Loss of functional movement is a common consequence of stroke for which a wide range of interventions has been developed. In this Review, we aimed to provide an overview of the available evidence on interventions for motor recovery after stroke through the evaluation of systematic reviews, supplemented by recent randomised controlled trials. Most trials were small and had some design limitations. Improvements in recovery of arm function were seen for constraint-induced movement therapy, electromyographic biofeedback, mental practice with motor imagery, and robotics. Improvements in transfer ability or balance were seen with repetitive task training, biofeedback, and training with a moving platform. Physical fitness training, high-intensity therapy (usually physiotherapy), and repetitive task training improved walking speed. Although the existing evidence is limited by poor trial designs, some treatments do show promise for improving motor recovery, particularly those that have focused on high-intensity and repetitive task-specific practice.

https://www.thelancet.com/pdfs/journals/laneur/PIIS1474-4422(09)70150-4.pdf

Motor recovery after stroke: a systematic review

Stroke Care 2: Stroke rehabilitation

Purpose—The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods—Writing group members were nominated by th...

Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association

Reductions in blood flow to the brain of sufficient duration and extent lead to stroke, which results in damage to neuronal networks and the impairment of sensation, movement or cognition. Evidence from animal models suggests that a time-limited window of neuroplasticity opens following a stroke, during which the greatest gains in recovery occur. Plasticity mechanisms include activity-dependent rewiring and synapse strengthening. The challenge for improving stroke recovery is to understand how to optimally engage and modify surviving neuronal networks, to provide new response strategies that compensate for tissue lost to injury.

Plasticity during stroke recovery: from synapse to behaviour.

Thank you for downloading textbook of work physiology physiological bases of exercise. As you may know, people have look hundreds times for their chosen novels like this textbook of work physiology physiological bases of exercise, but end up in infectious downloads. Rather than reading a good book with a cup of tea in the afternoon, instead they cope with some harmful virus inside their desktop computer.

Textbook Of Work Physiology Physiological Bases Of Exercise

https://me.queensu.ca/People/Deluzio/JAM/files/10.22.09_Yang.pdf

Accelerometer and rate gyroscope measurement of kinematics: an inexpensive alternative to optical motion analysis systems.

A general-purpose system to obtain the kinematics of gait in the sagittal plane based on body-mounted sensors was developed. It consisted of four uniaxial seismic accelerometers and one rate gyroscope per body segment. Tests were done with 10 young healthy volunteers, walking at five different speeds on a treadmill. In order to study the system’s accuracy, measurements were made with an optic, passive-marker system and the body-mounted system, simultaneously. In all the comparison cases, the curves obtained from the two systems were very close, showing root mean square errors representing o7% full range in 75% of the cases (overall mean 6.64%, standard deviation 4.13%) and high coefficients of multiple correlation in 100% of cases (overall mean 0.9812, standard deviation 0.02). Calibration of the body-mounted system is done against gravity. The body-mounted sensors do not hinder natural movement. The calculation algorithms are computationally demanding and only are applicable off-line. The body-mounted sensors are accurate, inexpensive and portable and allow long-term recordings in clinical, sport and ergonomics settings. r 2002 Elsevier Science Ltd. All rights reserved.

https://me.queensu.ca/people/deluzio/jam/files/10.22.09_yang.pdf

Short communication Accelerometer and rate gyroscope measurement of kinematics: an inexpensive alternative to optical motion analysis systems

Aim: Many studies have been performed on the methodological qualities of the (modified) Ashworth Scale but overall these studies seem inconclusive. The aim of this study was to investigate the construct validity and inter-rater reliability of the Ashworth Scale (AS) for the assessment of spasticity in the upper and lower extremities. -
Method: A cross-sectional study on spasticity in the elbow flexors (part 1) and knee extensors (part 2) was carried out. In both parts AS was assessed while muscle activity and resistance were recorded simultaneously in patients with upper motor neuron syndrome. Each patient was measured by three raters. - 
Results: 30 patients participated, 19 in each part of the study. For elbow flexor muscles, AS was not significantly associated with electromyographic parameters, except for rater 2 (rho = 0.66, p<0.01). A significant moderate association was found with resistance (0.54≤ rho ≤0.61, p<0.05). For knee extensors, AS scores were moderately associated with muscle activity (0.56≤ rho ≤0.66, p<0.05) and also with resistance (0.55≤ rho ≤0.87, p<0.05). The intraclass correlation coefficient for absolute agreement was 0.58 for elbow flexors and 0.63 for knee extensors. In linear mixed model analysis, the factor rater appeared to be highly associated with AS. - 
Conclusion: The validity and reliability of the AS is insufficient to be used as a measure of spasticity.

https://jnnp.bmj.com/content/jnnp/81/1/46.full.pdf

Stop using the Ashworth Scale for the assessment of spasticity

Objective Analysis of the available evidence on the improvement of walking in stroke patients with a dropped foot when using peroneus stimulation.

Methods  A systematic review was performed to identify trials that investigated the orthotic effect of functional electrical stimulation (FES) on walking in stroke patients with a dropped foot. Two independent raters scored the methodological quality of the included articles. Walking speed and physiological cost index (PCI) were selected as the primary outcome measures. Studies that measured walking speed were pooled and a pooled difference including confidence interval was calculated.

Results  Eight studies were included in the review, of which one was a randomized controlled trial. Methodological score ranged from 8 to 18 out of 19. Six studies measured walking speed. The pooled improvement in walking speed was 0.13 m/s (0.07–0.2) or 38% (22.18–53.8).

Conclusions  The present review suggests a positive orthotic effect of functional electrical stimulation on walking speed

The orthotic effect of functional electrical stimulation on the improvement of walking in stroke patients with a dropped foot: A systematic review

https://www.archives-pmr.org/article/S0003-9993(07)00328-0/pdf

Anand V. Nene

Papers

Accelerometer and rate gyroscope measurement of kinematics: an inexpensive alternative to optical motion analysis systems.

Short communication Accelerometer and rate gyroscope measurement of kinematics: an inexpensive alternative to optical motion analysis systems

Stop using the Ashworth Scale for the assessment of spasticity

The orthotic effect of functional electrical stimulation on the improvement of walking in stroke patients with a dropped foot: A systematic review

A Randomized Controlled Trial of an Implantable 2-Channel Peroneal Nerve Stimulator on Walking Speed and Activity in Poststroke Hemiplegia