Executive function improvement in response to meta-cognitive training in chronic mTBI / PTSD.

Objective: We tested Goal Management Training (GMT), which has been recommended as an executive training protocol that may improve the deficits in the complex tasks inherent in life role participation experienced by those with chronic mild traumatic brain injury and post-traumatic stress disease (mTBI/PTSD). We assessed, not only cognitive function, but also life role participation (quality of life).

Methods: We enrolled and treated 14 individuals and administered 10 GMT sessions in-person and provided the use of the Veterans Task Manager (VTM), a Smartphone App, which was designed to serve as a "practice-buddy" device to ensure translation of in-person learning to independent home and community practice of complex tasks.

Underlying Mechanisms and Neurorehabilitation of Gait after Stroke.

The title of this is: "Underlying Mechanisms and Neurorehabilitation of Gait after Stroke" [...

Update on an Observational, Clinically Useful Gait Coordination Measure: The Gait Assessment and Intervention Tool (G.A.I.T.).

With discoveries of brain and spinal cord mechanisms that control gait, and disrupt gait coordination after disease or injury, and that respond to motor training for those with neurological disease or injury, there is greater ability to construct more efficacious gait coordination training paradigms. Therefore, it is critical in these contemporary times, to use the most precise, sensitive, homogeneous (i.e.

Targeting CNS Neural Mechanisms of Gait in Stroke Neurorehabilitation.

The central nervous system (CNS) control of human gait is complex, including descending cortical control, affective ascending neural pathways, interhemispheric communication, whole brain networks of functional connectivity, and neural interactions between the brain and spinal cord. Many important studies were conducted in the past, which administered gait training using externally targeted methods such as treadmill, weight support, over-ground gait coordination training, functional electrical stimulation, bracing, and walking aids. Though the phenomenon of CNS activity-dependent plasticity has served as a basis for more recently developed gait training methods, neurorehabilitation gait training has yet to be precisely focused and quantified according to the CNS source of gait control.

Thigh and Shank, Kinetic and Potential Energies during Gait Swing Phase in Healthy Adults and Stroke Survivors.

Background/Problem. Given the treatment-resistant gait deficits after stroke and known elevated energy cost of gait after stroke, it is important to study the patterns of mechanical energies of the lower limb segments. There is a dearth of information regarding mechanical energies specifically for the thigh and shank across the gait cycle.

Comment on Chow, J.W.; Stokic, D.S. Longitudinal Changes in Temporospatial Gait Characteristics during the First Year Post-Stroke. 2021, , 1648.

The field of neurorehabilitation has moved considerably beyond a narrow use of gait speed [...

Stance Phase Gait Training Post Stroke Using Simultaneous Transcranial Direct Current Stimulation and Motor Learning-Based Virtual Reality-Assisted Therapy: Protocol Development and Initial Testing.

Gait deficits are often persistent after stroke, and current rehabilitation methods do not restore normal gait for everyone. Targeted methods of focused gait therapy that meet the individual needs of each stroke survivor are needed. Our objective was to develop and test a combination protocol of simultaneous brain stimulation and focused stance phase training for people with chronic stroke (>6 months).

Necessity and Content of Swing Phase Gait Coordination Training Post Stroke; A Case Report.

Unlabelled: Background/Problem: Standard neurorehabilitation and gait training has not proved effective in restoring normal gait coordination for many stroke survivors. Rather, persistent gait dyscoordination occurs, with associated poor function, and progressively deteriorating quality of life. One difficulty is the array of symptoms exhibited by stroke survivors with gait deficits.

Trajectories of stroke recovery of impairment, function, and quality of life in response to 12-month mobility and fitness intervention.

Background: Gait deficits and functional disability are persistent problems for many stroke survivors, even after standard neurorehabilitation. There is little quantified information regarding the trajectories of response to a long-dose, 12-month intervention.

Objective: We quantified treatment response to an intensive neurorehabilitation mobility and fitness program.

Four methods of brain pattern analyses of fMRI signals associated with wrist extension versus wrist flexion studied for potential use in future motor learning BCI.

