Multivariate Analysis of Improvement and Outcome Following Stroke Rehabilitation

Heinemann, Allen W.; Roth, Elliot J.; Cichowski, Kristine; Betts, Henry B.

doi:10.1001/archneur.1987.00520230051013

Cited by 164 publications

(103 citation statements)

References 11 publications

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“…48,49 The role that the nonlesional hemisphere plays remains controversial. In the short term, ipsilateral primary motor cortex has been shown to compensate for an acute loss of the opposite sided primary motor cortex.…”

Section: Discussionmentioning

confidence: 99%

Unique Cortical Physiology Associated With Ipsilateral Hand Movements and Neuroprosthetic Implications

Wisneski

Anderson

Schalk

et al. 2008

Stroke

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Background and Purpose-Brain computer interfaces (BCIs) offer little direct benefit to patients with hemispheric stroke because current platforms rely on signals derived from the contralateral motor cortex (the same region injured by the stroke). For BCIs to assist hemiparetic patients, the implant must use unaffected cortex ipsilateral to the affected limb. This requires the identification of distinct electrophysiological features from the motor cortex associated with ipsilateral hand movements. Methods-In this study we studied 6 patients undergoing temporary placement of intracranial electrode arrays. Electrocorticographic (ECoG) signals were recorded while the subjects engaged in specific ipsilateral or contralateral hand motor tasks. Spectral changes were identified with regards to frequency, location, and timing. Results-Ipsilateral hand movements were associated with electrophysiological changes that occur in lower frequency spectra, at distinct anatomic locations, and earlier than changes associated with contralateral hand movements. In a subset of 3 patients, features specific to ipsilateral and contralateral hand movements were used to control a cursor on a screen in real time. In ipsilateral derived control this was optimal with lower frequency spectra. Conclusions-There are distinctive cortical electrophysiological features associated with ipsilateral movements which can be used for device control. These findings have implications for patients with hemispheric stroke because they offer a potential methodology for which a single hemisphere can be used to enhance the function of a stroke induced hemiparesis. (Stroke. 2008;39:3351-3359.)

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Section: Discussionmentioning

confidence: 99%

Unique Cortical Physiology Associated With Ipsilateral Hand Movements and Neuroprosthetic Implications

Wisneski

Anderson

Schalk

et al. 2008

Stroke

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“…19 The Barthel Index measures functional independence at one point in time, and the change in Barthel Index score from rehabilitation commencement to discharge can be calculated as one measure of functional improvement. Rehabilitation efficiency 15 is the amount of improvement divided by the duration of rehabilitation stay and can be regarded as the average increase in Barthel Index score per day: rehabilitation efficiency=(discharge Barthel Index score-initial Barthel Index score)-^duration of rehabilitation stay. Since the potential improvement for patients with high initial scores is lower than that for those with low initial scores, another way to measure functional improvement is achievement of potential improvement.…”

Section: Methodsmentioning

confidence: 99%

Efficiency, effectiveness, and duration of stroke rehabilitation.

Shah

Vanclay

Cooper

1990

Stroke

195

132

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“…In a meta-analysis study by Ottenbacher et al, the median interrater reliability coefficient for the total FIM was 0.95, the median test-retest reliability coefficient was 0.95, and the equivalence reliability coefficient was 0.92 [32]. Multiple studies have demonstrated validity of the FIM [33][34][35][36][37][38][39][40][41]. The FONE FIM (telephone version of the FIM) was used in each current study to collect data on functional status from the veteran at 3 months postdischarge.…”

Section: Veteran Functional Statusmentioning

confidence: 99%

A culturally sensitive Transition Assistance Program for stroke caregivers: Examining caregiver mental health and stroke rehabilitation

Perrin¹,

Johnston²,

Vogel³

et al. 2010

JRRD

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Abstract-This study developed and implemented the Transition Assistance Program (TAP) for stroke caregivers. The program is composed of (1) skill development, (2) education, and (3) supportive problem solving. Sixty-one dyads (n = 122) participated: thirty-nine from Puerto Rico and twenty-two from Texas. Participants were randomly assigned to the TAP treatment or a control group. As caregiver satisfaction with the TAP increased, strain and depression decreased, and caregivers reported a very high rate of program satisfaction (9.5 out of 10). The TAP effectively reduced caregiver strain at the 3-month follow-up. When controlling for baseline differences, we found that the treatment group had lower depression (p = 0.07) than the control group at follow-up and that the TAP may have had a preventative effect on depression for caregivers who had not been depressed at discharge, although this visual trend did not reach statistical significance. Among veterans with low functioning at baseline, veterans whose caregivers had received the TAP improved in functioning more than did veterans whose caregivers had been in the control group, although this visual trend was not significant. Functioning in veterans with stroke was also significantly linked to caregiver satisfaction with the TAP. The findings from the current study warrant further evaluation of the TAP intervention.

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Multivariate Analysis of Improvement and Outcome Following Stroke Rehabilitation

Cited by 164 publications

References 11 publications

Unique Cortical Physiology Associated With Ipsilateral Hand Movements and Neuroprosthetic Implications

Unique Cortical Physiology Associated With Ipsilateral Hand Movements and Neuroprosthetic Implications

Efficiency, effectiveness, and duration of stroke rehabilitation.

A culturally sensitive Transition Assistance Program for stroke caregivers: Examining caregiver mental health and stroke rehabilitation

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