[Thesis] Recovery of arm-hand function after stroke: developing neuromechanical biomarkers to optimize rehabilitation strategies. – Leiden University

Abstract

The aim of this thesis was to explore the neuromechanics of recovery of arm-hand function after stroke. A literature review revealed six articles that measured biomechanical and electromyographical outcome measures simultaneously, while applying active and passive tasks and multiple movement velocities to separate neural and non-neural contributors to movement disorders after stroke. Therefore, a neuromechanic assessment protocol was developed. Parameters were responsive to clinical status and had good to excellent test-retest reliability. Selective muscle activation was assessed with high measurement reliability and was significantly lower in chronic stroke patients compared to healthy participants. Longitudinally, neuromechanical parameters were combined with data on arm-hand function at six months after stroke. Paresis and diminished modulation of reflexes were associated with poor functional outcome. Changes in tissue properties were represented by a shift in wrist rest angle towards flexion and decline in passive range of motion. Increase in active range of motion and steady rest angle contributed most to prediction of functional outcome. The precision diagnostics provided by a neuromechanical assessment protocol could support clinical decision making and should be used in prediction models and as biomarkers in recovery of arm-hand function after stroke, for example by improving the selection of time-window and patients.

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application/pdf Chapter 1 84.13Kb Προβολή/Άνοιγμα
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application/pdf Chapter 8: Summary in Dutch 82.10Kb Προβολή/Άνοιγμα
application/pdf Bibliography_Curriculum Vitae_Acknowledgements 72.81Kb Προβολή/Άνοιγμα

via Recovery of arm-hand function after stroke: developing neuromechanical biomarkers to optimize rehabilitation strategies.

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