Posts Tagged cerebral vascular accident

[Abstract + References] Monitoring System for Home-Based Hand Rehabilitation – IEEE Conference Publication


The paper proposes a solution for monitoring of cardiovascular parameters during home-based hand rehabilitation. The most important cause of long-term disability in Europe is cerebral vascular accident (CVA) or stroke. The effects of stroke can vanish after a short period or can remain for the rest of the life depending on therapeutic program. The system developed for this study is not only therapeutically devices that allow the movement of hand for physical exercises controlled by electromyography (EMG) but also record one or more biomedical parameters such as: electromyogram (EMG), electrocardiogram (ECG), pulse wave, heart rate (HR), temperature, respiration rate, non-invasive blood pressure (NIBP) or oxygen concentration in the blood (SpO2). These physiological parameters are selected according to the physician’s prescription and the patient needs. In this paper it is presented an application that refers to the hand rehabilitation of post-stroke. It was observed the cardiovascular system status, analyzing the heart rate variability. During therapeutic procedure it was recorded ECG (1 lead) and pulse wave (using an ear lobe sensor). After that HRV was calculated for each signal. The results were used to determine the stress level induced by the rehabilitation program.
1. I.I. Costache, E. Miftode, O. Petriş, A.D. Popa, D. Iliescu, E.G. Botnariu, “Associations between Area of residence and Cardiovascular risk”, Revista de cercetare şi intervenţie socială, vol. 49, pp. 68-79, May 2015.

2. V.L. Roger, A.S. Go, D.M. Lloyd-Jones, E.J. Benjamin, J.D. Berry, W.B. Borden, D.M. Bravata, S. Dai, E.S. Ford, C.S. Fox, H.J. Fullerton, C. Gillespie, S.M. Hailpern, J.A. Heit, V.J. Howard, B.M. Kissela, S.J. Kittner, D.T. Lackland, J.H. Lichtman, L.D. Lisabeth, D.M. Makuc, G.M. Marcus, A. Marelli, D.B. Matchar, C.S. Moy, D. Mozaffarian, M.E. Mussolino, G. Nichol, N.P. Paynter, E.Z. Soliman et al., “Heart disease and stroke statistics–2012 update: a report from the American Heart Association”, Circulation, vol. 125, pp. e2-e220, 2012.

3. P.U. Heuschmann, A. Di Carlo, Y. Bejot, D. Rastenyte, D. Ryglewicz, C. Sarti, M. Torrent, C.D. Wolfe, “Incidence of stroke in Europe at the beginning of the 21st century”, Stroke, vol. 40, pp. 1557-1563, May 2009.

4. I.I. Costache, E. Miftode, O. Mitu, V. Aursulesei, “Sex differences in cardiovascular risk factors in a rural community from north Romania region”, Revista de cercetare şi intervenţie socială, vol. 55, pp. 204-214, 2016.

5. E. Stevens, C. McKevitt, E. Emmett, C. Wolfe, Y. Wang, “The Burden of Stroke in Europe”, report for Stroke Alliance for Europe, 2017.

6. J. Chen, D. Nichols, E.B. Brokaw, P.S. Lum, “Home-Based Therapy After Stroke Using the Hand Spring Operated Movement Enhancer (HandSOME)”, IEEE Transactions on Neural Systems and Rehabilitation Engineering, vol. 25, no. 12, pp. 2305-2312, 2017.

7. M. Ciorap, M. Munteanu, D. Andritoi, R. Ciorap, “Low Cost Device for “at Home” Rehabilitation After a Stroke Event”, International conference KNOWLEDGE-BASED ORGANIZATION, vol. 24, pp. 26-31, 2018, [online] Available:

8. A. Basteris, S.M. Nijenhuis, A.HA. Stienen, J.H. Buurke, G.B Prange, F. Amirabdollahian, “Training modalities in robot-mediated upper limb rehabilitation in stroke: a framework for classification based on a systematic review”, Journal of NeuroEngineering and Rehabilitation, vol. 11, no. 111, 2014.

9. S.M. Hunter, H. Johansen-Berg, N. Ward, N.C. Kennedy, E. Chandler, C.J. Weir, J. Rothwell, A.M. Wing, M.J. Grey, G. Barton, N.M. Leavey, C. Havis, R.N. Lemon, J. Burridge, A. Dymond, V.M. Pomeroy, “Functional Strength Training and Movement Performance Therapy for Upper Limb Recovery Early Poststroke-Efficacy Neural Correlates Predictive Markers and Cost-Effectiveness: FAST-INdiCATE Trial”, FRONTIERS IN NEUROLOGY, vol. 8, 2018.

