|
1
|
Guo Z, Xu L, Tan W, Chen F. Impact of Generation Rate of Speech Imagery on Neural Activity and BCI Decoding Performance: A fNIRS Study. IEEE Trans Neural Syst Rehabil Eng 2025; 33:1180-1190. [PMID: 40100695 DOI: 10.1109/tnsre.2025.3552606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2025]
Abstract
Brain-computer interface (BCI) enables stroke patients to actively modulate neural activity, fostering neuroplasticity and thereby accelerating the recovery process. Due to being portable, non-invasive, and safe, functional near-infrared spectroscopy (fNIRS) has become one of the most widely used neuroimaging techniques. Current BCI research primarily focuses on improving the decoding performance. However, a key aspect of stroke rehabilitation lies in inducing stronger cortical activations in the damaged brain areas, thereby accelerating the recovery of brain functions. This study investigated the regulatory mechanism of the generation rate of speech imagery on neural activity and its impact on BCI decoding performance based on fNIRS. As the generation rate increased from 1 word/4 s to 1 word/2 s, and finally to 1 word/1 s, neural activity in speech-related brain regions steadily enhanced. Correspondingly, the accuracy of detecting speech imagery tasks increased from 83.83% to 85.39%, and ultimately showed a significant improvement, reaching 88.28%. Additionally, the differences in neural activities between the "yes" and "no" speech imagery tasks became more pronounced as the generation rate increased, leading to an improvement in classification performance from 62.81% to 65.78%, and ultimately to 67.50%. This study demonstrates that the neural activity level of most speech-related brain regions during speech imagery enhanced as the generation rate increased. Therefore, accelerating the generation rate of speech imagery induces stronger neural activity and more distinct response patterns between different tasks, which holds the potential to facilitate the development of a BCI feedback system with higher neuroplasticity induction and improved decoding performance.
Collapse
|
|
2
|
Wankhede NL, Koppula S, Ballal S, Doshi H, Kumawat R, Raju SS, Arora I, Sammeta SS, Khalid M, Zafar A, Taksande BG, Upaganlawar AB, Gulati M, Umekar MJ, Kopalli SR, Kale MB. Virtual reality modulating dynamics of neuroplasticity: Innovations in neuro-motor rehabilitation. Neuroscience 2025; 566:97-111. [PMID: 39722287 DOI: 10.1016/j.neuroscience.2024.12.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2024] [Revised: 12/06/2024] [Accepted: 12/21/2024] [Indexed: 12/28/2024]
Abstract
Virtual reality (VR) technology has emerged as a ground-breaking tool in neuroscience, revolutionizing our understanding of neuroplasticity and its implications for neurological rehabilitation. By immersing individuals in simulated environments, VR induces profound neurobiological transformations, affecting neuronal connectivity, sensory feedback mechanisms, motor learning processes, and cognitive functions. These changes highlight the dynamic interplay between molecular events, synaptic adaptations, and neural reorganization, emphasizing the potential of VR as a therapeutic intervention in various neurological disorders. This comprehensive review delves into the therapeutic applications of VR, focusing on its role in addressing multiple conditions such as stroke, traumatic brain injuries, phobias, and post-traumatic stress disorder. It highlights how VR can enhance motor recovery, cognitive rehabilitation, and emotional resilience, showcasing its potential as an innovative and effective tool in neurological rehabilitation. Integrating molecular neuroscience with VR technology allows for a deeper understanding of the molecular mechanisms underlying neuroplasticity, opening doors to personalized interventions and precise treatment strategies for individuals with neurological impairments. Moreover, the review emphasizes the ethical considerations and challenges that come with implementing VR-based interventions in clinical practice, stressing the importance of data privacy, informed consent, and collaborative interdisciplinary efforts. By leveraging advanced molecular imaging techniques, VR-based research methodologies, and computational modelling, the review envisions a future where VR technology plays a central role in revolutionizing neuroscience research and clinical neurorehabilitation, ultimately providing tailored and impactful solutions for individuals facing neurological challenges.
Collapse
Affiliation(s)
- Nitu L Wankhede
- Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Nagpur, Maharashtra 441002, India
| | - Sushruta Koppula
- College of Biomedical and Health Sciences, Konkuk University Chungju-Si, Chungcheongbuk Do 27478, Republic of Korea
| | - Suhas Ballal
- Department of Chemistry and Biochemistry, School of Sciences, JAIN (Deemed to be University), Bangalore, Karnataka, India
| | - Hardik Doshi
- Marwadi University Research Center, Department of Computer Engineering, Faculty of Engineering & Technology, Marwadi University, Rajkot 360003, Gujarat, India
| | - Rohit Kumawat
- Department of Allied Science, Graphic Era Hill University, Dehradun, India; Graphic Era Deemed to be University, Dehradun, Uttarakhand, India
| | - SSrinadh Raju
- Department of Computer Science and Engineering, Raghu Engineering College, Vishakhapatnam 531162, Andhra Pradesh, India
| | - Isha Arora
- Chandigarh Pharmacy College, Chandigarh Group of Colleges-Jhanjeri, Mohali, Punjab, India
| | - Shivkumar S Sammeta
- National Institute of Pharmaceutical Education and Research, Hyderabad, India
| | - Mohammad Khalid
- Department of Pharmacognosy, College of Pharmacy, Prince Sattam Bin Abdulaziz University Alkharj, Saudi Arabia
| | - Ameeduzzafar Zafar
- Department of Pharmaceutics, College of Pharmacy, Jouf University, Sakaka 72341, Al-Jouf, Saudi Arabia
| | - Brijesh G Taksande
- Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Nagpur, Maharashtra 441002, India
| | - Aman B Upaganlawar
- SNJB's Shriman Sureshdada Jain College of Pharmacy, Neminagar, Chandwad, Nashik, Maharashtra, India
| | - Monica Gulati
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, 1444411, India; ARCCIM, Faculty of Health, University of Technology Sydney, Ultimo, NSW 20227, Australia
| | - Milind J Umekar
- Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Nagpur, Maharashtra 441002, India
| | - Spandana Rajendra Kopalli
- Department of Bioscience and Biotechnology, Sejong University, Gwangjin-gu, Seoul 05006, Republic of Korea
| | - Mayur B Kale
- Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Nagpur, Maharashtra 441002, India.
