The Influence of Age, Lesion Side and Location on Rehabilitation Outcome After Stroke

Measurement of sensory deficiency in fine touch after stroke during textile fabric stimulation by electroencephalography (EEG)

Objective

Sensory deficiency of fine touch limits the restoration of motor functions after stroke, and its evaluation was seldom investigated from a neurological perspective. In this study, we investigated the cortical response measured by electroencephalography (EEG) on the fine touch sensory impairment during textile fabric stimulation after stroke.

Approach

Both participants with chronic stroke (n = 12, stroke group) and those unimpaired (n = 15, control group) were recruited. To investigate fine touch during textile fabric stimulations, full brain EEG recordings (64-channel) were used, as well as the touch sensation questionnaires based on the American Association of Textile Chemists and Colorists (AATCC) Evaluation Procedure 5. During the EEG measurement, relative spectral power (RSP) and EEG topography were used to evaluate the neural responses toward the fabric stimuli. In the subjective questionnaire, the fine touch for fabric stimuli was rated and represented by 13 different sensation parameters. The correlation between the fine touch evaluated by the EEG and the questionnaire was also investigated.

Main results

The neural responses of individuals with fine touch impairments after stroke were characterized by a shifted power spectrum to a higher frequency band, enlarged sensory cortical areas and higher RSP intensity (P < 0.05). Asymmetric neural responses were obtained when stimulating different upper limbs for both unimpaired participants and stroke participants (P < 0.05). The fine touch sensation of the stroke participants was impaired even in the unaffected limb. However, as a result of different neural processes, the correlation between the EEG and the questionnaire was weak (r < 0.2).

Significance

EEG RSP was able to capture the varied cortical responses induced by textile fabric fine touch stimulations related to the fine touch sensory impairment after stroke.

The effects of Pilates exercise training on static and dynamic balance in chronic stroke patients: a randomized controlled trial

[Purpose] The purpose of this study was to analyze the effects of Pilates exercise on static and dynamic balance in chronic stroke patients. [Subjects and Methods] Nineteen individuals with unilateral chronic hemiparetic stroke (age, 64.7 ± 6.9 years; height, 161.7 ± 7.9 cm; weight, 67.0 ± 11.1 kg) were randomly allocated to either a Pilates exercise group (PG, n=10) or a control group (CG, n=9). The PG attended 24 exercise sessions conducted over an 8-week period (3 sessions/week). Center of pressure (COP) sway and COP velocity were measured one week before and after the exercise program and compared to assess training effects. [Results] Pilates exercise positively affected both static and dynamic balance in patients with chronic stroke. For static balance, COP sway and velocity in the medial-lateral (M-L) and anterior-posterior (A-P) directions were significantly decreased in the PG after training while no significant differences were found in the CG. For dynamic balance, measured during treadmill walking, the PG showed significantly reduced COP sway and velocity in the M-L and A-P directions for both the paretic and non-paretic leg. [Conclusions] The findings provide initial evidence that Pilates exercise can enhance static and dynamic balance in patients with chronic stroke.

Walking ability after stroke in patients from Argentina: predictive values of two tests in subjects with subacute hemiplegia

[Purpose] This study aimed to determine the predictive values of the trunk control test (TCT) and functional ambulation category (FAC) for independent walking up to 6 months post stroke. [Subjects] Twenty-seven subjects with hemiplegia secondary to a unilateral hemisphere stroke were included. [Methods] The protocol was started at 45 days post stroke, with the TCT and FAC as walking predictors. At 90, 120, and 180 days post stroke, the subjects’ independent walking ability was assessed by using the Wald test. [Results] The TCT was identified as an independent predictor of ambulation at 90, 120, and 180 days. Subjects who scored ≥ 49 in the initial test had 93.8% probability of achieving independent gait at 6 months. The FAC proved that 100% of the subjects who scored 2 at 45 days post stroke walked independently at 90 days, 100% of the subjects who scored 1 walked independently at 120 days, and only 33.3% of the subjects who scored 0 walked independently at 180 days. [Conclusion] The TCT and FAC can predict independent walking at 45 days post stroke. In subjects with FAC 0, the TCT should be used to predict patients who will be able to walk independently.