Designing Unpowered Shoulder Complex Exoskeleton via Contralateral Drive for Self-rehabilitation of Post-stroke Hemiparesis

Your doctor should request details on this, I can't figure out anything based upon this abstract. 

Designing Unpowered Shoulder Complex Exoskeleton via Contralateral Drive for Self-rehabilitation of Post-stroke Hemiparesis

• Ning Li,
• Tie Yang,
• Yang Yang,
• Wenyuan Chen,
• Peng Yu,
• Chuang Zhang,
• Ning Xi,
• Ying Zhao &
• Wenxue Wang 

Journal of Bionic Engineering (2022)Cite this article

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Abstract

Rehabilitation using exoskeleton robots can effectively remediate dysfunction and restore post-stroke survivors’ physical ability. However, low kinematic compatibility and poor self-participation of post-stroke patients in rehabilitation restrict the outcomes of exoskeleton-based therapy. The study presents an Unpowered Shoulder Complex Exoskeleton (USCE), consisting of Shoulder Girdle Mechanism (SGM), Ball-and-Socket Joint Mechanism (BSM), Gravity Compensating Mechanism (GCM) and Adjustable Alignment Design (AAD), to achieve self-rehabilitation of shoulder via energy transfer from the healthy upper limb to the affected counterpart of post-stroke hemiplegic patients. The SGM and AAD are designed to improve the kinematic compatibility by compensating for displacements of the glenohumeral joint with the adaptable size of USCE for different wearers. The BSM and GCM can transfer the body movement and energy from the healthy half of the body to the affected side without external energy input and enhance the self-participation with sick posture correction. The experimental results show that the USCE can provide high kinematic compatibility with 90.9% movement similarity between human and exoskeleton. Meanwhile, the motion ability of a post-stroke patient’s affected limb can be increased through energy transfer. It is expected that USCE can improve outcomes of home-based self-rehabilitation.

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Data Availability

The datasets generated during and/or analysed during the current study are available from the corresponding author upon reasonable request.

Shoulder and elbow muscle activity during fully supported trajectory tracking in people who have had a stroke

What have your doctors and therapists done with this in 13 years to help survivor recovery? NOTHING? Then why the fuck are you seeing and paying them? I expect my medical professionals to be professional, meaning up-to-date on all appropriate research. The massive number of research articles published every year is no excuse.

Shoulder and elbow muscle activity during fully supported trajectory tracking in people who have had a stroke

Received 19 February 2009

Received in revised form 4 August 2009 

Accepted 6 August 2009

Shoulder and elbow muscle activity during fully supported trajectory tracking in people who have had a stroke

Well you described something, but I see nothing produced from here that is going to do survivors one fucking bit of good.

Shoulder and elbow muscle activity during fully supported trajectory tracking in people who have had a stroke

 

A.M. Hughes a,*, 

C.T. Freeman b, 

J.H. Burridge a, 

P.H. Chappell b, 

P.L. Lewin b, 

E. Rogers b
a School of Health Sciences, University of Southampton, Southampton, SO17 1BJ, UK
b School of Electronics and Computer Science, University of Southampton, Southampton, SO17 1BJ, UK

 abstract

An inability to perform tasks involving reaching is a common problem for stroke patients. This paper provides an insight into mechanisms associated with recovery of upper limb function by examining how stroke participants’ upper limb muscle activation patterns differ from those of neurologically intact participants, and how they change in response to an intervention.In this study, five chronic stroke participants undertook nine tracking tasks in which trajectory (orientation and length), speed and resistance to movement were varied. During these tasks, EMG signals were recorded from triceps, biceps, anterior deltoid, upper, middle and lower trapezius and pectoralis major.Data collection was performed in sessions both before, and after, an intervention in which participants performed a similar range of tracking tasks with the addition of responsive electrical stimulation applied to their triceps muscle. The intervention consisted of eighteen one hour treatment sessions, with two participants attending an additional seven sessions. During all sessions, each participant’s arm was supported by a hinged arm holder which constrained their hand to move in a two dimensional plane.Analysis of the pre intervention EMG data showed that timing and amplitude of peak EMG activity for all stroke participants differed from neurologically intact participants. Analysis of post intervention EMG data revealed that statistically significant changes in these quantities had occurred towards those of neu-rologically intact participants.

