On the generalizability of post‐stroke proportional recovery

Wortman-Jutt, Susan; Edwards, Dylan

doi:10.1111/ene.13408

Cited by 3 publications

(2 citation statements)

References 22 publications

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Section: Recommendationsmentioning

confidence: 99%

“…Further exploration into the natural recovery of the 2 modalities. Existing studies on the proportional recovery rule as it applies to post-stroke motor versus language improvement have yet to yield conclusive data73 • • Determination of the effect of acute poststroke intervention such as intra-arterial treatment or pharmacological therapies on motor versus aphasia recovery 74 • • Examination of whether combinatorial motor-language approaches to aphasia recovery are always synergistic or could be competitive • • Analysis of the effect of aphasia therapy when it is delivered concurrently with motor-limb treatment, versus the effect when it is provided sequentially • • Experimentation to address the effects of training the dominant versus nondominant upper limb • • Establishing whether altered attention at an execu-…”

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Poststroke Aphasia Rehabilitation: Why All Talk and No Action?

Wortman-Jutt

Edwards

2019

Neurorehabil Neural Repair

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Aphasia is a debilitating language disorder that often follows stroke. It can affect any or all aspects of linguistic expression and comprehension, whether verbal, written, or gestural. Despite a growing understanding of the phenomenology of aphasia, new treatment paradigms are needed that directly target the underlying impairment. There are varying aphasia types and levels of severity, determined largely by the site and extent of stroke lesion as well as the degree of white matter integrity. 1 Herein, we will focus largely on the nonfluent or expressive poststroke aphasias, emphasizing how the affected anterior brain regions of the dominant hemisphere are interwoven with proximate cortical areas supporting upper limb and hand movement. Speech therapy is beneficial for patients with aphasia; however, no single treatment has proven most advantageous. 2 Many patients with aphasia experience chronic language deficits. Promising strategies to reduce permanent language deficits, such as pharmacological agents 3 and noninvasive brain stimulation 4 alone or in combination with speech therapy, have yet to be tested in appropriately powered clinical trials. One exciting perspective that is emerging from these multidisciplinary studies is the potential interaction between motor and aphasia recovery. 5,6 Increasingly, collateral effects on language production and comprehension have been reported as a result of the observation of movement. 7 Not coincidentally, given the close proximity of handarm and speech-language neural structures, in many patients with poststroke aphasia, the contralesional hand and arm are often simultaneously impaired. While the extent and limitations of hand-arm and speech-language cortical reciprocity remain under debate, it is likely that hand-arm movement and spoken language have at least a parallel, if not primary, relationship. 8 Nonetheless, stroke patients receiving speech-language therapy for aphasia are frequently seated during treatment, with hands and arms impassive. The use of hand-arm movement and exercise (eg, reaching, grasping, lifting) has not been sufficiently explored for direct use in aphasia rehabilitation. Objects that may be named in aphasia treatment, however, may also be simultaneously grasped. Manual tasks may be accompanied by verbal language, as they often are during activities of daily living. In this "Point-of-View" article, we provide an overview of data supporting hand-arm and language cortical reciprocity garnered from literature across multiple disciplines. Toward this aim, a PubMed search was conducted using multiple combinations of the terms "Limb," "Arm," "Gesture," "Speech," "Language" "Motor," "Action Verbs" and "Aphasia," yielding 652 articles. We excluded 384 articles due to their lack of relevance to our topic. For example, if the terms were combined incongruously or as part of a larger unrelated topic, these articles were excluded.

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confidence: 99%

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confidence: 99%

Poststroke Aphasia Rehabilitation: Why All Talk and No Action?

Wortman-Jutt

Edwards

2019

Neurorehabil Neural Repair

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Non-invasive Brain Stimulation in Human Stroke Survivors

Wortman-Jutt

Groen

Edwards

2020

Neurovascular Neuropsychology

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Effects of different acupuncture methods combined with routine rehabilitation on gait of stroke patients

Lou¹,

Yang²,

Ma³

et al. 2020

WJCC

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BACKGROUND Stroke refers to a group of cerebrovascular diseases associated with organic brain injury. It is characterized by the sudden and rapid onset of focal or diffuse dysfunction. In recent years, in addition to routine treatment, Chinese medicine acupuncture has been administered to patients with hemiplegia, and it can be considered a new treatment for rehabilitation. AIM To investigate the effects of eye acupuncture needle retention and body acupuncture combined with routine rehabilitation on gait performance and plantar pressure in patients recovering from stroke. METHODS Thirty-two stroke patients who met the inclusion criteria were randomly divided into an experimental group and a control group, with 16 patients in each group. Both groups underwent routine rehabilitation. The experimental group was treated by eye acupuncture needle retention, and the control group was treated by body acupuncture. Before and after 4 wk of treatment, both groups underwent kinematic and plantar pressure synchronous tests to assess gait performance. RESULTS The step length, gait speed, step frequency, joint angles of the lower limbs, and ground reaction force impulse in the anterior region of the affected foot in both groups significantly increased from before to after treatment ( P < 0.05); the center of mass displacement, peak pressure values, and impulse in the anterior region of the healthy foot and posterior regions of both the affected and healthy feet significantly decreased from before to after treatment ( P < 0.05). The patients in the experimental group showed greater improvement in the following parameters than the control group: Step length, gait speed, step frequency, lower extremity joint angles, center of gravity displacement, and peak pressure values and impulse in the anterior and posterior regions of both the affected and healthy feet ( P < 0.05). CONCLUSION Eye acupuncture needle retention and body acupuncture combined with routine rehabilitation can effectively improve the gait performance of patients recovering from stroke. Between these two treatments, eye acupuncture needle retention combined with routine treatment is better than body acupuncture, and it can be considered a practical and effective clinical treatment.

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On the generalizability of post‐stroke proportional recovery

Cited by 3 publications

References 22 publications

Poststroke Aphasia Rehabilitation: Why All Talk and No Action?

Poststroke Aphasia Rehabilitation: Why All Talk and No Action?

Non-invasive Brain Stimulation in Human Stroke Survivors

Effects of different acupuncture methods combined with routine rehabilitation on gait of stroke patients

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