• Title, Summary, Keyword: Motor recovery

Search Result 330, Processing Time 0.042 seconds

Applications of Diffusion Tensor MRI to Predict Motor Recovery of Stroke Patients in the Chronic Stages

  • Tae, Ki-Sik;Song, Sung-Jae;Kim, Young-Ho
    • Journal of Biomedical Engineering Research
    • /
    • v.29 no.2
    • /
    • pp.114-121
    • /
    • 2008
  • Within 2 to 5 months after stroke, patients recover variable degrees of function, depending on the initial deficit. An impaired hand function is one of the most serious disability in chronic stroke patients. Therefore, to evaluate the extent of motor dysfunction in the hemiplegic hand is important in stroke rehabilitation. In this paper, motor recoveries in 8 chronic stroke patients with Fugl-Meyer (FM) and white matter changes before and after the training program with a designed bilateral symmetrical arm trainer (BSAT) system were examined. The training was performed at 1 hr/day, 5 days/week during 6weeks. In all patients, FM was significantly improved after the 6-week training. Diffusion tensor imaging (DTI) results showed that tractional anisotropy ratio (FAR) and fiber tracking ratio (FTR) in the posterior internal capsule were significantly increased after the training. It seemed that the cortical reorganization was induced by the 6 week training with the BSAT. In all parameters proposed this study, a significant correlation was found between these parameters (FAR and FTR) and motor recoveries. This study demonstrated that DTI technique could be useful in predicting motor recovery in chronic hemiparetic patients.

Effects of Repetitive Transcranial Magnetic Stimulation on Motor Recovery in Lower Extremities of Subacute Stage Incomplete Spinal Cord Injury Patients: A Randomized Controlled Trial

  • Ji, Sang-Goo;Cha, Hyun-Gyu;Kim, Myoung-Kwon
    • Journal of Magnetics
    • /
    • v.20 no.4
    • /
    • pp.427-431
    • /
    • 2015
  • The aim of this study was to investigate whether repetitive transcranial magnetic stimulation (rTMS) can improve motor recovery in the lower extremities of the patients with subacute stage spinal cord injury (SCI). This study was conducted with 19 subjects diagnosed with paraplegia because of SCI. The experimental group included 10 subjects who underwent active rTMS, and the control group included 9 subjects who underwent sham rTMS. The SCI patients in the experimental group underwent conventional rehabilitation therapy, and active rTMS was applied daily to the hotspot of the lesional hemisphere. The SCI patients in the control group underwent sham rTMS and conventional rehabilitation therapy. The participants in both the groups received therapy five days per week for six weeks. Latency, amplitude, and velocity were assessed before and after the six-week therapy period. A significant difference in post-treatment gains for the latency and velocity was observed between the experimental and control groups (p < 0.05). However, no significant differences in the amplitude were observed between the two groups (p > 0.05). The results of this study indicate that rTMS may be beneficial in improving motor recovery in the lower extremities of subacute stage SCI patients.

Comparisons of the Prognostic Predictors of Traumatic Brain Injury According to Admission Glasgow Coma Scale Scores Based on 1- and 6-month Assessments

  • Oh Hyun-Soo;Seo Wha-Sook;Lee Seul;Song Ho-Sook
    • Journal of Korean Academy of Nursing
    • /
    • v.36 no.4
    • /
    • pp.621-629
    • /
    • 2006
  • Purpose. The purpose of this study was to identify the clinical variables that predict functional and cognitive recovery at 1- and 6-month in both severe and moderate/mild traumatic brain injury patients. Methods. The subjects of this study were 82 traumatically brain-injured patients who were admitted to a Neurological Intensive Care Unit at a university hospital. Potential prognostic factors included were age, motor and pupillary response, systolic blood pressure, heart rate, and the presence of intracranial hematoma at admission. Results. The significant predictors of functional disability in severe traumatic brain injury subjects were, age, systolic blood pressure, the presence of intracranial hematoma, motor response, and heart rate at admission. In moderate/mild traumatic brain injury patients, motor response, abnormal pupil reflex, and heart rate at admission were identified as significant predictors of functional disability. On the other hand, the significant predictors of cognitive ability for severe traumatic brain injury patients were motor response and the presence of intracranial hematoma at admission, whereas those for moderate/mild patients were motor response, pupil reflex, systolic blood pressure at admission, and age. Conclusions. The results of the present study indicate that the significant predictors of TBI differ according to TBI severity on admission, outcome type, and outcome measurement time. This can be meaningful to critical care nurses for a better understanding on the prediction of brain injury patients. On the other hand, the model used in the present study appeared to produce relatively low explicabilities for functional and cognitive recovery although a direct comparison of our results with those of others is difficult due to differences in outcome definition and validation methods. This implies that other clinical variables should be added to the model used in the present study to increase its predicting power for determining functional and cognitive outcomes.

