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Article ; Online: Advances in Stroke Recovery Therapeutics.

Richards, Lorie G / Cramer, Steven C

2021 Volume 53, Issue 1, Page(s) 260–263

MeSH term(s)	Aphasia/therapy ; Humans ; Recovery of Function/physiology ; Stroke/therapy ; Stroke Rehabilitation/methods
Language	English
Publishing date	2021-12-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.121.038018
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Therapies Targeting Stroke Recovery.

Richards, Lorie G / Cramer, Steven C

Stroke

2022 Volume 54, Issue 1, Page(s) 265–269

Abstract: Stroke recovery therapeutics include many classes of intervention and numerous treatment targets. Stroke is a very heterogeneous disease. As such, stroke recovery therapeutics benefit from a personalized medicine approach that considers intersubject ... ...

Abstract	Stroke recovery therapeutics include many classes of intervention and numerous treatment targets. Stroke is a very heterogeneous disease. As such, stroke recovery therapeutics benefit from a personalized medicine approach that considers intersubject differences, such as in infarct location or stroke severity, when assigning treatment. Prediction of treatment responders can be improved by incorporating biological measures, such as neural injury and neural function, as the bedside behavioral phenotype has an incomplete relationship with the biological events underlying stroke recovery. Another ramification of high variability between patients is the need to examine effects of restorative therapies in relation to dose, time poststroke, and stroke severity in clinical trials. For example, enrollment across a wide time interval poststroke or in a population with a very broad range of deficits means high variance across patients in the biological state of the brain. The doses of rehabilitation therapy being studied are often low; it takes substantial practice to acquire a skill in the healthy brain; this is more, not less, pronounced after a stroke. Recognition and treatment of poststroke depression represents a major unmet need. These points are considered in the context of a review of recent advances in stroke recovery therapeutics.
MeSH term(s)	Humans ; Stroke Rehabilitation ; Recovery of Function ; Stroke/therapy ; Brain ; Precision Medicine
Language	English
Publishing date	2022-12-07
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.122.041729
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Advances in Stroke: Therapies Targeting Stroke Recovery.

Richards, Lorie G / Cramer, Steven C

Stroke

2020 Volume 52, Issue 1, Page(s) 348–350

Abstract: Stroke recovery therapies promote favorable neural plasticity, both during spontaneous recovery and the chronic phase. Activity-based therapies based on intense practice, some aided by integration of computers and telehealth, have shown promise. These ... ...

Abstract	Stroke recovery therapies promote favorable neural plasticity, both during spontaneous recovery and the chronic phase. Activity-based therapies based on intense practice, some aided by integration of computers and telehealth, have shown promise. These studies emphasize key therapeutic variables such as dose, intensity, and timing. Preclinical drug studies have shown promise, but human translation has been challenged by identifying the target patient subgroup, requirements for concomitant training, and aligning biomarkers with preclinical evidence.
MeSH term(s)	Attention ; Humans ; Language ; Mesenchymal Stem Cell Transplantation ; Motor Activity ; Recovery of Function ; Stroke/drug therapy ; Stroke/psychology ; Stroke/therapy ; Stroke Rehabilitation/trends
Language	English
Publishing date	2020-12-22
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.120.033231
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Article ; Online: Cognitive Deficits After Stroke.

Cramer, Steven C / Richards, Lorie G / Bernhardt, Julie / Duncan, Pamela

Stroke

2022 Volume 54, Issue 1, Page(s) 5–9

Abstract: Cognition is a central feature of human existence and brain function. Cognitive deficits are common after stroke and may strongly impact functional outcome. Recent years have seen substantial advances in our understanding of cognitive functions in the ... ...

