Advances and challenges in stroke rehabilitation

Stinear, Cathy M.; Lang, Catherine E.; Zeiler, Steven R.; Byblow, Winston D.

doi:10.1016/s1474-4422(19)30415-6

Cited by 487 publications

(374 citation statements)

References 69 publications

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“…Stroke remains a leading cause of adult disability and the demand for stroke rehabilitation services is growing (Stinear et al, 2020). So, the future research of stroke must expand its horizon to find new strategies.…”

Section: Discussionmentioning

confidence: 99%

“…Stroke remains a leading cause of adult disability and the demand for stroke rehabilitation services is growing (Stinear et al, 2020). Especially, ischemic stroke at young age is an increasing problem in both developing and developed countries due to rising incidence, high morbidity and mortality, and long-term psychological, physical, and social consequences (Boot et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

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Astragaloside IV Exerts Cognitive Benefits and Promotes Hippocampal Neurogenesis in Stroke Mice by Downregulating Interleukin-17 Expression via Wnt Pathway

et al. 2020

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Background: Stroke remains a leading cause of adult disability and the demand for stroke rehabilitation services is growing, and Astragaloside IV (As IV), a primary bioactive compound of Radix Astragali: Astragalus mongholicus Bunge (Fabaceae), may be a promising stroke therapy. Methods: To access the effect of As IV on adult mice after ischemic stroke, a photochemical ischemia model was established on C57BL/6 mice, which were intravenously administered As IV for three consecutive days later. And then the cognitive benefits and hippocampal neurogenesis were evaluated by Morris Water Maze (MWM) test, Golgi staining, and immunohistochemical staining in vivo and in vitro. Furthermore, to find out the underlying mechanism, interleukin-17 (IL-17) knockout (KO) mice were used, through RNA sequence (RNA-seq) analysis and immunohistochemistry. Then the mechanism of neurogenesis promoted by As IV was observed by western blot both in vivo and in vitro. Specifically, As IV, recombinant mouse IL-17A and IL-17F, and Wingless/integrated (Wnt)-expressing virus was administered respectively in neural stem cells (NSCs), and then their diameters and protein expression of Nestin, IL-17, and Wnt pathway relevant protein, were measured in vitro. Results: Administering As IV resulted in significant amelioration of stroke-induced cognitive deficits. And more hippocampal neurons with normal morphology, significant increments in the length of the apical dendrites, and the density of their spines were observed in As IV-treated mice. Furthermore, the immunohistochemistry staining of DCX/ BrdU and Sox2/Nestin showed As IV could promote hippocampal neurogenesis and NSC proliferation after ischemic stroke, as well as in vitro. For the mechanism underlying, IL-17 expression was downregulated significantly by As IV treatment and knocking out IL-17 was associated with nervous regeneration and synapse repair according to the analysis of RNA-seq. Consistent to As IV treatment, knocking out IL-17 showed some promotion on hippocampal neurogenesis and proliferation of NSCs, with activating Wnt pathway after

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Astragaloside IV Exerts Cognitive Benefits and Promotes Hippocampal Neurogenesis in Stroke Mice by Downregulating Interleukin-17 Expression via Wnt Pathway

et al. 2020

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“…A study conducted by American Heart Association including millions of cerebral infarction patients shows that only 3.7% of them used tPA to thrombolysis [3] . Up to 80% stroke patients are leaved with varying degrees of disabilities due to the limited treatment methods [4] . The disability of motor function, especially the malperformance of lower limb, seriously affects their quality of life, so it is important to reestablish their motor function safely and effectively [5] .…”

Section: Introductionmentioning

confidence: 99%

“…The rehabilitation guidelines and clinical experience have proved that early and scienti c rehabilitation training can reduce the disability rate of stroke and improve the quality of patients' life [6] . At present, the rehabilitation of patients' lower extremity motor function mostly depends on therapists for one-to-one training, which can hardly meet the requirement of highintensity and personalized training, and the curative effect is di cult to be objectively evaluated [4] .…”

