Improving functional ability in stroke patients by improving movement impairments

Do improvements in a specific task used in massed practice therapy transfer to untrained tasks. This question was answered by Schaefer SY et al. from Washington University School of Medicine, St Louis, MO, USA in Neurorehabilitation and Neural Repair, 04/24/2013. The team aimed at showing that task-specific training is a viable approach for recovering motor function after stroke and also to help design task–specific training plans to maximize therapy benefits. The group found that for stroke patients with chronic mild to moderate hemiparesis the improvements in impairments achieved during task practice did transfer to untrained upper-extremity motor tasks e.g washing, feeding and dressing.

 

Active movement training of ankle improves mobility impairments in stroke and motor function

Active movement training of the ankle improves motor function and mobility post stroke. Waldman G et al. from Feinberg School of Medicine, Northwestern University, IL, USA looked at patients at least 3 months post stroke. Writing in NeuroRehabilitation, 04/19/2013 the group studied Robot-assisted passive stretching and active movement training as a means of intensive stroke rehabilitation for motor impairments post stroke. The outcome measures looked at include reduction in spasticity measured by modified Ashworth scale, mobility by Stroke Rehabilitation Assessment of Movement (STREAM),

and the balance by Berg balance score. Additional outcome measures were isolated movement parameters including dorsiflexion passive range of motion, dorsiflexion active range of motion and dorsiflexor strength after the training.

The MediTouch can be used to give assisted active ankle stroke rehabilitation practice.

Early intensive physical and occupational therapy improves motor abilities post stroke

Early intensive physical and occupational therapy leads to greater improvement in motor abilities post stroke. This conclusion was reached by Lang KC et al. from Emory University, Atlanta, GA, USA writing in Neurorehabilitation and Neural Repair, 04/19/2013. The group looked at 2 groups of post stroke patients  3-9 months and 15 to 21 months post stroke. The groups underwent the same dose and intensity of constraint-induced movement therapy (CIMT) and the outcome measure was the Wolf Motor Function Test (WMFT).

 

Computer-based cognitive rehabilitation (CBCR) after stroke

Computer-based cognitive rehabilitation (CBCR) effective on improving cognitive function after stroke. This conclusion was reached by occupational therapists from Department of Occupational Therapy, Semyung University, Jecheon, Republic of Korea. The group publish their results in NeuroRehabilitation, 04/16/2013.

The MediTouch HandTutor and ArmTutor work on improving motor sensory and cognitive movement ability through. The system is used in the clinic and at home and offers motivating customized exercise practice with OT and PT support.

Intensive exercise practice improves walking ability in Stroke patients

Resistive training is the use of closed kinetic chain CKC exercise practice. Lee NY et al writing in  NeuroRehabilitation, 04/16/2013  show that both closed kinetic chain CKC exercises and open kinetic chain exercises OKC in a group of stroke patients performing physiotherapy 5 times per week for 6 weeks showed are an effective treatment method for improving normal gait patterns in stroke patients. These findings may be attributed to the fact that  CKC and OKC exercise induced use of the ankle and knee muscles and provided repetitive sensory input from the affected foot. The researchers are from the Department of Rehabilitation Science, Graduate School, Daegu University, Kyeongbuk, Republic of Korea. The LegTutor and 3DTutor is used for customized closed kinetic chain CKC and open kinetic chain exercise practice.

Who benefits from residential intensive neurorehabilitation as opposed to community therapy in the UK

Answering this question Foy CML et al from the Rehabilitation Services, Brain Injury Centre, Banstead, Surrey, UK and Sutton Hospital, look at patient functional ability following rehabilitation at a mixed therapy and educational residential programme. The clients received 5 hours of education and/or physiotherapy and occupational therapy each day.

BothTBI and nonTBI made clinically and statistically significant improvements in their functional abilities during their neurorehabilitation and benefited from a mixed inpatient neurorehabilitation programme. The movement and functional improvements was predicted by the patients functional abilities at admission and the length of stay. Therefore preinjury and injury variables do give insight into functional recovery in traumatic brain injury (TBI) and non traumatic brain injury (nonTBI) patients.

Improving the walking function of community-based of incomplete spinal cord injury (SCI) patients

Community-based ambulation training for ambulatory patients with incomplete spinal cord injury (SCI) seen to remarkably improve both indoor and outdoor walking function of incomplete spinal cord injury patients. These results were reported in NeuroRehabilitation, 04/15/2013 by Oh DW et al from Department of Physical Therapy, College of Health Science, Cheongju University, Chungbuk, Republic of Korea. The walking training consisted on 1-hour sessions six times a week for a 4-week period.

Neurorehabilitation and Neural Repair – hand function in chronic stroke

Dr. Lefebvre S et al. from Université Catholique de Louvain (UCL), Yvoir, Belgium discuss improving dexterity of the paretic hand function in chronic stroke patients. The report on using transcranial direct current stimulation (tDCS) in Neurorehabilitation and Neural Repair, 04/08/2013.

Home based ongoing physiotherapy improves walking ability post stroke

In order to improve walking ability 6 months after stroke, this study shows that a home exercise impairment based training program was as effective as clinic based outpatient sessions of clinic based locomotor training program LTP – walking training on a treadmill using body-weight support and overground walking training following stroke. Physical therapists at University of Florida, Gainesville, FL, USA, and the Department of Veterans Affairs writing in Neurorehabilitation and Neural Repair, 04/08/2013 therefore concluded that ongoing Physical therapy following inpatient physiotherapy improves walking ability at 6 months post stroke.

Preventing falls post stroke by improving dynamic stability

Patients post stroke fall more often than age-matched controls. Dr. Mansfield A et al from Toronto Rehabilitation Institute-UHN, Toronto, ON, Canada writing in  Neurorehabilitation and Neural Repair, 04/04/2013 show that falls are related to the inability to react to loss of balance in stroke patients. The results confirm that stepping reactions need to be targeted with physiotherapy treatment during inpatient rehabilitation. Physical therapy will improve dynamic stability control and potentially prevent falls.