Abstract	Cognition is a central feature of human existence and brain function. Cognitive deficits are common after stroke and may strongly impact functional outcome. Recent years have seen substantial advances in our understanding of cognitive functions in the healthy state, and this new body of knowledge promises to open new avenues for understanding and treating poststroke impairments, including cognitive deficits. The 5 reviews in this Focused Update from an international cast of experts provide excellent updates on cognitive syndromes that commonly contribute to poststroke disability: neglect, aphasia, apraxia, loss of executive function, and memory disorders. Cognitive impairment remains a major source of morbidity after stroke; these reviews approach this problem by considering clinical presentations, pathophysiology, measurement tools, and treatment approaches. In doing so, they highlight a number of key questions and critical gaps. A number of issues emerge as common across cognitive domains poststroke and are summarized herein. There is a need for improved methods to measure cognitive impairments, as well as for improved insights into pathophysiology of symptom onset and mechanisms of recovery after stroke, including validated biomarkers. These 5 state of the art summaries are sure to prove useful toward these goals.
MeSH term(s)	Humans ; Cognition Disorders/psychology ; Stroke ; Aphasia ; Cognitive Dysfunction/etiology ; Cognition ; Neuropsychological Tests ; Stroke Rehabilitation
Language	English
Publishing date	2022-12-21
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.122.041775
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ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Myoelectric Arm Orthosis Assists Functional Activities: A 3-Month Home Use Outcome Report.

Chang, Sarah R / Hofland, Nicole / Chen, Zhengyi / Tatsuoka, Curtis / Richards, Lorie G / Bruestle, Margaretta / Kovelman, Harry / Naft, Jonathan

Archives of rehabilitation research and clinical translation

2023 Volume 5, Issue 3, Page(s) 100279

Abstract: Objective: The objective was to compare task performance in individuals with upper limb impairments with and without a myoelectric arm orthosis.: Design: Three-month observational study. Participants met at 4 time points after receiving their ... ...

Abstract	Objective: The objective was to compare task performance in individuals with upper limb impairments with and without a myoelectric arm orthosis. Design: Three-month observational study. Participants met at 4 time points after receiving their myoelectric orthosis (2-Weeks, Month-1, Month-2, Month-3) to complete 4 standardized common daily tasks. Setting: Nationwide sessions completed remotely over videoconference calls at home. There were no specific clinic affiliations. Participants: Adults with upper limb impairment due to stroke who were in the process of being fit with a myoelectric arm orthosis as a first-time user. Interventions: The orthosis was a custom-fabricated myoelectric arm orthosis called the MyoPro®. Main outcome measures: Functional tasks were completed at each session with and without the MyoPro. Participants were evaluated on their success and the time required to complete each functional task. Longitudinal mixed and longitudinal mixed logistic regression models were analyzed. Results: Eighteen individuals with chronic arm weakness due to stroke were included in the analysis. Statistically significant and clinically meaningful improvements were observed on the functional tasks in the participants' homes. By 3 months, participants successfully used the MyoPro to accomplish the tasks, reduced the amount of time spent to complete the tasks, and had a higher probability of success as compared with at 2 weeks. With the MyoPro, participants showed significant improvement in overall task completion and completed the tasks in a significantly decreased time as compared with without the MyoPro. Conclusions: The MyoPro provides a stabilizing support to the weak arm of individuals after stroke and enables individuals to use their impaired arm to complete functional tasks independently in the home environment.
Language	English
Publishing date	2023-07-13
Publishing country	United States
Document type	Journal Article
ISSN	2590-1095
ISSN (online)	2590-1095
DOI	10.1016/j.arrct.2023.100279
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Intimate Relationships and Stroke: Piloting a Dyadic Intervention to Improve Depression.

Terrill, Alexandra L / Reblin, Maija / MacKenzie, Justin J / Baucom, Brian R W / Einerson, Jackie / Cardell, Beth / Richards, Lorie G / Majersik, Jennifer J

International journal of environmental research and public health

2022 Volume 19, Issue 3

Abstract: Stroke affects not only the survivor but also their romantic partner. Post-stroke depression is common in both partners and can have significant negative consequences, yet few effective interventions are available. The purpose of this study was to pilot ... ...

