• Title/Summary/Keyword: motor recovery

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The Approach of Robot-assisted Gait Therapy for Locomotor Recovery of Chronic Stroke Patients: a Case Report

  • Shin, Hee-Joon;Lee, Ju-Hyeok;Seo, Dong-Kyu;Kim, Hong-Rae;Moon, Ok-Kon;Park, Si-Eun;Park, Joo-Hyun;Kim, Nyeon-Jun;Min, Kyung-Ok
    • Journal of International Academy of Physical Therapy Research
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    • v.2 no.1
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    • pp.207-213
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    • 2011
  • In this case report, we investigated the effects of robot-assisted gait therapy in a chronic stroke patient using motor assessment and gait analysis. A patient who suffered from the right hemiparesis following the left corona radiata and basal ganglia infarction received 30 minutes of robot-assisted gait therapy, 3 times a week for 4 weeks. Outcome was measured using Motoricity index(MI), Fugl-Meyer assessment(FMA), modified motor assessment scale(MMAS), isometric torque, body tissue composition, 10-meter gait speed and gait analysis. After robot-assisted gait therapy, the patient showed improvement in motor functions measured by MI, FMA, MMAS, isometric torque, skeletal muscle mass, 10-meter gait speed. In gait analysis, cadence, single support time, double support time, step length, walking speed improvement in after robot-assisted gait therapy. The results of this study showed that robot-assisted gait therapy is considered to facilitate locomotor recovery of the chronic hemiparetic stroke patient.

The Correlation between the Balance, Cognition, Motor Recovery and Activity of Daily Living in Stroke Patie (뇌졸중 환자의 균형, 인지, 기능회복, 일상생활 평가도구의 상관성)

  • Cho, Ki-Hun;Kim, Chan-Mun
    • Journal of Korean Physical Therapy Science
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    • v.18 no.1
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    • pp.61-67
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    • 2011
  • Background: The purpose of the present study was to determine correlations between the Berg Balance Scale (BBS), Modified Barthel Index(MBI), Mini-Mental State Examination(MMSE) and Fugl-Meyer motor function Assessment(FMA) in persons with strokes. Methods: We recruited 77 stroke patients from the Seoul Bukbu Geriatric Hospital in Seoul, Korea. Balance was measured by BBS. Activity of Daily Living was assessed using MBI. Cognitive function was examined using MMSE. Motor Recovery was measured using FMA. Data was analyzed using Pearson' correlation. Resurts: There were a statistically significant correlation between BBS and MBI, BBS and MMES, BBS and FMA upper extremity, BBS and FMA lower extremity. There were a statistically significant correlation between MBI and MMSE, MBI and FMA upper extremity, MBI and FMA lower extremity. There were a statistically significant correlated between FMA upper extremity and FMA lower extremity. Conclusions: This study will help rehabilitation program for stroke patients and will be the reference data for selection of therapy and evaluation method.

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A Systematic Review of Cortical Excitability during Dual-Task in Post-Stroke Patients

  • Soyi Jung;Chang-Sik An
    • Physical Therapy Rehabilitation Science
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    • v.13 no.2
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    • pp.213-222
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    • 2024
  • Objective: Stroke is a leading cause of disability worldwide, often leaving survivors with significant cognitive and motor impairments. Dual-task (DT), which involves performing cognitive and motor tasks simultaneously, can influence brain activation patterns and functional recovery in stroke patients. Design: A systematic review Methods: Following PRISMA guidelines, databases including MEDLINE, CINAHL, Embase, and Web of Science were searched for studies assessing cortical activation via functional near-infrared spectroscopy (fNIRS) during DT performance in stroke patients. Studies were selected based on predefined eligibility criteria, focusing on changes in hemodynamic responses and their correlation with task performance. Results: Eight studies met the inclusion criteria. Findings indicate that DT leads to increased activation in the prefrontal cortex (PFC), premotor cortex (PMC), and posterior parietal cortex (PPC), suggesting an integrated cortical response to managing concurrent cognitive and motor demands. However, increased activation did not consistently translate to improved functional outcomes, highlighting the complex relationship between brain activation and rehabilitation success. Conclusions: DT interventions may enhance cortical activation and neuroplasticity in post-stroke patients, but the relationship between increased brain activity and functional recovery remains complex and requires further investigation. Tailored DT programs that consider individual neurophysiological and functional capacities are recommended to optimize rehabilitation outcomes.