| |
Collapse
|
|
3
|
Meghani S, Frishkopf M, Park T, Montgomery CL, Norris C, Papathanassoglou E. Music-based interventions and theoretical mechanisms in post-ICU survivors: A critical narrative synthesis. Intensive Crit Care Nurs 2025; 86:103777. [PMID: 39182325 DOI: 10.1016/j.iccn.2024.103777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 07/08/2024] [Accepted: 07/17/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND Hospitalization in the ICU can have long-term physiological and psychological impacts, affecting functional recovery and quality of life of post-ICU patients. Despite systematic reviews showing the impact of music interventions on physiological and psychological outcomes in ICU patients, their applicability and effectiveness in the post-ICU context remain unclear. AIM This review aimed to summarize: a) the types and characteristics of music/sound of interventions used in the rehabilitation of ICU patients, b) evidence on the feasibility, safety and acceptability of sound and music interventions for post ICU survivors, c) the types of post-ICU outcomes explored and the effects of sound and music interventions on any type of outcome in post-ICU survivors, and d) potential mechanisms or theoretical frameworks underlying the effects of sound and music interventions. METHOD We combined current systematic review search methods with a critical narrative approach to synthesize a diverse body of evidence. RESULTS Results showed that music interventions positively affect the psychological well-being and health outcomes of post-ICU patients. Outcomes included improvements in stress, anxiety, mood, movement, sleep, and pain, despite differences in patient populations and intervention design. No safety concerns were reported. The identified theoretical frameworks described physiological, neurobiological and/or psycho-social pathways as key mediators, however, these mechanisms are not completely understood. CONCLUSION Research evidence supports the positive effects of music interventions in post-ICU patients. Further experimental studies are required, especially in adult post-ICU populations to elucidate the characteristics, components, feasibility, and long-term effects of sound/music interventions. IMPLICATION TO PRACTICE 1. Music interventions help in post-ICU patients' recovery benefitting stress, anxiety, PTSD, mood, movement, sleep, and pain. 2. Integrating theoretical frameworks into music interventions can expand outcome measures to include physiological markers alongside psychological ones, improving quality of life. 3. Further rigorous interventional studies are required to identify the effectiveness of sound and music interventions in post-ICU patients.
Collapse
Affiliation(s)
- Shaista Meghani
- Faculty of Nursing, University of Alberta Edmonton Clinic Health Academy, Edmonton, AB T6G 1C9, Canada.
| | - Michael Frishkopf
- Canadian Centre for Ethnomusicology (CCE), Faculty of Medicine and Dentistry, Department of Music, Faculty of Arts, University of Alberta, 3-98 Fine Arts Building, Edmonton, AB T6G 2C9, Canada.
| | - Tanya Park
- College of Healthcare Sciences, James Cook University, Nguma-bada Campus, Cairns, Queensland, Australia.
| | - Carmel L Montgomery
- Faculty of Nursing, University of Alberta, 3-141 ECHA, 11405 87 Avenue NW, Edmonton, AB T6G 1C9, Canada.
| | - Colleen Norris
- Faculty of Nursing, University of Alberta, 5-246 ECHA, 11405 87 Avenue NW, Edmonton, AB T6G 1C9, Canada.
| | - Elizabeth Papathanassoglou
- Faculty of Nursing, University of Alberta, Scientific Director, Neurosciences Rehabilitation & Vision Strategic Clinical Network TM Edmonton Clinic Health Academy, Edmonton, AB T6G 1C9, Canada.
| |
Collapse
|
|
4
|
Xua R, Bai Y, Liang J, Wang N, He Y, Meng L, Ming D. The effects of different challenge-level balance tasks on stroke cortical responses and balance assessment using EEG. IEEE Trans Neural Syst Rehabil Eng 2025; PP:640-652. [PMID: 40030936 DOI: 10.1109/tnsre.2025.3529890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2025]
Abstract
Previous studies have validated that different balance tasks induce different cortical responses, which are key indexes of balance assessment. Assessing balance is crucial for stroke survivors to prevent falls and improve rehabilitation outcomes. However, it was unclear whether these tasks may affect the balance assessment, particularly regarding the relationship between task difficulty and the corresponding cortical responses involved in balance control. Therefore, we sought to explore the effects of different challenge-level balance tasks on balance assessment. Eighteen participants with stroke and thirteen healthy individuals were recruited in this study. The EEG was collected during sitting, standing and perturbation tasks. The pairwise-derived Brain Symmetry Index (pdBSI), and Granger Causality (GC) were analyzed with a two-way (task ×group) RMANOVA. Finally, a multiple linear regression analysis was applied to predict the BBS score with the above parameters. We found a significant interaction effect on pdBSI and GC. In the frontal lobe, participants with stroke exhibited significantly higher pdBSI (standing: p=0.042, perturbation: p=0.013) and lower GC (standing: p<0.001, perturbation: p=0.028) compared to healthy controls. Similarly, in the parietal lobe, stroke survivors showed markedly higher pdBSI (standing: p = 0.006, perturbation: p=0.012) and lower GC (standing: p=0.030, perturbation: p=0.011). Finally, The Berg Balance Scale (BBS) scores could be reliably predicted using parietal BSI and frontal GC metrics recorded during standing (p<0.001, adjusted R²=0.938) and perturbation tasks (p=0.001, adjusted R²=0.644). It was discovered that the more challenging balance tasks better revealed the difference in the power distribution and the directional functional connection between groups. The pdBSI and GC during standing and perturbation tasks, could be used as biomarkers for stroke balance assessment.
Collapse
|
|
5
|
Lf Eichinger F, Noveletto F, Domenech SC, Moulin T, Sagawa Y, Soares AV. Mim-pong: a serious game for assessment and treatment of the lower limb in hemiparetic stroke patients. Arch Physiother 2025; 15:59-68. [PMID: 40151381 PMCID: PMC11948263 DOI: 10.33393/aop.2025.3301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Accepted: 02/25/2025] [Indexed: 03/29/2025] Open
Abstract
Introduction The motor impairment evidenced post-stroke results in limitations to performing activities of daily living (ADL), especially when it involves locomotion. The Serious Games (SG) are an interesting therapeutic option, as they allow the performance of exercises according to stroke treatment guidelines. However, there is little research exploring the evaluation potential of SG. This study aimed to evaluate the possible metric properties of the mim-pong SG in addition to the therapeutic effects. Methods Twenty-four hemiparetic stroke patients were divided into two non-randomized groups: the experimental group (EG) (n = 16) and the control group (CG) (n = 8). Participants were evaluated in terms of motor impairment (lower limb), muscle strength (MS), motor control, and functional mobility. Results The significant correlations observed between the score generated by the SG and clinical variables in both groups are highlighted, especially with MS (rho = 0.62-0.66; p = 0.000, and rho = 0.67-0.71; p = 0.002-0.005, for the experimental and CGs, respectively) and motor function of the lower limb for the EG (rho = 0.41, p = 0.018). In addition, the results indicated improvements in all variables in the EG, with superiority over the CG. Conclusions This study showed that the mim-pong serious game could be considered a potential resource for the assessment and treatment of hemiparetic stroke patients.
