Transcranial Magnetic Stimulation

Constraint-Induced Physical Therapy is a specialized rehabilition approach used to improve motor ability and the functional use of a limb affected by brain injury or a stroke. After suffering a stroke, a person can lose the function of one of their limbs. These stroke survivors can get frustrated and learn to stop using affected limb and start relying on the unaffected limb. Constraint-Induced Physical Therapy tries to decrease the effects of learned non-use by forcing patients to use the affected side. CIMT uses techniques like placing a mitt on the patient’s unaffected functional hand and forcing them to perform tasks with their stroke-affected limb for a majority of the day. This therapy also has the patient perform repetitive movements to repair the brains pathways. CIMT is a deliberate practice that focuses on relearning previously acquired motor skills. Relearning motor skills is measured by acquisition, retention, and transfer of skills. Acquisition is the performance of a previously learned motor skill. To relearn a motor skill, the skill must be rehearsed repeatedly. The more time a patient devotes to a task the more opportunity they have to improve their movement

This allows the patient to develop sufficient endurance required to proceed with TMR myoelectric prosthetic training. As a result of the redirected pathways from the brain to the host muscle, the OT must have in-depth knowledge of peripheral nerve distribution in order to perform the appropriate strengthening exercises. In addition, the therapist must know the details of the surgery and the possible effects for every patient since each case is unique. An occupational therapist’s knowledge of TMR is also advantageous for a myriad of patients who are physically active, due to the commonality of shoulder dislocations. Patients with prosthetics have an increased number of EMG signals, which result from more intuitive, controlled upper body movements with less effort[p1] . Additionally, these developed prosthetic movements are more efficient and fluid without the necessity of switching between degrees of freedom. Patients with TMR demonstrate increased performance in comparison to conventional myoelectric control (Stubblefield, 2009). For example, TMR patients were 50 percent faster in a clothespin-moving test and improved in the Assessment of Motor and Process Skills. Due to the twofold effects of surgical and postoperative therapy intricacy, TMR provides the opportunity for clinical skill enhancement through the guidance of occupational therapists and thus

The control group received only standard physical therapy treatments (stretching and strengthening exercises). There were three experimental groups. One group received estim to the intensity of stimulating only sensory nerves. The next group received estim with an intensity that minimally stimulated motor neurons. The final group received “full movement neuromuscular electric stimulation,” which was an estim intensity to the maximum tolerated intensity to receive maximum muscle movement. All three experimental groups also received standard PT interventions (stretching and strengthening exercises).

It is believed that cross-limb transfer involves motor cortical areas representing the trained and untrained limbs (ipsilateral hemisphere in relation to the training side). In an interesting study, Lee et al. (2010) showed that repetitive transcranial magnetic stimulation (rTMS) over the right primary motor cortex (M1) (controlling the untrained side) led to reduced cross-limb transfer. In contrast, rTMS of the left M1 (controlling

Appropriate selection of CIMT as an intervention is essential, depending on the patient’s severity of stroke, functional limitations, and cognitive level. Our PICO question of “in middle-aged stroke patients, will CIMT compared to no treatment improve functional outcomes?” has been analyzed through multiple studies. CIMT has shown positive effects in improving function and quality of use of affected upper extremity in stroke patients. CIMT can produce cortical reorganization that increases the area of cortex involved in the innervations of movement of the more-affected limb (Taub, 1998). It is recommended that future studies be conducted to evaluate the long-term effects of CIMT years after treatment. Depending on a patient’s individual health

110 people were screened through telephone and out of that many, 64 went to an on-site screening. 41 of those people met the criteria and out of that many 40 were then randomized into a treatment group. Participants were randomized using a “high quality pseudorandom deviate generator in SAS in a 1:1 ratio and a blocked randomized scheme, and placed in a sequentially numbered sealed envelopes.”(Brach, et al.) 18 participants were put into the motor learning group and 20 were put into the standard group. 38 of those participants were able to complete the trial. The two who did not complete the trial had developed unrelated medical conditions and walked more slowly than the rest of the participants. The interventions were given by a physical therapist which lasted for 12 weeks with 60 minutes in

The ideal resistance-training program to decrease fatigue in Multiple Sclerosis (MS) patients is uncertain and requires further research. The current study is designed to explore the effect of a progressive resistance training and a high-intensity resistance training program on fatigue in relapsing-remitting MS (RRMS) patients through the fatigue severity scale. The design of the study consists of a 12-week randomized controlled trial including a 12-week follow-up.

