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Kettlety SA, Finley JM, Leech KA. Visuospatial Skills Explain Differences in the Ability to Use Propulsion Biofeedback Post-stroke. J Neurol Phys Ther 2024:01253086-990000000-00070. [PMID: 38912856 DOI: 10.1097/npt.0000000000000487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
BACKGROUND AND PURPOSE Visual biofeedback can be used to help people post-stroke reduce biomechanical gait impairments. Using visual biofeedback engages an explicit, cognitively demanding motor learning process. Participants with better overall cognitive function are better able to use visual biofeedback to promote locomotor learning; however, which specific cognitive domains are responsible for this effect are unknown. We aimed to understand which cognitive domains were associated with performance during acquisition and immediate retention when using visual biofeedback to increase paretic propulsion in individuals post-stroke. METHODS Participants post-stroke completed cognitive testing, which provided scores for different cognitive domains, including executive function, immediate memory, visuospatial/constructional skills, language, attention, and delayed memory. Next, participants completed a single session of paretic propulsion biofeedback training, where we collected treadmill-walking data for 20 min with biofeedback and 2 min without biofeedback. We fit separate regression models to determine if cognitive domain scores, motor impairment (measured with the lower-extremity Fugl-Meyer), and gait speed could explain propulsion error and variability during biofeedback use and recall error during immediate retention. RESULTS Visuospatial/constructional skills and motor impairment best-explained propulsion error during biofeedback use (adjusted R 2 = 0.56, P = 0.0008), and attention best-explained performance variability (adjusted R 2 = 0.17, P = 0.048). Language skills best-explained recall error during immediate retention (adjusted R 2 = 0.37, P = 0.02). DISCUSSION AND CONCLUSIONS These results demonstrate that specific cognitive domain impairments explain variability in locomotor learning outcomes in individuals with chronic stroke. This suggests that with further investigation, specific cognitive impairment information may be useful to predict responsiveness to interventions and personalize training parameters to facilitate locomotor learning.
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Affiliation(s)
- Sarah A Kettlety
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California (S.A.K., J.M.F., K.A.L.); Neuroscience Graduate Program, University of Southern California, Los Angeles, California (J.M.F., K.A.L.); and Department of Biomedical Engineering, University of Southern California, Los Angeles, California (J.M.F.)
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Włodarczyk L, Cichon N, Karbownik MS, Saluk J, Miller E. Exploring the Role of MMP-9 and MMP-9/TIMP-1 Ratio in Subacute Stroke Recovery: A Prospective Observational Study. Int J Mol Sci 2024; 25:5745. [PMID: 38891934 PMCID: PMC11172289 DOI: 10.3390/ijms25115745] [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: 04/17/2024] [Revised: 05/14/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
Despite the significant changes that unfold during the subacute phase of stroke, few studies have examined recovery abilities during this critical period. As neuroinflammation subsides and tissue degradation diminishes, the processes of neuroplasticity and angiogenesis intensify. An important factor in brain physiology and pathology, particularly neuroplasticity, is matrix metalloproteinase 9 (MMP-9). Its activity is modulated by tissue inhibitors of metalloproteinases (TIMPs), which impede substrate binding and activity by binding to its active sites. Notably, TIMP-1 specifically targets MMP-9 among other matrix metalloproteinases (MMPs). Our present study examines whether MMP-9 may play a beneficial role in psychological functions, particularly in alleviating depressive symptoms and enhancing specific cognitive domains, such as calculation. It appears that improvements in depressive symptoms during rehabilitation were notably linked with baseline MMP-9 plasma levels (r = -0.36, p = 0.025), and particularly so with the ratio of MMP-9 to TIMP-1, indicative of active MMP-9 (r = -0.42, p = 0.008). Furthermore, our findings support previous research demonstrating an inverse relationship between pre-rehabilitation MMP-9 serum levels and post-rehabilitation motor function. Crucially, our study emphasizes a positive correlation between cognition and motor function, highlighting the necessity of integrating both aspects into rehabilitation planning. These findings demonstrate the potential utility of MMP-9 as a prognostic biomarker for delineating recovery trajectories and guiding personalized treatment strategies for stroke patients during the subacute phase.
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Affiliation(s)
- Lidia Włodarczyk
- Department of Neurological Rehabilitation, Medical University of Lodz, Milionowa 14, 93-113 Lodz, Poland; (L.W.); (E.M.)
| | - Natalia Cichon
- Biohazard Prevention Centre, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236 Lodz, Poland
| | - Michał Seweryn Karbownik
- Department of Pharmacology and Toxicology, Medical University of Lodz, Żeligowskiego 7/9, 90-752 Lodz, Poland;
| | - Joanna Saluk
- Department of General Biochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236 Lodz, Poland;
| | - Elzbieta Miller
- Department of Neurological Rehabilitation, Medical University of Lodz, Milionowa 14, 93-113 Lodz, Poland; (L.W.); (E.M.)
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Tanaka M, Vécsei L. A Decade of Dedication: Pioneering Perspectives on Neurological Diseases and Mental Illnesses. Biomedicines 2024; 12:1083. [PMID: 38791045 PMCID: PMC11117868 DOI: 10.3390/biomedicines12051083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024] Open
Abstract
Welcome to Biomedicines' 10th Anniversary Special Issue, a journey through the human mind's labyrinth and complex neurological pathways [...].
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Affiliation(s)
- Masaru Tanaka
- HUN-REN-SZTE Neuroscience Research Group, Hungarian Research Network, University of Szeged, Danube Neuroscience Research Laboratory, Tisza Lajos krt. 113, H-6725 Szeged, Hungary;
| | - László Vécsei
- HUN-REN-SZTE Neuroscience Research Group, Hungarian Research Network, University of Szeged, Danube Neuroscience Research Laboratory, Tisza Lajos krt. 113, H-6725 Szeged, Hungary;
- Department of Neurology, Albert Szent-Györgyi Medical School, University of Szeged, Semmelweis u. 6, H-6725 Szeged, Hungary
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Kleih SC, Botrel L. Inconclusive results of slow cortical potential neurofeedback for the treatment of chronic post-stroke attention deficits. Front Hum Neurosci 2024; 18:1301622. [PMID: 38646162 PMCID: PMC11026669 DOI: 10.3389/fnhum.2024.1301622] [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: 09/25/2023] [Accepted: 03/06/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction Individuals who have suffered a stroke may experience long-lasting cognitive impairments that can worsen if left untreated. We investigated whether voluntary control of slow cortical potentials (SCP) through neurofeedback would help alleviate chronic post-stroke symptoms of impaired attention. Methods The study initially enrolled twenty-eight participants, but due to a high drop-out rate, only sixteen participants completed eight SCP neurofeedback training sessions within three to four weeks. During these sessions, we gave feedback to the participants on their ability to regulate SCPs on a computer screen. Results Our findings showed a non-significant increase in SCP regulation towards cortical negativity. On the behavioral level, we found improved test values in the divided attention and attentional flexibility subtests of the test battery for attention performance. However, we cannot eliminate the possibility that nonspecific effects influenced or caused our results. We have not observed any improvement regarding the effects of attention deficits on participants' daily lives. We identified five individuals who could gain SCP control successfully and consistently towards negativity. In this group of responders, we observed an improvement in the test results related to divided attention but no other attention-related improvements. Discussion Based on our observations, results of SCP neurofeedback training for the treatment of attention deficits after a stroke are inconclusive. More research is necessary to determine the effectiveness of SCP neurofeedback in helping stroke survivors cope with attention-related challenges in their daily lives.
