Abstract:Interdisciplinary combinations of medicine and engineering are part of the strategic plan of many universities aiming to be world-class institutions. One area in which these interactions have been prominent is rehabilitation of stroke hemiplegia. This article reviews advances in the last five years of stroke hemiplegia rehabilitation via interdisciplinary combination of medicine and engineering. Examples of these technologies include VR, RT, mHealth, BCI, tDCS, rTMS, and TCM rehabilitation. In this article, we… Show more
“…Hand spasm in hemiplegic patients after stroke is a manifestation of abnormal muscle tone after upper motor neuron injury, which is caused by increased activity of spinal cord reflex and is characterized by the increase of stretch reflex with the increase of speed. It is caused by the loss of regulation of stretch reflex in the higher center after stroke [ 6 ]. In short, the recovery of hand dysfunction is difficult and time-consuming, which is not only a difficult problem for rehabilitation workers, but also brings many difficulties and challenges to the rehabilitation training of the upper limb and hand function of hemiplegic patients because of hand spasm.…”
Objective. The purpose of the systematic review is to verify the effect of biofeedback therapy on limb motor rehabilitation in patients with acute stroke and to provide evidence-based medicine for the promotion and use of biofeedback therapy. Methods. The randomized controlled trials (RCT) of biofeedback therapy in the treatment of cerebral palsy were searched in PubMed, EMBASE, ScienceDirect, Cochrane Library, China National Knowledge Infrastructure (CNKI), China VIP Database, Wanfang Database, and Chinese Biomedical Literature Database (CBM). The starting time and ending time of this study are from the time of building the database of the number of pieces to October 31, 2018. The data included in this study were extracted by two independent researchers and evaluated the bias risk of all the literature included in the study according to the Cochrane manual 5.1.0 criteria. RevMan5.4 statistical software was used to analyze the collected data by meta. Results. This systematic review included 9 RCT studies with a total of 1410 patients. The results of meta-analysis showed that there were significant differences in the improvement of lower limb muscle tension, comprehensive spasm scale score, EMG score, and passive range of motion of ankle joint between biofeedback therapy and routine rehabilitation therapy. Conclusion. Biofeedback therapy can improve lower limb muscle tension, spasticity, EMG integral value, and passive range of motion of ankle joint in children with cerebral palsy and provide better conditions for improving the motor ability of lower extremities in children with cerebral palsy. However, more studies and follow-up with higher methodological quality and longer intervention time are needed to further verify.
“…Hand spasm in hemiplegic patients after stroke is a manifestation of abnormal muscle tone after upper motor neuron injury, which is caused by increased activity of spinal cord reflex and is characterized by the increase of stretch reflex with the increase of speed. It is caused by the loss of regulation of stretch reflex in the higher center after stroke [ 6 ]. In short, the recovery of hand dysfunction is difficult and time-consuming, which is not only a difficult problem for rehabilitation workers, but also brings many difficulties and challenges to the rehabilitation training of the upper limb and hand function of hemiplegic patients because of hand spasm.…”
Objective. The purpose of the systematic review is to verify the effect of biofeedback therapy on limb motor rehabilitation in patients with acute stroke and to provide evidence-based medicine for the promotion and use of biofeedback therapy. Methods. The randomized controlled trials (RCT) of biofeedback therapy in the treatment of cerebral palsy were searched in PubMed, EMBASE, ScienceDirect, Cochrane Library, China National Knowledge Infrastructure (CNKI), China VIP Database, Wanfang Database, and Chinese Biomedical Literature Database (CBM). The starting time and ending time of this study are from the time of building the database of the number of pieces to October 31, 2018. The data included in this study were extracted by two independent researchers and evaluated the bias risk of all the literature included in the study according to the Cochrane manual 5.1.0 criteria. RevMan5.4 statistical software was used to analyze the collected data by meta. Results. This systematic review included 9 RCT studies with a total of 1410 patients. The results of meta-analysis showed that there were significant differences in the improvement of lower limb muscle tension, comprehensive spasm scale score, EMG score, and passive range of motion of ankle joint between biofeedback therapy and routine rehabilitation therapy. Conclusion. Biofeedback therapy can improve lower limb muscle tension, spasticity, EMG integral value, and passive range of motion of ankle joint in children with cerebral palsy and provide better conditions for improving the motor ability of lower extremities in children with cerebral palsy. However, more studies and follow-up with higher methodological quality and longer intervention time are needed to further verify.
