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Book: Motor recovery after stroke

Harvey, Richard L.

(Physical medicine and rehabilitation clinics of North America ; 14,1, Suppl.)

2003

Author's details	guest ed. Richard L. Harvey
Series title	Physical medicine and rehabilitation clinics of North America ; 14,1, Suppl.
Collection
Language	English
Size	XVIII, S164 S. : Ill., graph. Darst.
Publisher	Saunders
Publishing place	Philadelphia u.a.
Publishing country	United States
Document type	Book
HBZ-ID	HT013633961
Database	Catalogue ZB MED Medicine, Health

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Article ; Online: NeuroRehabilitation: New concepts in stroke rehabilitation.

Harvey, Richard L

NeuroRehabilitation

2018 Volume 43, Issue 1, Page(s) 1–2

Language	English
Publishing date	2018-07-24
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1087912-2
ISSN	1878-6448 ; 1053-8135
ISSN (online)	1878-6448
ISSN	1053-8135
DOI	10.3233/NRE-180002
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Article ; Online: Central pain syndromes.

Hassaballa, Deena / Harvey, Richard L

NeuroRehabilitation

2020 Volume 47, Issue 3, Page(s) 285–297

Abstract: The management of pain in persons with neurological injuries is challenging and complex. A holistic view and clinical approach are necessary when addressing pain in patients with neurological impairment because interpreting signs and symptoms and ... ...

Abstract	The management of pain in persons with neurological injuries is challenging and complex. A holistic view and clinical approach are necessary when addressing pain in patients with neurological impairment because interpreting signs and symptoms and deciphering sources of pain is never a straightforward process. This problem is further magnified with the management of central pain syndromes. The best approach is to have a good understanding of the clinical characteristics commonly found in this patient population, in particular for patients with stroke, multiple sclerosis (MS), or spinal cord injury (SCI), as central pain manifests differently between these groups. This paper will focus on the history, clinical presentation, pathophysiology, assessment, and treatment of central pain in patients with these types of neurological conditions. In addition to being at risk for a decline in quality of life, patients with pain syndromes are also prone to adverse responses to treatments (e.g., opioid addiction). It is therefore important to methodically analyze the similarities and differences between patients with different pain syndromes.
MeSH term(s)	Antidepressive Agents/therapeutic use ; Central Nervous System Diseases/diagnosis ; Central Nervous System Diseases/etiology ; Central Nervous System Diseases/therapy ; Humans ; Multiple Sclerosis/complications ; Multiple Sclerosis/diagnosis ; Multiple Sclerosis/therapy ; Pain/diagnosis ; Pain/etiology ; Pain Management/methods ; Pain Measurement/methods ; Quality of Life ; Spinal Cord Injuries/complications ; Spinal Cord Injuries/diagnosis ; Spinal Cord Injuries/therapy ; Stroke/complications ; Stroke/diagnosis ; Stroke/therapy ; Syndrome ; Transcutaneous Electric Nerve Stimulation/methods
Chemical Substances	Antidepressive Agents
Language	English
Publishing date	2020-09-22
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	1087912-2
ISSN	1878-6448 ; 1053-8135
ISSN (online)	1878-6448
ISSN	1053-8135
DOI	10.3233/NRE-208003
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Article ; Online: Predictors of Functional Outcome Following Stroke.

Harvey, Richard L

Physical medicine and rehabilitation clinics of North America

2015 Volume 26, Issue 4, Page(s) 583–598

Abstract: Predicting functional outcome in stroke is challenging to most clinicians, partly because of the complexity of the condition and also because of the lack of validated prognostic models. The strongest predictors of functional outcome are age and motor ... ...