Delayed Intraventricular Nogo Receptor Antagonist Promotes Recovery from Stroke by Enhancing Axonal Plasticity

  • Kim, Tae-Won;Lee, Jung-Kil;Joo, Sung-Pil;Kim, Tae-Sun;Kim, Jae-Hyoo;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.39 no.2
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    • pp.130-135
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    • 2006
  • Objective : After ischemic stroke, partial recovery of function frequently occurs and may depend on the plasticity of axonal connections. Here, we examine whether blockade of the Nogo/NogoReceptor[NgR] pathway might enhance axonal sprouting and thereby recovery after focal brain infarction. Methods : Adult male Sprague Dawley rats weighing $250{\sim}350g$ were used. Left middle cerebral artery occlusion[MCAO] was induced with a intraluminal filament. An osmotic mini pump [Alzet 2ML4, Alza Scientific Products, Palo Alto, CA] for the infusion of NgR-Ecto[310]-Fc to block Nogo/NgR pathway was implanted 1 week after cerebral ischemia. Prior to induction of ischemia, all animals received training in the staircase and rotarod test. Two weeks after biotin dextran amine injection, animals were perfused transcardially with PBS, followed by 4% paraformadehyde/PBS solution. Brain and cervical spinal cord were dissected. Eight coronal sections spaced at 1mm intervals throughout the forebrain of each animal with cresyl violet acetate for determination of infarction size. Images of each section were digitized and the infarct area per section was measured with image analysis software. Results : Histological examination at 11 weeks post-MCAO demonstrates reproducible stroke lesions and no significant difference in the size of the stroke between the NgR[310]Ecto-Fc protein treated group and the control group. Behavioral recovery is significantly better and more rapid in the NgR-Ecto[310]-Fe treated group. Blockade of NgR enhances axonal sprouting from the uninjured cerebral cortex and improves the return of motor task performance. Conclusion : Pharmacological interruption of NgR allows a greater degree of axonal plasticity in response this is associated with improved functional recovery of complicated motor tasks.

Effects of Differences Frequency of Repeated Transcranial Magnetic Stimulation Applied to the Less Affected Contralesional Corticomotor Area on Upper Extremity Function in Patients with Stroke (뇌졸중 환자의 비손상측 대뇌겉질 운동영역에 적용한 반복 경두개 자기자극의 빈도가 팔 기능에 미치는 영향 )

  • Ha-Na Kim;Sang-Mi Chung
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.4
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    • pp.281-289
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    • 2023
  • Purpose : In this study, we aimed to determine how frequencies different of repetitive transcranial magnetic stimulation applied to the less affected contalesional corticomotor area affect upper extremity motor function in patients with acute stroke within 3 months of onset. By doing so, we aimed to propose a new method of rTMS intervention based on the degree of damage and recovery status of the patient, rather than the generalized rTMS intervention that has been used uniformly. Methods : The rTMS intervention was applied on the contralesional side of the cerebral hemisphere damage. 15 subjects in the HF-rTMS group, 12 subjects in the LF-rTMS group, and 14 subjects in the SF-rTMS group were randomized to receive the rTMS intervention in each group for a total of 10 sessions on five consecutive weekdays for two weeks, and underwent FMA-U to determine changes in upper extremity function following the intervention in each group. FMA-U was performed within 24 hours before and after the rTMS intervention. Results : When the FMA-U was performed to determine the pre- and post-intervention changes in upper extremity motor function within the groups, no statistically significant differences were found in the SF-rTMS group before and after the intervention, but significant statistical differences were found in the HF-rTMS group (p=.006) and the LF-rTMS group (p=.020), with greater significance in the HF-rTMS group than the LF-rTMS group. Conclusion : This study confirmed that compensatory action by activating the less affected contralesional corticomotor area based on the bimodal balance-recovery model can support upper extremity recovery patients with acute stroke within 3 months of onset, depending on the degree of damage level and recovery status. Therefore, the results of the contralesional HF-rTMS application in this study may provide a basis for proposing a new rTMS intervention for upper extremity recovery in stroke patients.