10. A. Pollock, B. St George, M. Fenton, L. Firkins, “Top ten research priorities relating to life after stroke”, Lancet Neurology, vol. 11, no. 3, pp. 209, 2012.

11. M.T. Schultheis, A.A. Rizzo, “The application of virtual reality technology in rehabilitation”, Rehabil Psychol, vol. 46, no. 3, pp. 296-311, 2001.

12. H. Sveistrup, “Motor rehabilitation using virtual reality”, Journal of Neuro Engineering and Rehabilitation, vol. 1, no. 10, 2004.

13. R. Ciorap, D. Arotariţei, F. Topoliceanu, R. Lupu, C. Corciovă, M. Ungureanu, “E-health application for home monitoring of neuromuscular rehabilitation”, [Aplicaţie e-Health pentru monitorizarea la domiciliu a recuperării neuro-musculare] Revista Medico-Chirurgicală a Societăţii de Medici şi Naturalişti din Iaşi, vol. 109, no. 2, pp. 440-444, 2005.

14. F. Wittmann, J.P. Held, O. Lambercy, M.L. Starkey, A. Curt, R. Hover, R. Gassert, A.R. Luft, R.R. Gonzenbach, “Self-directed arm therapy at home after stroke with a sensor-based virtual reality training system”, Journal of Neuroengineering and Rehabilitation, vol. 13, 2016.

15. F. Muri, C. Carbajal, A.M. Echenique, H. Fernandez, M. Lopez, “Virtual reality upper limb model controlled by EMG signals”, Journal of Physics Conference Series 477 19th Argentinean Bioengineering Society Congress (SABI 2013).

16. R. Ciorap, C. Hritcu-Luca, C. Corciova, A. Stan, D. Zaharia, “Home Monitoring Device for Cardiovascular Diseases”, International Conference on Advancements of Medicine and Health Care through Technology, pp. 49-52, 23-26 Septembrie, 2009.

17. A.J. Meyer, C. Patten, B.J. Fregly, “Lower extremity EMG-driven modeling of walking with automated adjustment of musculoskeletal geometry”, PLOS ONE, vol. 12, no. 7, 2017.

18. R. Ciorap, D. Andritoi, V. Pomazan, L. Petcu, F. Ungureanu, D. Zaharia, “E-health system for monitoring of chronic diseases”, World Congress on Medical Physics and Biomedical Engineering, vol. 25, no. 5, pp. 259-262, 7 – 12 September 2009.

19. V. David, A. Salceanu, R. Ciorap, “Acquisition and Analysis of Biomedical Signals in Case of Peoples Exposed to Electromagnetic Fields” in Pervasive and Mobile Sensing and Computing for Healthcare Subhas Chandra Mukhopadhyay and O. A. Postolache, Springer, pp. 269-295, 2012.

20. V.M. Pomazan, L.C. Petcu, S.R. Sintea, R. Ciorap, “Active Data Transportation and Processing for Chronic Diseases Remote Monitoring”, International Conference on Signal Processing Systems (ICSPS 2009), pp. 853-857, 15-17 May, 2009.

21. R. Ciorap, C. Corciova, M. Ciorap, D. Zaharia, “Optimization of the Treatment for Chronic Disease Using an e-Health System”, 7th International Symposium on ADVANCED TOPICS IN ELECTRICAL ENGINEERING 2011 Bucureşti, pp. 143-146, 12-14 Mai, 2011.

22. D. Andriţoi, V. David, R. Ciorap, “An Portable Device for ECG and Photoplethysmographic Signal Acquisition”, 2014 International Conference and Exposition on Electrical and Power Engineering (EPE2014), 16-18 October 2014.

23. M. Ciorap, M. Munteanu, D. Andritoi, R. Ciorap, “Low Cost Device for at Home Rehabilitation After a Stroke Event”, International conference KNOWLEDGE-BASED ORGANIZATION, vol. 24, no. 3, pp. 26-31, [online] Available:

24. I.I. Costache, M.C. Ungureanu, D. Iliescu, A. Petriş, G. Botnariu, “Electrocardiographic changes in the most frequent endocrine disorders associated with cardiovascular diseases. Review of the literature”, Revista Medico-Chirurgicală a Societăţii de Medici şi Naturalişti din Iaşi, vol. 119, no. 1, pp. 9-13, 2015.