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Affiliation(s)
- Sonja C Kleih
- Institute of Psychology, Biological Psychology Clinical Psychology and Psychotherapy, Faculty of Human Sciences, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Loic Botrel
- Institute of Psychology, Biological Psychology Clinical Psychology and Psychotherapy, Faculty of Human Sciences, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
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Rose Sin Yi L, Jing Jing S, Hammoda AO, Jonathan B, Ladislav B, Jing Q. Effects of virtual reality-based cognitive interventions on cognitive function and activity of daily living among stroke patients: Systematic review and meta-analysis. J Clin Nurs 2024; 33:1169-1184. [PMID: 38234275 DOI: 10.1111/jocn.16986] [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: 10/14/2022] [Revised: 10/24/2023] [Accepted: 12/12/2023] [Indexed: 01/19/2024]
Abstract
AIMS To examine the effects of virtual reality-based cognitive interventions on cognitive function and activities of daily living among stroke patients, and to identify the optimal design for such intervention. DESIGN Systematic review and meta-analysis. DATA SOURCES Medline, EMBASE, Cochrane, CINANL, JBI-EBP and Web of Science from inception to October 2023. METHODS Methodological quality was assessed by Risk of Bias Tool. Meta-analyses were assessed by Review Manager 5.4. Subgroup analyses were conducted to explore the influence of study design. Grading of Recommendations Assessment, Development and Evaluation approach was adopted to assess the certainty of evidence. RESULTS Twenty-five randomized controlled trials (1178 participants) were included. Virtual reality-based cognitive interventions demonstrated moderate-to-large effects in improving global cognitive function (SMD = 0.43; 95% CI [0.01, 0.85]), executive function (SMD = 0.84; 95% CI [0.25, 1.43]) and memory (SMD = 0.65; 95% CI [0.15, 1.16]) compared to control treatments. No significant effects were found on language, visuospatial ability and activities of daily living. Subgroup analyses indicated one-on-one coaching, individualized design and dynamic difficulty adjustment, and interventions lasting ≥ 6 weeks had particularly enhanced effects, especially for executive function. CONCLUSIONS Virtual reality-based cognitive interventions improve global cognitive function, executive function and memory among stroke patients. IMPLICATIONS FOR THE PATIENT CARE This review underscores the broad cognitive advantages offered by virtual technology, suggesting its potential integration into standard stroke rehabilitation protocols for enhanced cognitive recovery. IMPACT The study identifies key factors in virtual technology interventions that effectively improve cognitive function among stroke patients, offering healthcare providers a framework for leveraging such technology to optimize cognitive outcomes in stroke rehabilitation. REPORTING METHOD PRISMA 2020 statement. PROSPERO REGISTRATION NUMBER CRD42022342668.
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Affiliation(s)
- Lin Rose Sin Yi
- School of Nursing, Elaine C. Hubbard Center for Nursing Research on Aging, University of Rochester, Rochester, New York, USA
| | - Su Jing Jing
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Abu-Odah Hammoda
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Bayuo Jonathan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Batalik Ladislav
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
- Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Qin Jing
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Valenzuela-López L, Moreno-Verdú M, Cuenca-Zaldívar JN, Romero JP. Effects of Hand Motor Interventions on Cognitive Outcomes Post-stroke: A Systematic Review and Bayesian Network Meta-analysis. Arch Phys Med Rehabil 2024:S0003-9993(24)00029-7. [PMID: 38211761 DOI: 10.1016/j.apmr.2023.12.013] [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: 05/30/2023] [Revised: 11/29/2023] [Accepted: 12/14/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE To synthetize the evidence on the effects of hand rehabilitation (RHB) interventions on cognition post-stroke and compare their efficacy. DATA SOURCES PubMed, Embase, Cochrane, Scopus, Web of Science, and CINAHL were searched from inception to November 2022. DATA SELECTION Randomized controlled trials conducted in adults with stroke where the effects of hand motor interventions on any cognitive domains were assessed. DATA EXTRACTION Data were extracted by 2 independent reviewers. A Bayesian Network Meta-analysis (NMA) was applied for measures with enough studies and comparisons. Risk of bias was assessed with the Cochrane Risk of Bias tool. DATA SYNTHESIS Fifteen studies were included in qualitative synthesis, and 11 in NMA. Virtual reality (VR) (n=7), robot-assisted (n=5), or handgrip strength (n=3) training were the experimental interventions and conventional RHB (n=14) control intervention. Two separate NMA were performed with MoCA (n=480 participants) and MMSE (n=350 participants) as outcome measures. Both coincided that the most probable best interventions were robot-assisted and strength training, according to SUCRA and rankogram, followed by conventional RHB and VR training. No significant differences between any of the treatments were found in the MoCA network, but in the MMSE, robot-assisted and strength training were significantly better than conventional RHB and VR. No significant differences between robot-assisted and strength training were found nor between conventional RHB and VR. CONCLUSIONS Motor interventions can improve MoCA/MMSE scores post-stroke. Most probable best interventions were robot-assisted and strength training. Limited literature assessing domain-specific cognitive effects was found.
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Affiliation(s)
- Laura Valenzuela-López
- Faculty of Experimental Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain; Brain Injury and Movement Disorders Neurorehabilitation Group (GINDAT), Institute of Life Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain
| | - Marcos Moreno-Verdú
- Faculty of Experimental Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain; Brain Injury and Movement Disorders Neurorehabilitation Group (GINDAT), Institute of Life Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain.
| | - Juan Nicolás Cuenca-Zaldívar
- Research Group in Physiotherapy and Pain, Department of Nursing and Physiotherapy, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain; Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute - Segovia de Arana (IDIPHISA), Madrid, Spain; Physical Therapy Unit. Primary Health Care Center "El Abajón", Madrid, Spain; Interdisciplinary Group on Musculoskeletal Disorders, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Spain
| | - Juan Pablo Romero
- Faculty of Experimental Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain; Brain Injury and Movement Disorders Neurorehabilitation Group (GINDAT), Institute of Life Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain; Brain Damage Unit, Beata María Ana Hospital, Madrid, Spain
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Basagni B, Malloggi S, Polito C, Pellicciari L, Campagnini S, Pancani S, Mannini A, Gemignani P, Salvadori E, Marignani S, Giovannelli F, Viggiano MP, Hakiki B, Grippo A, Macchi C, Cecchi F. MoCA Domain-Specific Pattern of Cognitive Impairment in Stroke Patients Attending Intensive Inpatient Rehabilitation: A Prospective Study. Behav Sci (Basel) 2024; 14:42. [PMID: 38247694 PMCID: PMC10813017 DOI: 10.3390/bs14010042] [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: 10/31/2023] [Revised: 12/18/2023] [Accepted: 12/24/2023] [Indexed: 01/23/2024] Open
Abstract
A domain-specific perspective to cognitive functioning in stroke patients may predict their cognitive recovery over time and target stroke rehabilitation intervention. However, data about domain-specific cognitive impairment after stroke are still scarce. This study prospectively investigated the domain-specific pattern of cognitive impairments, using the classification proposed by the Montreal Cognitive Assessment (MoCA), in a cohort of 49 stroke patients at admission (T0), discharge (T1), and six-month follow-up (T2) from subacute intensive rehabilitation. The predictive value of T0 cognitive domains cognitive impairment at T1 and T2 was also investigated. Patients' cognitive functioning at T0, T1, and T2 was assessed through the MoCA domains for executive functioning, attention, language, visuospatial, orientation, and memory. Different evolutionary trends of cognitive domain impairments emerged across time-points. Patients' impairments in all domains decreased from T0 to T1. Attention and executive impairments decreased from T0 to T2 (42.9% and 26.5% to 10.2% and 18.4%, respectively). Conversely, altered visuospatial, language, and orientation increased between T1 and T2 (16.3%, 36.7%, and 40.8%, respectively). Additionally, patients' global cognitive functioning at T1 was predicted by the language and executive domains in a subacute phase (p = 0.031 and p = 0.001, respectively), while in the long term, only attention (p = 0.043) and executive (p = 0.019) domains intervened. Overall, these results confirm the importance of a domain-specific approach to target cognitive recovery across time in stroke patients.
