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Background: The effectiveness of transcranial direct current stimulation (tDCS) in the upper limb (UL) motor rehabilitation of stroke has been widely studied. However, the long-term maintenance of its improvements has not yet been proven. Methods: A systematic search was conducted in MEDLINE/Pubmed, Web of Science, PEDRo, and Scopus databases from inception to April 2021. Randomized controlled trials were included if they performed a tDCS intervention combined with UL rehabilitation in stroke patients, performed several sessions (five or more), and assessed long-term results (at least three-month follow-up). Risk of bias and methodological quality were evaluated with the Cochrane RoB-2 and the Oxford quality scoring system. Results: Nine studies were included, showing a high methodological quality. Findings regarding UL were categorized into (1) functionality, (2) strength, (3) spasticity. All the studies that showed significant improvements retained them in the long term. Baseline functionality may be a limiting factor in achieving motor improvements, but not in sustaining them over the long term. Conclusion: It seems that the improvements achieved during the application of tDCS combined with UL motor rehabilitation in stroke were preserved until the follow-up time (from 3 months to 1 year). Further studies are needed to clarify the long-term effects of tDCS.
Víctor Navarro-López; Manuel del Valle-Gratacós; Rubén Fernández-Matías; María Carratalá-Tejada; Alicia Cuesta-Gómez; Francisco Molina-Rueda. The Long-Term Maintenance of Upper Limb Motor Improvements Following Transcranial Direct Current Stimulation Combined with Rehabilitation in People with Stroke: A Systematic Review of Randomized Sham-Controlled Trials. Sensors 2021, 21, 5216 .
AMA StyleVíctor Navarro-López, Manuel del Valle-Gratacós, Rubén Fernández-Matías, María Carratalá-Tejada, Alicia Cuesta-Gómez, Francisco Molina-Rueda. The Long-Term Maintenance of Upper Limb Motor Improvements Following Transcranial Direct Current Stimulation Combined with Rehabilitation in People with Stroke: A Systematic Review of Randomized Sham-Controlled Trials. Sensors. 2021; 21 (15):5216.
Chicago/Turabian StyleVíctor Navarro-López; Manuel del Valle-Gratacós; Rubén Fernández-Matías; María Carratalá-Tejada; Alicia Cuesta-Gómez; Francisco Molina-Rueda. 2021. "The Long-Term Maintenance of Upper Limb Motor Improvements Following Transcranial Direct Current Stimulation Combined with Rehabilitation in People with Stroke: A Systematic Review of Randomized Sham-Controlled Trials." Sensors 21, no. 15: 5216.
Background: The effectiveness of transcranial direct current stimulation (tDCS) together with conventional physiotherapy in motor rehabilitation after stroke has been widely studied. Despite this, few studies have focused on its application in gait and balance rehabilitation. This review aimed to determine the efficacy of transcranial direct current stimulation combined with conventional physiotherapy on gait, balance, and the functionality of the lower limb after stroke. Methods: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four electronic databases were systematically searched for relevant articles. Randomized clinical trials in English or Spanish that evaluated the use of the transcranial direct current stimulation, combined with physiotherapy, to improve gait, balance, and lower limb functionality after stroke were included. Main results: 10 articles were included, with a total of 222 subjects. Data about population, assessment tools, protocols, sessions, and results were extracted. The methodological quality of the included studies ranged between 3 and 5. Conclusion: The use of transcranial direct current stimulation combined with physiotherapy improves gait parameters, static and dynamic balance, and lower limb functionality in stroke patients. Long-term effects have not yet been demonstrated.
Víctor Navarro-López; Francisco Molina-Rueda; Samuel Jiménez-Jiménez; Isabel Alguacil-Diego; María Carratalá-Tejada. Effects of Transcranial Direct Current Stimulation Combined with Physiotherapy on Gait Pattern, Balance, and Functionality in Stroke Patients. A Systematic Review. Diagnostics 2021, 11, 656 .
AMA StyleVíctor Navarro-López, Francisco Molina-Rueda, Samuel Jiménez-Jiménez, Isabel Alguacil-Diego, María Carratalá-Tejada. Effects of Transcranial Direct Current Stimulation Combined with Physiotherapy on Gait Pattern, Balance, and Functionality in Stroke Patients. A Systematic Review. Diagnostics. 2021; 11 (4):656.
Chicago/Turabian StyleVíctor Navarro-López; Francisco Molina-Rueda; Samuel Jiménez-Jiménez; Isabel Alguacil-Diego; María Carratalá-Tejada. 2021. "Effects of Transcranial Direct Current Stimulation Combined with Physiotherapy on Gait Pattern, Balance, and Functionality in Stroke Patients. A Systematic Review." Diagnostics 11, no. 4: 656.
The aim of the present systematic review was to describe the gait pattern in people with multiple sclerosis (MS) by compiling the main findings obtained from studies using three-dimensional capture systems of human movement. The search was carried out in PubMed, Web of Science, Physiotherapy Evidence Database (PEDro), and the Cumulative Index to Nursing and Allied Health (CINAHL) databases. Studies that used three-dimensional gait analysis systems and that analyzed spatiotemporal, kinematic, kinetic, or electromyographic parameters, were included. The quality of the studies was assessed using the Critical Review Form–Quantitative Studies scale. 12 articles were included with 523 (342 women and 181 men) people with a diagnosis of MS. The present work suggests that people with MS have a decrease in speed and stride length, as well as an increase in double-stance intervals during gait. Likewise, it is common to observe a decrease in hip extension during the stance period, a decrease in knee flexion in the swing period, a decrease in ankle dorsiflexion in the initial contact and a decrease in ankle plantar flexion during the pre-swing phase. The subjects with MS decrease the hip extensor moment and the ankle power during the stance period of walking.
María Coca-Tapia; Alicia Cuesta-Gómez; Francisco Molina-Rueda; María Carratalá-Tejada. Gait Pattern in People with Multiple Sclerosis: A Systematic Review. Diagnostics 2021, 11, 584 .