Abstract	Stroke affects not only the survivor but also their romantic partner. Post-stroke depression is common in both partners and can have significant negative consequences, yet few effective interventions are available. The purpose of this study was to pilot test a novel 8-week remotely administered dyadic intervention (ReStoreD) designed to help couples better cope with stroke-related changes and reduce depressive symptoms. Thirty-four cohabitating survivor-partner dyads at least 3 months post-stroke and reporting some changes in mood were enrolled. Depressive symptoms were assessed pre- and post-intervention and at 3-month follow-up. Repeated measures analysis of variance was used to assess the effects of ReStoreD over time on depressive symptoms in stroke survivors and their partners. Twenty-six dyads completed the study. Although statistical significance was not reached, there was a large effect size for improvements in depressive symptoms for stroke survivors. There was no significant improvement for partners, and the effect size was minimal. Those with more significant depressive symptoms at baseline were more likely to benefit from the intervention. This pilot study established proof-of-concept by demonstrating that depressive symptoms can be lessened in stroke survivors and partners with more severe depressive symptoms. Future research will establish the efficacy of the intervention in a fully powered study.
MeSH term(s)	Caregivers ; Depression ; Humans ; Pilot Projects ; Stroke ; Survivors
Language	English
Publishing date	2022-02-05
Publishing country	Switzerland
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph19031804
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Impaired Discrimination of Electrocutaneous Stimulation in the Paretic Hand of Stroke Survivors.

Citterman, Abigail R / Stewart, Ada E / Urban, Rebecca J / Trout, Marshall A / Maitre, Patrick P / Edgley, Steven R / Richards, Lorie G / Iversen, Marta M / George, Jacob A

Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference

2023 Volume 2023, Page(s) 1–6

Abstract: Artificial sensory feedback via electrocutaneous stimulation can be used to assist or rehabilitate stroke survivors with sensory deficits. Conveying the magnitude of tactile stimuli is an important aspect of artificial sensory feedback. Here, we explore ... ...

Abstract	Artificial sensory feedback via electrocutaneous stimulation can be used to assist or rehabilitate stroke survivors with sensory deficits. Conveying the magnitude of tactile stimuli is an important aspect of artificial sensory feedback. Here, we explore how stroke-related sensory deficits impact the ability of electrocutaneous stimulation to convey the magnitude of tactile stimuli. Using classical psychophysical methods, we quantified the threshold of detection and the just-noticeable difference of electrocutaneous stimulation current in five stroke survivors with unilateral sensory deficits. We show significantly greater (40%) stimulation currents are needed for initial perception on the paretic hand compared to the non-paretic hand. We also show significantly greater percent changes in stimulation current (140%) are needed for reliable incremental perception on the paretic hand compared to the non-paretic hand. Lastly, we show little correlation between electrocutaneous discrimination performance and clinical sensory assessments of light-touch and spatial mechanoperception. These findings can help guide the implementation of artificial sensory feedback as an assistive or rehabilitative intervention for individuals experiencing sensory loss after a stroke.Clinical Relevance- Our results can help guide the implementation of electrical stimulation as an assistive or rehabilitative intervention for individuals with sensory loss after stroke.
MeSH term(s)	Humans ; Hand ; Stroke/complications ; Touch/physiology ; Stroke Rehabilitation ; Electric Stimulation Therapy
Language	English
Publishing date	2023-12-11
Publishing country	United States
Document type	Journal Article
ISSN	2694-0604
ISSN (online)	2694-0604
DOI	10.1109/EMBC40787.2023.10340295
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Lifestyle Modification Group for Lymphedema and Obesity Results in Significant Health Outcomes.

Keith, Leslyn / Rowsemitt, Carol / Richards, Lorie G

American journal of lifestyle medicine

2017 Volume 14, Issue 4, Page(s) 420–428

Abstract: This study investigated whether a lifestyle modification program that encouraged a ketogenic diet (KD) for participants with lymphedema and obesity would reduce weight and limb volume and improve quality of life. A total of 12 participants with ... ...

Abstract	This study investigated whether a lifestyle modification program that encouraged a ketogenic diet (KD) for participants with lymphedema and obesity would reduce weight and limb volume and improve quality of life. A total of 12 participants with lymphedema and obesity (mean body mass index = 38.38; SD = 7.02) were enrolled in a lifestyle modification group. The timespan from baseline data collection to 30-day follow-up was 18 weeks. Retention rate was 83.3%. Data were analyzed with repeated-measures ANOVA and Pearson correlation. Participants demonstrated statistically significant improvement in most outcome measures. Mean weight loss was 5.18 kg-F(4, 36) = 11.17; P < .001-or 4.8% of mean baseline weight. The average limb volume reduction was 698.9 ml-F(4, 36) = 9.4; P < .001-and was positively correlated with weight loss (r = 0.8; P = .005). There appeared to be a tendency for participants who used a KD (n = 6) to demonstrate superior results in most outcome measures compared with those who did not use the diet (n = 4), although the sample size of the 2 groups was too small to report definitive results. This lifestyle modification program provided insight into the possible value of a KD for obesity and lymphedema management.
Language	English
Publishing date	2017-11-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2265653-4
ISSN	1559-8284 ; 1559-8276
ISSN (online)	1559-8284
ISSN	1559-8276
DOI	10.1177/1559827617742108
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Intimate Relationships and Stroke

