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Stroke Rehabilitation Related Brain Research: Latest Developments and Perspectives

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (3 April 2023) | Viewed by 6111

Special Issue Editors


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Guest Editor
Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
Interests: mental health; stroke recovery; motor cretex

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Guest Editor
Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife 50670-901, PE, Brazil
Interests: spinal cord injury; steoarthritis

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Guest Editor
Physiotherapy Department, Federal University of Pernambuco, Recife 50670-901, PE, Brazil
Interests: neural imaging; motor cortex; chronic stroke

Special Issue Information

Dear Colleagues,

According to the World Health Organization (WHO), stroke is the second most common cause of death and a primary cause of disability in the world. Given the significant advancements in acute stroke medical management leading to improved survival rates, the number of stroke survivors with disabilities is likely to increase over the coming decades. For this reason, improving rehabilitation efficacy is critical for reducing the global stroke burden. In the last decade, significant advances in knowledge of the brain mechanisms of recovery after stroke have provided hope for future treatment applications.

In this issue, we invite investigators to contribute with original research and review articles that address brain-research-based strategies to promote optimal ongoing physical, cognitive, and emotional recovery for acute, subacute, or chronic stroke survivors.

Potential topics include but are not limited to:

  • Variable patterns of treatment responsiveness;
  • Biomarkers associated with stroke recovery;
  • Use of technologies such as MRI, TMS and EEG measures to guide rehabilitation strategies;
  • Brain-research–based approaches in stroke rehabilitation.

Dr. Kátia Monte-Silva
Dr. Lívia Shirahige
Dr. Adriana Baltar
Guest Editors

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Keywords

  • recovery
  • stroke
  • biomarker
  • brain imaging
  • rehabilitation

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Published Papers (2 papers)

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11 pages, 1831 KiB  
Article
Do Higher Transcranial Direct Current Stimulation Doses Lead to Greater Gains in Upper Limb Motor Function in Post-Stroke Patients?
by Raylene Pires, Adriana Baltar, Maria Paz Sanchez, Gabriel Barreto Antonino, Rodrigo Brito, Marina Berenguer-Rocha and Katia Monte-Silva
Int. J. Environ. Res. Public Health 2023, 20(2), 1279; https://doi.org/10.3390/ijerph20021279 - 10 Jan 2023
Cited by 6 | Viewed by 1806
Abstract
Objective: To investigate whether a higher number of transcranial direct current stimulation (tDCS) sessions results in a greater improvement in upper limb function in chronic post-stroke patients. Materials and methods: A randomized, sham-controlled, double-blind clinical trial was conducted in 57 chronic post-stroke [...] Read more.
Objective: To investigate whether a higher number of transcranial direct current stimulation (tDCS) sessions results in a greater improvement in upper limb function in chronic post-stroke patients. Materials and methods: A randomized, sham-controlled, double-blind clinical trial was conducted in 57 chronic post-stroke patients (≥ 3 months after their injuries). The patients were allocated to receive sessions of tDCS combined with physiotherapy and divided into three groups (anodal, cathodal, and sham). The Fugl-Meyer Assessment of Upper Extremity (FMA-UE) was used to assess the sensorimotor impairment of the patients’ upper limbs before (baseline) and after five and ten sessions. The percentage of patients who achieved a clinically significant improvement (> five points on the FMA-UE) was also analyzed. Results: The FMA-UE score increased after five and ten sessions in both the anodal and cathodal tDCS groups, respectively, compared to the baseline. However, in the sham group, the FMA-UE score increased only after ten sessions. When compared to the sham group, the mean difference from the baseline after five sessions was higher in the anodal tDCS group. The percentage of individuals who achieved greater clinical improvement was higher in the stimulation groups than in the sham group and after ten sessions when compared to five sessions. Conclusions: Our results suggest that five tDCS sessions are sufficient to augment the effect of standard physiotherapy on upper limb function recovery in chronic post-stroke patients, and ten sessions resulted in greater gains. Full article
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20 pages, 1100 KiB  
Systematic Review
Evidence of High-Intensity Exercise on Lower Limb Functional Outcomes and Safety in Acute and Subacute Stroke Population: A Systematic Review
by Shi Min Mah, Alicia M. Goodwill, Hui Chueng Seow and Wei-Peng Teo
Int. J. Environ. Res. Public Health 2023, 20(1), 153; https://doi.org/10.3390/ijerph20010153 - 22 Dec 2022
Cited by 6 | Viewed by 3824
Abstract
This systematic review investigated the effects of high-intensity exercise (HIE) on lower limb (LL) function in acute and subacute stroke patients. A systematic electronic search was performed in PubMed, CINAHL and the Web of Science from inception to 30 June 2022. Outcomes examined [...] Read more.
This systematic review investigated the effects of high-intensity exercise (HIE) on lower limb (LL) function in acute and subacute stroke patients. A systematic electronic search was performed in PubMed, CINAHL and the Web of Science from inception to 30 June 2022. Outcomes examined included LL function and measures of activities of daily living such as the Barthel index, 6 min walk test (6MWT), gait speed and Berg balance scale (BBS), adverse events and safety outcomes. The methodological quality and the quality of evidence for each study was assessed using the PEDro scale and the Risk of Bias 2 tool (RoB 2). HIE was defined as achieving at least 60% of the heart rate reserve (HRR) or VO2 peak, 70% of maximal heart rate (HRmax), or attaining a score of 14 or more on the rate of perceived exertion Borg scale (6–20 rating scale). This study included randomized controlled trials (RCTs) which compared an intervention group of HIE to a control group of lower intensity exercise, or no intervention. All participants were in the acute (0–3 months) and subacute (3–6 months) stages of stroke recovery. Studies were excluded if they were not RCTs, included participants from a different stage of stroke recovery, or if the intervention did not meet the pre-defined HIE criteria. Overall, seven studies were included that used either high-intensity treadmill walking, stepping, cycling or overground walking exercises compared to either a low-intensity exercise (n = 4) or passive control condition (n = 3). Three studies reported significant improvements in 6MWT and gait speed performance, while only one showed improved BBS scores. No major adverse events were reported, although minor incidents were reported in only one study. This systematic review showed that HIE improved LL functional task performance, namely the 6MWT and gait speed. Previously, there was limited research demonstrating the efficacy of HIE early after stroke. This systematic review provides evidence that HIE may improve LL function with no significant adverse events report for stroke patients in their acute and subacute rehabilitation stages. Hence, HIE should be considered for implementation in this population, taking into account the possible benefits in terms of functional outcomes, as compared to lower intensity interventions. Full article
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