Robotics in shoulder rehabilitation

 Ask your doctor what is the present status of robotic technologies? No knowledge, have everyone in that stroke hospital fired.

Robotics in shoulder rehabilitation

Giovanni Merolla
2014, Muscles, Ligaments and Tendons Journal
D. Cervesi Hospital, Cattolica, Italy
Corresponding author:
Giovanni Merolla
Unit of Shoulder and Elbow Surgery
Biomechanics Laboratory “Marco Simoncelli”
D. Cervesi Hospital, AUSL della Romagna Ambito
Territoriale di Rimini
L.V. Beethoven, 5
47841 Cattolica (RN), Italy
phone: +39 0541 966382
fax: +39 0541 966312
E-mail: giovannimerolla@hotmail.com;
giovanni.merolla@auslrn.net

Summary

In the last few decades, several researches have been conducted in the field of robotic rehabilitation to meet the intensive, repetitive and task-oriented training, with the goal to recover the motor function. Up to now, robotic rehabilitation studies of the upper extremity have generally focused on stroke survivors leaving less explored the field of orthopaedic shoulder rehabilitation. In this review we analyse the present status of robotic technologies, in order to understand which are the current indications and which may be the future perspective for their application in both neurological and orthopaedic shoulder rehabilitation.

Introduction

The aim of conventional rehabilitation is to recover the motor function using therapeutic exercises guided by a therapist who moves the patient’s body. An early and repetitive rehabilitation can substantially improve the long-term mobility of the shoulder in both neurological and orthopaedic patients^1,2; furthermore, longer and more frequent training sessions have been shown to
have beneficial effect in the short term^3-5. Traditional rehabilitation techniques rely on well-established standard exercises, carried out by a therapist during in-patient hospital care and continued at home. As the rehabilitation sessions require involvement of a therapist for each patient this entails human and financial resources. In the last decades, in order to meet the intensive, repetitive and task-oriented rehabilitation, numerous and extensive research programs have been conducted in the field of robotic rehabilitation^1-4. These systems can provide external assistive support to the human body, helping patients to experience pre-programmed limb movements and to improve related sensory-motor functions through repetitive practices. This may allow the patient to extend their training sessions providing an objective measure of the repeatability that it is hard to achieve with conventional physiotherapy. Up to date, robotic rehabilitation of the upper extremity have focused on stroke survivors studies^1,2,5 without significant applications in orthopaedics. Motor disorders of the upper extremities, following orthopaedic or neurological injuries, include joint and muscular stiffness, muscle weakness, spasms, disturbed muscle timing and reduced ability to selectively activate muscles with abnormal synergistic movement patterns of arm and shoulder girdle. In the rehabilitation field, disabilities, residual motor function and efficacy of treatment cannot be quantified reliably as semi-quantitative evaluation scales are the only established methods to assess motor functions and its changes. Robots could allow quantitative measures of physical properties in a wide range of variation with
levels of speed, accuracy, power and endurance over time that are unachievable by humans. Anyway, robots lack flexibility and adaptability, code-independent communication, high level information processing, detection and responsiveness to weak and otherwise undetected significant sensory inputs that characterize humans^6-9. In the current study we describe the modern robotic systems for shoulder rehabilitation, focusing on the indications and other potential technologies that combined with robots can increase the benefits of rehabilitation to restore shoulder function.

Key components of mechanical work predict outcomes in robotic stroke therapy

Good luck figuring out what negative work at the shoulder is and the exact robots used here. 

Maybe here?

Shoulder Eccentric Exercises

Concentric elbow strengthening

 

You do know you can't do a damn thing with my recommendations, I'm not medically trained. Is your doctor?

 

Key components of mechanical work predict outcomes in robotic stroke therapy

Journal of NeuroEngineering and Rehabilitation , Volume 17(53)

NARIC Accession Number: J83561.  What's this?
ISSN: 1743-0003.
Author(s): Wright, Zachary A. ; Majeed, Yazan A.; Patton, James L. ; Huang, Felix C..
Publication Year: 2020.
Number of Pages: 12.

