups, we will gain a greater understanding of the effects of the type of spasticity on these movements and, potentially a better understanding of the underlying impairment mechanisms. 相似文献8.
Leonard E Kahn Michele L Zygman W Zev Rymer David J Reinkensmeyer 《Journal of neuroengineering and rehabilitation》2006,3(1):12-13
Background and purpose
Providing active assistance to complete desired arm movements is a common technique in upper extremity rehabilitation after stroke. Such active assistance may improve recovery by affecting somatosensory input, motor planning, spasticity or soft tissue properties, but it is labor intensive and has not been validated in controlled trials. The purpose of this study was to investigate the effects of robotically administered active-assistive exercise and compare those with free reaching voluntary exercise in improving arm movement ability after chronic stroke. 相似文献9.
Anouk Lamontagne Joyce Fung Bradford J McFadyen Jocelyn Faubert 《Journal of neuroengineering and rehabilitation》2007,4(1):22-8
Background
Walking speed, which is often reduced after stroke, can be influenced by the perception of optic flow (OF) speed. The present study aims to: 1) compare the modulation of walking speed in response to OF speed changes between persons with stroke and healthy controls and 2) investigate whether virtual environments (VE) manipulating OF speed can be used to promote volitional changes in walking speed post stroke. 相似文献10.
Early versus late‐applied constraint‐induced movement therapy: A multisite,randomized controlled trial with a 12‐month follow‐up 下载免费PDF全文
Roland Stock Gyrd Thrane Audny Anke Ragna Gjone Torunn Askim 《Physiotherapy research international》2018,23(1)
Background and Purpose
A direct comparison between the effects of constraint‐induced movement therapy (CIMT) applied early after stroke and that of CIMT applied in the chronic phase has not been conducted. This study aimed to compare the long‐term effects of CIMT applied 6 months after stroke with the results of CIMT applied within 28 days post‐stroke.Methods
This study was a single‐blinded, multicentre, randomized controlled trial with a crossover design. Forty‐seven patients received CIMT either early (within 28 days) or 6 months after stroke. Both groups received standard rehabilitation and were tested at 5 time points. The primary outcome measure was Wolf Motor Function Test (WMFT); the secondary measures were Nine‐Hole Peg Test (NHPT), the Fugl‐Meyer Assessment (FMA) of the upper extremity, Stroke Impact Scale, and Modified Rankin Scale (MRS).Results
Compared with baseline data, both groups showed significant improvements in the primary and secondary outcome measures after 12 months. No significant differences between the 2 treatment groups were found before and after the delayed intervention group received CIMT at 6 months and during the 12‐month follow‐up. Both groups recovered considerably and showed only minor impairment (median FMA score of 64) after 6 months. The early intervention group showed an initially faster recovery curve of WMFT, NHPT, and MRS scores.Discussion
In contrast to most CIMT studies, our study could not find an effect of CIMT applied 6 months after stroke. Our results indicate that commencing CIMT early is as good as delayed intervention in the long term, specifically in this group of patients who might have reached a ceiling effect during the first 6 months after stroke. Nevertheless, the early CIMT intervention group showed a faster recovery curve than the delayed intervention group, which can be a clinically important finding for patients in the acute phase. 相似文献11.
Background
The majority of stroke patients have to cope with impaired arm function. Gravity compensation of the arm instantaneously affects abnormal synergistic movement patterns. The goal of the present study is to examine whether gravity compensated training improves unsupported arm function.Methods
Seven chronic stroke patients received 18 half-hour sessions of gravity compensated reach training, in a period of six weeks. During training a motivating computer game was played. Before and after training arm function was assessed with the Fugl-Meyer assessment and a standardized, unsupported circle drawing task. Synergistic movement patterns were identified based on concurrent changes in shoulder elevation and elbow flexion/extension angles.Results
Median increase of Fugl-Meyer scores was 3 points after training. The training led to significantly increased work area of the hemiparetic arm, as indicated by the normalized circle area. Roundness of the drawn circles and the occurrence of synergistic movement patterns remained similar after the training.Conclusions
A decreased strength of involuntary coupling might contribute to the increased arm function after training. More research is needed to study working mechanisms involved in post stroke rehabilitation training. The used training setup is simple and affordable and is therefore suitable to use in clinical settings. 相似文献12.
Richard W Bohannon Steven Harrison Jeffrey Kinsella-Shaw 《Journal of neuroengineering and rehabilitation》2009,6(1):30-7
Background
Spasticity is a common impairment accompanying stroke. Spasticity of the quadriceps femoris muscle can be quantified using the pendulum test. The measurement properties of pendular kinematics captured using a magnetic tracking system has not been studied among patients who have experienced a stroke. Therefore, this study describes the test-retest reliability and known groups and convergent validity of the pendulum test measures obtained with the Polhemus tracking system. 相似文献13.
Kimberly J Wisneski Michelle J Johnson 《Journal of neuroengineering and rehabilitation》2007,4(1):7-14
Background
Robotic therapy is at the forefront of stroke rehabilitation. The Activities of Daily Living Exercise Robot (ADLER) was developed to improve carryover of gains after training by combining the benefits of Activities of Daily Living (ADL) training (motivation and functional task practice with real objects), with the benefits of robot mediated therapy (repeatability and reliability). In combining these two therapy techniques, we seek to develop a new model for trajectory generation that will support functional movements to real objects during robot training. We studied natural movements to real objects and report on how initial reaching movements are affected by real objects and how these movements deviate from the straight line paths predicted by the minimum jerk model, typically used to generate trajectories in robot training environments. We highlight key issues that to be considered in modelling natural trajectories. 相似文献14.
