Medicine and Health Sciences Commons^™

Exploring The Relationship Between Hemispheric Prefrontal Cortex Activation, Standing Balance, And Fatigue In Individuals Post-Stroke: A Fnirs Study, Sarthak Kohli

Electronic Thesis and Dissertation Repository

Balance impairments are common after stroke. Reasons for this are multifactorial and include motor dysfunction and fatigue. Limited research has explored the combined effects of post-stroke fatigue and balance on brain activation patterns. Research has shown that prefrontal cortex (PFC) activation may be involved in both motor control and fatigue throughout the recovery process post-stroke. The aim of this thesis was to determine whether: (1) PFC activation levels change between standing balance tasks, (2) PFC hemispheric activation is asymmetric during standing balance tasks, and (3) fatigue levels are associated with task-based activation. Patients with hemiparesis were recruited from the inpatient …

Barriers To Exercise And Physical Activity - Insight From The Rural Practitioner, Erin G. Tillery

Honors College Theses

Sedentary lifestyles are a growing public health concern. Furthermore, many rural Americans lack adequate access to healthcare resources. When healthcare is sought, the patient-practitioner interactions may serve to influence the patient’s lifestyle choices. The practitioners' exercise and physical activity habits may shape the effectiveness of the patient-practitioners interaction. Here, we explored the potential barriers to exercise and physical activity (PA) in licensed physical and occupational therapists. In addition, we aimed to describe barriers to exercise and PA in individuals with a history of stroke from the perspective of the practitioner. Lastly, how current exercise and physical activity habits influence their …

Biomechanically Inspired Assistive Technology To Restore Movement Of The Upper Limbs After Stroke, Ariel Thomas

Graduate Theses, Dissertations, and Problem Reports

A stroke often damages the neural structures responsible for movement. Stroke is a heterogeneous disease, affecting each survivor differently. There are common motor features of a stroke, but even these features vary across time as an individual proceeds through different stages of recovery. The different ways in which stroke motor impairment can present itself are often overlooked, but these differences are fundamental to the understanding of the disease and its recovery. When motor assessments are capable of acquiring information necessary to parse out a detailed profile of each stroke case, this will lead to an improved neuromechanical understanding of the …

The Effects Of Somatosensory Input On Gait In Individuals Post-Stroke, Victor Hung, Amanda Reilly, Rachel Wood, Nikita Yuskov

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Stroke is a leading cause of disability that results in various neurological deficits, one of which is hemiplegia. This deficit alters the gait cycle, resulting in decreased propulsion force by plantar flexor muscles, decreased activation of dorsiflexor (DF) muscles, and increased coactivation of antagonistic ankle muscles. Stroke also leads to altered somatosensory input which results in decreased balance and gait speed, ultimately increasing fall risk. Therapies targeting increased somatosensory input have been shown to be beneficial in stroke as well as other neurological populations. However, no known studies have investigated the acute effects of local vibration to …

Neurodynamics Under Different Walking Speeds In Individuals With Chronic Post-Stroke Hemiparesis, Corey Ackley, Kiley Aki, Joshua Arias, Jassie Trinh

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Stroke is the leading cause of long-term disability in adults worldwide. The ability to return to walking is often a main goal of rehabilitation in individuals with chronic post-stroke hemiparesis. To increase walking speed, non-neurologically impaired individuals produce greater ankle propulsion force at push-off with greater ankle dorsiflexion angles in swing phase with no change in ankle muscle co-contraction index in the swing phase. It remains unclear if individuals post-stroke would adopt similar neuromuscular strategies. Therefore, our aim was to examine the effect of altered walking speeds on propulsion force at push-off, ankle dorsiflexion angle during swing, …

Modulation Of Corticospinal Excitability Using Cathodal Transcranial Direct Current Stimulation To Improve Walking In Individuals With Chronic Post Stroke Hemiparesis, Neil Drobitch, Kylie Henry, Sage Lyons, James Schomig

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Individuals who have experienced a pyramidal cerebrovascular accident (pCVA) often exhibit impairments to volitional control of corresponding motor tasks. Promising effects in motor response, post-application of transcranial direct current stimulation (tDCS), have been reported in studies on individuals with the ability to achieve independent gait for 20 minutes. These studies mainly examined the effects of combined tDCS with locomotor training on lower extremity function among higher functioning individuals post-stroke. The purpose of this study was to determine the effect of tDCS among individuals post-stroke who may not have independent ambulatory capabilities, focusing on motor response and less …

Exploring The Complexities Of Real World Upper Limb Performance After Stroke, Kimberly Waddell

Arts & Sciences Electronic Theses and Dissertations

Stroke is the leading cause of long-term disability in the United States. Hemiparesis, or weakness on one side of the body, is a common impairment following a stroke. Approximately 80% of individuals with stroke will experience upper limb paresis, with only a small percentage regaining full functional use of their paretic upper limb. Individuals report ongoing difficulties with incorporating their paretic upper limb into routine activities after a stroke. Rehabilitation interventions often try to increase real world upper limb use by improving what an individual is capable of doing (i.e. capacity) in the rehabilitation clinic. Both clinicians and researchers assume …

Assessing The Impact Of Caregiver Outcomes On Function And Reintegration Of Stroke Survivors Participating In A Community Stroke Rehabilitation Program., Spencer R. Thompson

