Top Stroke Rehabil
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Impaired postural control is a key characteristic of mobility problems in stroke patients and has great impact on the incidence of falls and on the level of independence in activities of daily living. The role played by the thigh muscles in balance impairment in stroke patients has not been sufficiently investigated. This study investigated the activities of the thigh muscles in stroke patients during standing balance manipulations. ⋯ The vastus medialis, rectus femoris, and biceps femoris muscles on the affected side and the rectus femoris muscle on the unaffected side of stroke patients are involved in the static balance deficits, while the biceps femoris on the affected side influences dynamic balance control.
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Multicenter Study
Clinician perspectives of an intensive comprehensive aphasia program.
Intensive comprehensive aphasia programs (ICAPs) have increased in number in recent years in the United States and abroad. ⋯ Although there is a potential for bias with the small sample size, this pilot study gives insight into the clinician perspective of what makes working in an ICAP both worthwhile and challenging.
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The energy cost of transport is higher for persons with stroke compared with neurologically intact subjects, and this has a negative impact on ambulatory activity and function. Whether the high energy cost of walking after stroke is influenced by gait training interventions is generally not considered. ⋯ Energy and caloric cost of transport at self-selected walking speeds improved pre to post training but were unaffected at an absolute walking speed, suggesting that the improved energy cost of transport was through improvements in the subject's self-selected walking speed. These results illustrate that improvements in walking speed following an intervention are an important mechanism by which the energy cost of transport can be reduced post stroke.
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Review Case Reports
Central poststroke pain: current diagnosis and treatment.
Central post-stroke pain syndrome (CPSP) is a debilitating sequel that can follow thalamic sensory stroke. Less well recognized, CPSP follows lateral medullary stroke and parietal cortical stroke and may develop anywhere along the spinothalamic or trigemino-thalamic pathways. ⋯ It is treatable disorder. Pharmacological therapy, magnetic stimulation, and invasive electrical stimulation are reviewed and recommendations made.
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Randomized Controlled Trial Clinical Trial
Modified constraint-induced movement therapy improved upper limb function in subacute poststroke patients: a small-scale clinical trial.
Constraint-induced movement therapy (CIMT) has been advocated as a means of facilitating motor function in poststroke patients; however, the evidence for its efficacy is controversial. ⋯ Our study provides additional support for the use of modified CIMT during a subacute rehabilitation period of poststroke patients. CIMT may facilitate functional improvement of a plegic hand.