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Affiliation(s)
- Benedetta Basagni
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Serena Malloggi
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Cristina Polito
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Leonardo Pellicciari
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Silvia Campagnini
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Silvia Pancani
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Andrea Mannini
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Paola Gemignani
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Emilia Salvadori
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Sara Marignani
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Fabio Giovannelli
- Department of NEUROFARBA, University of Florence, 50143 Firenze, Italy; (F.G.); (M.P.V.)
| | - Maria Pia Viggiano
- Department of NEUROFARBA, University of Florence, 50143 Firenze, Italy; (F.G.); (M.P.V.)
| | - Bahia Hakiki
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Antonello Grippo
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
- Department of Experimental and Clinical Medicine, University of Florence, 50143 Firenze, Italy
| | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
- Department of Experimental and Clinical Medicine, University of Florence, 50143 Firenze, Italy
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Peng C, Wang Z. Diagnosis of motor function injury based on near-infrared spectroscopy brain imaging (fNIRS) technology. Prev Med 2023; 174:107641. [PMID: 37481167 DOI: 10.1016/j.ypmed.2023.107641] [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: 05/13/2023] [Revised: 07/14/2023] [Accepted: 07/19/2023] [Indexed: 07/24/2023]
Abstract
Most clinical stroke patients may have difficulty moving, affecting their self-care ability and quality of life, and causing serious interference with the normal life and work of other family members. At present, in clinical literature, researchers provide functional training for patients with motor disorders through repeated and effective training, which can ultimately effectively promote the recovery of limb function. Therefore, the near-infrared spectroscopy imaging technology (fNIRS) used in this study combines the diagnosis of sports injury with the mechanism of brain function. FNIRS technology has many advantages, such as fast, and non-invasive, and has shown great value in detecting brain activity. Therefore, it has become a promising method in the biomedical field, especially in the field of brain science. Based on the clinical effects of sports injury treatment, fNIRS technology is used to detect the hemodynamic changes of hemoglobin circulation in the patient's brain tissue during training, and to detect the brain activity mechanism in the exercise mechanism, providing a basis for the clinical application of this method.
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Affiliation(s)
- Cheng Peng
- School of Rehabilitation Medicine, Jiangsu Vocational College Of Medicine, Yancheng, Jiangsu 224000, China.
| | - Ziyi Wang
- School of Rehabilitation Medicine, Jiangsu Vocational College Of Medicine, Yancheng, Jiangsu 224000, China
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Kleih-Dahms SC, Botrel L. Neurofeedback therapy to improve cognitive function in patients with chronic post-stroke attention deficits: a within-subjects comparison. Front Hum Neurosci 2023; 17:1155584. [PMID: 37497040 PMCID: PMC10367101 DOI: 10.3389/fnhum.2023.1155584] [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: 01/31/2023] [Accepted: 06/12/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction We investigated a slow-cortical potential (SCP) neurofeedback therapy approach for rehabilitating chronic attention deficits after stroke. This study is the first attempt to train patients who survived stroke with SCP neurofeedback therapy. Methods We included N = 5 participants in a within-subjects follow-up design. We assessed neuropsychological and psychological performance at baseline (4 weeks before study onset), before study onset, after neurofeedback training, and at 3 months follow-up. Participants underwent 20 sessions of SCP neurofeedback training. Results Participants learned to regulate SCPs toward negativity, and we found indications for improved attention after the SCP neurofeedback therapy in some participants. Quality of life improved throughout the study according to engagement in activities of daily living. The self-reported motivation was related to mean SCP activation in two participants. Discussion We would like to bring attention to the potential of SCP neurofeedback therapy as a new rehabilitation method for treating post-stroke cognitive deficits. Studies with larger samples are warranted to corroborate the results.
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Salvalaggio S, Turolla A, Andò M, Barresi R, Burgio F, Busan P, Cortese AM, D’Imperio D, Danesin L, Ferrazzi G, Maistrello L, Mascotto E, Parrotta I, Pezzetta R, Rigon E, Vedovato A, Zago S, Zorzi M, Arcara G, Mantini D, Filippini N. Prediction of rehabilitation induced motor recovery after stroke using a multi-dimensional and multi-modal approach. Front Aging Neurosci 2023; 15:1205063. [PMID: 37469951 PMCID: PMC10352609 DOI: 10.3389/fnagi.2023.1205063] [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: 04/13/2023] [Accepted: 06/19/2023] [Indexed: 07/21/2023] Open
Abstract
Background Stroke is a debilitating disease affecting millions of people worldwide. Despite the survival rate has significantly increased over the years, many stroke survivors are left with severe impairments impacting their quality of life. Rehabilitation programs have proved to be successful in improving the recovery process. However, a reliable model of sensorimotor recovery and a clear identification of predictive markers of rehabilitation-induced recovery are still needed. This article introduces the cross-modality protocols designed to investigate the rehabilitation treatment's effect in a group of stroke survivors. Methods/design A total of 75 stroke patients, admitted at the IRCCS San Camillo rehabilitation Hospital in Venice (Italy), will be included in this study. Here, we describe the rehabilitation programs, clinical, neuropsychological, and physiological/imaging [including electroencephalography (EEG), transcranial magnetic stimulation (TMS), and magnetic resonance imaging (MRI) techniques] protocols set up for this study. Blood collection for the characterization of predictive biological biomarkers will also be taken. Measures derived from data acquired will be used as candidate predictors of motor recovery. Discussion/summary The integration of cutting-edge physiological and imaging techniques, with clinical and cognitive assessment, dose of rehabilitation and biological variables will provide a unique opportunity to define a predictive model of recovery in stroke patients. Taken together, the data acquired in this project will help to define a model of rehabilitation induced sensorimotor recovery, with the final aim of developing personalized treatments promoting the greatest chance of recovery of the compromised functions.
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Affiliation(s)
- Silvia Salvalaggio
- IRCCS San Camillo Hospital, Venice, Italy
- Padova Neuroscience Center, Università degli Studi di Padova, Padua, Italy
| | - Andrea Turolla
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum – Università di Bologna, Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | | | | | | | - Anna Maria Cortese
- Department of Rehabilitation Medicine, AULSS 3 Serenissima, Venice, Italy
| | | | | | | | | | - Eleonora Mascotto
- Department of Physical Medicine and Rehabilitation, Venice Hospital, Venice, Italy
| | | | | | | | - Anna Vedovato
- General Hospital San Camillo of Treviso, Treviso, Italy
| | - Sara Zago
- IRCCS San Camillo Hospital, Venice, Italy
| | - Marco Zorzi
- IRCCS San Camillo Hospital, Venice, Italy
- Padova Neuroscience Center, Università degli Studi di Padova, Padua, Italy
- Department of General Psychology, University of Padova, Padua, Italy
| | | | - Dante Mantini
- IRCCS San Camillo Hospital, Venice, Italy
- Movement Control and Neuroplasticity Research Group, KU Leuven, Leuven, Belgium
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11
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Salvalaggio S, Cacciante L, Maistrello L, Turolla A. Clinical Predictors for Upper Limb Recovery after Stroke Rehabilitation: Retrospective Cohort Study. Healthcare (Basel) 2023; 11:healthcare11030335. [PMID: 36766910 PMCID: PMC9913979 DOI: 10.3390/healthcare11030335] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/25/2023] Open
Abstract
After stroke, recovery of upper limb (UL) motor function is enhanced by a high dose of rehabilitation and is supposed to be supported by attentive functions. However, their mutual influence during rehabilitation is not well known yet. The aim of this retrospective observational cohort study was to investigate the association between rehabilitation dose and motor and cognitive functions, during UL motor recovery. Inpatients with first unilateral stroke, without time restrictions from onset, and undergoing at least 15 h of rehabilitation were enrolled. Data on dose and modalities of rehabilitation received, together with motor and cognitive outcomes before and after therapy, were collected. Fugl-Meyer values for the Upper Extremity were the primary outcome measure. Logistic regression models were used to detect any associations between UL motor improvement and motor and cognitive-linguistic features at acceptance, regarding dose of rehabilitation received. Thirty-five patients were enrolled and received 80.57 ± 30.1 h of rehabilitation on average. Manual dexterity, level of independence and UL motor function improved after rehabilitation, with no influence of attentive functions on motor recovery. The total amount of rehabilitation delivered was the strongest factor (p = 0.031) influencing the recovery of UL motor function after stroke, whereas cognitive-linguistic characteristics were not found to influence UL motor gains.
