Bi-cephalic transcranial direct current stimulation combined with functional electrical stimulation for upper-limb stroke rehabilitation : A double-blind randomized controlled trial / Ana Paula Salazar in Annals of physical and rehabilitation medicine, Vol. 63, n°1 (Janvier 2020)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 63, n°1 (Janvier 2020) . - p. 4-11 Titre : Bi-cephalic transcranial direct current stimulation combined with functional electrical stimulation for upper-limb stroke rehabilitation : A double-blind randomized controlled trial Type de document : texte imprimé Auteurs : Ana Paula Salazar ; Veronica Cimolin ; Giulia Palermo Schifino ; Katia Daniele Rech ; Ritchele Redivo Marchese ; Aline Souza Pagnussat Année de publication : 2020 Article en page(s) : p. 4-11 Note générale : doi.org/10.1016/j.rehab.2019.05.004 Langues : Anglais (eng) Résumé : Background Stroke survivors often present poor upper-limb (UL) motor performance and reduced movement quality during reaching tasks. Transcranial direct current stimulation (tDCS) and functional electrical stimulation (FES) are widely used strategies for stroke rehabilitation. However, the effects of combining these two therapies to rehabilitate individuals with moderate and severe impairment after stroke are still unknown. Objective Our primary aim was to evaluate the effects of concurrent bi-cephalic tDCS and FES on UL kinematic motor performance and movement quality of chronic post-stroke subjects with moderate and severe compromise. Our secondary aim was to verify the effects of combining these therapies on handgrip force and UL motor impairment. Methods We randomized 30 individuals with moderate and severe chronic hemiparesis after stroke into tDCS plus FES (n = 15) and sham tDCS plus FES (n = 15) groups. Participants were treated 5 times a week for 2 weeks. Kinematic motor performance (movement cycle time, velocity profile) and movement quality (smoothness, trunk contribution, joint angles) were assessed during an UL reach-to-target task.Handgrip force and motor impairment were also recorded before and after the intervention. Results Participants allocated to the tDCS plus FES group improved movement cycle time (P = 0.039), mean reaching velocity (P = 0.022) and handgrip force (P = 0.034). Both groups improved the mean returning phase velocity (P = 0.018), trunk contribution (P = 0.022), movement smoothness (P = 0.001) and UL motor impairment (P = 0.002). Conclusions Concurrent bi-cephalic tDCS and FES slightly improved reaching motor performance and handgrip force of chronic post-stroke individuals with moderate and severe UL impairment. Permalink : ./index.php?lvl=notice_display&id=90681 [article] Bi-cephalic transcranial direct current stimulation combined with functional electrical stimulation for upper-limb stroke rehabilitation : A double-blind randomized controlled trial [texte imprimé] / Ana Paula Salazar ; Veronica Cimolin ; Giulia Palermo Schifino ; Katia Daniele Rech ; Ritchele Redivo Marchese ; Aline Souza Pagnussat . - 2020 . - p. 4-11. doi.org/10.1016/j.rehab.2019.05.004 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 63, n°1 (Janvier 2020) . - p. 4-11 Résumé : Background Stroke survivors often present poor upper-limb (UL) motor performance and reduced movement quality during reaching tasks. Transcranial direct current stimulation (tDCS) and functional electrical stimulation (FES) are widely used strategies for stroke rehabilitation. However, the effects of combining these two therapies to rehabilitate individuals with moderate and severe impairment after stroke are still unknown. Objective Our primary aim was to evaluate the effects of concurrent bi-cephalic tDCS and FES on UL kinematic motor performance and movement quality of chronic post-stroke subjects with moderate and severe compromise. Our secondary aim was to verify the effects of combining these therapies on handgrip force and UL motor impairment. Methods We randomized 30 individuals with moderate and severe chronic hemiparesis after stroke into tDCS plus FES (n = 15) and sham tDCS plus FES (n = 15) groups. Participants were treated 5 times a week for 2 weeks. Kinematic motor performance (movement cycle time, velocity profile) and movement quality (smoothness, trunk contribution, joint angles) were assessed during an UL reach-to-target task.Handgrip force and motor impairment were also recorded before and after the intervention. Results Participants allocated to the tDCS plus FES group improved movement cycle time (P = 0.039), mean reaching velocity (P = 0.022) and handgrip force (P = 0.034). Both groups improved the mean returning phase velocity (P = 0.018), trunk contribution (P = 0.022), movement smoothness (P = 0.001) and UL motor impairment (P = 0.002). Conclusions Concurrent bi-cephalic tDCS and FES slightly improved reaching motor performance and handgrip force of chronic post-stroke individuals with moderate and severe UL impairment. Permalink : ./index.php?lvl=notice_display&id=90681

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Effectiveness of static stretching positioning on post-stroke upper-limb spasticity and mobility: Systematic review with meta-analysis / Ana Paula Salazar in Annals of physical and rehabilitation medicine, Vol. 62, n°4 (Juillet 2019)  

