Use the labels in the right column to find what you want. Or you can go thru them one by one, there are only 33,991 posts. Searching is done in the search box in upper left corner. I blog on anything to do with stroke. DO NOT DO ANYTHING SUGGESTED HERE AS I AM NOT MEDICALLY TRAINED, YOUR DOCTOR IS, LISTEN TO THEM. BUT I BET THEY DON'T KNOW HOW TO GET YOU 100% RECOVERED. I DON'T EITHER BUT HAVE PLENTY OF QUESTIONS FOR YOUR DOCTOR TO ANSWER.
Changing stroke rehab and research worldwide now.Time is Brain!trillions and trillions of neuronsthatDIEeach day because there areNOeffective 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.
Showing posts with label Margaret Yekutiel. Show all posts
Showing posts with label Margaret Yekutiel. Show all posts
Absolutely nothing here gets survivors recovered! You're all fired!
(Margaret
Yekutiel wrote a whole book about this in 2001, 'Sensory Re-Education
of the Hand After Stroke'. Does your incompetent? doctor and therapists even know about it?)
We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.
Abstract
Background
Post-stroke reorganization of the prefrontal-sensorimotor network is critical for functional recovery, yet single connectivity metrics fail to capture its multidimensional characteristics. This exploratory study investigates network reorganization patterns and their clinical relevance to motor function and daily independence using multimodal electroencephalography (EEG) connectivity analysis, including Coherence (COH), phase lag index (PLI), and Granger causality (GC).
Methods
Resting-state EEG from stroke patients (n = 22) and healthy controls (n = 22) was analyzed. COH, PLI, and GC metrics were computed for key regional connections involving the prefrontal (PFC), motor (MC), sensory (SC), and parietal (PC) cortices and correlated with Fugl-Meyer Assessment for Upper Extremity (FMA-UE) and Modified Barthel Index(MBI) scores. For stroke patients, hemispheres were classified as ipsilesional (i, affected) and contralesional (c, unaffected) based on the lesion side.
Results
Compared to healthy controls, stroke patients exhibited distinct reorganization patterns. Preliminary evidence suggests enhanced parietal-motor coherence (COH_cPC-cMC↑) in the unaffected hemisphere alongside reduced motor-to-prefrontal directed connectivity (GC_cMC→cPFC↓). Interhemispherically, the findings may indicate weakened information flow from the unaffected to affected motor/sensory areas (GC_cMC→iMC↓, GC_cMC→iSC↓), accompanied by reduced bilateral motor synchronization (PLI_iMC-cMC↓). Within the affected hemisphere, there was evidence of enhanced bidirectional parietal-motor phase transfer (PLI_iPC-iMC↑), whereas directed pathways were significantly impaired (GC_iMC→iSC↓, GC_iPC→iSC↓, GC_iPFC→iMC↓). Clinically, the affected motor-to-sensory pathway (GC_iMC→iSC) showed a strong negative correlation with the MBI (r = -0.61, P = 0.002), and both interhemispheric motor regulation (GC_cMC→iMC) and synchronization (PLI_iMC-cMC) were significantly correlated with functional deficits (P < 0.05).
Conclusion
Post-stroke networks may exhibit a “local compensation-global impairment” reorganization pattern. The affected motor-sensory pathway (GC_iMC→iSC) may be a biomarker for functional independence and thus allow for guided sensory integration-based precision rehabilitation.
Summary: Stroke remains a primary driver of long-term adult disability globally. Even when survivors undergo intensive early-stage physical therapy, immense numbers continue to struggle with permanent upper limb deficits, experiencing a profound loss of hand dexterity, blunted sensory perception, and distorted body ownership.
While standard rehabilitation routines can slowly improve basic muscle mechanics, they almost exclusively prioritize raw movement training. This leaves underlying sensory deficits and altered body awareness virtually unaddressed, leaving a critical structural gap in comprehensive neuro-rehabilitation strategy.
To close this therapeutic gap, an international engineering coalition developed MultiSensy, a personalized rehabilitation platform that seamlessly merges immersive virtual reality (VR) with real-time transcutaneous electrical nerve stimulation (TENS). Rather than treating movement in a vacuum, MultiSensy pairs targeted digital tasks (such as reaching, grasping, and pinching) with synchronized skin electrodes that physically recreate the tactile sensation of touching virtual objects.