AMA StyleMaría Coca-Tapia, Alicia Cuesta-Gómez, Francisco Molina-Rueda, María Carratalá-Tejada. Gait Pattern in People with Multiple Sclerosis: A Systematic Review. Diagnostics. 2021; 11 (4):584.
Chicago/Turabian StyleMaría Coca-Tapia; Alicia Cuesta-Gómez; Francisco Molina-Rueda; María Carratalá-Tejada. 2021. "Gait Pattern in People with Multiple Sclerosis: A Systematic Review." Diagnostics 11, no. 4: 584.
The aim of this study was to evaluate the test–retest reliability of a conventional gait model (CGM), the Plug-in Gait model, to calculate the angles of the hip, knee, and ankle during initial contact (IC) and toe-off (TO). Gait analysis was performed using the Vicon Motion System® (Oxford Metrics, Oxford, UK). The study group consisted of 50 healthy subjects. To evaluate the test–retest reliability, the intraclass correlation coefficient (ICC), the standard error of measurement (SEM), the minimal detectable change (MDC), and the Bland–Altman analysis with 95% limits of agreement were calculated. The ICC for the joint angles of the hip, knee, and ankle was higher than 0.80. However, the ankle angle at IC had an ICC lower than 0.80. The SEM was 5°) for the hip angle at IC. The Bland–Altman analysis indicated that the magnitude of divergence was between ±5° and ±9° at IC and around ±7° at TO. In conclusion, the ICC for the plug-in gait model was good for the hip, knee, and ankle angles during IC and TO. The plots revealed a disagreement between measurements that should be considered in patients’ clinical assessments.
Francisco Molina-Rueda; Pilar Fernández-González; Alicia Cuesta-Gómez; Aikaterini Koutsou; María Carratalá-Tejada; Juan Miangolarra-Page. Test–Retest Reliability of a Conventional Gait Model for Registering Joint Angles during Initial Contact and Toe-Off in Healthy Subjects. International Journal of Environmental Research and Public Health 2021, 18, 1343 .
AMA StyleFrancisco Molina-Rueda, Pilar Fernández-González, Alicia Cuesta-Gómez, Aikaterini Koutsou, María Carratalá-Tejada, Juan Miangolarra-Page. Test–Retest Reliability of a Conventional Gait Model for Registering Joint Angles during Initial Contact and Toe-Off in Healthy Subjects. International Journal of Environmental Research and Public Health. 2021; 18 (3):1343.
Chicago/Turabian StyleFrancisco Molina-Rueda; Pilar Fernández-González; Alicia Cuesta-Gómez; Aikaterini Koutsou; María Carratalá-Tejada; Juan Miangolarra-Page. 2021. "Test–Retest Reliability of a Conventional Gait Model for Registering Joint Angles during Initial Contact and Toe-Off in Healthy Subjects." International Journal of Environmental Research and Public Health 18, no. 3: 1343.
To study postural control and muscle activity during the limit of stability test (LOS) in subjects with chronic ankle instability. Observational study. University laboratory. 10 healthy subjects were included in the control group and 10 subjects in the CAI group (age between 18 and 30 years, with history of the multiple ankle “giving way” episodes in the last six months and score ≤24 in the Cumberland Ankle Instability Tool). A computerized dynamic posturography equipment was used for assessing the LOS. The electromyography activity of tibialis anterior (TA), soleus (SOL), medial gastrocnemius (MG) and peroneus longus (PL) was registered. Subjects with CAI had a greater activation in TA to forward (p < .01), forward affected (p = .001), backward affected (p = .007) and backward directions (p < .01); in PL to forward affected (p < .01) and affected directions (p = .001); in MG to forward (p = .023) and affected directions (p < .01) and in SOL to the affected direction (p = .009). We observed restricted excursions and less directional control in subjects with CAI. Subjects with CAI exhibited poorer ability to move their center of gravity within stability limits. In addition, they have an altered ankle muscle activity during LOS test toward the affected ankle joint.
Francisco Molina-Rueda; Alicia Cuesta-Gómez; María Carratalá-Tejada; Aikaterini Koutsou; Pilar Fernández-González; Isabel María Alguacil-Diego. Ankle muscle activation during the limits of stability test in subjects with chronic ankle instability. Physical Therapy in Sport 2020, 47, 134 -139.
AMA StyleFrancisco Molina-Rueda, Alicia Cuesta-Gómez, María Carratalá-Tejada, Aikaterini Koutsou, Pilar Fernández-González, Isabel María Alguacil-Diego. Ankle muscle activation during the limits of stability test in subjects with chronic ankle instability. Physical Therapy in Sport. 2020; 47 ():134-139.
Chicago/Turabian StyleFrancisco Molina-Rueda; Alicia Cuesta-Gómez; María Carratalá-Tejada; Aikaterini Koutsou; Pilar Fernández-González; Isabel María Alguacil-Diego. 2020. "Ankle muscle activation during the limits of stability test in subjects with chronic ankle instability." Physical Therapy in Sport 47, no. : 134-139.
Gait analysis is necessary to diagnose movement disorders. In order to reduce the costs of three-dimensional motion capture systems, new low-cost methods of motion analysis have been developed. The purpose of this study was to evaluate the inter- and intra-rater reliability of Kinovea® and the agreement with a three-dimensional motion system for detecting the joint angles of the hip, knee and ankle during the initial contact phase of walking. Fifty healthy subjects participated in this study. All participants were examined twice with a one-week interval between the two appointments. The motion data were recorded using the VICON Motion System® and digital video cameras. The intra-rater reliability showed a good correlation for the hip, the knee and the ankle joints (Intraclass Correlation Coefficient, ICC > 0.85) for both observers. The ICC for the inter-rater reliability was >0.90 for the hip, the knee and the ankle joints. The Bland–Altman plots showed that the magnitude of disagreement was approximately ±5° for intra-rater reliability, ±2.5° for inter-rater reliability and around ±2.5° to ±5° for Kinovea® versus Vicon®. The ICC was good for the hip, knee and ankle angles registered with Kinovea® during the initial contact of walking for both observers (intra-rater reliability) and higher for the agreement between observers (inter-rater reliability). However, the Bland–Altman plots showed disagreement between observers, measurements and systems (Kinovea® vs. three-dimensional motion system) that should be considered in the interpretation of clinical evaluations.
