Gait Neurorehabilitation in Stroke Patients

Krobot, Alois; Kolářová, Barbora; Kolář, Petr; Schusterová, Bronislava; Tomsová, Jana

doi:10.14735/amcsnn2017521

Cited by 2 publications

(3 citation statements)

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“…The therapeutic procedure in this study represented usual care in clinical practice. In the current understanding, traditional or conventional rehabilitation procedures are those that are carried out exclusively by the physical therapist [ 6 ]. Individual exercises were focused on improving motor control, sitting and standing stability, gait, and activities of daily living (ADL).…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness analysis of robot-assisted gait training in patients with bilateral spastic cerebral palsy

Klobucká,

Klobucký,

Valovičová

et al. 2023

Cost Eff Resour Alloc

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Background To date, there have been no published studies evaluating the cost-effectiveness of robot-assisted gait training (RAGT) in adolescent and adult patients with cerebral palsy (CP). The study´s aim was to analyse the cost-effectiveness of RAGT versus conventional kinesiotherapy (CON) from the health care provider’s perspective. Methods We expressed the cost-effectiveness of RAGT in the Lokomat® system after analysing the costs and effects of RAGT and conventional therapy through the Incremental Cost-Effectiveness Ratio (ICER) based on a bicentric randomized controlled study, in which we demonstrated that the intensive RAGT regimen is more effective than conventional therapy in terms of improvements in gross motor functions in adolescent and adult patients with bilateral spastic CP. Results According to the calculated ICER ratio for Lokomat®, an additional improvement per unit of effect (1% in GMFM), compared to conventional therapy, results in an average cost increase of EUR70.38 per patient in a therapeutic block consisting of 20 TUs (Therapeutic Units). Conclusion However, from the comprehensive analysis of the results and evaluation of the long-term effects, it follows that RAGT applied in adolescent and adult patients with bilateral spastic CP is not only more effective in terms of evaluation of monitored clinical parameters, but in the long term it is also more cost-effective compared to conventional therapy.

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Section: Methodsmentioning

confidence: 99%

Cost-effectiveness analysis of robot-assisted gait training in patients with bilateral spastic cerebral palsy

Klobucká,

Klobucký,

Valovičová

et al. 2023

Cost Eff Resour Alloc

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“…All subjects were treated with BoNT-A injections into the spastic muscles of the affected arm at W0 followed by a dedicated physiotherapy protocol [25,26] . The injections were performed using EMG guidance (Medtronic Keypoint, Alpine Biomed ApS, Denmark), preferably using electrical stimulation to localize the target.…”

Section: Methodsmentioning

confidence: 99%

“…All subjects were treated with BoNT-A injections into the spastic muscles of the affected arm at W0 followed by a dedicated physiotherapy protocol. [25,26] The injections were performed using EMG guidance (Medtronic Keypoint, Alpine Biomed ApS, Denmark), preferably using electrical stimulation to localize the target. The following muscles were always injected: flexor carpi ulnaris, flexor carpi radialis, flexor digitorum superficialis, and flexor digitorum profundus.…”

Section: Treatmentmentioning

confidence: 99%

Cortical somatosensory processing after botulinum toxin therapy in post-stroke spasticity

et al. 2021

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In dystonic and spastic movement disorders, abnormalities of motor control and somatosensory processing as well as cortical modulations associated with clinical improvement after botulinum toxin A (BoNT-A) treatment have been reported, but electrophysiological evidence remains controversial. In the present observational study, we aimed to uncover central correlates of post-stroke spasticity (PSS) and BoNT-A-related changes in the sensorimotor cortex by investigating the cortical components of somatosensory evoked potentials (SEPs). Thirty-one chronic stroke patients with PSS of the upper limb were treated with BoNT-A application into the affected muscles and physiotherapy. Clinical and electrophysiological evaluations were performed just before BoNT-A application (W0), then 4 weeks (W4) and 11 weeks (W11) later. PSS was evaluated with the modified Ashworth scale (MAS). Median nerve SEPs were examined in both upper limbs with subsequent statistical analysis of the peak-to-peak amplitudes of precentral P22/N30 and postcentral N20/P23 components. At baseline (W0), postcentral SEPs were significantly lower over the affected cortex. At follow up, cortical SEPs did not show any significant changes attributable to BoNT-A and/or physiotherapy, despite clear clinical improvement. Our results imply that conventional SEPs are of limited value in evaluating cortical changes after BoNT-A treatment and further studies are needed to elucidate its central actions.

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Gait Neurorehabilitation in Stroke Patients

Cited by 2 publications

References 0 publications

Cost-effectiveness analysis of robot-assisted gait training in patients with bilateral spastic cerebral palsy

Cost-effectiveness analysis of robot-assisted gait training in patients with bilateral spastic cerebral palsy

Cortical somatosensory processing after botulinum toxin therapy in post-stroke spasticity

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