During rehabilitation, we make an attempt to bring something back to an original or normalized state. Neurological rehabilitation is based off of multiple concepts of understanding how the brain operates in regards to speech, self-control of movement, and active cognitive functions. There are several theories of motor control and according to the hierarchical theory, it would be best to treat a patient based on the emphasis of “inhibition of lower level reflex patterns so that higher brain areas can regain control (An Introduction to Music Therapy 263).” Other models have suggested that a sense of control is based on strategies to successfully achieve movement goals as opposed

Transcranial Electric Current Stimulation (tES) is a non-invasive brain stimulation technique done on the outside of the brain using an electric current to cause activity in the brain.

The MEP is followed by a silent period and is a pause in ongoing voluntary EMG activity. . The first part of the silent period is from spinal cord refractoriness and the second part is from cortical inhibition The silent period is calculated as the interval from TMS delivery to the continuation of voluntary EMG. The silent period has been noted to reflect the recruitment of inhibitory cortical interneurons This silent period has been seen to lengthen as fatigue develops and any value of MVC does not seem to affect the duration of the silent period had 23 sedentary male subjects randomly assigned to a control or a training group. The control acted as a sedentary control while the training group performed an 8-week low-force strength training

Cheng, Y., Hsieh, W., Kao, C., & Chan, R. (2012). Principles of rehabilitation for common chronic neurologic diseases in the elderly. Journal of Clinical Gerontology and Geriatrics, 3(1),

The current version of the WMFT takes into account important factors of movement and the items included cover a wide range of movements both joint specific and total limb. Used to assess motor function among people with moderate to severe motor deficits of the upper extremity. By performing this measure severity and upper extremity motor deficit will noted. Performance of this test will allow therapists to track progress and identify the effect of rehabilitation on upper extremity movement to modify interventions.

Different exercise modes may elicit varying physiological responses; therefor professionals aiming to augment their patient or athlete’s rehabilitation and training regimens should consider the latter (Barfield, Sherman and Michael, 2003). Different exercise modes target variable body segments, some being full-body and others targeting only the lower or upper body. Due to differing numbers of

Incorporating individuals suffering from tetraparesis from spinal cord injury, brainstem stroke, muscular dystrophy, or amyotrophic lateral sclerosis, neuromotor prostheses are used to send signals to external receptors in the place of lost internal receptors (i.e. absence of useable muscle of limbs). Consent regarding the pending array (multiple electrodes) was obtained prior to the surgical insertion (which has yet to be published). In order to record possible neurons despite the differentiating layers, the array was inserted into the arm/hand. The signals run through an external apparatus and cross the skin in order to reach an internal apparatus on the skull, which translates through cables in order to produce an output defined as a neural cursor. The recording sessions took place at the participant?s residence to the discretion of the participant. All stimulation was kept constant by the selected electrodes when participants faced external devices that demanded output by way of neural signals, such as video games. As the participant rested, units in data gathered were determined by a technician using time-amplitude windows according to a 1.6 ms

Previous studies have reported an existence of common neural networks between muscles or within a muscle during isometric or dynamic motor task in human [1-4] or animal models [5, 6]. These studies have a great impact in better strategizing therapies for the functional recovery after neurotrauma. However, understanding this common neural elements between different motor tasks could also be an important topic because the similar the neural networks involved between motor tasks, the greater the transfer of the motor learning [7]. Although an existence of common neural input between different motor tasks has been reported, this analysis was performed between isometric and an anisometric contractions of a hand muscle [4]. Recently, the