Functional magnetic stimulation: A new modality for enhancing systemic fibrinolysis

Lin, Vernon W.; Perkash, A; Liu, Hongjian; Todd, Danielle; Hsiao, Ian; Perkash, Inder

doi:10.1016/s0003-9993(99)90197-1

Cited by 12 publications

(6 citation statements)

References 34 publications

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“…The MAS is extensively and reliably used in clinical practice and research to evaluate spasticity and is reported to have good validity in patients with chronic stroke. 24 The scale is graded in 6 stages (0, no increase in tone; 1, slightly increased tone, giving a catch/release or minimal resistance at the end range of motion [ROM]; 1 + , slightly increased tone, giving a catch followed by minimal resistance throughout the remainder [less than half] of the ROM; 2, more markedly increased tone through most of the ROM but affected part easily moved; 3, considerably increased tone and passive movement difficult; and 4, limb rigid in flexion or extension). For convenience of statistical analysis, MAS grade 1 + was point 2; grades 2, 3, and 4 were respectively matched to 3, 4, and 5.…”

Section: Methodsmentioning

confidence: 99%

Effect of Radial Shock Wave Therapy on Spasticity of the Upper Limb in Patients With Chronic Stroke

et al. 2016

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Recently, studies have reported that extracorporeal shock wave therapy (ESWT) is a safe, noninvasive, alternative treatment for spasticity. However, the effect of ESWT on spasticity cannot be determined, because most studies to date have enrolled small patient numbers and have lacked placebo-controlled groups and/or long-term follow-up. In addition, whether varying the number of ESWT sessions would affect the duration of the therapeutic effect has not been investigated in a single study. Hence, we performed a prospective, randomized, single blind, placebo-controlled study to investigate the long-term effect of radial ESWT (rESWT) in patients with poststroke spasticity and surveyed the outcome of functional activity.Sixty patients were randomized into 3 groups. Group A patients received 1 session of rESWT per week for 3 consecutive weeks; group B patients received a single session of rESWT; group C patients received one session of sham rESWT per week for 3 consecutive weeks. The primary outcome was Modified Ashworth Scale of hand and wrist, whereas the secondary outcomes were Fugl-Meyer Assessment of hand function and wrist control. Evaluations were performed before the first rESWT treatment and immediately 1, 4, 8, 12, and 16 weeks after the last session of rESWT.Compared to the control group, the significant reduction in spasticity of hand and wrist lasted at least 16 and 8 weeks in group A and B, respectively. Three sessions of rESWT had a longer-lasting effect than one session. Furthermore, the reduction in spasticity after 3 sessions of rESWT may be beneficial for hand function and wrist control and the effect was maintained for 16 and 12 weeks, respectively.rESWT may be valuable in decreasing spasticity of the hand and wrist with accompanying enhancement of wrist control and hand function in chronic stroke patients.

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Section: Methodsmentioning

confidence: 99%

Effect of Radial Shock Wave Therapy on Spasticity of the Upper Limb in Patients With Chronic Stroke

et al. 2016

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“…Many perturbation studies were designed to assess spasticity and instructed subjects to relax and not intervene or react to the perturbation [ 14 , 19 , 23 – 25 ]. Other studies have instructed subjects to actively assist [ 26 ] or actively resist [ 27 ] the perturbation. In these paradigms the applied perturbation directly controlled limb motion so that the subject could not actively achieve the behavioural goal.…”

Section: Introductionmentioning

confidence: 99%

Impaired corrective responses to postural perturbations of the arm in individuals with subacute stroke