Pilar Fernández-González; Aikaterini Koutsou; Alicia Cuesta-Gómez; María Carratalá-Tejada; Juan Carlos Miangolarra-Page; Francisco Molina-Rueda. Reliability of Kinovea® Software and Agreement with a Three-Dimensional Motion System for Gait Analysis in Healthy Subjects. Sensors 2020, 20, 3154 .
AMA StylePilar Fernández-González, Aikaterini Koutsou, Alicia Cuesta-Gómez, María Carratalá-Tejada, Juan Carlos Miangolarra-Page, Francisco Molina-Rueda. Reliability of Kinovea® Software and Agreement with a Three-Dimensional Motion System for Gait Analysis in Healthy Subjects. Sensors. 2020; 20 (11):3154.
Chicago/Turabian StylePilar Fernández-González; Aikaterini Koutsou; Alicia Cuesta-Gómez; María Carratalá-Tejada; Juan Carlos Miangolarra-Page; Francisco Molina-Rueda. 2020. "Reliability of Kinovea® Software and Agreement with a Three-Dimensional Motion System for Gait Analysis in Healthy Subjects." Sensors 20, no. 11: 3154.
Gait pattern is altered in persons with lower extremity amputation. To assess gait pattern, it is important to use observational gait scales with a good content validity. To design an observational gait scale and to analyze its content validity. An expert committee was formed to obtain a version of the scale. The same committee was responsible for evaluating the scale. The content validity index (CVI) was calculated, both for each item and for the global scale. The main kinematic and spatiotemporal alterations were selected to design the items. The scale consists of 2sections and 25 items, with a maximum score of 35 points. An overall CVI score of 0.90 was obtained, and an index of validity for most items with values higher than 0.78. The Observational gait scale for persons with amputation of the lower extremity showed excellent content validity according to the CVI obtained. Future studies should evaluate its reliability and construct validity.
Francisco Molina-Rueda; M. Garrido-Balaguer; A. Cortés-Rodríguez; Maria Carratala Tejada; A. Cuesta-Gómez; P. Fernández-González; I.M. Alguacil-Diego; E. Monge-Pereira; R. Cano-De-La-Cuerda; A. Molero-Sánchez; J.C. Miangolarra-Page. [Observational gait scale for persons with lower extremity amputation. Design and content validity]. Rehabilitación 2020, 54, 79 -86.
AMA StyleFrancisco Molina-Rueda, M. Garrido-Balaguer, A. Cortés-Rodríguez, Maria Carratala Tejada, A. Cuesta-Gómez, P. Fernández-González, I.M. Alguacil-Diego, E. Monge-Pereira, R. Cano-De-La-Cuerda, A. Molero-Sánchez, J.C. Miangolarra-Page. [Observational gait scale for persons with lower extremity amputation. Design and content validity]. Rehabilitación. 2020; 54 (2):79-86.
Chicago/Turabian StyleFrancisco Molina-Rueda; M. Garrido-Balaguer; A. Cortés-Rodríguez; Maria Carratala Tejada; A. Cuesta-Gómez; P. Fernández-González; I.M. Alguacil-Diego; E. Monge-Pereira; R. Cano-De-La-Cuerda; A. Molero-Sánchez; J.C. Miangolarra-Page. 2020. "[Observational gait scale for persons with lower extremity amputation. Design and content validity]." Rehabilitación 54, no. 2: 79-86.
Background: Although the median frequency is used as a basis to assess the presence of muscular fatigue, some studies have found that it is not a good estimator for this purpose. Physiotherapists often deal with patients with movement issues related to fatigue. A new objective estimator that is easy to obtain and interpret can help with the management of such patients. Objective and Purpose: The aim of this study was to identify the frequency bands most affected by fatigue and propose a protocol to obtain such information. Methods: Thirty healthy subjects (age 22.05 ± 2.42 years, height 1.71 ± 0.08 m, and weight 68.75 ± 11.42 kg) were recruited to measure the rectus femoris electromyography (EMG) of both legs during gait, before and after a fatiguing protocol. Four frequency bands were studied: high frequency (107–250 Hz), midfrequency (65–94 Hz), 40 Hz (34–53 Hz), and low frequency (< 25 Hz). Each frequency band is related to different aspects of the muscular contraction. Results: The main finding is that the ratios of the 40-Hz frequency and low-frequency bands showed significant differences in both legs between pre-fatigue and post-fatigue recordings. Critical thresholds F* 4.86 and 4.93 were exceeded at 4.5–8.7%, 30.64–46%.38, 63.75–66.8%, and 83.69–90.79% and at 0–2.53%, 4.7–15.21%, 18.15–54.65%, and 55.81–99.95% of the gait cycle, respectively, with p values < .05. Conclusions: The low-frequency band constitutes the best indicator to assess fatigue in gait.
Alberto Fidalgo-Herrera; Juan Miangolarra-Page; Maria Carratala Tejada. Traces of muscular fatigue in the rectus femoris identified with surface electromyography and wavelets on normal gait. Physiotherapy Theory and Practice 2020, 1 -15.
AMA StyleAlberto Fidalgo-Herrera, Juan Miangolarra-Page, Maria Carratala Tejada. Traces of muscular fatigue in the rectus femoris identified with surface electromyography and wavelets on normal gait. Physiotherapy Theory and Practice. 2020; ():1-15.
Chicago/Turabian StyleAlberto Fidalgo-Herrera; Juan Miangolarra-Page; Maria Carratala Tejada. 2020. "Traces of muscular fatigue in the rectus femoris identified with surface electromyography and wavelets on normal gait." Physiotherapy Theory and Practice , no. : 1-15.
