Neurorehabilitation and Neural Repair最新文献

{"title":"Impairments in Cognitive Control Using a Reverse Visually Guided Reaching Task Following Stroke","authors":"C. Lowrey, S. Dukelow, S. Bagg, Benjamin R Ritsma, S. Scott","doi":"10.1177/15459683221100510","DOIUrl":"https://doi.org/10.1177/15459683221100510","url":null,"abstract":"Background Cognitive and motor function must work together quickly and seamlessly to allow us to interact with a complex world, but their integration is difficult to assess directly. Interactive technology provides opportunities to assess motor actions requiring cognitive control. Objective To adapt a reverse reaching task to an interactive robotic platform to quantify impairments in cognitive-motor integration following stroke. Methods Participants with subacute stroke (N=59) performed two tasks using the Kinarm: Reverse Visually Guided Reaching (RVGR) and Visually Guided Reaching (VGR). Tasks required subjects move a cursor “quickly and accurately” to virtual targets. In RVGR, cursor motion was reversed compared to finger motion (i.e., hand moves left, cursor moves right). Task parameters and Task Scores were calculated based on models developed from healthy controls, and accounted for the influence of age, sex, and handedness. Results Many stroke participants (86%) were impaired in RVGR with their affected arm (Task Score > 95% of controls). The most common impairment was increased movement time. Seventy-three percent were also impaired with their less affected arm. The most common impairment was larger initial direction angles of reach. Impairments in RVGR improved over time, but 71% of participants tested longitudinally were still impaired with the affected arm ∼6 months post-stroke. Importantly, although 57% were impaired with the less affected arm at 6 months, these individuals were not impaired in VGR. Conclusions Individuals with stroke were impaired in a reverse reaching task but many did not show similar impairments in a standard reaching task, highlighting selective impairment in cognitive-motor integration.","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":"36 1","pages":"449 - 460"},"PeriodicalIF":4.2,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43940988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upper Extremity Contralaterally Controlled Functional Electrical Stimulation Versus Neuromuscular Electrical Stimulation in Post-Stroke Individuals: A Meta-Analysis of Randomized Controlled Trials","authors":"Mei-Sean Loh, Y. Kuan, Chin-Wen Wu, Chun-De Liao, Jia-Pei Hong, Hung-Chou Chen","doi":"10.1177/15459683221092647","DOIUrl":"https://doi.org/10.1177/15459683221092647","url":null,"abstract":"Background Electrical stimulation has been employed as a safe and effective therapy for improving arm function after stroke. Contralaterally controlled functional electrical stimulation (CCFES) is a unique method that has progressed from application in small feasibility studies to implementation in several randomized controlled trials. However, no meta-analysis has been conducted to summarize its efficacy. Objective To summarize the effect size of CCFES through measures of upper extremity motor recovery compared with that of neuromuscular electrical stimulation (NMES). Methods The PubMed, Cochrane Library, EMBASE, Scopus, and Google Scholar databases were searched. Randomized controlled trials (RCTs) were selected and subjected to meta-analysis and risk of bias assessment. Results 6 RCTs were selected and 267 participants were included. The Upper Extremity Fugl-Meyer assessment (UEFMA) was included in all studies, the Box and Blocks test (BBT) and active range of motion (AROM) were included in 3 and 4 studies, respectively. The modified Barthel Index (mBI) and Arm Motor Abilities Test (AMAT) were included in 2 and 3 studies, respectively. The CCFES group demonstrated greater improvement than the NMES did in UEFMA (SMD = .42, 95% CI = .07–.76), BBT (SMD = .48, 95% CI = .10–.86), AROM (SMD = .54, 95% CI = .23–.86), and mBI (SMD = .54, 95% CI = .12–.97). However, the results for AMAT did not differ significantly (SMD = .34, 95% CI = −.03–.72). Conclusion Contralaterally controlled functional electrical stimulation produced greater improvements in upper extremity hemiplegia in people with stroke than NMES did. PROSPERO registration number: CRD42021245831","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":"36 1","pages":"472 - 482"},"PeriodicalIF":4.2,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43283810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individuals with Higher Levels of Physical Activity after Stroke Show Comparable Patterns of Myelin to