Abstract:
:There is no "magic bullet" in rehabilitation. In the absence of direct neural transplants, neurological rehabilitation is an arduous process. We have pioneered the clinical application of robotics in stroke rehabilitation and have shown evidence of the positive impact of targeted exercise on stroke recovery. In this article, we will review results obtained in the initial clinical trials with 96 stroke patients at the Burke Rehabilitation Hospital. We will provide evidence that robot-aided training enhances recovery, that this enhanced recovery is sustained in the long term, and that this recovery is not due to a general physiological improvement--in fact, it appears to be limb and muscle group specific. An evidence-based approach must now segue into a more scientific approach to stroke rehabilitation. Given the length of the required protocols and patients' variability and limited census, the practical limitations of the evidence-based approach are self-evident and extend trials for years. Each patient and lesion is unique in stroke rehabilitation, so there is no reason to believe that a "one-size-fits-all" optimal treatment exists. To optimize therapy for individual patients, we need science-based models. In this article, we will summarize the scientific tools and models that we are investigating and present some of the results to date.
journal_name
Top Stroke Rehabiljournal_title
Topics in stroke rehabilitationauthors
Krebs HI,Volpe BT,Ferraro M,Fasoli S,Palazzolo J,Rohrer B,Edelstein L,Hogan Ndoi
10.1310/6177-QDJJ-56DU-0NW0keywords:
subject
Has Abstractpub_date
2002-01-01 00:00:00pages
54-70issue
4eissn
1074-9357issn
1945-5119journal_volume
8pub_type
杂志文章abstract:BACKGROUND:Demonstrating the treatment fidelity of an intervention is a key methodological requirement of any trial testing the impact of the intervention. PURPOSE:The purpose of this report was to serve as a model for evaluating treatment fidelity in stroke exercise intervention studies and to provide evidence for tr...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/tsr18s01-611
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Complex regional pain syndrome type I (CPRS I), is a complex of symptoms characterized by diffuse pain usually with associated swelling, vasomotor instability, and severe functional impairment of the affected extremity in stroke patients. Pain is a prominent feature and is often refractory to var...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,随机对照试验
doi:10.1179/1074935714Z.0000000025
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Virtual reality (VR) is becoming a popular alternative to traditional upper and lower limb rehabilitation following a stroke. OBJECTIVE:To conduct a systematic review and meta-analysis on the effectiveness of VR interventions for improving balance in a chronic stroke (≥6 months) population. DATA SOURCES:A ...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,meta分析,评审
doi:10.1080/10749357.2016.1192361
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:The brain mechanisms underlying successful recovery of hand fuenction after stroke are still not fully understood, although functional MRI (fMRI) studies underline the importance of neuronal plasticity. METHODS:We explored potential changes in brain activity in 7 patients with subacute to chronic stroke (69...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/tsr2004-308
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Against the background of linguistic and cultural differences, there is a need for translation and adaptation from the English version of the Fugl-Meyer Assessment (FMA) to Japanese. In addition, there is no study of inter-rater reliability of FMA all domains for affected upper extremities with appropriate s...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.2018.1484987
更新日期:2018-10-01 00:00:00
abstract::Intrathecal baclofen (ITB) therapy is a widely recognized management technique for severe, disabling spasticity in individuals with cerebral palsy and spinal and brain injuries. Its utility in the stroke population has only been recognized recently. Unlike the aforementioned patient populations, many stroke survivors ...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/14PN-TV5C-AYUB-NDP2
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:Balance is a common mobility limitation following stroke, but determination of the most effective balance-related plan of care can be difficult due to multiple balance impairments that vary between individuals. The Brief-BESTest is a validated outcome measure for balance based on six systems of postural cont...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.2018.1517493
更新日期:2019-01-01 00:00:00
abstract::Stroke is commonly thought of as a disease of the elderly, but it should be understood that stroke also occurs in young adults. Furthermore, it is important to appreciate the differences in epidemiology of these cohorts in order to effectively care for young adults with stroke. Diagnostic imaging has proven to be extr...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.1994.11754002
更新日期:1994-03-01 00:00:00
abstract::In terms of integration of the paretic upper extremity in activities of daily living (ADLs), outcome is poor after stroke. Furthermore, amount of real-world arm use appears only weakly correlated with laboratory motor function scales. Therefore, amount of arm use may depend critically on the location, extent, and type...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/tsr1604-237
更新日期:2009-07-01 00:00:00
abstract:UNLABELLED:As hypothermia by immersion can reduce the sensory nerve conduction velocity, this study hypothesized that the reduction of sensory input to the ipsilesional upper extremity (UE) using cryotherapy would reduce the inhibitory activity of the contralesional hemisphere in chronic stroke subjects. OBJECTIVE:In ...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1179/1074935714Z.0000000023
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVES:This study was carried out to quantify the degree of cognitive impairment and the extent of speech, language, and swallowing problems in a representative cohort of Swahili-speaking people with stroke in Tanzania. METHODS:A case-control design was used, comparing people with and without stroke on a screening...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,多中心研究
doi:10.1310/tsr2101-52
更新日期:2014-01-01 00:00:00
abstract:PURPOSE:Hope is said to be important in recovery from illness or injury, supporting adjustment, perseverance, and positive outcomes. There has been little exploration of hope in people after stroke. This is reflected in the literature, which lacks consistent definition and terminology. This purpose of this article is t...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,评审
doi:10.1310/tsr1805-490
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Impaired balance and weak muscle strength are common deficits associated with stroke. Limited research has examined the relationship between balance and strength in people post-stroke. OBJECTIVE:To investigate the association between balance and muscular strength in people post-stroke. METHODS:A total of 1...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.2019.1574417
更新日期:2019-04-01 00:00:00