“…Furthermore, damage to specific motoneurons, such as those innervating type II fibers, may be more affected post-stroke, and thus harder to activate given that they need greater synaptic excitation due to their size [51,84]. It is important to note that muscle atrophy is primarily understood as the result of disrupted neurological connections, leading to hemiparesis [85]. Thus, physical exercise may be one of the most effective therapies in enhancing neural plasticity in post-stroke recovery to compensate for the effects of the lesion and its negative downstream effects seen in the musculoskeletal system [86][87][88].…”
This comprehensive review elucidates the intricate, multifactorial pathophysiology underpinning post-stroke skeletal muscle atrophy, a detrimental complication impacting patient outcomes. Post-stroke complications including dysphagia, malabsorption, and inadequate protein intake precipitate a catabolic state, exacerbating muscle wasting. The dearth of essential amino acids perpetuates proteolysis over protein synthesis, highlighting the importance of nutritional interventions. Immobility-induced disuse atrophy and dysregulation of anabolic pathways, notably IGF/Akt/PI3K, favor proteolysis, disrupting muscle protein homeostasis. Proteolytic systems including the ubiquitin-proteasome pathway and autophagy play central roles. Moreover, transcriptomic alterations, insulin resistance, autonomic dysregulation, inflammation, oxidative stress, and dysregulated microRNAs contribute to reduced muscle mass post-stroke. Notably, matrix metalloproteinases’ (MMPs) implication unveils potential therapeutic avenues via MMP inhibition. Unraveling this complex pathophysiological interplay is crucial for developing multi-modal interventions to manage post-stroke muscle atrophy effectively.
“…İnme, serebral damarlarda rüptür varsa hemorajik ve serebral kan akımında kesilme varsa iskemik olarak iki şekilde sınıflandırılır. İskemik sınıf; başka bir alandan kopup gelmiş ise embolik, kesintiye sebep yerel bir trombüs ise trombotik olarak belirtilir (1,2). Erişkinlerde önemli sağlık sorunlarından biri olan inme, özürlülük yapan hastalıklar içinde ilk sırada yer alıp kardiyovasküler hastalıklar ve kanserden sonra dünyada en sık 3. ölüm nedeni olan bir durumdur.…”
Amaç: Bu çalışmada hastanemizin fiziksel tıp ve rehabilitasyon kliniğinde yatışı yapılarak tedavi alan 18 yaş ve üstündeki hemiplejik hastaların dosyalarını retrospektif yöntemle bakarak hastaların hastalık etyolojisini ve demografik özelliklerini incelemeyi amaçladık.
Materyal ve Metod: Çalışma Harran Üniversitesi Tıp Fakültesi Araştırma ve Uygulama Hastanesi fiziksel tıp ve rehabilitasyon bölümünde yapıldı. Çalışmada 1 Ağustos 2021 ile 1 Ağustos 2022 tarihleri arasında yatışı verilen 18 yaş ve üstündeki hastaların kayıtları retrospektif olarak incelenmiştir. Hemiplejik tanısı alan hastaların hastalık etyolojisi yanı sıra klinik ve demografik özelliklerini incelendi.
Bulgular: Çalışmaya kriterleri sağlayan, 14’ü (%53,8) erkek ve 12’si (%46,2) bayan olmak üzere toplamda 26 hasta alındı. Hastaların en düşük yaşı 31 ve en yüksek yaşı 82 olup yaş ortalaması 61.76±13,49 yıl olarak tespit edilmiştir. İnmeye bağlı hemipleji gelişen 26 hastanın plejisi sağ tarafta %50 ve sol tarafta %50 olarak tespit edilmiştir. Etyolojide, hastaların %80,8’inde neden iskemik faktör iken %19,2’sinde ise hemorajik nedenliydi. Sistemik hastalık açısından %84,6 oranı ile en sık hipertansiyon (HT) gözlenmiş olup, bunu %38,5 ile diabetes mellitus (DM) hastalığı takip etmekteydi. Kalp hastalığı (KH) %26,9 ile sistemik hastalık açısından 3. sıklıkta gözlendi. Herhangi bir sistemik hastalığı olmayanlar ise sadece 1 kişi (%3,8) idi. Hastaların %34,6’sınde HT ve DM birlikteliği mevcuttu.
Sonuç: Sonuç olarak, HT ve DM gibi kronik hastalıklar başta olmak üzere inme geçirmiş hemiplejik hastalarda diğer risk faktörlerinin sıklığı arttığından ayrıntılı incelenmelidir. Bu yüzden inmeye neden olabilecek risk faktörleri için koruyucu önlemlerin alınması, gelişebilecek komplikasyonların önüne geçmesi açısından önemlidir.
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