Not sure what this is trying to say, incomprehensible to me. I guess I'm not smart enough to understand stroke research, which obviously means I should not be commenting on stupid stroke research. So my 24,330 posts on stroke are all invalid. Guess I should just shut up and let stroke continue to fail survivors spectactularly. But I will persevere anyway since someone needs to tell the stroke medical world they are all naked.
Regional cerebral blood perfusion changes in chronic stroke survivors as potential brain correlates of the functional outcome following gamified home-based rehabilitation (IntelliRehab)—a pilot study
Journal of NeuroEngineering and Rehabilitation volume 19, Article number: 94 (2022)
Abstract
Background
Hospital-based stroke rehabilitation for stroke survivors in developing countries may be limited by staffing ratios and length of stay that could hamper recovery potential. Thus, a home-based, gamified rehabilitation system (i.e., IntelliRehab) was tested for its ability to increase cerebral blood flow (CBF), and the secondary impact of changes on the upper limb motor function and functional outcomes.
Objective
To explore the effect of IntelliRehab on CBF in chronic stroke patients and its correlation with the upper limb motor function.
Methods
Two-dimensional pulsed Arterial Spin Labelling (2D-pASL) was used to obtain CBF images of stable, chronic stroke subjects (n = 8) over 3-months intervention period. CBF alterations were mapped, and the detected differences were marked as regions of interest. Motor functions represented by Fugl-Meyer Upper Extremity Assessment (FMA) and Stroke Impact Scale (SIS) were used to assess the primary and secondary outcomes, respectively.
Results
Regional CBF were significantly increased in right inferior temporal gyrus and left superior temporal white matter after 1-month (p = 0.044) and 3-months (p = 0.01) of rehabilitation, respectively. However, regional CBF in left middle fronto-orbital gyrus significantly declined after 1-month of rehabilitation (p = 0.012). Moreover, SIS-Q7 and FMA scores significantly increased after 1-month and 3-months of rehabilitation. There were no significant correlations, however, between CBF changes and upper limb motor function.
Conclusions
Participants demonstrated improved motor functions, supporting the benefit of using IntelliRehab as a tool for home-based rehabilitation. However, within-participant improvements may have limited potential that suggests the need for a timely administration of IntelliRehab to get the maximum capacity of improvement.
Introduction
Cerebrovascular disease (CVD) such as stroke is the third leading cause of death in the United States, Canada, Europe, and Japan. The American Heart Association and the American Stroke Association estimated that approximately 800,000 new strokes occur each year, resulting in more than 130,000 annual deaths in the U.S. alone [1]. CVD is also the second leading cause of disability-adjusted life-years (DALYs) [2]. In Malaysia, the incidence rate for both hemorrhagic and ischemic stroke has increased annually by 18.7% and 29.5% respectively, making stroke as the third leading cause of mortality [3].
Previous studies had shown that lesion localization influences the functional outcome of stroke patient, hence, different infarct locations will lead to different pattens of brain injury and functional reorganization [4]. Also, the blood supply in the involved regions may be affected by the ischemic infarct that leads to tissue damage in the peri-infarct regions. Studies have demonstrated that cerebral blood flow (CBF) disruption that arises from stroke can influence the lesion areas, homologous sites in the contralesional hemisphere and even in remote regions that are generally connected to the site of injury [5,6,7,8]. Thus, abnormal CBF may have an effect on the hemodynamic response [9,10,11], and decreased CBF in neuroanatomically intact regions may still contribute to functional deficits [12]. Previous research had suggested that different CBF alteration patterns in chronic stroke patients with different infarct locations within subcortical motor pathways, potentially provide important information for the initiation of individualized rehabilitation strategies for stroke patients involving different infarct types [13].
In this study, we sought to understand the effect of IntelliRehab (which is an intelligent medical system with customized exercises for personalized home telerehabilitation) on CBF in the whole brain and the associated region of interests (ROI). The aim of this study was therefore to measure changes in the CBF patterns of different infarction locations involving the motor pathways, and its correlation on upper limb motor function.
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