Alexandra L. Terrill / Maija Reblin / Justin J. MacKenzie / Brian R. W. Baucom / Jackie Einerson / Beth Cardell / Lorie G. Richards / Jennifer J. Majersik

International Journal of Environmental Research and Public Health, Vol 19, Iss 1804, p

Piloting a Dyadic Intervention to Improve Depression

2022 Volume 1804

Abstract	Stroke affects not only the survivor but also their romantic partner. Post-stroke depression is common in both partners and can have significant negative consequences, yet few effective interventions are available. The purpose of this study was to pilot test a novel 8-week remotely administered dyadic intervention (ReStoreD) designed to help couples better cope with stroke-related changes and reduce depressive symptoms. Thirty-four cohabitating survivor–partner dyads at least 3 months post-stroke and reporting some changes in mood were enrolled. Depressive symptoms were assessed pre- and post-intervention and at 3-month follow-up. Repeated measures analysis of variance was used to assess the effects of ReStoreD over time on depressive symptoms in stroke survivors and their partners. Twenty-six dyads completed the study. Although statistical significance was not reached, there was a large effect size for improvements in depressive symptoms for stroke survivors. There was no significant improvement for partners, and the effect size was minimal. Those with more significant depressive symptoms at baseline were more likely to benefit from the intervention. This pilot study established proof-of-concept by demonstrating that depressive symptoms can be lessened in stroke survivors and partners with more severe depressive symptoms. Future research will establish the efficacy of the intervention in a fully powered study.
Keywords	stroke ; post-stroke depression ; depression ; caregiver ; dyadic intervention ; positive psychology ; Medicine ; R
Subject code	150
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Predicting Motor Outcomes in Stroke Patients Using Diffusion Spectrum MRI Microstructural Measures.

Hodgson, Kyler / Adluru, Ganesh / Richards, Lorie G / Majersik, Jennifer J / Stoddard, Greg / Adluru, Nagesh / DiBella, Edward

Frontiers in neurology

2019 Volume 10, Page(s) 72

Abstract: Improved understanding of neuroimaging signal changes and their relation to patient outcomes after ischemic stroke is needed to improve ability to predict motor improvement and make therapy recommendations. The posterior limb of the internal capsule ( ... ...

Abstract	Improved understanding of neuroimaging signal changes and their relation to patient outcomes after ischemic stroke is needed to improve ability to predict motor improvement and make therapy recommendations. The posterior limb of the internal capsule (PLIC) is a hub of afferent and efferent motor signaling and this work proposes new, image-based methods for prognosis based on interhemispheric differences in the PLIC. In this work, nine acute supratentorial ischemic stroke patients with motor impairment received a baseline, 203-direction diffusion brain MRI and a clinical assessment 3-12 days post-stroke and were compared to nine age-matched healthy controls. Asymmetries based on the mean and Kullback-Leibler divergence in the ipsilesional and contralesional PLIC were calculated for diffusion tensor imaging (DTI) and diffusion spectrum imaging (DSI) measures from the baseline MRI. Predictions of upper extremity Fugl-Meyer (FM) scores at 5-weeks follow-up from baseline measures of PLIC asymmetry in diffusion tensor imaging (DTI) and diffusion spectrum imaging (DSI) models were evaluated. For the stroke participants, the baseline asymmetry measures in the PLIC for the orientation dispersion index of the neurite orientation dispersion and density imaging (NODDI) model were highly correlated with upper extremity FM outcomes (
Language	English
Publishing date	2019-02-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2019.00072
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