Assessment of the Impact of the Tipstim® Device Application and the Study Position on Motor Coordination and Grip Strength of the Affected Upper Limb Post-Ischemic Stroke—A Randomized Parallel Crossover Trial (original) (raw)
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Brain Sciences
Stroke is one of the leading causes of human disability globally. Motor function deficits resulting from a stroke affect the entire body, but relatively often it is the upper limbs that remain ineffective, which is very limiting in everyday life activities. The finding in neurorehabilitation that trunk control contributes to upper limb function is relatively common but has not been confirmed in clinical trials. This observational prospective study aims to analyze the effect of the position of the trunk and the affected upper limb on the coordination and grip strength of the affected dominant and non-dominant hand and wrist in people after ischemic stroke. The research was carried out at the Department of Neurological Rehabilitation, on a group of 60 patients with acute ischemic stroke. A Hand Tutor device and a hand dynamometer were used for the main measurements of the motor coordination parameters (maximum range of motion, frequency of movement) and the grip strength of the domina...
HandTutorTM enhanced hand rehabilitation after stroke - a pilot study
Physiotherapy Research International, 2011
Background and Purpose. This study assessed the potential therapeutic benefi t of using HandTutor TM in combination with traditional rehabilitation in a post-stroke sub-acute population. The study compares an experimental group receiving traditional therapy combined with HandTutor TM treatment, against a control group receiving only traditional therapy. Method. An assessor-blinded, randomized controlled pilot trial, was conducted in the Reuth rehabilitation unit in Israel. Thirty-one stroke patients in the sub-acute phase, were randomly assigned to one of the two groups (experimental or control) in sets of three. The experimental group (n = 16) underwent a hand rehabilitation programme using the HandTutor TM combined with traditional therapy. The control group (n = 15) received only traditional therapy. The treatment schedules for both groups were of similar duration and frequency. Improvements were evaluated using three indicators: 1) The Brunnström-Fugl-Meyer (FM) test, 2) the Box and Blocks (B&B) test and 3) improvement parameters as determined by the HandTutor TM software. Results. Following 15 consecutive treatment sessions, a signifi cant improvement was observed within the experimental group (95% confi dence intervals) compared with the control group: B&B p = 0.015; FM p = 0.041, HandTutor TM performance accuracy on x axis and performance accuracy on y axis p < 0.0003. Conclusion. The results from this pilot study support further investigation of the use of the HandTutor TM in combination with traditional occupational therapy and physiotherapy during post stroke hand function rehabilitation.
A new hand assessment instrument for severely affected stroke patients
NeuroRehabilitation, 2014
Standard assessment instruments cannot differentiate patients with minimal residual hand function after stroke. As a result, changes in motor recovery are difficult to document using currently-available tests. In a controlled study with chronic stroke patients without residual finger extension, a new hand function test has been developed. This instrument, called Broetz Hand Test (BzH), allows to assess small variations in hand function in severely paralyzed stoke patients. The instrument is easy to use, and was developed using principles of motor learning and behavioral assessment. The instrument consists of seven daily life-oriented tasks, each of which asks for movement of the paralyzed hand. BzH of 20 patients after stroke was evaluated before and after a behavioral physiotherapy treatment. Sensitivity, inter-observer reliability, test-retest reliability and construct validity was calculated. Two-tailed paired-samples t-test before and after treatment demonstrated sufficient sens...
Measurement properties of the lower extremity motor coordination test in individuals with stroke
Journal of rehabilitation medicine, 2015
To evaluate the construct validity, inter- and intra-rater reliabilities, best scoring method and testing methods (direct vs video observations), and to determine the smallest real difference (SRD) and standard error of the measurement (SEM) of the lower Extremity Motor Coordination Test (LEMOCOT). Methodological study. Thirty-six stroke subjects. Outcomes include measures of motor recovery, muscular tone, strength, motor coordination, foot tactile sensation, and gait speed. The LEMOCOT scores were able to discriminate between stroke individuals from those predicted for healthy subjects, between the paretic and non-paretic limbs for both the sub-acute and chronic groups and differentiated between individuals with different functional levels and degrees of motor recovery. For the intra- and inter-rater reliabilities, very high and significant coefficients were found for both the paretic and non-paretic lower limbs for both groups (intra-class correlation coefficients (ICC) > 0.97,...