Key Facts
The Hybrid MultiSensy Array: MultiSensy combines an immersive, task-based VR environment with real-time skin electrodes that stimulate peripheral nerves, enabling stroke survivors to physically feel the shape, position, and texture of virtual digital objects.
Doubling Motor Recovery Rate: On the Fugl-Meyer Assessment (FMA-UE)—the global clinical gold standard for measuring post-stroke upper limb motor recovery—the MultiSensy group demonstrated nearly twice the structural improvement seen in the conventional control group.
Everyday Functional Gains: Participants using the sensory-VR platform achieved massive functional leaps on the Action Research Arm Test (ARAT), proving that the combined training transfers directly into everyday life activities like forearm rotation and pinching.
Healing Altered Body Somatognosis: Beyond restoring motor control, the real-time electrical feedback successfully repaired touch deficits and reduced body schema distortions, such as patients perceiving their paralyzed arm as warped in size, shape, or space.
Continuous Kinematic Data Logging: The MultiSensy platform functions as an active diagnostic tool, continuously harvesting precise movement and trajectory data during gameplay to supply clinicians with automated, objective indicators of recovery.
Chronic-Phase Efficacy: The clinical trial confirms that sensory-motor integration can successfully trigger neuroplastic recovery in chronic stroke patients long after the acute event (greater than three months post-stroke), clearing a pathway for future home-based, decentralized therapy.
Source: University of Vienna
Stroke is one of the leading causes of long-term disability worldwide. Even after intensive early physiotherapy, many stroke survivors continue to live with reduced arm and hand function, impaired sensation and altered body awareness long after the initial event.
While conventional rehabilitation can improve motor functions, it often focuses primarily on movement training, instead sensory deficits and body awareness are frequently given insufficient attention. There is therefore a need for more comprehensive rehabilitation strategies.
Combining immersive tasks with electrotactile feedback accelerates upper limb motor recovery by closing the brain’s processing loop. Credit: Neuroscience NewsPersonalised training in a virtual environment
To address this need, a research team led by Stanisa Raspopovic (Center for Medical Physics and Biomedical Engineering, MedUni Vienna) has developed “MultiSensy”, a rehabilitation platform for patients with arm and hand impairments following a stroke, which combines immersive virtual reality with transcutaneous electrical nerve stimulation. The system turns rehabilitation exercises into interactive virtual tasks designed to train specific arm and hand functions, including reaching, grasping, pinching, and forearm rotation.
At the same time, electrodes attached to their skin stimulate the nerves in real time, allowing participants to feel virtual objects as if they were physically touching them. Inspired by occupational therapy principles, the games can be adapted to each participant’s impairment level, allowing training to be both targeted and engaging.
“Our aim was to go beyond mere movement training,” says study leader Stanisa Raspopovic. “After a stroke, patients often have difficulty not only moving the affected limb, but also feeling it and perceiving it correctly. MultiSensy was developed to reconnect movement, sensation and body awareness during rehabilitation.” (Fixing proprioception then!)
The system was tested on 34 patients who had suffered a stroke more than three months before the study. Some participants trained using MultiSensy: they wore VR goggles and performed arm and hand exercises in a digital training environment designed to simulate everyday tasks. The control group received conventional rehabilitation, including physiotherapy and occupational therapy. Both groups completed a three-week rehabilitation protocol consisting of twelve training sessions. The clinical examinations were supported by a team from the Faculty of Medicine in Belgrade.
Improvements in function and body perception
The study showed greater improvements in arm and hand recovery in participants treated with MultiSensy than in those receiving conventional rehabilitation. In the Fugl-Meyer Assessment for the upper limb, a standard measure of motor impairment after stroke, the MultiSensy group showed nearly twice the improvement observed in the control group. Similar benefits were also seen in the Action Research Arm Test, which evaluates how well patients can use their arm and hand in everyday functional tasks. But motor disability is just a part of the problem.
