Effects of Age on Long-Term Functional Recovery in Patients with Stroke

Yoo, Ji-Yeon; Hong, Bo Young; Jo, Leechan; Kim, Joon-Sung; Park, Jung-Geun; Shin, Bo Kyung; Lim, Seong Hoon

doi:10.3390/medicina56090451

Cited by 36 publications

(31 citation statements)

References 29 publications

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“…[ 15 , 16 ] The secondary outcome measure was the change in ADL, assessed by the Korean version of the Modified Barthel Index (MBI). [ 1 , 17 , 18 ]…”

Section: Methodsmentioning

confidence: 99%

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Graded motor imagery training as a home exercise program for upper limb motor function in patients with chronic stroke

Ji¹,

Wang²,

Jung³

et al. 2021

Medicine

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Purpose: Although several types of occupational therapy for motor recovery of the upper limb in patients with chronic stroke have been investigated, most treatments are performed in a hospital or clinic setting. We investigated the effect of graded motor imagery (GMI) training, as a home exercise program, on upper limb motor recovery and activities of daily living (ADL) in patients with stroke. Methods: This prospective randomized controlled trial recruited 42 subjects with chronic stroke. The intervention group received instruction regarding the GMI program and performed it at home over 8 weeks (30 minutes a day). The primary outcome measure was the change in motor function between baseline and 8 weeks, assessed the Manual Function Test (MFT) and Fugl-Meyer Assessment (FMA). The secondary outcome measure was the change in ADL, assessed with the Modified Barthel Index (MBI). Results: Of the 42 subjects, 37 completed the 8-week program (17 in the GMI group and 20 controls). All subjects showed significant improvements in the MFT, FMA, and MBI over time (P < .05). However, the improvements in the total scores for the MFT, FMA, and MBI did not differ between the GMI and control groups. The MFT arm motion score for the GMI group was significantly better than that of the controls (P < .05). Conclusions: The GMI program may be useful for improving upper extremity function as an adjunct to conventional rehabilitation for patients with chronic stroke.

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“…[ 15 , 16 ] The secondary outcome measure was the change in ADL, assessed by the Korean version of the Modified Barthel Index (MBI). [ 1 , 17 , 18 ]…”

Section: Methodsmentioning

confidence: 99%

“…Most of the functional recovery is achieved within 3 months after onset. [ 1 – 5 ] During the chronic stage, functional recovery is slow and then reaches a plateau. [ 3 , 5 ] Thus, in-patient rehabilitation usually continues in the acute and subacute phases of stroke.…”

Section: Introductionmentioning

confidence: 99%

Graded motor imagery training as a home exercise program for upper limb motor function in patients with chronic stroke

Ji¹,

Wang²,

Jung³

et al. 2021

Medicine

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“…The values are summed across joints; a score of 100 indicates the absence of any impairment. Functional disability was assessed using the Korean version of the Modified Barthel Index (MBI) [ 16 , 17 ]. Patients were classified as having spatial neglect when they showed typical clinical behavior such as (i) spontaneous deviation of the head and eyes toward the ipsilesional side, (ii) orienting toward the ipsilesional side when addressed from the front or the left, and (iii) ignoring of contralesionally located people or objects [ 18 , 19 ].…”

Section: Methodsmentioning

confidence: 99%

Is Lateropulsion Really Related with a Specific Lesion of the Brain?