Krebs HI Ferraro M Buerger SP Newbery MJ Makiyama A Sandmann M Lynch D Volpe BT Hogan N 《Journal of neuroengineering and rehabilitation》2004,1(1):5
Background
Previous results with the planar robot MIT-MANUS demonstrated positive benefits in trials with over 250 stroke patients. Consistent with motor learning, the positive effects did not generalize to other muscle groups or limb segments. Therefore we are designing a new class of robots to exercise other muscle groups or limb segments. This paper presents basic engineering aspects of a novel robotic module that extends our approach to anti-gravity movements out of the horizontal plane and a pilot study with 10 outpatients. Patients were trained during the initial six-weeks with the planar module (i.e., performance-based training limited to horizontal movements with gravity compensation). This training was followed by six-weeks of robotic therapy that focused on performing vertical arm movements against gravity. The 12-week protocol includes three one-hour robot therapy sessions per week (total 36 robot treatment sessions). 相似文献15.
Alexander Koenig Ximena Omlin Jeannine Bergmann Lukas Zimmerli Marc Bolliger Friedemann Müller Robert Riener 《Journal of neuroengineering and rehabilitation》2011,8(1):14
Background
The overall goal of this paper was to investigate approaches to controlling active participation in stroke patients during robot-assisted gait therapy. Although active physical participation during gait rehabilitation after stroke was shown to improve therapy outcome, some patients can behave passively during rehabilitation, not maximally benefiting from the gait training. Up to now, there has not been an effective method for forcing patient activity to the desired level that would most benefit stroke patients with a broad variety of cognitive and biomechanical impairments. 相似文献16.
Background
There is a need to develop cost-effective, sensitive stroke assessment instruments. One approach is examining kinematic measures derived from goal-directed tasks, which can potentially be sensitive to the subtle changes in the stroke rehabilitation process. This paper presents the findings from a pilot study that uses a computer-assisted neurorehabilitation platform, interfaced with a conventional force-reflecting joystick, to examine the assessment capability of the system by various types of goal-directed tasks. 相似文献17.
Maruyama H Nagoya H Kato Y Deguchi I Fukuoka T Ohe Y Horiuchi Y Dembo T Uchino A Tanahashi N 《The journal of headache and pain》2012,13(3):247-253
Background and objective
Cervicocephalic arterial dissection can cause both ischemic stroke and hemorrhagic stroke. However, spontaneous cervicocephalic arterial dissection presenting only with headache and neck pain has rarely been reported. The clinical features of patients with spontaneous cervicocephalic arterial dissection presenting only with headache and neck pain were investigated. 相似文献18.
Torunn Askim Bent Indredavik Asta Håberg 《Archives of physical medicine and rehabilitation》2010,91(10):1529-1536
Askim T, Indredavik B, Håberg A. Internally and externally paced finger movements differ in reorganization after acute ischemic stroke.
Objective
To identify adaptive changes within the motor network for internally and externally paced finger movements in the acute and chronic phase after ischemic stroke.Design
A functional magnetic resonance imaging study of internally and externally paced thumb-index-finger opposition 4 to 7 days and 3 months after stroke and in healthy controls. Images were compared within and between groups, with the actual number of movements as regressors.Setting
Stroke Unit, University Hospital.Participants
Twelve patients with mild to moderate acute ischemic stroke and 15 controls (N=27).Intervention
Stroke unit treatment focused on very early rehabilitation, followed by early supported discharge service.Main Outcome Measure
Differences in brain activation between patients and controls and between the tasks.Results
Patients showed significant improvement in hand function at follow-up. Brain activity related to internally paced finger movements normalized with time. For the externally paced, accurate timing task, brain activity in the chronic phase differed from that seen in the controls despite successful recovery of hand function. In comparing the externally and internally paced tasks, a trend toward recruiting a premotor-parietal-striatal network was found in patients in the chronic phase, whereas controls had increased activation of a sensorimotor network consisting of primary motor cortex, supplementary motor cortex, superior parietal lobe, thalamus, and cerebellum.Conclusions
After ischemic stroke, brain activity subserving an internally paced motor task normalized with time, whereas motor activity in response to an externally paced task became dependent on a premotor network. These findings underscore the importance of task-specific training in the rehabilitation of stroke patients. In the future, physiotherapists should evaluate the possibility of enhancing the recovery of a more efficient network for externally paced tasks. 相似文献19.
William H Gage Karl F Zabjek Kathryn M Sibley Ada Tang Dina Brooks William E McIlroy 《Journal of neuroengineering and rehabilitation》2007,4(1):41-10
Background
There is an important need to better understand the activities of individual patients with stroke outside of structured therapy since this activity is likely to have a profound influence on recovery. A case-study approach was used to examine the activity levels and associated physiological load of patients with stroke throughout a day. 相似文献20.
Patricia Staubli Tobias Nef Verena Klamroth-Marganska Robert Riener 《Journal of neuroengineering and rehabilitation》2009,6(1):46-10