Medicine and Health Sciences Commons^™

Occupational Therapy In Stroke: A Case Study Using The Bobath Frame Of Reference And Task Oriented Approach, Reza Nur Arsyi, Afifah Fadhilah Nursyam, Muhammad Luthfi, Hermito Gidion, Ayleen Alicia Kosasi, Erna Faryza Mohd Poot, Rosilah Wahab, Nur Atiqah Azman

Jurnal Fisioterapi Terapan Indonesia or Indonesian Journal of Applied Physiotherapy

Stroke is a sudden neurological disorder caused by vascular injury to the brain, leading to significant functional limitations. This case study examines the use of occupational therapy interventions, specifically the Bobath and Task Oriented approaches, for a 43-year-old male with left hemiparesis to enhance independence in motorcycling. The patient experienced various limitations, including vestibular function, range of motion, muscle tone and strength, postural control, and fine motor skills. Using the Ashworth scale and the Canadian Occupational Performance Measure (COPM) for assessment, occupational therapy interventions showed progress in several aspects, although the primary goal has not yet been fully achieved. This …

Application Of Intravenous Laser Irradiation Of Blood (Ilib) In Physical Medicine: A Narrative Review, Ya-Chi Chuang, Yuan-Yang Cheng

Rehabilitation Practice and Science

Intravenous laser irradiation of blood (ILIB) involves a type of intravascular treatment which applies a helium-neon laser possessing a wavelength of 632.8nm. Since its first use in 1981 by Russian scientists, it is now widely applied in the treatment of various diseases, including chronic musculoskeletal pain, wound healing, spinal cord injury, stroke, traumatic brain injury, coronary artery disease, type 2 diabetes mellitus, rheumatoid arthritis and acute kidney injury. The underlying mechanism for ILIB may be associated with its anti-oxidative (through regulating the reactive oxygen species systems) and anti-inflammatory effects (by reducing the production of inflammatory cytokines). Moreover, positive effects on …

Pain Management Series For Stroke: Identifying Teaching Methods To Increase Clinical Self-Efficacy For Occupational Therapy Doctoral Students, Apasara Jittprasert

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose Post-stroke pain has been identified as a significant challenge for individuals experiencing a stroke. Occupational therapists play a crucial role in the complex treatment of post-stroke pain but often face challenges due to a lack of self-efficacy in implementing treatments for stroke-related pain. This project’s purpose was to,1) to identify which teaching methods are effective for increasing clinical self-efficacy in doctoral occupational therapy students for implementing pain management treatment for individuals’ post-stroke and 2) to increase reported clinical self-efficacy levels among these students following the completion of a pain management educational program for stroke pain. Methodology This project recruited …

An Occupational Therapy Approach To Improving Adl/Iadl Performance In Diabetic Adults With Stroke And Upper Extremity Pathologies, Halle Thomas, Cassandra Nelson

Spring 2024 Virtual OTD Capstone Symposium

This capstone presentation depicts the impact of diabetic management with an occupational therapy approach on upper extremity motor function for the adult stroke population. This program utilizes dietary management, a home exercise program, and task modification strategies to improve ADL and IADL performance.

What Is Task-Oriented Training? A Scoping Review, Erin Halford, Samantha Jakubiszak, Kassidy Krug, Amanda Umphress

Student Journal of Occupational Therapy

Task-Oriented Training (TOT) is an proven stroke rehabilitation intervention with significant evidence-based research that supports its effectiveness. The absence of a clear definition has led to variability in research reporting and subsequent confusion with practical implementation. A consistent definition seeks to remedy this ambiguity to facilitate knowledge translation. The objective of this study was to determine a comprehensive definition of TOT that encapsulates previous definitions and descriptions in the literature. In order to derive this definition, a two stage scoping review process was conducted across four databases searching for articles on the use of TOT in adult stroke rehabilitation therapy. …

Criteria And Indicators For Centers Of Clinical Excellence In Stroke Recovery And Rehabilitation: A Global Consensus Facilitated By Isrra, Rachel C. Stockley, Marion F. Walker, Margit A. Murphy, Noor A. A. Aziz, Philemon Amooba, Leonid Churliov, Amanda Farrin, Natalie A. Fini, Emma Ghaziani, Erin Godecke, Tania Gutierrez-Panchana, Jie Jia, Thoshenthri Kandasamy, Patrice Lindsay, John Solomon, Vincent Thijs, Tierney Tindall, Donna C. Tippett, Caroline Watkins, Elizabeth Lynch