Healthy Older Adults","authors":"B. Greeley, Cristina Rubino, Ronan Denyer, B. Chau, B. Larssen, B. Lakhani, L. Boyd","doi":"10.1177/15459683221100497","DOIUrl":"https://doi.org/10.1177/15459683221100497","url":null,"abstract":"Background Myelin asymmetry ratios (MARs) relate and contribute to motor impairment and function after stroke. Physical activity (PA) may induce myelin plasticity, potentially mitigating hemispheric myelin asymmetries that can occur after a stroke. Objective The aim of this study was to determine whether individuals with higher levels of PA showed lower MAR compared to individuals with lower levels of PA. Methods Myelin water fraction was obtained from 5 bilateral motor regions in 22 individuals with chronic stroke and 26 healthy older adults. Activity levels were quantified with wrist accelerometers worn for a period of 72 hours (3 days). Higher and lower PA levels were defined by a cluster analysis within each group. Results MAR was similar regardless of PA level within the older adult group. Compared to the higher PA stroke group, lower PA stroke participants displayed greater MAR. There was no difference in MAR between the stroke and older adult higher PA groups. Within the lower PA groups, individuals with stroke showed greater MAR compared to the older adults. Arm impairment, lesion volume, age, time since stroke, and preferential arm use were not different between the PA stroke groups, suggesting that motor impairment severity and extent of brain damage did not drive differences in PA. Conclusion Individuals who have had a stroke and are also physically active display lower MAR (i.e., similar myelin in both hemispheres) in motor regions. High levels of PA may be neuroprotective and mitigate myelin asymmetries once a neurological insult, such as a stroke, occurs. Alternately, it is possible that promoting high levels of PA after a stroke may reduce myelin asymmetries.","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":"36 1","pages":"381 - 389"},"PeriodicalIF":4.2,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42203948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telerehabilitation for Stroke is Here to Stay. But at What Cost?","authors":"K. Laver, M. Walker, N. Ward","doi":"10.1177/15459683221100492","DOIUrl":"https://doi.org/10.1177/15459683221100492","url":null,"abstract":"The use of telerehabilitation after stroke has necessarily increased in the last 2 years because of the COVID-19 pandemic, and many rehabilitation teams rapidly adapted to offering their services remotely. Evidence supporting the efficacy of telerehabilitation is still scarce with few randomized controlled trials, although current systematic reviews suggest that telerehabilitation does not lead to inferior outcomes when compared to face-to-face treatment. Increasing experience of telerehabilitation however has highlighted some of the pitfalls that need to be solved before we see widespread pragmatic adoption of new practices. We must ensure that offering services using digital technologies does not exclude those who need our services. We must acknowledge that our interactions online differ, both in the way we relate to each other and in the content of clinical consultations. Furthermore, we need to consider how to support staff who may be feeling disconnected and fatigued after spending hours providing remote therapies. Telerehabilitation is likely here to stay and has potential to help deliver rehabilitation to the many people who could benefit, but there are obstacles, challenges and trade-offs to be considered and overcome.","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":"36 1","pages":"331 - 334"},"PeriodicalIF":4.2,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48914144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early, Intensive, Lower Extremity Rehabilitation Shows Preliminary Efficacy After Perinatal Stroke: Results of a Pilot Randomized Controlled Trial","authors":"C. Hurd, D. Livingstone, K. Brunton, Allison Smith, M. Gorassini, M. Watt, J. Andersen, A. Kirton, Jaynie F. Yang","doi":"10.1177/15459683221090931","DOIUrl":"https://doi.org/10.1177/15459683221090931","url":null,"abstract":"Background Perinatal stroke injures motor regions of the brain, compromising movement for life. Early, intensive, active interventions for the upper extremity are efficacious, but interventions for the lower extremity remain understudied. Objective To determine the feasibility and potential efficacy of ELEVATE—Engaging the Lower Extremity Via Active Therapy Early—on gross motor function. Methods We conducted a single-blind, two-arm, randomized controlled trial (RCT), with the