Background Non-immersive video games are currently being used as technological rehabilitation tools for individuals with Parkinson’s disease (PD). The aim of this feasibility study was to evaluate the effectiveness of the Leap Motion Controller® (LMC) system used with serious games designed for the upper limb (UL), as well as the levels of satisfaction and compliance among patients in mild-to-moderate stages of the disease. Methods A non-probabilistic sampling of non-consecutive cases was performed. 23 PD patients, in stages II-IV of the Hoehn & Yahr scale, were randomized into two groups: an experimental group (n = 12) who received treatment based on serious games designed by the research team using the LMC system for the UL, and a control group (n = 11) who received a specific intervention for the UL. Grip muscle strength, coordination, speed of movements, fine and gross UL dexterity, as well as satisfaction and compliance, were assessed in both groups pre-treatment and post-treatment. Results Within the experimental group, significant improvements were observed in all post-treatment assessments, except for Box and Blocks test for the less affected side. Clinical improvements were observed for all assessments in the control group. Statistical intergroup analysis showed significant improvements in coordination, speed of movements and fine motor dexterity scores on the more affected side of patients in the experimental group. Conclusions The LMC system and the serious games designed may be a feasible rehabilitation tool for the improvement of coordination, speed of movements and fine UL dexterity in PD patients. Further studies are needed to confirm these preliminary findings.
Pilar Fernández-González; Maria Carratala Tejada; Esther Monge-Pereira; Susana Collado-Vázquez; Patricia Sánchez-Herrera Baeza; Alicia Cuesta-Gómez; Edwin Daniel Oña Simbaña; Alberto Jardon Huete; Francisco Molina-Rueda; Carlos Balaguer-Bernaldo De Quirós; Juan Carlos Miangolarra-Page; Roberto Cano-De La Cuerda. Leap motion controlled video game-based therapy for upper limb rehabilitation in patients with Parkinson’s disease: a feasibility study. Journal of NeuroEngineering and Rehabilitation 2019, 16, 1 -10.
AMA StylePilar Fernández-González, Maria Carratala Tejada, Esther Monge-Pereira, Susana Collado-Vázquez, Patricia Sánchez-Herrera Baeza, Alicia Cuesta-Gómez, Edwin Daniel Oña Simbaña, Alberto Jardon Huete, Francisco Molina-Rueda, Carlos Balaguer-Bernaldo De Quirós, Juan Carlos Miangolarra-Page, Roberto Cano-De La Cuerda. Leap motion controlled video game-based therapy for upper limb rehabilitation in patients with Parkinson’s disease: a feasibility study. Journal of NeuroEngineering and Rehabilitation. 2019; 16 (1):1-10.
Chicago/Turabian StylePilar Fernández-González; Maria Carratala Tejada; Esther Monge-Pereira; Susana Collado-Vázquez; Patricia Sánchez-Herrera Baeza; Alicia Cuesta-Gómez; Edwin Daniel Oña Simbaña; Alberto Jardon Huete; Francisco Molina-Rueda; Carlos Balaguer-Bernaldo De Quirós; Juan Carlos Miangolarra-Page; Roberto Cano-De La Cuerda. 2019. "Leap motion controlled video game-based therapy for upper limb rehabilitation in patients with Parkinson’s disease: a feasibility study." Journal of NeuroEngineering and Rehabilitation 16, no. 1: 1-10.
Recovery of motor function following stroke is essential to restore adequate functionality. The use of functional electrical stimulation (FES) technology as a neuroprosthesis to enhance the motor function of the UL, and thus facilitate the performance of ADL, could lead to a stroke patient's greater activity and participation in daily life. The aim of the present study was to establish whether the application of FES in patients who have suffered a stroke with UL motor impairment is able to modify and facilitate their reaching patterns, measured by a three-dimensional motion capture system. 20 patients with chronic stroke participated in this study. For muscle stimulation, the electrical stimulator Compex® was used. Motion analysis was performed using the VICON Motion System®. Joint movements of the thorax, shoulder and elbow were analyzed in the sagittal plane, during the reaching movement under two different conditions of stimulation: FES condition and placebo condition. Differences between FES condition and placebo condition were observed. In the FES condition it was recorded: an increased shoulder flexion and elbow extension in the reaching movement. Functional electrical stimulation improved reaching movement in stroke patients with upper limb impairment.
Alicia Cuesta-Gómez; María Carratalá-Tejada; Francisco Molina-Rueda; Juan Carlos Miangolarra-Page. Functional electrical stimulation improves reaching movement in the shoulder and elbow muscles of stroke patients: A three-dimensional motion analysis. Restorative Neurology and Neuroscience 2019, 37, 231 -238.
AMA StyleAlicia Cuesta-Gómez, María Carratalá-Tejada, Francisco Molina-Rueda, Juan Carlos Miangolarra-Page. Functional electrical stimulation improves reaching movement in the shoulder and elbow muscles of stroke patients: A three-dimensional motion analysis. Restorative Neurology and Neuroscience. 2019; 37 (3):231-238.
Chicago/Turabian StyleAlicia Cuesta-Gómez; María Carratalá-Tejada; Francisco Molina-Rueda; Juan Carlos Miangolarra-Page. 2019. "Functional electrical stimulation improves reaching movement in the shoulder and elbow muscles of stroke patients: A three-dimensional motion analysis." Restorative Neurology and Neuroscience 37, no. 3: 231-238.
The Gait Assessment and Intervention Tool (GAIT) has been recently developed for gait assessment in patients with stroke, and it is considered as a tool that may identify clinically relevant deviations from normal gait and quantifies relevant changes in gait because of an intervention. The objective was to analyze the GAIT psychometric properties in participants with stroke. A convenience sample of 15 adults with stroke was selected (58.15±7.8 years; 5.38±3.3 years from injury). We used the GAIT for evaluating the gait in patients with stroke. GAIT scoring is based on observations of anterior/posterior and lateral-view video documents. Inter-rater reliability of the GAIT between trained raters was good (intraclass correlation coefficient=0.762; P=0.008; 95% confidence interval=0.251–0.927). The minimal detectable change was 7.68 points (12.39%). Inter-rater reliability for the hip, knee, and ankle items was also good. In conclusion, the current study demonstrated that GAIT has good inter-rater reliability and good internal consistency.
