Bilateral Arm Training vs Unilateral Arm Training for Severely Affected Patients With Stroke: Exploratory Single-Blinded Randomized Controlled Trial.

Objective: To compare the effects of unilateral and bilateral arm training on arm impairment in severely affected patients with stroke.

Design: Single-blinded, randomized controlled trial.

Setting: Inpatient rehabilitation center.

Comparison of visual and auditory emotion recognition in patients with cerebellar and Parkinson´s disease.

Widespread cortical-subcortical networks are involved in the recognition and discrimination of emotional contents of facial and vocal expression, whereby the cerebellum and basal ganglia are two subcortical regions implicated in these networks with limited evidence to their specific contributions. To investigate this we compared patients with circumscribed cerebellar lesions and patients with Parkinson's disease (PD) on an approved test battery. We studied two groups with subcortical disease, focal cerebellar infarction (n = 22) and PD (n = 22), and a neurological control group with focal supratentorial ischemia (SI) (n = 16) were.

Exploratory Study of the Influence of Posture and Hand Task on Corticomotor Excitability of Upper Extremity Muscles After Stroke.

Objective: To explore the interaction between postural stability and hand task on the corticospinal excitability (CE) of upper extremity muscles and how it is affected by lesion location.

Design: Cross-sectional explorative survey.

Setting: Inpatient rehabilitation center.

Constraint-Induced Aphasia Therapy in the Acute Stage: What Is the Key Factor for Efficacy? A Randomized Controlled Study.

Background: Constraint-induced aphasia therapy (CIAT) has proven effective in patients with subacute and chronic forms of aphasia. It has remained unclear, however, whether intensity of therapy or constraint is the relevant factor. Data about intensive speech and language therapy (SLT) are conflicting.

Group therapy task training versus individual task training during inpatient stroke rehabilitation: a randomised controlled trial.

Objective: To compare the efficacy of intensive daily applied progressive group therapy task training with equally dosed individual progressive task training on self-reported mobility for patients with moderate to severe stroke during inpatient rehabilitation.

Design: Randomized controlled clinical trial.

Setting: In-patient rehabilitation center.

The influence of gender on the injury severity, course and outcome of traumatic brain injury.

Objective: To examine the independent association of gender with injury severity, clinical course, pituitary dysfunction and outcome after traumatic brain injury (TBI).

Design: Prospective cohort, analysis of a data sub-set collected as part of the nation-wide database 'The Structured Data Assessment of Hypopituitarism after TBI and SAH'.

Methods And Procedures: Four hundred and twenty-seven patients following TBI were observed from acute care through neurological rehabilitation.

Choosing the optimal trigger point for analysis of movements after stroke based on magnetoencephalographic recordings.

The aim of this study was to select the optimal procedure for analysing motor fields (MF) and motor evoked fields (MEF) measured from brain injured patients. Behavioural pretests with patients have shown that most of them cannot stand measurements longer than 30 minutes and they also prefer to move the hand with rather short breaks between movements. Therefore, we were unable to measure the motor field (MF) optimally.

Repetitive training of complex hand and arm movements with shaping is beneficial for motor improvement in patients after stroke.

Objective: Repetitive training of simple upper limb movements is effective in stroke rehabilitation. For the repetitive training of complex movements, however, results are inconsistent. The aim of this study was to determine whether repetitive training of complex upper limb movements, focussing on strength and velocity as shaping elements, is effective in stroke rehabilitation.

Intracortical excitability after repetitive hand movements is differentially affected in cortical versus subcortical strokes.

Repetitive training of isolated movements induces reorganization of motor cortical representations. To elucidate the mechanisms of practice-dependent cortical plasticity within the lesioned central motor system at the time of the application of a therapeutic intervention, we examined the effect of repetitive movements on intracortical facilitation (ICF) and inhibition of agonist (extensor carpi radialis [ECR]) and antagonist (flexor carpi ulnaris) muscles of the hand shortly after the movements, by the paired-pulse technique in patients with cortical (n = 9) and subcortical strokes (n = 11). Short intracortical inhibition and ICF were studied by using interstimulus intervals of 2 and 8 milliseconds, respectively, and their interaction with active or passive movement.

Change of strength and rate of rise of tension relate to functional arm recovery after stroke.

Objective: To examine the relationship between individual strength parameters and functional motor ability over time during rehabilitation in stroke patients.

Design: A multiple-baseline experiment with assessment at inclusion and after 3 and 6 weeks.

Setting: Secondary-care rehabilitation center.

Isotonic and isometric contractions exert the same amount of corticomotor system excitability in healthy subjects and patients after stroke.

Objective: Active, voluntary training of the centrally paretic upper limb is crucial for functional recovery after brain damage. The aim of this study was to determine whether the type of voluntary contraction has a differential influence on corticomotor system excitability in healthy subjects and patients after stroke.

Design: Experimental cross-sectional study.

Procedural learning eliminates specific slowing down of response selection in patients with idiopathic Parkinson syndrome.

