Monday, April 9, 2018

Combined Transcranial Direct Current Stimulation and Virtual Reality-Based Paradigm for Upper Limb Rehabilitation in Individuals with Restricted Movements. A Feasibility Study with a Chronic Stroke Survivor with Severe Hemiparesis

How many fucking times does virtual reality need to be proven in research before someone writes up a fucking stroke protocol on it? NEVER I BET.
With 89 virtual reality posts back to September, 2011 it just shows the fucking incompetence in stroke.   Is this anodal tDCS, cathodal tDCS or HD-tDCS?
https://link.springer.com/article/10.1007/s10916-018-0949-y


  • María Antonia Fuentes
  • Adrián Borrego
  • Jorge Latorre
  • Carolina Colomer
  • Mariano Alcañiz
  • María José Sánchez-Ledesma
  • Enrique Noé
  • Roberto Llorens
  • María Antonia Fuentes
    • 1
  • Adrián Borrego
    • 2
  • Jorge Latorre
    • 2
  • Carolina Colomer
    • 1
  • Mariano Alcañiz
    • 2
  • María José Sánchez-Ledesma
    • 3
  • Enrique Noé
    • 1
  • Roberto Llorens
    • 1
    • 2
  1. 1.Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales VITHAS-NISAFundación Hospitales NISAValenciaSpain
  2. 2.Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en BioingenieríaUniversitat Politècnica de ValènciaValenciaSpain
  3. 3.VisualMed Systems GroupUniversity of SalamancaSalamancaSpain
Patient Facing Systems
Part of the following topical collections:
  1. Emergent Visualization Systems in Biomedical Sciences (TEEM 2017)

Abstract

Impairments of the upper limb function are a major cause of disability and rehabilitation. Most of the available therapeutic options are based on active exercises and on motor and attentional inclusion of the affected arm in task oriented movements. However, active movements may not be possible after severe impairment of the upper limbs. Different techniques, such as mirror therapy, motor imagery, and non-invasive brain stimulation have been shown to elicit cortical activity in absence of movements, which could be used to preserve the available neural circuits and promote motor learning. We present a virtual reality-based paradigm for upper limb rehabilitation that allows for interaction of individuals with restricted movements from active responses triggered when they attempt to perform a movement. The experimental system also provides multisensory stimulation in the visual, auditory, and tactile channels, and transcranial direct current stimulation coherent to the observed movements. A feasibility study with a chronic stroke survivor with severe hemiparesis who seemed to reach a rehabilitation plateau after two years of its inclusion in a physical therapy program showed clinically meaningful improvement of the upper limb function after the experimental intervention and maintenance of gains in both the body function and activity. The experimental intervention also was reported to be usable and motivating. Although very preliminary, these results could highlight the potential of this intervention to promote functional recovery in severe impairments of the upper limb.

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