Francisco Molina-Rueda; Maria Carratala Tejada; Roberto Cano de la Cuerda; Isabel M. Alguacil-Diego; Juan Carlos Miangolarra Page; Alicia Cuesta-Gómez. Examination of the reliability of Gait Assessment and Intervention Tool in patients with a stroke. International Journal of Rehabilitation Research 2018, 41, 84 -86.
AMA StyleFrancisco Molina-Rueda, Maria Carratala Tejada, Roberto Cano de la Cuerda, Isabel M. Alguacil-Diego, Juan Carlos Miangolarra Page, Alicia Cuesta-Gómez. Examination of the reliability of Gait Assessment and Intervention Tool in patients with a stroke. International Journal of Rehabilitation Research. 2018; 41 (1):84-86.
Chicago/Turabian StyleFrancisco Molina-Rueda; Maria Carratala Tejada; Roberto Cano de la Cuerda; Isabel M. Alguacil-Diego; Juan Carlos Miangolarra Page; Alicia Cuesta-Gómez. 2018. "Examination of the reliability of Gait Assessment and Intervention Tool in patients with a stroke." International Journal of Rehabilitation Research 41, no. 1: 84-86.
The aim of the study was to investigate the differences in the stability limits between patients with vascular and nonvascular unilateral transtibial amputation (UTA) and patients without amputation. Eighteen patients with UTA who used a prosthesis were divided into two groups: vascular (n=9) and nonvascular (n=9). Twenty-four patients without amputation served as the control group. Computerized dynamic posturography Smart EquiTest System, version 8.0 was used for measuring stability limits. The limits of stability test was used to assess the participants’ ability to voluntarily sway to various locations in space. The measured parameters were maximum centre of gravity (COG) excursion, endpoint COG excursion and directional control. Single-factor analysis of variance and Bonferroni adjustment a posteriori tests was performed to investigate the differences between groups. The patients with vascular UTA had significantly lower endpoint COG excursion to oblique and forward direction compared with controls (P=0.017). In addition, the patients with vascular UTA had significantly lower maximum COG excursion to oblique and forward and to oblique and backward directions (P=0.031; 0.019). Patients with vascular UTA had significantly lower endpoint and maximum COG excursion to oblique and backward direction compared with patients with nonvascular UTA (P=0.30; 0.029). To summarize, patients with vascular UTA have substantially reduced limits of stability compared with patients without amputation and the patients with nonvascular UTA.
Francisco Molina-Rueda; Alberto Molero-Sánchez; Maria Carratala Tejada; Alicia Cuesta-Gómez; Juan C. Miangolarra-Page; Isabel M. Alguacil-Diego. Limits of stability in patients with vascular (due to diabetes) and nonvascular unilateral transtibial amputation: a cross-sectional study. International Journal of Rehabilitation Research 2017, 40, 227 -231.
AMA StyleFrancisco Molina-Rueda, Alberto Molero-Sánchez, Maria Carratala Tejada, Alicia Cuesta-Gómez, Juan C. Miangolarra-Page, Isabel M. Alguacil-Diego. Limits of stability in patients with vascular (due to diabetes) and nonvascular unilateral transtibial amputation: a cross-sectional study. International Journal of Rehabilitation Research. 2017; 40 (3):227-231.
Chicago/Turabian StyleFrancisco Molina-Rueda; Alberto Molero-Sánchez; Maria Carratala Tejada; Alicia Cuesta-Gómez; Juan C. Miangolarra-Page; Isabel M. Alguacil-Diego. 2017. "Limits of stability in patients with vascular (due to diabetes) and nonvascular unilateral transtibial amputation: a cross-sectional study." International Journal of Rehabilitation Research 40, no. 3: 227-231.
Introduction. Reaching movements in stroke patients are characterized by decreased amplitudes at the shoulder and elbow joints and greater displacements of the trunk, compared to healthy subjects. The importance of an appropriate and specific contraction of the interscapular and upper limb (UL) muscles is crucial to achieving proper reaching movements. Functional electrical stimulation (FES) is used to activate the paretic muscles using short-duration electrical pulses. Objective. To evaluate whether the application of FES in the UL and interscapular muscles of stroke patients with motor impairments of the UL modifies patients’ reaching patterns, measured using instrumental movement analysis systems. Design. A cross-sectional study was carried out. Setting. The VICON Motion System® was used to conduct motion analysis. Participants. 21 patients with chronic stroke. Intervention. The Compex® electric stimulator was used to provide muscle stimulation during two conditions: a placebo condition and a FES condition. Main Outcome Measures. We analyzed the joint kinematics (trunk, shoulder and elbow) from the starting position until the affected hand reached the glass. Results. Participants receiving FES carried out the movement with less trunk flexion, while shoulder flexion elbow extension was increased, compared to placebo conditions. Conclusions. The application of FES to the UL and interscapular muscles of stroke patients with motor impairment of the UL, has improved reaching movements.
Alicia Cuesta-Gómez; Francisco Molina-Rueda; Maria Carratala Tejada; Eukene Imatz Ojanguren; Diego Torricelli; Juan Carlos Miangolarra-Page. The Use of Functional Electrical Stimulation on the Upper Limb and Interscapular Muscles of Patients with Stroke for the Improvement of Reaching Movements: A Feasibility Study. Frontiers in Neurology 2017, 8, 186 .
AMA StyleAlicia Cuesta-Gómez, Francisco Molina-Rueda, Maria Carratala Tejada, Eukene Imatz Ojanguren, Diego Torricelli, Juan Carlos Miangolarra-Page. The Use of Functional Electrical Stimulation on the Upper Limb and Interscapular Muscles of Patients with Stroke for the Improvement of Reaching Movements: A Feasibility Study. Frontiers in Neurology. 2017; 8 ():186.
Chicago/Turabian StyleAlicia Cuesta-Gómez; Francisco Molina-Rueda; Maria Carratala Tejada; Eukene Imatz Ojanguren; Diego Torricelli; Juan Carlos Miangolarra-Page. 2017. "The Use of Functional Electrical Stimulation on the Upper Limb and Interscapular Muscles of Patients with Stroke for the Improvement of Reaching Movements: A Feasibility Study." Frontiers in Neurology 8, no. : 186.