Immediate Group receiving the intervention while the Delay Group served as a 3-month waitlist control. A separate cohort living beyond commuting distance was trained by their parents with guidance from physical therapists. Participants were 8 months to 3 years old, with MRI-confirmed perinatal ischemic stroke and early signs of hemiparesis. The intervention was play-based, focused on weight-bearing, balance and walking for 1 hour/day, 4 days/week for 12 weeks. The primary outcome was the Gross Motor Function Measure-66 (GMFM-66). Secondary outcomes included steps and gait analyses. Final follow-up occurred at age 4. Results Thirty-four children participated (25 RCT, 9 Parent-trained). The improvement in GMFM-66 over 12 weeks was greater for the Immediate than the Delay Group in the RCT (average change 3.4 units higher) and greater in younger children. Average step counts reached 1370-3750 steps/session in the last week of training for all children. Parent-trained children also improved but with greater variability. Conclusions Early, activity-intensive lower extremity therapy for young children with perinatal stroke is feasible and improves gross motor function in the short term. Longer term improvement may require additional bouts of intervention. Clinical trial registration This study was registered at ClinicalTrials.gov (NCT01773369).","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":"36 1","pages":"360 - 370"},"PeriodicalIF":4.2,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42162630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Way of Measuring Dual-Task Interference: The Reliability and Construct Validity of the Dual-Task Effect Battery in Neurodegenerative Disease","authors":"J. Longhurst, J. Rider, J. Cummings, S. John, B. Poston, Elissa Held Bradford, M. Landers","doi":"10.1177/15459683221088864","DOIUrl":"https://doi.org/10.1177/15459683221088864","url":null,"abstract":"Background. Decreased automaticity is common among individuals with neurodegenerative disease and is often assessed using dual-task (DT) paradigms. However, the best methods for assessing performance changes related to DT demands remain inconclusive. Objective. To investigate the reliability and validity of a novel battery of DT measures (DT Effect—Battery (DTE-B)) encompassing three domains: task-specific interference, task prioritization, and automaticity. Methods. Data for this retrospective cross-sectional study included 125 participants with Parkinson’s disease (PD), 127 participants with Alzheimer’s disease (AD), and 84 healthy older adults. Reliability analyses were conducted using a subset of each population. DTE-B measures were calculated from single and DT performance on the Timed Up and Go test and a serial subtraction task. Construct validity was evaluated via associations within the DTE-B and with theoretically supported measures as well as known-groups validity analyses. Results. Good to excellent reliability was found for DTE-B measures of task interference (motor and cognitive DT effects) (ICCs≥.658) and automaticity (combined DT effect (cDTE)) (ICCs≥.938). Evidence for convergent validity was found with associations within the hypothesized constructs. Known-groups validity analyses revealed differences in the DTE-B among the healthy group and PD and AD groups (ps≤.001), excepting task prioritization (ps≥.061). Conclusions. This study provides evidence to support the DTE-B as a reliable measure of multiple constructs pertinent to DT performance. The cDTE demonstrated evidence to support its validity as a measure of automaticity. Further investigation of the utility of the DTE-B in both PD and AD, as well as other populations, is warranted.","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":"36 1","pages":"346 - 359"},"PeriodicalIF":4.2,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49414827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whole-Brain Metabolic Abnormalities Are Associated With Mobility in Older Adults With Multiple Sclerosis.","authors":"Christina Mueller,&nbsp;Jessica F Baird,&nbsp;Robert W Motl","doi":"10.1177/15459683221076461","DOIUrl":"https://doi.org/10.1177/15459683221076461","url":null,"abstract":"<p><strong>Background: </strong>Older adults with multiple sclerosis (MS) experience mobility impairments, but conventional brain imaging is a poor predictor of walking abilities in this population.</p><p><strong>Objective: </strong>To test whether brain metabolites measured with Magnetic Resonance Spectroscopy (MRS) are associated with walking performance in older adults with MS.