Abstract: 

Study investigated how the energetic contributions of stroke survivors during robot-assisted training relate to upper-limb recovery. Eleven stroke survivors completed upper-extremity motor exploration (self-directed movement practice) training with customized forces in six sessions over two weeks, while 11 control group participants trained without assistance. Multiple regression analysis was used to predict patient outcomes with computed mechanical work as independent variables, including separate features for elbow versus shoulder joints, positive (concentric) and negative (eccentric), flexion and extension. The results showed that increases in total mechanical work during therapy were positively correlated with the final outcome metric, velocity range. Further analysis revealed that greater amounts of negative work at the shoulder and positive work at the elbow as the most important predictors of recovery. However, the work features were likely mutually correlated, suggesting a prediction model that first removed shared variance. These results support robotic training for stroke survivors that increases energetic activity in eccentric shoulder and concentric elbow actions.
Descriptor Terms: BIOENGINEERING, BODY MOVEMENT, LIMBS, MOTOR SKILLS, OCCUPATIONAL THERAPY, ROBOTICS, STROKE, THERAPEUTIC TRAINING.


Can this document be ordered through NARIC's document delivery service*?: Y.
Get this Document: https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-020-00672-8.

Citation: Wright, Zachary A. , Majeed, Yazan A., Patton, James L. , Huang, Felix C.. (2020). Key components of mechanical work predict outcomes in robotic stroke therapy.  Journal of NeuroEngineering and Rehabilitation , 17(53) Retrieved 6/11/2020, from REHABDATA database.

Applying LDA-based pattern recognition to predict isometric shoulder and elbow torque generation in individuals with chronic stroke with moderate to severe motor impairment

Fuck, we don't care about prediction you blithering idiots. What is the protocol to resolve the shoulder impairment?  Have a stroke and try to recover with your stupidity of research.  I take no prisoners.

Applying LDA-based pattern recognition to predict isometric shoulder and elbow torque generation in individuals with chronic stroke with moderate to severe motor impairment 

• Joseph V. Kopke,
• Levi J. Hargrove and
• Michael D. EllisEmail author

Journal of NeuroEngineering and Rehabilitation201916:35

https://doi.org/10.1186/s12984-019-0504-1

©  The Author(s). 2019

• Received: 11 September 2018
• Accepted: 22 February 2019
• Published: 5 March 2019

Abstract

Background

Abnormal synergy is a major stroke-related movement impairment that presents as an unintentional contraction of muscles throughout a limb. The flexion synergy, consisting of involuntary flexion coupling of the paretic elbow, wrist, and fingers, is caused by and proportional to the amount of shoulder abduction effort and limits reaching function. A wearable exoskeleton capable of predicting movement intent could augment abduction effort and therefore reduce the negative effects of distal joint flexion synergy. However, predicting movement intent from abnormally-coupled torques or EMG signals and subsequent use as a control signal remains elusive. One control strategy that has proven viable, effective, and computationally efficient in myoelectric prostheses for use in individuals with amputation is linear discriminant analysis (LDA)-based pattern recognition. However, following stroke, shoulder effort has been shown to have a negative effect on classification accuracy of hand tasks due to the multi-joint torque coupling of abnormal synergy. This study focuses on the evaluation of an LDA-based classifier to predict individual degrees-of-freedom of the shoulder and elbow joints.

Methods

Six degree-of-freedom load cell data along with eight channels of EMG data were recorded during eight tasks (shoulder abduction and adduction, horizontal abduction and adduction, internal rotation and external rotation, and elbow flexion and extension) and used to create feature sets for LDA-based classifiers to distinguish between these eight classes.

Results

Cross-validation yielded functional offline classification accuracies (> 90%) for two of the eight classes using EMG-only, four of the eight classes using load cell-only, and six of the eight classes using a combined feature set with average accuracies of 83, 91, and 92% respectively.

Conclusions

The most common misclassifications were between shoulder adduction and internal rotation followed by shoulder abduction and external rotation. It is unknown whether the strategies used were due to abnormal synergy or other factors. LDA-based pattern recognition may be a viable control option for predicting movement intention and providing a control signal for a wearable exoskeletal assistive device. Future work will need to test the approach in a more complex multi-joint task, specifically one that attempts to tease apart shoulder abduction/external rotation and adduction/internal rotation.