Background: The association between motor-related cortical activity and peripheral stimulation with temporal precision has been proposed as a possible intervention to facilitate cortico-muscular pathways and thereby improve motor rehabilitation after stroke. Previous studies with patients have provided evidence of the possibility to implement brain-machine interface platforms able to decode motor intentions and use this information to trigger afferent stimulation and movement assistance. This study tests the use a low-latency movement intention detector to drive functional electrical stimulation assisting upper-limb reaching movements of patients with stroke. Methods: An eight-sessions intervention on the paretic arm was tested on four chronic stroke patients along one month. Patients' intentions to initiate reaching movements were decoded from electroencephalographic signals and used to trigger functional electrical stimulation that in turn assisted patients to do the task. The analysis of the patients’ ability to interact with the intervention platform, the assessment of changes in patients' clinical scales and of the system usability and the kinematic analysis of the reaching movements before and after the intervention period were carried to study the potential impact of the intervention. Results: On average 66.3 ± 15.7 % of trials (resting intervals followed by self-initiated movements) were correctly classified with the decoder of motor intentions. The average detection latency (with respect to the movement onsets estimated with gyroscopes) was 112 ± 278 ms. The Fügl-Meyer index upper extremity increased 11.5 ± 5.5 points with the intervention. The stroke impact scale also increased. In line with changes in clinical scales, kinematics of reaching movements showed a trend towards lower compensatory mechanisms. Patients’ assessment of the therapy reflected their acceptance of the proposed intervention protocol. Conclusions: According to results obtained here with a small sample of patients, Brain-Machine Interfaces providing low-latency support to upper-limb reaching movements in patients with stroke are a reliable and usable solution for motor rehabilitation interventions with potential functional benefits.
Jaime Ibáñez; Esther Monge-Pereira; Francisco Molina-Rueda; J. Ignacio Serrano; Maria D. Del Castillo; Alicia Cuesta-Gómez; Maria Carratala Tejada; Roberto Cano de la Cuerda; Isabel M. Alguacil-Diego; Juan C. Miangolarra-Page; Jose L. Pons. Low Latency Estimation of Motor Intentions to Assist Reaching Movements along Multiple Sessions in Chronic Stroke Patients: A Feasibility Study. Frontiers in Neuroscience 2017, 11, 126 .
AMA StyleJaime Ibáñez, Esther Monge-Pereira, Francisco Molina-Rueda, J. Ignacio Serrano, Maria D. Del Castillo, Alicia Cuesta-Gómez, Maria Carratala Tejada, Roberto Cano de la Cuerda, Isabel M. Alguacil-Diego, Juan C. Miangolarra-Page, Jose L. Pons. Low Latency Estimation of Motor Intentions to Assist Reaching Movements along Multiple Sessions in Chronic Stroke Patients: A Feasibility Study. Frontiers in Neuroscience. 2017; 11 ():126.
Chicago/Turabian StyleJaime Ibáñez; Esther Monge-Pereira; Francisco Molina-Rueda; J. Ignacio Serrano; Maria D. Del Castillo; Alicia Cuesta-Gómez; Maria Carratala Tejada; Roberto Cano de la Cuerda; Isabel M. Alguacil-Diego; Juan C. Miangolarra-Page; Jose L. Pons. 2017. "Low Latency Estimation of Motor Intentions to Assist Reaching Movements along Multiple Sessions in Chronic Stroke Patients: A Feasibility Study." Frontiers in Neuroscience 11, no. : 126.
Corrigendum: Low Latency Estimation of Motor Intentions to Assist Reaching Movements along Multiple Sessions in Chronic Stroke Patients: A Feasibility Study
Jaime Ibáñez; Esther Monge-Pereira; Francisco Molina-Rueda; J. Ignacio Serrano; Maria D. Del Castillo; Alicia Cuesta-Gómez; Maria Carratala Tejada; Roberto Cano de la Cuerda; Isabel M. Alguacil-Diego; Juan C. Miangolarra-Page; Jose L. Pons. Corrigendum: Low Latency Estimation of Motor Intentions to Assist Reaching Movements along Multiple Sessions in Chronic Stroke Patients: A Feasibility Study. Frontiers in Neuroscience 2017, 11, 422 .
AMA StyleJaime Ibáñez, Esther Monge-Pereira, Francisco Molina-Rueda, J. Ignacio Serrano, Maria D. Del Castillo, Alicia Cuesta-Gómez, Maria Carratala Tejada, Roberto Cano de la Cuerda, Isabel M. Alguacil-Diego, Juan C. Miangolarra-Page, Jose L. Pons. Corrigendum: Low Latency Estimation of Motor Intentions to Assist Reaching Movements along Multiple Sessions in Chronic Stroke Patients: A Feasibility Study. Frontiers in Neuroscience. 2017; 11 ():422.
Chicago/Turabian StyleJaime Ibáñez; Esther Monge-Pereira; Francisco Molina-Rueda; J. Ignacio Serrano; Maria D. Del Castillo; Alicia Cuesta-Gómez; Maria Carratala Tejada; Roberto Cano de la Cuerda; Isabel M. Alguacil-Diego; Juan C. Miangolarra-Page; Jose L. Pons. 2017. "Corrigendum: Low Latency Estimation of Motor Intentions to Assist Reaching Movements along Multiple Sessions in Chronic Stroke Patients: A Feasibility Study." Frontiers in Neuroscience 11, no. : 422.