Research outputs 2022 to 2026

Background: The aim of the International Stroke Recovery and Rehabilitation Alliance is to create a world where worldwide collaboration brings major breakthroughs for the millions of people living with stroke. A key pillar of this work is to define globally relevant criteria for centers that aspire to deliver excellent clinical rehabilitation and generate exceptional outcomes for patients. Objectives: This paper presents consensus work conducted with an international group of expert stroke recovery and rehabilitation researchers, clinicians, and people living with stroke to identify and define criteria and measurable indicators for Centers of Clinical Excellence (CoCE) in stroke recovery and rehabilitation. …

Feasibility And Outcomes Of Supplemental Gait Training By Robotic And Conventional Means In Acute Stroke Rehabilitation, Mukul Talaty, Alberto Esquenazi

Moss-Magee Rehabilitation Papers

INTRODUCTION: Practicality of implementation and dosing of supplemental gait training in an acute stroke inpatient rehabilitation setting are not well studied but can have positive impact on outcomes.

OBJECTIVES: To determine the feasibility of early, intense supplemental gait training in inpatient stroke rehabilitation, compare functional outcomes and the specific mode of delivery.

DESIGN AND SETTING: Assessor blinded, randomized controlled trial in a tertiary Inpatient Rehabilitation Facility.

PARTICIPANTS: Thirty acute post-stroke patients with unilateral hemiparesis (≥ 18 years of age with a lower limb MAS ≤ 3).

INTERVENTION: Lokomat® or conventional gait training (CGT) in addition to standard mandated therapy time. …

Effects Of A Multi-Modal Gait Training Program In An Individual With Chronic Stroke: A Case Study, Anne Boddy, Lindsay A. Perry, Chitralakshmi K. Balasubramanian

Internet Journal of Allied Health Sciences and Practice

Purpose: Multi-modal gait training (MMGT) may improve impairments and functional limitations in individuals’ post-stroke. The purpose of this case study was to investigate effects of MMGT on gait and balance outcomes immediately post-intervention, 30-day short term (ST) and 1-year long term follow-up periods. Method: A 63-year-old patient, eight years post-stroke, participated in a MMGT program that included evidence-based gait interventions: unilateral treadmill training, inclined treadmill training at 8%, and over-ground fast walking. The eight sessions lasted 45-minutes each and consisted of the three interventions lasting 10-minutes each with rest breaks. Results: Self-selected (SS) and fastest comfortable gait speed revealed meaningful …

The Level Of Functionality Of The Affected Upper Limb In Stroke Patients Depends On The Type Of Therapy Used And The Lateralization Of The Subjects' Body - A Randomized Observational Study., Anna Olczak, Marcin Dornowski

Baltic Journal of Health and Physical Activity

Introduction: Impairment of the functions of the upper limb and hand is a major problem in stroke patients. The aim of the study was to evaluate various therapies in terms of their influence on changes in the activity of the affected, dominant, and non-dominant upper limb in patients after ischemic stroke. Material/Methods: This is a randomized, double-blinded study. The research was carried out in a rehabilitation clinic on a group of 60 stroke patients who were randomly assigned to groups differing in the rehabilitation program. The study group had physiotherapy based on the NDT Bobath concept and the control group …

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 …

Treatment Of Adult Spasticity With Botox (Onabotulinumtoxina): Development, Insights, And Impact, Alberto Esquenazi, Wolfgang H. Jost, Catherine C. Turkel, Theodore Wein, Rozalina Dimitrova

Moss-Magee Rehabilitation Papers

Upper and lower limb spasticity (ULS, LLS) often occur following a stroke or in patients with other neurological disorders, leading to difficulties in mobility and daily living and decreased quality of life. Prior to the use of onabotulinumtoxinA, antispastic medications had limited efficacy and often caused sedation. Phenol injections were difficult for physicians to perform, painful, and led to tissue destruction. The success of onabotulinumtoxinA in treating cervical dystonia led to its use in spasticity. However, many challenges characterized the development of onabotulinumtoxinA for adult spasticity. The wide variability in the presentation of spasticity among patients rendered it difficult to …