Electronic Thesis and Dissertation Repository

There is a limited amount of literature evaluating the relationship between caregivers, and the stroke survivors’ function and reintegration. The objectives were to evaluate the association between caregivers’ lifestyle changes on function and the role of functioning as a moderator between caregiving and reintegration among stroke survivors receiving community-based rehabilitation. Data were collected from January 2011 to January 2016. A one-way repeated measures analysis of variance and multivariable linear regression were performed on Functional Independence Measure, Bakas Caregiving Outcomes Scale, Reintegration to Normal Living Index across admission, discharge, and follow-up. Mean age was 70.2±13.17 years with 58% males (n=200). A …

Reliability Of Clinical Evaluators Of Spasticity In Patients With Stroke, Tiffany Alvino, Shiney David, Chelsea Gendvil

Dissertations, Theses, and Capstone Projects

Spasticity is characterized by hyperexcitable stretch reflexes with amplitude increases in response to velocity dependent passive movement and resistance. Spasticity is the result of abnormal function of segmental and suprasegmental neuronal circuits. The objective of this study was to determine any positive correlation between three clinical evaluators of spasticity (i.e., the pendulum test, the patellar tendon tap test (PTT), and the Modified Ashworth scale) in their reliability to assess spasticity in people post-stroke. It was hypothesized that the use of force movement sensors along with surface electromyography increases the reliability of the standardized clinical tests. The results show that all …

Effect Of Stance Symmetry On Perturbation-Induced Protective Stepping In Persons Poststroke And Controls, Katherine M. Martinez

Department of Physical Therapy Student Theses, Dissertations and Capstones

Problem Statement: Stepping is a common strategy after a perturbation. Stroke survivors display a predilection for stepping with non-paretic leg. Insight into induced stepping between stroke survivors and age-matched control may guide our understanding for reactive postural control training post stroke. Purpose: To investigate the difference in perturbation-induced stepping between chronic stroke survivors and age-matched controls at three phases of the stepping response: preparation, execution, and landing and association with clinical outcome measures. Procedure: Twenty-one community-dwelling chronic stroke survivors (mean age 59y/o ±13yrs) and 17 age- and gender-matched controls (mean age 54.4y/o ±17yrs) completed this study. Clinical measures of gait, …

Outcomes After A Comprehensive Inpatient Rehabilitation Treatment Program For A Patient With A Right Pontine Stroke: A Case Report, Traci Rzeszutko

All Capstone Projects

Background/Purpose: A stroke occurs as a result of decreased blood flow to the brain and can cause serious limitations in mobility, balance, coordination, and strength resulting in functional limitations. The purpose of this case study is to examine the effects of a comprehensive acute inpatient rehabilitation program focusing on gait, balance, lower extremity strengthening, neuromuscular control, bed mobility, coordination, and stair training on a 67-year-old male after a right pontine stroke with a medical history that includes a right stroke eight years ago.

Case Description: The subject was a 67-year-old male with a diagnosis of right pontine stroke. The subject …

Treatment Of A 92 Year Old Female Deconditioned After Hospitalization Secondary To A Hemorrhagic Stroke: A Case Report, Paul A. Naujokas

All Capstone Projects

Background and Purpose: Research suggests that older adults are more likely to be hospitalized and to be at risk for hospital-associated deconditioning after successful treatment of their medical condition.This case report demonstrates that a walking program with progressive resistive exercises (PREs) helped one 92 year old female patient, suffering from hospital associated deconditioning, improve her strength, cardiovascular endurance, and functional abilities, including sit-stand transfers, ambulation with the least resistive assistive device (LRAD) and stair climbing. These improvements allowed the patient to return to her prior level of functioning, living independently in her 2nd story apartment with assistance as needed from …

Developing The Rehabilitation Education For Caregivers And Patients (Recap) Model: Application To Physical Therapy In Stroke Rehabilitation, Megan M. Danzl

Theses and Dissertations--Rehabilitation Sciences

Patient and caregiver education is recognized as a critical component of stroke rehabilitation and physical therapy practice yet the informational needs of stroke survivors and caregivers are largely unmet and optimal educational interventions need to be established. The objective of this dissertation was to develop a theory and model of “Rehabilitation Education for Caregivers and Patients” (RECAP) in the context of physical therapy and stroke rehabilitation, grounded in the experiences and perceptions of stroke survivors, their caregivers, and physical therapists.

Qualitative research methods with a novel grounded theory approach were used. Potential constructs of RECAP were identified from existing research. …

Motor Control Of Exercise That Emphasizes Speed Post-Stroke, Vicki L. Gray

Electronic Thesis and Dissertation Repository

Purpose: To investigate whether a single session of closed kinetic chain (CKC) and open kinetic chain (OKC) exercises emphasizing speed post-stroke could evoke changes in the motor control and whether these improvements would transfer to postural tasks.

Methods: Thirty-two individuals post-stroke and 32 age- and sex- matched controls performed a single session of 50 fast squats and steps (Chapter 3). Internal perturbations (arm raise/load drop) were used to assess postural responses before exercises (Pre), immediately after exercises (Post) and 15 minutes after exercises (Retention) (Chapter 4). Eleven individuals post-stroke performed a single session of 50 fast knee and ankle OKC …