Objective. Gait performance is an indicator of mobility impairment after stroke. This study evaluated changes in balance, lower extremity motor function, and spatiotemporal gait parameters after receiving body weight supported treadmill training (BWSTT) and conventional overground walking training (CT) in patients with subacute stroke using 3D motion analysis.Setting. Inpatient department of rehabilitation medicine at a university-affiliated hospital.Participants. 24 subjects with unilateral hemiplegia in the subacute stage were randomized to the BWSTT(n=12)and CT(n=12)groups. Parameters were compared between the two groups. Data from twelve age matched healthy subjects were recorded as reference.Interventions. Patients received gait training with BWSTT or CT for an average of 30 minutes/day, 5 days/week, for 3 weeks.Main Outcome Measures. Balance was measured by the Brunel balance assessment. Lower extremity motor function was evaluated by the Fugl-Meyer assessment scale. Kinematic data were collected and analyzed using a gait capture system before and after the interventions.Results. Both groups improved on balance and lower extremity motor function measures(P<0.05), with no significant difference between the two groups after intervention. However, kinematic data were significantly improved(P<0.05)after BWSTT but not after CT. Maximum hip extension and flexion angles were significantly improved(P<0.05)for the BWSTT group during the stance and swing phases compared to baseline.Conclusion. In subacute patients with stroke, BWSTT can lead to improved gait quality when compared with conventional gait training. Both methods can improve balance and motor function.

Virtual reality is a new technology that simulates a three-dimensional virtual world on a computer and enables the generation of visual, audio, and haptic feedback for the full immersion of users. Users can interact with and observe objects in three-dimensional visual space without limitation. At present, virtual reality training has been widely used in rehabilitation therapy for balance dysfunction. This paper summarizes related articles and other articles suggesting that virtual reality training can improve balance dysfunction in patients after neurological diseases. When patients perform virtual reality training, the prefrontal, parietal cortical areas and other motor cortical networks are activated. These activations may be involved in the reconstruction of neurons in the cerebral cortex. Growing evidence from clinical studies reveals that virtual reality training improves the neurological function of patients with spinal cord injury, cerebral palsy and other neurological impairments. These findings suggest that virtual reality training can activate the cerebral cortex and improve the spatial orientation capacity of patients, thus facilitating the cortex to control balance and increase motion function.

Objective. To critically evaluate the studies that were conducted over the past 10 years and to assess the impact of virtual reality on static and dynamic balance control in the stroke population.Method. A systematic review of randomized controlled trials published between January 2006 and December 2015 was conducted. Databases searched were PubMed, Scopus, and Web of Science. Studies must have involved adult patients with stroke during acute, subacute, or chronic phase. All included studies must have assessed the impact of virtual reality programme on either static or dynamic balance ability and compared it with a control group. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the included studies.Results. Nine studies were included in this systematic review. The PEDro scores ranged from 4 to 9 points. All studies, except one, showed significant improvement in static or dynamic balance outcomes group.Conclusions. This review provided moderate evidence to support the fact that virtual reality training is an effective adjunct to standard rehabilitation programme to improve balance for patients with chronic stroke. The effect of VR training in balance recovery is less clear in patients with acute or subacute stroke. Further research is required to investigate the optimum training intensity and frequency to achieve the desired outcome.

Mobile and tablet apps, ubiquitous and pervasive computing, wearable computing and domotics for health.

This study applied a comprehensive electroencephalography (EEG) analysis for movement-related cortical potentials (MRCPs) and event-related desynchronization (ERD) in order to understand movement-related brain activity changes during movement preparation and execution stage of unilateral wrist extension. Thirty-four healthy subjects completed two event-related potential tests in the same sequence. Unilateral wrist extension was involved in both tests as the movement task. Instruction Response Movement (IRM) was a brisk movement response task with visual “go” signal, while Cued Instruction Response Movement (CIRM) added a visual cue contenting the direction information to create a prolonged motor preparation stage. Recorded EEG data were segmented and averaged to show time domain changes and then transformed into time-frequency mapping to show the time-frequency changes. All components were calculated and compared among C3, Cz, and C4 locations. The motor potential appeared bilaterally in both tests' movement execution stages, and Cz had the largest peak value among the investigated locations (p < 0.01). In CIRM, a contingent negative variation (CNV) component presented bilaterally during the movement preparation stage with the largest amplitude at Cz. ERD of the mu rhythm (mu ERD) presented bilateral sensorimotor cortices during movement execution stages in both tests and was the smallest at Cz among the investigated locations. In the movement preparation stage of CIRM, mu ERD presented mainly in the contralateral sensory motor cortex area (C3 and C4 for right and left wrist movements, respectively) and showed significant differences between different locations. EEG changes in the time and time-frequency domains showed different topographical features. Movement execution was controlled bilaterally, while movement preparation was controlled mainly by contralateral sensorimotor cortices. Mu ERD was found to have stronger contra-lateralization features in the movement preparation stage and might be a better indicator for detecting movement intentions. This information could be helpful and might provide comprehensive information for studying movement disorders (such as those in post-stroke hemiplegic patients) or for facilitating the development of neuro-rehabilitation engineering technology such as brain computer interface.

Introduction. The reliability of using MyotonPRO to quantify muscles mechanical properties in a ward setting for the acute stroke population remains unknown. Aims. To investigate the within-session relative and absolute interrater reliability of MyotonPRO. Methods. Mechanical properties of biceps brachii, brachioradialis, rectus femoris, and tibialis anterior were recorded at bedside. Participants were within 1 month of the first occurrence of stroke. Relative reliability was assessed by intraclass correlation coefficient (ICC). Absolute reliability was assessed by standard error of measurement (SEM), SEM%, smallest real difference (SRD), SRD%, and the Bland-Altman 95% limits of agreement. Results. ICCs of all studied muscles ranged between 0.63 and 0.97. The SEM of all muscles ranged within 0.30–0.88 Hz for tone, 0.07–0.19 for decrement, 6.42–20.20 N/m for stiffness, and 0.04–0.07 for creep. The SRD of all muscles ranged within 0.70–2.05 Hz for tone, 0.16–0.45 for decrement, 14.98–47.15 N/m for stiffness, and 0.09–0.17 for creep. Conclusions. MyotonPRO demonstrated acceptable relative and absolute reliability in a ward setting for patients with acute stroke. However, results must be interpreted with caution, due to the varying level of consistency between different muscles, as well as between different parameters within a muscle.