Collapse
Affiliation(s)
- Fernando Lf Eichinger
- Faculty of Physiotherapy and Graduate Program in Health and Environment, University of Joinville Region, Joinville - Brazil
| | - Fabrício Noveletto
- Faculty of Electrical Engineering, State University of Santa Catarina, Joinville - Brazil
| | - Susana C Domenech
- Faculty of Design, State University of Santa Catarina, Florianopolis - Brazil
| | - Thierry Moulin
- Laboratory for Integrative Neuroscience and Cognitive Psychology (LINC) UMR 1322 INSERM, University of Franche-Comté, Besançon - France
| | - Yoshimasa Sagawa
- Laboratory for Integrative Neuroscience and Cognitive Psychology (LINC) UMR 1322 INSERM, University of Franche-Comté, Besançon - France
| | - Antonio V Soares
- Faculty of Physiotherapy and Graduate Program in Health and Environment, University of Joinville Region, Joinville - Brazil
- Laboratory for Integrative Neuroscience and Cognitive Psychology (LINC) UMR 1322 INSERM, University of Franche-Comté, Besançon - France
| |
Collapse
|
|
6
|
Ventoulis I, Gkouma KR, Ventouli S, Polyzogopoulou E. The Role of Mirror Therapy in the Rehabilitation of the Upper Limb's Motor Deficits After Stroke: Narrative Review. J Clin Med 2024; 13:7808. [PMID: 39768730 PMCID: PMC11728355 DOI: 10.3390/jcm13247808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2024] [Revised: 12/10/2024] [Accepted: 12/16/2024] [Indexed: 01/03/2025] Open
Abstract
Stroke is one of the leading causes of death and disability worldwide and poses a tremendous socioeconomic burden upon individuals, countries and healthcare systems. It causes debilitating symptoms and thus interferes with many aspects of the patient's life, including physical functioning, cognition, emotional status, activities of daily living, social reintegration and quality of life. Post-stroke patients frequently experience functional motor disabilities of the upper limb, which restrict autonomy and self-efficacy and cause limitations in engagement with activities and social participation, as well as difficulties in performing important occupations. It is therefore not surprising that motor impairment or loss of motor function of the upper limb is one of the most devastating sequelae of stroke. On these grounds, achieving optimal functioning of the upper limb after stroke remains a fundamental goal of stroke rehabilitation. Mirror therapy (MT) represents one of the several rehabilitation techniques used for restoring the upper limb's motor function after a stroke. However, conflicting results about the role of MT in the rehabilitation of the upper limb's motor deficits have been reported in the literature. Accordingly, the aim of this narrative review is to summarize existing evidence regarding the effects of MT on the upper limb's motor function in post-stroke patients and to further explore its role when applied in different phases of stroke.
Collapse
Affiliation(s)
- Ioannis Ventoulis
- Department of Occupational Therapy, University of Western Macedonia, Keptse Area, 50200 Ptolemaida, Greece;
| | - Kyriaki-Rafaela Gkouma
- Department of Occupational Therapy, University of Western Macedonia, Keptse Area, 50200 Ptolemaida, Greece;
| | - Soultana Ventouli
- Department of Statistics and Insurance Science, University of Western Macedonia, 6th km of Old National Motorway Grevena-Kozani, 51100 Grevena, Greece;
| | - Effie Polyzogopoulou
- Emergency Medicine Department, Attikon University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari, 12462 Athens, Greece;
| |
Collapse
|
|
7
|
Cheng C, Liu T, Zhang B, Wu X, Song Z, Zhao Z, Ren X, Zhao M, Su Y, Wang J. Effects of robot-assisted hand function therapy on brain functional mechanisms: a synchronized study using fNIRS and sEMG. Front Med (Lausanne) 2024; 11:1411616. [PMID: 39544380 PMCID: PMC11560759 DOI: 10.3389/fmed.2024.1411616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 10/17/2024] [Indexed: 11/17/2024] Open
Abstract
Background Robot-assisted hand function therapy is pivotal in the rehabilitation of patients with stroke; however, its therapeutic mechanism remains elusive. Currently, research examining the impact of robot-assisted hand function therapy on brain function in patients with stroke is scarce, and there is a lack of studies investigating the correlation between muscle activity and alterations in brain function. Objective This study aimed to investigate the correlation between forearm muscle movement and brain functional activation by employing the synchronized use of functional near-infrared spectroscopy and surface electromyography methods. Moreover, it sought to compare neural activity patterns during different rehabilitation tasks and refine the mechanism of robot-assisted hand function therapy for post-stroke hand function impairments. Methods Stroke patients with hand dysfunction underwent three sessions of robot-assisted hand function therapy within 2 weeks to 3 months of onset. The fNIRS-sEMG synchronous technique was used to observe brain function and forearm muscle activation. Ten participants were randomly assigned to receive mirror, resistance, or passive rehabilitation training. During the intervention, cortical and muscle activation information was obtained using fNIRS and electromyographic signals. The primary outcomes included changes in oxyhemoglobin concentration and root mean square of surface electromyography. Results Compared to the resting state, the Oxy-Hb concentration in the brain regions involved in three rehabilitation tasks with robot-assisted hand function therapy significantly increased (p < 0.05). Mirror therapy significantly enhanced the prefrontal cortex and the superior frontal cortex activation levels. In contrast, resistance therapy significantly promoted the activation of the supplementary motor area and the premotor cortex. Passive rehabilitation tasks showed some activation in the target brain area premotor cortex region. Robot-assisted hand function therapy has shown that forearm muscle movement is closely related to oxygenated hemoglobin concentration activity in specific brain regions during different rehabilitation tasks. Conclusion The simultaneous sEMG-fNIRS study found a significant correlation between muscle movement and brain activity after stroke, which provides an important basis for understanding the treatment mechanism of hand function impairment.
Collapse
Affiliation(s)
- Changfeng Cheng
- Shanghai Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tiantian Liu
- Shanghai Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Beibei Zhang
- The first affiliated hospital of Anhui University of Traditional Chinese Medicine, Anhui, China
| | - Xubo Wu
- Shanghai Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhenwang Song
- Shanghai Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhongzhi Zhao
- Shanghai Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xue Ren
- Shanghai Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Minjun Zhao
- Shanghai Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yajuan Su
- Shanghai Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jiening Wang
- Shanghai Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| |
Collapse
|
|
8
|
Zhang Q, Jiang H, Han S, Gao T, Meng L, Gao B, Cao L, Wen J, Ju Y, Wu W. Magnetic resonance imaging quantitative assessment of corticospinal tract damage in basal ganglia infarction. Medicine (Baltimore) 2024; 103:e40300. [PMID: 39470499 PMCID: PMC11521009 DOI: 10.1097/md.0000000000040300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 04/27/2024] [Accepted: 10/11/2024] [Indexed: 10/30/2024] Open
Abstract
To retrospectively explore the role of magnetic resonance imaging (MRI) diffusion tensor imaging (DTI) in analyzing the corticospinal tract injury in acute cerebral anterior circulation infarction in the basal ganglia region and the correlation between DTI parameters and neurological function scores, patients with acute cerebral infarction and stroke had undergone plain MRI and DTI sequence scanning were enrolled. Diffusion tensor tractography was used to perform 3-dimensional reconstruction of bilateral corticospinal tracts (CST). The image data were processed to obtain fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values, and the correlation between the DTI parameters and neurological function scores of National Institutes of Health Stroke Scale (NIHSS) was evaluated. A total of thirty-two patients with acute ischemic cerebral infarction were retrospectively enrolled, including 19 males and 13 females with a mean age 63.22 ± 7.78 years. The CST score was 0 in 2 (6.25%) patients, 1 in 9 (28.13%), 2 in 9 (28.13%), 3 in 7 (21.88%), and 4 in 5 (15.63%). The FA value significantly (P = .01) decreased (0.52 ± 0.03 vs 0.62 ± 0.04) on the ischemic side compared with that on the normal side. A significant (P < .05) difference was detected in the number of nerve fibers (223.3 ± 110.0 vs 246.7 ± 104.4) rather than in the ADC values (0.86 ± 0.06 vs 0.84 ± 0.06) between the ischemic and healthy sides. The FA and ADC values were not significantly (P > .05) different according to the CST scores 0, 1, 2, 3, or 4 between the ischemic and healthy sides. There was a significant (P < .05) negative correlation between the FA value on the infarcted side and the NIHSS score. In conclusion, with the DTI technology, varying degrees of damage to the corticospinal tract at the infarcted side can be detected and important clinical information can be provided for the diagnosis and prognosis of acute cerebral infarction by evaluating the degree of corticospinal tract injury.
