Relation Between Sensorimotor Rhythm During Motor Attempt/Imagery and Upper-Limb Motor Impairment in Stroke

2021 ◽  
pp. 155005942110199
Author(s):  
Shugeng Chen ◽  
Xiaokang Shu ◽  
Jie Jia ◽  
Hewei Wang ◽  
Li Ding ◽  
...  
Keyword(s):  
Upper Limb ◽  
Motor Impairment ◽  
Motor Dysfunction ◽  
Motor Tasks ◽  
Rehabilitation Technology ◽  
Modified Ashworth Scale ◽  
Sensorimotor Rhythm ◽  
The Relationship ◽  
Ashworth Scale ◽  
Wrist Flexors

Motor attempt (MA)/motor imagery (MI)-based brain–computer interface (BCI) is a newly developing rehabilitation technology for motor impairment. This study aims to explore the relationship between electroencephalography sensorimotor rhythm and motor impairment to provide reference for a BCI design. Twenty-eight stroke survivors with varying levels of motor dysfunction and spasticity status in the subacute or chronic stage were enrolled in the study to perform MA and MI tasks. Event-related desynchronization (ERD)/event-related synchronization (ERS) during and immediately after motor tasks were calculated. The Fugl–Meyer assessment scale (FMA) and the modified Ashworth scale (MAS) were applied to characterize upper-limb motor dysfunction and spasticity. There was a positive correlation between FMA total scores and ERS in the contralesional hemisphere in the MI task ( P < .05) and negative correlations between FMA total scores and ERD in both hemispheres in the MA task ( P < .05). Negative correlations were found between MAS scores of wrist flexors and ERD in the ipsilesional hemisphere ( P < .05) in the MA task. It suggests that motor dysfunction may be more correlated to ERS in the MI task and to ERD in the MA task while spasticity may be more correlated to ERD in the MA task.

Safety and efficacy of letibotulinumtoxinA(BOTULAX®) in treatment of post stroke upper limb spasticity: a randomized, double blind, multi-center, phase III clinical trial

2017 ◽  
Vol 31 (9) ◽  
pp. 1179-1188 ◽  
Author(s):  
Kyung Hee Do ◽  
Min Ho Chun ◽  
Nam-Jong Paik ◽  
Yoon Ghil Park ◽  
Shi-Uk Lee ◽  
...  
Keyword(s):  
Upper Limb ◽  
Botulinum Neurotoxin ◽  
Primary Outcome ◽  
Secondary Outcome ◽  
Safety Measures ◽  
Modified Ashworth Scale ◽  
Burden Scale ◽  
Limb Spasticity ◽  
Ashworth Scale ◽  
Wrist Flexors

Objective: To investigate a new botulinum neurotoxin type A, termed letibotulinumtoxinA(Botulax®) and compare its efficacy and safety for post-stroke upper limb spasticity with that of onabotulinumtoxinA(Botox®). Design: A prospective, double-blinded, multicenter, randomized controlled clinical study. Setting: Six university hospitals in Korea. Subjects: A total of 187 stroke participants with upper limb spasticity. Interventions: Two kinds of botulinum neurotoxin type A were used. One set of injection was performed and total injected doses were 309.21±62.48U(Botulax) and 312.64±49.99U(Botox)( P>0.05). Main measures: Primary outcome was measured using the modified Ashworth scale for wrist flexors at week 4 and secondary outcome was measured using modified Ashworth scale for wrist flexors, elbow flexors, finger flexors, and thumb flexors as well as Global Assessment in spasticity, Disability Assessment Scale, and Caregiver Burden Scale. Safety measures including adverse events, vital signs and physical examination, and laboratory tests were also monitored. Results: The mean ages for the Botulax group were 56.81±9.49 and which for the Botox group were 56.93±11.93( P>0.05). In primary outcome, the change in modified Ashworth scale for wrist flexors was -1.45±0.61 in the Botulax group and -1.40±0.57 in the Botox group, and the difference between the two groups was -0.06(95% CI:-0.23–0.12, P>0.05). In secondary outcome, both groups demonstrated significant improvements with respect to modified Ashworth scale, Global Assessment in spasticity, Disability Assessment Scale, and Caregiver Burden Scale ( P<0.05), and no significant difference was observed between the two groups ( P>0.05). In addition, safety measures showed no significant differences between the two groups ( P>0.05). Conclusions: The efficacy and safety of Botulax were comparable with those of Botox in treatment of post-stoke upper limb spasticity.

scholarly journals Relationship Between Clinical Measures of Upper Limb Movement Quality and Activity Poststroke

2019 ◽  
Vol 33 (6) ◽  
pp. 432-441 ◽  
Author(s):  
Mindy F. Levin ◽  
Vimonwan Hiengkaew ◽  
Yongchai Nilanont ◽  
Donna Cheung ◽  
David Dai ◽  
...  
Keyword(s):  
Upper Limb ◽  
Controlled Trial ◽  
Motor Impairment ◽  
Limb Movement ◽  
Reach To Grasp ◽  
Cross Sectional ◽  
Movement Quality ◽  
Performance Time ◽  
Multicenter Randomized Controlled Trial ◽  
The Relationship

