Impact of early applied upper limb stimulation: the EXPLICIT-stroke programme design.
Identifieur interne : 001357 ( PubMed/Corpus ); précédent : 001356; suivant : 001358Impact of early applied upper limb stimulation: the EXPLICIT-stroke programme design.
Auteurs : Gert Kwakkel ; Carel G M. Meskers ; Erwin E. Van Wegen ; Guus J. Lankhorst ; Alexander C H. Geurts ; Annet A. Van Kuijk ; Eline Lindeman ; Anne Visser-Meily ; Erwin De Vlugt ; J Hans ArendzenSource :
- BMC neurology [ 1471-2377 ] ; 2008.
English descriptors
- KwdEn :
- Adaptation, Physiological, Clinical Protocols, Electric Stimulation Therapy, Humans, Magnetic Resonance Imaging, Musculoskeletal Manipulations (methods), Nerve Regeneration, Recovery of Function, Research Design, Restraint, Physical (methods), Robotics (methods), Single-Blind Method, Stroke (rehabilitation), Time Factors, Transcranial Magnetic Stimulation, Upper Extremity.
- MESH :
- methods : Musculoskeletal Manipulations, Restraint, Physical, Robotics.
- rehabilitation : Stroke.
- Adaptation, Physiological, Clinical Protocols, Electric Stimulation Therapy, Humans, Magnetic Resonance Imaging, Nerve Regeneration, Recovery of Function, Research Design, Single-Blind Method, Time Factors, Transcranial Magnetic Stimulation, Upper Extremity.
Abstract
Main claims of the literature are that functional recovery of the paretic upper limb is mainly defined within the first month post stroke and that rehabilitation services should preferably be applied intensively and in a task-oriented way within this particular time window. EXplaining PLastICITy after stroke (acronym EXPLICIT-stroke) aims to explore the underlying mechanisms of post stroke upper limb recovery. Two randomized single blinded trials form the core of the programme, investigating the effects of early modified Constraint-Induced Movement Therapy (modified CIMT) and EMG-triggered Neuro-Muscular Stimulation (EMG-NMS) in patients with respectively a favourable or poor probability for recovery of dexterity.
DOI: 10.1186/1471-2377-8-49
PubMed: 19091088
Links to Exploration step
pubmed:19091088Le document en format XML
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Lankhorst</name></author><author><name sortKey="Geurts, Alexander C H" sort="Geurts, Alexander C H" uniqKey="Geurts A" first="Alexander C H" last="Geurts">Alexander C H. Geurts</name></author><author><name sortKey="Van Kuijk, Annet A" sort="Van Kuijk, Annet A" uniqKey="Van Kuijk A" first="Annet A" last="Van Kuijk">Annet A. Van Kuijk</name></author><author><name sortKey="Lindeman, Eline" sort="Lindeman, Eline" uniqKey="Lindeman E" first="Eline" last="Lindeman">Eline Lindeman</name></author><author><name sortKey="Visser Meily, Anne" sort="Visser Meily, Anne" uniqKey="Visser Meily A" first="Anne" last="Visser-Meily">Anne Visser-Meily</name></author><author><name sortKey="De Vlugt, Erwin" sort="De Vlugt, Erwin" uniqKey="De Vlugt E" first="Erwin" last="De Vlugt">Erwin De Vlugt</name></author><author><name sortKey="Arendzen, J Hans" sort="Arendzen, J Hans" uniqKey="Arendzen J" first="J Hans" last="Arendzen">J Hans Arendzen</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2008">2008</date><idno type="doi">10.1186/1471-2377-8-49</idno><idno type="RBID">pubmed:19091088</idno><idno type="pmid">19091088</idno><idno type="wicri:Area/PubMed/Corpus">001357</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Impact of early applied upper limb stimulation: the EXPLICIT-stroke programme design.</title><author><name sortKey="Kwakkel, Gert" sort="Kwakkel, Gert" uniqKey="Kwakkel G" first="Gert" last="Kwakkel">Gert Kwakkel</name><affiliation><nlm:affiliation>Dept. Rehabilitation Medicine, VU University Medical Centre, Amsterdam, The Netherlands. g.kwakkel@vumc.nl</nlm:affiliation></affiliation></author><author><name sortKey="Meskers, Carel G M" sort="Meskers, Carel G M" uniqKey="Meskers C" first="Carel G M" last="Meskers">Carel G M. Meskers</name></author><author><name sortKey="Van Wegen, Erwin E" sort="Van Wegen, Erwin E" uniqKey="Van Wegen E" first="Erwin E" last="Van Wegen">Erwin E. Van Wegen</name></author><author><name sortKey="Lankhorst, Guus J" sort="Lankhorst, Guus J" uniqKey="Lankhorst G" first="Guus J" last="Lankhorst">Guus J. Lankhorst</name></author><author><name sortKey="Geurts, Alexander C H" sort="Geurts, Alexander C H" uniqKey="Geurts A" first="Alexander C H" last="Geurts">Alexander C H. Geurts</name></author><author><name sortKey="Van Kuijk, Annet A" sort="Van Kuijk, Annet A" uniqKey="Van Kuijk A" first="Annet A" last="Van Kuijk">Annet A. Van Kuijk</name></author><author><name