The restoration of the shoulder joint function in the patients presenting with hemiparesis during the acute phase of hemispheric stroke

Nothing in here even suggests they got an objective damage diagnosis. Thus this research is totally not repeatable and useless. If you don't even know the starting point you can't measure an ending point.
https://europepmc.org/abstract/med/29985378

(PMID:29985378)

PMID:29985378

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S N Kaurkin

Federal research and clinical centre for specialized types of medical assistance and medical technologies of the Federal medical-biological Agency of Russia, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Moscow, Russia.More

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D V Skvortsov

Federal research and clinical centre for specialized types of medical assistance and medical technologies of the Federal medical-biological Agency of Russia, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Moscow, Russia.More

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Voprosy Kurortologii, Fizioterapii, i Lechebnoi Fizicheskoi Kultury [01 Jan 2018, 95(3):26-34]

2018/01

Type: Journal Article, English Abstract (lang: rus)
DOI: 10.17116/kurort201895326

Abstract

The impaired function of the shoulder joint resulting from cerebral stroke is a common disorder involving permanent total disability as well as impaired capability of self-care. The functional pathological changes in the shoulder joint and the dynamics of the patients' health status during the acute period of cerebral stroke remain virtually unexplored.The objective of the present study was to obtain a deeper insight into the process of recovery of the movements in the shoulder joint of the patients presenting with hemiparesis during the acute period of hemispheric stroke based on the results of the analysis of the biomechanical data and the targeted training with biofeedback (BFB).The study included three groups comprised of 25 subjects each. One (control) group included the subjects having neither neurological nor orthopedic pathology. The second group consisted of the patients receiving the conventional treatment in the combination with therapeutic physical exercises (TPE). Group 3 was composed of the patients given the standard course of conventional and physical (TPE) therapy complemented by biofeedback training (the TPE/BFB group). The study included clinical investigations and biomechanical registration of the movements of the shoulder joints and trunk.The results of the study gave evidence that the patients presenting with hemiparesis during the acute period of hemispheric ischemic stroke including those treated with the application of the active means and methods of rehabilitation, such as BFB training, showed no appreciable dynamics of the parameters being evaluated with the use of the relevant clinical scales. The biomechanical study has demonstrated that the movements in the shoulder joints (in a single plain) of the patients comprising the control group are characterized by the presence of the main component with a maximum amplitude in the plane of this movement and additional components (in other planes with a significantly lower amplitude); they are accompanied by the ancillary movements of the trunk. Functionally, the condition of paresis at the level of the shoulder joint is characterized by a decrease in the amplitude of the primary movement and the increase of one of the additional amplitudes, with the growing amplitude of the auxiliary movements of the trunk. The biomechanical methods for the objective assessment have revealed the following functional changes in the shoulder joints: the 6% improvement of flexion in the group of the patients treated with the use of therapeutic physical exercises and the 10% improvement in those treated with the combination of TPE and BFB. Moreover, abduction in the patients of these two groups improved by 4% and 9% respectively.The method for the study of kinematics of the movements in the shoulder joints appears to be most sensitive and informative for the purpose of diagnostics of disorders of the motor function and assessment of the process of its restoration in the patients presenting with hemiparesis during the acute period of hemispheric stroke.

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A Randomized Controlled Trial of EEG-Based Motor Imagery Brain-Computer Interface Robotic Rehabilitation for Stroke

Useless until your stroke hospital gets the protocol for using this.  They've had 4 years and I bet nothing was accomplished in those 4 years. Incompetence reigns supreme in your stroke hospital.

A Randomized Controlled Trial of EEG-Based Motor Imagery Brain-Computer Interface Robotic Rehabilitation for Stroke

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Kai Keng Ang¹

Kai Keng Ang

1Institute for Infocomm and Research, Agency of Science, Technology and Research, Singapore
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, Karen Sui Geok Chua²

Karen Sui Geok Chua

2Department of Rehabilitation Medicine, Tan Tock Seng Hospital Rehabilitation Centre, Singapore
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, Kok Soon Phua¹

Kok Soon Phua

1Institute for Infocomm and Research, Agency of Science, Technology and Research, Singapore
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Chuanchu Wang¹