</p><p><strong>Methods: </strong>Fifteen older adults with MS (mean age: 60.9, SD: 5.1) and 22 age-matched healthy controls (mean age: 64.2, SD: 5.7) underwent whole-brain MRS and mobility testing. Levels of N-acetylaspartate (NAA), myo-inositol (MI), choline (CHO), and temperature in 47 brain regions were compared between groups and correlated with walking speed (Timed 25 Foot Walk) and walking endurance (Six-Minute Walk).</p><p><strong>Results: </strong>Older adults with MS had higher MI in 23 areas, including the bilateral frontal (right: t (21.449) = -2.605, P = .016; left: t (35) = -2.434, P = .020), temporal (right: t (35) = -3.063, P = .004; left: t (35) = -3.026, P = .005), and parietal lobes (right: t (21.100) = -2.886, P = .009; left: t (35) = -2.507, P = .017), and right thalamus (t (35) = -2.840, P = .007). MI in eleven regions correlated with walking speed, and MI in twelve regions correlated with walking endurance. NAA was lower in MS in the bilateral thalami (right: t (35) = 3.449, P < .001; left: t (35) = 2.061, P = .047), caudate nuclei (right: t (33) = 2.828, P = .008; left: t (32) = 2.132, P = .041), and posterior cingulum (right: t (35) = 3.077, P = .004; left: t (35) = 2.972, P = .005). NAA in four regions correlated with walking speed and endurance. Brain temperature was higher in MS patients in four regions, but did not correlate with mobility measures. There were no group differences in CHO.</p><p><strong>Conclusion: </strong>MI and NAA may be useful imaging end-points for walking ability as a clinical outcome in older adults with MS.</p>","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":"36 4-5","pages":"286-297"},"PeriodicalIF":4.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9007860/pdf/nihms-1771040.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39630719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Best Choice of Oxygen Cost Prediction Equation for Computing Post-Stroke Walking Energy Expenditure Using an Accelerometer.","authors":"Maxence Compagnat,&nbsp;Jean-Yves Salle,&nbsp;Maria Vinti,&nbsp;Romain Joste,&nbsp;Jean Christophe Daviet","doi":"10.1177/15459683221076469","DOIUrl":"https://doi.org/10.1177/15459683221076469","url":null,"abstract":"<p><strong>Background: </strong>The integration of oxygen cost into the accelerometer's algorithms improves accuracy of total energy expenditure (TEE) values as post-stroke individuals walk. Recent work has shown that oxygen cost can be estimated from specific prediction equations for stroke patients.</p><p><strong>Objective: </strong>The objective is to the validity of the different oxygen cost estimation equations available in the literature for calculating TEE using ActigraphGT3x as individuals with stroke sequelae walk.</p><p><strong>Method: </strong>Individuals with stroke sequelae who were able to walk without human assistance were included. The TEE was calculated by multiplying the walking distance provided by an ActigraphGT3x worn on the healthy ankle and the patient's oxygen cost estimated from the selected prediction equations. The TEE values from each equation were compared to the TEE values measured by indirect calorimetry. The validity of the prediction methods was evaluated by Bland-Altman analysis (mean bias (MB) and limits of agreement (LoA) values).</p><p><strong>Results: </strong>We included 26 stroke patients (63.5 years). Among the selected equations, those of Compagnat and Polese obtained the best validity parameters for the ActigraphGT3x: MB_Compagnat = 1.2 kcal, 95% LoA_Compagnat = [-12.0; 14.3] kcal and MB_Polese = 3.5 kcal, 95% LoA_Polese = [-9.2; 16.1] kcal. For comparison, the estimated TEE value according to the manufacturer's algorithm reported MB_Manufacturer = -15 kcal, 95% LoA_Manufacturer = [-52.9; 22.8] kcal.</p><p><strong>Conclusion: </strong>The Polese and Compagnat equations offer the best validity parameters in comparison with the criterion method. Using oxygen cost prediction equations is a promising approach to improving assessment of TEE by accelerometers in post-stroke individuals.</p>","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":"36 4-5","pages":"298-305"},"PeriodicalIF":4.