Abstract	Predicting functional outcome in stroke is challenging to most clinicians, partly because of the complexity of the condition and also because of the lack of validated prognostic models. The strongest predictors of functional outcome are age and motor function at stroke onset. There is a growing literature on predicting recovery of upper limb after stroke; however, literature on prediction of language recovery remains sparse. This review covers the current status of predicting functional outcome after stroke focusing on recovery of activities of daily living, ambulation, upper limb use, and aphasia. Use of clinical factors, imaging, and neurophysiological measures are discussed.
MeSH term(s)	Activities of Daily Living ; Diagnostic Imaging ; Humans ; Neurologic Examination ; Predictive Value of Tests ; Prognosis ; Recovery of Function ; Stroke/physiopathology ; Stroke Rehabilitation
Language	English
Publishing date	2015-11
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1196791-2
ISSN	1558-1381 ; 1047-9651
ISSN (online)	1558-1381
ISSN	1047-9651
DOI	10.1016/j.pmr.2015.07.002
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Article ; Online: Locked-In Syndrome: Practical Rehabilitation Management.

Farr, Ellen / Altonji, Kathryn / Harvey, Richard L

PM & R : the journal of injury, function, and rehabilitation

2021 Volume 13, Issue 12, Page(s) 1418–1428

Abstract: Locked-in syndrome is a rare and devastating condition that results in tetraplegia, lower cranial nerve paralysis, and anarthria with preserved cognition, vertical gaze, and upper eyelid movements. Although acute management is much like that of any ... ...

Abstract	Locked-in syndrome is a rare and devastating condition that results in tetraplegia, lower cranial nerve paralysis, and anarthria with preserved cognition, vertical gaze, and upper eyelid movements. Although acute management is much like that of any severe stroke, rehabilitation and recovery of these patients have not been previously described. Challenges relevant to this population include blood pressure management and orthostasis, timing and appropriateness of reinstating oral feeding, ventilatory support, decannulation after tracheostomy, bowel and bladder management, vestibular dysfunction, and eye care. Targeted rehabilitation of head, neck, and trunk stability to improve function, and proper fit in an appropriate wheelchair are essential to assist with mobility. Rehabilitation interventions should include a focus on distal motor control and upright tolerance training followed by balance and mobility exercises. In addition, special considerations must be given to developing early methods of communication through use of augmentative systems to call for help and express needs. These systems along with additional technology provide the basis to promote connectivity to family and friends through the use of social media and the internet. Establishment of communication, mobility, and connectivity is essential in promoting independence, autonomy, and improving quality of life. Overall, with specialized rehabilitative care and access to the proper equipment, long-term outcomes and quality of life in these patients can be favorable.
MeSH term(s)	Humans ; Locked-In Syndrome ; Quadriplegia/rehabilitation ; Quality of Life ; Stroke ; Stroke Rehabilitation/methods ; Wheelchairs
Language	English
Publishing date	2021-02-20
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2608988-9
ISSN	1934-1563 ; 1934-1482
ISSN (online)	1934-1563
ISSN	1934-1482
DOI	10.1002/pmrj.12555
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Article ; Online: The minimal clinically important difference of the motricity index score.

Lin, Chen / Arevalo, Yurany A / Harvey, Richard L / Prabhakaran, Shyam / Martin, Kimberly D

Topics in stroke rehabilitation

2022 Volume 30, Issue 3, Page(s) 298–303

Abstract: Introduction: The Motricity Index (MI) can predict motor function after rehabilitation, but its minimal clinically important difference (MCID) has not been established. The primary study aim was to estimate the MCID value of the MI arm score.: Methods! ...

