Rehabilitation and Therapy Commons^™

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 …

Comparison Of Laryngeal Excursion In Stroke Patients With And Without Penetration/Aspiration By Videofluoroscopy Swallowing Study, Yun-Fang Lee, Yung-Chun Chi, Shih-Chung Chang

Rehabilitation Practice and Science

Objective: Post-stroke dysphagia is associated with increased morbidity and mortality in acute stroke patients due to malnutrition or aspiration. This study compares the hyolaryngeal movement during swallowing between post-stroke dysphagia patients with and without penetration/aspiration by videofluoroscopy swallowing study (VFSS). The goal was to find out possible defects in swallow mechunism for improving post-stroke dysphagia swallowing training. Method: We retrospectively collected VFSS images from stroke in-patients in a medical center in Central Taiwan from October 2015 to April 2017. The subjects were subdivided according to the VFSS results and 8-point penetration-aspiration scale (PAS) into those with penetration/aspiration (PAS ≥ 3) …

Hand Temperature And Heart Rate Variability In Stroke Patients When Using Yole Hands And Conventional Elastic Bandages During Passive Upper Limb Exercises, Mei-Yi Lee, Chun-Han Yang, Ko-Long Lin, Shih-Ming Chen, Shu-Shi Chen

Rehabilitation Practice and Science

Therapeutic exercise can mitigate sensorimotor deficit and improve motor function in the upper limbs of stroke patients. During physical rehabilitation, elastic bandages (EB) are often used to secure stroke patients' affected upper limbs to exercise equipment. However, the application of EB can reduce blood flow and lower skin temperature in patients' hands. Furthermore, reduced skin temperature can lead to autonomic nervous reactions, of which heart rate variability (HRV) is an effective indicator. This study investigates the correlation between hand temperature and HRV. Stroke patients' hand temperatures and HRVs were documented during passive upper limb exercises, and the results between the …

External Load On The Hemi-Paretic Lower Limb With Task-Oriented Training To Improve Gait Post Right Aca Stroke, Jacob France, Lindsey Perry

St. Augustine, Fall 2018

The purpose of this case report is to describe the treatment of a 77-year-old male post-stroke with the application of an external load to the paretic lower limb in conjunction with task-oriented training to improve gait.

Strength, balance, gait speed, and functional tasks all improved over the course of physical therapy. At the end of 2 weeks, the patient exceeded the minimal detectable change (MDC) for the TUG (2.9 sec) and achieved the minimal clinically important difference (MCID) for the FIM (22 points).^4-5 Although the MCID is not established for the Modified Ashworth Scale (MAS), the patient experienced improvements …

Predicting Gains With Visuospatial Training After Stroke Using An Eeg Measure Of Frontoparietal Circuit Function, Robert J. Zhou, Hossein M. Hondori, Maryam Khademi, Jessica M. Cassidy, Katherine M. Wu, Derek Z. Yang, Nikhita Kathuria, Fareshte R. Erani, Lucy Dodakian, Alison Mckenzie, Cristina V. Lopes, Walt Scacchi, Ramesh Srinivasan, Steven C. Cramer

Physical Therapy Faculty Articles and Research

The heterogeneity of stroke prompts the need for predictors of individual treatment response to rehabilitation therapies. We previously studied healthy subjects with EEG and identified a frontoparietal circuit in which activity predicted training-related gains in visuomotor tracking. Here we asked whether activity in this same frontoparietal circuit also predicts training-related gains in visuomotor tracking in patients with chronic hemiparetic stroke. Subjects (n = 12) underwent dense-array EEG recording at rest, then received 8 sessions of visuomotor tracking training delivered via home-based telehealth methods. Subjects showed significant training-related gains in the primary behavioral endpoint, Success Rate score on a standardized test …

Neural Constraints Affect The Ability To Generate Hip Abduction Torques When Combined With Hip Extension Or Ankle Plantarflexion In Chronic Hemiparetic Stroke, Natalia Sánchez, Ana M. Acosta, Roberto López-Rosado, Julius P. A. Dewald

Physical Therapy Faculty Articles and Research

Stroke lesions interrupt descending corticofugal fibers that provide the volitional control of the upper and lower extremities. Despite the evident manifestation of movement impairments post-stroke during standing and gait, neural constraints in the ability to generate joint torque combinations in the lower extremities are not yet well determined. Twelve chronic hemiparetic participants and 8 age-matched control individuals participated in the present study. In an isometric setup, participants were instructed to combine submaximal hip extension or ankle plantarflexion torques with maximal hip abduction torques. Statistical analyses were run using linear mixed effects models. Results for the protocol combining hip extension and …

Application Of Forced Use In A Traditional Acute Hospital Setting With A 77-Year-Old Female Post Left Cva, Jimmie Parten, Anne H. Boddy

St. Augustine, Summer 2018

The purpose of this case report is to look at the positive outcomes following the application of forced use physical therapy techniques in the traditional acute hospital setting with a 77-year-old female post left CVA.