Chuanchu Wang

1Institute for Infocomm and Research, Agency of Science, Technology and Research, Singapore
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, Zheng Yang Chin¹

Zheng Yang Chin

1Institute for Infocomm and Research, Agency of Science, Technology and Research, Singapore
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, Christopher Wee Keong Kuah²

Christopher Wee Keong Kuah

2Department of Rehabilitation Medicine, Tan Tock Seng Hospital Rehabilitation Centre, Singapore
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, Wilson Low³

Wilson Low

3Clinical Research Unit, Tan Tock Seng Hospital, Singapore
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, Cuntai Guan¹

Cuntai Guan

1Institute for Infocomm and Research, Agency of Science, Technology and Research, Singapore
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...

First Published April 21, 2014 Research Article

https://doi.org/10.1177/1550059414522229

Article information

Article Information

Volume: 46 issue: 4, page(s): 310-320

Article first published online: April 21, 2014; Issue published: October 1, 2015

https://doi.org/10.1177/1550059414522229

Kai Keng Ang¹, Karen Sui Geok Chua², Kok Soon Phua¹, Chuanchu Wang¹, Zheng Yang Chin¹, Christopher Wee Keong Kuah², Wilson Low³, Cuntai Guan¹

¹Institute for Infocomm and Research, Agency of Science, Technology and Research, Singapore

²Department of Rehabilitation Medicine, Tan Tock Seng Hospital Rehabilitation Centre, Singapore

³Clinical Research Unit, Tan Tock Seng Hospital, Singapore

Corresponding Author: Kai Keng Ang, Institute for Infocomm and Research, Agency of Science, Technology and Research (A*STAR), 1 Fusionopolis Way, #21-01 Connexis (South Tower), 138632, Singapore. Email: kkang@i2r.a-star.edu.sg

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Abstract

Section:

Electroencephalography (EEG)–based motor imagery (MI) brain-computer interface (BCI) technology has the potential to restore motor function by inducing activity-dependent brain plasticity. The purpose of this study was to investigate the efficacy of an EEG-based MI BCI system coupled with MIT-Manus shoulder-elbow robotic feedback (BCI-Manus) for subjects with chronic stroke with upper-limb hemiparesis. In this single-blind, randomized trial, 26 hemiplegic subjects (Fugl-Meyer Assessment of Motor Recovery After Stroke [FMMA] score, 4-40; 16 men; mean age, 51.4 years; mean stroke duration, 297.4 days), prescreened with the ability to use the MI BCI, were randomly allocated to BCI-Manus or Manus therapy, lasting 18 hours over 4 weeks. Efficacy was measured using upper-extremity FMMA scores at weeks 0, 2, 4 and 12. ElEG data from subjects allocated to BCI-Manus were quantified using the revised brain symmetry index (rBSI) and analyzed for correlation with the improvements in FMMA score. Eleven and 15 subjects underwent BCI-Manus and Manus therapy, respectively. One subject in the Manus group dropped out. Mean total FMMA scores at weeks 0, 2, 4, and 12 weeks improved for both groups: 26.3 ± 10.3, 27.4 ± 12.0, 30.8 ± 13.8, and 31.5 ± 13.5 for BCI-Manus and 26.6 ± 18.9, 29.9 ± 20.6, 32.9 ± 21.4, and 33.9 ± 20.2 for Manus, with no intergroup differences (P = .51). More subjects attained further gains in FMMA scores at week 12 from BCI-Manus (7 of 11 [63.6%]) than Manus (5 of 14 [35.7%]). A negative correlation was found between the rBSI and FMMA score improvement (P = .044). BCI-Manus therapy was well tolerated and not associated with adverse events. In conclusion, BCI-Manus therapy is effective and safe for arm rehabilitation after severe poststroke hemiparesis. Motor gains were comparable to those attained with intensive robotic therapy (1,040 repetitions/session) despite reduced arm exercise repetitions using EEG-based MI-triggered robotic feedback (136 repetitions/session). The correlation of rBSI with motor improvements suggests that the rBSI can be used as a prognostic measure for BCI-based stroke rehabilitation.

