OBJECTIVE: This study aims to assess how enhancing upper limb function on the affected side of stroke influences the gait of the lower limb.
METHODS: Forty eligible stroke patients were randomly assigned to either a control group or a treatment group, with 20 patients in each group. Both groups underwent dynamic evaluation using artificial intelligence and computer vision before treatment. This evaluation focused on analyzing the range of motion of the shoulder and elbow during the gait cycle, as well as various gait parameters (such as step length, step speed, and percentage of stance phase) on the affected side. Following evaluation, the control group received routine rehabilitation treatment.
RESULTS: The results indicated that there was no significant difference between the two groups before treatment. However, following treatment, there was a notable improvement in the motion of the shoulder and elbow joints on the affected side among patients in the treatment group (p<0.05), whereas the control group showed only slight improvement, which was not statistically significant (p>0.05).
CONCLUSIONS: The improvement in upper limb function on the affected side also appears to positively influence gait recovery. However, it\'s important to note that the observation period was relatively short. Further studies are needed to confirm whether this effect is sustained over the long term.

OBJECTIVE: To derive and validate a prediction model for minimal clinically important differences (MCID) in upper extremity (UE) motor function after intention-driven robotic-hand training using residual voluntary EMG signals from affected UE.
METHODS: A prospective longitudinal multicenter cohort study. We collected pre-intervention candidate predictors: demographics, clinical characteristics, Fugl-Meyer assessment of UE (FMAUE), Action Research Arm Test scores, and motor-intention of flexor digitorum and extensor digitorum (ED) measured by EMG during maximal voluntary contraction (MVC). For EMG measures, recognizing challenges for stroke survivors to move paralyzed hand, peak signals were extracted from eight time-windows during MVC-EMG (0.1s-5s) to identify subjects\' motor-intention. Classification And Regression Tree algorithm was employed to predict survivors with MCID of FMAUE. Relationship between predictors and motor-improvements was further investigated.
METHODS: Nine rehabilitation centers.
METHODS: Chronic stroke survivors (N=131), including 87 for Derivation-sample, and 44 for Validation-sample.
METHODS: All participants underwent 20-session robotic-hand training (40min/session, 3-5sessions/week).
METHODS: Prediction efficacies of models were assessed by area under the receiver operating characteristic curve (AUC). The best effective model was final model and validated using AUC and overall accuracy.
RESULTS: The best model comprised FMAUE (cut-off score: 46) and peak activity of ED from one-second MVC-EMG (MVC-EMG 4.604 times higher than resting-EMG), which demonstrated significantly higher prediction accuracy (AUC: 0.807) than other time-windows or solely using clinical-scores (AUC: 0.595). In external validation, this model displayed robust prediction (AUC: 0.916). Significant quadratic relationship was observed between ED-EMG and FMAUE increases.
CONCLUSIONS: This study presents a prediction model for intention-driven robotic-hand training in chronic stroke survivors. It highlights significance of capturing motor-intention through 1-second EMG-window as a predictor for MCID improvement in UE motor-function after 20-session robotic-training. Survivors in two conditions showed high percentage of clinical motor-improvement: moderate-to-high motor-intention and low-to-moderate function; as well as high-intention and high-function.