Shock And Awe: Functional Strength Training To Improve Balance And Function In A Patient Post Electrocution, Amanda K. Boone, Anne H. Boddy

St. Augustine, Summer 2018

The purpose of this case study is to study the effects of functional strength training rehabilitation in a patient post electrocution suffering from a concurrent stroke.

Motor Compensation During Lower Limb Pedaling After Stroke, Brice Thomas Cleland

Dissertations (1934 -)

Long-term motor dysfunction in the lower limb is common after stroke. One potential contributor is motor compensation, a behavior in which functions originally performed by the paretic limb are performed by the non-paretic limb. Compensation in chronic stroke may contribute to long-term motor dysfunction by limiting functional ability, impairing future recovery, and eliciting maladaptive neuroplasticity. The purpose of this dissertation was to describe the impact of compensation on motor function and brain activation during lower limb pedaling and identify elements that produce this behavior. To achieve this purpose, we evaluated muscle activation and motor performance when compensation was prevented. During …

Type-2 Diabetes Mellitus Reduces Cortical Thickness And Decreases Oxidative Metabolism In Sensorimotor Regions After Stroke., Jennifer K Ferris, Sue Peters, Katlyn E Brown, Katherine Tourigny, Lara A Boyd

Physical Therapy Publications

Individuals with type-2 diabetes mellitus experience poor motor outcomes after ischemic stroke. Recent research suggests that type-2 diabetes adversely impacts neuronal integrity and function, yet little work has considered how these neuronal changes affect sensorimotor outcomes after stroke. Here, we considered how type-2 diabetes impacted the structural and metabolic function of the sensorimotor cortex after stroke using volumetric magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS). We hypothesized that the combination of chronic stroke and type-2 diabetes would negatively impact the integrity of sensorimotor cortex as compared to individuals with chronic stroke alone. Compared to stroke alone, individuals with …

Biomarkers Of Rehabilitation Therapy Vary According To Stroke Severity, Erin Burke Quinlan, Lucy Dodakian, Jill See, Alison Mckenzie, Jill Campbell Stewart Pt,Phd, Steven C. Cramer

Faculty Publications

Biomarkers that capture treatment effects could improve the precision of clinical decision making for restorative therapies. We examined the performance of candidate structural, functional, and angiogenesis-related MRI biomarkers before and after a 3-week course of standardized robotic therapy in 18 patients with chronic stroke and hypothesized that results vary significantly according to stroke severity. Patients were 4.1 ± 1 months poststroke, with baseline arm Fugl-Meyer scores of 20–60. When all patients were examined together, no imaging measure changed over time in a manner that correlated with treatment-induced motor gains. However, when also considering the interaction with baseline motor status, treatment-induced …

In-Home Delivery Of Constraint-Induced Movement Therapy Via Virtual Reality Gaming, Alexandra L. Borstad, Roger Crawfis, Kala Phillips, Linda Pax Lowes, David Maung, Ryan Mcpherson, Amelia Siles, Lise Worthen-Chaudhari, Lynne V. Gauthier

Journal of Patient-Centered Research and Reviews

Purpose: People with chronic hemiparesis are frequently dissatisfied with the recovery of their hand and arm, yet many lack access to effective treatments. Constraint-induced movement therapy (CI therapy) effectively increases arm function and spontaneous use in persons with chronic hemiparesis. The purpose of this study was to determine the feasibility and measure safety and outcomes of an in-home model of delivering CI therapy using a custom, avatar-based virtual reality game.

Methods: Seventeen individuals with chronic hemiparesis participated in this pretest/posttest quasi-experimental design study. The 10-day intervention had three components: 1) high-repetition motor practice using virtual reality gaming; 2) constraint of …

Selection Of Post-Acute Care For Stroke Patients, Kathryn M. Gulfo, Glen Gillen, Lauri Bishop, Clare C. Bassile, Randy B. Kolodny, Joel Stein

The Open Journal of Occupational Therapy

Background: Significant variation exists in post-acute care for stroke survivors. This study examines referral practices of occupational and physical therapists for patients after acute stroke.

Method: Occupational therapists (OTs) and physical therapists (PTs) were surveyed either electronically or in person at a national conference. The respondents selected the most appropriate referral for each of five case vignettes. The referral choices included Inpatient Rehabilitation Facility (IRF), Skilled Nursing Facility (SNF), Long-Term Acute Care Hospital (LTACH), home with home services, or home with outpatient services. Demographic data included practice location, setting, and duration. The respondents were also asked to rate …

Thrombolysis And Early Speech And Language Recovery After Stroke, Sarah E. Campbell

Theses and Dissertations--Rehabilitation Sciences

Speech and language impairments after left hemisphere stroke are life altering. Neuroprotective interventions, such as tissue plasminogen activator, or tPA, are utilized to diminish the impact of the stroke on functional ability.

The purpose of this study was to examine speech and language recovery in the first three months after stroke in individuals with aphasia and to further investigate any differences between individuals who did and individuals who did not receive tPA, using objective speech and language measures.

Twenty-six individuals, thirteen of whom received tPA and thirteen who did not, suffering from first-ever left hemisphere stroke with resulting aphasia were …