“After a stroke, some patients struggle to feel touch in their affected hand and may even perceive the arm as distorted in size, shape, or position. Participants treated with the new system showed improvements in their sense of touch and in perception of their affected arm,” adds lead author Valerio Aurucci (ETH Zurich).
Furthermore, the platform collects movement data during training, providing objective indicators of rehabilitation progress. This allows patients’ performance and recovery to be monitored over time, helping clinicians to assess progress more precisely and adapt therapy for each individual.
“The results provide early clinical evidence that immersive virtual reality combined with sensory nerve stimulation can support recovery after stroke, even after months from the event”, says Stanisa Raspopovic.
“The technology is still at the research stage, and larger clinical trials are needed to confirm its benefits. However, the study opens a promising perspective for future personalised and potentially home-based stroke rehabilitation.”
Key Questions Answered:
Q: Why does adding tactile electrical simulation to a VR game make a stroke survivor’s paralyzed arm recover twice as fast?
A: When a stroke damages the brain’s motor networks, it doesn’t just interrupt the signals going out to the muscles; it also breaks the sensory pathways coming back in. Traditional therapy focuses on moving the limb, but without sensory feedback, the brain struggles to map out and rewire the damaged circuits. MultiSensy fixes this by closing the sensory-motor loop. When a patient reaches out in VR and grabs a digital cup, electrodes instantly stimulate their skin nerves to mimic the physical touch. This combined blast of visual intent and tactile reality forces the brain’s remaining pathways to undergo accelerated neuroplasticity, effectively doubling the speed of motor recovery.
(Margaret
Yekutiel wrote a whole book about this in 2001, 'Sensory Re-Education
of the Hand After Stroke'. Does your incompetent? doctor and therapists even know about it?)
Q: What is a “distorted body schema,” and how does this technology help fix it after a stroke?
A: Following a stroke, the brain can lose its internal map of the body, a condition known as distorted body somatognosis. Because the brain is no longer receiving healthy baseline signals from the affected limb, patients often perceive their arm as a dead weight, or even visualize it as warped, swollen, or structurally altered in size and position. By immersing patients in a virtual environment where they see a healthy digital arm moving perfectly in tandem with their real-world attempts, while simultaneously feeling accurate touch bursts, MultiSensy anchors the brain back to reality. This multi-sensory synchronization recalibrates the brain’s internal map, restoring an accurate sense of touch and limb ownership.
Q: Is this technology ready for stroke patients to use at home right now?
A: Currently, MultiSensy is still in its advanced research and clinical validation phase, meaning it isn’t quite ready for commercial purchase or deployment in home kitchens. While this initial 34-patient clinical trial delivered phenomenal proof-of-concept evidence, larger and more diverse clinical trials are required to fully clear safety and regulatory hurdles. However, because the system relies on portable VR headsets and standard transcutaneous skin electrodes rather than massive, hospital-locked robotic exoskeletons, the ultimate goal of the research team is to scale this into an affordable, home-based, personalized telerehabilitation system.
Editorial Notes:
This article was edited by a Neuroscience News editor.
Journal paper reviewed in full.
Additional context added by our staff.
About this stroke and neurotech research news
Author: Karin Kirschbichler Source: University of Vienna Contact: Karin Kirschbichler – University of Vienna Image: The image is credited to Neuroscience News
Margaret
Yekutiel wrote a whole book about this in 2001, 'Sensory Re-Education
of the Hand After Stroke'.
Of course, your competent? doctor put
together somatosensory protocols from this earlier research a long time
ago to prevent cognitive impairment, right? Oh no, you DON'T
have a functioning stroke doctor, do you? Too bad, it's your problem to
solve since your stroke hospital board of directors is fucking
incompetent in running their hospital! 25 years of incompetence! WOW, that's got to be a record for staying incompetent!
I bet your doctor isn't competent enough to get this research going in stroke subjects!
The links between sensory and motor impairments and mild cognitive impairment remain poorly understood.
These associations persisted across two large cross-sectional cohorts.
Higher sensorimotor function was associated with reduced likelihood
of mild cognitive impairment in two cohorts of older individuals,
according to findings published in Alzheimer’s & Dementia.
