Day 1 :
Keynote Forum
Chan WC, Au-Yeung SY
Department of Rehabilitation Science, The Hong Kong Polytechnic University
Keynote: Motor Recovery of the Severely Impaired Paretic Upper Limb after Mirror Therapy in Sub-acute Stroke- A Randomised Controlled Trial
Biography:
Chan WC has completed his MSc in Health Care in The Hong Kong Polytechnic Unversity since 1997. He is now enrolled in doctoral degree in Health Care Science. Chan is currently a founding fellow of the Hong Kong Colleage of Physiotherapy, and Chair of Neurology Speciality Group of Hong Kong Physiotherapy Association. He has presented his master thesis in local and international conference such as WCNR. He is interested in the field of clinical rehabilitation in stroke and other neurological conditions.
Abstract:
This study investigated on the effectiveness of high-dose-mirror-therapy (HDMT) on the motor recovery of severely impaired paretic upper limb (UL) in patents during sub-acute stroke. It was a prospective assessor-blind randomized-controlled-trial. Patients admitted for first super-tentorial stroke for less than a month were included if they aged > 35, presented with severe to moderate UL impairment and able to follow instructions. The exclusion criteria were visual impairment, cognitive impairment, aphasia, visual neglect, and history of impaired UL function. Subjects were randomized to HDMT or control (CT) group. In addition to conventional rehabilitation treatment, HDMT group received 2 sessions of 30 minutes MT daily, 5 days a week for 4 weeks. During MT, subjects performed a standardized bilateral ULs exercise (BULE) while watching the reflective image of the non-paretic UL from a mirror placed between the ULs. The CT practiced the same BULE without mirror. The outcomes were Fugl-Meyer Assessment Upper Extremity (FMA-UE) and Wolf Motor Functional Test (WMFT) performed before and after the intervention. Within- and between group differences were analyzed by SPSS version 17 with level of significance at 0.05. Thirty-four subjects (HDMT=15, CT=19) completed the study. There was no difference between HDMT and CT in the demographic characteristics and baseline outcomes. Both HDMT and CT showed within-groups improvement in FMA-UE and WMFT after program but no between-groups difference showed. HDMT was not superior in promoting motor recovery of the severely impaired paretic UL of patients during sub-acute stroke when compared to CT involving similar intensity of BULE.
- Neurorehabilitation Therapies
Location: Brisbane, Australia
Session Introduction
Urvashy Gopaul
physiotherapist, specialised in Neurorehabilitation , University of Newcastle
Title: Description of a novel “Combined Physical and SEnsOry training†(COMPoSE) intervention to improve arm function after stroke, using TIDIER checklist
Biography:
I am a physiotherapist, specialised in Neurorehabilitation. I am currently doing, a PhD in upper arm recovery at the University of Newcastle and the Hunter Medical Research Institute (Newcastle, Australia). I am particularly interested in researching about the sensorimotor control of the upper and lower limb and effective rehabilitation strategies influencing neuroplasticity by priming the sensory and motor pathways of brain. I have presented my previous research in both International (Singapore) and National (Australia)
Abstract:
Background/Aim:Complex interventions used in stroke rehabilitation trials are often described in insufficient detail to allow their application to clinical practice. Thus, the template for intervention description and replication (TIDieR) checklist was designed to guide the reporting of therapeutic interventions in randomised controlled trials. TIDieR could be equally useful in reporting interventions in Phase I trials. The aim of this abstract is to describe a new upper limb stroke rehabilitation intervention “Combined Physical and SEnsOry training” (COMPoSE), being used in a Phase I study, using the TIDieR checklist. Methods:The COMPoSE intervention was developed through the following stages: 1) Generation of sensory and motor variables used in training sensation and movement after stroke; 2) Development of methods to give feedback to enhance skill acquisition; and 3) Combination of sensory and motor variables, and feedback, into a standardised matrix. TIDieR was used to describe the COMPoSE intervention to facilitate replication of the intervention in the future. Results:The essential features of COMPoSE included:combined sensorimotor training variables (grasp pressure, distance, object size, crushability, surface texture and friction), intensive practice (216 repetitions/session), feedback using a wearable device providing kinematic measures and a haptic device providing measures of grasp pressure. Ten sessions of treatment will be delivered over 3 weeks, using a standardised matrix for treatment delivery. Conclusion:The COMPoSE intervention is ready to be evaluated in a Phase 2 trial. TIDieR is an efficient way to describe the development and content of a complex intervention used in Phase I trials in stroke rehabilitation research.
- Neurorehabilitation
Location: Brisbane, Australia
Session Introduction
ANUP KUMAR
Director – Neurology at Institute of Neurosciences, Medanta Hospital, Lucknow.
Title: ROLE OF PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION IN STROKE
Biography:
Dr. Anup Kumar Thacker is a Director – Neurology at Institute of Neurosciences, Medanta Hospital, Lucknow. Dr. Thacker initiated Neurology services at BRD Medical College, Gorakhpur and at Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow. He has published over 100 papers in international academic journals of repute.
