Rehabilitation and Therapy Commons^™

Mechanisms Of The Contextual Interference Effect In Individuals Poststroke, Nicolas Schweughofer, Jeong-Yoon Lee, Hui-Ting Goh, Youggeun Choi, Sung Shin Kim, Jill Campbell Stewart Pt,Phd, Rebecca Lewthwaite, Carolee J. Winstein

Faculty Publications

Although intermixing different motor learning tasks via random schedules enhances long-term retention compared with “blocked” schedules, the mechanism underlying this contextual interference effect has been unclear. Furthermore, previous studies have reported inconclusive results in individuals poststroke. We instructed participants to learn to produce three grip force patterns in either random or blocked schedules and measured the contextual interference effect by long-term forgetting: the change in performance between immediate and 24-h posttests. Nondisabled participants exhibited the contextual interference effect: no forgetting in the random condition but forgetting in the blocked condition. Participants at least 3 mo poststroke exhibited no forgetting in …

Is Gait Training With The Elliptically Based Robotic Gait Trainer (Ebrgt) Feasible In Ambulatory Patients After Stroke?, J. Cortney Bradford

Theses and Dissertations

In response to the potential benefits of task specific training in rehabilitation of gait after stroke and the need for affordable, simple ways to implement it, our group designed the elliptically based robotic gait trainer (EBRGT). A design review of the EBRGT, covering the design goals, an overview of the mechanical and electrical design, and a discussion of the novelty of the device and why it may be beneficial for individuals with hemiparesis secondary to stroke is discussed (Chapter 2). To characterize the new device, a study was performed to determine if the EBRGT produced a gait pattern that mimicked …

Effects Of Distributed Constraint-Induced Therapy On Trunk Control, Daily Function, And Quality Of Life In Patients With Chronic Stroke, Yi-An Chen, Keh-Chung Lin, Ching-Yi Wu, Yin-Chou Lin, Ngok-Kiu Chu, Jyh-Yuh Ke, Pei-Hsuan Wu

Rehabilitation Practice and Science

Objective: Patients commonly have impaired arm trunk coordination following a stroke. The trunk compensation often used by stroke patients may hinder recovery of the affected arm. Given that the extent to which constraint-induced therapy (CIT) affects arm-trunk coordination has not been investigated previously, this study examines how distributed CIT (dCIT) affects arm trunk coordination and trunk compensation strategy, as well as functional performance and quality of life.Materials and Methods: Sixteen participants (at least 6 months post-onset) after stroke were randomly assigned to either the dCIT group which received training 2 hours daily for 3 weeks, with the unaffected arm restrained …

The Effects Of Rehabilitation Exercises In Community-Dwelling Elderly With Osteoarthritis And Stroke: A Pilot Study, Jia-Ching Chen, Chun-Hsiang Lin, Li-Chun Chen, Yu-Chun Wei, Jung Hsiao, Nan-Yueh Lin, Chung-Chao Liang

Rehabilitation Practice and Science

The prevalence of chronic disease in community-dwelling elderly has increased with the increase in the elderly population in Taiwan. This study investigated the effects of regular rehabilitation exercises provided by rehabilitation professionals in community-dwelling elderly people with osteoarthritis and stroke. A single group with pretest-posttest design was used in this pilot study. A total of 32 elderly people in the community were recruited and classified into two groups, one with osteoarthritis (n=21) and the other with chronic stroke (n=11). The intervention of one consisted of one 3-hour rehabilitation exercise session each week provided by a physical therapist and consultation with …

Novel Orthoses For Male Hemiplegic Patients To Perform Clean Intermittent Catheterization: A Casereport, Yu-Lin Tsai, Mao-Hsiung Huang, Chia-Hsin Chen

Rehabilitation Practice and Science

A 37-year-old male suffered from hemorrhagic stroke with left side hemiplegia and neurogenic bladder. On admission, due to post-renal acute renal failure with hydronephrosis, he received indwelling catheterization but felt very uncomfortable. However, he was physically unable to perform clean intermittent catheterization (CIC) due to his hemiplegia. Two novel devices were designed to help him perform CIC using one side of his body. As in our experience with this case, hemiplegic patients may now be able to perform CIC by themselves to achieve adequate bladder drainage using one-sided limbs under the assistance of the novel orthoses.