“Identifying precursors to mild cognitive impairment (MCI) — the
transitional stage between unimpaired cognition and dementia — is a
public health priority,” Amal A.Wanigatunga, PhD, MPH, FACSM, assistant professor of epidemiology, Johns Hopkins Bloomberg School of Public Health, and colleagues, wrote.
Data derived from Wanigatunga AA, et al. Alz & Dem. 2026;doi:10.1002/alz.71332.
The potential links between sensory and motor impairments and MCI
remain poorly understood, according to the researchers. “Their
integrated contribution as a sensorimotor construct remains
underexplored,” they wrote.
Wanigatunga and colleagues analyzed cross-sectional data from
the Atherosclerosis Risk in Communities (ARIC; n = 880; 63,4% women) and
Baltimore Longitudinal Study of Aging (BLSA; n = 681; 56.8% women). The
mean age of participants in the ARIC cohort was 78.9 years, while the
mean age of the BLSA cohort was 74.4 years, according to the findings.
Eligibility criteria stipulated that individuals with stroke, Parkinson’s disease or dementia were excluded from the study.The researchers compiled a composite score for sensorimotor function
that included variables such as hearing, vision, olfaction, balance,
gait speed, and grip strength.
Assessment of participants in the ARIC cohort showed that 59% had
unimpaired balance, while 71% had unimpaired walking speed, 65% had
unimpaired strength and performance, and 61% demonstrated unimpaired
handgrip strength. Sensory function data showed that 42% had unimpaired
hearing, 27% reported unimpaired vision, and 84% reported unimpaired
olfaction.
The researchers added that participants in the ARIC cohort
demonstrated more unimpaired motor and sensory function prevalence than
the BLSA cohort, including parameters of balance, upper extremities
motor strength and vision.
Results showed that higher sensorimotor function carried an inverse
association with MCI in individuals from both the ARIC cohort (OR =
0.53; 95% CI, 0.4–0.71) and the BLSA cohort (OR = 0.59; 95% CI,
0.43–0.81).
This trend persisted across adjusted analyses for age, race, sex,
education and BMI in both cohorts. Moreover, morbidity and depressive
symptoms also failed to reduce the significance of the associations.
“Sensorimotor function appears robustly related with MCI in a large
sample of older adults,” Wanigatunga and colleagues concluded. “These
findings highlight the potential value of incorporating sensorimotor
assessments in early detection for cognitive decline.”
Margaret
Yekutiel wrote a whole book about this in 2001, 'Sensory Re-Education
of the Hand After Stroke'.
Of course, your competent? doctor put
together somatosensory protocols from this earlier research a long time
ago, right? Oh no, you DON'T
have a functioning stroke doctor, do you? Too bad, it's your problem to
solve since your stroke hospital board of directors is fucking
incompetent in running their hospital! 24 years of incompetence! WOW, that's got to be a record for staying incompetent!
Post-stroke
patients need to be rehabilitated in order to gain partly or fully some
of the motor facilities that seem to have ceased to function
effectively. According to the research, post-stroke deficits in the
human ability to palpate and comprehend surface features is the major
difficulty a stroke survivor may experience; often they cause harm or
accidentally destroy objects due to an incorrect manner of holding them.
This research offers a new strategy with the aid of wearable haptic
interface in the form of a smart glove that employs an ESP32
microcontroller and force sensors to identify surface texture. Using
pattern recognition, we can effectively distinguish between a rough and a
smooth surface to adapt to the pressure required to hold any object.
This innovation apart from improving safety also gives the patient
feedback in the process of rehabilitation. The use of machine learning
in particular proves to be more preferable when it comes to texture
recognition preventing shortcomings observed in other senor-based
approaches.
This would seem to be making the process that Margaret
Yekutiel wrote a whole book about this in 2001, 'Sensory Re-Education
of the Hand After Stroke' automatic.
Of course your competent? doctor put together somatosensory protocols from this earlier research a long time ago, right? Oh no, you DON'T have a functioning stroke doctor, do you? Too bad, it's your problem to solve since your stroke hospital board of directors is fucking incompetent in running their hospital!