UNASSIGNED: Intermittent theta-burst stimulation and repetitive peripheral magnetic stimulation can improve motor function in poststroke patients, but the therapeutic effect of this combination remains unclear.
UNASSIGNED: To determine the effects of central intermittent theta-burst stimulation and repetitive peripheral magnetic stimulation on upper limb function.
UNASSIGNED: Fifty-six subacute stroke patients were randomly assigned to three groups: the CMS (n = 18), peripheral magnetic stimulation (PMS) (n = 19) and CPS (n = 19) groups. The CMS group received intermittent theta-burst stimulation and peripheral false stimulation, while the PMS group received repetitive peripheral magnetic stimulation and central false stimulation once a day for five days a week over four weeks. The CPS group received intermittent theta-burst stimulation and repetitive peripheral magnetic stimulation simultaneously once daily for four weeks. The Fugl-Meyer Assessment, Action Research Arm Test, Modified Barthel Index and Modified Ashworth Scale evaluated outcomes before and after four weeks of treatment.
UNASSIGNED: The motor function scores of all groups were significantly increased after treatment compared with before treatment, while the Modified Ashworth Scale score showed no significant change. There was a significant difference in the motor function score of the CPS group compared with that of the CMS and PMS groups, but there was no significant improvement in the Modified Ashworth Scale score.
UNASSIGNED: Combining the two treatment methods can improve patients\' motor function and daily living abilities but cannot improve muscle tone.
UNASSIGNED: La estimulación intermitente de theta-burst y la estimulación magnética periférica repetitiva pueden mejorar la función motora en pacientes postictus, pero el efecto terapéutico de esta combinación sigue sin estar claro.
UNASSIGNED: Determinar el efecto de la estimulacion central intermitente theta-burst y la estimulación magnética repetitiva periférica en la función del miembro superior.
UNASSIGNED: Se asignaron aleatoriamente a tres grupos 56 pacientes con ictus subagudo: CMS (n = 18), estimulación magnética periferica (PMS) (n = 19) y CPS(Cm1) (n = 19). El grupo CMS recibió estimulación intermitente de theta-burst y falsa estimulación periférica, el grupo PMS recibió estimulación magnética periférica repetitiva y falsa estimulación central una vez al día durante cinco días a la semana a lo largo de cuatro semanas. El grupo SPC recibió estimulación intermitente theta-burst y estimulación magnética periférica repetitiva simultáneamente una vez al día durante cuatro semanas. Se utilizaron la Fugl-Meyer Assessment, Action Research Arm Test, Modified Barthel Index and Modified Ashworth Scale para evaluar losresultados antes y después de cuatro semanas de tratamiento.
UNASSIGNED: Las puntuaciones de la función motora de todos los grupos aumentaron significativamente después del tratamiento en comparación con antes del tratamiento, mientras que la puntuación de la Escala de Ashworth Modificada no mostró cambios significativos. Hubo una diferencia significativa en la puntuación de la función motora del grupo CPS en comparación con la de los grupos CMS y PMS, pero no hubo una mejora significativa en la puntuación de la Escala de Ashworth Modificada.
UNASSIGNED: La combinación de los dos métodos de tratamiento puede mejorar la función motora y las capacidades de la vida diaria de los pacientes, pero no puede mejorar el tono muscular.

Objective.To promote the development of objective and comprehensive motion function assessment for patients, based on high-density surface electromyography (HD-sEMG), this study investigates the temporal and spatial variations of neuromuscular activities related to upper limb motor dysfunction.Approach.Patients with unilateral upper limb motor dysfunction and healthy controls were enrolled in the study. HD-sEMG was collected from both arms while they were performing eight hand and wrist movements. Muscle synergies were extracted from the HD-sEMG. Symmetry of bilateral upper limb synergies and synergy differences between motions were proposed as spatial indicators to measure alterations in synergy spatial distribution. Additionally, as a temporal characteristic, the correlation of bilateral upper limb activation coefficient was proposed to describe the coordination control of the central nervous system. All temporal and spatial indicators were compared between patients and healthy subjects.Main results.The patients showed a significant decrease (p< 0.05) in the symmetry of bilateral upper limb synergy spatial distribution and correlation of bilateral upper limb activation coefficient. Patients with motor dysfunction also showed an increase in synergy similarity between motions, indicating altered spatial distribution of muscle synergies.Significance.These findings provide valuable insights into specific patterns associated with motor dysfunction, informing motor function assessment, and guiding targeted interventions and rehabilitation strategies for neurologically disordered patients.