Collapse
Affiliation(s)
- Qiuyue Zhang
- Department of Radiology, Hebei Provincial Gucheng County People’s Hospital, Gucheng County, Hebei Province, China
| | - Hongxin Jiang
- Department of Radiology, Hebei Provincial Gucheng County People’s Hospital, Gucheng County, Hebei Province, China
| | - Shuman Han
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Tingting Gao
- Department of Radiology, Hebei Provincial Gucheng County People’s Hospital, Gucheng County, Hebei Province, China
| | - Linghui Meng
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Bulang Gao
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Lei Cao
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jinxu Wen
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yanmei Ju
- Department of Radiology, Hebei Provincial Gucheng County People’s Hospital, Gucheng County, Hebei Province, China
| | - Wenjuan Wu
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| |
Collapse
|
|
9
|
Huang Y, Cao S, Li T, Wang J, Xia Z. Exploring core and bridge symptoms in patients recovering from stroke: a network analysis. Front Neurol 2024; 15:1434303. [PMID: 39416666 PMCID: PMC11479880 DOI: 10.3389/fneur.2024.1434303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 09/17/2024] [Indexed: 10/19/2024] Open
Abstract
Background Patients recovering from stroke experience a variety of symptoms that present as a synergistic and mutually reinforcing "symptom cluster," rather than as singular symptoms. In this study, we researched and systematic analyzed these symptom clusters, including core and bridge symptoms, to help determine the relationships between symptoms and to identify key symptom targets, providing a new approach for formulating precise symptom management interventions. Methods Convenience sampling was applied to select 432 stroke recovery patients treated in the Seventh People's Hospital of Changzhou City from August 1, 2023 to April 14, 2024. Subsequently, a cross-sectional survey was conducted using the General Information Questionnaire and Stroke Symptom Experience Scale to extract symptom clusters via exploratory factor analysis. Finally, the "qgraph" and "bootnet" packages in the R language were used to construct a network layout to describe the relationships between symptoms and calculate the centrality index. Results The average age of the 432 enrolled recovering stroke patients was 68.17 ± 12.14 years, including 268 males (62.04%) and 164 females (37.96%), none of whom underwent surgical intervention. Among this cohort, the 3 symptoms with the highest incidence rates were "limb weakness" (A2, 80.56%), "fatigue" (A5, 77.78%), and "limitations of limb movement" (A1, 68.06%). A total of 5 symptom clusters were extracted: the somatic activity disorder, mood-disorder-related, cognitive-linguistic dysfunction, somatic-pain-related, and foot dysfunction symptom clusters. In the symptom network, the 2 most common symptoms in terms of intensity and expected impact were "fatigue" (A5, rs = 1.14, re = 1.00) and "pessimism about the future" (B3, rs = 1.09, re = 1.02). The symptom with the strongest bridge intensity was "limb pain" (D1, rs = 2.64). Conclusion This study uses symptom network analysis to explore the symptoms of stroke patients during recovery, identifying core symptoms and bridge symptoms. Based on these findings, we can develop more targeted management plans to improve the accuracy and efficiency of interventions. Through this management approach, we can enhance treatment effectiveness, reduce unnecessary medication, lower adverse drug reactions, and optimize the allocation of medical resources.
Collapse
Affiliation(s)
- Yao Huang
- Department of Nursing, The Affiliated Hospital of Jiangsu University, Zhenjiang, China
- Department of Neurology, Changzhou Seventh People’s Hospital, Changzhou, China
| | - Songmei Cao
- Department of Nursing, The Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Teng Li
- Department of Nursing, The Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Jingjing Wang
- Department of Nursing, The Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Zhuoran Xia
- Department of Nursing, The Affiliated Hospital of Jiangsu University, Zhenjiang, China
| |
Collapse
|
|
10
|
Muñoz-Gómez E, Aguilar-Rodríguez M, Mollà-Casanova S, Sempere-Rubio N, Inglés M, Serra-Añó P. A randomized controlled trial on the effectiveness of mirror therapy in improving strength, range of movement and muscle activity, in people with carpal tunnel syndrome. J Hand Ther 2024; 37:534-543. [PMID: 38458950 DOI: 10.1016/j.jht.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/07/2024] [Accepted: 02/09/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND There is little information on the potential effects of mirror therapy (MT) on motor recovery in individuals with Carpal Tunnel Syndrome (CTS). PURPOSE To compare the effectiveness of a MT protocol versus a therapeutic exercise (TE) protocol, in improving strength, range of motion (ROM), muscle activity, pain, and functionality in patients with CTS. STUDY DESIGN Randomized clinical trial. METHODS Thirty-nine participants with unilateral CTS were divided into two groups: (i) MT group (n = 20) that followed an exercise protocol applied to the unaffected hand reflected in a mirror, and (ii) TE group (n = 19) that followed the same exercise protocol using the unaffected hand but without a mirror. Strength, wrist ROM, muscle activity, pain and functionality, were assessed at baseline (T0), after treatment (T1) and one month after treatment (T2). RESULTS At T1, the MT group showed significantly higher wrist flexion-extension ROM compared to TE (p = 0.04, d = 0.8), maintained at T2 (p = 0.02, d = 0.8). No significant changes were observed in ulnar-radius deviation, pronosupination, or fatigue following either MT or TE (p > 0.05). MT exhibited enhanced handgrip strength at T1 (p = 0.001, d = 0.7), as well as an increase in the extensor carpi radialis (ECR) and flexor carpi radialis (FCR) maximum muscle activity (p = 0.04, d = 1.0; p = 0.03, d = 0.4). At T1, both groups decreased pain (p = 0.002, d = 1.1; p = 0.02, d = 0.7), and improved functionality (p < 0.001, d = 0.8; p = 0.01, d = 0.5) (MT and TE respectively). DISCUSSION MT led to enhancements in wrist flexion-extension movement, handgrip strength and functionality unlike TE. MT notably increased muscle activity, particularly in the ECR and FCR muscles. CONCLUSIONS MT is a favorable strategy to improve wrist flexion-extension ROM, handgrip strength, ECR and FCR muscle activity, and functionality in people with unilateral CTS.
