Upper extremity rehabilitation of stroke: Facilitation of corticospinal excitability using virtual mirror paradigm

Kang, Youn Joo; Park, Hae-Kyung; Kim, Hyun-Jung Grace; Lim, Taeo; Ku, Jeonghun; Cho, Sangwoo; Kim, Sun I l; Park, Eun Sook

doi:10.1186/1743-0003-9-71

Cited by 69 publications

(64 citation statements)

References 31 publications

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“…A study that compared VR based mirror feedback to regular mirror therapy in a sample of subjects with mild to moderate upper extremity hemiparesis found increased corticospinal excitability of the ipsilesional M1 in both treatment groups; with the VR based method showing the larger change in MEP amplitude and latency. [22] However, it is important to note that this single study does not provide definitive support that VR based visual priming is superior to traditionally presented visual priming. With regards to neural correlates, our group has demonstrated in chronic stroke that virtual mirror training activates regions in the sensory-motor cortex similar to those activated by volitional movement of the affected hand, suggesting that this type of feedback may facilitate regions that are relevant for motor control in individuals with moderate hemiparesis post-stroke.…”

Section: Introductionmentioning

confidence: 76%

“…[23] Furthermore, a study by Kang et al[22] demonstrated greater cortical excitability of the affected hemisphere using VR based visual mirror feedback as compared to a mirror box or control. Although there is no direct evidence, it is interesting to consider that the increase in maximal pinch force in the affected hand after the priming tasks for four of the five subjects may have been related to an increase in ipsilesional cortical excitability induced by these tasks.…”

Section: Discussionmentioning

confidence: 99%

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Exploring the impact of visual and movement based priming on a motor intervention in the acute phase post-stroke in persons with severe hemiparesis of the upper extremity

Patel

Qiu

Yarossi

et al. 2016

Disability and Rehabilitation

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Purpose Explore the potential benefits of using priming methods prior to an active hand task in the acute phase post-stroke in persons with severe upper extremity hemiparesis. Methods Five individuals were trained using priming techniques including virtual reality (VR) based visual mirror feedback and contralaterally controlled passive movement strategies prior to training with an active pinch force modulation task. Clinical, kinetic, and neurophysiological measurements were taken pre and post the training period. Clinical measures were taken at six months post training. Results The two priming simulations and active training were well tolerated early after stroke. Priming effects were suggested by increased maximal pinch force immediately after visual and movement based priming. Despite having no clinically observable movement distally, the subjects were able to volitionally coordinate isometric force and muscle activity (EMG) in a pinch tracing task. The Root Mean Square Error (RMSE) of force during the pinch trace task gradually decreased over the training period suggesting learning may have occurred. Changes in motor cortical neurophysiology were seen in the unaffected hemisphere using Transcranial Magnetic Stimulation (TMS) mapping. Significant improvements in motor recovery as measured by the Action Research Arm Test (ARAT) and the Upper Extremity Fugl Meyer Assessment (UEFMA) were demonstrated at six months post training by three of the five subjects. Conclusion This study suggests that an early hand-based intervention using visual and movement based priming activities and a scaled motor task allows participation by persons without the motor control required for traditionally presented rehabilitation and testing.

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Section: Introductionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Exploring the impact of visual and movement based priming on a motor intervention in the acute phase post-stroke in persons with severe hemiparesis of the upper extremity

Patel

Qiu

Yarossi

et al. 2016

Disability and Rehabilitation

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“…This study showed that, when the mirror image and proprioceptive illusions were in the same direction, they reinforced each other. A previous study with healthy subjects and stroke patients showed that the rates of amplitude increment and latency decrement of motor evoked potentials (MEPs) were higher when using a virtual mirror compared to a real mirror [41]. It is suggested that the reason for this MEP enhancement could be the more interactive and task oriented characteristics of the virtual mirror, leading to increased attention.…”

Section: Discussionmentioning

confidence: 95%

Combined tendon vibration and virtual reality for post-stroke hand rehabilitation

