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 ± 8 years) with moderate- to high-grade distal paresis of the upper limb (Motricity Index: 59.4) after standardized robotic finger-hand rehabilitation training, in addition to conventional rehabilitation therapy for 3 weeks. Behavioral and fMRI assessments were carried out before and after training to characterize changes in brain activity and behavior. RESULTS:The Motricity Index (pre: 59.4, post: 67.2, P < .05) and grip force (pre: 7.26, post: 11.87, P < .05) of the paretic hand increased significantly after rehabilitation. On fMRI, active movement of the affected (left) hand resulted in contralesional (ie, ipsilateral) activation of the primary sensorimotor cortex prior to rehabilitation. After rehabilitation, activation appeared "normalized," including the ipsilesional primary sensorimotor cortex and supplementary motor area (SMA). No changes and no abnormalities of activation maps were seen during movement of the unaffected hand. Subsequent region-of-interest analyses showed no significant ipsilesional activation increases after rehabilitation. CONCLUSION:Despite behavioral improvements, we failed to identify consistent patterns of functional reorganization in our sample. This warrants caution in the use of fMRI as a tool to explore neural plasticity in heterogeneous samples lacking sufficient statistical power.
journal_name
Top Stroke Rehabiljournal_title
Topics in stroke rehabilitationauthors
Pinter D,Pegritz S,Pargfrieder C,Reiter G,Wurm W,Gattringer T,Linderl-Madrutter R,Neuper C,Fazekas F,Grieshofer P,Enzinger Cdoi
10.1310/tsr2004-308subject
Has Abstractpub_date
2013-07-01 00:00:00pages
308-16issue
4eissn
1074-9357issn
1945-5119pii
N4V74401813511K7journal_volume
20pub_type
杂志文章abstract::Stroke remains a leading cause of disability for older adults. While is it well established in the literature that exercise programs can have significant benefit, many stroke survivors do not receive specific recommendations for exercise or lack the motivation to continue exercising following discharge from rehabilita...
journal_title:Topics in stroke rehabilitation
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pub_type: 杂志文章
doi:10.1179/1074935714Z.0000000042
更新日期:2015-10-01 00:00:00
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journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.2020.1812938
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journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,评审
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journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,评审
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journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,评审
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journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
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journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,meta分析,评审
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更新日期:2017-01-01 00:00:00
abstract::Purpose To use a mixed method design to evaluate how clinicians judge falls in stroke patients as a beneficial event, and to identify patient-specific characteristics associated with beneficial falls. Methods The definition of beneficial falls was based on interviews with six experienced clinicians in stroke rehabilit...
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journal_title:Topics in stroke rehabilitation
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journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1310/MHRL-NWL5-9XCG-JEMC
更新日期:2004-04-01 00:00:00
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journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,多中心研究
doi:10.1310/tsr1901-63
更新日期:2012-01-01 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
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journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.1994.11754002
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doi:10.1080/10749357.2020.1790731
更新日期:2021-03-01 00:00:00
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journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
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更新日期:1997-04-01 00:00:00
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journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.2016.1210873
更新日期:2017-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1310/K8W2-TR3D-8JQ0-DWYD
更新日期:2002-10-01 00:00:00
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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:OBJECTIVES:In India, post-stroke outcomes are determined using functional outcome measures (FOMs), the contents of which have not been validated for their relevance to the Indian population. In this study, we aimed to evaluate the cultural validity of five frequently used stroke-specific FOMs by comparing their content...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.2016.1234190
更新日期:2017-04-01 00:00:00
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journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章
doi:10.1080/10749357.2020.1834276
更新日期:2020-10-20 00:00:00
abstract::Background Somatosensory stimulation may have a positive impact on recovery of motor function by maintaining cortical representation of the hand and acting to prime the motor system for movement. Objective Determine the efficacy of somatosensory stimulation on upper limb motor function after stroke. Methods Five elect...
journal_title:Topics in stroke rehabilitation
pub_type: 杂志文章,meta分析,评审
doi:10.1080/10749357.2017.1389054
更新日期:2018-03-01 00:00:00