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Affiliation(s)
- Silvia Salvalaggio
- Laboratory of Healthcare Innovation Technology, IRCCS San Camillo Hospital, Via Alberoni 70, 30126 Venice, Italy
- Padova Neuroscience Center, Università degli Studi di Padova, Via Orus 2/B, 35131 Padova, Italy
| | - Luisa Cacciante
- Laboratory of Healthcare Innovation Technology, IRCCS San Camillo Hospital, Via Alberoni 70, 30126 Venice, Italy
- Correspondence: ; Tel.: +39-0412207521
| | | | - Andrea Turolla
- Department of Biomedical and Neuromotor Sciences–DIBINEM, Alma Mater Studiorum Università di Bologna, Via Massarenti 9, 40138 Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9, 40138 Bologna, Italy
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12
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Nayak A, Bhave AC, Misri Z, Unnikrishnan B, Mahmood A, Joshua AM, Karthikbabu S. Facilitators and barriers of community reintegration among individuals with stroke: a scoping review. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2023. [DOI: 10.1080/21679169.2022.2156599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Akshatha Nayak
- Department of Physiotherapy, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Aishwarya C. Bhave
- Department of Physiotherapy, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Zulkifli Misri
- Department of Neurology, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Bhaskaran Unnikrishnan
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Amreen Mahmood
- Department of Physiotherapy, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Abraham M. Joshua
- Department of Physiotherapy, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
| | - Suruliraj Karthikbabu
- KMCH College of Physiotherapy, Kovai Medical Center Research and Educational Trust, Coimbatore, The Tamil Nadu Dr. M.G.R. Medical University, Chennai
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13
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Spinal cord stimulation improves motor function in disorders of consciousness: A case report. JOURNAL OF NEURORESTORATOLOGY 2023. [DOI: 10.1016/j.jnrt.2023.100041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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14
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Einstad MS, Schellhorn T, Thingstad P, Lydersen S, Aamodt EB, Beyer MK, Saltvedt I, Askim T. Neuroimaging markers of dual impairment in cognition and physical performance following stroke: The Nor-COAST study. Front Aging Neurosci 2022; 14:1037936. [PMID: 36561134 PMCID: PMC9765078 DOI: 10.3389/fnagi.2022.1037936] [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: 09/06/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Background Cognitive decline and decline in physical performance are common after stroke. Concurrent impairments in the two domains are reported to give increased risk of dementia and functional decline. The concept of dual impairment of physical performance and cognition after stroke is poorly investigated. Clinically accessible imaging markers of stroke and pre-existing brain pathology might help identify patients at risk. Objective The primary aim of this study was to investigate to which extent pre-stroke cerebral pathology was associated with dual impairment in cognition and physical performance at time of stroke. Secondary aims were to examine whether white matter hyperintensities, medial temporal lobe atrophy, and stroke lesion volume and location were associated with dual impairment. Methods Participants from the Norwegian Cognitive Impairment After Stroke (Nor-COAST) study with available MRI data at baseline were included in this cross-sectional study. Logistic regression analyses were conducted, with impairment status (no impairment, impaired cognition, impaired physical performance, and dual impairment) as the dependent variable and MRI markers as covariates. Pre-existing brain pathologies were classified into neurodegenerative, cerebrovascular, or mixed pathology. In addition, white matter hyperintensities and medial temporal lobe atrophy were included as independent covariates. Stroke volume and location were also ascertained from study-specific MRI scans. Results Participants' (n = 348) mean (SD) age was 72.3 (11.3) years; 148 (42.5%) were women. Participants with dual impairment (n = 99) were significantly older, had experienced a more severe stroke, and had a higher comorbidity burden and poorer pre-stroke function. Stroke lesion volume (odds ratio 1.03, 95%, confidence interval 1.00 to 1.05, p = 0.035), but not stroke location or pre-existing brain pathology, was associated with dual impairment, after adjusting for age and sex. Conclusion In this large cohort of stroke survivors having suffered mainly mild to moderate stroke, stroke lesion volume-but not pre-existing brain pathology-was associated with dual impairment early after stroke, confirming the role of stroke severity in functional decline.
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Affiliation(s)
- Marte Stine Einstad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway,*Correspondence: Marte Stine Einstad,
| | - Till Schellhorn
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Pernille Thingstad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Lydersen
- Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Eva Birgitte Aamodt
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Mona Kristiansen Beyer
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Ingvild Saltvedt
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway,Department of Geriatric Medicine, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Torunn Askim
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway,Stroke Unit, Department of Internal Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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15
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Hooyman A, VanGilder JL, Schaefer SY. Mediation Analysis of the Effect of Visuospatial Memory on Motor Skill Learning in Older Adults. J Mot Behav 2022; 55:68-77. [PMID: 35902117 PMCID: PMC9792432 DOI: 10.1080/00222895.2022.2105793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 06/10/2022] [Accepted: 07/20/2022] [Indexed: 02/02/2023]
Abstract
There is high inter-individual variability in motor skill learning among older adults. Identifying the nature of these individual differences remains challenging due to interactions between participant characteristics (e.g., age, cognition) and task-related factors (e.g., nature of task, level of skill pre-training), making it difficult to determine plausibly causal relationships. This study addresses these competing explanations by using mediation analysis to examine plausible causal inference between visuospatial memory and one-month retention of both gross and fine motor components of a functional upper-extremity task following training. Results suggest that better visuospatial memory results in more retention of fine but not gross motor skill, expanding on previous correlational studies in older adults and informing future interventions for maximizing motor learning in geriatric populations.
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Affiliation(s)
- Andrew Hooyman
- School of Biological and Health Systems Engineering,
Arizona State University, Tempe, AZ, USA
- The Arizona Alzheimer's Consortium, Phoenix, AZ,
USA
| | | | - Sydney Y. Schaefer
- School of Biological and Health Systems Engineering,
Arizona State University, Tempe, AZ, USA
- The Arizona Alzheimer's Consortium, Phoenix, AZ,
USA
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16
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Lanza MB, Gray VL. The effects of stroke on weight transfer before voluntary lateral and forward steps. Front Neurol 2022; 13:891439. [PMID: 35937060 PMCID: PMC9355404 DOI: 10.3389/fneur.2022.891439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/04/2022] [Indexed: 11/18/2022] Open
Abstract
There is a higher rate of falls in the first year after a stroke, and the ability to step in different directions is essential for avoiding a fall and navigating small spaces where falls commonly occur. The lateral transfer of weight is important for stabilizing the body before initiating a step. Hence, understanding the ability to control lateral weight transfer (WT) in different step directions might help understand falls in individuals with stroke. The present study aimed to compare the WT characteristics (onset time, duration, mediolateral center of pressure (ML COP) velocity, and ML COP displacement) and hip abduction torque preceding a lateral and forward voluntary step between individuals with stroke (paretic and non-paretic leg) and controls. Twenty individuals with stroke and ten controls performed voluntary choice reaction tests in the lateral and forward directions. Ten trials (five on each side-right and left) were performed for each step direction. The overall primary findings were that (1) the WT before a lateral step was shorter and initiated earlier, with a larger ML COP displacement and greater hip abductor torque in the stepping leg than the forward step, (2) there was greater hip abductor produced in the stance leg before a forward step than a lateral step, (3) the WT before the lateral step took longer to initiate and was slower to execute in individuals with stroke regardless of the leg (4) the WT before the forward step had more differences in the paretic than the non-paretic leg. Thus, for the first time, it was shown that the WT characteristics and hip abduction torque during the WT are different according to step direction and also appear to be impaired in individuals with stroke. These results have implications for understanding the direction that individuals with stroke are more susceptible to being unable to recover balance and are at risk of falling.