Introductory Analysis of Human Upper Extremity After Stroke
International Journal of Privacy and Health Information Management
The most reliable prognostic factors associated with upper extremity (UE) recovery are localized motor impairments, especially in the musculature of the hand and abduction of the shoulder in the first days after a stroke. An evaluation of the biomechanics of the hand allows an accurate identification of the motion arcs of the digital joints. This article includes an assess the prognostic value of the range of motion of the finger joints using an instrumental glove (CyberGlove II®) for the time one week after stroke for UE functional recovery. A prospective, longitudinal, observational study is made with follow-ups at 3-4 days, 1 week, 3 and 6 months of the patients with UE motor impairment. Variables collected included: demographic data, level of stroke severity (NIHSS), deep sensitivity, sphincter incontinence, Fugl Meyer assessment of UE (FM-UE), muscle balance with the Medical Research Council (MRC), muscle tone (Modified Ashworth Scale) and pre- and post-stroke functional abilit...
Effect of Physiotherapy on Hand Rehabilitation in Acute Ischemic Stroke Survivor: A Case Report
Journal of Pharmaceutical Research International, 2022
Background: Ischemic injury to the brain caused by a sudden drop in blood supply causes over 80% of strokes. Large artery blockage occurs in about 25-35 percent of strokes, and patients in this category often have severe neurological impairments. The prognosis is bleak if treatment is not started right away. Imaging of the brain after a stroke is crucial for determining the extent of tissue damage and guiding treatment. Aim: To determine the effect of early hand rehabilitation post ischemic stroke. Presentation of Case: A 35-year-old woman with a history of hypertension acquired aphasia, left hemiplegia, and hemisensory loss all at the same time. She was sent to the hospital's emergency room. On CT the blockage of the right middle cerebral artery revealed an acute ischemic stroke. The Motor Assessment Scale is taken in which there is a hand function domain also to assess it. Discussion: There are many studies on hand rehabilitation, but usually we stated hand rehabilitation late...
International Journal of Environmental Research and Public Health
Objective: The stroke is considered a common disease of the elderly. Young people also get sick, but the risk of stroke increases with the age of 60. Stroke, regardless of the age of the patients, causes functional deficits; therefore, the aim of the study was to analyze the significance of the body position and examined upper limb on the parameters of motor coordination and handgrip strength in various age groups of people after stroke and healthy people. Material and method: This is an observational study. A total of 117 people participated in the study (60 stroke patients and 57 healthy people without neurological disorders). Both patients and healthy volunteers were prospectively divided into three age groups: 18–45, 46–60, and 61+. The tests were carried out in two starting positions: sitting without back support and lying on the back with the upper limb stabilized against the body. HandTutorTM and a hand dynamometer were used to assess the motor coordination, including the max...
Introduction: Previous research has reported impaired hand function on the “unaffected” ipsilateral side after stroke, but its incidence, origins, and impact on rehabilitation remain unclear. Ipsilateral side deficits are usually not given much importance in stroke rehabilitation. The objective of this study is to evaluate the ipsilateral upper extremity muscle strength and grip strength and compare it with normal individuals. Materials and Methods: A comparative study was done by convenient sampling of 50 subjects of ischemic stroke of 1 month duration and 60 normal subjects matched with age, sex and hand dominance with the stroke subjects were taken for the study. Ipsilateral upper extremity muscle strength and grip strength of stroke subjects and corresponding normal were assessed using Hand Dynamometer and Manual Muscle Testing. Results: There was significant difference between the ipsilateral upper extremity muscle strength and grip strength of stroke subjects and that of normal (p< 0.05) independent of the side of lesion. Conclusion: The ipsilateral upper limb which is considered normal is also affected after stroke not only in dexterity of hand as stated earlier by other researchers but also in the muscle strength as well as in the grip strength regardless of the side of involvement.