Similar motor recovery of upper and lower extremities after stroke.

Duncan, Pamela W.; Goldstein, Larry B.; Horner, Ronnie D.; Landsman, Pamela B.; Samsa, Gregory P.; Matchar, David B.

doi:10.1161/01.str.25.6.1181

Cited by 320 publications

(242 citation statements)

References 16 publications

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“…That is, if the improvement in the shoulder function was affected by the natural recovery or the conventional therapy, the shoulderunrelated functions of the upper lower limb functions should have been improved. This is by the findings that the patterns of the natural motor recovery are similar for the upper extremities [48]. As for the mechanism of the recovery in this study, the requirement of a certain level of motor intention (EMG) may have elicited activity of the target muscle in the patients.…”

Section: Discussionmentioning

confidence: 63%

Electromyogram-controlled assistive exercise for the motor recovery of shoulder in chronic hemiplegia: A pilot study

Park

Kim

Kwon

et al. 2015

BME

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Abstract. Correct-active-repetitive exercise is important for the motor recovery in hemiplegics. The present study hypothesizes that the electromyogram (EMG)-controlled assistance of motion would be an effective implementation of the concept for the rehabilitation of the hemiplegic shoulder, even in chronic patients. This study aims to investigate the feasibility of the suggested method. The motor intention is derived from the EMG of the shoulder muscles and the shoulder movement (flexion and abduction) is assisted by an electro-mechanical system only when the motor intention (EMG amplitude) exceeded the threshold. Twelve patients in the chronic stage of stroke participated in this pilot study. The EMGcontrolled assistive exercise lasts for two weeks, 20 min per day and 5 days a week. The active range of motion in both abduction and flexion increases significantly after the intervention (p < 0.01). The maximum torque increases in both directions, and the increase is significant in the abduction (p < 0.01). The Fugl-Myer motor assessment score is improved greatly in the shoulder-related items (p < 0.01), but neither in the shoulder-unrelated items of the upper extremity (p = 0.13) nor in the lower extremity items (p = 0.19). This pilot study demonstrates that EMG-controlled assistive exercise can improve shoulder motor functions related to selected muscles and the suggested method is promising for the motor recovery of the shoulder in chronic hemiplegia.

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Section: Discussionmentioning

confidence: 63%

Electromyogram-controlled assistive exercise for the motor recovery of shoulder in chronic hemiplegia: A pilot study

Park

Kim

Kwon

et al. 2015

BME

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“…It is likely that, in the clinic, individual goals may cover a broader range of deficits, including cognitive and attentional dysfunction. While all deficits merit attention, this study aimed to provide a more comprehensive understanding of individual goals relative to the UE, given that over 70% of individuals experience hemiparesis after a stroke [28,29]. Finally, age was treated as a dichotomous variable when it is actually a continuous one.…”

Section: Discussionmentioning

confidence: 99%

An Exploratory Analysis of the Self-Reported Goals of Individuals With Chronic Upper-Extremity Paresis Following Stroke

Birkenmeier¹,

Waddell²

2015

The American Journal of Occupational Therapy

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Purpose-To classify the self-identified goals of individuals post-stroke with chronic upper extremity (UE) paresis, and determine if age, UE functional capacity, and pre-stroke hand dominance influence overall goal selection.Method-Sixty five subjects participated. Using the Canadian Occupational Performance Measure (COPM) to establish treatment goals, the top five goals were categorized using the Occupational Therapy Practice Framework into five categories: activities of daily living (ADL), instrumental activities of daily living (IADL), leisure, work, and general UE movement. A chisquare analysis determined if age, UE functional capacity (measured by the Action Research Arm Test), and UE hand dominance influenced individual goal selection.Results-The majority of goals were in the ADL (37%) and IADL (40%) categories. A small percentage (12%) was related to general UE movement. Individuals with moderate UE functional capacity identified more ADL goals than those with higher UE functional capacity. There was not a difference between age and UE dominance across all five goal areas.Conclusions-Individuals with chronic UE paresis had specific goals that were not influenced by age or hand dominance, but partially influenced by severity. General UE movement goals were identified less than goals related to specific activities.After a stroke, an individual's capacity to participate in activities that are personally meaningful is often compromised. On average, individuals post-stroke discontinue 57% of their activities [1]. Decreased participation is often a result of many stroke-related deficits, the primary one being upper extremity (UE) paresis. At 6 months post-stroke, 65% of survivors cannot incorporate their affected hand into routine activity [2]. Given the vital role of both upper extremities in daily activities [3], deficits in participation following a stroke can be attributed, in part, to UE paresis and its resulting loss of function.

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“…Despite the chronic nature of the participants' hemiplegia, improvements were found in both their CGS and MGS. Motor recovery typically shows the greatest improvements between 3 and 6 weeks post-stroke, and a clear plateau is reached by 90 days 31,32) . Our subjects were a minimum of 6 months post-stroke and were therefore at the "chronic" stage.…”

Section: Discussionmentioning

confidence: 99%

Effects of 3-month Combined Functional Training at an Adult Day-care Facility on Lower Extremity Muscle Strength and Gait Performance in Community-dwelling People with Chronic Hemiplegia

Hashidate

Shiomi

Sasamoto³

2011

J Phys Ther Sci

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Abstract.[Purpose] The purpose of this study was to examine the effects of low-frequency combined functional training over a 3-month period on lower extremity muscle strength and gait performance in community-dwelling people with chronic post-stroke hemiplegia.[Subjects] The subjects were 23 individuals with chronic post-stroke hemiplegia, utilizing the services of an adult day-care facility.[Methods] All subjects performed functional training programs consisting of stretching, strengthening, postural balance training, and gait training once or twice a week for 3 months. Leg muscle strength measured using a leg press machine at one repetition maximum (1RM), comfortable gait speed (CGS), maximal gait speed (MGS), and the difference between MGS and CGS (ΔGS) were assessed before and after intervention.[Results] Comparison of each outcome before and after intervention revealed significant increases in 1RM, CGS, MGS, and ΔGS. The change rate of ΔGS was correlated only with that of MGS.[Conclusion] Three-month combined functional training was effective at enhancing lower extremity muscle strength and gait performance, and ΔGS was increased by enhancement of MGS in community-dwelling people with chronic post-stroke hemiplegia.

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Similar motor recovery of upper and lower extremities after stroke.

Abstract: In patients with anterior circulation ischemic stroke, the severity of motor impairment and the patterns of motor recovery are similar for the upper and lower extremities. The most rapid recovery for both extremities occurs within 30 days.

Cited by 320 publications

References 16 publications

Electromyogram-controlled assistive exercise for the motor recovery of shoulder in chronic hemiplegia: A pilot study

Electromyogram-controlled assistive exercise for the motor recovery of shoulder in chronic hemiplegia: A pilot study

An Exploratory Analysis of the Self-Reported Goals of Individuals With Chronic Upper-Extremity Paresis Following Stroke

Effects of 3-month Combined Functional Training at an Adult Day-care Facility on Lower Extremity Muscle Strength and Gait Performance in Community-dwelling People with Chronic Hemiplegia

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