The Hemineglect And Hemianopia In Right Hemispheric Stroke Patients, Yung-Nan Hsu, Liu-Ing Bih, Chang-Zern Hong

Rehabilitation Practice and Science

This study investigated whether a stroke patient with left hemianopsia, which was confirmed by the perimetric test, may also have hemineglect. The relationship between hemineglect and hemianopia in patients with right hemispheric stroke was evaluated. Eleven subjects with left unilateral neglect underwent three testing sessions separated in time. The three test sessions, including cancellation and static perimetric tests, were performed at approximately 3 months, 4 months, and 7 months post the onset of the stroke. For the cancellation test, patients were asked to circle 60 marks on the test paper, and the number of marks correctly circled was scored. For …

The Impact Of Left Hemisphere Stroke On Force Control With Familiar And Novel Objects: Neuroanatomic Substrates And Relationship To Apraxia, Amanda M. Dawson, Laura J. Buxbaum, Susan V. Duff

Physical Therapy Faculty Articles and Research

Fingertip force scaling for lifting objects frequently occurs in anticipation of finger contact. An ongoing question concerns the types of memories that are used to inform predictive control. Object-specific information such as weight may be stored and retrieved when previously encountered objects are lifted again. Alternatively, visual size and shape cues may provide estimates of object density each time objects are encountered. We reasoned that differences in performance with familiar versus novel objects would provide support for the former possibility. Anticipatory force production with both familiar and novel objects was assessed in six left hemisphere stroke patients, two of whom …

Observation Of Amounts Of Movement Practice Provided During Stroke Rehabilitation, Catherine E. Lang, Jillian R. Macdonald, Darcy S. Reisman, Lara Boyd, Teresa Jacobson Kimberley, Sheila M. Schindler-Ivens, T. George Hornby, Sandy A. Ross, Patricia L. Scheets

Physical Therapy Faculty Research and Publications

Objective

To investigate how much movement practice occurred during stroke rehabilitation, and what factors might influence doses of practice provided.

Design

Observational survey of stroke therapy sessions.

Setting

Seven inpatient and outpatient rehabilitation sites.

Participants

We observed a convenience sample of 312 physical and occupational therapy sessions for people with stroke.

Interventions

Not applicable.

Main Outcome Measures

We recorded numbers of repetitions in specific movement categories and data on potential modifying factors (patient age, side affected, time since stroke, FIM item scores, years of therapist experience). Descriptive statistics were used to characterize amounts of practice. Correlation and regression analyses were …

Initial Blood Glucose Level In The Emergency Department As A Prognostic Factor On Functional Outcome Of Ischemic Stroke, Yi-Min Chen, Gwo-Chi Hu, Jiann-Perng Chen, Chien-Shen Chen, Cheng-Tsong Liao, Kuan-Wen Chen

Rehabilitation Practice and Science

Although many studies are available in focus on prognostic factors for acute cerebral vascular disease, there are few reports to discuss the impact of the initial glucose level on the functional outcome after stroke. The initial glucose level in the emergency department is more representative of acute glucose response after stroke and is not influenced by the treatment in the emergency department. The aim of our study is to evaluate the prognostic role of the initial glucose level on the functional outcome after stroke.We recruited individuals who sustained first-ever stroke and were admitted to an inpatient stroke rehabilitation program. Patients …

Intensive Cardiopulmonary Rehabilitation Program For Patients With Severe Heart Failure And Acute Stroke: A Report Of Two Cases, Chyi-Yann Wang, Jue-Long Wang, Ai-Lun Yang, Ko-Long Lin

Rehabilitation Practice and Science

Cardiovascular disease is a major factor restricting successful outcomes after stroke rehabilitation. While neurological recovery after stroke has been extensively investigated, cardiovascular adaptations to physical activities poststroke have received little attention. Severe heart failure patients have been well known for limitation of ambulation, but the influence over acute poststroke patients have rarely been investigated. Exercise testing has become a mainstay for the prognostic assessment of patients with heart failure. Various studies have shown that patients with impaired exercise capacity, as measured by low peak oxygen consumption (Vo2), have an unfavorable outcome, independent of other parameters. Whether parameters from submaximal test …

A Reviewarticle Of Psychometric Properties Of Five Tests Of Attention Commonly Used In Patients With Stroke, Hui-Yan Chiau, I-Ping Hsueh, Chia-Lin Koh, Hui-Chun Chen, Chin-Ling Hsieh

Rehabilitation Practice and Science

Background and purpose: Comparison of the psychometric properties of tests of attention can provide guidelines with which clinicians and researchers can determine a useful measurement. The purpose of this study is to reviewarticle and appraise the psychometric properties of attentional tests frequently used during the last 3 years in empirical studies of stroke and to determine how well these tests can be applied on people with stroke.Methods: This study included two parts: first, a search from the MEDLINE, PsycINFO, CINAHL and Index to Chinese Periodical Literature databases for attentional tests used more than twice in empirical studies of stroke in …

The Pressure Distribution Of Hemiplegics At The Femoral Greater Trochanter And Sacrum In Different Bed Positions, Chin-Teng Chung, Wei-Feng Tang, Chorng-Song Chou, Lu-Han Liu, May-Hua Liao, Yu-Chun Yin

