Poststroke Upper Limb Recovery

Tsu, Adelyn; Abrams, Gary; Byl, Nancy N.

doi:10.1055/s-0034-1396002

Cited by 15 publications

(7 citation statements)

References 58 publications

(95 reference statements)

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“…Consequently, participants in stages 2 and 3 were able to practice their selected upper limb movements, and they practiced tai chi at home with good compliance. Considering that movement practice is dramatically influenced in severely impaired upper limb reported by previous studies [ 38 , 39 ], the capability of participants in stage 2 and 3 to perform multiple repetitions of tai chi movements is already a meaningful advancement. It should be noted that participants in stage 2 in the study were able to have isolated shoulder movements without compensatory the trunk movements before treatment.…”

Section: Discussionmentioning

confidence: 99%

Adapting Tai Chi for Upper Limb Rehabilitation Post Stroke: A Feasibility Study

et al. 2017

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Background: Tai chi (TC) has been reported as being beneficial for improving balance post stroke, yet its utility in upper limb rehabilitation remains unknown. Methods: Twelve chronic stroke survivors with persistent paresis of an upper limb underwent 60 minutes of adapted TC twice a week for eight weeks, with a 4-week follow up. A 10-min TC home program was recommended for the days without sessions. TC level of performance, attendance to the sessions, duration of self-practice at home, and adapted TC movements used were recorded. Results: Eleven participants completed the study. A clinical reasoning algorithm underlying the adaptation of TC was elaborated throughout the trial. Participants with varying profiles including a severely impaired upper limb, poor balance, shoulder pain, and severe spasticity were not only capable of practicing the adapted TC, but attended all 16 sessions and practiced TC at home for a total of 16.51 ± 9.21 h. The degree of self-practice for subgroups with low upper limb function, shoulder pain, or moderate-to-severe spasticity was similar to that of subgroups with greater upper limb function, no shoulder pain, and minimal-to-no spasticity. Conclusion: Adapted TC seems feasible for upper limb rehabilitation post stroke. Although the study was based on a small sample size and requires confirmation, low upper limb function, insufficient balance, spasticity, and shoulder pain do not appear to hinder the practice of TC.

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Section: Discussionmentioning

confidence: 99%

Adapting Tai Chi for Upper Limb Rehabilitation Post Stroke: A Feasibility Study

et al. 2017

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“…Therefore, future research needs to improve the design of the audio-visual feedback to guide stroke individuals to reduce compensatory movements. VRS and telerehabilitation The development of such VRS is essential in the current social context, given the high prevalence of chronic stroke patients with persistent UE impairments [ 4 ], and only 5% of them fully recover the hemiparetic upper extremity [ 37 ]. Moreover, there is a short supply of workforce resources and limited therapist-patient interaction time [ 6 ] in the community to meet the increasing global demand of a rising aging population.…”

Section: Discussionmentioning

confidence: 99%

Development of a compensation-aware virtual rehabilitation system for upper extremity rehabilitation in community-dwelling older adults with stroke

Luo

Lim

Ponraj

et al. 2023

J NeuroEngineering Rehabil

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Background Compensatory movements are commonly observed in older adults with stroke during upper extremity (UE) motor rehabilitation, which could limit their motor recovery. Aim This study aims to develop a compensation-aware virtual rehabilitation system (VRS) that can detect compensatory movements and improve the outcome of UE rehabilitation in community-dwelling older adults with stroke. Methods The VRS development includes three main components: (1) the use of thresholds for determining compensatory movements, (2) the algorithm for processing the kinematic data stream from Kinect to detect compensation in real-time, and (3) the audio-visual feedback to assist older adults with stroke to be aware of the compensation. Two studies were conducted following the VRS development, where Study 1 identified the value of thresholds for determining compensatory movements in two planar motor exercises, and Study 2 provided preliminary validation for the developed VRS by comparing two groups undergoing VR training or conventional training (CT) in a community rehabilitation center. Results The VRS could effectively detect all determined compensatory movements and timely trigger feedback in response to the detected compensatory movements. The VR participants showed significant improvements in Fugl-Meyer Assessment-Upper Extremity (FMA-UE, p = 0.045) and Wolf Motor Function Test (WMFT, p = 0.009). However, the VR and CT groups had no significant differences in outcome measures. Conclusion The VRS demonstrates the ability to detect compensation and the potential of assisting older adults with stroke to improve motor functions. Suggestions are given for further improvements of the VRS to support the older adult with stroke to reduce compensation.

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“… 1 , 2 , 3 While two-thirds of patients succeed in walking independently after an injury, less than half regain basic upper limb functions 6 months or longer after the injury, typically suffering unilateral spastic limb paralysis. 4 , 5 , 6 Strategies to regain function of the paralyzed hand predominantly focus on repairing the injured hemisphere and reducing spasticity of the upper limb, but substantial improvement is rare. 7 , 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

Reconstruction of paralyzed arm function in patients with hemiplegia through contralateral seventh cervical nerve cross transfer: a multicenter study and real-world practice guidance

Feng

et al. 2022

eClinicalMedicine

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Background A previous randomized controlled trial showed contralateral seventh cervical nerve (CC7) cross transfer to be safe and effective in restoring the arm function of spastic arm paralysis patients in a specified population. Guidance on indications, safety and expected long-term improvements of the surgery are needed for clinical practice.Methods This is a retrospective, multicenter, propensity score-matched cohort study. All patients registered between 2013 and 2019 with unilateral spastic arm paralysis over 1 year who were registered at one of five centers in China and South Korea were included. Patients received CC7 cross transfer or rehabilitation treatment in each center. Primary outcome was the change in the upper-extremity Fugl−Meyer (UEFM) score from baseline to 2-year follow-up; larger increase indicated better functional improvements.

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Poststroke Upper Limb Recovery

Cited by 15 publications

References 58 publications

Adapting Tai Chi for Upper Limb Rehabilitation Post Stroke: A Feasibility Study

Adapting Tai Chi for Upper Limb Rehabilitation Post Stroke: A Feasibility Study

Development of a compensation-aware virtual rehabilitation system for upper extremity rehabilitation in community-dwelling older adults with stroke

Reconstruction of paralyzed arm function in patients with hemiplegia through contralateral seventh cervical nerve cross transfer: a multicenter study and real-world practice guidance

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