Customizing Functional Electrical Therapy Using a ‘Rehabilitation Problem-Solving Form’ – A Preliminary Study

Banerjee, Alakananda; Kumar, Rajiv; Khattar, Bhawna; Dutta, Anirban

doi:10.1007/978-3-642-34546-3_29

Cited by 1 publication

(1 citation statement)

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“…In the HSM of neurorehabilitation, the service delivery assets into a network consist of an anchor establishment (hub) which will offer a full array of services, complemented by secondary community-based establishments (spokes) that can offer local neurorehabilitation service arrays, routing patients needing more intensive services to the hub for treatment. Here, the feasibility of an online assessment document called 'Rehabilitation Problem-Solving Form' (RPS-Form) [87] was shown by us in a preliminary study in India to monitor patient's response to a short-duration moderate-intensity neurostimulation therapy by assessing all the ICF components. Here, our innovative online RPS-Form captures patients' perspective that has been shown in our preliminary study [87] to facilitate communications between the patient (at the spoke in HSM) and his/her multi-disciplinary rehabilitation team (at the hub in HSM) consisting of physiotherapists, occupational therapists, medical doctors, and rehabilitation engineers.…”

Section: Discussionmentioning

confidence: 99%

Deep Cerebellar Transcranial Direct Current Stimulation of the Dentate Nucleus to Facilitate Standing Balance in Chronic Stroke Survivors—A Pilot Study

et al. 2020

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Objective: Cerebrovascular accidents are the second leading cause of death and the third leading cause of disability worldwide. We hypothesized that cerebellar transcranial direct current stimulation (ctDCS) of the dentate nuclei and the lower-limb representations in the cerebellum can improve functional reach during standing balance in chronic (>6 months’ post-stroke) stroke survivors. Materials and Methods: Magnetic resonance imaging (MRI) based subject-specific electric field was computed across a convenience sample of 10 male chronic (>6 months) stroke survivors and one healthy MRI template to find an optimal bipolar bilateral ctDCS montage to target dentate nuclei and lower-limb representations (lobules VII–IX). Then, in a repeated-measure crossover study on a subset of 5 stroke survivors, we compared 15 min of 2 mA ctDCS based on the effects on successful functional reach (%) during standing balance task. Three-way ANOVA investigated the factors of interest– brain regions, montages, stroke participants, and their interactions. Results: “One-size-fits-all” bipolar ctDCS montage for the clinical study was found to be PO9h–PO10h for dentate nuclei and Exx7–Exx8 for lobules VII–IX with the contralesional anode. PO9h–PO10h ctDCS performed significantly (alpha = 0.05) better in facilitating successful functional reach (%) when compared to Exx7–Exx8 ctDCS. Furthermore, a linear relationship between successful functional reach (%) and electric field strength was found where PO9h–PO10h montage resulted in a significantly (alpha = 0.05) higher electric field strength when compared to Exx7–Exx8 montage for the same 2 mA current. Conclusion: We presented a rational neuroimaging based approach to optimize deep ctDCS of the dentate nuclei and lower limb representations in the cerebellum for post-stroke balance rehabilitation. However, this promising pilot study was limited by “one-size-fits-all” bipolar ctDCS montage as well as a small sample size.

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Section: Discussionmentioning

confidence: 99%