sortKey="Lindeman, Eline" sort="Lindeman, Eline" uniqKey="Lindeman E" first="Eline" last="Lindeman">Eline Lindeman</name></author><author><name sortKey="Visser Meily, Anne" sort="Visser Meily, Anne" uniqKey="Visser Meily A" first="Anne" last="Visser-Meily">Anne Visser-Meily</name></author><author><name sortKey="De Vlugt, Erwin" sort="De Vlugt, Erwin" uniqKey="De Vlugt E" first="Erwin" last="De Vlugt">Erwin De Vlugt</name></author><author><name sortKey="Arendzen, J Hans" sort="Arendzen, J Hans" uniqKey="Arendzen J" first="J Hans" last="Arendzen">J Hans Arendzen</name></author></analytic><series><title level="j">BMC neurology</title><idno type="eISSN">1471-2377</idno><imprint><date when="2008" type="published">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adaptation, Physiological</term><term>Clinical Protocols</term><term>Electric Stimulation Therapy</term><term>Humans</term><term>Magnetic Resonance Imaging</term><term>Musculoskeletal Manipulations (methods)</term><term>Nerve Regeneration</term><term>Recovery of Function</term><term>Research Design</term><term>Restraint, Physical (methods)</term><term>Robotics (methods)</term><term>Single-Blind Method</term><term>Stroke (rehabilitation)</term><term>Time Factors</term><term>Transcranial Magnetic Stimulation</term><term>Upper Extremity</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Musculoskeletal Manipulations</term><term>Restraint, Physical</term><term>Robotics</term></keywords><keywords scheme="MESH" qualifier="rehabilitation" xml:lang="en"><term>Stroke</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adaptation, Physiological</term><term>Clinical Protocols</term><term>Electric Stimulation Therapy</term><term>Humans</term><term>Magnetic Resonance Imaging</term><term>Nerve Regeneration</term><term>Recovery of Function</term><term>Research Design</term><term>Single-Blind Method</term><term>Time Factors</term><term>Transcranial Magnetic Stimulation</term><term>Upper Extremity</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Main claims of the literature are that functional recovery of the paretic upper limb is mainly defined within the first month post stroke and that rehabilitation services should preferably be applied intensively and in a task-oriented way within this particular time window. EXplaining PLastICITy after stroke (acronym EXPLICIT-stroke) aims to explore the underlying mechanisms of post stroke upper limb recovery. Two randomized single blinded trials form the core of the programme, investigating the effects of early modified Constraint-Induced Movement Therapy (modified CIMT) and EMG-triggered Neuro-Muscular Stimulation (EMG-NMS) in patients with respectively a favourable or poor probability for recovery of dexterity.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">19091088</PMID><DateCreated><Year>2009</Year><Month>01</Month><Day>27</Day></DateCreated><DateCompleted><Year>2009</Year><Month>02</Month><Day>27</Day></DateCompleted><DateRevised><Year>2014</Year><Month>09</Month><Day>01</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2377</ISSN><JournalIssue CitedMedium="Internet"><Volume>8</Volume><PubDate><Year>2008</Year></PubDate></JournalIssue><Title>BMC neurology</Title><ISOAbbreviation>BMC Neurol</ISOAbbreviation></Journal><ArticleTitle>Impact of early applied upper limb stimulation: the EXPLICIT-stroke programme design.</ArticleTitle><Pagination><MedlinePgn>49</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/1471-2377-8-49</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Main claims of the literature are that functional recovery of the paretic upper limb is mainly defined within the first month post stroke and that rehabilitation services should preferably be applied intensively and in a task-oriented way within this particular time window. EXplaining PLastICITy after stroke (acronym EXPLICIT-stroke) aims to explore the underlying mechanisms of post stroke upper limb recovery. Two randomized single blinded trials form the core of the programme, investigating the effects of early modified Constraint-Induced Movement Therapy (modified CIMT) and EMG-triggered Neuro-Muscular Stimulation (EMG-NMS) in patients with respectively a favourable or poor probability for recovery of dexterity.