Rehabilitation Practice and Science

Pressure ulcers frequently develop in hemiplegic stroke patients who are immobilized and bedridden. Common sites for pressure ulcers include the sacrum, greater trochanter of the femur, lateral malleolus, and the heel. Such ulcers cause extra burdens for the whole medical team, the caregiver, and the patients themself. The ulcers also increase more medical cost at the same time. Patients with pressure ulcers also become depressed and less motivated to undergo rehabilitation. The prevention of pressure ulcer formation has thus become an important issue among stroke patients.The most important factor in pressure ulcer formation is the direct pressure of the mattress …

Correlation Between Impairment And Motor Performance During Reaching Tasks In Subjects With Spastic Hemiparesis, Charles Leonard, Kelsey A. Gardipee, Jennifer R. Koontz, John-Henry Anderson, Scott A. Wilkins

Physical Therapy and Rehabilitation Science Faculty Publications

Objective: The main purposes of this study were to examine, in subjects with chronic hemiparesis following a stroke: (i) the correlations between tests of muscle tone, stiffness, spasticity, paresis and co-contraction, and (ii) the correlations of these tests and measurements of impairment to upper extremity motor performance.

Design: Prospective, cross-sectional, correlation matrix using sample of convenience.

Subjects: Thirteen subjects with chronic hemiparesis secondary to a cerebrovascular accident (stroke) were tested.

Methods: Subjects were assessed using the Fugl-Meyer Upper Extremity Motor Assessment, modified Ashworth scale, deep tendon reflexes, and muscle characteristics that included quantification of muscle stiffness, paresis and co-contraction during …

Risk Factors Of Post-Stroke Depression In Middle-Aged Adults And The Elderly, Yuan-Yang Cheng, Chen-Liang Chou, Shun-Ping Cheng, Tcho-Jen Liu, Rai-Chi Chan, Wen-Jang Wong

Rehabilitation Practice and Science

In order to evaluate the prevalence and risk factors of post-stroke depression, this study collected the data of 102 stroke patients from the outpatient clinic of the neurology and rehabilitation departments in a medical center in Taipei. The patients' objective data, such as age, infarction area of the brain, duration from the stroke attack to the time of our study, number of stroke attacks, antidepressant use, and rehabilitation program, were obtained from the history chart. A questionnaire evaluation of the swallowing function, depression status, and functional independence measure was also done by interviewing the patients individually. The results showed that …

Quantitative Emg Evaluation In Spastic Upper Extremity After Botulinum Toxin Injection-A Preliminary Report, Chiao-Wen Hwang, Ching-Hsiang Lu, Pei-Te Sheu, Ya-Wen Hsu, Kun-Shou Tsai, Ji-Long Wang

Rehabilitation Practice and Science

Spasticity of the upper limb muscles is a common complication following stroke. Injection of botulinum toxin can decrease upper limb spasticity. The effects of botulinum toxin treatment are usually evaluated by activities of daily living, range of motion (ROM), or modified Ashworth scale. However, in this study, we evaluated the effect of botulinum toxin injection by quantitative EMG, and investigated the relationship between EMG and conventional evaluation methods.Twenty patients with chronic stroke-related spasticity of the upper limb muscles received botulinum injections. All injections were guided by EMG. Outcome measures included total modified Ashworth scale score on the elbow, wrist, metacarpal …

Thickening Of Finger Extensor Tendons In Hemiplegic Hands Of Stroke Patients, Nai-Hsin Meng, Sui-Foon Lo, Ting-I Han, Yi-Fang Hu, I-Shien Tseng, Mu-Jung Kao

Rehabilitation Practice and Science

Thickening of finger extensor tendons in hemiplegic hands of stroke patients has never been reported. We reported 11 patients with stroke who experienced gradual onset of a painless swelling at the dorsal aspect of the hemiplegic wrist. Soft tissue sonography revealed that the swellings were mainly composed of thickened finger extensor tendons. This thickening typically involved the tendons of the 4th dorsal extensor compartment between the proximal carpal and mid-metacarpal levels. The maximal thickness of these tendons could reach over three times that of the corresponding tendons of the contralateral hand. The synovial tissue surrounding the thickened tendon was also …

The Study On Cognitive Function In Stroke Patients, Shih-Pin Chao, Shich-Fu Wu

Rehabilitation Practice and Science

Mini-Mental State Examination (MMSE) is a simple and effective bed-side screening test for cognitive function. Cognitive defect is frequently encountered clinically in stroke patients, but several sophisticated cognitive function tests are not proper for them. MMSE is used as a tool to investigate the correlation between cognitive function and the severity of brain damage of the stroke patient. A total of 65 patients, who had developed hemiplegia, hemiparesis or cerebellar dysfunction as a result of cerebral vascular disease, were collected in this study. All patients had received MMSE, motor status examination of affected limbs, and brain CT within 3 weeks …