Abstract	Introduction: The Motricity Index (MI) can predict motor function after rehabilitation, but its minimal clinically important difference (MCID) has not been established. The primary study aim was to estimate the MCID value of the MI arm score. Methods: Between 2017 and 2018, 173 participants hospitalized with confirmed ischemic stroke were recruited into an observational rehabilitation study. Participants with motor weakness as measured by the Fugl-Meyer upper-extremity (FM-UE) and MI with complete baseline and follow-up assessments at 3 months were included in this analysis. The longitudinal recovery of the MI arm score was anchored to having a poor outcome based on the FM-UE recovery (<9) longitudinally. Results reported include the area-under-curve (AUC), along with sensitivity, specificity, and optimal cut-points based on maximizing the Youden statistic. Results: Sixty-nine patients (median [IQR] age 70 [18] years; 48% male; 54% white) were included in the final analysis. Mean ± standard deviation outcome scores at 3-months were: MI arm: 83.19 ± 22.80; FM-UE: 53.04 ± 17.26. For the primary results, the MI arm score optimal MCID cutoff for observed recovery was 13 points with a sensitivity of 80% (95% Confidence Interval (CI)(67.6%, 92.4%)) and a specificity of 69.0% (95% CI (52.1, 85.8%)), and the AUC was 0.8082 (0.7007, 0.9157). Conclusions: This was the first study to report the MCID of the MI arm score, as anchored to the FM-UE recovery between acute evaluation and 3-months. The estimated optimal MCID of improvement in the MI arm score was 13 points.
MeSH term(s)	Humans ; Male ; Aged ; Female ; Stroke Rehabilitation ; Stroke/complications ; Stroke/diagnosis ; Minimal Clinically Important Difference ; Recovery of Function ; Disability Evaluation ; Upper Extremity
Language	English
Publishing date	2022-01-30
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	1213112-x
ISSN	1945-5119 ; 1074-9357
ISSN (online)	1945-5119
ISSN	1074-9357
DOI	10.1080/10749357.2022.2031532
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Article ; Online: Electric Field Navigated 1-Hz rTMS for Poststroke Motor Recovery: The E-FIT Randomized Controlled Trial.

Edwards, Dylan J / Liu, Charles Y / Dunning, Kari / Fregni, Felipe / Laine, Jarmo / Leiby, Benjamin E / Rogers, Lynn M / Harvey, Richard L

Stroke

2023 Volume 54, Issue 9, Page(s) 2254–2264

Abstract: Background: To determine if low-frequency repetitive transcranial magnetic stimulation targeting the primary motor cortex contralateral (M1: Methods: The present E-FIT trial (Electric Field Navigated 1Hz rTMS for Post-stroke Motor Recovery Trial) ... ...

Abstract	Background: To determine if low-frequency repetitive transcranial magnetic stimulation targeting the primary motor cortex contralateral (M1 Methods: The present E-FIT trial (Electric Field Navigated 1Hz rTMS for Post-stroke Motor Recovery Trial) included 5 of 12 NICHE trial outpatient US rehabilitation centers. The stimulation protocol remained identical (1 Hz repetitive transcranial magnetic stimulation, M1 Results: Of 60 participants randomized, 58 completed treatment and were included for analysis. Bayesian analysis of combined data from the E-FIT and the NICHE trials indicated that active treatment was not superior to sham at the primary end point (posterior mean odds ratio of 1.94 [96% credible interval of 0.61-4.80]). For the E-FIT intent-to-treat population, upper extremity Fugl-Meyer improvement ≥5 pts occurred in 60% (18/30) active group and 50% (14/28) sham group. Participants enrolled 3 to 6 months following stroke had a 67% (31%-91% CI) response rate in the active group at the 6-month end point versus 50% in the sham group (21.5%-78.5% CI). There were significant improvements from baseline to 6 months for both active and sham groups in upper extremity Fugl-Meyer, Action Research Arm Test, and EQ-5D ( Conclusions: Intensive motor rehabilitation 3 to 12 months after stroke improved clinical impairment, function, and quality of life; however, 1 Hz-repetitive transcranial magnetic stimulation was not an effective treatment adjuvant in the present sample population with mixed lesion location and extent. Registration: URL: https://www. Clinicaltrials: gov; Unique identifier: NCT03010462.
MeSH term(s)	Humans ; Stroke Rehabilitation/methods ; Quality of Life ; Bayes Theorem ; Stroke/complications ; Stroke/therapy ; Transcranial Magnetic Stimulation/methods ; Treatment Outcome ; Upper Extremity ; Recovery of Function
Language	English
Publishing date	2023-08-14
Publishing country	United States
Document type	Randomized Controlled Trial ; 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.123.043164
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Article ; Online: Noninvasive Transcranial Magnetic Brain Stimulation in Stroke.