Collapse
Affiliation(s)
- Elena Muñoz-Gómez
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Marta Aguilar-Rodríguez
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain.
| | - Sara Mollà-Casanova
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Nuria Sempere-Rubio
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Marta Inglés
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Pilar Serra-Añó
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| |
Collapse
|
|
11
|
Zhi L, Hou D, Hong Y, Ke M, Zhang Q, Wang Y, Long J. Research on music therapy from 2013 to 2022: a bibliometric and visualized study. Front Psychiatry 2024; 15:1323794. [PMID: 39224478 PMCID: PMC11366619 DOI: 10.3389/fpsyt.2024.1323794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 07/25/2024] [Indexed: 09/04/2024] Open
Abstract
Background Music therapy is a rapidly evolving multidisciplinary field. But there has been no research analyzing the latest research status and development trends in this research field from a macro perspective. We aim to identify hotspots, knowledge base, and frontiers in the field of music therapy through bibliometric analysis. Methods All data were retrieved from the Web of Science core database from January 1, 2013 to December 31, 2022.CiteSpace and Bibliometrix software were employed for bibliometric analysis and visualization analysis. Results A total of 2,397 articles were included. In the past decade, there has been a consistent increase in the number of publications. The countries and institutions with the largest production in this field are the USA and the University of London. Based on the analysis of the total number of citations, centrality, and production, the results show that the most influential journals are PLoS One and Cochrane Database Syst Rev. Keyword co-occurrence analysis and highly cited study analysis are mainly used to analyze research hotspots in the field of music therapy, while the keyword burst analysis is employed to explore frontiers and potential developmental trends. Hot keywords include "interventions", "anxiety" and "randomized controlled trial". The burst keywords include "validity", "preterm infants", and "mild cognitive impairment". In the ranking of highly cited study, the top ranked studies are "Music-based interventions in neurological rehabilitation" and "Music interventions for improving psychological and physical outcomes in cancer patients". Conclusion In the past decade, the research focus in music therapy was the effect of music therapy on neurological diseases and the improvement of psychological symptoms such as pain and anxiety. The neurophysiological mechanisms that bring about these therapeutic effects need to be future researched.
Collapse
Affiliation(s)
- Liang Zhi
- School of Rehabilitation, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Dianrui Hou
- Rehabilitation Medicine Department, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Yaqing Hong
- School of Rehabilitation, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Meihua Ke
- School of Rehabilitation, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Qingfang Zhang
- School of Rehabilitation, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yulong Wang
- Rehabilitation Medicine Department, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Jianjun Long
- Rehabilitation Medicine Department, Shenzhen Second People’s Hospital, Shenzhen, China
| |
Collapse
|
|
12
|
Nuwagi TB, Ramachandran S, Radhika CM. Effect of Forward Reaching With a Modified Sitting Position on Muscle Contraction in the Paretic Lower Extremity of Individuals in the Early Sub-Acute Phase of Stroke: A Randomized Control Trial. Cureus 2024; 16:e66998. [PMID: 39280412 PMCID: PMC11402332 DOI: 10.7759/cureus.66998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2024] [Indexed: 09/18/2024] Open
Abstract
Introduction Forward reaching in sitting has been shown to facilitate muscle contraction in the paretic lower limb of stroke survivors. Change in the sitting surface has been shown to alter the contribution of lower extremity muscles to maintain postural control. This study investigated the effect of forward reaching in a modified sitting position on the paretic lower extremity muscles of patients with stroke. Methods First-time cerebral stroke survivors in their early sub-acute phase were randomly allocated to the experimental or control group. The experimental group engaged in training sessions focusing on reaching a target while seated with only the paretic foot placed on a support, whereas the control group performed the same task with both feet supported on the surface. Each group completed three sets of 10 repetitions of forward reaching for eight days as a part of the training. Quadriceps and tibialis anterior muscle activity in the paretic leg were measured using surface electromyography before the first and after the last session of intervention. Statistical analysis was conducted using parametric tests with a significance level set at p < 0.05. Results Sixty-three subjects completed the study, with 31 in the experimental group and 32 in the control group. The results of the post-intervention analysis indicated a statistically significant increase in the EMG activity of the tibialis anterior and quadriceps muscle surfaces in both groups (p < 0.001). Notably, the experimental group exhibited significantly higher muscle activity in both quadriceps and tibialis anterior compared to the control group (p < 0.001). Conclusion Forward reaching with only the paretic lower limb grounded effectively improves quadriceps and tibialis anterior muscle recruitment in the early sub-acute phase of stroke.
Collapse
Affiliation(s)
- Tluway B Nuwagi
- Department of Physiotherapy, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Sivakumar Ramachandran
- Department of Physiotherapy, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - C M Radhika
- Department of Physiotherapy, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| |
Collapse
|
|
13
|
Quattrocelli S, Russo EF, Gatta MT, Filoni S, Pellegrino R, Cangelmi L, Cardone D, Merla A, Perpetuini D. Integrating Machine Learning with Robotic Rehabilitation May Support Prediction of Recovery of the Upper Limb Motor Function in Stroke Survivors. Brain Sci 2024; 14:759. [PMID: 39199453 PMCID: PMC11352886 DOI: 10.3390/brainsci14080759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 07/24/2024] [Accepted: 07/26/2024] [Indexed: 09/01/2024] Open
Abstract
Motor impairment is a common issue in stroke patients, often affecting the upper limbs. To this standpoint, robotic neurorehabilitation has shown to be highly effective for motor function recovery. Notably, Machine learning (ML) may be a powerful technique able to identify the optimal kind and intensity of rehabilitation treatments to maximize the outcomes. This retrospective observational research aims to assess the efficacy of robotic devices in facilitating the functional rehabilitation of upper limbs in stroke patients through ML models. Specifically, clinical scales, such as the Fugl-Meyer Assessment (A-D) (FMA), the Frenchay Arm Test (FAT), and the Barthel Index (BI), were used to assess the patients' condition before and after robotic therapy. The values of these scales were predicted based on the patients' clinical and demographic data obtained before the treatment. The findings showed that ML models have high accuracy in predicting the FMA, FAT, and BI, with R-squared (R2) values of 0.79, 0.57, and 0.74, respectively. The findings of this study suggest that integrating ML into robotic therapy may have the capacity to establish a personalized and streamlined clinical practice, leading to significant improvements in patients' quality of life and the long-term sustainability of the healthcare system.
Collapse
Affiliation(s)
- Sara Quattrocelli
- Department of Engineering and Geology, University “G. d’Annunzio” of Chieti-Pescara, 65127 Pescara, Italy; (S.Q.); (L.C.); (D.C.); (A.M.)
| | - Emanuele Francesco Russo
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy; (E.F.R.); (M.T.G.)
| | - Maria Teresa Gatta
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy; (E.F.R.); (M.T.G.)
| | - Serena Filoni
- I.R.R.C.S. Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy;
| | - Raffaello Pellegrino
- Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, 6912 Lugano-Pazzallo, Switzerland;
- Santa Chiara Institute, 73100 Lecce, Italy
| | - Leonardo Cangelmi
- Department of Engineering and Geology, University “G. d’Annunzio” of Chieti-Pescara, 65127 Pescara, Italy; (S.Q.); (L.C.); (D.C.); (A.M.)
| | - Daniela Cardone
- Department of Engineering and Geology, University “G. d’Annunzio” of Chieti-Pescara, 65127 Pescara, Italy; (S.Q.); (L.C.); (D.C.); (A.M.)
| | - Arcangelo Merla
- Department of Engineering and Geology, University “G. d’Annunzio” of Chieti-Pescara, 65127 Pescara, Italy; (S.Q.); (L.C.); (D.C.); (A.M.)
| | - David Perpetuini
- Department of Engineering and Geology, University “G. d’Annunzio” of Chieti-Pescara, 65127 Pescara, Italy; (S.Q.); (L.C.); (D.C.); (A.M.)