Loss of hsp70.1 Decreases Functional Motor Recovery after Spinal Cord Injury in Mice

  • Kim, Hyun-Jeong;Jung, Ji-In;Kim, Young-Kyung;Lee, Jae-Seon;Yoon, Young-Wook;Kim, June-Sun
    • The Korean Journal of Physiology and Pharmacology
    • /
    • v.14 no.3
    • /
    • pp.157-161
    • /
    • 2010
  • Heat shock proteins (HSPs) are specifically induced by various forms of stress. Hsp70.1, a member of the hsp70 family is known to play an important role in cytoprotection from stressful insults. However, the functional role of Hsp70 in motor function after spinal cord injury (SCI) is still unclear. To study the role of hsp70.1 in motor recovery following SCI, we assessed locomotor function in hsp70.1 knockout (KO) mice and their wild-type (WT) mice via the Basso, Beattie and Bresnahan (BBB) locomotor rating scale, before and after spinal hemisection at T13 level. We also examined lesion size in the spinal cord using Luxol fast blue/cresyl violet staining. One day after injury, KO and WT mice showed no significant difference in the motor function due to complete paralysis following spinal hemisection. However, when it compared to WT mice, KO mice had significantly delayed and decreased functional outcomes from 4 days up to 21 days after SCI. KO mice also showed significantly greater lesion size in the spinal cord than WT mice showed at 21 days after spinal hemisection. These results suggest that Hsp70 has a protective effect against traumatic SCI and the manipulation of the hsp70.1 gene may help improve the recovery of motor function, thereby enhancing neuroprotection after SCI.

Plasticity Associated Changes in Neurophysiological Tests Following Non Invasive Brain Stimulation in Stroke Rat Model (뇌졸중 쥐모델에서 비침습적뇌자극치료 이후 신경생리학적 검사에서 나타난 뇌가소성과 연관된 변화)

  • Sohn, Min Kyun;Song, Hee-Jung;Jee, Sungju
    • Annals of Clinical Neurophysiology
    • /
    • v.16 no.2
    • /
    • pp.62-69
    • /
    • 2014
  • Background: Neuromodulation therapy has been used to an adjunctive treatment promoting motor recovery in stroke patients. The objective of the study was to determine the effect of repetitive transcranial magnetic stimulation (rTMS) on neurobehavioral recovery and evoked potentials in rats with middle cerebral artery occlusion. Methods: Seventy Sprague-Daley rats were induced permanent middle cerebral artery occlusion (MCAO) stroke model and successful stroke rats (n=56) assigned to the rTMS (n=28) and sham (n=28) group. The 10 Hz, high frequency rTMS gave on ipsilesional forepaw motor cortex during 2 weeks in rTMS group. The somatosensory evoked potential (SSEP) and motor evoked potential (MEP) were used to evaluate the electrophysiological changes. Behavioral function of the stroke rat was evaluated by the Rota rod and Garcia test. Results: Forty rats ($N_{rTMS}=20;\;N_{sham}=20$) completed all experimental course. The rTMS group showed better performance than sham group in Rota rod test and Garcia test at day 11 (p<0.05) but not day 18 (p>0.05). The amplitude of MEP and SSEP in rTMS group was larger than sham group at day 18 (p<0.05). Conclusions: These data confirm that the high frequency rTMS on ipsilesional cerebral motor cortex can help the early recovery of motor performance in permanent middle cerebral artery stroke model and it may simultaneously associate with changes in neurophysiological activity in brain.

