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Multisensory stimulation to promote upper extremity motor recovery in stroke: A pilot study / Lawla L.F. Law in The British Journal of Occupational Therapy, Vol.81 Issue 11 (Novembre 2018)
[article]
Titre : Multisensory stimulation to promote upper extremity motor recovery in stroke: A pilot study Type de document : texte imprimé Auteurs : Lawla L.F. Law ; Kenneth N.K. Fong ; Ray K.F. Li Année de publication : 2018 Article en page(s) : p. 641-648 Note générale : doi.org/10.1177/0308022618770141 Langues : Anglais (eng) Mots-clés : Multisensory motor recovery stroke upper extremity Résumé : Introduction
Occupational therapists have been using various preparatory methods as part of the treatment sessions to prepare clients for occupational performance and participation in occupation. Studies have shown sensory stimulation both activates brain areas inducing cortical reorganization and modulates motor cortical excitability for the stimulated afferents, hence re-establishing the disrupted sensorimotor loop due to stroke. This pilot investigates the potential effects of using multisensory stimulation as a preparatory method prior to conventional training (CT) on upper-extremity motor recovery and self-care function in stroke patients.
Method
This was a quasi-randomized controlled pilot. Twelve participants (age in years = 67.17 + /−11.29) with upper extremity motor deficits were randomly allocated to multisensory therapy (n = 6) or conventional (n = 6) groups for 12-week training. Assessments were conducted at baseline and post-intervention using Fugl-Meyer Assessment of Motor Recovery after Stroke (FMA), Manual Muscle Testing (MMT), Functional Test for the Hemiplegic Upper Extremity (Hong Kong version FTHUE-HK) and Modified Barthel Index (MBI).
Results
Significant between-group differences were shown in FMA (p = 0.003), FTHUE-HK (p = 0.028) and MMT (p = 0.034).
Conclusion
Multisensory stimulation could be used as a preparatory method prior to CT in improving upper extremity motor recovery in stroke rehabilitation. Further well-designed larger scale studies are needed to validate the potential benefits of this application.Permalink : ./index.php?lvl=notice_display&id=80278
in The British Journal of Occupational Therapy > Vol.81 Issue 11 (Novembre 2018) . - p. 641-648[article] Multisensory stimulation to promote upper extremity motor recovery in stroke: A pilot study [texte imprimé] / Lawla L.F. Law ; Kenneth N.K. Fong ; Ray K.F. Li . - 2018 . - p. 641-648.
doi.org/10.1177/0308022618770141
Langues : Anglais (eng)
in The British Journal of Occupational Therapy > Vol.81 Issue 11 (Novembre 2018) . - p. 641-648
Mots-clés : Multisensory motor recovery stroke upper extremity Résumé : Introduction
Occupational therapists have been using various preparatory methods as part of the treatment sessions to prepare clients for occupational performance and participation in occupation. Studies have shown sensory stimulation both activates brain areas inducing cortical reorganization and modulates motor cortical excitability for the stimulated afferents, hence re-establishing the disrupted sensorimotor loop due to stroke. This pilot investigates the potential effects of using multisensory stimulation as a preparatory method prior to conventional training (CT) on upper-extremity motor recovery and self-care function in stroke patients.
Method
This was a quasi-randomized controlled pilot. Twelve participants (age in years = 67.17 + /−11.29) with upper extremity motor deficits were randomly allocated to multisensory therapy (n = 6) or conventional (n = 6) groups for 12-week training. Assessments were conducted at baseline and post-intervention using Fugl-Meyer Assessment of Motor Recovery after Stroke (FMA), Manual Muscle Testing (MMT), Functional Test for the Hemiplegic Upper Extremity (Hong Kong version FTHUE-HK) and Modified Barthel Index (MBI).
Results
Significant between-group differences were shown in FMA (p = 0.003), FTHUE-HK (p = 0.028) and MMT (p = 0.034).