Rinderknecht

Kim

Santos-Carreras

et al. 2013

2013 World Haptics Conference (WHC)

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Sensory function is essential for functional post-stroke recovery and control of basic hand movements like grasping. Despite this fact, therapy focuses strongly on motor aspects of rehabilitation, requiring active participation and thus excluding stroke patients with severe paresis. The aim of our novel therapeutic approach combining virtual reality, based on clinically proven mirror therapy, and tendon vibration of hand and wrist muscles is to induce neuroplastic changes leading to improved hand function. This paper presents the further development and evaluation of a robotic device, which can apply vibrations at precise locations on the finger flexor tendons to create illusions of extension movements and visualize the movements with a virtual hand. A preliminary study including 16 healthy subjects investigated the influence of the virtual reality on the perception of proprioceptive illusory movements. The experimental results provided evidence that the addition of the virtual reality enhanced the perception of the illusory movement generated by tendon vibration, by inducing movements with significantly higher extension (+4.5%, p < 0.05). Furthermore, the virtual reality allowed a better controlled temporal elicitation of the illusion. These findings indicate the potential of this novel strategy for a more effective therapy, especially for severely impaired patients.

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“…Therefore repetitive stimulation increased muscle strength and prevent more damage of the neuromuscular and prevent its spread to other areas [2]. Cortex area of human brain which called F5 with respect to its role in motor movements and visuomotor that send signals when observing, imitating or copying the certain action of what is observed so that the person imagination activated the movement area same as the actual movement.Ease of Use [3].…”

Section: Introductionmentioning

confidence: 99%

“…The mirror will provide visual stimulation to the brain (cerebral motor nerves i.e. ipsilateral or contralateral for hemiparesis movement) and the hemiparesis will be observed and imitated like the one in the mirror [2].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Mirror Therapy for Muscle Strength in Ischemic Stroke Patients with Hemiparesis

Sandi¹,

Irawandi²,

Alfa³

et al. 2017

Proceedings of the 8th International Nursing Conference on Education, Practice and Research Development in Nursing (INC 2017)

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Abstract-Background: Stroke is clinical symptoms which disturbances in blood circulation to the brain caused either local or global malfunctioning that occurs suddenly and rapidly progressive that usually caused hemiparesis in stroke patients. Late and inappropriate exercises management may cause permanent disability. The range of motion exercises and early mobilization in stroke patients may reduce the risk of disability. The one of rehabilitation and intervention is muscle strength exercise by stimulating the nerves and improve the functional status of the motor/muscle strength by using mirror therapy. Method: These research based on the literature review (systematic review) of international journals, which is use quasiexperiment, one group pre-post test design. These research using purposive sampling with 24 respondents, while the research instruments using observation sheet those are muscle strength scale and visual imagery scale, the exercise guide sheets and mirror as media. The research analysis using univariate and bivariate analysis. A bivariate analysis using Wilcoxon test. Results: The results of these studies indicate that there is increasing in average muscle strength after mirror therapy exercises five times a day for 7 days evidenced by prior intervention the muscles strength mean of upper extremities is 2:12 (0.45) and the muscle strength mean of the lower extremities is 2:12 (0:45 ). After the intervention, the muscle strength mean of upper extremities became 3.83 (0.56) and the muscle strength mean of the lower extremities became 4.00 (0.66). Based on the results of bivariate analysis obtained the calculated value (4369) and significance levels (p) <0.05. Conclusion: The results of the journal's review can be concluded that there is significant differences are muscle strength before and after mirror therapy exercise in ischemic stroke patients with hemiparesis.

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Upper extremity rehabilitation of stroke: Facilitation of corticospinal excitability using virtual mirror paradigm

Cited by 69 publications

References 31 publications

Exploring the impact of visual and movement based priming on a motor intervention in the acute phase post-stroke in persons with severe hemiparesis of the upper extremity

Exploring the impact of visual and movement based priming on a motor intervention in the acute phase post-stroke in persons with severe hemiparesis of the upper extremity

Combined tendon vibration and virtual reality for post-stroke hand rehabilitation

Effectiveness of Mirror Therapy for Muscle Strength in Ischemic Stroke Patients with Hemiparesis

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