OBJECTIVE: This study introduces a novel methodology combining rapid stretch compound training with blood flow restriction (BFR) to investigate post activation performance enhancement (PAPE) in basketball players, a field that has been predominantly explored for lower limbs. We aimed to assess the efficacy of this combined approach on upper limb muscle performance in athletes.
METHODS: We employed a randomized, self-controlled crossover trial with ten male basketball players. The bench press throw (BPT) served as the primary metric, with players undergoing four interventions post-baseline: (1) STR-plyometric training; (2) BFR-blood flow restriction; (3) COMB-STR integrated with BFR; and (4) CON-control. Innovatively, we utilized an intelligent tracking sensor to precisely measure peak power (PP), peak velocity (PV), mean power (MP), and mean velocity (MV) at 4, 8, and 12 min post-intervention, providing a detailed temporal analysis of PAPE.
RESULTS: The COMB intervention demonstrated superior PAPE effects at 4 min, significantly outperforming STR and BFR alone and the control group across all measured indices (p < 0.05). Notably, the COMB group maintained these improvements for PV, PP, and H up to 12 min post-intervention, suggesting a prolonged effect.
CONCLUSIONS: (1) The COMB stimulation has been shown to successfully induce PAPE more effectively than STR and BFR modality alone. (2) It appears that the optimal effects of PAPE are achieved within 4 min of exercising under this COMB. By the 12 min mark, only the COMB group continued to show significant improvements in PV, PP, and H compared to both the baseline and the CON group, while the effects in the STR and BFR groups further diminished. This suggests that although the PAPE effect is maintained over time, its optimal performance may peak at the 4 min mark and then gradually weaken as time progresses.

UNASSIGNED: Upper extremity (UE) motor function impairment is a major poststroke complication whose recovery remains one of the most challenging tasks in neurological rehabilitation. This study examined the efficacy and safety of the personalized neuroimaging-guided high-dose theta-burst stimulation (TBS) for poststroke UE motor function recovery.
UNASSIGNED: Patients after stroke with UE motor impairment from a China rehabilitation center were randomly assigned to receive high-dose intermittent TBS (iTBS) to ipsilesional UE sensorimotor network, continuous TBS (cTBS) to contralesional UE sensorimotor network, or sham stimulation, along with conventional therapy for 3 weeks. The primary outcome was the score changes on the Fugl-Meyer assessment-UE from baseline to 1 and 3 weeks. The secondary outcomes included the response rate on Fugl-Meyer assessment-UE scores posttreatment (≥9-point improvement) and score changes in multidimensional scales measuring UE, lower extremity, and activities and participation.
UNASSIGNED: From June 2021 to June 2022, 45 participants were randomized and 43 were analyzed. The iTBS and continuous TBS groups showed significantly greater improvement in Fugl-Meyer assessment-UE (mean improvement, iTBS: 10.73 points; continuous TBS: 10.79 points) than the sham group (2.43 points) and exhibited significantly greater response rates on Fugl-Meyer assessment-UE (iTBS, 60.0%; continuous TBS, 64.3%) than the sham group (0.0%). The active groups consistently exhibited superior improvement on the other 2 UE assessments at week 3. However, only the iTBS group showed greater efficacy on 1 lower extremity assessment than the sham group at week 3. Both active groups showed significant improvements in activities and participation assessments.
UNASSIGNED: The study provides evidence for the efficacy and safety of high-dose TBS in facilitating poststroke UE rehabilitation.
UNASSIGNED: URL: www.chictr.org.cn; Unique identifier: ChiCTR2100047340.

