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.

Monday, November 16, 2020

Evidence of Neuroplasticity With Robotic Hand Exoskeleton Study for Post-Stroke Rehabilitation: A Randomized Controlled Trial

 I expect a protocol to be written about this and delivered to all 10 million yearly stroke survivors  now and into the future.

Evidence of Neuroplasticity With Robotic Hand Exoskeleton Study for Post-Stroke Rehabilitation: A Randomized Controlled Trial

Preprint from Research Square, 10 Nov 2020
DOI: 10.21203/rs.3.rs-67841/v2 PPR: PPR236907 

Preprint v2

This article is a preprint. It may not have been peer reviewed.

Preprint version history

  • Version 2 [10 Nov 2020]
  • Version 1 [02 Sep 2020]

Abstract 

Abstract 
Background : 
A novel electromechanical robotic-exoskeleton was designed in-house for rehabilitation of wrist joint and Metacarpophalangeal (MCP) joint. 
Objective: 
The objective was to compare the rehabilitation effectiveness (clinical-scales and neurophysiological-measures) of robotic-therapy training-sessions with dose-matched control in patients with stroke.  
 
Methods: 
A pilot prospective parallel single-blinded randomized controlled study at clinical-settings was designed with patients with stroke within 2 years of chronicity. Patients were randomly assigned to receive an intervention of 20 sessions of 45-minutes each, five days a week for four-weeks, in Robotic-therapy Group (RG) (n=12) and conventional upper-limb rehabilitation in Control-Group (CG) (n=11). We hypothesized to evaluate the exoskeleton based therapy for the effects on functionality of upper-limb and cortical-excitability in patients with stroke as compared to conventional-rehabilitation. Clinical-scales– Modified Ashworth Scale, Active Range of Motion, Barthel-Index, Brunstrom stage and Fugl-Meyer scale (Shoulder/Elbow and Wrist/Hand component), and neurophysiological-measures of cortical-excitability (using Transcranial Magnetic Stimulation) –Motor Evoked Potential and Resting Motor-threshold, were acquired pre and post-therapy. No side effects were noticed in any of the patients. Results : RG and CG showed significant (p<0.05) improvement in all clinical motor-outcomes except Modified Ashworth Scale in CG. RG showed significantly (p<0.05) higher improvement over CG in Modified Ashworth Scale, Active Range of Motion and Fugl-Meyer (FM) scale and FM Wrist-/Hand component). Increase in cortical-excitability in ipsilesional hemisphere was found to be statistically significant (p<0.05) in RG over CG, as indexed by decrease in Resting Motor-Threshold and increase in amplitude of Motor Evoked Potential. No significant changes were shown by the contralesional-hemisphere. Interhemispheric RMT-asymmetry evidenced significant (p<0.05) changes in RG over CG indicating increased cortical-excitability in ipsilesional-hemisphere along with interhemispheric changes. 
Conclusion: 
Neurophysiological changes in RG could most likely be a consequence of plastic-reorganization and use-dependent plasticity. Robotic-exoskeleton training could significantly improve motor-outcomes and cortical-excitability in patients with stroke.
 
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