Objective: In stroke survivors, a treatment-resistant problem is inability to volitionally differentiate upper limb wrist extension versus flexion. When one intends to extend the wrist, the opposite occurs, wrist flexion, rendering the limb non-functional. Conventional therapeutic approaches have had limited success in achieving functional recovery of patients with chronic and severe upper extremity impairments.

Combined real-time fMRI and real time fNIRS brain computer interface (BCI): Training of volitional wrist extension after stroke, a case series pilot study.

Objective: Pilot testing of real time functional magnetic resonance imaging (rt-fMRI) and real time functional near infrared spectroscopy (rt-fNIRS) as brain computer interface (BCI) neural feedback systems combined with motor learning for motor recovery in chronic severely impaired stroke survivors.

Approach: We enrolled a four-case series and administered three sequential rt-fMRI and ten rt-fNIRS neural feedback sessions interleaved with motor learning sessions. Measures were: Arm Motor Assessment Tool, functional domain (AMAT-F; 13 complex functional tasks), Fugl-Meyer arm coordination scale (FM); active wrist extension range of motion (ROM); volume of activation (fMRI); and fNIRS HbO concentration.

Innovative Long-Dose Neurorehabilitation for Balance and Mobility in Chronic Stroke: A Preliminary Case Series.

(1) Objective: The objective was two-fold: (a) test a protocol of combined interventions; (b) administer this combined protocol within the framework of a six-month, intensive, long-duration program. The array of interventions was designed to target the treatment-resistant impairments underlying persistent mobility dysfunction: weakness, balance deficit, limb movement dyscoordination, and gait dyscoordination. (2) Methods: A convenience sample of eight chronic stroke survivors (>4 months post stroke) was enrolled.

Construct Validity of the Gait Assessment and Intervention Tool (GAIT) in People With Multiple Sclerosis.

Introduction: In clinical practice, observational scales are the most common approach used to assess gait pattern in people with neurological disorders. The Gait Assessment and Intervention Tool (GAIT) is an observational gait scale, and it has proved to be the most comprehensive, homogeneous, and objective of all the observational gait scales studied in people with neurological conditions.

Objective: To study the construct validity of the GAIT in people with multiple sclerosis (MS).

Development of a combined, sequential real-time fMRI and fNIRS neurofeedback system to enhance motor learning after stroke.

Background: After stroke, wrist extension dyscoordination precludes functional arm/hand. We developed a more spatially precise brain signal for use in brain computer interface (BCI's) for stroke survivors.

New Method: Combination BCI protocol of real-time functional magnetic resonance imaging (rt-fMRI) sequentially followed by functional near infrared spectroscopy (rt-fNIRS) neurofeedback, interleaved with motor learning sessions without neural feedback.

Reliability and Minimal Detectable Change in the Gait Assessment and Intervention Tool in Patients With Multiple Sclerosis.

Background: Gait impairment is one of the main causes of disability in people with multiple sclerosis. The Gait Assessment and Intervention Tool is an observational gait scale that assesses kinematic parameters using video recordings.

Objective: To study intra- and interrater reliability and the minimal detectable change of the Gait Assessment and Intervention Tool in individuals with multiple sclerosis.

Interpreting Prefrontal Recruitment During Walking After Stroke: Influence of Individual Differences in Mobility and Cognitive Function.

: Functional near-infrared spectroscopy (fNIRS) is a valuable neuroimaging approach for studying cortical contributions to walking function. Recruitment of prefrontal cortex during walking has been a particular area of focus in the literature. The present study investigated whether task-related change in prefrontal recruitment measured by fNIRS is affected by individual differences in people post-stroke.

Long-Dose Intensive Therapy Is Necessary for Strong, Clinically Significant, Upper Limb Functional Gains and Retained Gains in Severe/Moderate Chronic Stroke.

. Effective treatment methods are needed for moderate/severely impairment chronic stroke. .

Common Data Elements for Unruptured Intracranial Aneurysm and Subarachnoid Hemorrhage Clinical Research: Recommendations from the Working Group on Long-Term Therapies.

