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A review of combined neuromodulation and physical therapy interventions for enhanced neurorehabilitation
Rehabilitation approaches for individuals with neurologic conditions have increasingly shifted toward promoting neuroplasticity for enhanced recovery and restoration of function. This review focuses on exercise strategies and non-invasive neuromodulation techniques that target neuroplasticity, including transcranial magnetic stimulation (TMS), vagus nerve stimulation (VNS), and peripheral nerve stimulation (PNS). We have chosen to focus on non-invasive neuromodulation techniques due to their greater potential for integration into routine clinical practice. We explore and discuss the application of these interventional stra...
Source: Frontiers in Human Neuroscience - July 21, 2023 Category: Neuroscience Source Type: research

Hitting the Target? Achieving Optimal Cardiovascular Intensity for Persons With Spinal Cord Injury And Stroke
To investigate the feasibility of achieving the American Physical Therapy Association Locomotor Clinical Practice Guideline's cardiovascular intensity recommendations for persons with acute or sub-acute spinal cord injury (SCI) and acute or sub-acute cerebrovascular accident (CVA).
Source: Archives of Physical Medicine and Rehabilitation - December 1, 2022 Category: Rehabilitation Authors: Zachary Crump, Amol Karmarkar Tags: Research Poster 2184095 Source Type: research

Physical Therapy Provider Continuity Predicts Functional Improvements in Inpatient Rehabilitation
CONCLUSIONS: PT provider continuity is related to the functional improvement of neurologically impaired patients in inpatient rehabilitation.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A405, which discusses the findings of this work in a narrative format).PMID:36279402 | DOI:10.1097/NPT.0000000000000422
Source: Health Physics - October 24, 2022 Category: Physics Authors: Mitchell D Adam Debra K Ness John H Hollman Source Type: research

A Narrative Review of Alternate Gait Training Using Knee-ankle-foot Orthosis in Stroke Patients with Severe Hemiparesis
Phys Ther Res. 2021 Dec 6;24(3):195-203. doi: 10.1298/ptr.R0015. eCollection 2021.ABSTRACTImpairments resulting from stroke lead to persistent difficulties with walking. Subsequently, an improved walking ability is one of the highest priorities for people living with stroke. The degree to which gait can be restored after a stroke is related to both the initial impairment in walking ability and the severity of paresis of the lower extremities. However, there are some patients with severe motor paralysis and a markedly disrupted corticospinal tract who regain their gait function. Recently, several case reports have described...
Source: Physical Therapy - January 17, 2022 Category: Physiotherapy Authors: Hiroaki Abe Kei Kadowaki Naohide Tsujimoto Toru Okanuka Source Type: research

Clinical Practice Guideline to Improve Locomotor Function Following Chronic Stroke, Incomplete Spinal Cord Injury, and Brain Injury
Discussion: The collective findings suggest that large amounts of task-specific (ie, locomotor) practice may be critical for improvements in walking function, although only at higher cardiovascular intensities or with augmented feedback to increase patient's engagement. Lower-intensity walking interventions or impairment-based training strategies demonstrated equivocal or limited efficacy. Limitations: As walking speed and distance were primary outcomes, the research participants included in the studies walked without substantial physical assistance. This guideline may not apply to patients with limited ambulatory fun...
Source: Journal of Neurologic Physical Therapy - December 17, 2019 Category: Physiotherapy Tags: Clinical Practice Guidelines Source Type: research

Clinical Practice Guideline to Improve Locomotor Function Following Chronic Stroke, Incomplete Spinal Cord Injury, and Brain Injury.
DISCUSSION: The collective findings suggest that large amounts of task-specific (ie, locomotor) practice may be critical for improvements in walking function, although only at higher cardiovascular intensities or with augmented feedback to increase patient's engagement. Lower-intensity walking interventions or impairment-based training strategies demonstrated equivocal or limited efficacy. LIMITATIONS: As walking speed and distance were primary outcomes, the research participants included in the studies walked without substantial physical assistance. This guideline may not apply to patients with limited ambulatory fun...
Source: Physical Therapy - December 14, 2019 Category: Physiotherapy Authors: Hornby TG, Reisman DS, Ward IG, Scheets PL, Miller A, Haddad D, Fox EJ, Fritz NE, Hawkins K, Henderson CE, Hendron KL, Holleran CL, Lynskey JE, Walter A, and the Locomotor CPG Appraisal Team Tags: J Neurol Phys Ther Source Type: research

Influence of Combined Transcranial Direct Current Stimulation and Motor Training on Corticospinal Excitability in Children With Unilateral Cerebral Palsy
Conclusion This proof-of-principle study evaluated the influence of cathodal contralesional tDCS on corticospinal excitability in pediatric participants with UCP. A hypothesized decrease in contralesional excitability was noted in participants in the Active+CIMT group, however, the efficacy of tDCS to modulate corticospinal excitability was not statistically different than the Sham+CIMT group. A more detailed understanding of how tDCS impacts M1 neurophysiology will be essential to inform future clinical trials on the optimal dosing parameters, based on individual brain circuitry, to explore the potential functional benef...
Source: Frontiers in Human Neuroscience - April 23, 2019 Category: Neuroscience Source Type: research

Learning to Walk Again
When someone suffers a stroke, he or she often loses some mobility, and some 60 percent of survivors are left with lower-limb deficits. “They usually have one leg that's more impaired than the other leg, and then they undergo rehabilitation and physical therapy. And often they don't fully recover,” said Conor Walsh, professor of engineering and applied sciences at the John A. Paulson Harvard School of Engineering and Applied Sciences and a core faculty member at the Wyss Institute for Biologically Inspired Engineering, in an interview with MD+DI. But a new device called ReSto...
Source: MDDI - April 17, 2019 Category: Medical Devices Authors: Susan Shepard Tags: Design Source Type: news

Does acupuncture help patients with spasticity? A narrative review
Publication date: Available online 5 November 2018Source: Annals of Physical and Rehabilitation MedicineAuthor(s): Yi Zhu, Yujie Yang, Jianan LiAbstractSpasticity is a motor disorder encountered after upper motor neuron lesions. It adversely affects quality of life in most patients and causes long-term burden of care and has significant financial implications. The effect of conventional therapies for spasticity including physical therapy, surgery, and pharmacotherapy are not always satisfying because of the short-term effects or side effects in some patients. Acupuncture is a part of traditional medicine originating from C...
Source: Annals of Physical and Rehabilitation Medicine - November 6, 2018 Category: Rehabilitation Source Type: research

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