Effectiveness of Client-Centered "Tune-Ups" on Community Reintegration, Mobility, and Quality of Life After Stroke: A Randomized Controlled Trial.

Objective: To explore the effectiveness of a 2-week client-centered rehabilitation intervention (tune-up) delivered 6 months after inpatient discharge on community reintegration at 1 year in people with stroke.

Design: A multicenter randomized controlled trial with 2 groups: an intervention ("tune-up") group and a control group having the same exposure to assessment.

Setting: Three research laboratories.

Do Performance Measures of Strength, Balance, and Mobility Predict Quality of Life and Community Reintegration After Stroke?

Objective: To investigate the extent to which physical performance measures of strength, balance, and mobility taken at discharge from inpatient stroke rehabilitation can predict health-related quality of life (HRQoL) and community reintegration after 6 months.

Design: Longitudinal study.

Setting: University laboratory.

Effect of early supervised physiotherapy on recovery from acute ankle sprain: randomised controlled trial.

Objective:  To assess the efficacy of a programme of supervised physiotherapy on the recovery of simple grade 1 and 2 ankle sprains.

Design:  A randomised controlled trial of 503 participants followed for six months.

Setting:  Participants were recruited from two tertiary acute care settings in Kingston, ON, Canada.

Use of Rasch Analysis to Evaluate and Refine the Community Balance and Mobility Scale for Use in Ambulatory Community-Dwelling Adults Following Stroke.

Background: The Community Balance and Mobility Scale (CB&M) is increasingly used to evaluate walking balance following stroke.

Objective: This study applied Rasch analysis to evaluate and refine the CB&M for use in ambulatory community-dwelling adults following stroke.

Methods: The CB&M content was linked to task demands and motor skill classifications.

Noninvasive neurostimulation in chronic stroke: a double-blind randomized sham-controlled testing of clinical and corticomotor effects.

Background: Repetitive peripheral magnetic stimulation (RPMS) is a painless and noninvasive method to produce afferents via the depolarization of the peripheral nervous system. A few studies tested RPMS after-effects on cerebral plasticity and motor recovery in stroke individuals, but evidences remain limited.

Objectives: This study aimed to explore whether RPMS could mediate improvements in corticomotor and clinical outcomes associated with ankle impairments in chronic stroke.

Energy flow analysis of the lower extremity during gait in persons with chronic stroke.

Background: A decline in walking capacity and high energy cost can limit mobility following stroke. Mechanical energy exchange between lower limb and trunk segments can reflect gait inefficiencies, but reveals little about active energy flow between adjacent segments through muscle actions. This study evaluated mechanical energy expenditures (MEEs) during walking in stroke and healthy groups to understand movement control and explore the impact of walking speed on mechanical energy exchanges.

Activity classification in persons with stroke based on frequency features.

Recent advances in the use of inertial measurement units (IMUs) for motion analysis suggest the possibility of using this technology for the monitoring of daily activities of individuals during rehabilitation post-stroke. Previous studies have utilized features extracted from accelerometer and gyroscope signals to develop classification models capable of identifying activities performed within large datasets. In this study, nine k-nearest neighbor cross-validated classifiers were developed using frequency-features derived from shank-mounted IMUs on the less-affected and affected limbs of subjects with stroke.

Measurement of lower limb joint kinematics using inertial sensors during stair ascent and descent in healthy older adults and stroke survivors.

This study validated the feasibility of inertial sensors in estimating lower limb joint kinematics during stair ambulation in healthy older adults and stroke survivors. Three dimensional motion data were collected using an inertial sensor-based system from 9 persons with stroke and 9 healthy older adults as they ascended and descended a staircase at a self-selected pace. The measured joint angles were compared with a laboratory-based motion capture system by computing differences in range of motion (RoM), grand mean error, standard deviation, and coefficients of multiple correlations.

Concurrent validation of Xsens MVN measurement of lower limb joint angular kinematics.