To analyze the clinical and psychometric properties of observational gait assessment scales in people with neurological disorders. The databases used for the literature search were MEDLINE, the Cochrane Central Register of Controlled Trial, Web of Science, and the Cumulative Index to Nursing and Allied Health. The search was conducted between September 15 and November 30, 2014. Studies that investigate and validate observational gait assessment scales in people with central nervous system disorders. General characteristics of the studies, including number of patients and observational gait assessment scales analyzed and their psychometric properties, were extracted. After the literature search, 15 articles were included in this review. Seven of the 15 articles studied the Tinetti Gait Scale (TGS), 2 studied the Rivermead Visual Gait Assessment (RVGA), 1 studied the Gait Assessment and Intervention Tool (G.A.I.T.), 3 studied the Wisconsin Gait Scale, and one of them compared the TGS and the G.A.I.T. The scale that appears to be the most suitable for both clinical practice and research is the G.A.I.T. because it has shown to be valid, reliable, and sensitive to change, homogeneous, and comprehensive, containing a large number of items that assess most components of the gait pattern. The RVGA was studied in those with diverse neurological disorders, including multiple sclerosis. For those with Parkinson disease, the TGS showed sensitivity and the Tinetti Performance-Oriented Mobility Assessment (POMA) showed predictive capability for falls and mortality as well as intra- and interrater reliability. The Tinetti POMA was also studied in those with normal pressure hydrocephalus, showing sensitivity and in those with Huntington disease, showing reliability and validity. More research is needed to more comprehensively analyze the psychometric properties of the RVGA, Wisconsin Gait Scale, TGS, and G.A.I.T. in patients with diverse neurological disorders, other than stroke.
María Dolores Gor-García-Fogeda; Roberto Cano de la Cuerda; Maria Carratala Tejada; Isabel Mª. Alguacil-Diego; Francisco Molina-Rueda. Observational Gait Assessments in People With Neurological Disorders: A Systematic Review. Archives of Physical Medicine and Rehabilitation 2015, 97, 131 -140.
AMA StyleMaría Dolores Gor-García-Fogeda, Roberto Cano de la Cuerda, Maria Carratala Tejada, Isabel Mª. Alguacil-Diego, Francisco Molina-Rueda. Observational Gait Assessments in People With Neurological Disorders: A Systematic Review. Archives of Physical Medicine and Rehabilitation. 2015; 97 (1):131-140.
Chicago/Turabian StyleMaría Dolores Gor-García-Fogeda; Roberto Cano de la Cuerda; Maria Carratala Tejada; Isabel Mª. Alguacil-Diego; Francisco Molina-Rueda. 2015. "Observational Gait Assessments in People With Neurological Disorders: A Systematic Review." Archives of Physical Medicine and Rehabilitation 97, no. 1: 131-140.
Subjects with lower limb amputation develop new motor control strategies to preserve balance when they experience unexpected perturbations. Most studies performed thus far have not aimed to discuss the possible differences in postural control between subjects with vascular unilateral transtibial amputation (UTA) and subjects with traumatic UTA. To analyze the automatic postural reaction in response to unexpected surface perturbations in a sample of subjects with traumatic and vascular UTA and to compare these observations with those for a group of healthy subjects. University department. Observational study. A total of 9 men with traumatic UTA, 7 men with vascular UTA, and 10 control subjects without amputation. Computerized dynamic posturography Smart EquiTest System version 8.0 was used to measure automatic postural responses in both groups. The motor control test was used to assess the participants' automatic postural responses to unexpected surface perturbations. Latency scores showed that subjects with traumatic UTA coped with faster latencies under their sound limb than did the subjects with vascular UTA in medium backward and forward perturbations (medium-backward: P = .004; medium-forward: P = .037). In addition, the subjects with traumatic UTA also managed faster responses to medium-backward (P = .017 versus right control limb; P = .046 versus left control limb) and large-backward (P = .021 versus right control limb) and medium-forward (P = .012 versus right control limb; P = .043 versus left control limb) perturbations in their sound limb in contrast to control subjects. Weight symmetry showed that the subjects with traumatic UTA bore significantly more weight through their sound limb compared with the control subjects during medium and large backward translations (P = .028 and P = .045, respectively). The subjects with traumatic UTA had a greater reliance on their sound limb, and they had faster latencies and more weight in the sound limb upon experiencing unexpected perturbations compared with the control subjects. Conversely, persons with vascular UTA experienced slower latency responses in the sound limb compared with persons with traumatic UTA.
Francisco Molina-Rueda; Alberto Molero-Sánchez; Isabel M. Alguacil-Diego; Maria Carratala Tejada; Alicia Cuesta-Gómez; Juan Carlos Miangolarra-Page. Weight Symmetry and Latency Scores for Unexpected Surface Perturbations in Subjects With Traumatic and Vascular Unilateral Transtibial Amputation. PM&R 2015, 8, 235 -240.
AMA StyleFrancisco Molina-Rueda, Alberto Molero-Sánchez, Isabel M. Alguacil-Diego, Maria Carratala Tejada, Alicia Cuesta-Gómez, Juan Carlos Miangolarra-Page. Weight Symmetry and Latency Scores for Unexpected Surface Perturbations in Subjects With Traumatic and Vascular Unilateral Transtibial Amputation. PM&R. 2015; 8 (3):235-240.
Chicago/Turabian StyleFrancisco Molina-Rueda; Alberto Molero-Sánchez; Isabel M. Alguacil-Diego; Maria Carratala Tejada; Alicia Cuesta-Gómez; Juan Carlos Miangolarra-Page. 2015. "Weight Symmetry and Latency Scores for Unexpected Surface Perturbations in Subjects With Traumatic and Vascular Unilateral Transtibial Amputation." PM&R 8, no. 3: 235-240.
Introduction: In recent decades there has been a special interest in theories that could explain the regulation of motor control, and their applications. These theories are often based on models of brain function, philosophically reflecting different criteria on how movement is controlled by the brain, each being emphasised in different neural components of the movement. The concept of motor learning, regarded as the set of internal processes associated with practice and experience that produce relatively permanent changes in the ability to produce motor activities through a specific skill, is also relevant in the context of neuroscience. Thus, both motor control and learning are seen as key fields of study for health professionals in the field of neuro-rehabilitation. Development: The major theories of motor control are described, which include, motor programming theory, systems theory, the theory of dynamic action, and the theory of parallel distributed processing, as well as the factors that influence motor learning and its applications in neuro-rehabilitation. Conclusions: At present there is no consensus on which theory or model defines the regulations to explain motor control. Theories of motor learning should be the basis for motor rehabilitation. The new research should apply the knowledge generated in the fields of control and motor learning in neuro-rehabilitation. © 2011 Sociedad Española de Neurología.Peer Reviewe
R. Cano-De-La-Cuerda; A. Molero-Sánchez; Maria Carratala Tejada; I.M. Alguacil-Diego; Francisco Molina-Rueda; J.C. Miangolarra-Page; D. Torricelli. Teorías y modelos de control y aprendizaje motor. Aplicaciones clínicas en neurorrehabilitación. Neurología 2015, 30, 32 -41.