Steven Barlow, Corwin Moore Professor in special
education and communication disorders, attaches the pTACS' thermoplastic
tactile "touch" capsules to the hand of Jacob Greenwood, doctoral
candidate in biological systems engineering.
Now,
a group of Husker researchers, led by Steven Barlow, has patented a
groundbreaking frontline treatment — the pTACS Somatosensory Biomedical
Device — for cerebrovascular accidents that is portable, making it a
versatile product for use in rehabilitation clinics, emergency rooms
and, potentially, transport ambulances.
“It's a very low-cost
device,” said Barlow, Corwin Moore Professor in special education and
communication disorders, affiliate faculty in biological systems
engineering and resident faculty in the Center for Brain, Biology and
Behavior. “That means centers and rehabilitation facilities all over the
country and beyond will be able to use this technology. Stroke is the
number one health problem worldwide, now surpassing other types of
diseases.”
The device includes a “smart” pneumatic controller and a
microprocessor that is packaged inside a small black toolbox case and
runs on rechargeable lithium-ion batteries — the same type and size of
battery in a smartphone. The pTACS is a more compact, portable and
precise successor to the Galileo,
which Barlow’s team developed more than a decade ago to research how
somatosensory treatment employing micro pulses of air could aid in
stroke therapy. With funding from the National Institutes of Health,
American Heart Association, Barkley Trust and Nebraska Research, Barlow
was able to develop and fine-tune the somatosensory therapy protocols
through individualized research trials at the University of Nebraska–Lincoln.
The
success of those clinical trials led Barlow and team member Jacob
Greenwood, a doctoral candidate in biomedical engineering, to focus the
design of the device on performance, portability and usability. Barlow
and Greenwood share inventor status on the U.S. patent.
Loren Rye | Pixel Lab
“We take advantage of the inherent anatomy of the human
brain — the way these sensory pathways are laid out — and by placing
these cells on different parts of the body, we can selectively drive
different parts of the brain with tremendous precision.
Steven Barlow
Corwin Moore Professor in special education and communication disorders
The pTACS biomedical device is a non-invasive method of brain
stimulation. It utilizes rapidly compressed air pulses that are
delivered through small plastic tubes into thermoplastic tactile "touch"
capsules adhered to the hands, face, feet or other area of the skin to
evoke repeated volleys of nerve responses. The pTACS stimulation has
been shown to increase blood flow in tissues of the cerebral cortex that
are near the damaged area of the brain. Animal models developed in the Frostig laboratory
at the University of California, Irvine (Lay, Davis, Chen-Bee, Frostig,
2010) have shown that repeated somatosensory stimulation delivered
during critical periods of recovery has the potential to save brain
cells from death, preventing the formation of cerebral infarct.
“We
take advantage of the inherent anatomy of the human brain — the way
these sensory pathways are laid out — and by placing these cells on
different parts of the body, we can selectively drive different parts of
the brain with tremendous precision,” Barlow said.
The toolbox
containing the pTACS hardware and firmware is attached to a small laptop
containing the software to run the machine, delivering a programmed set
of air pulses based on research Barlow and his students have conducted
in the Barkley Speech-Language and Hearing Clinic and the Center for
Brain, Biology and Behavior, and at other area institutions.
“The
connected computer allows the user to select the protocol you want to
run, and once that protocol is selected, it does everything,” Greenwood
said.
Receiving a patent for the pTACS is a step in the process of
getting FDA approval for the device. Barlow said he expects to receive
an additional patent for his stroke treatment protocol and is working
with NUtech Ventures to create a biomedical startup to manufacture and
commercialize the device. Barlow has previous success with developing
and commercializing groundbreaking medical devices. He developed and commercialized the NTrainer System 2.0, now sold and marketed internationally by Cardinal Health as the Kangaroo NTrainer System.
Frontline
stroke treatment could be just one of the pTACS’ therapeutic
possibilities. Barlow and his team are developing and seeking funding to
further research treatment protocols for post-stroke injury and
speech-language therapy functions, including for those on the autism
spectrum disorder.
Loren Rye | Pixel Lab
Jacob Greenwood (front) and Steven Barlow are co-inventors of the recently patented pTACS Somatosensory Biomedical Device.
