Frontiers in Neurology

ObjectiveTo study the pattern reversal visual evoked potential (PRVEP) in patients with post stroke cognitive impairment (PSCI) and to provide an objective and accurate basis for the neurophysiological assessment of cognitive function in stroke patients. MethodsFirst stroke patients admitted to the department of Rehabilitation Medicine of the Second Hospital of Jilin University between 01-10-2022 and 31-10-2023 were enrolled as subjects according to the inclusion criteria, exclusion criteria, s...

Hyperreflexia is common after neurological injury such as stroke, yet clinical interventions have had mixed success. Our previous research has shown that hyperreflexia of the rectus femoris (RF) during pre-swing is closely associated with reduced swing phase knee flexion in those with post-stroke Stiff-Knee gait (SKG). Thus, reduction of RF hyperreflexia may improve walking function in those with SKG after stroke. A non-pharmacological and non-surgical procedure for reducing hyperreflexia has em...

BackgroundCurrent guidelines recommend combining botulinum toxin type A (BoNT-A) with adjunctive therapies for upper limb spasticity management, but evidence for individualized splinting remains limited and inconsistent. ObjectiveThis pilot randomized controlled trial investigated whether adding individualized splint therapy to BoNT-A enhances therapeutic outcomes compared to BoNT-A alone in chronic stroke patients with upper limb spasticity. MethodsTwenty-six chronic stroke patients with uppe...

BackgroundNeuropathic pain after spinal cord injury (SCI) is notoriously hard to treat. Mechanisms of neuropathic pain are unclear, which makes finding effective treatments challenging. Prior studies have shown that adults with SCI have body awareness deficits. Recent imaging studies, including ours, point to the parietal operculum and insula as key areas for both pain perception and body awareness. Cognitive multisensory rehabilitation (CMR) is a physical therapy approach that helps improve bod...

ObjectivesSpatial neglect, a debilitating cognitive syndrome and predictor of poor functional outcome, affects attention and awareness after stroke. Early rehabilitation is essential but neglect itself may impede participation in therapy. In a proof-of-concept study nested within an RCT, we investigated whether the oft-reported immediate effects of prism adaptation training (PAT) might enable engagement if introduced at the start of an occupational therapy session. MethodsEarly after stroke we ...

Background and PurposeAcute intermittent hypoxia (AIH) is a novel therapeutic intervention that has the potential to facilitate recovery of function, but its safety and efficacy have not been tested in people with stroke. The purpose here was to examine whether AIH is safe and effective in people with stroke. MethodsParticipants (n=10) with a unilateral, ischemic, hemispheric stroke were assessed before and following 4 sessions of AIH. Clinical tests and upper limb strength were assessed before...

IntroductionUp to 80% of individuals affected by Spinal Cord Injury (SCI) develops spasticity, both in the acute and chronic phases. Botulinum NeuroToxin (BoNT) injections have been proven to be an effective intervention to treat focal spasticity in Stroke, Cerebral Palsy and Multiple Sclerosis. However, to the best of our knowledge, only one systematic review published in 2015 evaluated the efficacy of BoNT in treating spasticity in patients affected by SCI. ObjectiveWe formulated the followin...

BackgroundStroke commonly results in permanent damage to central neural circuits. At a physiological level, this damage manifests as neuromotor impairments like reduced muscle strength, altered coordination, and delayed reaction time. At a functional level, this damage results in reduced gait speed, endurance, and balance ability, which leads to long-term disability and loss of independence. However, the interplay between these neuromotor impairments and functional disability is not well underst...

Dizziness after mild traumatic brain injury (mTBI) is commonly attributed to impairment within the vestibular system. However, oculomotor, mobility, and autonomic dysfunction can also contribute to patient-reported dizziness. The purpose of this preliminary study was to examine whether a multimodal battery of assessments could help explain patient-reported dizziness after mTBI. Twenty-three participants with concussion-related symptoms completed the Dizziness Handicap Inventory (DHI) to evaluate...

BackgroundIntensive and high-dose upper extremity training, concentrating on movement quality in the early phase after a stroke, can enhance motor recovery compared to standard care. Unfortunately, such programs do not exist due to limited resources, patient compliance, and administrative challenges. ObjectiveTo examine the feasibility and potential efficacy, and to evaluate the resources of an intensive technology-based upper extremity training emphasizing movement quality during inpatient str...