25. I.I. Costache, R. Al Namat, F. Mitu, M. Ciocoiu, V. Aursulesei, O. Mitu, A.D. Costache, D. Marcu, A.M. Buburuz, “The Prognostic Value of Left Bundle Branch Block and Biochemical Parameters in Alcoholic Dilated Cardiomyopathy”, REV. CHIM., vol. 68, no. 12, pp. 2967-2969, 2017.

26. D. Andriţoi, C. Corciovă, C. Luca, D. Matei, R. Ciorap, “Heart Rate dynamics study on the impact of “Mirror therapy” in patients with stroke”, International Conference Advancements of Medicine and Health Care Through Technology MEDITECH 2016, 12th – 15th October 2016.

27. D. Andritoi, V. David, R. Ciorap, M. Branzila, “Recording and processing electrocardiography signals during magneto therapy procedures”, Environmental Engineering and Management Journal, vol. 12, no. 6, pp. 1231-1238, 2013.


via Monitoring System for Home-Based Hand Rehabilitation – IEEE Conference Publication

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[Abstract] Dual-task training effects on motor and cognitive functional abilities in individuals with stroke: a systematic review

This systematic review aimed to examine the effects of dual-task balance and mobility training in people with stroke.

An extensive electronic databases literature search was conducted using MEDLINE, PubMed, EBSCO, The Cochrane Library, Web of Science, SCOPUS, and Wiley Online Library. Randomized controlled studies that assessed the effects of dual-task training in stroke patients were included for the review (last search in December 2017). The methodological quality was evaluated using the Cochrane Collaboration recommendation, and level of evidence was determined according to the criteria described by the Oxford Center for Evidence-Based Medicine.

About 13 articles involving 457 participants were included in this systematic review. All had substantial risk of bias and thus provided level IIb evidence only. Dual-task mobility training was found to induce more improvement in single-task walking function (standardized effect size = 0.14–2.24), when compared with single-task mobility training. Its effect on dual-task walking function was not consistent. Cognitive-motor balance training was effective in improving single-task balance function (standardized effect size = 0.27–1.82), but its effect on dual-task balance ability was not studied. The beneficial effect of dual-task training on cognitive function was provided by one study only and thus inconclusive.

There is some evidence that dual-task training can improve single-task walking and balance function in individuals with stroke. However, any firm recommendation cannot be made due to the weak methodology of the studies reviewed.


via Dual-task training effects on motor and cognitive functional abilities in individuals with stroke: a systematic review – Ying He, Lei Yang, Jing Zhou, Liqing Yao, Marco Yiu Chung Pang, 2018

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[ARTICLE] The Role of Task-Specific Training in Rehabilitation Therapies

…Task-oriented therapy is important. It makes intuitive sense that the best way to relearn a given task is to train specifically for that task. In animals, functional reorganization is greater for tasks that are meaningful to the animal. Repetition alone, without usefulness or meaning in terms of function, is not enough to produce increased motor cortical representations. In humans, less intense but task-specific training regimens with the more affected limb can produce cortical reorganization and associated, meaningful functional improvements…

via Topics in Stroke Rehabilitation – online access – Volume 12 – Number 3/Summer 2005 – Animal and Clinical Research in Stroke Recovery and Rehabilitation – The Role of Task-Specific Training in Rehabilitation Therapies.

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[ARTICLE] A Pilot Study of an Android-Based Game: Stroke Patient Rehabilitation


Background Cerebral vascular accidents (strokes) are the primary cause of disability worldwide and the second leading cause of death both in the Philippines and internationally. In recent years, a number of computer-based applications have been developed to assist in the stroke recovery process.

Aim This article discusses an Android-based tablet game, FINDEX, that aids in the rehabilitation process of stroke survivors with impaired fine motor skills.

Method FINDEX was designed and developed in the Philippines. The game contains assessment and monitoring support for tracking the patient’s progress in terms of fine finger dexterity, for example, finger control, isolation and coordination, and range of motions. The baselines for data comparison and analysis were gathered through an initial test with subjects with normal hand function. Three stroke survivors then participated in a pilot study, using the game for a total of nine testing sessions.

Results Objective measures showed that patients’ dexterity did in fact improve, although it is not possible to draw strong conclusions because of the small sample size. In subsequent interviews, patients indicated that they believed that the games helped in their recovery and said that they preferred playing with the game over performing the standard therapeutic activities.

Conclusion The development of this game and the preliminary findings from the pilot study suggest that games may indeed be effective instruments for therapy.

via Stroke Patient Rehabilitation.

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