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Affiliation(s)
- Marcel Bahia Lanza
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, United States
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17
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Zavaliangos‐Petropulu A, Lo B, Donnelly MR, Schweighofer N, Lohse K, Jahanshad N, Barisano G, Banaj N, Borich MR, Boyd LA, Buetefisch CM, Byblow WD, Cassidy JM, Charalambous CC, Conforto AB, DiCarlo JA, Dula AN, Egorova‐Brumley N, Etherton MR, Feng W, Fercho KA, Geranmayeh F, Hanlon CA, Hayward KS, Hordacre B, Kautz SA, Khlif MS, Kim H, Kuceyeski A, Lin DJ, Liu J, Lotze M, MacIntosh BJ, Margetis JL, Mohamed FB, Piras F, Ramos‐Murguialday A, Revill KP, Roberts PS, Robertson AD, Schambra HM, Seo NJ, Shiroishi MS, Stinear CM, Soekadar SR, Spalletta G, Taga M, Tang WK, Thielman GT, Vecchio D, Ward NS, Westlye LT, Werden E, Winstein C, Wittenberg GF, Wolf SL, Wong KA, Yu C, Brodtmann A, Cramer SC, Thompson PM, Liew S. Chronic Stroke Sensorimotor Impairment Is Related to Smaller Hippocampal Volumes: An ENIGMA Analysis. J Am Heart Assoc 2022; 11:e025109. [PMID: 35574963 PMCID: PMC9238563 DOI: 10.1161/jaha.121.025109] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/29/2022] [Indexed: 11/22/2022]
Abstract
Background Persistent sensorimotor impairments after stroke can negatively impact quality of life. The hippocampus is vulnerable to poststroke secondary degeneration and is involved in sensorimotor behavior but has not been widely studied within the context of poststroke upper-limb sensorimotor impairment. We investigated associations between non-lesioned hippocampal volume and upper limb sensorimotor impairment in people with chronic stroke, hypothesizing that smaller ipsilesional hippocampal volumes would be associated with greater sensorimotor impairment. Methods and Results Cross-sectional T1-weighted magnetic resonance images of the brain were pooled from 357 participants with chronic stroke from 18 research cohorts of the ENIGMA (Enhancing NeuoImaging Genetics through Meta-Analysis) Stroke Recovery Working Group. Sensorimotor impairment was estimated from the FMA-UE (Fugl-Meyer Assessment of Upper Extremity). Robust mixed-effects linear models were used to test associations between poststroke sensorimotor impairment and hippocampal volumes (ipsilesional and contralesional separately; Bonferroni-corrected, P<0.025), controlling for age, sex, lesion volume, and lesioned hemisphere. In exploratory analyses, we tested for a sensorimotor impairment and sex interaction and relationships between lesion volume, sensorimotor damage, and hippocampal volume. Greater sensorimotor impairment was significantly associated with ipsilesional (P=0.005; β=0.16) but not contralesional (P=0.96; β=0.003) hippocampal volume, independent of lesion volume and other covariates (P=0.001; β=0.26). Women showed progressively worsening sensorimotor impairment with smaller ipsilesional (P=0.008; β=-0.26) and contralesional (P=0.006; β=-0.27) hippocampal volumes compared with men. Hippocampal volume was associated with lesion size (P<0.001; β=-0.21) and extent of sensorimotor damage (P=0.003; β=-0.15). Conclusions The present study identifies novel associations between chronic poststroke sensorimotor impairment and ipsilesional hippocampal volume that are not caused by lesion size and may be stronger in women.
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Affiliation(s)
- Artemis Zavaliangos‐Petropulu
- Mark and Mary Stevens Neuroimaging and Informatics InstituteKeck School of Medicine, University of Southern CaliforniaLos AngelesCA
- Neuroscience Graduate ProgramUniversity of Southern CaliforniaLos AngelesCA
| | - Bethany Lo
- Chan Division of Occupational Science and Occupational TherapyUniversity of Southern CaliforniaLos AngelesCA
| | - Miranda R. Donnelly
- Chan Division of Occupational Science and Occupational TherapyUniversity of Southern CaliforniaLos AngelesCA
| | - Nicolas Schweighofer
- Biokinesiology and Physical TherapyUniversity of Southern CaliforniaLos AngelesCA
| | - Keith Lohse
- Physical Therapy and NeurologyWashington University School of Medicine in Saint LouisMO
| | - Neda Jahanshad
- Mark and Mary Stevens Neuroimaging and Informatics InstituteKeck School of Medicine, University of Southern CaliforniaLos AngelesCA
| | - Giuseppe Barisano
- Mark and Mary Stevens Neuroimaging and Informatics InstituteKeck School of Medicine, University of Southern CaliforniaLos AngelesCA
- Neuroscience Graduate ProgramUniversity of Southern CaliforniaLos AngelesCA
| | - Nerisa Banaj
- Laboratory of NeuropsychiatryIRCCS Santa Lucia FoundationRomeItaly
| | - Michael R. Borich
- Division of Physical TherapyDepartment of Rehabilitation MedicineEmory University School of MedicineAtlantaGA
| | - Lara A. Boyd
- Department of Physical TherapyUniversity of British ColumbiaVancouverCanada
| | | | - Winston D. Byblow
- Department of Exercise Sciences, and Centre for Brain ResearchUniversity of AucklandNew Zealand
| | - Jessica M. Cassidy
- Department of Allied Health SciencesUniversity of North Carolina at Chapel HillNC
| | - Charalambos C. Charalambous
- Department of Basic and Clinical SciencesUniversity of Nicosia Medical SchoolNicosiaCyprus
- Center for Neuroscience and Integrative Brain Research (CENIBRE)NicosiaCyprus
| | - Adriana B. Conforto
- Hospital das ClínicasSão Paulo UniversitySão PauloBrazil
- Hospital Israelita Albert EinsteinSão PauloBrazil
| | - Julie A. DiCarlo
- Center for Neurotechnology and Neurorecovery (CNTR)Massachusetts General HospitalBostonMA
| | - Adrienne N. Dula
- Department of NeurologyDell Medical SchoolUniversity of Texas at AustinTX
| | | | - Mark R. Etherton
- Department of NeurologyJ. Philip Kistler Stroke Research CenterMassachusetts General HospitalBostonMA
| | - Wuwei Feng
- Department of NeurologyDuke University School of MedicineDurhamNC
| | - Kelene A. Fercho
- Basic Biomedical SciencesUniversity of South DakotaVermillionSD
- Federal Aviation AdministrationCivil Aerospace Medical InstituteOklahoma CityOK
| | | | | | - Kathryn S. Hayward
- Departments of Physiotherapy and Medicine, University of MelbourneHeidelbergVictoriaAustralia
- The Florey Institute of Neuroscience and Mental HealthHeidelbergVictoriaAustralia
| | - Brenton Hordacre
- Innovation, Implementation and Clinical Translation (IIMPACT) in HealthAllied Health and Human PerformanceUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | - Steven A. Kautz
- Ralph H Johnson Veterans Affairs Medical CenterCharlestonSC
- Department of Health Sciences & ResearchMedical University of South CarolinaCharlestonSC
| | - Mohamed Salah Khlif
- The Florey Institute of Neuroscience and Mental HealthHeidelbergVictoriaAustralia
| | - Hosung Kim
- Mark and Mary Stevens Neuroimaging and Informatics InstituteKeck School of Medicine, University of Southern CaliforniaLos AngelesCA
| | - Amy Kuceyeski
- Department of RadiologyWeill Cornell MedicineNew YorkNY
| | - David J. Lin
- Center for Neurotechnology and Neurorecovery (CNTR)Massachusetts General HospitalBostonMA
| | - Jingchun Liu
- Department of RadiologyTianjin Medical University General HospitalTianjinChina
| | - Martin Lotze
- Functional ImagingInstitute for Diagnostic Radiology and NeuroradiologyUniversity Medicine GreifswaldGermany
| | - Bradley J. MacIntosh
- Hurvitz Brain Sciences ProgramSunnybrook Research InstituteTorontoCanada
- Department of Medical BiophysicsUniversity of TorontoOntarioCanada
| | - John L. Margetis
- Chan Division of Occupational Science and Occupational TherapyUniversity of Southern CaliforniaLos AngelesCA
| | - Feroze B. Mohamed
- Department of RadiologyJefferson Integrated MR CenterThomas Jefferson UniversityPhiladelphiaPA
| | - Fabrizio Piras
- Laboratory of NeuropsychiatryIRCCS Santa Lucia FoundationRomeItaly
| | - Ander Ramos‐Murguialday
- Institute of Medical Psychology and Behavioral NeurobiologyUniversity of TübingenGermany
- Health DivisionTECNALIASan SebastianSpain
| | | | - Pamela S. Roberts
- Chan Division of Occupational Science and Occupational TherapyUniversity of Southern CaliforniaLos AngelesCA
- Department of Physical Medicine and RehabilitationCedars‐SinaiLos AngelesCA
| | - Andrew D. Robertson
- Department of Kinesiology and Health SciencesUniversity of WaterlooOntarioCanada
| | - Heidi M. Schambra
- Departments of Neurology & Rehabilitation MedicineNYU LangoneNew YorkNY
| | - Na Jin Seo
- Ralph H Johnson Veterans Affairs Medical CenterCharlestonSC