AMA StyleR. Cano-De-La-Cuerda, A. Molero-Sánchez, Maria Carratala Tejada, I.M. Alguacil-Diego, Francisco Molina-Rueda, J.C. Miangolarra-Page, D. Torricelli. Teorías y modelos de control y aprendizaje motor. Aplicaciones clínicas en neurorrehabilitación. Neurología. 2015; 30 (1):32-41.
Chicago/Turabian StyleR. Cano-De-La-Cuerda; A. Molero-Sánchez; Maria Carratala Tejada; I.M. Alguacil-Diego; Francisco Molina-Rueda; J.C. Miangolarra-Page; D. Torricelli. 2015. "Teorías y modelos de control y aprendizaje motor. Aplicaciones clínicas en neurorrehabilitación." Neurología 30, no. 1: 32-41.
To assess the clinical and psychometric properties of stroke motor assessment scales. The databases consulted for the literature research were MEDLINE, PEDro, ISI Web of Knowledge, and Cumulative Index to Nursing and Allied Health (CINAHL). The search was carried out between March 2011 and January 2014. Studies that describe and validate a measurement scale designed to assess gross motor function in stroke. The articles were classified according to the levels of evidence and grades of recommendation for diagnosis studies of the Oxford Center for Evidence-Based Medicine. General characteristics of the studies, including number of patients, motor function assessment scales analyzed, and their psychometric properties, were collected. After the literature search, 19 articles were included in this review; 32 articles were excluded for not meeting the inclusion criteria. Four of the 19 articles studied the Motor Assessment Scale, 5 the Fugl-Meyer Assessment, 3 investigated the Sodring Motor Evaluation for Stroke Patients, 4 the Stroke Rehabilitation Assessment of Movement, 2 were about the Motricity Index, and 2 about the Rivermead Motor Assessment. All of them were classified as level 2b according to the levels of evidence and grades of recommendation. All the scales compiled in this review have been shown to be useful both in clinical practice and in terms of research. The most suitable scales to be used in the clinical field would be the short versions of the Fugl-Meyer Assessment and the Stroke Rehabilitation Assessment of Movement. A real consensus about the measurement of gross motor function in patients with stroke is not available in the recent literature.
María Dolores Gor-García-Fogeda; Francisco Molina-Rueda; Alicia Cuesta-Gómez; Maria Carratala Tejada; Isabel M. Alguacil-Diego; Juan Carlos Miangolarra-Page. Scales to Assess Gross Motor Function in Stroke Patients: A Systematic Review. Archives of Physical Medicine and Rehabilitation 2014, 95, 1174 -1183.
AMA StyleMaría Dolores Gor-García-Fogeda, Francisco Molina-Rueda, Alicia Cuesta-Gómez, Maria Carratala Tejada, Isabel M. Alguacil-Diego, Juan Carlos Miangolarra-Page. Scales to Assess Gross Motor Function in Stroke Patients: A Systematic Review. Archives of Physical Medicine and Rehabilitation. 2014; 95 (6):1174-1183.
Chicago/Turabian StyleMaría Dolores Gor-García-Fogeda; Francisco Molina-Rueda; Alicia Cuesta-Gómez; Maria Carratala Tejada; Isabel M. Alguacil-Diego; Juan Carlos Miangolarra-Page. 2014. "Scales to Assess Gross Motor Function in Stroke Patients: A Systematic Review." Archives of Physical Medicine and Rehabilitation 95, no. 6: 1174-1183.
Treatment of spasticity has traditionally been targeted at reducing stretch reflex activity and muscle tone. However, these spasticity indicators and the actual movement disorder following a spinal or supraspinal lesion have been found to be unrelated. Increased muscle tone could be considered secondary and adaptive to a primary disorder and necessary for the continuing support of the body during locomotion. It is evident that antispastic medication is necessary for patients who experience severe pain and discomfort associated with increased muscle tone during rest. However, most therapies currently prescribed are directed at reducing excitation or increasing inhibition and may potentially interfere with voluntary movement. Impairment of walking may be due to a lack of descending input and a reduction in the afferent input to the spinal neuronal circuits. The result is reduced muscle strength, decreased physiological modulation of reflexes and muscle activity as well as cocontraction of agonist and antagonist muscles. Future therapeutic approaches aiming to assist ambulation in mobile spastic patients should focus on the treatment of these aspects in order to improve a patient’s movement ability. Emerging therapies include robot-assisted treadmill training, repetitive electrical stimulation, paired associative stimulation (PAS) and H-reflex conditioning which may provide a new approach for restoring motor function in the spastic patient population.
Sabata Gervasio; Catherine Macleod; Elisabeth Bravo Esteban-Herreros; Lin Meng; María Carratalá Tejada. Motor Control and Emerging Therapies for Improving Mobility in Patients with Spasticity. Converging Clinical and Engineering Research on Neurorehabilitation 2013, 147 -169.
AMA StyleSabata Gervasio, Catherine Macleod, Elisabeth Bravo Esteban-Herreros, Lin Meng, María Carratalá Tejada. Motor Control and Emerging Therapies for Improving Mobility in Patients with Spasticity. Converging Clinical and Engineering Research on Neurorehabilitation. 2013; ():147-169.
Chicago/Turabian StyleSabata Gervasio; Catherine Macleod; Elisabeth Bravo Esteban-Herreros; Lin Meng; María Carratalá Tejada. 2013. "Motor Control and Emerging Therapies for Improving Mobility in Patients with Spasticity." Converging Clinical and Engineering Research on Neurorehabilitation , no. : 147-169.