Experiences And Perspectives Of Filipino Patients With Stroke On Physical Therapy Telerehabilitation: A Phenomenological Study Protocol, Christopher G. Cruz, Donald S. Lipardo, Nicole Trizia S. Esplana, Beatrice Ann Q. Loa, Micah L. Dismaya, Janelle Meara Y. Lau, Mirzi Chelsea R. Quizzagan, Arianne B. Cardenas, Adellene Therese S. Celso, Hanz Lauren A. Taguinod, Kristian Joseph C. Martin, Leonardo S. Uy Iii

Philippine Journal of Physical Therapy

Introduction: Stroke is the third leading cause of death in the Philippines, so these patients must continuously undergo rehabilitation for faster recovery. With the rise of COVID-19, physical therapy (PT) telerehabilitation (TR) has emerged, where services are provided outside the usual rehabilitation setting for patients with stroke to continue their treatment while reducing the risk of acquiring COVID-19. However, it is a relatively new service in the country; hence, further research is needed to identify the factors and needs of these patients during TR, which may help improve PT TR services.

Objective: This study aims to explore the experiences …

Ultrasound Assessment Of Spastic Muscles In Ambulatory Chronic Stroke Survivors Reveals Function-Dependent Changes, Javier González-Buonomo, Alexander H Pham, Jaskiran Ghuman, Aila Malik, Nuray Yozbatiran, Gerard E Francisco, Walter R Frontera, Sheng Li

Student and Faculty Publications

OBJECTIVE: To correlate ultrasound characteristics of spastic muscles with clinical and functional measurements in chronic stroke survivors.

METHODS: Ultrasound assessment and clinical and functional assessments were performed in 28 ambulatory stroke survivors (12 females, mean age 57.8 ± 11.8 years, 76 ± 45 months after stroke).

RESULTS: Muscle thickness in the affected side was decreased compared with the contralateral side (p < 0.001). The decrease was more evident in the upper limb muscles. On the affected side, the modified Heckmatt scale score was lowest (closer to normal) in the rectus femoris (RF) muscle compared with other muscles (biceps brachii (BB), flexor carpi ulnaris (FCU) and medial gastrocnemius (MG)). Muscle thickness and echogenicity of spastic muscles did not correlate with spasticity, as measured with the modified Ashworth scale (MAS), Fugl-Meyer motor assessment scores, age, or time since stroke. There was a significant negative correlation between grip strength and percentage decrease in muscle thickness for the spastic FCU muscle (r = -0.49, p = 0.008). RF muscle thickness correlated with ambulatory function (Timed Up and Go test (r = 0.44, p = 0.021) and 6-metre walk test (r = 0.41, p = 0.032)). There was no significant correlation between echogenicity and functional assessments Conclusion: Ambulatory chronic stroke survivors had function-dependent changes in muscle thickness on the affected side. Muscle thickness and echogenicity of spastic muscles did not correlate with spasticity, Fugl-Meyer motor assessment scores, age, or time since stroke.

The Effects Of Cognitive-Linguistic Interventions To Treat Aphasia In The First 90 Days Post-Stroke: A Systematic Review, Emily Eley, Maayken Van Den Berg, Miranda L. Rose, John E. Pierce, Abby Foster, Edwina Lamborn, Sarah D’Souza, Erin Godecke, Lucette Lanyon, Ciara Shiggins, Ian Kneebone, Caroline Baker

Research outputs 2022 to 2026

Background: Cognitive-linguistic interventions for aphasia are behavioural-based approaches to therapy that aim to treat language impairment skills post-acquired brain injury. The purpose of cognitive-linguistic intervention is to restore and rehabilitate language impairment skills through targeting phonologic, semantic and syntactic systems, which may support goals to improve everyday communication. Aims: The aim of this systematic review was to investigate the effects of cognitive-linguistic interventions on language processing for aphasia in the first 90 days post-stroke. Secondary aims include the investigation of the effects of these interventions on functional communication and quality of life. Methods: A systematic search was conducted across six …