This study aims to validate a commercially available inertial sensor based motion capture system, Xsens MVN BIOMECH using its native protocols, against a camera-based motion capture system for the measurement of joint angular kinematics. Performance was evaluated by comparing waveform similarity using range of motion, mean error and a new formulation of the coefficient of multiple correlation (CMC). Three dimensional joint angles of the lower limbs were determined for ten healthy subjects while they performed three daily activities: level walking, stair ascent, and stair descent.

Estimation of spatio-temporal parameters for post-stroke hemiparetic gait using inertial sensors.

This paper represents the first step in developing an inertial sensor system that is capable of assessing post-stroke gait in terms of walking speed and temporal gait symmetry. Two inertial sensors were attached at the midpoint of each shank to measure the accelerations and angular velocity during walking. Despite the abnormalities in hemiparetic gait, the angular velocity of most of the testing subjects (12 out of 13) exhibited similar characteristics as those from a healthy population, enabling walking speed estimation and gait event detection based on the pendulum walking model.

Kinematic and kinetic evaluation of the stance phase of stair ambulation in persons with stroke and healthy adults: a pilot study.

This study describes and contrasts the kinematics and kinetics of stair ambulation in people with chronic stroke and healthy control subjects. Three-dimensional motion data were collected from 10 persons with stroke (7 males) and 10 sex and age-matched older adults as they ascended and descended an instrumented staircase at self-selected speed with and without a handrail. Ankle, knee and hip joint angle and moment profiles were generated during stance and range of motion and peak moments were contrasted between groups, sides (stroke only) and condition.

Strength and aerobic requirements during stair ambulation in persons with chronic stroke and healthy adults.

Objective: To estimate the cost of stair ascent and descent in relation to a measured standard of strength and metabolic (aerobic) capacities in persons with chronic stroke compared with healthy adults.

Design: Descriptive cross-sectional study.

Setting: Motion analysis laboratory.

Performance on a manual tracking task differentiates individuals at risk of developing carpal tunnel syndrome from those not at risk.

Introduction: The purpose of this study was to determine whether sensorimotor abnormalities are detectable in asymptomatic individuals deemed at risk of developing carpal tunnel syndrome (CTS) METHODS: Seventeen individuals deemed at risk of developing CTS and 16 asymptomatic individuals deemed to be at minimal risk of developing CTS participated. Nerve conduction velocity, two-point discrimination ability, pressure acuity, Purdue Pegboard Test performance and tracking error and tracking variance on a manual tracking task performed at two different speeds were measured in all participants and compared between the groups.

Results: None of the measures of nerve conduction, sensory perception, or Purdue Pegboard task performance were different between the groups.

Primary motor cortex underlies multi-joint integration for fast feedback control.

A basic difficulty for the nervous system is integrating locally ambiguous sensory information to form accurate perceptions about the outside world. This local-to-global problem is also fundamental to motor control of the arm, because complex mechanical interactions between shoulder and elbow allow a particular amount of motion at one joint to arise from an infinite combination of shoulder and elbow torques. Here we show, in humans and rhesus monkeys, that a transcortical pathway through primary motor cortex (M1) resolves this ambiguity during fast feedback control.

Relationship between stair ambulation with and without a handrail and centre of pressure velocities during stair ascent and descent.

Introduction: Stair ambulation is one of the most challenging and hazardous types of locomotion for older adults and often requires the adoption of compensatory strategies such as increased handrail use to mitigate disability and increase stability. Centre of pressure velocity (VCOP) describes the neuromuscular response to shifts of the body's centre of mass and serves as an indicator of stability. Knowledge of VCOP may provide some understanding of strategies to improve measured and perceived stability during stair negotiation.

Mechanical energy transfers across lower limb segments during stair ascent and descent in young and healthy older adults.

Older adults present with altered movement patterns during stair negotiation although the extent to which modifications in pattern and speed influence mechanical efficiency is unknown. This study evaluated mechanical energy transfers attributed to active force production during stair negotiation in young and older adults to provide insight into age-related changes in mechanical efficiency. Secondary analysis on data obtained from 23 young (23.

