Feasibility and Preliminary Efficacy of Visual Cue Training to Improve Adaptability of Walking after Stroke: Multi-Centre, Single-Blind Randomised Control Pilot Trial.

Objectives: Given the importance of vision in the control of walking and evidence indicating varied practice of walking improves mobility outcomes, this study sought to examine the feasibility and preliminary efficacy of varied walking practice in response to visual cues, for the rehabilitation of walking following stroke.

Design: This 3 arm parallel, multi-centre, assessor blind, randomised control trial was conducted within outpatient neurorehabilitation services.

Participants: Community dwelling stroke survivors with walking speed <0.

Recognising neuroplasticity in musculoskeletal rehabilitation: a basis for greater collaboration between musculoskeletal and neurological physiotherapists.

Evidence is emerging for central nervous system (CNS) changes in the presence of musculoskeletal dysfunction and pain. Motor control exercises, and potentially manual therapy, can induce changes in the CNS, yet the focus in musculoskeletal physiotherapy practice is conventionally on movement impairments with less consideration of intervention-induced neuroplastic changes. Studies in healthy individuals and those with neurological dysfunction provide examples of strategies that may also be used to enhance neuroplasticity during the rehabilitation of individuals with musculoskeletal dysfunction, improving the effectiveness of interventions.

Feedback device for improvement of coordination of reach-to-grasp after stroke.

Objective: To describe a novel feedback device (Grasp Rehabilitation Accessory for Stroke Patients [GRASP]) that gives feedback on the time lag between the start of hand opening and the start of transport during reach-to-grasp movements, and to report the results of a preliminary series of single case studies to assess the utility of the device for improving the coordination of arm and hand at the beginning of a reach-to-grasp movement.

Design: A multiple baseline design across 6 subjects was used, with each subject performing 40 repetitions of reaching to grasp a jar. Two subjects each performed 10, 15, or 20 randomly assigned baseline repetitions.

Interventions for coordination of walking following stroke: systematic review.

Impairments in gait coordination may be a factor in falls and mobility limitations after stroke. Therefore, rehabilitation targeting gait coordination may be an effective way to improve walking post-stroke. This review sought to examine current treatments that target impairments of gait coordination, the theoretical basis on which they are derived and the effects of such interventions.

Ability to adjust reach extent in the hemiplegic arm.

Objective: Insufficient information exists about the ability of hemiparetic patients to adjust reach extent during early recovery from stroke. Further knowledge may suggest guidance for therapy intervention. The objective of this study was to investigate the ability of hemiparetic subjects to adjust reach extent within 6 months after stroke.

Use of information feedback and attentional focus of feedback in treating the person with a hemiplegic arm.

Background And Purpose: Feedback about motor performance can induce either an internal focus of attention (about body movement) or an external focus of attention (about the effects on the environment) in the learner. The main aim of this pilot study was to examine the attentional focus of feedback given by physiotherapists during treatment of the hemiplegic arm. A second aim was to examine the frequency of feedback about motor performance during treatment.

Coordination between reaching and grasping in patients with hemiparesis and healthy subjects.

Objective: To investigate the coordination of reach-to-grasp components in hemiparetic and healthy subjects.

Design: Split-plot repeated-measures design with 3 factors (group, object size, movement speed).

Setting: Movement laboratory.

Motor control and the management of musculoskeletal dysfunction.

This paper aims to develop understanding of three important motor control issues--feedforward mechanisms, cortical plasticity and task-specificity and assess the implications for musculoskeletal practice. A model of control for the reach-to-grasp movement illustrates how the central nervous system integrates sensorimotor processes to control complex movements. Feedforward mechanisms, an essential element of motor control, are altered in neurologically intact patients with chronic neck pain and low back pain.

Extrinsic feedback for motor learning after stroke: what is the evidence?

Purpose: There is little guidance on using extrinsic feedback to enhance motor learning after stroke. This narrative review synthesises research findings and identifies questions remaining to be answered.

Method: A summary is given relating to the use of extrinsic feedback in healthy subjects.