| |
Collapse
|
|
14
|
Gong D, Ye F. Effects of Music Therapy on Aphasia and Cognition of Patients with Post-stroke: A Systematic Review and Meta-analysis. Noise Health 2024; 26:136-141. [PMID: 38904813 PMCID: PMC11530103 DOI: 10.4103/nah.nah_24_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 06/22/2024] Open
Abstract
PURPOSE This investigation sought to systematically assess music therapy's impact on aphasia and cognition in patients with post-stroke. METHODS Comprehensive searches were performed across major databases, including PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, and Vip Chinese sci-tech periodicals (VIP), covering publications up to December 2023. After screening and extracting data from the retrieved literature, its quality was appraised, which was followed by a meta-analysis using RevMan software (version 5.4, Cochrane Collaboration, Oxford, UK). RESULTS Nine articles, which were published from 2008 to 2022, were covered in this investigation, comprising 309 stroke patients in total. Meta-analysis results from these variations were found to be not statistically significant in the degree of functional communication improvement between the experimental group and the control group (standardized mean difference [SMD] = 0.23, 95% confidence interval [CI] (-0.19; 0.77), P > 0.05). These variations were found to be not statistically significant in the improvement of understanding ability in the experimental group compared with that in the control group (SMD = 0.21, 95% CI [-0.66; 1.09], P > 0.05). The degree of improvement in repetitive ability of the experimental group was considerably greater than that of the control group (SMD = 0.37, 95% CI [0.01; 0.76], P < 0.05). These variations were found to be not statistically significant in the improvement of naming ability in the experimental group compared with that in the control group (SMD = 0.30, 95% CI [-0.19; 0.80], P > 0.05). The cognitive score of the experimental group was considerably greater than that of the control group (SMD = 0.75, 95% CI [0.44; 1.06], P < 0.05). CONCLUSION Music therapy can effectively ameliorate the repetition ability of patients with aphasia after stroke. It can also improve the cognitive ability of patients. Thus, music therapy could be further applied to treat this type of patients.
Collapse
Affiliation(s)
- Dajiao Gong
- Department of Neurology, Zhejiang Hospital Sandun District, Hangzhou City, Zhejiang Province, China
| | - Fengfang Ye
- Department of Neurology, Zhejiang Hospital Sandun District, Hangzhou City, Zhejiang Province, China
| |
Collapse
|
|
15
|
Arya KN, Pandian S, Joshi AK, Chaudhary N, Agarwal GG, Ahmed SS. Sensory deficits of the paretic and non-paretic upper limbs relate with the motor recovery of the poststroke subjects. Top Stroke Rehabil 2024; 31:281-292. [PMID: 37690032 DOI: 10.1080/10749357.2023.2253629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 08/27/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Post stroke, motor paresis has usually been considered to be a crucial factor responsible for the disability; other impairments such as somatosensory deficits may also play a role. OBJECTIVE To determine the relation between the sensory deficits (paretic and non-paretic upper limbs) and the motor recovery of the paretic upper limb and to predict the potential of motor recovery based on the sensory deficits among stroke subjects. METHODS The study was a cross-sectional study conducted in a rehabilitation institute. Ninety-five poststroke hemiparetic subjects having sensory impairment in any of the modalities were considered for this study. Sensory deficits were assessed on both the upper limbs (paretic and non-paretic) primarily using Erasmus MC modification of the revised version of Nottingham Sensory Assessment (Em-NSA) and Nottingham Sensory Assessment (Stereognosis) (NSA-S). The motor recovery was assessed using the Fugl-Meyer assessment (FMA). RESULTS The measures of sensory deficits exhibited weak but significant correlation [the paretic (Em-NSA and NSA; r = .38 to .58; p < .001) and the non-paretic (Em-NSA and NSA; r = .24 to .38; p = .03 to .001)] with the motor recovery of the paretic upper limb as measured by FMA. The potential of favorable recovery of the paretic upper limb may be predicted using the cutoff scores of Em-NSA (30, 21, and 24) and NSA-S (5, 8, and 5) of the paretic side. CONCLUSION In stroke, sensory deficits relate weakly with the recovery of the paretic upper limb and can predict recovery potential of the paretic upper limb.
Collapse
Affiliation(s)
- Kamal Narayan Arya
- Department of Occupational therapy, Pandit Deendayal Upadhyaya National Institute for Persons with Physical Disabilities, New Delhi, India
| | - Shanta Pandian
- Department of Occupational therapy, Pandit Deendayal Upadhyaya National Institute for Persons with Physical Disabilities, New Delhi, India
| | - Akshay Kumar Joshi
- Department of Occupational therapy, Pandit Deendayal Upadhyaya National Institute for Persons with Physical Disabilities, New Delhi, India
| | - Neera Chaudhary
- Department of Neurology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - G G Agarwal
- Department of Statistics, Lucknow University, Lucknow, India
| | | |
Collapse
|
|
16
|
Qi H, Tian D, Luan F, Yang R, Zeng N. Pathophysiological changes of muscle after ischemic stroke: a secondary consequence of stroke injury. Neural Regen Res 2024; 19:737-746. [PMID: 37843207 PMCID: PMC10664100 DOI: 10.4103/1673-5374.382221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/30/2023] [Accepted: 06/01/2023] [Indexed: 10/17/2023] Open
Abstract
Sufficient clinical evidence suggests that the damage caused by ischemic stroke to the body occurs not only in the acute phase but also during the recovery period, and that the latter has a greater impact on the long-term prognosis of the patient. However, current stroke studies have typically focused only on lesions in the central nervous system, ignoring secondary damage caused by this disease. Such a phenomenon arises from the slow progress of pathophysiological studies examining the central nervous system. Further, the appropriate therapeutic time window and benefits of thrombolytic therapy are still controversial, leading scholars to explore more pragmatic intervention strategies. As treatment measures targeting limb symptoms can greatly improve a patient's quality of life, they have become a critical intervention strategy. As the most vital component of the limbs, skeletal muscles have become potential points of concern. Despite this, to the best of our knowledge, there are no comprehensive reviews of pathophysiological changes and potential treatments for post-stroke skeletal muscle. The current review seeks to fill a gap in the current understanding of the pathological processes and mechanisms of muscle wasting atrophy, inflammation, neuroregeneration, mitochondrial changes, and nutritional dysregulation in stroke survivors. In addition, the challenges, as well as the optional solutions for individualized rehabilitation programs for stroke patients based on motor function are discussed.
