Assessment of Tissue Viability Following Amputation Surgery Using Near-Infrared Fluorescence Imaging With Indocyanine Green.

Background: Patients with chronic limb threatening ischemia have a risk of undergoing a major amputation within 1 year of nearly 30% with a substantial risk of re-amputation since wound healing is often impaired. Quantitative assessment of regional tissue viability following amputation surgery can identify patients at risk for impaired wound healing. In quantification of regional tissue perfusion, near-infrared (NIR) fluorescence imaging using Indocyanine Green (ICG) seems promising.

Early Shortening of Wrist Flexor Muscles Coincides With Poor Recovery After Stroke.

Background: The mechanism and time course of increased wrist joint stiffness poststroke and clinically observed wrist flexion deformity is still not well understood. The components contributing to increased joint stiffness are of neural reflexive and peripheral tissue origin and quantified by reflexive torque and muscle slack length and stiffness coefficient parameters.

Objective: To investigate the time course of the components contributing to wrist joint stiffness during the first 26 weeks poststroke in a group of patients, stratified by prognosis and functional recovery of the upper extremity.

Estimation of tissue stiffness, reflex activity, optimal muscle length and slack length in stroke patients using an electromyography driven antagonistic wrist model.

Background: About half of all chronic stroke patients experience loss of arm function coinciding with increased stiffness, reduced range of motion and a flexed wrist due to a change in neural and/or structural tissue properties. Quantitative assessment of these changes is of clinical importance, yet not trivial. The goal of this study was to quantify the neural and structural properties contributing to wrist joint stiffness and to compare these properties between healthy subjects and stroke patients.

Comprehensive neuromechanical assessment in stroke patients: reliability and responsiveness of a protocol to measure neural and non-neural wrist properties.

Background: Understanding movement disorder after stroke and providing targeted treatment for post stroke patients requires valid and reliable identification of biomechanical (passive) and neural (active and reflexive) contributors. Aim of this study was to assess test-retest reliability of passive, active and reflexive parameters and to determine clinical responsiveness in a cohort of stroke patients with upper extremity impairments and healthy volunteers.

Methods: Thirty-two community-residing chronic stroke patients with an impairment of an upper limb and fourteen healthy volunteers were assessed with a comprehensive neuromechanical assessment protocol consisting of active and passive tasks and different stretch reflex-eliciting measuring velocities, using a haptic manipulator and surface electromyography of wrist flexor and extensor muscles (Netherlands Trial Registry number NTR1424).

The gap between clinical gaze and systematic assessment of movement disorders after stroke.

Background: Movement disorders after stroke are still captured by clinical gaze and translated to ordinal scores of low resolution. There is a clear need for objective quantification, with outcome measures related to pathophysiological background. Neural and non-neural contributors to joint behavior should be separated using different measurement conditions (tasks) and standardized input signals (force, position and velocity).

Characterizing the protocol for early modified constraint-induced movement therapy in the EXPLICIT-stroke trial.

Constraint-induced movement therapy (CIMT) is a commonly used rehabilitation intervention to improve upper limb function after stroke. CIMT was originally developed for patients with a chronic upper limb paresis. Although there are indications that exercise interventions should start as early as possible after stroke, only a few randomized controlled trials have been published on either CIMT or modified forms of CIMT (mCIMT) during the acute phase after stroke.