Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, August 27, 2019

Treadmill training augmented with real-time visualisation feedback and function electrical stimulation for gait rehabilitation after stroke: a feasibility study

But what about all these other treadmills? Don't you believe in testing the complete universe of treadmills? Or too lazy to do them all?  So once again we will need followup research to identify the best intervention via treadmill. What a fucking waste just because we have NO stroke leadership and NO stroke strategy. 

Stroke Rehabilitation and the AlterG - Anti-gravity treadmill

 

The treadmill bike!?

 

air pressure treadmill 

 

Turning-Based Treadmill 

 

Air pressure treadmill instantly sheds 80% of your weight

 

underwater treadmill

 

Split Belt Treadmill 

 

rotating treadmill

 The latest here:

Treadmill training augmented with real-time visualisation feedback and function electrical stimulation for gait rehabilitation after stroke: a feasibility study

Abstract

Background

Stroke rehabilitation often uses the motor relearning concept that require patients to perform active practice of skill-specific training and to receive feedback. Treadmill training augmented with real-time visualisation feedback and functional electrical stimulation may have a beneficial synergistic effect on motor recovery. This study aims to determine the feasibility of this kind of enhanced treadmill training for gait rehabilitation among patients after stroke.

Methods

A system for dynamic visualisation of lower-limb movement based on 3-dimentional motion capture and a computer timed functional electrical stimulation system was developed. Participants received up to 20-min enhanced treadmill training instead of their over-ground gait training once or twice a week for 6 weeks at Coathill hospital, Lanarkshire, United Kingdom. Number of training sessions attended, and training duration were used to assess feasibility. Ankle kinematics in the sagittal plane of walking with and without functional electrical stimulation support of the pre-tibial muscles were also compared and used to confirm the functional electrical stimulation was triggered at the targeted time.

Results

Six patients after stroke participated in the study. The majority of participants were male (5/6) with a age range from 30 to 84 years and 4/6 had left hemiplegia. All participants suffered from brain infarction and were at least 3 months after stroke. Number of training sessions attended ranged from 5 to 12. The duration of training sessions ranged from 11 to 20 min. No serious adverse events were reported. The computerised functional electrical stimulation to the pre-tibial muscles was able to reduce plantarflexion angle during the swing phase with statistical significance (p = 0.015 at 80%; p = 0.008 at 90 and 100% of the gait cycle).

Conclusions

It is safe and feasible to use treadmill gait training augmented with real-time visual feedback and computer-controlled functional electrical stimulation with patients after stroke in routine clinical practice.

Trial registration

NCT03348215. Registered 20 November 2017.

Background

Stroke is a common neurological disease leading to many impairments and disabilities [1, 2]. The loss of or difficulty with walking is one of the most common concerns of stroke survivors. Impairment of motor control are the most common sequelae after stroke affecting approximately two third of stroke survivors [3], and seems to be the major contribution to walking difficulty after stroke. Patients immediately after a significant stroke are often dependent ambulators. Although, most patients after stroke are able to walk after a period of time often involving a rehabilitation programme, many of them do not reach community ambulation levels [4].
To encourage neuroplasticity, stroke rehabilitation often uses the motor relearning concept that requires patients to perform active practice of skill-specific training and to receive feedback [5]. Functional electrical stimulation (FES) is the application of a low-level electrical current to elicit contraction in weak or paralyzed muscles due to upper motor neuron injuries/diseases such as stroke. It is used to perform specific functions; for example, arm/hand control, standing, or walking. It can be used as an assistive device (neuroprosthetic effect) or to help restore or improve patient’s movement during rehabilitation such as drop foot stimulation during the swing phase of stroke survivors in gait retraining [6]. Moreover, there is clinical evidence that FES can encourage motor relearning and neuroplasticity by changing cortical excitability and stimulating cortical reorganization (therapeutic effect) [7]. Because stroke can affect gait performance in both stance and swing phase, multichannel FES (MFES) might have the potential for assisting gait training among patients after stroke. The clinical evidence indicates that MFES improves gait performance among patients with chronic stroke [8, 9]. The use of MFES for acute stroke combined with treadmill training may also be feasible and safe [10, 11] and may enhance acute recovery.
Three-dimensional kinematic motion capture systems (3D-MoCap) are one of the most accurate investigation tools for gait analysis. They can provide joint and segment kinematics, gait parameters, and can determine phases of the gait cycle. Nowadays, due to advanced computer technologies, 3D-MoCap can be used to create dynamic visualisation of lower-limb movement which provide patients after stroke with real-time visual feedback for motor relearning [12, 13]. It can also provide patients with a real-time feedback-controlled treadmill that adjusts continuously the treadmill speed to the patients’ gait speed which is called self-paced treadmill walking [14]. Treadmill training with or without body-weight support has been shown to increase walking speed and capacity but not to achieve greater levels of independent walking. However, treadmill training augmented by real-time visualisation feedback and computer-controlled FES may have a beneficial synergistic effect [15] and may enhance recovery. Hence, the present study aims to develop a 3D-MoCap based MFES system and to determine the feasibility of the treadmill training enhanced with real-time visual feedback and computerised FES for gait rehabilitation among patients after stroke.

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