Collapse
Affiliation(s)
- Hu Qi
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Dan Tian
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Fei Luan
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Ruocong Yang
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Nan Zeng
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| |
Collapse
|
|
17
|
Chen Y, Yu W, Benali A, Lu D, Kok SY, Wang R. Towards Human-like Walking with Biomechanical and Neuromuscular Control Features: Personalized Attachment Point Optimization Method of Cable-Driven Exoskeleton. Front Aging Neurosci 2024; 16:1327397. [PMID: 38371400 PMCID: PMC10870425 DOI: 10.3389/fnagi.2024.1327397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/05/2024] [Indexed: 02/20/2024] Open
Abstract
The cable-driven exoskeleton can avoid joint misalignment, and is substantial alterations in the pattern of muscle synergy coordination, which arouse more attention in recent years to facilitate exercise for older adults and improve their overall quality of life. This study leverages principles from neuroscience and biomechanical analysis to select attachment points for cable-driven soft exoskeletons. By extracting key features of human movement, the objective is to develop a subject-specific design methodology that provides precise and personalized support in the attachment points optimization of cable-driven exoskeleton to achieve natural gait, energy efficiency, and muscle coordination controllable in the domain of human mobility and rehabilitation. To achieve this, the study first analyzes human walking experimental data and extracts biomechanical features. These features are then used to generate trajectories, allowing better natural movement under complete cable-driven exoskeleton control. Next, a genetic algorithm-based method is employed to minimize energy consumption and optimize the attachment points of the cable-driven system. This process identifies connections that are better suited for the human model, leading to improved efficiency and natural movement. By comparing the calculated elderly human model driven by exoskeleton with experimental subject in terms of joint angles, joint torques and muscle forces, the human model can successfully replicate subject movement and the cable output forces can mimic human muscle coordination. The optimized cable attachment points facilitate more natural and efficient collaboration between humans and the exoskeleton, making significant contributions to the field of assisting the elderly in rehabilitation.
Collapse
Affiliation(s)
- Yasheng Chen
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, China
| | - Weiwei Yu
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, China
| | - Abderraouf Benali
- LISV, Versailles Systems Engineering Laboratory, Université de Versailles Saint Quentin en Yvelines, Paris, France
| | - Donglai Lu
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, China
| | - Siong Yuen Kok
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, China
| | - Runxiao Wang
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, China
| |
Collapse
|
|
18
|
Li XW, Xin YF, Chang AH, Zhang XG, Weng Y, Yang JH, Fu QZ. Correlation study between motor rehabilitation level and psychological state in patients with limb movement disorders after stroke. World J Psychiatry 2023; 13:912-918. [DOI: 10.5498/wjp.v13.i11.912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/09/2023] [Accepted: 10/27/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND The psychological state of patients with post stroke limb movement disorders undergoes a series of changes that affect rehabilitation training and recovery of limb motor function.
AIM To determine the correlation between motor rehabilitation and the psychological state of patients with limb movement disorders after stroke.
METHODS Eighty patients with upper and lower limb dysfunction post stroke were retrospectively enrolled in our study. Based on Hospital Anxiety and Depression Scale (HADS) scores measured before rehabilitation, patients with HADS scores ≥ 8 were divided into the psychological group; otherwise, the patients were included in the normal group. Motor function and daily living abilities were compared between the normal and psychological groups. Correlations between the motor function and psychological status of patients, and between daily living ability and psychological status of patients were analyzed.
RESULTS After 1, 2, and 3 wk of rehabilitation, both the Fugl-Meyer assessment and Barthel index scores improved compared to their respective baseline scores (P < 0.05). A greater degree of improvement was observed in the normal group compared to the psychological group (P < 0.05). There was a negative correlation between negative emotions and limb rehabilitation (-0.592 ≤ r ≤ -0.233, P < 0.05), and between negative emotions and daily living ability (-0.395 ≤ r ≤ -0.199, P < 0.05).
CONCLUSION There is a strong correlation between motor rehabilitation and the psychological state of patients with post stroke limb movement disorders. The higher the negative emotions, the worse the rehabilitation effect.
Collapse
Affiliation(s)
- Xiao-Wan Li
- Department of Medical Rehabilitation, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Yu-Fu Xin
- Department of Medical Rehabilitation, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Ai-Hui Chang
- Department of Medical Rehabilitation, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Xiao-Ge Zhang
- Department of Medical Rehabilitation, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Yan Weng
- Department of Medical Rehabilitation, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Jia-Hao Yang
- Department of Logistics, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Qi-Zhi Fu
- Department of Medical Intensive Care Unit, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| |
Collapse
|
|
19
|
Nilsson H. Consolation Management Aesthetics Within Holistic Nursing. Holist Nurs Pract 2023; 37:E53-E58. [PMID: 37335152 DOI: 10.1097/hnp.0000000000000592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
The aim of this article is to elaborate on consolation management aesthetics in terms of literature, art, and music. This article will be centered on holistic nurses who come in daily contact with vulnerable patients in need of both medical treatment and consolation, as they continue their journey toward one or another outcome. Consolation management aesthetics enables the patients to shift their attention from something that appears intractable to something that motivates, bolsters existential resilience, and offers hope and optimism for the future. Holistic nursing aesthetics, involving psychological healing through literature, art, and music, can help anxious, troubled patients to once again find beauty and balance in their lives.
Collapse
Affiliation(s)
- Håkan Nilsson
- Department of Social and Behavioral Science, University West, Trollhättan, Sweden
| |
Collapse
|
|
20
|
Rodríguez-Hernández M, Polonio-López B, Corregidor-Sánchez AI, Martín-Conty JL, Mohedano-Moriano A, Criado-Álvarez JJ. Can specific virtual reality combined with conventional rehabilitation improve poststroke hand motor function? A randomized clinical trial. J Neuroeng Rehabil 2023; 20:38. [PMID: 37016408 PMCID: PMC10071242 DOI: 10.1186/s12984-023-01170-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 03/30/2023] [Indexed: 04/06/2023] Open
Abstract
TRIAL OBJECTIVE To verify whether conventional rehabilitation combined with specific virtual reality is more effective than conventional therapy alone in restoring hand motor function and muscle tone after stroke. TRIAL DESIGN This prospective single-blind randomized controlled trial compared conventional rehabilitation based on physiotherapy and occupational therapy (control group) with the combination of conventional rehabilitation and specific virtual reality technology (experimental group). Participants were allocated to these groups in a ratio of 1:1. The conventional rehabilitation therapists were blinded to the study, but neither the participants nor the therapist who applied the virtual reality-based therapy could be blinded to the intervention. PARTICIPANTS Forty-six patients (43 of whom completed the intervention period and follow-up evaluation) were recruited from the Neurology and Rehabilitation units of the Hospital General Universitario of Talavera de la Reina, Spain. INTERVENTION Each participant completed 15 treatment sessions lasting 150 min/session; the sessions took place five consecutive days/week over the course of three weeks. The experimental group received conventional upper-limb strength and motor training (100 min/session) combined with specific virtual reality technology devices (50 min/session); the control group received only conventional training (150 min/session). RESULTS As measured by the Ashworth Scale, a decrease in wrist muscle tone was observed in both groups (control and experimental), with a notably larger decrease in the experimental group (baseline mean/postintervention mean: 1.22/0.39; difference between baseline and follow-up: 0.78; 95% confidence interval: 0.38-1.18; effect size = 0.206). Fugl-Meyer Assessment scores were observed to increase in both groups, with a notably larger increase in the experimental group (total motor function: effect size = 0.300; mean: - 35.5; 95% confidence interval: - 38.9 to - 32.0; wrist: effect size = 0.290; mean: - 5.6; 95% confidence interval: - 6.4 to - 4.8; hand: effect size = 0.299; mean: - -8.9; 95% confidence interval: - 10.1 to - 7.6). On the Action Research Arm Test, the experimental group quadrupled its score after the combined intervention (effect size = 0.321; mean: - 32.8; 95% confidence interval: - 40.1 to - 25.5). CONCLUSION The outcomes of the study suggest that conventional rehabilitation combined with a specific virtual reality technology system can be more effective than conventional programs alone in improving hand motor function and voluntary movement and in normalizing muscle tone in subacute stroke patients. With combined treatment, hand and wrist functionality and motion increase; resistance to movement (spasticity) decreases and remains at a reduced level. TRIALS REGISTRY International Clinical Trials Registry Platform: ISRCTN27760662 (15/06/2020; retrospectively registered).