The Functional Role of the Corticospinal Track in Relation to Motor Functions in Chronic Stroke Patients (만성 뇌졸중 환자에서 피질 척수로와 운동 능력의 상관관계 연구)

  • Yeo, Sang-Seok
    • PNF and Movement
    • /
    • v.12 no.3
    • /
    • pp.143-150
    • /
    • 2014
  • Purpose: The corticospinal tract (CST) is known to be an important pyramidal tract for walking and motor function. However, very little is known about the functional role of the CST in the recovery of motor function. In the current study, we investigated the relation between the CST and motor function in chronic hemiparetic stroke patients. Methods: Fifty-four patients and 20 normal subjects were recruited. The Functional Ambulation Category (FAC) was used in measurement of the walking ability. We classified patients into three groups according to the ability to walk independently: group A, patients who could not walk independently (FAC: 0-2); group B, patients who could walk independently (FAC: 3); and group C, patd walk functionally (stairs and uneven surfaces, FAC 4-5). The Motricity Index (MI) was used to measure the motor function of the affected upper and lower extremities (maximum score: 100). The fractional anisotropy (FA) value, apparent diffusion coefficient (ADC) value, and fiber volume of the CST were used for the diffusion tensor imaging (DTI) parameters. Results: In terms of the CST of the unaffected hemisphere, the FA value of group A was significantly lower than that of normal controls (p <0.05). The fiber volume of group C was significantly higher than that of normal controls (p <0.05). In contrast, the ADC values of all patient groups and the control group did not show any difference (p >0.05). In terms of lower MI and total MI, significant differences were observed between all patient groups (p <0.05). In addition, significant differences in terms of the upper MI scores were observed between groups A and C and between groups B and C (p <0.05); however, no significant difference was observed between groups A and B (p>0.05). Conclusion: The increased fiber volume of the CST in the unaffected hemisphere appears to be related to functional walking ability in chronic stroke patients. This result would be useful for elucidation of the neural recovery mechanism of walking and the investigation of new modalities for the recovery of walking following a stroke with CST injury.

  • PDF

Traumatic Spinal Cord Injury: Long-Term Motor, Sensory, and Urinary Outcomes

  • Motiei-Langroudi, Rouzbeh;Sadeghian, Homa
    • Asian Spine Journal
    • /
    • v.11 no.3
    • /
    • pp.412-418
    • /
    • 2017
  • Study Design: Retrospective study. Purpose: To evaluate how motor, sensory, and urinary outcomes of spinal cord injury (SCI) patients were influenced in the long term. Overview of Literature: SCI is a potentially disabling and devastating neurological outcome that can occur because of spinal column fractures. Most studies have not evaluated or have failed to show the influence of different surgical approaches and other parameters on neurological recovery. Methods: A thorough history regarding sensory, motor, and urinary complaints was taken from 103 patients with SCI due to vertebral fracture; patients were followed by a thorough neurological examination. Subsequently, all medical records of patients, including neurological state after trauma, trauma mechanism, treatment protocol, surgical protocol, and imaging findings, were evaluated. Results: Of the 103 patients, 73.8% were survivors of a major earthquake and 26.2% were victims of vehicle accidents; 92.2% patients were surgically treated, while 7.8% underwent conservative management. The mean follow-up duration was 10.3 years. In follow-up visits, 67.0%, 12.6%, 13.6%, and 6.8% patients showed no, partial, substantial, and complete motor improvement, respectively; 68.0%, 26.2%, and 5.8% showed no, mild, and substantial sensory improvement, respectively; and 73.8%, 17.5%, and 8.7% showed no, substantial, and complete urinary improvement, respectively. Logistic regression analysis showed that sex, age at injury time, follow-up duration, trauma mechanism, and stem cell therapy had no effect on motor, sensory, and urinary improvement. Higher initial scores on the American Spinal Injury Association (ASIA) classification, lumbar fracture level, and performance of laminectomy improved motor outcome; higher initial ASIA scores improved urinary and sensory outcomes. Conclusions: The initial ASIA score is the most important factor for prognosticating motor, sensory, and urinary improvement in SCI patients. Lumbar (L3-L5) and thoracic (T1-T10) fractures have the best and worst prognosis, respectively, in terms of motor recovery. Laminectomy during surgery improves motor function.