Patients with idiopathic Parkinson syndrome and normally aged controls participated in a psychological refractory period experiment. Two tasks were presented on each trial: auditory discrimination of high versus low tones, followed by visual classification of letters versus their mirror images. Speeded responses to both tasks were required.

Early prediction of functional outcome after stroke.

Objectives: (I) To obtain biomechanical parameters and assessment scores applied at a very early stage after stroke that predict best the functional outcome after rehabilitation. (II) To evaluate the predictive value of changes (i.e.

Clinical relevance of rehabilitation programs for patients with idiopathic Parkinson syndrome. II: Symptom-specific therapeutic approaches.

Clinical symptoms of the idiopathic Parkinson's syndrome (IPS) are numerous. Clinical experience as well as pharmacological research identified symptoms not responsive to dopaminergic stimulation. These symptoms in particular were the target of rehabilitative therapy approaches.

Clinical relevance of rehabilitation programs for Parkinson's disease. I: Non-symptom-specific therapeutic approaches.

The idiopathic Parkinson syndrome (IPS) affects multiple structures of the central nervous system and exhibits a broad variety of clinical symptoms that are only partially treatable by pharmacological treatment. Therefore, non-pharmacological approaches are highly warranted. The aim of this study was to identify, categorize and rate studies on rehabilitative therapeutic approaches for IPS regarding not only study design and statistics, but also clinical relevance.

Central compensation at short muscle range is differentially affected in cortical versus subcortical strokes.

Background And Purpose: The active force generated by a single muscle fiber is greatest in midrange. In healthy subjects, the reduced muscle force at short muscle length is partially compensated by modified patterns of muscle activation, probably central in origin. These patterns are presumed to be deficient after stroke.

Change of facilitation during voluntary bilateral hand activation after stroke.

Background And Purpose: The relearning of daily activities after stroke also involves performance of bimanual tasks. This raises the possibility that concurrent activation of the healthy hemisphere interferes with reorganization processes in the affected hemisphere due to inhibitory pathways between homologous motor cortex representations. This study investigated the effect of voluntary, simultaneous activation of both hands upon the non-dominant (healthy subjects) or affected (stroke patients) hemisphere.

Selective effect of repetitive hand movements on intracortical excitability.

Repetitive training of isolated movements induces local reorganization of the motor cortex. To investigate the effect of repetitive movements on intracortical inhibition and facilitation shortly after the movements, we performed paired-pulse transcranial magnetic stimulation in 12 healthy subjects by using interstimulus intervals of 2 and 8 ms, respectively. Motor evoked potentials (MEPs) were recorded simultaneously from the extensor carpi radialis (ECR) and the flexor carpi ulnaris muscle (FCU) following paired stimuli at rest or 1 s after repetitive (every 6 s) active or passive wrist extensions and compared with MEPs produced by single stimuli at rest.

Enhanced motor cortex excitability during ipsilateral voluntary hand activation in healthy subjects and stroke patients.

Background And Purpose: It is still a matter of debate whether the ipsilateral voluntary hand activation has a facilitatory or inhibitory effect on the nondominant or affected hemisphere. To give an answer to this question is of great importance for the rehabilitation of stroke patients, because they often use the unaffected hand for compensation.

Methods: Ten healthy volunteers and 11 stroke patients were investigated using transcranial magnetic stimulation (TMS).

Influence of repetitive hand movements on intracortical inhibition.

Repetitive movements have been reported to induce task-specific changes of intracortical inhibition and facilitation, but the mechanism operating shortly after hand movement is unclear. Transcranial magnetic single and paired stimuli (2 ms) were applied to 15 healthy subjects at rest and 1 s after repetitive (every 6 s) active and passive hand extensions. Motor evoked potentials (MEPs) were recorded from hand extensors (agonists) and flexors (antagonists).

Is the repetitive training of complex hand and arm movements beneficial for motor recovery in stroke patients?

Objective: To determine whether a repetitive training of complex movements of arm and hand contributes to functional recovery in stroke patients.

Design: Prospective, longitudinal, multiple baseline design across individuals.

Setting: Neurological rehabilitation centre.

Is the reduction of spasticity by botulinum toxin a beneficial for the recovery of motor function of arm and hand in stroke patients?

To determine the functional benefit of botulinum toxin A (BtxA) in spasticity of arm flexors, we conducted an open-label study with 10 stroke patients. 480 mouse units BtxA (Dysport((R))) were injected into flexor muscles. Outcome measures were done by the Modified Ashworth Scale, Rivermead Motor Assessment (arm section), active and passive ranges of motion (ROM), grip strength and a 3-dimensional motion analysis.

Motor-evoked potentials are facilitated during perceptual identification of hand position in healthy subjects and stroke patients.

Objective: To delineate the facilitatory and/or inhibitory influence of relevant and irrelevant sensory afferent information to the motor cortex. The study is based on the assumption that sensorimotor coupling is crucial for motor learning and recovery.

Design: The interaction of a standard transcranial magnetic stimulus (TMS) with the facilitatory and/or inhibitory influence that proprioceptive afferent information exerts on the motor cortex was investigated.