“We’ve had some patients in the clinic, and they're at least six
months post injury. Some of them are two and three years after their
stroke, and we're still able to generate very significant improvements
in their function,” Barlow said. “This therapy could be administered by a
speech-language pathologist, physical therapist, nurse practitioner or
someone with a neuroscience background.
“In a current MRI study in
collaboration with UNO Department of Biomechanics (Dr. Mukul Mukherjee)
and UNMC Department of Neurology (Dr. Pierre Fayad), we use the pTACS
device to drive mechanosensory nerve endings in the feet to stimulate
the balance and gait system and activate related brain pathways.”
Barlow anticipates more therapeutic uses for the pTACS device will be uncovered through additional research.
“It's
got a really good trajectory,” he said. “And we have a vibrant team. We
have a lot of investigators, and many students interested in this.”
Your competent? doctor already wrote protocols on this 20+ years ago based on Margaret
Yekutiel writing a whole book about this in 2001, 'Sensory Re-Education
of the Hand After Stroke'. Then ask what hand recovery protocols they wrote up from that 2001 book.
Do you prefer your doctor and hospital incompetence NOT KNOWING? OR NOT DOING?
If
they were competent at all they would have done something from this
back in 2001. But they incompetently didn't do anything, did they?
The
current review aims to address critical gaps in the field of stroke
rehabilitation related to sensory impairment. Here, we examine the role
and importance of sensation throughout recovery of neural injury,
potential clinical and experimental approaches for improving sensory
function, and mechanism-based theories that may facilitate the design of
sensory-based approaches for the rehabilitation of somatosensation.
Recent Findings
Recently,
the field of neurorehabilitation has shifted to using more quantitative
and sensitive measures to more accurately capture sensory function in
stroke and other neurological populations. These approaches have laid
the groundwork for understanding how sensory impairments impact overall
function after stroke. However, there is less consensus on which
interventions are effective for remediating sensory function, with
approaches that vary from clinical re-training, robotics, and sensory
stimulation interventions.
Summary
Current
evidence has found that sensory and motor systems are interdependent,
but commonly have independent recovery trajectories after stroke.
Therefore, it is imperative to assess somatosensory function in order to
guide rehabilitation outcomes and trajectory. Overall, considerable
work in the field still remains, as there is limited evidence for
purported mechanisms of sensory recovery, promising early-stage work
that focuses on sensory training, and a considerable evidence-practice
gap related to clinical sensory rehabilitation.
Your competent? doctor already wrote protocols on this 20+ years ago based on Margaret
Yekutiel writing a whole book about this in 2001, 'Sensory Re-Education
of the Hand After Stroke'. Then ask what hand recovery protocols they wrote up from that 2001 book.
Do you prefer your doctor and hospital incompetence NOT KNOWING? OR NOT DOING?
If
they were competent at all they would have done something from this
back in 2001. But they incompetently didn't do anything, did they?
Sensory
feedback is crucial for motor control as it establishes the internal
representation of motion. This study investigates changes in sensory
feedback in hemiparetic stroke by analyzing the laterality index (LI) of
somatosensory evoked potentials (SEPs) during movements of the paretic
arm, focusing on a shift from the lesioned to the contralesional
hemisphere. Three chronic stroke participants performed isometric lifts
of their paretic arms at two different levels of their maximum voluntary
contraction while receiving tactile finger stimulation. We found that
the hemispheric shift of somatosensory processing enhanced with higher
level arm lifting on N100, which is the component related to sensory
feedback. This result may provide a reference for the future development
of personalized neuromuscular electrical stimulation therapy to include
sensory components in motor rehabilitation post-stroke.
When this finally comes out, ask your doctor if anything newer than Margaret
Yekutiel writing a whole book about this in 2001, 'Sensory Re-Education
of the Hand After Stroke' is in there. And ask what hand recovery protocols they wrote up from that 2001 book.
Do you prefer your doctor and hospital incompetence NOT KNOWING OR NOT DOING anything on this?