Bourke

Coderre

Bagg

et al. 2015

J NeuroEngineering Rehabil

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BackgroundStroke is known to alter muscle stretch responses following a perturbation, but little is known about the behavioural consequences of these altered feedback responses. Characterizing impairments in people with stroke in their interactions with the external environment may lead to better long term outcomes. This information can inform therapists about rehabilitation targets and help subjects with stroke avoid injury when moving in the world.MethodsIn this study, we developed a postural perturbation task to quantity upper limb function of subjects with subacute stroke (n = 38) and non-disabled controls (n = 74) to make rapid corrective responses with the arm. Subjects were instructed to maintain their hand at a target before and after a mechanical load was applied to the limb. Visual feedback of the hand was removed for half of the trials at perturbation onset. A number of parameters quantified subject performance, and impairment in performance was defined as outside the 95th percentile performance of control subjects.ResultsIndividual subjects with stroke showed increased postural instability (44%), delayed motor responses (79%), delayed returns towards the spatial target (79%), and greater endpoint errors (74%). Several subjects also showed impairments in the temporal coordination of the elbow and shoulder joints when responding to the perturbation (47%). Interestingly, impairments in task parameters were often found for both arms of individual subjects with stroke (up to 58% for return time). Visual feedback did not improve performance on task parameters except for decreasing endpoint error for all subjects. Significant correlations between task performance and clinical measures were dependent on the arm assessed.ConclusionsThis study used a simple postural perturbation task to highlight that subjects with stroke commonly have difficulties responding to mechanical disturbances that may have important implications for their ability to perform daily activities.

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“…Spasticity will be evaluated using the Modified Ashworth Scale (MAS) [ 23 ]. This scale has been validated for the evaluation of spasticity [ 24 , 25 ] and is sensitive to change following BTX-A treatment [ 26 ]. Lastly, strength of the hip extensor, flexor and abductor, knee flexor and extensor, ankle dorsiflexor and plantarflexor muscles of the affected and non-affected lower limbs will be measured using the Medical Research Council (MRC) scale [ 27 , 28 ] (Table 2 ).…”

Section: Method/designmentioning

confidence: 99%

Effect of botulinum toxin injection on length and force of the rectus femoris and triceps surae muscles during locomotion in patients with chronic hemiparesis (FOLOTOX)

et al. 2018

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BackgroundAfter stroke, spasticity of the rectus femoris (RF) and triceps surae (TS) muscles frequently alters the gait pattern. Knee flexion and ankle dorsiflexion in swing are often reduced, respectively called Stiff Knee Gait (SKG) and equinus. A preliminary uncontrolled study suggested that botulinum toxin type A (BTX-A) injections could improve muscle length and force generated during gait, improving inter-segmental coordination.The aim of this randomised controlled study is thus to evaluate changes in the length of the RF and TS muscles during gait 1 month after either BTX-A or placebo injection in patients with chronic stroke, SKG and spastic equinus. The secondary aims are to evaluate peak length and peak force generated during gait, as well inter-segmental coordination assessed using the continuous relative phase method initially described by Barela et al. in patients with stroke.MethodsThis is a prospective, three-centre, randomised, placebo-controlled, triple blind study over 3 months with 4 visits. Forty patients will be included. During visits V1, V3 and V4, length and force generated by RF and TS during gait will be assessed using musculoskeletal models (MSM). Muscle force will also be assessed using an isokinetic dynamometer. Inter segmental coordination will be evaluated using 3D gait analysis and functional tests will be performed. During V2, patients will receive either an injection of BTX-A in the RF and TS muscles or a placebo injection of saline solution.DiscussionWe expect an increase in peak length and a decrease in peak force generated by the RF and TS muscles in the BTX-A group 1 month post injection. Moreover, we expect these parameters to be more improved in the BTX-A than the Control group. This is the first study to assess these parameters in a randomised, controlled trial using instrumented methods (isokinetic evaluation and 3D gait analysis). The results should help to improve understanding of the mechanism(s) underlying improvements in inter-segmental coordination that have been found in many previous uncontrolled studies.Trial registrationClinicalTrials.gov: NCT01821573, First received: March 27, 2013 Last updated: September 14, 2016 Last verified: September 2016 Other Study ID Numbers: P110136 AOM11223.

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Functional magnetic stimulation: A new modality for enhancing systemic fibrinolysis

Cited by 12 publications

References 34 publications

Effect of Radial Shock Wave Therapy on Spasticity of the Upper Limb in Patients With Chronic Stroke

Effect of Radial Shock Wave Therapy on Spasticity of the Upper Limb in Patients With Chronic Stroke

Impaired corrective responses to postural perturbations of the arm in individuals with subacute stroke

Effect of botulinum toxin injection on length and force of the rectus femoris and triceps surae muscles during locomotion in patients with chronic hemiparesis (FOLOTOX)

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