Stroke

Enhancing the Capacity of the Kentucky Appalachian Rural Rehabilitation Network- Conducting a Needs Assessment for People with Stroke Who Live in Appalachian Kentucky

Anne Harrison, PT, PhD, University of Kentucky, Rehabilitation Science Program

One assumption of rehabilitation has been that the standard services provided in acute settings (usually located in larger urban settings) is sufficient to meet the needs of all individuals with neurological conditions (those who return to live in urban settings and those living in rural communities).
Higher rates of unemployment and decreased access to rehabilitation services, for example, affect service delivery in rural rehabilitation (7). Noreau et al. (10) identified dimensions of life-style, such as poor nutrition habits and cigarette smoking, that are more likely to influence recovery among individuals with low income in rural communities. Research is needed to identify the special needs and barriers faced by individuals with neurological conditions living in rural communities in order to better provide the long-term rehabilitation care needed for maximizing quality of life of these individuals.

Read more: Enhancing the Capacity of the Kentucky Appalachian Rural Rehabilitation Network - Conducting a Needs Asssessment for People with Stroke Who Live in Appalachian Kentucky

   
Facilitating Gait Recovery with Transcranial Direct Current Stimulation in Chronic Stroke:A Feasibility Study
Lumy Sawaki, MD, PhD, University of Kentucky, Physical Medicine & Rehabilitation Department, Cardinal Hill Endowed Chair

Objectives: The purpose of this pilot project is to gather sufficient data to allow clarification of methodological issues prior to designing a full-scale, federally-funded clinical trial to evaluate the effectiveness of tDCS to optimize gait rehabilitation after stroke. Our specific aims include the following:    

Read more: Facilitating Gait Recovery wuth Transcranial Direct Current Stimulation in Chronic Stroke: A Feasibility Study

   
Enhancing Cortical Plasticity with Nerve Stimulation in Stroke Patients with Severe Motor Deficits
Lumy Sawaki, MD, PhD, University of Kentucky,  Physical Medicine & Rehabilitation Department, Cardinal Hill Endowed Chair

Objectives:  We propose to evaluate the effectiveness of sustained peripheral nerve stimulation (PNS) coupled with intensive task-oriented therapy to promote functional motor recovery in stroke patients with severe motor deficits.

Read more: Enhancing Cortical Plasticity with Nerve Stimulation in Stroke Patients with Severe Motor Deficits

   

Driving Neuroplasticity with Nerve Stimulation and Modified Constraint-Induced Therapy

Lumy Sawaki, MD, PhD, University of Kentucky, Physical Medicine & Rehabilitation Department, Cardinal Hill Endowed Chair

We propose to evaluate the effectiveness of sustained peripheral nerve stimulation (PNS) to enhance the therapeutic effects of a modified form CIT (mCIT).

The central hypothesis is that stroke patients receiving hand PNS and mCIT will have improved motor function compared to patients receiving sham PNS and mCIT, and the degree of this behaviorally-measured effect will correlate with the neurophysiological effect measured by TMS. We plan to accept or reject the central hypothesis by accomplishing two Specific Aims.

Read more: Driving Neuroplasticity with Nerve Stimulation and Modified Constraint-Induced Therapy

   

Sensory-driven Motor Recovery in Poorly Recovered Subacute Stroke Patients

Lumy Sawaki, MD, PhD, University of Kentucky, Physical Medicine &Rehabilitation Department, Cardinal Hill Endowed Chair

The long-range goals are to: (a) maximize the restoration of hand motor function in post-stroke patients with severe motor deficits, (b) determine the impact of this intervention in activities of daily living and quality of life of these patients, and (c) collect solid data to plan a future large multicenter randomized trial.

The central hypothesis is that sub-acute stroke patients with severe motor deficit receiving PNS and intensive task-oriented therapy will have improved motor function compared to patients receiving sham PNS and task-oriented therapy and also when compared to patients receiving PNS-only. Further, the degree of this behaviorally-measured effect will correlate with the neurophysiological effect measured by TMS. Severe motor deficit for this study will be defined as subjects unable to extend the affected metacarpophalangeal joints at least 10° and the wrist 20°. We plan to accept or reject the central hypothesis by accomplishing two Specific Aims.

Read more: Sensory-driven Motor Recovery in Poorly Recovered Subacute Stroke Patients

   

Enhancement of Post-stroke Neural Plasticity with Atomoxetine: A Pilot Study

Lumy Sawaki, MD, PhD, University of Kentucky, Physical Medicine &Rehabilitation Department, Cardinal Hill Endowed Chair

In the present application, we propose to evaluate whether treatment with atomoxetine, when combined with motor training, will improve motor function compared to physical therapy plus a placebo. This information is crucial in order to provide preliminary data that would support a large clinical trial of the effects of atomoxetine to enhance motor recovery and ultimately help patients who are recovering from a stroke in the future.

The long-range goals are to: (a) maximize the restoration of hand motor function after stroke, and (b) determine the impact of this intervention in activities of daily living and quality of life.

The central hypothesis is that stroke patients treated with atomoxetine paired with task-oriented therapy will have improved motor function compared to patients receiving therapy plus placebo, and the degree of this behaviorally-measured effect will correlate with the increase of training-dependent cortical plasticity measured by transcranial magnetic stimulation (TMS).

Read more: Enhancement of Post-stroke Neural Plasticity with Atomoxetine: A Pilot Study

   
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