Guided motor imagery in healthy adults and stroke: does strategy matter?

Background: Motor imagery (MI) enhances physical performance and skill acquisition in healthy and neurorehabilitation populations, yet little is known about the use of strategies to guide MI.

Objectives: To examine the relative effectiveness of visual, auditory, and combined (visual + auditory) cueing of an imagined finger abduction task on corticomotor excitability.

Methods: A total of 15 young (20-35 years) and 15 older people (over 55 years) and 10 people with chronic stroke, who could make voluntary movements of selected muscles, participated.

Validity of the Community Balance and Mobility Scale in community-dwelling persons after stroke.

Objectives: To examine the convergent validity, sensitivity to change, floor and ceiling effects of the Community Balance and Mobility Scale (CB&M) in community-dwelling stroke survivors. The secondary objective was to determine the correlations between the CB&M and lower-limb motor recovery and strength.

Design: Validity study.

Gait changes following botulinum toxin A treatment in stroke.

Purpose: To characterize the effects of botulinum toxin A treatment of spastic plantar flexors in stroke on joint mobility and gait kinematics and kinetics.

Method: Nine patients with hemiparetic stroke presenting with ankle hypertonicity participated in this exploratory open-label case series study. Comprehensive gait analysis provided bilateral kinematic and kinetic information for the ankle, knee, and hip joints throughout the stance phase.

A comparison of gait biomechanics and metabolic requirements of overground and treadmill walking in people with stroke.

Background: Comparisons of treadmill and overground walking following stroke indicate that symmetry in temporal-distance measures is better on the treadmill suggestive of better gait economy. We examined this issue by examining the kinematic, kinetic and metabolic demands associated with overground and treadmill walking at matched speeds and also explored the effect of increasing treadmill speed.

Methods: Ten people with hemiparesis walked overground at their preferred speed which was matched on the treadmill.

Kinematic, kinetic and metabolic parameters of treadmill versus overground walking in healthy older adults.

Background: Although treadmill and overground walking appear to be biomechanically similar in healthy, young adults it is not known whether this can be generalized to older subjects or if the metabolic demands are correspondingly comparable.

Methods: Ten healthy adults between 50 and 73 years of age walked at the same speed overground and on a treadmill. Temporal parameters, angular kinematics and vertical ground reaction forces were recorded during walking once subjects were in steady state as determined from their heart rate and oxygen uptake.

Short-term natural recovery of ankle sprains following discharge from emergency departments.

Study Design: Prospective cohort study.

Objectives: To examine the natural recovery from grade I and II ankle injuries over a 1-month period.

Background: There is a high rate of injury recurrence and persistence of symptoms following ankle sprains, suggesting that these injuries may not be adequately managed.

Test position and hip strength in healthy adults and people with chronic stroke.

Objective: To determine if peak torques generated by the hip flexors and extensors are dependent on test position in healthy adults and in people with chronic stroke.

Design: Cross-sectional study.

Setting: Motor performance laboratory.

Changes in muscle group work associated with changes in gait speed of persons with stroke.

Background: Knowledge of associations between changes in muscle work with changes in gait speed could assist gait training in persons with stroke. The purpose of the study was to determine changes in the work of major muscle groups during gait that were associated with increases in walking speed of persons with stroke following training.

Methods: The gait of 28 subjects (14 males, 14 females) with mean age of 64.

Are deficiencies in manual tracking associated with upper extremity cumulative trauma disorders?

Objectives: To examine the reliability of manual tracking performance and its association with impairment and disability in individuals symptomatic of an upper extremity cumulative trauma disorder (CTD).

Methods: Volunteer and physician referred subjects (100 control, 140 CTD) tracked a target cursor moving quasi-randomly using a hand-held stylus interfaced with a digitizing tablet. Impairment was physician-rated and the Disability of the Arm, Shoulder and Hand questionnaire measured disability.