Deans' stroke musings: Effectiveness of neurofeedback using near-infrared spectroscopy to enhance the efficacy of motor imagery-based rehabilitation in stroke patients: A Randomized trial

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, April 28, 2020

Effectiveness of neurofeedback using near-infrared spectroscopy to enhance the efficacy of motor imagery-based rehabilitation in stroke patients: A Randomized trial

Useless. NO PROTOCOL, requests further study.

Using Fugl-Meyer for anything in stroke is the height of stupidity, nothing objective in it, so nothing is repeatable.

Effectiveness of neurofeedback using near-infrared spectroscopy to enhance the efficacy of motor imagery-based rehabilitation in stroke patients: A Randomized trial

K J S SHAKTHI,

First published April 14, 2020,

Citation

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Abstract

Objective:

To study if neurofeedback using Near-infrared spectroscopy can enhance cortical activation associated with motor imagery in post-stroke rehabilitation

Background: Several reported previously on motor imagery-based rehabilitation in stroke patients. However, these reports have been irreconcilable. We studied along with motor imagery, whether Neurofeedback using Near-Infrared spectroscopy(NIRS) can enhance the efficacy of rehabilitation in stroke patients.

Design/Methods: Sixty patients with hemiplegia due to ischemic and hemorrhagic strokes visiting the AIIMS Neurology department from May 2017 to January 2019 were included in the study. The patients were randomly allocated into two groups. The intervention group received mental practice with motor imagery along with Neurofeedback using near-infrared spectroscopy. Both groups received standard stroke management.

Results: The patients in the intervention group showed significant improvement in the cortical activation when compared to the control group as measured by the change in oxyhemoglobin. At the end of 3 months HbO decreased in the control group(−0.6 + 6.6) whereas it increased in the intervention group(4.7 + 8.8) with a difference of −5.4, 95% Confidence Interval (CI) −9.4 to −1.4, p=0.008]. However, it failed to show a statistically significant difference in the clinical outcomes measured using Fugl Meyer Assessment Scale (90.8 + 30.9 and 101.8 + 26.0 in intervention and control group respectively with a difference of 10.9, 95% CI −3.7 to 25.6, p=0.14 ) and modified Rankin Scale (2.8 + 0.5 and 2.8 + 0.6 in intervention and control group respectively with 95% CI −0.3 to 0.2, p=0.79 ) in both the groups at the end of 3 months.

Conclusions: The Neurofeedback using NIRS has the potential to enhance the outcome of motor imagery-based rehabilitation in stroke patients. Further studies with large sample size and long follow up periods are required to establish the role of Neurofeedback with motor imagery in improving the motor recovery.

Disclosure: Dr. KJS has nothing to disclose. Dr. Prasad has nothing to disclose.

2 comments:

Peter G LevineApril 28, 2020 at 9:59 PM
Dude, don't dis the Fugl-Meyer. It correlates well with fMRI, TMS, and kinematic data. Yes, its true, I've done more of this test than anyone in the universe, so I'm biased. Also, it is true that in most studies people don't know how to do it (its kinda detailed). But, its a great test.
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