Objectives: The goal for the long-term therapies (LTT) working group (WG) of the Unruptured Intracranial Aneurysm (UIA) and Subarachnoid Hemorrhage (SAH) common data elements (CDEs) was to develop a comprehensive set of CDEs, data definitions, case report forms, and guidelines for use in UIA and SAH LTT clinical research, as part of a new joint effort between the National Institute of Neurological Disorders and Stroke (NINDS) and the National Library of Medicine of the US National Institutes of Health. These UIA and SAH CDEs will join other neurological disease-specific CDEs already developed and available for use by research investigators.

Methods: The eight LTT WG members comprised international UIA, and SAH experts reviewed existing NINDS CDEs and instruments, created new elements when needed, and provided recommendations for future LTT clinical research.

Spanish Cross-cultural Adaptation of the Gait Assessment and Intervention Tool.

Background: The Gait Assessment and Intervention Tool (G.A.I.

Mobility Function and Recovery After Stroke: Preliminary Insights From Sympathetic Nervous System Activity.

Background And Purpose: Poststroke hemiparesis increases the perceived challenge of walking. Perceived challenge is commonly measured by self-report, which is susceptible to measurement bias. A promising approach to objectively assess perceived challenge is measuring sympathetic nervous system (SNS) activity with skin conductance to detect the physiological stress response.

Association of spasticity and motor dysfunction in chronic stroke.

Background: The prevalence of increased muscle tone after stroke is frequently reported as 30% to 40%, and the condition is often concurrent with motor control deficits, manifesting as an inability to isolate paretic-limb joint movements.

Objective: The objectives of this retrospective analysis were to 1) report the prevalence of increased muscle tone in a convenience sample of 128 chronic stroke survivors with moderate/severe motor deficits and 2) quantify the relation between tone and motor impairment in chronic stroke survivors.

Methods: Analyses included descriptive statistics and multiple regression modeling, with the modified Ashworth Scale score (MAS; tone) as a predictor of isolated joint movement control (Fugl-Meyer score [FM]; motor impairment).

Greater Cortical Thickness Is Associated With Enhanced Sensory Function After Arm Rehabilitation in Chronic Stroke.

Objective: Somatosensory function is critical to normal motor control. After stroke, dysfunction of the sensory systems prevents normal motor function and degrades quality of life. Structural neuroplasticity underpinnings of sensory recovery after stroke are not fully understood.

Prefrontal over-activation during walking in people with mobility deficits: Interpretation and functional implications.

Background: Control of walking by the central nervous system includes contributions from executive control mechanisms, such as attention and motor planning resources. Executive control of walking can be estimated objectively by recording prefrontal cortical activity using functional near infrared spectroscopy (fNIRS).

Objective: The primary objective of this study was to investigate group differences in prefrontal/executive control of walking among young adults, older adults, and adults post-stroke.

Topographical measures of functional connectivity as biomarkers for post-stroke motor recovery.

Background: Biomarkers derived from neural activity of the brain present a vital tool for the prediction and evaluation of post-stroke motor recovery, as well as for real-time biofeedback opportunities.

Methods: In order to encapsulate recovery-related reorganization of brain networks into such biomarkers, we have utilized the generalized measure of association (GMA) and graph analyses, which include global and local efficiency, as well as hemispheric interdensity and intradensity. These methods were applied to electroencephalogram (EEG) data recorded during a study of 30 stroke survivors (21 male, mean age 57.

Effects of expiratory muscle strength training on maximal respiratory pressure and swallow-related quality of life in individuals with multiple sclerosis.

Background: Weakening and dyscoordination of expiratory muscles in multiple sclerosis (MS) can impair respiratory and swallow function.

Objective: The objective of this paper is to test a novel expiratory muscle strength training (EMST) device on expiratory pressure, swallow function, and swallow-related quality-of-life (SWAL-QOL) in individuals with MS.

Methods: Participants with MS were randomized to a five-week breathing practice of either positive pressure load (EMST) or near-zero pressure (sham).