1. Occupational Therapy, La Trobe University, Melbourne, VIC, Australia 2. Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3084, Australia Interests: neuroplasticity; stroke recovery; neurorehabilitation; touch; somatosensation; neuroimaging; implementation
Special Issue Information
Dear Colleagues,
One in two people lose the sense of touch after stroke. It is like
the hand is blind. If we are to address this problem using restorative
approaches to rehabilitation, we need to both advance our understanding
of the neuroscience of touch and how we might help stroke survivors
regain a sense of touch using approaches founded on neuroplasticity and
learning.
The aim of this special issue is to advance the neuroscience of touch
and recovery of somatosensation after stroke. We invite researchers in
the field to contribute their collective research and knowledge to
address this somewhat hidden problem. We welcome submissions from
pre-clinical and applied fields of research so that we can identify and
synthesise core knowledge and approaches to advance the field. Reviews
and original research papers on: processing of somatosensory
information; neuroimaging of touch and somatosensation; neuoplasticity
of touch; perceptual learning; impairment of touch, proprioceptive and
haptic object recognition after stroke; recovery of somatosensation
after stroke; and restorative approaches to rehabilitation are
encouraged. Clinical studies and studies that employ technologies such
as neuroimaging, magnetoencephalography and artificial intelligence, to
achieve new insights are suited to this Special Issue.
Prof. Dr. Leeanne Carey Guest Editor
Manuscript Submission Information
Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form.
Manuscripts can be submitted until the deadline. All submissions that
pass pre-check are peer-reviewed. Accepted papers will be published
continuously in the journal (as soon as accepted) and will be listed
together on the special issue website. Research articles, review
articles as well as short communications are invited. For planned
papers, a title and short abstract (about 100 words) can be sent to the
Editorial Office for announcement on this website.
Submitted manuscripts should not have been published previously, nor
be under consideration for publication elsewhere (except conference
proceedings papers). All manuscripts are thoroughly refereed through a
single-blind peer-review process. A guide for authors and other relevant
information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.
You'll have to watch this on your own. At 1 hour 13 minutes, way too long for me to waste my time. You can see if there are any references to Margaret
Yekutiel writing a whole book about this in 2001, 'Sensory Re-Education
of the Hand After Stroke'
Is this the flip side of Margaret
Yekutiel writing a whole book about this in 2001, 'Sensory Re-Education
of the Hand After Stroke'. And 21 years later the protocol still hasn't
been done. I'd fire a whole lot of people for such long lasting
incompetence.
NARIC Accession Number: J90012. What's this? ISSN: 1545-9683. Author(s):Borstad, Alexandra; Nichols-Larsen, Deborah; Uswatte, Gitendra; Strahl, Nancy; Simeo, Marie; Proffitt, Rachel; Gauthier, Lynne. Publication Year: 2022. Number of Pages: 10. Abstract:
Study compared the effect of four upper-limb motor rehabilitation
programs on the recovery of tactile sensation in adults with chronic
stroke. One hundred sixty-seven adults with chronic stroke and mild or
moderate upper-extremity hemiparesis were enrolled in the Video Game
Rehabilitation for Outpatient Stroke (VIGoROUS) multi-site randomized
controlled trial. Participants completed three weeks of gaming therapy,
gaming therapy with additional telerehabilition, constraint-induced
movement therapy, or traditional rehabilitation. Tactile sensation was
measured with monofilaments, before and after treatment, and 6 months
later. A mixed-effects general linear model revealed similar positive
change in tactile sensitivity regardless of the type of training. On
average, participants were able to detect a stimulus that was 32 percent
and 33 percent less after training and at 6-month follow-up,
respectively. One-third of participants experienced recategorization of
their level of somatosensory impairment (e.g., regained protective
sensation) following training. Poorer tactile sensation at baseline was
associated with greater change. The findings suggest that about
one-third of individuals with mild/moderate chronic hemiparesis
experience sustained improvements in tactile sensation following motor
rehabilitation, regardless of the extent of tactile input in the
rehabilitation program. Potential for sensory improvement is an
additional motivator for those stroke survivors. Characteristics of
those who improve and mechanisms of improvement are important future
questions. Descriptor Terms: HEMIPLEGIA, LIMBS, MOTOR SKILLS, OCCUPATIONAL THERAPY, PHYSICAL THERAPY, REHABILITATION, STROKE, TACTILE SYSTEMS.