Lee

Yoo

et al. 2021

Brain Sciences

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Lateropulsion (pusher syndrome) is an important barrier to standing and gait after stroke. Although several studies have attempted to elucidate the relationship between brain lesions and lateropulsion, the effects of specific brain lesions on the development of lateropulsion remain unclear. Thus, the present study investigated the effects of stroke lesion location and size on lateropulsion in right hemisphere stroke patients. The present retrospective cross-sectional observational study assessed 50 right hemisphere stroke patients. Lateropulsion was diagnosed and evaluated using the Scale for Contraversive Pushing (SCP). Voxel-based lesion symptom mapping (VLSM) analysis with 3T-MRI was used to identify the culprit lesion for SCP. We also performed VLSM controlling for lesion volume as a nuisance covariate, in a multivariate model that also controlled for other factors contributing to pusher behavior. VLSM, combined with statistical non-parametric mapping (SnPM), identified the specific region with SCP. Lesion size was associated with lateropulsion. The precentral gyrus, postcentral gyrus, inferior frontal gyrus, insula and subgyral parietal lobe of the right hemisphere seemed to be associated with the lateropulsion; however, after adjusting for lesion volume as a nuisance covariate, no lesion areas were associated with the SCP scores. The size of the right hemisphere lesion was the only factor most strongly associated with lateropulsion in patients with stroke. These results may be useful for planning rehabilitation strategies of restoring vertical posture and understanding the pathophysiology of lateropulsion in stroke patients.

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“…In addition, according to recent studies, the gender issue, i.e., that the female sex would worsen the outcome of stroke, has emerged as an important issue for recovery and predicting long-term outcomes for stroke [24][25][26][27]. Moreover, age, particularly aged 70 years or older, reported a negative impact on the 30-month outcomes of stroke [16]. Thus, a large-scale prospective longitudinal study for EVT with several clinical factors on the functional outcome would be needed to address the remaining questions.…”

Section: Discussionmentioning

confidence: 99%

“…All rehabilitation programs began within 5 days after onset. Treatment continued until 6 months after onset and consisted of both physical (neurodevelopmental treatment approach) and occupational (task-orientated approach) therapy for 1-2 h per day, 5 days per week [9,16]. Speech therapy was provided as needed.…”

Section: Study Design and Participantsmentioning

confidence: 99%

The Long-Term Functional Effect of Thrombectomy on Patients with Middle Cerebral Artery Occlusion Who Exhibit Moderate to Severe Disability

Lee

Hong

et al. 2021

Medicina

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Background and Objectives: Endovascular thrombectomy (EVT is an emerging gold standard treatment for acute cerebral infarction and may allow functional improvement after subacute cerebral infarction. However, the long-term functional benefits of EVT in patients with moderate to severe disability remain unclear. We investigated the effects of EVT on the activities of daily living (ADL), handicap, gait, and eating in patients with middle cerebral artery (MCA) occlusion who exhibited moderate to severe disability (score of 3–5 on the modified Rankin scale (mRS)) due to stroke, up to six months after onset. Materials and Methods: This retrospective longitudinal case–control study assessed 45 patients with MCA occlusion who exhibited moderate to severe disability (mRS score ≥ 3): 15 underwent EVT and 30 served as controls. Clinical assessments were conducted at two weeks (12–16 days), four weeks (26–30 days), and six months (180–210 days) after stroke onset. Functional assessments comprised the Korean version of the modified Barthel index (MBI), mRS, functional ambulation category (FAC), and dysphagia outcome severity scale (DOSS) to assess disability, handicap, gait, and eating. Results: The MBI, mRS, FAC, and DOSS scores all improved significantly (all p < 0.05) in the EVT group, compared to the controls. Conclusions: EVT has favorable effects on performing routine ADL, the handicap itself, walking, and eating. Therefore, EVT is recommended for patients with acute MCA occlusion, including those with severe disability at the initial assessment.

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Effects of Age on Long-Term Functional Recovery in Patients with Stroke

Cited by 36 publications

References 29 publications

Graded motor imagery training as a home exercise program for upper limb motor function in patients with chronic stroke

Graded motor imagery training as a home exercise program for upper limb motor function in patients with chronic stroke

Is Lateropulsion Really Related with a Specific Lesion of the Brain?

The Long-Term Functional Effect of Thrombectomy on Patients with Middle Cerebral Artery Occlusion Who Exhibit Moderate to Severe Disability

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