A Tailored Occupational Therapist-Led Vocational Intervention For People With Stroke: Protocol For A Pilot Randomized Controlled Trial, Sophie O'Keefe, Kathryn Radford, Amanda Farrin, Jodi Oakman, Serena Alves-Stein, Geoffrey Cloud, Jacinta Douglas, Mandy Stanley, Natasha A. Lannin

Research outputs 2022 to 2026

Background: Resuming work after stroke is a common goal of working-age adults, yet there are few vocational rehabilitation programs designed to address the unique challenges faced following stroke. The Work intervention was developed to address these gaps. Objective: This paper presents a protocol that outlines the steps that will be undertaken to pilot both the intervention and trial processes for the Work trial. Methods: The Work trial is a 2-arm, prospective, randomized, blinded-assessor study with intention-to-treat analysis. A total of 54 adults of working age who have experienced a stroke <4 months prior will be randomized 1:1 to either (1) an experimental group who will receive a 12-week early vocational intervention (Work intervention) plus usual clinical rehabilitation or (2) a control group who will receive only their usual clinical rehabilitation. Results: Outcomes include study and intervention feasibility and intervention benefit. In addition to evaluating the feasibility of delivering vocational intervention early after stroke, benefit will be assessed by measuring rates of vocational participation and quality-of-life improvements at the 3- and 6-month follow-ups. Process evaluation using data collected during the study, as well as postintervention individual interviews with participants and surveys with trial therapists, will complement quantitative data. Conclusions: The results of the trial will provide details on the feasibility of delivering the Work intervention embedded within the clinical rehabilitation context and inform future trial processes. Pilot data will enable a future definitive trial to determine the clinical effectiveness of vocational rehabilitation when delivered in the early subacute phase of stroke recovery.

Studi Kasus Penatalaksanaan Terapi Okupasi Bersumberdayamasyarakat Dalam Aktivitas Memasak Pada Penderita Strokedi Desa Setisari, Hermito Gidion, Muhammad Luthfi, Dini Fajariani, Aditya Denny Pratama

Jurnal Fisioterapi Terapan Indonesia or Indonesian Journal of Applied Physiotherapy

Stroke is a health problem that affects a person's independence. Occupational therapists can carry out community-based occupational therapy (TOBM) in intervening in stroke patients. The aim of this intervention is to improve the patient's ability to cook from an occupational therapy perspective. In community service through TOBM, stroke patients in Siteari village were given an intervention for 1 month to assess an increase in independence in cooking. There are results that TOBM can increase patient independence in cooking.

Efektivitas Balance Dan Core Exercise Untuk Meningkatkankeseimbangan Statis Pada Kasus Stroke Hemiparese Sinistra, Aditya Denny Pratama, Fatimah Fatimah, Mita Noviana, Riza Pahlawi

Jurnal Fisioterapi Terapan Indonesia or Indonesian Journal of Applied Physiotherapy

Stroke is a rapidly developing loss of brain function due to interruption of the blood supply to the brain. This can be caused by a blockage or bleeding in the blood vessels in the brain. The purpose of this study is to find out and understand how the effectiveness of balance and core exercise is to improve static balance in cases of left hemiparese stroke at Karmel Stroke Services. Of the various physiotherapy methods that can be done to overcome problems that can arise such as muscle weakness, balance disorders, posture disorders, and Activity Daily Living (ADL) disturbances in cases …

Effects Of Quadruped Movement In An Individual With Chronic Stroke: A Case Study, Maureen Romanow Pascal, Emily Connell, Alyssa Pratti, Kristina Russell

Student Research Poster Presentations 2022

Background/Purpose: Neuromuscular dysfunction encompasses a wide variety of conditions that impact proper muscle functioning. One common condition resulting in neuromuscular dysfunction is a cerebrovascular accident (CVA) which can disrupt sensory, motor, visual and language systems. The resulting combination of impairments can cause limitations in activity performance and restrict participation across domains. In addition, muscle weakness is widely recognized as a major contributing factor to decline in function. Literature is showing that rehabilitation programs focusing on development of core strength with emphasis on repetition, intensity and novelty are critical for recovery of motor function. The purpose of this research was to …