Pilot testing of the spring operated wearable enhancer for arm rehabilitation (SpringWear)

See how long it is before this gets to your hospital stroke department. I'm guessing 50 years.
https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-018-0352-4

• Ji ChenEmail authorView ORCID ID profile and
• Peter S. Lum

Journal of NeuroEngineering and Rehabilitation201815:13

https://doi.org/10.1186/s12984-018-0352-4

©  The Author(s). 2018

Received: 14 July 2017

Accepted: 7 February 2018

Published: 2 March 2018

Abstract

Background

Robotic devices for neurorehabilitation of movement impairments in persons with stroke have been studied extensively. However, the vast majority of these devices only allow practice of stereotyped components of simulated functional tasks in the clinic. Previously we developed SpringWear, a wearable, spring operated, upper extremity exoskeleton capable of assisting movements during real-life functional activities, potentially in the home. SpringWear assists shoulder flexion, elbow extension and forearm supination/pronation. The assistance profiles were designed to approximate the torque required to move the joint passively through its range. These three assisted DOF are combined with two passive shoulder DOF, allowing complex multi-joint movement patterns.

Methods

We performed a cross-sectional study to assess changes in movement patterns when assisted by SpringWear. Thirteen persons with chronic stroke performed range of motion (ROM) and functional tasks, including pick and place tasks with various objects. Sensors on the device measured rotation at all 5 DOF and a kinematic model calculated position of the wrist relative to the shoulder. Within subject t-tests were used to determine changes with assistance from SpringWear.

Results

Maximum shoulder flexion, elbow extension and forearm pronation/supination angles increased significantly during both ROM and functional tasks (p < 0.002). Elbow flexion/extension ROM also increased significantly (p < 0.001). When the subjects volitionally held up the arm against gravity, extension at the index finger proximal interphalangeal joint increased significantly (p = 0.033) when assisted by SpringWear. The forward reach workspace increased 19% (p = 0.002). Nine subjects could not complete the functional tasks unassisted and only one showed improvement on task completion with SpringWear.

Conclusions

SpringWear increased the usable workspace during reaching movements, but there was no consistent improvement in the ability to complete functional tasks. Assistance levels at the shoulder were increased only until the shoulder could be voluntarily held at 90 degrees of flexion. A higher level of assistance may have yielded better results. Also combining SpringWear with HandSOME, an exoskeleton for assisting hand opening, may yield the most dramatic improvements in functional task performance. These low-cost devices can potentially reduce effort and improve performance during task practice, increasing adherence to home training programs for rehabilitation.

Community promotion of superficial needling plus club swing for post-stroke motion impairment of the shoulder joint

With two variables you can't know which one to attribute recovery to. And since this doesn't mention timeframe it could just be spontaneous recovery. These were all high functioning survivors already.  I don't see how acupuncture can have any effects except placebo or spontaneous recovery since energy meridians have never been proven to exist.
http://link.springer.com/article/10.1007%2Fs11726-017-0985-z

• Authors
• Authors and affiliations

• Huan-huan Ni (倪欢欢)
• Yao-chi Wu (吴耀持)Email author
• Xiang-dong Shi (石向东)
• Yang Li (李洋)
• Yi-yi Zhang (张奕奕)
• Hui-ling Zeng (曾慧玲)
• Li Ji (季力)
• De-quan Huang (黄德权)
• Chun-shui Huang (黄春水)

• Huan-huan Ni (倪欢欢)
  • 1
• Yao-chi Wu (吴耀持)
  • 2
  Email author
• Xiang-dong Shi (石向东)
  • 3
• Yang Li (李洋)
  • 4
• Yi-yi Zhang (张奕奕)
  • 5
• Hui-ling Zeng (曾慧玲)
  • 1
• Li Ji (季力)
  • 1
• De-quan Huang (黄德权)
  • 1
• Chun-shui Huang (黄春水)
  • 1

1. 1.Shanghai Changning District Tianshan Hospital of Traditional Chinese MedicineShanghaiChina
2. 2.Department of Acupuncture, Tuina and TraumatologyShanghai Jiao Tong University Affiliated Sixth People’s HospitalShanghaiChina
3. 3.Shanghai Changning District Huayang Community Health CenterShanghaiChina
4. 4.Shanghai Changning District Zhoujiaqiao Community Health CenterShanghaiChina
5. 5.Shanghai Changning District Hongqiao Community Health CenterShanghaiChina

Special Topic Study

First Online:

23 April 2017

DOI: 10.1007/s11726-017-0985-z

Cite this article as:

Ni, H., Wu, Y., Shi, X. et al. J. Acupunct. Tuina. Sci. (2017) 15: 109. doi:10.1007/s11726-017-0985-z

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Abstract

Objective

To investigate the community promotion feasibility of superficial needling plus club swing for post-stroke motion impairment of the shoulder joint.