</AbstractText><AbstractText Label="METHODS/DESIGN" NlmCategory="METHODS">180 participants suffering from an acute, first-ever ischemic stroke will be recruited. Functional prognosis at the end of the first week post stroke is used to stratify patient into a poor prognosis group for upper limb recovery (N = 120, A2 project) and a group with a favourable prognosis (N = 60, A1 project). Both groups will be randomized to an experimental arm receiving respectively modified CIMT (favourable prognosis) or EMG-NMS (poor prognosis) for 3 weeks or to a control arm receiving usual care. Primary outcome variable will be the Action Research Arm Test (ARAT), assessed at 1,2,3,4,5, 8, 12 and 26 weeks post stroke. To study the impact of modified CIMT or EMG-NMS on stroke recovery mechanisms i.e. neuroplasticity, compensatory movements and upper limb neuromechanics, 60 patients randomly selected from projects A1 and A2 will undergo TMS, kinematical and haptic robotic measurements within a repeated measurement design. Additionally, 30 patients from the A1 project will undergo fMRI at baseline, 5 and 26 weeks post stroke.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">EXPLICIT stroke is a 5 year translational research programme which main aim is to investigate the effects of early applied intensive intervention for regaining dexterity and to explore the underlying mechanisms that are involved in regaining upper limb function after stroke. EXPLICIT-stroke will provide an answer to the key question whether therapy induced improvements are due to either a reduction of basic motor impairment by neural repair i.e. restitution of function and/or the use of behavioural compensation strategies i.e. substitution of function.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Kwakkel</LastName><ForeName>Gert</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Dept. Rehabilitation Medicine, VU University Medical Centre, Amsterdam, The Netherlands. g.kwakkel@vumc.nl</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Meskers</LastName><ForeName>Carel G M</ForeName><Initials>CG</Initials></Author><Author ValidYN="Y"><LastName>van Wegen</LastName><ForeName>Erwin E</ForeName><Initials>EE</Initials></Author><Author ValidYN="Y"><LastName>Lankhorst</LastName><ForeName>Guus J</ForeName><Initials>GJ</Initials></Author><Author ValidYN="Y"><LastName>Geurts</LastName><ForeName>Alexander C H</ForeName><Initials>AC</Initials></Author><Author ValidYN="Y"><LastName>van Kuijk</LastName><ForeName>Annet A</ForeName><Initials>AA</Initials></Author><Author ValidYN="Y"><LastName>Lindeman</LastName><ForeName>Eline</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Visser-Meily</LastName><ForeName>Anne</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>de Vlugt</LastName><ForeName>Erwin</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Arendzen</LastName><ForeName>J Hans</ForeName><Initials>JH</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016449">Randomized Controlled Trial</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2008</Year><Month>12</Month><Day>17</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Neurol</MedlineTA><NlmUniqueID>100968555</NlmUniqueID><ISSNLinking>1471-2377</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Arch Phys Med Rehabil. 2002 Nov;83(11):1629-37</RefSource><PMID Version="1">12422337</PMID></CommentsCorrections><CommentsCorrections 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Design</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D012149">Restraint, Physical</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000379">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D012371">Robotics</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000379">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D016037">Single-Blind Method</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D020521">Stroke</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000534">rehabilitation</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D013997">Time Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="Y" UI="D050781">Transcranial Magnetic Stimulation</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="Y" UI="D034941">Upper Extremity</DescriptorName></MeshHeading></MeshHeadingList><OtherID Source="NLM">PMC2630975</OtherID></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2008</Year><Month>9</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2008</Year><Month>12</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="aheadofprint"><Year>2008</Year><Month>12</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2008</Year><Month>12</Month><Day>19</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2008</Year><Month>12</Month><Day>19</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2009</Year><Month>2</Month><Day>28</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pii">1471-2377-8-49</ArticleId><ArticleId 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