Repository logo

Infoscience

  • English
  • French
Log In
Logo EPFL, École polytechnique fédérale de Lausanne

Infoscience

  • English
  • French
Log In
  1. Home
  2. Academic and Research Output
  3. Journal articles
  4. Neurophysiological underpinnings of an intensive protocol for upper limb motor recovery in subacute and chronic stroke patients
 
research article

Neurophysiological underpinnings of an intensive protocol for upper limb motor recovery in subacute and chronic stroke patients

Lassi, Michael
•
Dalise, Stefania
•
Bandini, Andrea
Show more
November 21, 2023
European Journal Of Physical And Rehabilitation Medicine

ABS T R A C T BACKGROUND: Upper limb (UL) motor impairment following stroke is a leading cause of functional limitations in activities of daily living. Robot-assisted therapy supports rehabilitation, but how its efficacy and the underlying neural mechanisms depend on the time after stroke is yet to be assessed. AIM: We investigated the response to an intensive protocol of robot-assisted rehabilitation in sub-acute and chronic stroke patients, by analyzing the underlying changes in clinical scores, electroencephalography (EEG) and end-effector kinematics. We aimed at identifying neural correlates of the participants' upper limb motor function recovery, following an intensive 2-week rehabilitation protocol. DESIGN: Prospective cohort study.SETTING: Inpatients and outpatients from the Neurorehabilitation Unit of Pisa University Hospital, Italy.POPULATION: Sub-acute and chronic stroke survivors. METHODS: Thirty-one stroke survivors (14 sub-acute, 17 chronic) with mild-to-moderate UL paresis were enrolled. All participants underwent ten rehabilitative sessions of task-oriented exercises with a planar end-effector robotic device. All patients were evaluated with the Fugl-Meyer Assessment Scale and the Wolf Motor Function Test, at recruitment (T0), end-of-treatment (T1), and one-month follow-up (T2). Along with clinical scales, kinematic parameters and quantitative EEG were collected for each patient. Kinematics metrics were related to velocity, accelera-tion and smoothness of the movement. Relative power in four frequency bands was extracted from the EEG signals. The evolution over time of kinematic and EEG features was analyzed, in correlation with motor recovery.RESULTS: Both groups displayed significant gains in motility after treatment. Sub-acute patients displayed more pronounced clinical improve-ments, significant changes in kinematic parameters, and a larger increase in Beta-band in the motor area of the affected hemisphere. In both groups these improvements were associated to a decrease in the Delta-band of both hemispheres. Improvements were retained at T2. CONCLUSIONS: The intensive two-week rehabilitation protocol was effective in both chronic and sub-acute patients, and improvements in the two groups shared similar dynamics. However, stronger cortical and behavioral changes were observed in sub-acute patients suggesting different reorganizational patterns.CLINICAL REHABILITATION IMPACT: This study paves the way to personalized approaches to UL motor rehabilitation after stroke, as highlighted by different neurophysiological modifications following recovery in subacute and chronic stroke patients.

  • Details
  • Metrics
Type
research article
DOI
10.23736/S1973-9087.23.07922-4
Web of Science ID

WOS:001146036100001

Author(s)
Lassi, Michael
•
Dalise, Stefania
•
Bandini, Andrea
•
Spina, Vincenzo
•
Azzollini, Valentina
•
Vissani, Matteo
•
Micera, Silvestro  
•
Mazzoni, Alberto
•
Chisari, Carmelo
Date Issued

2023-11-21

Publisher

Edizioni Minerva Medica

Published in
European Journal Of Physical And Rehabilitation Medicine
Subjects

Life Sciences & Biomedicine

•

Stroke

•

Biomarkers

•

Neurophysiology

•

Neurological Rehabilitation

•

Robotics

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
TNE  
FunderGrant Number

PERSONA Project - Regione Toscana-Bando Salute 2018

National Recovery and Resilience Plan (NRRP) , Mission 4 Component 2 Investment 1.3 of Italian Ministry of University and Research by the European Union-NextGenerationEU

Bertarelli Foundation

Show more
Available on Infoscience
February 21, 2024
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/205121
Logo EPFL, École polytechnique fédérale de Lausanne
  • Contact
  • infoscience@epfl.ch

  • Follow us on Facebook
  • Follow us on Instagram
  • Follow us on LinkedIn
  • Follow us on X
  • Follow us on Youtube
AccessibilityLegal noticePrivacy policyCookie settingsEnd User AgreementGet helpFeedback

Infoscience is a service managed and provided by the Library and IT Services of EPFL. © EPFL, tous droits réservés