Strategies to Reduce Fall Severity after a Perturbation during Ladder Climbing.

OCCUPATIONAL APPLICATIONSFalls from ladders remain a significant cause of injuries in workplaces as well as residential settings. While recent research reveals factors related to fall severity from a ladder, strategies that workers can adopt to minimize fall severity are not well understood. Results from our current study indicated that increased upper limb strength, achieving a higher hand hold, and controlled reestablishment of the foot on the rung have summative benefits to reduce fall severity and increase recovery from a misstep perturbation.

The Use of TheraBracelet Upper Extremity Vibrotactile Stimulation in a Child with Cerebral Palsy-A Case Report.

Background: TheraBracelet is peripheral vibrotactile stimulation applied to the affected upper extremity via a wristwatch-like wearable device during daily activities and therapy to improve upper limb function. The objective of this study was to examine feasibility of using TheraBracelet for a child with hemiplegic cerebral palsy.

Methods: A nine-year-old male with cerebral palsy was provided with TheraBracelet to use during daily activities in the home and community settings for 1.

Combining Cyproheptadine Hydrochloride With Targeted Muscle Activation Training to Treat Upper Extremity Stroke: A Randomized, Placebo-Controlled Trial.

Objective: To examine a treatment for upper extremity impairment in stroke survivors that combines administration of cyproheptadine hydrochloride with repetitive practice focused on control of muscle activation patterns.

Design: Double-blind, randomized controlled trial.

Settings: Laboratory within a free-standing rehabilitation hospital.

Cortical Sensorimotor Integration as a Neural Origin of Impaired Grip Force Direction Control following Stroke.

Background: Stroke is a major cause of disability worldwide. Upper limb impairment is prevalent after stroke. One of the post-stroke manifestations is impaired grip force directional control contributing to diminished abilities to grip and manipulate objects necessary for activities of daily living.

Wearable Sensor to Monitor Quality of Upper Limb Task Practice for Stroke Survivors at Home.

Many stroke survivors experience persistent upper extremity impairment that limits performance in activities of daily living. Upper limb recovery requires high repetitions of task-specific practice. Stroke survivors are often prescribed task practices at home to supplement rehabilitation therapy.

Data-driven biomarkers outperform theory-based biomarkers in predicting stroke motor outcomes.

Chronic motor impairments are a leading cause of disability after stroke. Previous studies have predicted motor outcomes based on the degree of damage to predefined structures in the motor system, such as the corticospinal tract. However, such theory-based approaches may not take full advantage of the information contained in clinical imaging data.

White Matter Integrity and Chronic Poststroke Upper Limb Function: An ENIGMA Stroke Recovery Analysis.

Background: Integrity of the corticospinal tract (CST) is an important biomarker for upper limb motor function following stroke. However, when structurally compromised, other tracts may become relevant for compensation or recovery of function.

Methods: We used the ENIGMA Stroke Recovery data set, a multicenter, retrospective, and cross-sectional collection of patients with upper limb impairment during the chronic phase of stroke to test the relevance of tracts in individuals with less and more severe (laterality index of CST fractional anisotropy ≥0.

Application of Deep Learning Algorithm to Monitor Upper Extremity Task Practice.

Upper extremity hemiplegia is a serious problem affecting the lives of many people post-stroke. Motor recovery requires high repetitions and quality of task-specific practice. Sufficient practice cannot be completed during therapy sessions, requiring patients to perform additional task practices at home on their own.

Associating Functional Neural Connectivity and Specific Aspects of Sensorimotor Control in Chronic Stroke.

Hand sensorimotor deficits often result from stroke, limiting the ability to perform daily living activities. Sensorimotor deficits are heterogeneous among stroke survivors. Previous work suggests a cause of hand deficits is altered neural connectivity.

Different aspects of hand grip performance associated with structural connectivity of distinct sensorimotor networks in chronic stroke.

Knowledge regarding the neural origins of distinct upper extremity impairments may guide the choice of interventions to target neural structures responsible for specific impairments. This cross-sectional pilot study investigated whether different brain networks explain distinct aspects of hand grip performance in stroke survivors. In 22 chronic stroke survivors, hand grip performance was characterized as grip strength, reaction, relaxation times, and control of grip force magnitude and direction.

Association of Brain Age, Lesion Volume, and Functional Outcome in Patients With Stroke.

Background And Objectives: Functional outcomes after stroke are strongly related to focal injury measures. However, the role of global brain health is less clear. In this study, we examined the impact of brain age, a measure of neurobiological aging derived from whole-brain structural neuroimaging, on poststroke outcomes, with a focus on sensorimotor performance.

Effect of Self-Directed Home Therapy Adherence Combined with TheraBracelet on Poststroke Hand Recovery: A Pilot Study.