Conclusion
Multisensory stimulation could be used as a preparatory method prior to CT in improving upper extremity motor recovery in stroke rehabilitation. Further well-designed larger scale studies are needed to validate the potential benefits of this application.Permalink : ./index.php?lvl=notice_display&id=80278 Exemplaires (1)
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Exclu du prêtNon-invasive brain stimulation (NIBS) and motor recovery after stroke / M. SIMONETTA-MOREAU in Annals of physical and rehabilitation medicine, Vol. 57, n°8 (Novembre 2014)
[article]
Titre : Non-invasive brain stimulation (NIBS) and motor recovery after stroke Titre original : Neuromodulation corticale non invasive (NIBS) et récupération motrice post-AVC Type de document : texte imprimé Auteurs : M. SIMONETTA-MOREAU, Auteur Année de publication : 2014 Article en page(s) : p.530-542 Langues : Français (fre) Mots-clés : Stroke Motor recovery rTMS TBS tDCS PAS Brain plasticity AVC Récupération motrice Plasticité cérébrale Résumé : Recovery of motor function after stroke occurs largely on the basis of a sustained capacity of the adult brain for plastic changes. This brain plasticity has been validated by functional imaging and electrophysiological studies. Various concepts of how to enhance beneficial plasticity and in turn improve functional recovery are emerging based on the concept of functional interhemispheric balance between the two motor cortices. Besides conventional rehabilitation interventions and the most recent neuropharmacological approaches, non-invasive brain stimulation (NIBS) has recently been proposed as an add-on method to promote motor function recovery after stroke. Several methods can be used based either on transcranial magnetic stimulation (repetitive mode: rTMS, TBS) via a coil, or small electric current via larges electrodes placed on the scalp, (transcranial direct current stimulation tDCS). Depending on the different electrophysiological parameters of stimulation used, NIBS can induce a transient modulation of the excitability of the stimulated motor cortex (facilitation or inhibition) via a probable LTP-LTD-like mechanism. Several small studies have shown feasible and positive treatment effects for most of these strategies and their potential clinical relevance to help restoring the disruption of interhemispheric imbalance after stroke. Results of these studies are encouraging but many questions remain unsolved: what are the optimal stimulation parameters? What is the best NIBS intervention? Which cortex, injured or intact, should be stimulated? What is the best window of intervention? Is there a special subgroup of stroke patients who could strongly benefit from these interventions? Finally is it possible to boost NIBS treatment effect by motor training of the paretic hand or by additional neuropharmacological interventions? There is clearly a need for large-scale, controlled, multicenter trials to answer these questions before proposing their routine use in the management of stroke patients.
Le cerveau d’un patient victime d’un accident vasculaire cérébral (AVC) a les capacités de reconfigurer son activité dans les suites de l’infarctus. Cette plasticité cérébrale spontanée, substrat de la récupération fonctionnelle, a fait l’objet de nombreux travaux de recherche en imagerie fonctionnelle et en électrophysiologie aboutissant au concept de balance interhémisphérique et au développement de techniques de neuromodulation corticale, visant à faciliter les processus naturels de plasticité corticale. Ces méthodes non invasives utilisent soit, l’application sur le scalp à travers un coil d’un courant magnétique en mode répétitif, (stimulation magnétique transcrânienne répétitive rTMS, TBS), soit l’application d’un courant électrique continu de faible intensité à travers deux larges électrodes placées sur le scalp, (stimulation électrique directe transcrânienne, tDCS). Elles permettent d’induire une modulation de l’excitabilité du cortex moteur sous-jacent transitoire et focale, (facilitation ou inhibition en fonction des paramètres de stimulation), par un mécanisme de type LTP/LTD. Ces méthodes visent principalement à restaurer l’équilibre de la balance interhémisphérique entre le cortex moteur du côté lésé et du côté sain. Plusieurs études ont souligné leur intérêt potentiel dans la récupération motrice post-AVC en montrant des améliorations sensibles des performances motrices de la main parétique comparativement à des stimulations placebo, ainsi que leur bonne tolérance. Cependant, de nombreuses questions demeurent encore en suspens avant de pouvoir les utiliser en routine, concernant les paramètres de stimulation optimaux, les cibles potentielles, le choix des techniques, la meilleure période de leur application (phase aiguë, chronique), les critères de sélection des patients susceptibles d’en bénéficier et finalement leur place par rapport aux techniques conventionnelles de rééducation et les approches neuropharmacologiques.Permalink : ./index.php?lvl=notice_display&id=34537
in Annals of physical and rehabilitation medicine > Vol. 57, n°8 (Novembre 2014) . - p.530-542[article] Non-invasive brain stimulation (NIBS) and motor recovery after stroke = Neuromodulation corticale non invasive (NIBS) et récupération motrice post-AVC [texte imprimé] / M. SIMONETTA-MOREAU, Auteur . - 2014 . - p.530-542.
