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Background and aims: To study possible interrelations of clinical and functional parameters with ultrasonographic findings of shoulders of hemiplegic stroke patients. This would assist in determining the need for a possible ultrasound evaluation of hemiplegic shoulders. Methods: Prospective case series were studied in the Department of Geriatric Medicine and Rehabilitation, at a university-affiliated referral hospital. We studied a total of 26 consecutive stroke patients with hemiplegic shoulders undergoing a standard rehabilitation course. Hemiplegic shoulders were studied by ultrasound and scored for the number of pathological (positive) findings. Shoulder scores were correlated with various clinical and functional parameters (Ashworth score, Fugl-Meyer score, Functional Independence Measure) as non-dependent variables. Results: No correlation was found between any of the parameters we have studied and the ultrasonographic score, except for shoulder pain (p = 0.012). A regression analysis documented painful shoulder (p = 0.002) and spasticity (p = 0.039) as significantly associated with higher ultrasonographic scores. Conclusions: Ultrasound investigation of hemiplegic upper extremities does not interrelate with any of the parameters associated with rehabilitation outcome and should be reserved for those suffering painful and spastic hemiplegic shoulders.

Background: Stroke, either haemorrhagic or ischemic in nature, has the ability to culminate in devastating clinical outcomes thus effective rehabilitation is needed. Objective: To analyze the efficacy of Erigo tilt-table over conventional physiotherapy between ischemic and haemorrhagic stroke patients. Methods: A total of 110 haemorrhagic and ischemic stroke patients (age $51.08\pm 7.48$ years, $8.69\pm 4.62$ days after stroke) were assigned randomly into four groups, haemorrhagic conventional physiotherapy group ($n=33$), haemorrhagic Erigo tilt-table group ($n=27$), ischemic conventional physiotherapy group ($n=22$) and ischemic Erigo tilt-table group ($n=28$). The National Institutes of Health Stroke Scale (NIHSS), Mini Mental Scale Examination (MMSE), Modified Ashworth Scale, Quality of Life (QOL) and muscle strength outcomes were assessed at baseline, after the intervention (30th) and on 90th day of follow up. Results: In haemorrhagic Subjects, Erigo tilt-table patients had significant improvement ($P<0.05$) in outcome variables NIHSS, Ashworth, QOL, absolute upper and lower limb strength except for MMS as compared to Conventional Physiotherapy Group. Whereas in ischemic Subjects, there was no statistically significant difference between both groups($P>0.05$) on 30th as well as on 90th day comparison. Conclusions: Erigo tilt-table training are found to be effective than conventional physiotherapy in haemorrhagic stroke whereas in ischemic stroke both the interventions are equally effective.

Hemiplegia means paralysis of half of the body. It commonly occurs following "stroke", which is due to impedance of blood supply to the brain, hence also termed as "cerebrovascular accident" (CVA). As a consequence of this, the brain tissues suffer from ischemic damage resulting in several symptoms, such as mere weakness, numbness to complete loss of power (paralysis). In order to restore or improve the lost functional movement of the body of the stroke-affected and hemiplegic subjects, a method called functional electrical stimulation (FES) has often been employed as the measure of rehabilitation. FES makes use of low levels of electrical current to activate the nerves and then the muscles, affected. The response of the body to this electrically triggered nervous stimulation could be recorded through different bio-signals. In our work, we measured the accelerometers of hemiplegic patient in two states; with FES and without FES. The nonlinear and nonstationary walking-function-related accelerometers are analyzed using recurrence plots (RP), which helps to visualize the dynamic behavior of the signals. The RPs of electromyography (EMG) signals with stimulation showed distinct periodicity and rhythm when compared to that without stimulation. In addition, we extracted recurrence quantification analysis (RQA) parameters from RP to quantify the obtained information from the RP. Lower values were observed for most of the RQA parameters with FES than obtained without FES. This also confirmed the fact that FES is very useful in bringing more order, rhythm and better control in the physical activities of hemiplegic people.

The objective of this study was to fully implement the comprehensive rehabilitation concept based on the International Classification of Functioning, Disability and Health (ICF) and integrate Mind-body Activation strategies into the holistic rehabilitation and supportive treatment of elderly patients with post-stroke hemiparesis. The aim was to assess the potential of promoting overall recovery in elderly stroke patients and explore a novel approach to stroke rehabilitation that emphasizes the integration of mind and body. A total of 103 elderly patients with post-stroke hemiplegia receiving rehabilitation treatment were selected and randomly assigned to the control group and experimental group. In the control group, 52 patients received intervention with routine rehabilitation exercise training, while in the experimental group, 51 patients adopted the Mind-body Activation strategy combined with routine rehabilitation exercise training to achieve physical and mental integration through techniques such as warm-up exercises and music therapy. Both groups were evaluated before and after the intervention in terms of walking function, balance function, daily living ability, and cognitive ability. The results showed that after the intervention for 3 months, the Holden walking functional grading, Berg scale score, Barthel scale score and MMSE score of patients in both groups were significantly higher than those before the intervention ($P<0.05$). Additionally, the above four indicators of patients in the experimental group were significantly higher than those in the control group ($P<0.05$). The Mind-body Activation strategy incorporated into routine rehabilitation exercise training can effectively enhance the walking function, balance function, daily living ability and cognitive ability of elderly stroke patients with hemiplegia. The Mind-body Activation strategy is a feasible and effective new rehabilitation method of hemiplegia after stroke, which is conducive to promoting the comprehensive rehabilitation of elderly stroke patients.

Control strategies are the chief attraction in the field of rehabilitation engineering, and especially in a functional electrical stimulation (FES) system, a reliable control method is important for paralyzed patients to restore lost their functions. In this paper, we have presented a demonstration of the control strategy, which is based on the patient-driven loop, used in a non-invasive FES system for hand function restoration. With the patient-driven loop control, hemiplegic patients could use their residual capabilities, such as shoulder movements in their sound extremities, the myoelectric signals generated from different muscles, etc, to operate the FES system. Here we have chosen the most common and acceptable signals as the input sources, i.e. electromyographic (EMG) signals, to control a non-invasive FES system, generating the electrical stimuli to excite the paralyzed muscles. In addition, EMG signals recorded by the sensors in the electrical stimulator can serve both as the trigger of the system and as the adjustment of the electrical stimulation parameters, thereby improving the system's performance and reliability. From the experimental results, subjects can successfully use their residual capabilities to control the FES system and restore their lost hand functions as well. On the other hand, from the viewpoints of rehabilitation and psychology, hemiplegics will benefit greatly by using their residual capabilities to regain their lost functions. It is believed that the patient-driven loop control is very useful, not only for the FES system in this study, but also for other assistive devices. By the control strategy proposed in this paper, we deeply hope that patients will benefit greatly and regain their self-confidence.