Therapeutic Efficacy Of Dynamic Hand Splints In Spastic Hemiparetic Hands: A Randomized Controlled Single-Blind Trial, Yi-Ching Huang, Shih-Che Lin, Kai-Hua Chen, Chien-Min Chen, Chia-Hao Chang, Chu-Hsu Lin

Rehabilitation Practice and Science

Background: It is usually challenging to treat patients following stroke or brain injury with spastic hemiparetic upper limbs. Dynamic hand splints have been used to manage this issue for years, but evidence of their efficacy is still lacking. Objective: To investigate the treatment efficacy of dynamic hand splinting in spastic hemiparetic patients. Methods: In this randomized controlled single-blind clinical trial, patients with spastic hemiparesis lasting more than half a year after a stroke or brain injury were enrolled. They were randomly divided into a splint group and a control group, and received 1 month of task-oriented training with or without …

Integrating Survivors Of Stroke Into Exercise‐Based Cardiac Rehabilitation Improves Endurance And Functional Strength, Elizabeth Wherley Regan Dpt, Ph.D., Reed Handlery, Jill Campbell Stewart, Joseph Lee Pearson Ms,Drph, Sarah Wilcox Phd, Stacy L. Fritz Phd, Pt

Faculty Publications

Background

Cardiac rehabilitation (CR) is a structured exercise program prevalent in the United States for people with cardiovascular disease that has been shown to increase cardiovascular endurance and improve quality of life. Despite similar cardiovascular risk factors, stroke is not among the covered diagnoses for CR. The purpose of this study was to examine the participant impact of integrating survivors of stroke into the exercise portion of an existing hospital‐based CR program through measures of physical function and other health impacts and through qualitative evaluation of participant perception.

Methods and Results

Subacute and chronic survivors of stroke were integrated into …

Hospital Staff, Volunteers’ And Patients’ Perceptions Of Barriers And Facilitators To Communication Following Stroke In An Acute And A Rehabilitation Private Hospital Ward: A Qualitative Description Study, Sarah D'Souza, Erin Godecke, Natalie Ciccone, Deborah J. Hersh, Heidi Janssen, Elizabeth Armstrong

Research outputs 2014 to 2021

Objectives

To explore barriers and facilitators to patient communication in an acute and rehabilitation ward setting from the perspectives of hospital staff, volunteers and patients following stroke.

Design

A qualitative descriptive study as part of a larger study which aimed to develop and test a Communication Enhanced Environment model in an acute and a rehabilitation ward.

Setting

A metropolitan Australian private hospital.

Participants

Focus groups with acute and rehabilitation doctors, nurses, allied health staff and volunteers (n=51), and interviews with patients following stroke (n=7), including three with aphasia, were conducted.

Results

The key themes related to barriers and facilitators to …

The Effects Of Virtual Rehabilitation Therapy On Multiple Sclerosis, Mary Price

Honors Projects

In this review article, the effect of virtual rehabilitation therapy on multiple sclerosis, a neurodegenerative disorder, is explored. Multiple sclerosis is characterized by damaged nerves that result in incomplete signal processing between the brain and the spinal cord. The symptoms of this condition can include vision loss, decreased coordination, pain, fatigue, and deteriorating motor output. The severity of the symptoms and the rate of progression of multiple sclerosis can vary from person to person; some individuals live the majority of their lives with mild symptoms while others become bedridden and immobile. There is no cure for this disease, however implementation …

An Exploration Of Quality Of Life Contributors For Stroke Survivors: Potential Implications For Service Delivery Within The Community Rehabilitation Context, Gaylea Fritsch, Sarah Patterson, Anita Blight, Renaye Daniells

Internet Journal of Allied Health Sciences and Practice

Purpose: Community rehabilitation services typically assist stroke survivors with function, participation, and quality of life. Many factors have been found to influence the overall quality of life including self-identity, control, social supports, personality, and participation in valued activities. This review explored the possible contributing quality of life factors for stroke survivors within a community rehabilitation context to assist with further development of service delivery within this clinical area. Method: A purposive sample of clients with stroke (n=20) was selected based on their overall quality of life change during their rehabilitation program as measured on the World Health Organisation Quality of …

Use Of Standardized Assessments And Online Resources In Stroke Rehabilitation, Susan H. Lin, Pamela R. Bosch, Veronica T. Rowe, Susan E. Fasoli, Jeanne Langan

The Open Journal of Occupational Therapy

Background: The extent to which movement-related standardized assessments and online resources are used in stroke rehabilitation is unclear in the United States.

