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Copyright © 2016 Maristela C. X. Pelicioni et al. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Motor rehabilitation of stroke survivors may include functional and/or nonfunctional strategy. The present study aimed to compare the effect of these two rehabilitation strategies by means of clinical scales and functional Magnetic Resonance Imaging (fMRI). Twelve hemiparetic chronic stroke patients were selected. Patients were randomly assigned a nonfunctional (NFS) or functional (FS) rehabilitation scheme. Clinical scales (Fugl-Meyer, ARA test, and modified Barthel) and fMRI were applied at four moments: before rehabilitation (P1) and immediately after (P2), 1 month after (P3), and three months after (P4) the end of rehabilitation. The NFS group improved significantly and exclusively their Fugl-Meyer scores at P2, P3, and P4, when compared to P1. On the other hand, the FS group increased significantly in Fugl-Meyer at P2, when compared to P1, and also in their ARA and Barthel scores. fMRI inspection at the individual level revealed that both rehabilitation schemes most often led to decreased activation sparseness, decreased activity of contralesional M1, increased asymmetry of M1 activity to the ipsilesional side, decreased perilesional activity, and decreased SMA activity. Increased M1 asymmetry with rehabilitation was also confirmed by Lateralization Indexes. Our clinical analysis revealed subtle differences between FS and NFS.

Details

Title
Functional versus Nonfunctional Rehabilitation in Chronic Ischemic Stroke: Evidences from a Randomized Functional MRI Study
Author
Maristela C X Pelicioni 1 ; Novaes, Morgana M 2 ; Peres, Andre S C 2 ; Altay A Lino de Souza 3 ; Minelli, Cesar 4 ; Fabio, Soraia R C 4 ; Pontes-Neto, Octavio M 4 ; Santos, Antonio C 5 ; de Araujo, Draulio B 2 

 Radiology Division, Department of Internal Medicine, Ribeirao Preto School of Medicine, University of Sao Paulo, 14049-900 Ribeirao Preto, SP, Brazil 
 Brain Institute/Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, 59153-155 Natal, RN, Brazil 
 Department of Psychobiology, Federal University of Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil 
 Department of Neuroscience and Behavior, Ribeirao Preto School of Medicine, University of Sao Paulo, 14049-900 Ribeirao Preto, SP, Brazil 
 Radiology Division, Department of Internal Medicine, Ribeirao Preto School of Medicine, University of Sao Paulo, 14049-900 Ribeirao Preto, SP, Brazil; Department of Neuroscience and Behavior, Ribeirao Preto School of Medicine, University of Sao Paulo, 14049-900 Ribeirao Preto, SP, Brazil 
Editor
Malgorzata Kossut
Publication year
2016
Publication date
2016
Publisher
John Wiley & Sons, Inc.
ISSN
20905904
e-ISSN
16875443
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2407660171
Copyright
Copyright © 2016 Maristela C. X. Pelicioni et al. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.