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 274-282 Titre : Effectiveness of static stretching positioning on post-stroke upper-limb spasticity and mobility: Systematic review with meta-analysis Type de document : texte imprimé Auteurs : Ana Paula Salazar ; Camila Pinto ; Joao Victor Ruschel Mossi ; Bruno Figueiro ; Janice Luisa Lukrafka ; Aline Souza Pagnussat Année de publication : 2019 Article en page(s) : p. 274-282 Note générale : doi.org/10.1016/j.rehab.2018.11.004 Langues : Anglais (eng) Mots-clés : Physical therapy modalities  Physiotherapy  Muscle stretching exercises  Muscle spasticity  Range of motion  Rehabilitation Résumé : Objective To systematically review the effects of static stretching with positioning orthoses or simple positioning combined or not with other therapies on upper-limb spasticity and mobility in adults after stroke. Methods This meta-analysis was conducted according to PRISMA guidelines and registered at PROSPERO. MEDLINE (Pubmed), Embase, Cochrane CENTRAL, Scopus and PEDro databases were searched from inception to January 2018 for articles. Two independent researchers extracted data, assessed the methodological quality and rated the quality of evidence of studies. Results Three studies (57 participants) were included in the spasticity meta-analysis and 7 (210 participants) in the mobility meta-analysis. Static stretching with positioning orthoses reduced wrist-flexor spasticity as compared with no therapy (mean difference [MD] = −1.89, 95% confidence interval [CI] −2.44 to −1.34; I2 79%, P < 0.001). No data were available concerning the spasticity of other muscles. Static stretching with simple positioning, combined or not with other therapies, was not better than conventional physiotherapy in preventing loss of mobility of shoulder external rotation (MD = 3.50, 95% CI −3.45 to 10.45; I2 54.7%, P = 0.32), shoulder flexion (MD = −1.20, 95% CI −8.95 to 6.55; I2 0%, P = 0.76) or wrist extension (MD = −0.32, 95% CI −6.98 to 5.75; I2 38.5%, P = 0.92). No data were available concerning the mobility of other joints. Conclusion This meta-analysis revealed very low-quality evidence that static stretching with positioning orthoses reduces wrist flexion spasticity after stroke as compared with no therapy. Furthermore, we found low-quality evidence that static stretching by simple positioning is not better than conventional physiotherapy for preventing loss of mobility in the shoulder and wrist. Considering the limited number of studies devoted to this issue in post-stroke survivors, further randomized clinical trials are still needed. En ligne : https://www.sciencedirect.com/science/article/pii/S1877065718314970 Permalink : ./index.php?lvl=notice_display&id=84132 [article] Effectiveness of static stretching positioning on post-stroke upper-limb spasticity and mobility: Systematic review with meta-analysis [texte imprimé] / Ana Paula Salazar ; Camila Pinto ; Joao Victor Ruschel Mossi ; Bruno Figueiro ; Janice Luisa Lukrafka ; Aline Souza Pagnussat . - 2019 . - p. 274-282. doi.org/10.1016/j.rehab.2018.11.004 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 274-282 Mots-clés : Physical therapy modalities  Physiotherapy  Muscle stretching exercises  Muscle spasticity  Range of motion  Rehabilitation Résumé : Objective To systematically review the effects of static stretching with positioning orthoses or simple positioning combined or not with other therapies on upper-limb spasticity and mobility in adults after stroke. Methods This meta-analysis was conducted according to PRISMA guidelines and registered at PROSPERO. MEDLINE (Pubmed), Embase, Cochrane CENTRAL, Scopus and PEDro databases were searched from inception to January 2018 for articles. Two independent researchers extracted data, assessed the methodological quality and rated the quality of evidence of studies. Results Three studies (57 participants) were included in the spasticity meta-analysis and 7 (210 participants) in the mobility meta-analysis. Static stretching with positioning orthoses reduced wrist-flexor spasticity as compared with no therapy (mean difference [MD] = −1.89, 95% confidence interval [CI] −2.44 to −1.34; I2 79%, P < 0.001). No data were available concerning the spasticity of other muscles. Static stretching with simple positioning, combined or not with other therapies, was not better than conventional physiotherapy in preventing loss of mobility of shoulder external rotation (MD = 3.50, 95% CI −3.45 to 10.45; I2 54.7%, P = 0.32), shoulder flexion (MD = −1.20, 95% CI −8.95 to 6.55; I2 0%, P = 0.76) or wrist extension (MD = −0.32, 95% CI −6.98 to 5.75; I2 38.5%, P = 0.92). No data were available concerning the mobility of other joints. Conclusion This meta-analysis revealed very low-quality evidence that static stretching with positioning orthoses reduces wrist flexion spasticity after stroke as compared with no therapy. Furthermore, we found low-quality evidence that static stretching by simple positioning is not better than conventional physiotherapy for preventing loss of mobility in the shoulder and wrist. Considering the limited number of studies devoted to this issue in post-stroke survivors, further randomized clinical trials are still needed. En ligne : https://www.sciencedirect.com/science/article/pii/S1877065718314970 Permalink : ./index.php?lvl=notice_display&id=84132

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