Method: The researchers used a cross-sectional descriptive survey that examined (a) therapists use of movement-related standardized assessments, (b) factors influencing learning of new assessments, and (c) use of frequency of online resources by occupational therapists and physical therapists in the United States.

Results: Of 151 respondents (46.4% occupational therapists, 53.6% physical therapists), the most frequently used movement-related assessments by occupational and physical therapists were the Berg and Fugl-Meyer Assessment, respectively. More physical therapists use motor-related …

The Effect Of Mirror Therapy On Upper Extremity Functioning For Patients Poststroke: A Systematic Review, Caitlin Beach, Halie Finke, Abby Garrity, Amanda Norcini, Lily Postus, Kristen Tekel, Lyn Kaiser, Otd, Otr/L

Student Papers, Posters & Projects

Due to the high incidence of stroke and the detrimental impact it can have on a patient’s independence, several systematic reviews examining the effect of MT on post-stroke rehabilitation for upper extremity functioning have been conducted. However, it is necessary to provide an update to existing systematic reviews to include new clinical studies that have recently been published. Since stroke is a leading cause of disability, this study aims to determine the effectiveness of MT in post-stroke rehabilitation for upper extremity function as compared to conventional therapy.

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 …

Development Of A Training Program To Increase Student Clinician Competency When Communicating With People With Aphasia, Meghan Doherty, Chevie Lay

Journal of Occupational Therapy Education

The Washington University in St. Louis Stroke Clinic is a student-run free clinic (SRSC) designed to enhance student learning and provide the community with no-cost evidence-based occupational therapy services. Aphasia is a common communication impairment after stroke that affects the ability to access services and give and get information, and impacts life participation and satisfaction. Conversation partner training is an evidence-based treatment approach to improve communication with people with aphasia (PWA). The purpose of this project was to develop and evaluate the effectiveness of student clinician training about communicating with PWA using conversation partner training in the SRSC. This study …

The Tailoring Of National Guidelines For Upper Extremity Post-Stroke Rehabilitation: A Concept In Use., Salem F. Alatawi

Internet Journal of Allied Health Sciences and Practice

Background: In Saudi Arabia, national evidence-based clinical guidelines (NCG) were created based for healthcare interventions. However, clinicians appear to be slow to incorporate the evidence into practice. As a result, there exists a time-gap between the gathering and presentation of evidence for best practice and the use of that evidence by clinicians. It becomes, therefore, imperative to investigate the gap between the research evidence and clinical practice. The knowledge to action (KTA) framework is available to facilitate the implementation of research evidence. This framework incorporates the theory of tailoring, a concept that is intended to create a fit between …

A Systematic Reviewarticle Of Turning Difficulties In Individuals With Stroke, Pei-Yi Chou, Shu-Chun Lee

Rehabilitation Practice and Science

Introduction: Making turn is a challenging task that is reported as one of the activities that most frequently leads to fall in stroke patients. Among community-dwelling older adults, hip fractures are eight times more likely to result from falls while making turns than from falls while walking straight. The stroke patients have asymmetric posture and movements due to hemiparesis, thus their turning performance may varied depending on the direction of the turn. Therefore, the purpose of this systematic reviewarticle was to summarize the characteristics of turning after stroke and discuss the possible neuromuscular mechanisms of turning difficulties. Methods: Searches of …

Vrshape: A Virtual Reality Tool For Shaping Movement Compensation, Matthew Hale Foreman

Arts & Sciences Electronic Theses and Dissertations

The majority of persons living with chronic stroke experience some form of upper extremity motor impairment that affects their functional movement, performance of meaningful activities, and participation in the flow of daily life. Stroke survivors often compensate for these impairments by adapting their movement patterns to incorporate additional degrees of freedom at new joints and body segments. One of the most common compensatory movements is the recruitment of excessive trunk flexion when reaching with the affected upper extremity. Long-term use of these compensations may lead to suboptimal motor recovery and chronic pain or injury due to overuse. Rehabilitation focuses on …