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39925821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inclusive Trial Designs in Acute Spinal Cord Injuries: Prediction-Based Stratification of Clinical Walking Outcome and Projected Enrolment Frequencies.","authors":"Adrian Cathomen,&nbsp;Laura Sirucek,&nbsp;Tim Killeen,&nbsp;Rainer Abel,&nbsp;Doris Maier,&nbsp;Norbert Weidner,&nbsp;Rüdiger Rupp,&nbsp;Torsten Hothorn,&nbsp;John D Steeves,&nbsp;Armin Curt,&nbsp;Marc Bolliger","doi":"10.1177/15459683221078302","DOIUrl":"https://doi.org/10.1177/15459683221078302","url":null,"abstract":"<p><strong>Background: </strong>New therapeutic approaches in neurological disorders are progressing into clinical development. Past failures in translational research have underlined the critical importance of selecting appropriate inclusion criteria and primary outcomes. Narrow inclusion criteria provide sensitivity, but increase trial duration and cost to the point of infeasibility, while broader requirements amplify confounding, increasing the risk of trial failure. This dilemma is perhaps most pronounced in spinal cord injury (SCI), but applies to all neurological disorders with low frequency and/or heterogeneous clinical manifestations.</p><p><strong>Objective: </strong>Stratification of homogeneous patient cohorts to enable the design of clinical trials with broad inclusion criteria.</p><p><strong>Methods: </strong>Prospectively-gathered data from patients with acute cervical SCI were analysed using an unbiased recursive partitioning conditional inference tree (URP-CTREE) approach. Performance in the 6-minute walk test at 6 months after injury was classified based on standardized neurological assessments within the first 15 days of injury. Functional and neurological outcomes were tracked throughout rehabilitation up to 6 months after injury.</p><p><strong>Results: </strong>URP-CTREE identified homogeneous outcome cohorts in a study group of 309 SCI patients. These cohorts were validated by an internal, yet independent, validation group of 172 patients. The study group cohorts identified demonstrated distinct recovery profiles throughout rehabilitation. The baseline characteristics of the analysed groups were compared to a reference group of 477 patients.</p><p><strong>Conclusion: </strong>URP-CTREE enables inclusive trial design by revealing the distribution of outcome cohorts, discerning distinct recovery profiles and projecting potential patient enrolment by providing estimates of the relative frequencies of cohorts to improve the design of clinical trials in SCI and beyond.</p>","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":"36 4-5","pages":"274-285"},"PeriodicalIF":4.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/58/d3/10.1177_15459683221078302.PMC9003761.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39924325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a Virtual Reality–Based Mirror Therapy Program on Improving Sensorimotor Function of Hands in Chronic Stroke Patients: A Randomized Controlled Trial","authors":"H. Hsu, L. Kuo, Yu-Ching Lin, F. Su, Tai-Hua Yang, Che-Wei Lin","doi":"10.1177/15459683221081430","DOIUrl":"https://doi.org/10.1177/15459683221081430","url":null,"abstract":"Background. Embedding mirror therapy within a virtual reality (VR) system may have a superior effect on motor remediation for chronic stroke patients. Objective. The objective is to investigate the differences in the effects of using conventional occupational therapy (COT), mirror therapy (MT), and VR-based MT (VR-MT) training on the sensorimotor function of the upper limb in chronic stroke patients. Methods. This was a single-blinded randomized controlled trial. A total of 54 participants, including chronic stroke patients, were randomized into a COT, MT, or VR-MT group. In addition to 20-minute sessions of task-specific training, patients received programs of 30 minutes of VR-MT, 30 minutes of MT, and 30 minutes of COT, respectively, in the VR-MT, MT, and COT groups twice a week for 9 weeks. The Fugl-Meyer motor assessment for the upper extremities (FM-UE; primary outcome), Semmes-Weinstein monofilament, motor activity log, modified Ashworth scale, and the box and block test were recorded at pre-treatment, post-intervention, and 12-week follow-up. Results. Fifty-two participants completed the study. There was no statistically significant group-by-time interaction effects on the FM-UE score (generalized estimating equations, (GEE), P = .075). Meanwhile, there were statistically significant group-by-time interaction effects on the wrist sub-score of the FM-UE (GEE, P = .012) and the result of box and block test (GEE, P = .044). Conclusions. VR-MT seemed to have potential effects on restoring the upper extremity motor function for chronic stroke patients. However, further confirmatory studies are warranted for the rather weak evidence of adding VR to MT on improving primary outcome of this study. Clinical trial registration: NCT03329417.","PeriodicalId":56104,"journal":{"name":"Neurorehabilitation and Neural Repair","volume":"36 1","pages":"335 - 345"},"PeriodicalIF":4.2,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44431588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}