abstract::The Medicare Modernization Act of 2003 (MMA'03) did more than introduce a prescription drug benefit for Medicare beneficiaries; it also laid the groundwork for several far-reaching changes in the Medicare program. These changes must be considered in the context of the "American devolution"--a much larger shift in Amer...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/R28D-5XJQ-B0TX-R4VM
更新日期:2005-04-01 00:00:00
abstract::The article will explore the use of the term medical necessity as it relates to wheeled mobility. Health insurance will cover a wheelchair if it is determined that it is medically necessary for a particular client. There are many different types of health insurance, and no universal definition of medical necessity. Th...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/564P-FWK1-Q96Y-5AXJ
更新日期:2005-07-01 00:00:00
abstract::The purpose of this article is to present the Kinesio taping method used to improve the upper extremity function in the adult with hemiplegia. The article discusses various therapeutic methods used in the treatment of stroke patients to achieve a functional upper extremity. The only taping technique for various upper ...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,评审
doi:10.1310/33KA-XYE3-QWJB-WGT6
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVE:Modifying assessments for people with aphasia has the potential to increase the validity of healthcare assessments across professional domains. This pilot study addressed the challenges of giving people with aphasia the power to fully participate in the assessment process. The study aimed to investigate the f...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1179/1074935714Z.0000000034
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Hemiparesis is a common disabling consequence of stroke that leads to abnormal gait patterns marked by asymmetries in step length, stance, and swing phases. Asymmetric gait patterns are correlated with decreased gait velocity and increased susceptibility to falls that can lead to serious injuries and hospita...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.2020.1834272
更新日期:2020-12-02 00:00:00
abstract::Background Stroke can compromise upper limb performance and influence the individual's participation in real life situations. Objective To investigate how components of body function and activity affect the individuals' self-perception of their participation after stroke. Methods In this observational study, the Inter...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.2017.1406177
更新日期:2018-04-01 00:00:00
abstract:PURPOSE:To evaluate the effects of a hand splint with reflex inhibitory characteristics on balance and functional ambulation activities by means of a randomly allocated controlled study. METHODS:Nineteen chronic stroke patients were randomly allocated to the control (n = 9) and study (n = 10) groups to compare the imm...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,随机对照试验
doi:10.1310/tsr1803-231
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Stroke is a chronic disease. Standardized assessment is essential in order to determine areas for treatment. Individuals with aphasia are often excluded from research, because it is believed that their language impairments may impact their ability to provide informed consent. Thus, right spatial neglect coul...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.2016.1196906
更新日期:2017-03-01 00:00:00
abstract::The privileging of the substituted judgment standard as the gold standard for surrogate decision making in law and bioethics has constrained the research agenda in end-of-life decision making. The empirical literature is inundated with a plethora of "Newlywed Game" designs, in which potential patients and potential su...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/tsr1404-80
更新日期:2007-07-01 00:00:00
abstract:PURPOSE:The rehabilitation of patients who are recovering from severe stroke is associated with a substantial use of resources but limited potential for functional improvement. As a result, these individuals are not perceived as being ideal candidates for inpatient stroke rehabilitation. The objective of this review wa...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,评审
doi:10.1310/tsr1902-122
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Fast treadmill walking combined with functional electrical stimulation to ankle muscles (FastFES) is a well-studied gait intervention that improves post-stroke walking function. Although individualized verbal feedback is commonly incorporated during clinical gait training, and a variable practice structure i...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.2020.1818480
更新日期:2020-09-18 00:00:00
abstract::This article uses the medium of clinicians' comments and stories to explore their perceptions of therapeutic relationships and how these relationships come to a close at discharge from aphasia therapy. These narratives are drawn from a qualitative, grounded theory study carried out in South Australia and Northern Terr...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/tsr1701-30
更新日期:2010-01-01 00:00:00
abstract:PURPOSE:This study investigated the physiological responses of stroke survivors to a 16-week program of moderate aerobic and anaerobic exercise. METHOD:Forty participants who were a minimum of 6 months post stroke underwent physiological testing over the course of 2 days that included a maximal VO(2) stress test, a Bi...
journal_title:Topics in stroke rehabilitation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1310/0J2K-MDNX-1Q0L-8LX6
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:To investigate whether bodyweight exercises can induce comparable levels of muscle activity as conventional machine exercises in chronic stroke patients. METHODS:Eighteen patients performed three repetitions of bilateral- and unilateral machine leg press and the bodyweight exercises chair rise and hip thrust...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.2016.1274466
更新日期:2017-05-01 00:00:00
abstract:PURPOSE:To identify the percentage of persons with stroke resuming therapy within 4 weeks of inpatient rehabilitation discharge, to compare the characteristics of those who did and did not resume therapy, and to determine the predictors of resuming physical (PT), occupational (OT), and speech (ST) therapy. METHOD:Soci...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/tsr1601-80
更新日期:2009-01-01 00:00:00
abstract::This article provides the rehabilitation team with some tips concerning how to maximize their chances for successful communication with individuals who have aphasia. These ideas can be applied across the range of settings in which health care is provided. The notions described here can increase the effectiveness of in...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.1996.11754090
更新日期:1996-01-01 00:00:00
abstract:PURPOSE:This study describes current stroke care within hospital acute care settings. METHOD:Twenty-two acute care hospital sites in Central South Ontario were mailed a survey exploring the prevalence of stroke admissions, use of protocols and policies, staff resources, stroke-specific training, and available equipmen...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/tsr1405-1
更新日期:2007-09-01 00:00:00