Methods

A total of 180 cases (duration <1.5 years) with post-stroke motion impairment of the shoulder joint were recruited from three community health centers in Changning District, 60 from each community. They were randomly allocated into an observation group (n=90) and a control group (n=90). Patients in both groups received standard internal and rehabilitation care. Patients in the observation group received additional superficial needling plus club swing. The visual analogue scale (VAS) was conducted before and 60 d after the treatment to evaluate the severity of shoulder pain. The active movement of the shoulder joint and activities of daily living (ADL) were also observed.

Results

There were no between-group statistical differences before the treatment (all P>0.05). After a 60-day treatment, the shoulder pain severity, active range of motion of the shoulder joint and ADL in the observation group were significantly improved than those in the control group (all P<0.01). In addition, no adverse events were reported by participants in the observation group.

Conclusion

Superficial needling plus club swing plays a positive role in improving post-stroke motion impairment of the shoulder joint. This safe, reliable and economical therapy has good patient compliance and is suitable for community promotion.

Compensatory Versus Noncompensatory Shoulder Movements Used for Reaching in Stroke

Once again pretty much useless research. A great stroke association president would be contacting these researchers to get useful solutions from each research trial rather than just posing a question and leaving the survivor hanging with no solution in sight. My reaching ability is pretty much non-existent, the first problem is the spasticity causing the arm to be hard to even lift to start the process, then the spasticity preventing the straightening of the arm, then no opening of the hand.  I see absolutely nothing here than would help me. 

Compensatory Versus Noncompensatory Shoulder Movements Used for Reaching in Stroke

1. Mindy F. Levin, PT, MSc, PhD1,2⇑
2. Dario G. Liebermann, MSc, PhD3
3. Yisrael Parmet, MSc, PhD4
4. Sigal Berman, MSc, PhD4

1. ¹McGill University, Montreal, Quebec, Canada
2. ²Center for Interdisciplinary Research in Rehabilitation (CRIR), Montreal, Quebec, Canada
3. ³University of Tel Aviv, Tel Aviv, Israel
4. ⁴Ben-Gurion University of the Negev, Beer-Sheva, Israel

1. Mindy F. Levin, PT, MSc, PhD, School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada. Email: mindy.levin@mcgill.ca

Abstract

Background. The extent to which the upper-limb flexor synergy constrains or compensates for arm motor impairment during reaching is controversial. This synergy can be quantified with a minimal marker set describing movements of the arm-plane. 

Objectives. To determine whether and how (a) upper-limb flexor synergy in patients with chronic stroke contributes to reaching movements to different arm workspace locations and (b) reaching deficits can be characterized by arm-plane motion.  

Methods. Sixteen post-stroke and 8 healthy control subjects made unrestrained reaching movements to targets located in ipsilateral, central, and contralateral arm workspaces. Arm-plane, arm, and trunk motion, and their temporal and spatial linkages were analyzed.  

Results. Individuals with moderate/severe stroke used greater arm-plane movement and compensatory trunk movement compared to those with mild stroke and control subjects. Arm-plane and trunk movements were more temporally coupled in stroke compared with controls. Reaching accuracy was related to different segment and joint combinations for each target and group: arm-plane movement in controls and mild stroke subjects, and trunk and elbow movements in moderate/severe stroke subjects. Arm-plane movement increased with time since stroke and when combined with trunk rotation, discriminated between different subject groups for reaching the central and contralateral targets. Trunk movement and arm-plane angle during target reaches predicted the subject group. 

Conclusions. The upper-limb flexor synergy was used adaptively for reaching accuracy by patients with mild, but not moderate/severe stroke. The flexor synergy, as parameterized by the amount of arm-plane motion, can be used by clinicians to identify levels of motor recovery in patients with stroke.