- Department of Rehabilitation SciencesDepartment of Health Science and ResearchMedical University of South CarolinaCharlestonSC
| | - Mark S. Shiroishi
- Mark and Mary Stevens Neuroimaging and Informatics InstituteKeck School of Medicine, University of Southern CaliforniaLos AngelesCA
- Department of RadiologyKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCA
| | | | - Surjo R. Soekadar
- Clinical Neurotechnology LaboratoryDepartment of Psychiatry and Neurosciences (CCM)Charité ‐ Universitätsmedizin BerlinBerlinGermany
| | | | - Myriam Taga
- NYU Langone Department of NeurologyNew YorkNY
| | - Wai Kwong Tang
- Department of PsychiatryThe Chinese University of Hong KongChina
| | - Gregory T. Thielman
- Department of Physical Therapy and NeuroscienceUniversity of the SciencesPhiladelphiaPA
| | - Daniela Vecchio
- Laboratory of NeuropsychiatryIRCCS Santa Lucia FoundationRomeItaly
| | - Nick S. Ward
- University College London Queen Square Institute of NeurologyLondonUnited Kingdom
| | - Lars T. Westlye
- Department of PsychologyUniversity of OsloNorway
- Department of Mental Health and AddictionOslo University HospitalOsloNorway
| | - Emilio Werden
- The Florey Institute of Neuroscience and Mental HealthHeidelbergVictoriaAustralia
- Melbourne Dementia Research CenterUniversity of MelbourneVictoriaAustralia
| | - Carolee Winstein
- Biokinesiology and Physical TherapyUniversity of Southern CaliforniaLos AngelesCA
| | - George F. Wittenberg
- Department of NeurologyUniversity of PittsburghPA
- Department of Veterans AffairsGeriatrics Research Educational & Clinical CenterVeterans Affairs Pittsburgh Healthcare System (VAPHS)PittsburghPA
| | - Steven L. Wolf
- Division of Physical TherapyDepartment of Rehabilitation MedicineEmory University School of MedicineAtlantaGA
- Department of MedicineEmory University School of MedicineAtlantaGA
| | - Kristin A. Wong
- Department of Physical Medicine & RehabilitationDell Medical SchoolUniversity of Texas at AustinTX
| | - Chunshui Yu
- Department of RadiologyTianjin Medical University General HospitalTianjinChina
| | - Amy Brodtmann
- The Florey Institute of Neuroscience and Mental HealthHeidelbergVictoriaAustralia
| | - Steven C. Cramer
- Department of NeurologyUniversity of California Los AngelesDavid Geffen School of MedicineLos AngelesCA
- California Rehabilitation HospitalLos AngelesCA
| | - Paul M. Thompson
- Mark and Mary Stevens Neuroimaging and Informatics InstituteKeck School of Medicine, University of Southern CaliforniaLos AngelesCA
| | - Sook‐Lei Liew
- Mark and Mary Stevens Neuroimaging and Informatics InstituteKeck School of Medicine, University of Southern CaliforniaLos AngelesCA
- Chan Division of Occupational Science and Occupational TherapyUniversity of Southern CaliforniaLos AngelesCA
- Biokinesiology and Physical TherapyUniversity of Southern CaliforniaLos AngelesCA
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18
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Burns SP, Fleming TK, Webb SS, Kam ASH, Fielder JDP, Kim GJ, Hu X, Hill MT, Kringle EA. Stroke Recovery During the COVID-19 Pandemic: A Position Paper on Recommendations for Rehabilitation. Arch Phys Med Rehabil 2022; 103:1874-1882. [PMID: 35533736 PMCID: PMC9072806 DOI: 10.1016/j.apmr.2022.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 12/02/2022]
Abstract
Health care delivery shifted and adapted with the COVID-19 pandemic caused by the novel severe acute respiratory syndrome coronavirus 2. Stroke care was negatively affected across the care continuum and may lead to poor community living outcomes in those who survived a stroke during the ongoing pandemic. For instance, delays in seeking care, changes in length of stays, and shifts in discharge patterns were observed during the pandemic. Those seeking care were younger and had more severe neurologic effects from stroke. Increased strain was placed on caregivers and public health efforts, and community-wide lockdowns, albeit necessary to reduce the spread of COVID-19, had detrimental effects on treatment and recommendations to support community living outcomes. The American Congress of Rehabilitation Medicine Stroke Interdisciplinary Special Interest Group Health and Wellness Task Force convened to (1) discuss international experiences in stroke care and rehabilitation and (2) review recently published literature on stroke care and outcomes during the pandemic. Based on the findings in the literature, the task force proposes recommendations and interdisciplinary approaches at the (1) institutional and societal level; (2) health care delivery level; and (3) individual and interpersonal level spanning across the care continuum and into the community.
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Affiliation(s)
- Suzanne Perea Burns
- Division of Occupational Therapy, University of New Mexico School of Medicine, Albuquerque, New Mexico.
| | - Talya K Fleming
- JFK Johnson Rehabilitation Institute at Hackensack Meridian Health, Edison, New Jersey
| | - Sam S Webb
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Alice Sau Han Kam
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada; Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Canada
| | | | - Grace J Kim
- Department of Occupational Therapy, New York University, New York City, New York; Department of Rehabilitation Medicine, NYU Langone Health, New York City, New York
| | - Xiaolei Hu
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Mary Thelander Hill
- Division of Occupational Therapy, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Emily A Kringle
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
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19
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Impact of Electronic Cigarette Vaping on Cerebral Ischemia: What We Know So Far. Transl Stroke Res 2022; 13:923-938. [DOI: 10.1007/s12975-022-01011-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/19/2022] [Accepted: 03/21/2022] [Indexed: 01/09/2023]
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20
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Dür M, Wenzel C, Simon P, Tucek G. Patients' and professionals' perspectives on the consideration of patients' convenient therapy periods as part of personalised rehabilitation: a focus group study with patients and therapists from inpatient neurological rehabilitation. BMC Health Serv Res 2022; 22:372. [PMID: 35313879 PMCID: PMC8939130 DOI: 10.1186/s12913-022-07755-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 03/07/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Research on the optimal period for administering health services, especially rehabilitation interventions, is scarce. The aims of this study were to explore the construct of patients' convenient therapy periods and to identify indicators based on the perspectives of patients and different health professionals from inpatient neurological rehabilitation clinics. METHODS This study was part of a larger project on patients' convenient therapy periods following a mixed methods approach. In the current study a grounded theory approach was employed based on the use of focus group interviews. Focus group interviews were conducted in three different inpatient neurological rehabilitation clinics. Patients and therapists from inpatient neurological rehabilitation clinics who were able to speak and to participate in conversations were included. RESULTS A total of 41 persons, including 23 patients and 18 therapists, such as music and occupational therapists, participated in a total of six focus group interviews. The analysis of the focus group interviews resulted in the identification of a total of 1261 codes, which could be summarised in fifteen categories. However, these categories could be divided into five indicators and ten impact factors of convenient therapy periods. Identified indicators were verbal and non-verbal communication, mental functions, physiological needs, recreational needs, and therapy initiation. CONCLUSIONS The results provide initial evidence that convenient therapy periods are clinically relevant for patients and therapists. Different states of patients' ability to effectively participate in a rehabilitation intervention exist. A systematic consideration of patients' convenient therapy periods could contribute to a personalised and more efficient delivery of intervention in neurological rehabilitation. To our knowledge, this study is one of the first attempts to research convenient therapy periods.