Hernandez-Pavon, Julio C / Harvey, Richard L

Physical medicine and rehabilitation clinics of North America

2019 Volume 30, Issue 2, Page(s) 319–335

Abstract: It is likely that transcranial magnetic brain stimulation will be used for the clinical treatment of stroke and stroke-related impairments in the future. The anatomic target and stimulation parameters will likely vary for any clinical focus, be it ... ...

Abstract	It is likely that transcranial magnetic brain stimulation will be used for the clinical treatment of stroke and stroke-related impairments in the future. The anatomic target and stimulation parameters will likely vary for any clinical focus, be it weakness, pain, or cognitive or communicative dysfunction. Biomarkers may also be useful for identifying patients who will respond best, with a goal to enhance clinical decision making. Combination with drugs or specific types of therapeutic exercise may be necessary to achieve maximal response.
MeSH term(s)	Humans ; Stroke/physiopathology ; Stroke Rehabilitation/methods ; Transcranial Magnetic Stimulation/methods
Language	English
Publishing date	2019-02-21
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1196791-2
ISSN	1558-1381 ; 1047-9651
ISSN (online)	1558-1381
ISSN	1047-9651
DOI	10.1016/j.pmr.2018.12.010
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Article ; Online: Association of Proportional Recovery After Stroke With Health-Related Quality of Life.

Lin, Chen / Martin, Kimberly / Arevalo, Yurany A / Harvey, Richard L / Prabhakaran, Shyam

Stroke

2021 Volume 52, Issue 9, Page(s) 2968–2971

Abstract: Background and purpose: No data exists on whether proportional recovery (PR) is associated with health-related quality of life (HRQOL) domains. We evaluated whether PR was associated with domain-specific HRQOL scores at 3 months after ischemic stroke.!## ...

Abstract	Background and purpose: No data exists on whether proportional recovery (PR) is associated with health-related quality of life (HRQOL) domains. We evaluated whether PR was associated with domain-specific HRQOL scores at 3 months after ischemic stroke. Methods: This prospective cohort study enrolled patients with ischemic stroke between January 2017 and June 2018. Impaired strength was assessed using the Fugl-Meyer Upper Extremity (range, 0–66 points) and Motricity Index (range, 0–100 points) during index hospitalization and 3 months. Both measures are well-validated and reliable in patients with stroke to assesses motor functioning. PR (defined as 70% of difference between initial score and maximum possible recovery) was calculated from the initial measurements. HRQOL was measured using Neuro-QOL domains: upper extremity, depression, and cognition domains. PR was evaluated with HRQOL domains using binomial logistic regression. Results: Final analysis included 84 patients (mean age 67.8±16.4 years; 44% male; 51.2% White). For both Fugl-Meyer Upper Extremity and Motricity Index, the PR threshold was met for 48.8% of patients. Failure to meet Motricity Index PR was only associated with increased odds of HRQOL depression impairment (adjusted odds ratio, 11.8 [95% CI, 1.23–112.7]). Failure to meet Fugl-Meyer Upper Extremity PR threshold was not associated with HRQOL impairment after adjustment. Conclusions: Our findings suggest that reaching the PR threshold provides poor discrimination of HRQOL. Despite not meeting expected PR thresholds, patients can still maintain un-impaired HRQOL, suggesting other factors play a role in preserved HRQOL.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Quality of Life ; Recovery of Function/physiology ; Stroke/physiopathology ; Stroke/psychology ; Stroke Rehabilitation/psychology ; Upper Extremity/physiopathology
Language	English
Publishing date	2021-07-29
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.120.033672
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Article: Treating musculoskeletal disorders and pain. Foreword.

Harvey, Richard L

Topics in stroke rehabilitation

2010 Volume 17, Issue 3, Page(s) v

MeSH term(s)	Humans ; Musculoskeletal Diseases/diagnosis ; Musculoskeletal Diseases/therapy ; Pain/diagnosis ; Pain Management
Language	English
Publishing date	2010-05
Publishing country	England
Document type	Introductory Journal Article
ZDB-ID	1213112-x
ISSN	1074-9357
ISSN	1074-9357
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