Langues : Français (fre)
in Annals of physical and rehabilitation medicine > Vol. 57, n°8 (Novembre 2014) . - p.530-542
Mots-clés : Stroke Motor recovery rTMS TBS tDCS PAS Brain plasticity AVC Récupération motrice Plasticité cérébrale Résumé : Recovery of motor function after stroke occurs largely on the basis of a sustained capacity of the adult brain for plastic changes. This brain plasticity has been validated by functional imaging and electrophysiological studies. Various concepts of how to enhance beneficial plasticity and in turn improve functional recovery are emerging based on the concept of functional interhemispheric balance between the two motor cortices. Besides conventional rehabilitation interventions and the most recent neuropharmacological approaches, non-invasive brain stimulation (NIBS) has recently been proposed as an add-on method to promote motor function recovery after stroke. Several methods can be used based either on transcranial magnetic stimulation (repetitive mode: rTMS, TBS) via a coil, or small electric current via larges electrodes placed on the scalp, (transcranial direct current stimulation tDCS). Depending on the different electrophysiological parameters of stimulation used, NIBS can induce a transient modulation of the excitability of the stimulated motor cortex (facilitation or inhibition) via a probable LTP-LTD-like mechanism. Several small studies have shown feasible and positive treatment effects for most of these strategies and their potential clinical relevance to help restoring the disruption of interhemispheric imbalance after stroke. Results of these studies are encouraging but many questions remain unsolved: what are the optimal stimulation parameters? What is the best NIBS intervention? Which cortex, injured or intact, should be stimulated? What is the best window of intervention? Is there a special subgroup of stroke patients who could strongly benefit from these interventions? Finally is it possible to boost NIBS treatment effect by motor training of the paretic hand or by additional neuropharmacological interventions? There is clearly a need for large-scale, controlled, multicenter trials to answer these questions before proposing their routine use in the management of stroke patients.
Le cerveau d’un patient victime d’un accident vasculaire cérébral (AVC) a les capacités de reconfigurer son activité dans les suites de l’infarctus. Cette plasticité cérébrale spontanée, substrat de la récupération fonctionnelle, a fait l’objet de nombreux travaux de recherche en imagerie fonctionnelle et en électrophysiologie aboutissant au concept de balance interhémisphérique et au développement de techniques de neuromodulation corticale, visant à faciliter les processus naturels de plasticité corticale. Ces méthodes non invasives utilisent soit, l’application sur le scalp à travers un coil d’un courant magnétique en mode répétitif, (stimulation magnétique transcrânienne répétitive rTMS, TBS), soit l’application d’un courant électrique continu de faible intensité à travers deux larges électrodes placées sur le scalp, (stimulation électrique directe transcrânienne, tDCS). Elles permettent d’induire une modulation de l’excitabilité du cortex moteur sous-jacent transitoire et focale, (facilitation ou inhibition en fonction des paramètres de stimulation), par un mécanisme de type LTP/LTD. Ces méthodes visent principalement à restaurer l’équilibre de la balance interhémisphérique entre le cortex moteur du côté lésé et du côté sain. Plusieurs études ont souligné leur intérêt potentiel dans la récupération motrice post-AVC en montrant des améliorations sensibles des performances motrices de la main parétique comparativement à des stimulations placebo, ainsi que leur bonne tolérance. Cependant, de nombreuses questions demeurent encore en suspens avant de pouvoir les utiliser en routine, concernant les paramètres de stimulation optimaux, les cibles potentielles, le choix des techniques, la meilleure période de leur application (phase aiguë, chronique), les critères de sélection des patients susceptibles d’en bénéficier et finalement leur place par rapport aux techniques conventionnelles de rééducation et les approches neuropharmacologiques.Permalink : ./index.php?lvl=notice_display&id=34537 Exemplaires (1)
Cote Support Localisation Section Disponibilité Revue Revue Centre de Documentation HELHa Campus Montignies Armoires à volets Document exclu du prêt - à consulter sur place
Exclu du prêt