Background. Understanding the relationship between movement quality (impairment) and performance (activity) in poststroke patients is important for rehabilitation intervention studies. This has led to an interest in kinematic characterization of upper limb motor impairment. Since instrumented motion analysis is not readily clinically available, observational kinematics may be a viable alternative. Objective. To determine if upper limb movement quality during a reach-to-grasp task identified by observation could be used to describe the relationship between motor impairments and the time to perform functional tasks. Methods. Cross-sectional, secondary analysis of baseline data from 141 participants with stroke, age 18 to 85 years, who participated in a multicenter randomized controlled trial. Clinical assessment of movement quality using the Reaching Performance Scale for Stroke (RPSS–Close and Far targets) and of performance (activity) from the Wolf Motor Function Test (WMFT–7 items) was assessed. The degree to which RPSS component scores explained scores on WMFT items was determined by multivariable regression. Results. Clinically significant decreases (>2 seconds) in performance time for some of the more complex WMFT tasks involving prehension were predicted from RPSS–Close and Far target components. Trunk compensatory movements did not predict either increases or decreases in performance time for the WMFT tasks evaluated. Overall, the strength of the regression models was low. Conclusions. In lieu of kinematic analysis, observational clinical movement analysis may be a valid and accessible method to determine relationships between motor impairment, compensations and upper limb function in poststroke patients. Specific relationships are unlikely to generalize to all tasks due to kinematic redundancy and task specificity.

scholarly journals Aberrant Auditory and Visual Memory Development of Children with Upper Limb Motor Disorders

2021 ◽  
Vol 11 (12) ◽  
pp. 1650
Author(s):  
Maria Koriakina ◽  
Olga Agranovich ◽  
Ekaterina Petrova ◽  
Dzerassa Kadieva ◽  
Grigory Kopytin ◽  
...  
Keyword(s):  
Cognitive Development ◽  
Motor Skills ◽  
Upper Limb ◽  
Cognitive Functions ◽  
Visual Memory ◽  
Motor Impairment ◽  
Motor Dysfunction ◽  
Motor Disorders ◽  
Healthy Children ◽  
Life Functioning

The current study aimed to compare differences in the cognitive development of children with and without upper limb motor disorders. The study involved 89 children from 3 to 15 years old; 57 children with similar upper limb motor disorders and 32 healthy children. Our results showed that motor disorders could impair cognitive functions, especially memory. In particular, we found that children between 8 and 11 years old with upper limb disorders differed significantly from their healthy peers in both auditory and visual memory scales. These results can be explained by the fact that the development of cognitive functions depends on the normal development of motor skills, and the developmental delay of motor skills affects cognitive functions. Correlation analysis did not reveal any significant relationship between other cognitive functions (attention, thinking, intelligence) and motor function. Altogether, these findings point to the need to adapt general habilitation programs for children with motor disorders, considering the cognitive impairment during their development. The evaluation of children with motor impairment is often limited to their motor dysfunction, leaving their cognitive development neglected. The current study showed the importance of cognitive issues for these children. Moreover, early intervention, particularly focused on memory, can prevent some of the accompanying difficulties in learning and daily life functioning of children with movement disorders.

scholarly journals Use of reliability tested clinically data towards a portable device measurement kit system for upper limb spasticity

2019 ◽  
Vol 15 (4) ◽  
pp. 622-625
Author(s):  
Khairunnisa Johar ◽  
Noor Ayuni Che Zakaria ◽  
Fazah Akhtar Hanapiah ◽  
Low Cheng Yee ◽  
Nurul Atiqah Othman ◽  
...  
Keyword(s):  
Upper Limb ◽  
Clinical Assessment ◽  
Intraclass Correlation ◽  
Medical Intervention ◽  
Portable Device ◽  
Modified Ashworth Scale ◽  
The Social ◽  
Limb Spasticity ◽  
Therapy Sessions ◽  
Ashworth Scale

Spasticity refers to the abnormal symptom of having resistance in the joints when patients tried to make a movement. Patients with spasticity need to undergo multiple therapy sessions with medical intervention to ensure that the upper limb achieve maximal function. Modified Ashworth Scale (MAS) is frequently used in clinical assessment with grading on a scale. However, this scale is limited in sensitivity and the accuracy of this evaluation is dependent on the physician’s and therapist’s experience. This study suggests developing a portable measurement device kit system during clinical assessment to reduce inter- and intra-rater variability, and to assist clinicians in making quick clinical evaluation of spasticity. In this study, 19 patients were involved in the data acquisition. Assessment data from upper limb of patients with spasticity were recorded using a Manual Muscle Tester (MMT) and digital goniometer to measure force and the angular motion. During the assessment, patients were examined through slow and fast motion for spasticity evaluation. The collected data were analyzed to study intra-rater reliability value by using Statistical Package for the Social Sciences (SPSS). The results of Intraclass Correlation Coefficient (ICC) values for all patients were in range 0.78 to 0.89. It can be considered that the collected data was reliable and can be used to formulate a model towards the development of a portable device measurement kit system for upper limb spasticity.