Currently, three expanded polytetrafluoroethylene (ePTFE) prosthetic graft types are most commonly used for patients with end-stage kidney disease (ESKD) who require long-term vascular access for hemodialysis. However, studies comparing the three ePTFE grafts are limited. This study compared the clinical efficacy and postoperative complications of three ePTFE prosthetic graft types used for upper limb arteriovenous graft (AVG) surgery among patients with ESKD. Patients with ESKD requiring upper limb AVG surgery admitted to our center between January 2016 and September 2019 were enrolled. Overall, 282 patients who completed the 2-year follow-up were included and classified into the following three groups according to the ePTFE graft type: the GPVG group with the PROPATEN® graft, the GAVG group with the straight-type GORE® ACUSEAL, and the BVVG group with the VENAFLO® II. The patency rate and incidence of access-related complications were analyzed and compared between groups. The patients were followed up postoperatively, and data were collected at 6, 12, 18, and 24 months postoperatively. Respective to these follow-up time points, in the GPVG group, the primary patency rates were 74.29%, 65.71%, 51.43%, and 42.86%; the assisted primary patency rates were 85.71%, 74.29%, 60.00%, and 48.57%; and the secondary patency rates were 85.71%, 80.00%, 71.43%, and 60.00%. In the GAVG group, the primary patency rates were 73.03%, 53.93%, 59.42%, and 38.20%; the assisted primary patency rates were 83.15%, 68.54%, 59.55%, and 53.93%; and the secondary patency rates were 85.39%, 77.53%, 68.54%, and 62.92%, respectively. In the BVVG group, the primary patency rates were 67.24%, 53.45%, 41.38%, and 29.31%; the assisted primary patency rates were 84.48%, 67.24%, 55.17%, and 44.83%; and the secondary patency rates were 86.21%, 81.03%, 68.97%, and 60.34%, respectively. The differences in patency rates across the three grafts were not statistically significant. Overall, 18, 4, and 12 patients in the GPVG, GAVG, and BVVG groups, respectively, experienced seroma. Among the three grafts, GORE® ACUSEAL had the shortest anastomosis hemostatic time. The first cannulation times for the three grafts were GPVG at 16 (±8.2), GAVG at 4 (±4.9), and BVVG at 18 (±12.7) days. No significant difference was found in the postoperative swelling rate between the GPVG group and the other two groups. Furthermore, no statistically significant differences were found across the three graft types regarding postoperative vascular access stenosis and thrombosis, ischemic steal syndrome, pseudoaneurysm, or infection. In conclusion, no statistically significant differences in the postoperative primary, assisted primary, or secondary graft patency rates were observed among the three groups. A shorter anastomosis hemostatic time, first cannulation time, and seroma occurrence were observed with the ACUSEAL® graft than with its counterparts. The incidence of upper extremity swelling postoperatively was greater with the PROPATEN® graft than with the other grafts. No statistically significant differences were observed among the three grafts regarding the remaining complications.

OBJECTIVE: To explore the clinical effect of interactive scalp acupuncture combined with task-oriented mirror therapy on hemiplegia after stroke.
METHODS: A total of 86 patients with hemiplegia after stroke were randomly divided into an observation group (43 cases, 2 cases dropped out) and a control group (43 cases, 2 cases dropped out). Both groups received routine treatment and rehabilitation treatment for stroke. The control group was treated with task-oriented mirror therapy, 40 min each time, once a day, 6 days a week. The observation group was treated with interactive scalp acupuncture at ipsilateral upper 1/5 and 2/5 of the parietal and temporal anterior oblique line and upper 1/5 and 2/5 of the parietal and temporal posterior oblique line on the basis of the treatment as the control group, 45 min each time, once a day, 6 days a week. Both groups were treated for 4 weeks. Before and after treatment and in follow-up of 8 weeks after treatment completion, the Fugl-Meyer assessment (FMA) score, modified Ashworth scale (MAS) score, shoulder abduction angle, wrist dorsiflexion angle and N20 latency and amplitude of somatosensory evoked potential were compared between the two groups.
RESULTS: After treatment and in follow-up, the FMA scores were increased (P<0.01), the MAS scores were decreased (P<0.01) compared with those before treatment in the two groups; the FMA scores in the observation group were higher than those in the control group (P<0.01), the MAS scores were lower than those in the control group (P<0.01). After treatment and in follow-up, the shoulder abduction angle and wrist dorsiflexion angle was increased (P<0.01), the N20 latency was shortened and amplitude was increased (P<0.01) compared with that before treatment in both groups; the shoulder abduction angle and wrist dorsiflexion angle in the observation group was greater than that in the control group (P<0.01), the N20 latency was shorter than that in the control group (P<0.01), and the N20 amplitude was higher than that in the control group (P<0.01).
CONCLUSIONS: Interactive scalp acupuncture combined with task-oriented mirror therapy can improve upper limb function in patients with hemiplegia after stroke, and reduce the muscular tone of the affected limb.
目的：探讨互动式头针联合任务导向性镜像疗法治疗脑卒中后偏瘫的临床疗效。方法：将86例脑卒中后偏瘫患者随机分为观察组（43例，脱落2例）和对照组（43例，脱落2例）。两组均接受脑卒中常规治疗和康复治疗，对照组在此基础上予以任务导向性镜像疗法治疗，每次40 min，每日1次，每周6 d；观察组在对照组治疗基础上予以互动式头针治疗，穴取病灶侧顶颞前斜线的上1/5、2/5和顶颞后斜线的上1/5、2/5，每次留针45 min，每日1次，每周6 d。两组均治疗4周。比较两组患者治疗前后及治疗结束后8周随访时Fugl-Meyer运动功能评定量表（FMA）评分、改良Ashworth量表（MAS）评分、肩外展角度、腕背伸角度及体感诱发电位N20潜伏期和波幅。结果：治疗后及随访时，两组患者FMA评分升高（P<0.01），MAS评分降低（P<0.01）；观察组患者FMA评分高于对照组（P<0.01），MAS评分低于对照组（P<0.01）。治疗后及随访时，两组患者肩外展、腕背伸角度增大（P<0.01），N20潜伏期缩短、波幅升高（P<0.01）；观察组患者肩外展、腕背伸角度大于对照组（P<0.01），N20潜伏期短于对照组、波幅高于对照组（P<0.01）。结论：互动式头针联合任务导向性镜像疗法可改善脑卒中后偏瘫患者上肢功能，降低患肢肌张力。.

