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
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.
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.
ReplyDeleteAh well, something better will eventually come; 1, performs partially; is a humongous range, never be able to find small improvements in there
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