Non-invasive brain stimulation for improving gait, balance, and lower limbs motor function in stroke

Veldema, Jitka; Gharabaghi, Alireza

doi:10.1186/s12984-022-01062-y

Cited by 55 publications

(47 citation statements)

References 95 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although a general examination of mobility-based characteristics ( Table 1 ) may be useful for an initial fall risk assessment with current IMU approaches, stratifying characteristics according to conceptual models ( Figure 1 ) may be more helpful to better understand discrete cognitive functions [ 30 ] and the effectiveness of targeted interventions [ 31 ]. Table 2 stratifies all mobility-based gait characteristics according to a free-living conceptual model [ 20 ], the use of which may enable more sensitive methods to better identify the use of a targeted intervention [ 32 ], particularly when the associated environmental context is known.…”

Section: Resultsmentioning

confidence: 99%

Enhancing Free-Living Fall Risk Assessment: Contextualizing Mobility Based IMU Data

Moore

Stuart

McMeekin

et al. 2023

Sensors

View full text Add to dashboard Cite

Fall risk assessment needs contemporary approaches based on habitual data. Currently, inertial measurement unit (IMU)-based wearables are used to inform free-living spatio-temporal gait characteristics to inform mobility assessment. Typically, a fluctuation of those characteristics will infer an increased fall risk. However, current approaches with IMUs alone remain limited, as there are no contextual data to comprehensively determine if underlying mechanistic (intrinsic) or environmental (extrinsic) factors impact mobility and, therefore, fall risk. Here, a case study is used to explore and discuss how contemporary video-based wearables could be used to supplement arising mobility-based IMU gait data to better inform habitual fall risk assessment. A single stroke survivor was recruited, and he conducted a series of mobility tasks in a lab and beyond while wearing video-based glasses and a single IMU. The latter generated topical gait characteristics that were discussed according to current research practices. Although current IMU-based approaches are beginning to provide habitual data, they remain limited. Given the plethora of extrinsic factors that may influence mobility-based gait, there is a need to corroborate IMUs with video data to comprehensively inform fall risk assessment. Use of artificial intelligence (AI)-based computer vision approaches could drastically aid the processing of video data in a timely and ethical manner. Many off-the-shelf AI tools exist to aid this current need and provide a means to automate contextual analysis to better inform mobility from IMU gait data for an individualized and contemporary approach to habitual fall risk assessment.

show abstract

Section: Resultsmentioning

confidence: 99%

Enhancing Free-Living Fall Risk Assessment: Contextualizing Mobility Based IMU Data

Moore

Stuart

McMeekin

et al. 2023

Sensors

View full text Add to dashboard Cite

show abstract

“…One could argue that NIBS could also have positive effects when coupled with conventional therapy. Actually, several works assessed NIBS coupled with conventional physiotherapy as compared to stand-alone for either upper or lower limbs, showing the coupled intervention as an effective strategy to improve motor function recovery in post-stroke patients [ 2 , 87 ]. No studies directly compared RAR, NIBS, and conventional physiotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…These include early reperfusion therapies (i.e., intravenous thrombolysis and mechanical thrombectomy) aimed at limiting damage and preventing further cell death to contain lesion size and disability [ 1 ]. Furthermore, traditional (neurofacilitation or functional retraining through either shaping or task practice) and advanced rehabilitation protocols, including pharmacological manipulation to increase sprouting and anatomical plasticity, non-invasive brain stimulation (NIBS) to modulate the activity of targeted brain areas, and robot-aided rehabilitation (RAR) to perform an intensive, repetitive, assisted-as-needed, and task-oriented motor practice, are available in any phase of the post-stroke recovery process [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ]. These rehabilitation strategies aim to increase the adaptive plasticity processes (mainly experience-dependent plasticity mechanisms) that develop in lesional and perilesional tissues [ 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…To date, NIBS and RAR represent two cornerstones of the modern post-stroke rehabilitation era. Both strategies have been employed singularly concerning post-stroke rehabilitation with valuable positive results [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ]. Both strategies aim at potentiating neuroplasticity mechanisms supporting functional recovery via bottom-up (RAR) and top-down (NIBS) mechanisms [ 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Improving Upper Limb and Gait Rehabilitation Outcomes in Post-Stroke Patients: A Scoping Review on the Additional Effects of Non-Invasive Brain Stimulation When Combined with Robot-Aided Rehabilitation

