Motor recovery after stroke_ a systematic review of the literature (pdf download available)

To collect and integrate existing data concerning the occurrence, extent, time course, and prognostic determinants of motor recovery after stroke using a systematic methodologic approach.

A computer-aided search in bibliographic databases was done of longitudinal cohort studies, original prognostic studies, and randomized controlled trials published in the period 1966 to November 2001, which was expanded by references from retrieved articles and narrative reviews.

After a preliminary screening, internal, external, and statistical validity was assessed by a priori methodologic criteria, with special emphasis on the internal validity.

The studies finally selected were discussed, based on the quantitative analysis of the outcome measures and prognostic determinants. Database keys with example Meta-analysis was pursued, but was not possible because of substantial heterogeneity.

The search resulted in 174 potentially relevant studies, of which 80 passed the preliminary screening and were subjected to further methodologic assessment; 14 studies were finally selected. Data recovery xfs Approximately 65% of the hospitalized stroke survivors with initial motor deficits of the lower extremity showed some degree of motor recovery. Database management systems 3rd edition In the case of paralysis, complete motor recovery occurred in less than 15% of the patients, both for the upper and lower extremities. Database engineer salary Hospitalized patients with small lacunar strokes showed relatively good motor recovery. Jstor database The recovery period in patients with severe stroke was twice as long as in patients with mild stroke. E m database The initial grade of paresis was the most important predictor for motor recovery (odds ratios [OR], >4). Data recovery richmond va Objective analysis of the motor pathways by motor-evoked potentials (MEPs) showed even higher ORs (ORs, >20).

Our knowledge of motor recovery after stroke in more accurate, quantitative, and qualitive terms is still limited. Data recovery software Nevertheless, our data synthesis and quantitative analysis comprises data from many methodologically robust studies, which may support the clinician in the management of stroke patients. Data recovery advisor With respect to early prognosis of motor recovery, our review confirms clinical experience that the initial grade of paresis (as measured on admission in the hospital) is the most important predictor, although the accuracy of prediction rapidly improves during the first few days after stroke. Database host name Initial paralysis implies the worst prognosis for subsequent motor recovery. Database performance Remarkably, the prognostic accuracy of MEPs appears much higher than that of clinical examination for different subgroups of patients.

[Show abstract] [Hide abstract] ABSTRACT: Various degrees of neural reorganization may occur in affected and unaffected hemispheres in the early phase after stroke and several months later. Data recovery broken hard drive Recent literature suggests to apply a stratification based on lesion location and to consider patients with cortico-subcortical and subcortical strokes separately: different lesion location may also influence therapeutic response. Database xe In this study we used a longitudinal approach to perform TMS assessment (Motor Evoked Potentials, MEP, and Silent Period, SP) and clinical evaluations (Barthel Index, Fugl-Meyer Assessment for upper limb motor function and Wolf Motor Function Test) in 10 cortical-subcortical and 10 subcortical ischemic stroke patients. Database yml mysql Evaluations were performed in a window between 10 and 45 days (t0) and at 3 months after the acute event (t1). 5 database is locked Our main finding is that 3 months after the acute event patients affected by subcortical stroke presented a reduction in contralateral SP duration in the unaffected hemisphere; this trend is related to clinical improvement of upper limb motor function. Database fundamentals In conclusion, SP proved to be a valid parameter to characterize cortical reorganization patterns in stroke survivors and provided useful information about motor recovery within three months in subcortical patients.

Hybrid assistive neuromuscular dynamic stimulation (HANDS) therapy improved paretic upper extremity motor function in patients with severe to moderate hemiparesis. Database concepts We hypothesized that brain machine interface (BMI) training would be able to increase paretic finger muscle activity enough to apply HANDS therapy in patients with severe hemiparesis, whose finger extensor was absent.

Twenty-nine patients with chronic stroke who could not extend their paretic fingers were participated this study. Database icon We applied BMI training for 10 days at 40 min per day. Database versioning The BMI detected the patients’ motor imagery of paretic finger extension with event-related desynchronization (ERD) over the affected primary sensorimotor cortex, recorded with electroencephalography. Database 2013 Patients wore a motor-driven orthosis, which extended their paretic fingers and was triggered with ERD. Database cursor When muscle activity in their paretic fingers was detected with surface electrodes after 10 days of BMI training, we applied HANDS therapy for the following 3 weeks. Database list In HANDS therapy, participants received closed-loop, electromyogram-controlled, neuromuscular electrical stimulation (NMES) combined with a wrist-hand splint for 3 weeks at 8 hours a day. Database queries must be Before BMI training, after BMI training, after HANDS therapy and 3month after HANDS therapy, we assessed Fugl-Meyer Assessment upper extremity motor score (FMA) and the Motor Activity Log14-Amount of Use (MAL-AOU) score.

After 10 days of BMI training, finger extensor activity had appeared in 21 patients. Database journal Eighteen of 21 patients then participated in 3 weeks of HANDS therapy. Data recovery boston We found a statistically significant improvement in the FMA and the MAL-AOU scores after the BMI training, and further improvement was seen after the HANDS therapy.