Training of reaching in stroke survivors with severe and chronic upper limb paresis using a novel non-robotic device: a randomized clinical trial

Barker, R. N., Brauer, S. G. and Carson, R. G. (2008) Training of reaching in stroke survivors with severe and chronic upper limb paresis using a novel non-robotic device: a randomized clinical trial. Stroke, 39 6: 1800-1807. doi:10.1161/STROKEAHA.107.498485


Author Barker, R. N.
Brauer, S. G.
Carson, R. G.
Title Training of reaching in stroke survivors with severe and chronic upper limb paresis using a novel non-robotic device: a randomized clinical trial
Journal name Stroke   Check publisher's open access policy
ISSN 0039-2499
Publication date 2008-01-01
Year available 2008
Sub-type Article (original research)
DOI 10.1161/STROKEAHA.107.498485
Open Access Status DOI
Volume 39
Issue 6
Start page 1800
End page 1807
Total pages 8
Editor Hachinski, V.
Place of publication United States
Publisher Lippincott Williams & Wilkins
Language eng
Subject C1
920201 Allied Health Therapies (excl. Mental Health Services)
920103 Cardiovascular System and Diseases
110317 Physiotherapy
110201 Cardiology (incl. Cardiovascular Diseases)
Abstract Brain-computer interface-assisted motor imagery (MI-BCI) or transcranial direct current stimulation (tDCS) has been used in stroke rehabilitation, though their combinatory effect is unknown. We investigated brain plasticity following a combined MI-BCI and tDCS intervention in chronic subcortical stroke patients with unilateral upper limb disability. Nineteen patients were randomized into tDCS and sham-tDCS groups. Diffusion and perfusion MRI, and transcranial magnetic stimulation were used to study structural connectivity, cerebral blood flow (CBF), and corticospinal excitability, respectively, before and 4 weeks after the 2-week intervention. After quality control, thirteen subjects were included in the CBF analysis. Eleven healthy controls underwent 2 sessions of MRI for reproducibility study. Whereas motor performance showed comparable improvement, long-lasting neuroplasticity can only be detected in the tDCS group, where white matter integrity in the ipsilesional corticospinal tract and bilateral corpus callosum was increased but sensorimotor CBF was decreased, particularly in the ipsilesional side. CBF change in the bilateral parietal cortices also correlated with motor function improvement, consistent with the increased white matter integrity in the corpus callosum connecting these regions, suggesting an involvement of interhemispheric interaction. The preliminary results indicate that tDCS may facilitate neuroplasticity and suggest the potential for refining rehabilitation strategies for stroke patients.
Keyword Clinical Neurology
Peripheral Vascular Disease
Neurosciences & Neurology
Cardiovascular System & Cardiology
CLINICAL NEUROLOGY
PERIPHERAL VASCULAR DISEASE
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2009 Higher Education Research Data Collection
School of Health and Rehabilitation Sciences Publications
 
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Created: Mon, 06 Apr 2009, 19:46:03 EST by Meredith Downes on behalf of School of Health & Rehabilitation Sciences