A neurocognitive approach for recovering upper extremity movement following subacute stroke: a randomized controlled pilot study

Abstract

[Purpose] This study aims to describe a protocol based on neurocognitive therapeutic exercises and determine its feasibility and usefulness for upper extremity functionality when compared with a conventional protocol. [Subjects and Methods] Eight subacute stroke patients were randomly assigned to a conventional (control group) or neurocognitive (experimental group) treatment protocol. Both lasted 30 minutes, 3 times a week for 10 weeks and assessments were blinded. Outcome measures included: Motor Evaluation Scale for Upper Extremity in Stroke Patients, Motricity Index, Revised Nottingham Sensory Assessment and Kinesthetic and Visual Imagery Questionnaire. Descriptive measures and nonparametric statistical tests were used for analysis. [Results] The results indicate a more favorable clinical progression in the neurocognitive group regarding upper extremity functional capacity with achievement of the minimal detectable change. The functionality results are related with improvements on muscle strength and sensory discrimination (tactile and kinesthetic). [Conclusion] Despite not showing significant group differences between pre and post-treatment, the neurocognitive approach could be a safe and useful strategy for recovering upper extremity movement following stroke, especially regarding affected hands, with better and longer lasting results. Although this work shows this protocol’s feasibility with the panel of scales proposed, larger studies are required to demonstrate its effectiveness.

Reinforced Feedback in Virtual Environment for Plantar Flexor Poststroke Spasticity Reduction and Gait Function Improvement

“…Moreover, the TR session was focused on the overall functional recovery of the patient (including the upper limb) [2,[45][46][47][48]. Patients allocated to the TR group received specific rehabilitation of the LE consisting of passive, assisted, and active exercises in many directions in the lower limb workspace (e.g., coxofemoral joint flexion and extension, abduction and adduction, internal and external rotation, knee flexion, and extension) and mixed techniques with different approaches [11].…”

“…Stroke patients suffer several deficits that affect (mildly to severely) the cognitive, psychological, or motor areas of the brain, at the expense of their quality of life [1]. Although rehabilitation techniques do not only act on the motor deficits [2], the effects associated with the interruptions of the corticospinal tract, as well as the subsequent adaptive changes, commonly require specific interventions. Among them, the most important changes are muscle weakness, loss of dexterity, cocontraction, and increased tone and abnormal postures [3].…”

Neurocognitive robot-assisted rehabilitation of hand function: a randomized control trial on motor recovery in subacute stroke

“…The neurocognitive rehabilitation method proposed by Perfetti [17] was selected as reference therapy approach. It focuses on the training of motor function, somatosensation and cognition, which all contribute to functional interactions between body and environment (e.g., information perception, as well as elaboration, selection and execution of motor plans) [18][19][20]. Because of the relevance of processing sensory inputs, this approach is particularly interesting for hand rehabilitation.…”

Exploratory study of how cognitive multisensory rehabilitation restores parietal operculum connectivity and improves upper limb movements in chronic stroke 

“…CMR, whose original Italian name is "riabilitazione neurocognitiva", is also translated in other publications as cognitive therapeutic exercises [69], Cognitive Sensory Motor Training [19], neurocognitive therapeutic exercise [70], cognitive exercise therapy [18], or (neuro)cognitive approach [71,72].…”