I guess that no one took the initiative and created protocols from Margaret
Yekutiel writing a whole book about this in 2001, 'Sensory Re-Education of the Hand After Stroke'. And 21 years later the protocol still hasn't been done. I'd fire a whole lot of people for such long lasting incompetence.
Stroke-induced
somatosensory impairments seem to be clinically overlooked, despite
their prevalence and influence on motor recovery post-stroke. Interest
in technology has been gaining traction over the past few decades as a
promising method to facilitate stroke rehabilitation. This
questionnaire-based cross-sectional study aimed to identify current
clinical practice and perspectives on the management of somatosensory
impairments post-stroke and the use of technology in assessing outcome
measures and providing intervention. Participants were 132
physiotherapists and occupational therapists currently working with
stroke patients in public hospitals and rehabilitation centres in
Singapore. It was found that the majority (64.4%) of the therapists
spent no more than half of the time per week on somatosensory
interventions. Functional or task-specific training was the primary form
of intervention applied to retrain somatosensory functions in stroke
survivors. Standardised assessments (43.2%) were used less frequently
than non-standardised assessments (97.7%) in clinical practice, with the
sensory subscale of the Fugl-Meyer Assessment being the most popular
outcome measure, followed by the Nottingham Sensory Assessment. While
the adoption of technology for assessment was relatively scarce, most
therapists (87.1%) reported that they have integrated technology into
intervention. There was a common agreement that proprioception is an
essential component in stroke rehabilitation, and that robotic
technology combined with conventional therapy is effective in enhancing
stroke rehabilitation, particularly for retraining proprioception. Most
therapists identified price, technology usability, and lack of available
space as some of the biggest barriers to integrating robotic technology
in stroke rehabilitation. Standardised assessments and interventions
targeting somatosensory functions should be more clearly delineated in
clinical guidelines. Although therapists were positive about
technology-based rehabilitation, obstacles that make technology
integration challenging ought to be addressed.
Figures
Citation: Sidarta
A, Lim YC, Wong RA, Tan IO, Kuah CWK, Ang WT (2022) Current clinical
practice in managing somatosensory impairments and the use of technology
in stroke rehabilitation. PLoS ONE 17(8):
e0270693.
https://doi.org/10.1371/journal.pone.0270693
Margaret
Yekutiel wrote a whole book about this in 2001, 'Sensory Re-Education of the Hand After Stroke'. And 21 years later you repeated the same thing? What a waste and indication how out-of-date you are.
Up to 85% of people with chronic stroke experience somatosensory
impairment, which contributes to poor sensorimotor control and non-use
of the affected limb. Neurophysiological mechanisms suggest motor
rehabilitation may improve tactile sense post-stroke, however,
somatosensory recovery has rarely been reported in controlled trials.
Objective.
To compare the effect of four upper limb motor rehabilitation programs
on the recovery of tactile sensation in adults with chronic stroke.
Methods.
Adults with chronic stroke and mild or moderate upper extremity hemiparesis (n
= 167) were enrolled in a multi-site randomized controlled trial.
Participants completed three weeks of gaming therapy, gaming therapy
with additional telerehabilition, Constraint-Induced Movement therapy,
or traditional rehabilitation. Here, we report the results of a
secondary outcome, tactile sensation, measured with monofilaments,
before and after treatment, and 6 months later.
Results.
A
mixed-effects general linear model revealed similar positive change in
tactile sensitivity regardless of the type of training. On average,
participants were able to detect a stimulus that was 32% and 33% less
after training and at 6-month follow-up, respectively. One-third of
participants experienced recategorization of their level of
somatosensory impairment (e.g., regained protective sensation) following
training. Poorer tactile sensation at baseline was associated with
greater change. Conclusions. About one-third of individuals with
mild/moderate chronic hemiparesis experience sustained improvements in
tactile sensation following motor rehabilitation, regardless of the
extent of tactile input in the rehabilitation program. Potential for
sensory improvement is an additional motivator for those post-stroke.
Characteristics of those who improve and mechanisms of improvement are
important future questions. Clinicaltrials.gov NCT02631850