Recovery from Stroke and Physical Therapy (뇌졸중 후 회복과 물리치료)

  • Kwon, Oh-Yun;Kim, Suhn-Yeop
    • Physical Therapy Korea
    • /
    • v.2 no.2
    • /
    • pp.98-107
    • /
    • 1995
  • Physical therapists use assumptions about motor control in every aspect of their work in treating stroke patients. An understanding of the recovery process after stroke, some neural mechanism of recovery and therapeutic model is critical factor for physical therapist to evaluate and obtain a higher final stage of recovery. The purpose of this article was to review the recovery process after stroke, some neural mechanism of recovery, the role of rehabilitation in the process of recovery, therapeutic model and its limitation. This article will help understanding of recovery process. evaluation, and treatment of the stroke patients. Each therapeutic method consists of a different set of assumptions and they are not completely independent of one another. Therefore specializing in any techniques of physical therapy will not be enough to treat stroke, so we are in need of integrated approach and objective measurement instrument to adequately evaluate and treat stroke patients.

  • PDF

Change of Magnetic Motor Evoked Potentials in Hemiparesis due to Cerebral Infarction (뇌경색에 의한 편측부전마비에서 자기운동유발전위의 변동)

  • Lee, Ju Ho;Park, Young Huk;Kim, Kwang Soo;Yoo, Kyung Moo
    • Annals of Clinical Neurophysiology
    • /
    • v.1 no.2
    • /
    • pp.99-105
    • /
    • 1999
  • Background and Objectives : The Motor evoked potentials (MEP) study may be useful in the evaluation of the degree of impairment in the motor nervous system and in the determination of the prognosis. The purpose of this study is to evaluate the status of central nervous system in acute and subacute state of cerebral ischemia by comparing the changes of MEP in the initial and follow-up study. Methods : Twenty patients with hemiparesis caused by ischemic stroke were recruited for this study. We tested MEP within 7 days and followed-up after 14 days after symptom onset. The cerebral motor cortex area, cervical area for upper extremity and lumbar area for lower extremity were stimulated by transmagnetic stimulator. The central motor conduction time(CMCT) was measured with the difference in MEP caused by stimulating the vertical area and spinal area. The CMCT of hemiparetic patients were classified into three groups-normal, delayed, and no evoked MEP groups. Results : The CMCT in hemiparetic side of acute ischemic stroke patients were singnificantly delayed (P < 0.05) compared with the control group. The CMCT of hemiparetic side in the follow-up study showed no sinificantly difference in comparison to the control group. The prognosis of motor improvement was better in the groups of delayed MEP than the groups of no evoked MEP. Conclusion : The CMCT of hemiparetic and contralateral sides were delayed in acute ischemic stroke, compared with control group and were returned to normal boundaries in subacute state. But in the most cases with no MEP response in the initial study, also showed no MEP response in the follow-up study. The recovery occurred in the subacute state in cases with mild hemiparesis, whereas recovery did not occur in the subacute stage in case with severe hemiparesis.

  • PDF

Even in Patients with a Small Hemorrhagic Volume, Stereotactic-Guided Evacuation of Spontaneous Intracerebral Hemorrhage Improves Functional Outcome

  • Kim, Young-Zoon;Kim, Kyu-Hong
    • Journal of Korean Neurosurgical Society
    • /
    • v.46 no.2
    • /
    • pp.109-115
    • /
    • 2009
  • Objective: The decision to adopt a conservative or surgical modality for a relatively small volume of spontaneous intracerebral hemorrhage (SICH) is difficult and often controversial, especially when consciousness is tolerable. The authors examined the results of stereotactic-guided evacuation of SICH for relatively small volumes with respect to functional outcome. Methods: This prospective study was performed on 387 patients with SICH who underwent stereotactic-guided evacuation (n = 204, group A) or conservative treatment (n = 183, group B) during the past 8 years. The primary end-point was recovery of functional status, which was estimated using the Modified Barthel Index (MBI) and the modified Rankin Scale (mRS). Results: All patients had a Glasgow coma scale (GCS) score of $\geq$ 13 and unilateral hemiparesis of less than motor power grade 3. Group demographic characteristics and initial neurological statuses were similar. In all cases, the volume of SICH involved was < 30 cm$^3$ and location was limited to basal ganglia and thalamus. At 6-month follow-ups, MBI was 90.9 in group A and 62.4 in group B (p < 005), and MRS was 1.2 in group A and 3.0 in group B (p < 0.05). Better motor function and stereotactic-guided evacuation had a significant effect on a functional recovery in regression analyses. Conclusion: Even in patients with a small volume of SICH, stereotactic-guided evacuation improved functional recovery in activities in daily life than conservative treatment did.