Muscle tissue is prone to changes in composition and architecture following stroke. Changes in muscle tissue of the extremities are thought to increase passive muscle stiffness and joint impedance. These effects likely compound neuromuscular impairments exacerbating movement function. Unfortunately, conventional rehabilitation is devoid of quantitative measures yielding to subjective assessment of passive joint mobility and end feel. Shear wave ultrasound elastography is a conventional tool used...

BackgroundAcute intermittent hypoxia (AIH) was recently demonstrated to improve motor and cognitive function in several patient populations, including incomplete spinal cord injury, stroke, multiple sclerosis and mild cognitive impairment. ObjectiveOur clinical trial aimed to establish if AIH can be safely administered in patients with traumatic brain injury (TBI) and to collect preliminary data about its potential efficacy for treating motor, cognitive and affective sequelae of TBI. MethodsTw...

ObjectivePost-stroke spasticity prevalence increases with time from stroke onset, and negatively impacts the patients quality of life. Vibratory stimulation (VS) to the spastic muscles can reduce spasticity, whereas action observation (AO) and mirror therapy (MT) are reported to be less effective for spasticity reduction. However, these effects have not been compared within the same individuals. Therefore, this study compared the spasticity-reducing effects of VS, AO, and MT. MethodsIndependent...

The discrepancy between residual functional capacity and reduced use of the contralesional hand, frequently observed after a brain lesion, has been termed Learned Non-Use (LNU) and is thought to depend on the interaction of neuronal mechanisms during recovery and learning-dependent mechanisms such as negative reinforcement. Despite the generally accepted existence of the LNU phenomenon among clinicians and researchers, no unequivocal and transdisciplinary definition exists to date. Furthermore, ...

BackgroundFollowing the discontinuation of the conventional Action Research Arm Test (ARAT) import in Japan, a domestically manufactured version with identical assessment protocols but modified equipment was developed. We aimed to evaluate the psychometric properties of the newly developed ARAT and compare it with the conventional ARAT in patients with stroke. MethodsThis single-center cross-sectional study enrolled 64 patients with stroke and hemiparesis who met predefined inclusion criteria. ...

BackgroundGoal-setting is a core principle used in clinical practice to guide treatment. Setting goals improves adherence to rehabilitation treatments and may lead to better outcomes in people with neurological disorders. However, there is a lack of research into the prevalence of goals using a Specific, Measurable, Action-Oriented, Realistic, and Time-Bound (SMART) framework. Additionally, it is currently unclear if the SMART framework improves ambulatory outcomes in outpatient stroke rehabilit...

Stroke survivors experience a significant risk of falls, with 73% falling within the first year post stroke. Clinical practice guidelines currently use more than 27 assessment tools to evaluate fall risk in this population. However, there are conflicting findings regarding their diagnostic accuracy in correctly identifying those at risk of falling. This systematic review and meta-analysis evaluates the sensitivity and specificity of the Timed Up and Go and the Berg Balance Scale, which are the m...

Stroke is a major global health issue, and many patients experience motor paralysis and sensory impairments that affect their independence in activities of daily living (ADL). Trunk and lower limb functions are crucial in post-stroke ADL independence. Although these two functions are closely related, few studies have evaluated them in combination, and the importance of assessment methods that consider their mutual relationship has not been thoroughly examined. In this study, we aimed to clarify ...

ObjectiveThe primary objective of this study was to retrospectively assess current care practices to determine the routinely collected measures that are most predictive of paretic upper extremity (PUE) functional outcome post-stroke in patients undergoing acute inpatient rehabilitation (AR). MethodsWe conducted a longitudinal chart review of patients post-stroke who received care in the Emory University Hospital system for acute hospitalization, AR, and outpatient therapy in fiscal years 2016-2...

ObjectiveTo investigate the association between depressive symptoms and time spent in unsupervised training among inpatients with subacute stroke. DesignThis study was a secondary analysis of an unpublished dataset from 34 inpatients with subacute stroke (19 males; median age 65 [interquartile range, 55-75] years). Primary outcome was the median time spent in unsupervised training across three leg cycle sessions. Secondary outcomes included the Functional Independence Measure motor scores at di...