Hand impairment is a common consequence of stroke, resulting in long-term disability and reduced quality of life. Recovery may be augmented through self-directed therapy activities at home, complemented by the use of rehabilitation devices such as peripheral sensory stimulation. The objective of this study was to determine the effect of adherence to self-directed therapy and the use of TheraBracelet (subsensory random-frequency vibratory stimulation) on hand function for stroke survivors.

Development and evaluation of an efficient training program to facilitate the adoption of a novel neurorehabilitation device.

Many rehabilitation devices are not adopted by therapists in practice. One major barrier is therapists' limited time and resources to get training. The objective of this study was to develop/evaluate an efficient training program for a novel rehabilitation device.

Effect of Sensory Impairment on Hand Functional Improvement with Therapy and Sensory Stimulation.

Sensory impairment may impact individual stroke survivors' motor recovery as well as their response to peripheral sensory stimulation treatment. The objective of this study was to determine the effect of sensory impairment level of individual stroke survivors on motor improvement with therapy and peripheral sensory stimulation. A secondary analysis of a pilot triple-blind randomized controlled trial was used.

Effect of Using TheraBracelet on Grasping versus Reaching in Poststroke Rehabilitation.

A peripheral sensory stimulation named TheraBracelet has recently been shown to have a potential to improve gross manual dexterity following stroke. Upper limb function requires both reach and grasp. It is unknown whether TheraBracelet affects one more than other.

The relationship between motor pathway damage and flexion-extension patterns of muscle co-excitation during walking.

Background: Mass flexion-extension co-excitation patterns during walking are often seen as a consequence of stroke, but there is limited understanding of the specific contributions of different descending motor pathways toward their control. The corticospinal tract is a major descending motor pathway influencing the production of normal sequential muscle coactivation patterns for skilled movements. However, control of walking is also influenced by non-corticospinal pathways such as the corticoreticulospinal pathway that possibly contribute toward mass flexion-extension co-excitation patterns during walking.

Neuroplasticity after upper-extremity rehabilitation therapy with sensory stimulation in chronic stroke survivors.

This study investigated the effect of using subthreshold vibration as a peripheral sensory stimulation during therapy on cortical activity. Secondary analysis of a pilot triple-blinded randomized controlled trial. Twelve chronic stroke survivors underwent 2-week upper-extremity task-practice therapy.

Chronic Stroke Sensorimotor Impairment Is Related to Smaller Hippocampal Volumes: An ENIGMA Analysis.

Background Persistent sensorimotor impairments after stroke can negatively impact quality of life. The hippocampus is vulnerable to poststroke secondary degeneration and is involved in sensorimotor behavior but has not been widely studied within the context of poststroke upper-limb sensorimotor impairment. We investigated associations between non-lesioned hippocampal volume and upper limb sensorimotor impairment in people with chronic stroke, hypothesizing that smaller ipsilesional hippocampal volumes would be associated with greater sensorimotor impairment.

Effect of novel training to normalize altered finger force direction post-stroke: study protocol for a double-blind randomized controlled trial.

Background: Functional task performance requires proper control of both movement and force generation in three-dimensional space, especially for the hand. Control of force in three dimensions, however, is not explicitly treated in current physical rehabilitation. To address this gap in treatment, we have developed a tool to provide visual feedback on three-dimensional finger force.

Concomitant sensory stimulation during therapy to enhance hand functional recovery post stroke.

Background: Post-stroke hand impairment is prevalent and persistent even after a full course of rehabilitation. Hand diminishes stroke survivors' abilities for activities of daily living and independence. One way to improve treatment efficacy is to augment therapy with peripheral sensory stimulation.

Use of an EMG-Controlled Game as a Therapeutic Tool to Retrain Hand Muscle Activation Patterns Following Stroke: A Pilot Study.

Background/purpose: To determine the feasibility of training with electromyographically (EMG) controlled games to improve control of muscle activation patterns in stroke survivors.

Methods: Twenty chronic stroke survivors (>6 months) with moderate hand impairment were randomized to train either unilaterally (paretic only) or bilaterally over 9 one-hour training sessions. EMG signals from the unilateral or bilateral limbs controlled a cursor location on a computer screen for gameplay.

The Prognostic Utility of Electroencephalography in Stroke Recovery: A Systematic Review and Meta-Analysis.

Background: Improved ability to predict patient recovery would guide post-stroke care by helping clinicians personalize treatment and maximize outcomes. Electroencephalography (EEG) provides a direct measure of the functional neuroelectric activity in the brain that forms the basis for neuroplasticity and recovery, and thus may increase prognostic ability.

Objective: To examine evidence for the prognostic utility of EEG in stroke recovery via systematic review/meta-analysis.