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Affiliation(s)
- Mona Dür
- Department of Health Sciences, IMC University of Applied Sciences, Applied Health Sciences Master Degree Programme, Piaristengasse 1, 3500, Krems, Austria. .,IMC University of Applied Sciences, Josef Ressel Centre for Horizons of personalised music therapy, University of Applied Sciences Krems, Piaristengasse 1, 3500, Krems, Austria. .,Duervation, Spitalgasse 6/1, 3500, Krems, Austria.
| | - Claudia Wenzel
- IMC University of Applied Sciences, Josef Ressel Centre for Horizons of personalised music therapy, University of Applied Sciences Krems, Piaristengasse 1, 3500, Krems, Austria.,Department of Health Sciences, IMC University of Applied Sciences, Music Therapy Bachelor and Master Degree Programme, Piaristengasse 1, 3500, Krems, Austria
| | - Patrick Simon
- IMC University of Applied Sciences, Josef Ressel Centre for Horizons of personalised music therapy, University of Applied Sciences Krems, Piaristengasse 1, 3500, Krems, Austria.,Department of Health Sciences, IMC University of Applied Sciences, Music Therapy Bachelor and Master Degree Programme, Piaristengasse 1, 3500, Krems, Austria
| | - Gerhard Tucek
- IMC University of Applied Sciences, Josef Ressel Centre for Horizons of personalised music therapy, University of Applied Sciences Krems, Piaristengasse 1, 3500, Krems, Austria.,Department of Health Sciences, IMC University of Applied Sciences, Music Therapy Bachelor and Master Degree Programme, Piaristengasse 1, 3500, Krems, Austria
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21
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Gangwani R, Cain A, Collins A, Cassidy JM. Leveraging Factors of Self-Efficacy and Motivation to Optimize Stroke Recovery. Front Neurol 2022; 13:823202. [PMID: 35280288 PMCID: PMC8907401 DOI: 10.3389/fneur.2022.823202] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 01/13/2022] [Indexed: 01/01/2023] Open
Abstract
The International Classification of Functioning, Disability and Health framework recognizes that an individual's functioning post-stroke reflects an interaction between their health condition and contextual factors encompassing personal and environmental factors. Personal factors significantly impact rehabilitation outcomes as they determine how an individual evaluates their situation and copes with their condition in daily life. A key personal factor is self-efficacy-an individual's belief in their capacity to achieve certain outcomes. Self-efficacy influences an individual's motivational state to execute behaviors necessary for achieving desired rehabilitation outcomes. Stroke rehabilitation practice and research now acknowledge self-efficacy and motivation as critical elements in post-stroke recovery, and increasing evidence highlights their contributions to motor (re)learning. Given the informative value of neuroimaging-based biomarkers in stroke, elucidating the neurological underpinnings of self-efficacy and motivation may optimize post-stroke recovery. In this review, we examine the role of self-efficacy and motivation in stroke rehabilitation and recovery, identify potential neural substrates underlying these factors from current neuroimaging literature, and discuss how leveraging these factors and their associated neural substrates has the potential to advance the field of stroke rehabilitation.
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Affiliation(s)
- Rachana Gangwani
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Human Movement Sciences Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Amelia Cain
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Amy Collins
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jessica M. Cassidy
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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22
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Kim H, Fraser S. Neural correlates of dual-task walking in people with central neurological disorders: a systematic review. J Neurol 2022; 269:2378-2402. [PMID: 34989867 DOI: 10.1007/s00415-021-10944-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND People with central neurological disorders experience difficulties with dual-task walking due to disease-related impairments. The objective of this review was to provide a comprehensive examination of the neural correlates (structural/functional brain changes) of dual-task walking in people with Parkinson's disease (PD), multiple sclerosis (MS), stroke, and Alzheimer's disease (AD). METHODS A systematic review of the literature was conducted, following PRISMA guidelines, on Medline, Embase, and Scopus. Included studies examined the relationship between structural and functional brain imaging and dual-task walking performance in people with PD, MS, stroke, and AD. Articles that met the inclusion criteria had baseline characteristics, study design, and behavioral and brain outcomes extracted. Twenty-three studies were included in this review. RESULTS Most structural imaging studies (75%) found an association between decreased brain integrity and poor dual-task performance. Specific brain regions that showed this association include the striatum regions and hippocampus in PD and supplementary motor area in MS. Functional imaging studies reported an association between increased prefrontal activity and maintained (compensatory recruitment) or decreased dual-task walking performance in PD and stroke. A subset (n = 2) of the stroke papers found no significant correlations. Increased supplementary motor area activity was associated with decreased performance in MS and stroke. No studies on AD were identified. CONCLUSION In people with PD, MS, and stroke, several neural correlates of dual-task walking have been identified, however, the direction of the association between neural and performance outcomes varied across the studies. The type of cognitive task used and presentation modality (e.g., visual) may have contributed to these mixed findings.
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Affiliation(s)
- Hyejun Kim
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125 University Private, Ottawa, ON, K1N 6N5, Canada
| | - Sarah Fraser
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 25 University Private, Ottawa, ON, K1N 7K4, Canada.
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23
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Vuong V, Patterson KK, Cole LP, Henechowicz TL, Sheridan C, Green REA, Thaut MH. Relationship Between Cognition and Gait at 2- and 12-Months Post-Traumatic Brain Injury. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:726452. [PMID: 36188837 PMCID: PMC9397897 DOI: 10.3389/fresc.2021.726452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 11/04/2021] [Indexed: 11/13/2022]
Abstract
Background: A common and debilitating challenge experienced by people with TBI is gait-associated mobility impairment and persisting cognitive impairments. Cognitive and physical impairments are often addressed independently during rehabilitation, however, increasing evidence links cognitive and motor processes more closely.Objectives: (1) To determine if correlations exist between measures of cognitive and gait recovery, post-TBI. (2) To investigate the predictive power of cognition at 2-months on gait outcomes at 12-months post-TBI.Methods: In this secondary, longitudinal study of cognitive and neural recovery, data from 93 participants admitted to an inpatient neurorehabilitation program were analyzed. Spatiotemporal gait variables [velocity, step time variability (STV), step length variability (SLV)] were collected along with cognitive variables [Trail Making Test-B (TMT-B), Digit Span-Forward (DS-F)]. Spearman's correlation coefficients were calculated between gait and cognitive variables. Multilinear and step wise regression analyses were calculated to determine predictive value of cognitive variables at 2-months on gait performance at 12-months-post TBI.Results: At 2-months post-injury, TMT-B was significantly correlated with gait velocity and STV; and DS-F was significantly correlated with velocity. At 12-months post-injury, TMT-B and DS-F was still significant correlated with velocity. TMT-B at 2-months was correlated with SLV and STV at 12-months; and DS-F correlated significantly with velocity. Regression models showed TMT-B at 2-months predicting STV, SLV, and velocity at 12-months.Conclusions: Significant associations and predictions between physical and cognitive recovery post-TBI were observed in this study. Future directions may consider a “neural internetwork” model as a salient rehabilitation approach in TBI that integrates physical and cognitive functions.