Collapse
Affiliation(s)
- Marta Rodríguez-Hernández
- Faculty of Health Sciences, University of Castilla-La Mancha, 45600, Talavera de la Reina, Spain
- Technological Innovation Applied to Health Research Group (ITAS Group), Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
| | - Begoña Polonio-López
- Faculty of Health Sciences, University of Castilla-La Mancha, 45600, Talavera de la Reina, Spain.
- Technological Innovation Applied to Health Research Group (ITAS Group), Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain.
| | - Ana-Isabel Corregidor-Sánchez
- Faculty of Health Sciences, University of Castilla-La Mancha, 45600, Talavera de la Reina, Spain
- Technological Innovation Applied to Health Research Group (ITAS Group), Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
| | - José L Martín-Conty
- Faculty of Health Sciences, University of Castilla-La Mancha, 45600, Talavera de la Reina, Spain
- Technological Innovation Applied to Health Research Group (ITAS Group), Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
| | - Alicia Mohedano-Moriano
- Faculty of Health Sciences, University of Castilla-La Mancha, 45600, Talavera de la Reina, Spain
- Technological Innovation Applied to Health Research Group (ITAS Group), Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
| | - Juan-José Criado-Álvarez
- Faculty of Health Sciences, University of Castilla-La Mancha, 45600, Talavera de la Reina, Spain
- Technological Innovation Applied to Health Research Group (ITAS Group), Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Spain
- Institute of Health Sciences, Talavera de la Reina, Spain
| |
Collapse
|
|
21
|
Tang Z, Han K, Wang R, Zhang Y, Zhang H. Excitatory Repetitive Transcranial Magnetic Stimulation Over the Ipsilesional Hemisphere for Upper Limb Motor Function After Stroke: A Systematic Review and Meta-Analysis. Front Neurol 2022; 13:918597. [PMID: 35795793 PMCID: PMC9251503 DOI: 10.3389/fneur.2022.918597] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background Repetitive transcranial magnetic stimulation (rTMS) is a promising therapy to promote recovery of the upper limb after stroke. According to the regulation of cortical excitability, rTMS can be divided into excitatory rTMS and inhibitory rTMS, and excitatory rTMS includes high-frequency rTMS (HF-rTMS) or intermittent theta-burst stimulation (iTBS). We aimed to evaluate the effects of excitatory rTMS over the ipsilesional hemisphere on upper limb motor recovery after stroke. Methods Databases of PubMed, Embase, ISI Web of Science, and the Cochrane Library were searched for randomized controlled trials published before 31 December 2021. RCTs on the effects of HF-rTMS or iTBS on upper limb function in patients diagnosed with stroke were included. Two researchers independently screened the literature, extracted the data, and assessed quality. The meta-analysis was performed by using Review Manager Version 5.4 software. Results Fifteen studies with 449 participants were included in this meta-analysis. This meta-analysis found that excitatory rTMS had significant efficacy on upper limb motor function (MD = 5.88, 95% CI, 3.32–8.43, P < 0.001), hand strength (SMD = 0.53, 95% CI, 0.04–1.01, P = 0.03), and hand dexterity (SMD = 0.76, 95% CI, 0.39–1.14, P < 0.001). Subgroup analyses based on different types of rTMS showed that both iTBS and HF-rTMS significantly promoted upper limb motor function (iTBS, P < 0.001; HF-rTMS, P < 0.001) and hand dexterity (iTBS, P = 0.01; HF-rTMS, P < 0.001) but not hand strength (iTBS, P = 0.07; HF-rTMS, P = 0.12). Further subgroup analysis based on the duration of illness demonstrated that applying excitatory rTMS during the first 3 months (<1 month, P = 0.01; 1–3 months, P = 0.001) after stroke brought significant improvement in upper limb motor function but not in the patients with a duration longer than 3 months (P = 0.06). We found that HF-rTMS significantly enhanced the motor evoked potential (MEP) amplitude of affected hemisphere (SMD = 0.82, 95% CI, 0.32–1.33, P = 0.001). Conclusion Our study demonstrated that excitatory rTMS over the ipsilesional hemisphere could significantly improve upper limb motor function, hand strength, and hand dexterity in patients diagnosed with stroke. Both iTBS and HF-rTMS which could significantly promote upper limb motor function and hand dexterity, and excitatory rTMS were beneficial to upper limb motor function recovery only when applied in the first 3 months after stroke. HF-rTMS could significantly enhance the MEP amplitude of the affected hemisphere. High-quality and large-scale randomized controlled trials in the future are required to confirm our conclusions. Clinical Trial Registration www.crd.york.ac.uk/prospero/, identifier: CRD42022312288.
Collapse
Affiliation(s)
- Zhiqing Tang
- School of Rehabilitation, Capital Medical University, Beijing, China
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Kaiyue Han
- School of Rehabilitation, Capital Medical University, Beijing, China
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Rongrong Wang
- School of Rehabilitation, Capital Medical University, Beijing, China
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Yue Zhang
- School of Rehabilitation, Capital Medical University, Beijing, China
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Hao Zhang
- School of Rehabilitation, Capital Medical University, Beijing, China
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
- Cheeloo College of Medicine, Shandong University, Jinan, China
- University of Health and Rehabilitation Sciences, Qingdao, China
- *Correspondence: Hao Zhang
| |
Collapse
|
|
22
|
Xu C, He Z, Shen Z, Huang F. Potential Benefits of Music Therapy on Stroke Rehabilitation. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:9386095. [PMID: 35757506 PMCID: PMC9217607 DOI: 10.1155/2022/9386095] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/15/2022] [Accepted: 05/24/2022] [Indexed: 11/17/2022]
Abstract
Stroke is associated with a high rate of disability and mortality, and survivors are usually accompanied with dysphagia, aphasia, motor dysfunction, cognitive impairment, depression, and other complications. In the past decades, many studies have been conducted to reveal the pathogenesis and pathological mechanisms of stroke. Furthermore, treatment methods have been developed that contribute to the elevated survival rate of stroke patients. Early rehabilitation poststroke is starting to be recognized as important and has been receiving increasing attention in order to further improve the quality of life of the patients. As an emerging method of poststroke rehabilitation, music therapy can help attenuate dysphagia and aphasia, improve cognition and motor function, alleviate negative moods, and accelerate neurological recovery in stroke patients. This review helps summarize the recent progress that has been made using music therapy in stroke rehabilitation and is aimed at providing clinical evidence for the treatment of stroke patients.
Collapse
Affiliation(s)
- Chengyan Xu
- Department of Neurosurgery, The Children's Hospital Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Zixia He
- Department of Outpatient, The Children's Hospital Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Zhipeng Shen
- Department of Neurosurgery, The Children's Hospital Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Fei Huang
- Department of Science and Education, Hangzhou Women's Hospital, Hangzhou Maternity and Child Health Care Hospital, Hangzhou, China
| |
Collapse
|