Effects of Gastrodiae Elata Pharmacopuncture at GB20 on Motor Control and Cognitive Function in Mild TBI Rats (중등도 외상성 뇌손상 흰쥐에서 천마약침(天麻藥鍼)이 운동조정 및 인지 기능회복에 미치는 효과)

  • Kim, Kyung-Yoon;Jeong, Hyun-Woo;Kim, Gye-Yeop
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.5
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    • pp.1080-1086
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    • 2009
  • This study was designed to investigate the effects of Gastrodiae Elata Pharmacopuncure at GB20 on motor control and cognitive dysfunction recovery after mild traumatic brain injury in rats. Rats were divided into three groups; (1) no treatment after traumatic brain injury(experiment I), (2) Treatment with NPA after traumatic brain injury(experiment II), (3) Treatment with GEP after traumatic brain injury(experiment III). In our study, we carried out behavioral test(Rotarod, Morris water maze) and immunohistochemistry study of the change BDNF in the hippocampus(pre, $7^{th}$, $14^{th}$ day). In Rotarod test(motor control function) was significantly increased in the experimental group III as compared with experimental group I, II on $7^{th}$(p<0.01) and $14^{th}$ day(p<0.001). In Morris water maze test(cognitive function) was significantly decreased in the experimental group III as compared with experimental group I, II on $14^{th}$ day(p<0.001). In immunohistochemistric response of BDNF in the hippocampus, the experimental group III was more immune response than the other groups on $14^{th}$ day. These results imply that Gastrodiae Elata Pharmacopuncure at GB20 can play a role in facilitating recovery of motor control and cognitive function after mild traumatic brain injury in rats.

Targetting Balance and Gait Rehabilitation with Multichannel Transcranial Direct Current Stimulation in a Sub-Acute Stroke Survivor-A Case Report

  • Gakhar, Kazal;Arumugam, Narkeesh;Midha, Divya
    • Physical Therapy Rehabilitation Science
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    • v.11 no.1
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    • pp.8-15
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    • 2022
  • Objective: Post stroke motor recovery is facilitated by the brain reorganization or the neuroplastic changes. The therapeutic approach mentioned in the current case is one of the approaches for enhancing motor recovery by stimulating the damaged neural networks directing the motor behaviour of a person. The aim of the present study was to establish the changes in the balance and gait pattern of an individual through multi target stimulation of areas of cerebral cortex by utilising multichannel trans cranial direct current stimulation (M-tDCS) in a sub-acute stroke survivor. Design: A Case Report Methods: The present patient was the participant of the trial (CTRI/2021/02/031044).The patient was intervened with M-tDCS (anodes over left primary motor cortex that is C3 point and left dorsolateral prefrontal cortex i.e., F3 point and cathodes over supraorbital areas, Intensity - 1.2mA) for the duration of 20 minutes along with turbo med extern - an AFO to facilitate ankle dorsi flexion and conventional physiotherapy rehabilitation. The Fugl-Meyer assessment lower extremity (FMA-LE), Berg Balance Scale (BBS), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures were used for outcome assessment. Baseline assessment was done on day 0 followed by assessment on 10 and 20 post intervention. Results: Improvement was seen in all the tools i.e. (FMA -LE), BBS, SSQOL and WGS over the time period of 20 days. Conclusions: M-tDCS resulted in improvement in gait parameters, balance and motor functions of lower extremity of the patient.