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Affiliation(s)
- Veronica Vuong
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
- *Correspondence: Veronica Vuong
| | - Kara K. Patterson
- Knowledge, Innovation, Talent, Everywhere (KITE) Research Institute, University Health Network, Toronto, ON, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lauren Patricia Cole
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Tara Lynn Henechowicz
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Conor Sheridan
- Knowledge, Innovation, Talent, Everywhere (KITE) Research Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Robin E. A. Green
- Knowledge, Innovation, Talent, Everywhere (KITE) Research Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Michael H. Thaut
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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24
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Lingo VanGilder J, Lopez-Lennon C, Paul SS, Dibble LE, Duff K, Schaefer SY. Relating Global Cognition With Upper-Extremity Motor Skill Retention in Individuals With Mild-to-Moderate Parkinson's Disease. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:754118. [PMID: 36188810 PMCID: PMC9397847 DOI: 10.3389/fresc.2021.754118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/27/2021] [Indexed: 11/18/2022]
Abstract
Background and Purpose: Cognition has been linked to rehabilitation outcomes in stroke populations, but this remains unexplored in individuals with Parkinson's disease (PD). The purpose of this secondary data analysis from a recent clinical trial (NCT02600858) was to determine if global cognition was related to skill performance after motor training in individuals with PD. Methods: Twenty-three participants with idiopathic PD completed 3 days of training on an upper-extremity task. For the purposes of the original clinical trial, participants trained either "on" or "off" their dopamine replacement medication. Baseline, training, and 48-h retention data have been previously published. Global cognition was evaluated using the Montreal Cognitive Assessment (MoCA). Linear regression examined whether MoCA score predicted longer-term retention at nine-day follow-up; baseline motor task performance, age, PD severity, depressive symptoms, and group (medication "on"/"off") were included as covariates. Baseline and follow-up motor task performance were assessed for all participants while "on" their medication. Results: MoCA score was positively related to follow-up motor task performance, such that individuals with better cognition were faster than those with poorer cognition. Baseline task performance, age, PD severity, depressive symptoms, and medication status were unrelated to follow-up performance. Discussion and Conclusions: Results of this secondary analysis align with previous work that suggest cognitive impairment may interfere with motor learning in PD and support the premise that cognitive training prior to or concurrent with motor training may enhance rehabilitative outcomes for individuals with PD. Findings also suggest that assessing cognition in individuals with PD could provide prognostic information about their responsiveness to motor rehabilitation.
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Affiliation(s)
- Jennapher Lingo VanGilder
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States
| | - Cielita Lopez-Lennon
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
| | - Serene S. Paul
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Leland E. Dibble
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
| | - Kevin Duff
- Center for Alzheimer's Care, Imaging and Research, University of Utah Health Sciences Center, Salt Lake City, UT, United States
- Department of Neurology, University of Utah Hospital, Salt Lake City, UT, United States
| | - Sydney Y. Schaefer
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
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25
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Lingo VanGilder J, Hooyman A, Bosch PR, Schaefer SY. Generalizing the predictive relationship between 1-month motor skill retention and Rey-Osterrieth Delayed Recall scores from nondemented older adults to individuals with chronic stroke: a short report. J Neuroeng Rehabil 2021; 18:94. [PMID: 34082761 PMCID: PMC8173502 DOI: 10.1186/s12984-021-00886-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/25/2021] [Indexed: 11/24/2022] Open
Abstract
Motor learning is fundamental to motor rehabilitation outcomes. There is growing evidence from non-neurological populations supporting the role of visuospatial memory function in motor learning, but current predictive models of motor recovery of individuals with stroke generally exclude cognitive measures, thereby overlooking the potential link between motor learning and visuospatial memory. Recent work has demonstrated that a clinical test of visuospatial memory (Rey-Osterrieth Complex Figure Delayed Recall) may predict 1-month skill learning in older adults; however, whether this relationship persists in individuals with chronic stroke remains unknown. The purpose of this short report was to validate previous findings using Rey-Osterrieth Complex Figure Delayed Recall test scores to predict motor learning and determine if this relationship generalized to a set of individuals post-stroke. Two regression models (one including Delayed Recall scores and one without) were trained using data from non-stroke older adults. To determine the extent to which Delayed Recall test scores impacted prediction accuracy of 1-month skill learning in older adults, we used leave-one-out cross-validation to evaluate the prediction error between models. To test if this predictive relationship generalized to individuals with chronic ischemic stroke, we then tested each trained model on an independent stroke dataset. Results indicated that in both stroke and older adult datasets, inclusion of Delayed Recall scores explained significantly more variance of 1-month skill performance than models that included age, education, and baseline motor performance alone. This proof-of-concept suggests that the relationship between delayed visuospatial memory and 1-month motor skill performance generalizes to individuals with chronic stroke, and supports the idea that visuospatial testing may provide prognostic insight into clinical motor rehabilitation outcomes.
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Affiliation(s)
| | - Andrew Hooyman
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, USA
| | - Pamela R Bosch
- Department of Physical Therapy, Northern Arizona University, Phoenix Campus, Phoenix, USA
| | - Sydney Y Schaefer
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, USA.
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, USA.
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26
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Einstad MS, Saltvedt I, Lydersen S, Ursin MH, Munthe-Kaas R, Ihle-Hansen H, Knapskog AB, Askim T, Beyer MK, Næss H, Seljeseth YM, Ellekjær H, Thingstad P. Associations between post-stroke motor and cognitive function: a cross-sectional study. BMC Geriatr 2021; 21:103. [PMID: 33546620 PMCID: PMC7863272 DOI: 10.1186/s12877-021-02055-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Motor and cognitive impairments are frequently observed following stroke, but are often managed as distinct entities, and there is little evidence regarding how they are related. The aim of this study was to describe the prevalence of concurrent motor and cognitive impairments 3 months after stroke and to examine how motor performance was associated with memory, executive function and global cognition. METHODS The Norwegian Cognitive Impairment After Stroke (Nor-COAST) study is a prospective multicentre cohort study including patients hospitalized with acute stroke between May 2015 and March 2017. The National Institutes of Health Stroke Scale (NIHSS) was used to measure stroke severity at admission. Level of disability was assessed by the Modified Rankin Scale (mRS). Motor and cognitive functions were assessed 3 months post-stroke using the Montreal Cognitive Assessment (MoCA), Trail Making Test Part B (TMT-B), 10-Word List Recall (10WLR), Short Physical Performance Battery (SPPB), dual-task cost (DTC) and grip strength (Jamar®). Cut-offs were set according to current recommendations. Associations were examined using linear regression with cognitive tests as dependent variables and motor domains as covariates, adjusted for age, sex, education and stroke severity. RESULTS Of 567 participants included, 242 (43%) were women, mean (SD) age was 72.2 (11.7) years, 416 (75%) had an NIHSS score ≤ 4 and 475 (84%) had an mRS score of ≤2. Prevalence of concurrent motor and cognitive impairment ranged from 9.5% for DTC and 10WLR to 22.9% for grip strength and TMT-B. SPPB was associated with MoCA (regression coefficient B = 0.465, 95%CI [0.352, 0.578]), TMT-B (B = -9.494, 95%CI [- 11.726, - 7.925]) and 10WLR (B = 0.132, 95%CI [0.054, 0.211]). Grip strength was associated with MoCA (B = 0.075, 95%CI [0.039, 0.112]), TMT-B (B = -1.972, 95%CI [- 2.672, - 1.272]) and 10WLR (B = 0.041, 95%CI [0.016, 0.066]). Higher DTC was associated with more time needed to complete TMT-B (B = 0.475, 95%CI [0.075, 0.875]) but not with MoCA or 10WLR. CONCLUSION Three months after suffering mainly minor strokes, 30-40% of participants had motor or cognitive impairments, while 20% had concurrent impairments. Motor performance was associated with memory, executive function and global cognition. The identification of concurrent impairments could be relevant for preventing functional decline. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02650531 .
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Affiliation(s)
- Marte Stine Einstad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.
| | - Ingvild Saltvedt
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- Department of Geriatric Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Stian Lydersen
- Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Marie H Ursin
- Department of Medicine, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Ragnhild Munthe-Kaas
- Department of Medicine, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Hege Ihle-Hansen
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Torunn Askim
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Mona K Beyer
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Halvor Næss
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
- Institute of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Yngve M Seljeseth
- Medical Department, Ålesund Hospital, Møre and Romsdal Health Trust, Ålesund, Norway
| | - Hanne Ellekjær
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
- Stroke Unit, Department of Internal Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Pernille Thingstad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Trondheim, Norway
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