Intra-rater reliability of the Modified Modified Ashworth Scale (MMAS) in the assessment of upper-limb muscle spasticity

2012 ◽  
Vol 31 (2) ◽  
pp. 215-222 ◽  
Author(s):  
Noureddin Nakhostin Ansari ◽  
Soofia Naghdi ◽  
Masoud Mashayekhi ◽  
Scott Hasson ◽  
Zahra Fakhari ◽  
...  
Keyword(s):  
Upper Limb ◽  
Limb Muscle ◽  
Rater Reliability ◽  
Muscle Spasticity ◽  
Modified Ashworth Scale ◽  
Ashworth Scale

Constraint-induced movement therapy in the rehabilitation of chronic hemiparetic patients in the Amazonia

2017 ◽  
Vol 18 (4) ◽  
pp. 449
Author(s):  
Larissa Salgado de Oliveira Rocha ◽  
Lizandra Dias Magno ◽  
Luciane Lobato Sobral ◽  
Rodrigo Santiago Barbosa Rocha ◽  
Rosana Macher Teodori
Keyword(s):  
Upper Limb ◽  
Muscle Tone ◽  
Human Movement ◽  
Movement Therapy ◽  
Constraint Induced Movement Therapy ◽  
End Of Treatment ◽  
Modified Ashworth Scale ◽  
Flexion Extension ◽  
The World ◽  
Ashworth Scale

Introduction: The stroke is one of the incident diseases in the world, causing numerous changes to the functionality especially those related to upper limb functions. Objective: To evaluate the influence of modified Constraint-Induced Movement Therapy (mCIMT) on functional recovery, range of motion (ROM) and muscle tone of chronic hemiparetic upper limb (UL). Methods: Seven subjects (52.75 ± 6.63 years old) were evaluated before, straightaway and one month after 12 sessions of mCIMT, by goniometry, modified Fugl-Meyer Assessment (mFMA) and modified Ashworth Scale (MAS). Results: Functionality improved 74.7% after treatment and 79.5% one month after the end of treatment. There was improvement in passive motion (p = 0.01), in pain (p = 0.004) and UL motor function (p ≤ 0.001), increased range of flexion, extension, abduction and adduction of the shoulder and flexion and radial deviation of the wrist (p = 0.05) and muscle tone reduction (p < 0.05). Conclusion: mCIMT was effective for recovery of ROM in shoulder and wrist; recovery of the paretic UL functionality and spasticity reduction, and the results remained after the end of treatment.Key-words: stroke, physical therapy, rehabilitation, human movement, modified constraint-induced movement therapy.

Antispastic Effect of Electroacupuncture and Moxibustion in Stroke Patients

2003 ◽  
Vol 31 (03) ◽  
pp. 467-474 ◽  
Author(s):  
Sang-Kwan Moon ◽  
Yeon-Kyu Whang ◽  
Sung-Uk Park ◽  
Chang-Nam Ko ◽  
Young-Suk Kim ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Motor Impairment ◽  
Control Group ◽  
Stroke Patients ◽  
Paretic Side ◽  
Modified Ashworth Scale ◽  
Significant Change ◽  
And Control ◽  
Ashworth Scale ◽  
Efficacy Of Treatment

Spasticity is a frequently observed motor impairment that develops after stroke. The objective of this study was to evaluate the efficacy of electroacupuncture (EA) and moxibustion (Mox) on spasticity due to stroke. The subjects consisted of 35 stroke patients with elbow spasticity whose mean duration of stroke was 2.97 months. Fifteen patients were randomized to the EA group, ten to Mox, and ten to control. Every other day, 30 minutes of electrical stimulation with a frequency of 50 Hz was given through four needles on the Ch'ü-Ch'ih-San-Li (LI-11-LI-10) and Wai-Kuan-Ho-Ku (TB-5-LI-4) points of the paretic side. Direct Mox was applied to Ch'ü-Ch'ih (LI-11), San-Li (LI-10), Wai-Kuan (TB-5) and Ho-Ku (LI-4) points three times a day every other day. The control group was given only the routine acupuncture therapy for stroke and range of motion (ROM) exercise, which were also applied to the EA and Mox groups. The efficacy of treatment was measured before, immediately, 1 hour, 3 hours, 1 day, 5 days, 10 days and 15 days after the start of treatment using a modified Ashworth scale (MAS). In the EA group, spasticity was significantly reduced immediately, 1 hour and 3 hours after treatment (p < 0.05). Reductions were significant on the 5th day and thereafter (p < 0.05). In the Mox group, there was no significant change in the MAS scores after the first treatment. In the Mox and control group, there was no significant change in MAS scores. This study suggests that EA can temporarily reduce spasticity due to stroke, and if applied repeatedly it can maintain reduced spasticity.

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