Objective: Mu and beta EEG oscillations show typical desynchronization patterns during movement. The aim of the current study was to assess whether in sub-acute stroke patients the magnitude of movement-related desynchronization reflects the extent of residual motor ability in the paretic upper limb.
Methods: EEG and EMG data were recorded from 14 first-event stroke patients during repeated wrist extension movements of the paretic upper limb. Residual motor ability was assessed by the Fugl Meyer and Box and Blocks standardized clinical tests. Normalized lesion data was analyzed using the MEDx software.
Results: The magnitude of event-related de-synchronization (ERD) of the high-mu and low-beta bands of the EEG, measured over the affected hemisphere, correlated significantly with (a) residual motor function in the paretic upper limb as measured by standard clinical tests; (b) the magnitude of EMG recorded from the paretic upper limb during wrist extension; and (c) the total hemispheric volume loss (negative correlation).
Conclusion: The magnitude of high-mu and low-beta ERD recorded from the lesioned hemisphere of subacute stroke patients correlates with residual motor ability in the paretic upper limb.
Significance: Measures derived from quantitative EEG analysis may play an important role in neurorehabilitation clinical practice.
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http://dx.doi.org/10.1016/j.clinph.2019.06.008 | DOI Listing |
J Neural Eng
January 2025
Department of Physical Medicine and Rehabilitation, MetroHealth Medical Center, 4229 Pearl Road, Suite N4-13, Cleveland, Ohio, 44109-1998, UNITED STATES.
Ipsilateral motor evoked potentials (iMEPs) are believed to represent cortically evoked excitability of uncrossed brainstem-mediated pathways. In the event of extensive injury to (crossed) corticospinal pathways, which can occur following a stroke, uncrossed ipsilateral pathways may serve as an alternate resource to support the recovery of the paretic limb. However, iMEPs, even in neurally intact people, can be small, infrequent, and noisy, so discerning them in stroke survivors is very challenging.
View Article and Find Full Text PDFCureus
December 2024
Department of Rehabilitation, Musashigaoka Hospital, Kumamoto, JPN.
Gait asymmetry in post-stroke patients is an important gait characteristic that is associated with their balance control, inefficiency, and risks of musculoskeletal injury to the non-paretic lower limb and falling. Unfortunately, most stroke patients retain an asymmetrical gait pattern, even though their gait independence and gait speed improve. We describe the clinical course of a subacute stroke patient who achieved a symmetrical gait at discharge after undergoing both gait training with orthoses and robot-assisted gait training from the early intervention phase.
View Article and Find Full Text PDFPLoS One
January 2025
Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
Background: Increasing one's walking speed is an important goal in post-stroke gait rehabilitation. Insufficient arm swing in people post-stroke might limit their ability to propel the body forward and increase walking speed.
Purpose: To investigate the speed-dependent changes (and their contributing factors) in the arm swing of persons post-stroke.
J Neuroeng Rehabil
December 2024
Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA.
Background: This research aims to improve the control of assistive devices for individuals with hemiparesis after stroke by providing intuitive and proportional motor control. Stroke is the leading cause of disability in the United States, with 80% of stroke-related disability coming in the form of hemiparesis, presented as weakness or paresis on half of the body. Current assistive exoskeletonscontrolled via electromyography do not allow for fine force regulation.
View Article and Find Full Text PDFAnn Neurol
December 2024
Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Objective: Vagus nerve stimulation (VNS) paired with rehabilitation therapy improved motor status compared to rehabilitation alone in the phase III VNS-REHAB stroke trial, but treatment response was variable and not associated with any clinical measures acquired at baseline, such as age or side of paresis. We hypothesized that neuroimaging measures would be associated with treatment-related gains, examining performance of regional injury measures versus global brain health measures in parallel with clinical measures.
Methods: Baseline magnetic resonance imaging (MRI) scans in the VNS-REHAB trial were used to derive regional injury measures (extent of injury to corticospinal tract, the primary regional measure; plus extent of injury to precentral gyrus and postcentral gyrus; lesion volume; and lesion topography) and global brain health measures (degree of white matter hyperintensities, the primary global brain measure; plus volumes of cerebrospinal fluid, cortical gray matter, white matter, each thalamus, and total brain).
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