Objective. This research aims to reveal how the synergistic control of upper limb muscles adapts to varying requirements in complex motor tasks and how expertise shapes the motor modules.Approach. We study the muscle synergies of a complex, highly skilled and flexible task-piano playing-and characterize expertise-related muscle-synergy control that permits the experts to effortlessly execute the same task at different tempo and force levels. Surface EMGs (28 muscles) were recorded from adult novice (N= 10) and expert (N= 10) pianists as they played scales and arpeggios at different tempo-force combinations. Muscle synergies were factorized from EMGs.Main results. We found that experts were able to cover both tempo and dynamic ranges using similar synergy selections and achieved better performance, while novices altered synergy selections more to adapt to the changing tempi and keystroke intensities compared with experts. Both groups relied on fine-tuning the muscle weights within specific synergies to accomplish the different task styles, while the experts could tune the muscles in a greater number of synergies, especially when changing the tempo, and switch tempo over a wider range.Significance. Our study sheds light on the control mechanism underpinning expertise-related motor flexibility in highly skilled motor tasks that require decade-long training. Our results have implications on musical and sports training, as well as motor prosthetic design.

BACKGROUND: Jin\'s three needle (JTN) is a commonly utilized treatment for ischemic stroke in China. Mirror therapy (MT) is also gradually transitioning from treating limb discomfort to restoring motor function in the damaged limb. Investigations into the 2 treatments\' mechanisms of action are still ongoing. We used functional magnetic resonance imaging (fMRI) technique in this study to examine the effects of JTN combined with mirror therapy MT on brain function in patients with upper limb dysfunction in ischemic stroke, as well as potential central mechanisms. The goal was to provide a solid evidence-based medical basis to support the continued use of JTN combination MT.
METHODS: This study will be a single-blind, randomized, and controlled experiment. Randomization was used to assign 20 patients who met the study\'s eligibility requirements to the JTN + MT treatment group or the JTN control group. Each intervention will last for 4 weeks, with 6 days of treatment per week. The JTN acupuncture points are 3 temporal acupuncture points on the opposite side of the wounded limb, 3 hand acupuncture points on the injured upper limb, 3 shoulder acupuncture points, Renzhong and Baihui, The (JTN + MT) group simultaneously takes MT for 30 minutes. fMRI of the brain using BOLD and T1-weighted images was done both before and after therapy. Brain areas exhibiting changes in regional homogeneity during the pre and posttreatment periods were analyzed.
RESULTS: By the end of the treatment course, Jin three-needle therapy plus MT activated more relevant brain functional regions and increased cerebral blood oxygen perfusion than Jin three-needle therapy alone (P <.05).
CONCLUSIONS: In patients with upper limb impairment following an ischemic stroke, JTN with MT may improve brain function reconstruction in the relevant areas.