Section: Introductionmentioning

confidence: 99%

Clinical research of lower extremity exoskeleton robot In post-stroke hemiplegic patients

Wang¹,

Yu²,

Hui-min³

et al. 2020

Preprint

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Background In recent years, the number of people suffering from stroke-induced motor function lost increased considerably. Recovery of motility is essential in improving their quality of life. However, the existing rehabilitation methods cannot fulfill patients’ training requirements. As a new rehabilitation technology, exoskeleton robot provides a new treatment scheme for post-stroke hemiplegic patients. Objective To explore the safety and effectiveness of exoskeleton-assisted gait training for post-stroke hemiplegic patients. Methods A lower extremity hip joint exoskeleton robot was designed by the cooperation team, and 9 post-stroke hemiplegic patients were included for exoskeleton-assisted gait training. The three-dimensional gait parameters, plantar pressure and surface electromyography were used to validate the effectiveness of the exoskeleton robot in post-stroke hemiplegic patients. Results Exoskeleton-assisted ambulation training for post-stroke hemiplegic patients can correct the asymmetry of gait and abnormal phase of gait cycle, increase the toe-ground clearance and the angle of hip joint, reduce the pressure of non-paretic plantar and the impulse of bilateral feet, which help balance the plantar pressure distribution. It can also improve the integral electromyography value of specific muscle, which means that corresponding muscles are stimulated to generate activities. Conclusions The exoskeleton robot designed by our team can correct the hemiplegic gait and foot drop phenomenon of post-stroke patients, protecting them from damage caused by long-term abnormal gait, which contributes to the recovery of lower extremity motor function in hemiplegic patients. The results also provide important information for the design of lower extremity exoskeleton robot. In the future, we should further explore the rehabilitation function of exoskeleton robot in post-stroke hemiplegic patients, as well as the ambulation and rehabilitation function in other lower extremity motor dysfunction patients.

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“…Stroke is a severe disease that alters cortical processing producing long lasting motor or cognitive deficits. Treatments generally include motor rehabilitation, pharmacological therapies, brain stimulation, or combinations of them (Stinear et al, 2020). However, the functional outcome, measured as behavioural recovery, depends on multiple factors such as age, lesion size and type, edema formation or inflammation and is hardly predictable (Burke Quinlan et al, 2015;Prabhakaran et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Cortical propagation as a biomarker for recovery after stroke

Cecchini

Scaglione

Mascaro

et al. 2020

Preprint

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Stroke is a debilitating condition which affects millions of people worldwide. The development of improved rehabilitation paradigms rests on finding biomarkers suitable for tracking functional damage and recovery. We perform a detailed spatiotemporal analysis of wide-field calcium images from mice during longitudinal motor training before and after focal stroke induction. We define three indicators that characterise the duration, the angle of propagation and the smoothness of global movement-evoked activation patterns. During acute stroke we observe an increase in global event duration and a decrease in smoothness over the ipsilesional hemisphere. For both rehabilitation via motor training alone and combined with pharmacological therapy, we find clear signs of recovery, but surprisingly, cortical propagation in double treated mice with generalised recovery is even faster and smoother than before stroke. Our propagation-based biomarkers deliver unforeseen insight into brain mechanisms underlying motor recovery and thus pave the way towards a more targeted post-stroke therapy.

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Advances and challenges in stroke rehabilitation

Cited by 487 publications

References 69 publications

Astragaloside IV Exerts Cognitive Benefits and Promotes Hippocampal Neurogenesis in Stroke Mice by Downregulating Interleukin-17 Expression via Wnt Pathway

Astragaloside IV Exerts Cognitive Benefits and Promotes Hippocampal Neurogenesis in Stroke Mice by Downregulating Interleukin-17 Expression via Wnt Pathway

Clinical research of lower extremity exoskeleton robot In post-stroke hemiplegic patients

Cortical propagation as a biomarker for recovery after stroke

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