Abstract:
- Objective: To assess the role of proprioceptive Neuromuscular facilitation (PNF) in Rehabilitation of acute Stroke.
- Background: Majority of stroke survivors are left with moderate to severe functional disability. Effective rehabilitation intervention initiated in the early part is known to improve the outcome. However uncertainties exist to about the best rehabilitative method particularly in a resource poor country. PNF is one such method, shown to improve the functional outcome in stroke.
- Methods: Proprioceptors were stimulated by rhythmic imitation technique by various principles (upper & lower extremities and the trunk & pelvis for 30 minutes twice daily for 5 days a week) for 2 weeks initially and thereafter every month for six months. The stroke severity and Quality of life scales were assessed at each visit & at 6 months. The differences in the scales at admission and at 6 months were statistically analysed.
- Results: Forty six consecutive patients of Stroke [ 28 males,17 females F; age range 29 to 70 years; ischemic Strokes in 32, hemorrhagic strokes in 13. left hemiparesis in 29 & right hemiparesis in 17] admitted to the Neurology Ward formed the study material. The Mean day of entry to ictus was 6.56 +1.8 days. Average GCS at admission was 14.9, NIHSS score 6.7, modified Rankin scale 3.7 & Barthel index 35.5+29.0, Fugal – Meyer score 152.28 + 46.8,QOL for stroke was 165.0 +41.2. The patients were followed for six months & the last three scales were measured again at 6 months There was a significant improvement in three scales study points to all
- Conclusion. Though the number of patients in this ongoing study is small the study points to a definitive role of PNF in patients with stroke.
- Neural Repair
Location: Brisbane, Australia
Session Introduction
Mrs Reethu Elsa Effect
Mrs Reethu Elsa professer
Title: Effect Of Motor Imagery Of Truncal Exercises On Trunk Function And Balance In Early Stroke: A Randomized Controlled Trial
Biography:
Mrs Reethu Elsa Effect Of Motor Imagery Of Truncal Exercises On Trunk Function And Balance In Early Stroke: A Randomized Controlled Trial
Abstract:
Title: Effect Of Motor Imagery Of Truncal Exercises On Trunk Function And Balance In Early Stroke: A Randomized Controlled Trial
Background: Studies in the past focused on benefits of motor imagery in improving upper and lower limb functions when administered along with conventional therapy. Nevertheless, there is a paucity of literature proving the effects of motor imagery of truncal exercise in improving trunk function in patients with stroke.
Aims/purpose: To study the effect of motor imagery of truncal exercises on trunk function and balance in early stroke.
Methods: A total of 24 patients were included in the study. Trunk function was measured using Trunk Control Test (TCT), Trunk Impairment Scale Verheyden (TIS Verheyden) and Trunk Impairment Scale Fujiwara (TIS Fujiwara). Balance was assessed using Brunel Balance Assessment (BBA) and Tinetti POMA. The MI intervention included a 3-week practice of trunk exercises after observing the video while the control group practiced the trunk exercises alone. Measurements were taken before, after and 4 weeks after intervention.
Results: MI group showed improvement after 3 weeks intervention on values of TIS (Verheyden), BBA, Tinetti balance and gait with a large effect size of 1.69, 1.06, 1.63 and 0.97 respectively. Moderate effect size on TIS Fujiwara (0.58) and small effect size on TCT (0.12) was observed. When measured after 4 weeks, large effect size was seen on TIS Verheyden (1.59) and Tinetti balance (1.24). Moderate effect size was observed on BBA (0.62) and Tinetti gait (0.72).
Conclusion:. Trunk motor imagery is effective in improving trunk function and balance in patents with stroke and has a carryover effect in the aspects of mobility. The therapy gain that was observed during the time of discharge was seen to be maintained at the follow up levels.
- Addiction and Rehabilitation
Location: Brisbane, Australia
Session Introduction
Nasim fooladi
Associate Professor, Guilan University of Medical Sciences, Rasht, Iran
Title: The Effect of Methadone on Sexual Function in Men Dependent on Opiates
Biography:
Nasim fooladi
Mazandaran University of Medical Sciences, Sari, Iran The Effect of Methadone on Sexual Function in Men Dependent on Opiates
Abstract:
Sexual dysfunction disorder is one of the most common problems faced by opiates dependent people. Accordingly, the present study examined the effect of methadone maintenance treatment on sexual function in men dependent on opiates before and after 6 months of treatment. In this study, a cross-sectional method was used in which 100 married men addicted to drug referring to rehabilitation centers in Rasht were selected and evaluated. Initially, the patients' demographic data were collected and then, their sexual function before and after treatment was assessed by the international index of erectile function. The results showed that erectile function, sexual satisfaction and overall sexual satisfaction increased significantly after 6 months of treatment, while the orgasmic function of people addicted to opiates decreased significantly during this period. Overall, results showed an average prevalence of sexual dysfunction disorder at the beginning of treatment and improvement of some sexual function components after treatment with methadone.