Naro

Calabrò

2022

Brain Sciences

View full text Add to dashboard Cite

Robot-aided rehabilitation (RAR) and non-invasive brain stimulation (NIBS) are the two main interventions for post-stroke rehabilitation. The efficacy of both approaches in combination has not been well established yet. The importance of coupling these interventions, which both enhance brain plasticity to promote recovery, lies in augmenting the rehabilitation potential to constrain the limitation in daily living activities and the quality of life following stroke. This review aimed to evaluate the evidence of NIBS coupled with RAR in improving rehabilitation outcomes of upper limb and gait motor impairment in adult individuals with stroke. We included 18 clinical trials in this review. All studies were highly heterogeneous concerning the technical characteristics of robotic devices and NIBS protocols. However, the studies reported a global improvement in body structure and function and activity limitation for the upper limb, which were non-significant between the active and control groups. Concerning gait training protocols, the active group outperformed the control group in improving walking capacity and recovery. According to this review, NIBS and RAR in combination are promising but not yet largely recommendable as a systematic approach for stroke rehabilitation as there is not enough data about this. Therefore, more homogenous clinical trials are required, pointing out the best characteristics of the combined therapeutic protocols.

show abstract

“…However, their effects were not always favorable, and they seem to be influenced by the type of protocol used [21,28] or by the heterogenous capacity of individuals to induce M1 plasticity, both in healthy and poststroke-treated patients [30][31][32]. Regarding protocols, a meta-analysis on 445 stroke patients evidenced that bilateral transcranial electric stimulation and cathodal tDCS over the contralesional hemisphere were superior to other stimulation montages/patterns/protocols [33]. Promising results were also obtained with different protocols of NIBS applied to poststroke survivors.…”

Section: Introductionmentioning

confidence: 99%

From Molecule to Patient Rehabilitation: The Impact of Transcranial Direct Current Stimulation and Magnetic Stimulation on Stroke—A Narrative Review

et al. 2023

View full text Add to dashboard Cite

Stroke is a major health problem worldwide, with numerous health, social, and economic implications for survivors and their families. One simple answer to this problem would be to ensure the best rehabilitation with full social reintegration. As such, a plethora of rehabilitation programs was developed and used by healthcare professionals. Among them, modern techniques such as transcranial magnetic stimulation and transcranial direct current stimulation are being used and seem to bring improvements to poststroke rehabilitation. This success is attributed to their capacity to enhance cellular neuromodulation. This modulation includes the reduction of the inflammatory response, autophagy suppression, antiapoptotic effects, angiogenesis enhancement, alterations in the blood-brain barrier permeability, attenuation of oxidative stress, influence on neurotransmitter metabolism, neurogenesis, and enhanced structural neuroplasticity. The favorable effects have been demonstrated at the cellular level in animal models and are supported by clinical studies. Thus, these methods proved to reduce infarct volumes and to improve motor performance, deglutition, functional independence, and high-order cerebral functions (i.e., aphasia and heminegligence). However, as with every therapeutic method, these techniques can also have limitations. Their regimen of administration, the phase of the stroke at which they are applied, and the patients’ characteristics (i.e., genotype and corticospinal integrity) seem to influence the outcome. Thus, no response or even worsening effects were obtained under certain circumstances both in animal stroke model studies and in clinical trials. Overall, weighing up risks and benefits, the new transcranial electrical and magnetic stimulation techniques can represent effective tools with which to improve the patients’ recovery after stroke, with minimal to no adverse effects. Here, we discuss their effects and the molecular and cellular events underlying their effects as well as their clinical implications.

show abstract

Non-invasive brain stimulation for improving gait, balance, and lower limbs motor function in stroke

Cited by 55 publications

References 95 publications

Enhancing Free-Living Fall Risk Assessment: Contextualizing Mobility Based IMU Data

Enhancing Free-Living Fall Risk Assessment: Contextualizing Mobility Based IMU Data

Improving Upper Limb and Gait Rehabilitation Outcomes in Post-Stroke Patients: A Scoping Review on the Additional Effects of Non-Invasive Brain Stimulation When Combined with Robot-Aided Rehabilitation

From Molecule to Patient Rehabilitation: The Impact of Transcranial Direct Current Stimulation and Magnetic Stimulation on Stroke—A Narrative Review

Contact Info

Product

Resources

About