Effects of Prism Adaptation on Unilateral Neglect After Stroke: An Updated Meta-Analysis of Randomized Controlled Trials.

OBJECTIVE: The aim of this study was to investigate the effects of prism adaptation (PA) on unilateral neglect after stroke. METHODS: Randomized clinical trials, published up to January 31, 2020, comparing PA with neutral goggles or no goggles were systematically searched and included. Two independent reviewers performed data extraction and assessed the quality of studies using the Physiotherapy Evidence Database scale. RESULTS: A total of seven randomized trials, involving 211 participants, satisfied the inclusion criteria. There was no significant immediate benefit of PA as measured by Behavioral Inattention Test (BIT) (weighted mean difference [WMD], 5.10; [95% confidence interval (CI), -6.68 to 16.88]), behavioral subset (BIT-B; WMD, 3.40 [95% CI, -3.97 to 10.76), conventional subset (BIT-C; WMD, 9.98 [95% CI, -0.42 to 20.38]), and Catherine Bergego Scale (WMD, -0.52 [95% CI, -1.98 to 0.93]). No statistical difference was observed between PA and control on the long-term effect (BIT: WMD, 1.92 [95% CI, -9.34 to 13.18]; BIT-B: WMD, -3.28 [95% CI, -11.89 to 5.34]; BIT-C: WMD, 2.66 [95% CI, -10.35 to 11.67]; Catherine Bergego Scale: WMD, -1.22 [95% CI, -3.05 to 0.62]). CONCLUSIONS: PA did not show a greater improvement on neglect symptoms in post-stroke patients with unilateral neglect, compared with placebo or no treatment. These findings do not support the routine use of PA in patients with unilateral neglect after stroke.

Adaptive Differential Evolution With Sorting Crossover Rate for Continuous Optimization Problems.

Differential evolution (DE) is one of the best evolutionary algorithms (EAs). The effort of improving its performance has received great research attentions, such as adaptive DE (JADE). Based on the analysis on the aspects that may improve the performance of JADE, we introduce a modified JADE version with sorting crossover rate (CR). In JADE, CR values are generated based on mean value and Gaussian distribution. In the proposed algorithm, a smaller CR value is assigned to individual with better fitness value. Therefore, the components of the individuals, which have better fitness values, can appear in the offspring with higher possibility. In addition, the better offspring generated from last iteration are supposed to have better schemes, hence these schemes are preserved in next offspring generation procedure. This modified version is called as JADE algorithm with sorting CR (JADE_sort). The experiments results with several excellent algorithms show the effectiveness of JADE_sort.

Whole Body Vibration Training Improves Walking Performance of Stroke Patients with Knee Hyperextension: A Randomized Controlled Pilot Study.

OBJECTIVE: To investigate the effect of 8-week whole body vibration training on gait performance and lower extremity function in stroke patients with knee hyperextension. METHODS: Total 30 subjects with stroke were randomized into the control group (n=15) or the intervention group (n=15). The patients of intervention group were treated with whole body vibration while the control group was treated with placebo. The walking function, lower limb function and knee hyperextension times were assessed in this study. Gait performances were evaluated by 10-meter walk test. The knee hyperextension times was visually observed and counted. The lower limb function was evaluated by Fugl-Meyer motor assessment. RESULTS: The times of the knee hyperextension of the intervention group was significantly decreased compared with control groups (P=0.000, d=1.749, 95%CI[2.915,7.285]). The walking function assessed by 10-meter test of intervention group was significantly improved compared with control group (P=0.001, d=1.345, 95%CI[1.896,6.704]). The performances of all the three tests were improved after training in both groups (P=0.000/P=0.000, d=1.500/d=1.952, 95%CI[3.309,9.891]/ 95%CI[5.549,12.45]; P=0.000/P=0.000, d=2.015/d=2.952, 95%CI[5.214,11.39]/95%CI[9.423, 15.98]; P=0.000/P=0.000, d=3.537/d=5.108, 95%CI[19.05,12.35]/95%CI[16.52,22.28]). CONCLUSION: The results suggest that 8 weeks whole body vibration training can reduce knee hyperextension and increase ambulatory speed in stroke patients.

Comparison of the Effects of Contralaterally Controlled Functional Electrical Stimulation and Neuromuscular Electrical Stimulation on Upper Extremity Functions in Patients with Stroke.

BACKGROUND: Contralaterally controlled functional electrical stimulation (CCFES) is an innovative method to improve upper extremity functions after stroke. OBJECTIVE: To compare the effects of CCFES versus neuromuscular electrical stimulation (NMES) on the upper extremity functions in patients with stroke. METHODS: Sixty patients with stroke were randomly assigned into CCFES group (n=30) or NMES group (n=30). All patients were also treated with conventional medical treatment and rehabilitation training. Patients in CCFES group received CCFES to the affected wrist extensors while the NMES group received NMES. The stimulus current was biphasic wave with a pulse duration of 200 µs and a frequency of 60 Hz. The electrical stimulation lasted for 20 min per session, 5 sessions per week for 3 weeks. The intensity of the CCFES was based on the electromyography (EMG) value of the unaffected side while the subjects voluntarily extended their unaffected wrist slightly (<10% range of motion, ROM), moderately (about 50% ROM) and completely (100% ROM). Fugl-Meyer assessment (FMA), motricity index (MI), the Hong Kong version of functional test for the hemiplegic upper extremity (FTHUE-HK) and active range of motion (AROM) of wrist extension were measured before and after 3 weeks of treatment. RESULTS: Compared with the baseline values, both groups showed significant improvements in all the measurements after treatment (p<0.05). Patients in CCFES group showed significantly higher upper extremity FMA, FTHUE-HK scores and AROM of wrist extension than those in NMES group (p<0.05). CONCLUSION: Compared with the conventional NMES, CCFES provides better recovery of upper extremity function in patients with stroke.

Left hemiparalexia of Chinese characters: neglect dyslexia or disruption of pathway of visual word form processing?

The objective of the study was to further elucidate the potential mechanisms underlying left hemiparalexia induced by a splenium lesion in corpus callosum. A patient KY, who had infarctions in the splenium and the left ventral medial occipitotemporal area, was examined with neuropsychological tests and fMRI. KY presented left hemiparalexia when he read aloud characters presented in central foveal field tachistoscopically as well as in free-view field. KY also showed left hemialexia for characters in left visual field, while no left hemiparalexia occurred when characters were presented in the right visual field. KY performed poorly in lexical decision tasks. He could judge the directions of Landolt's rings gaps in the left or right visual field equally. The result of fMRI indicated that characters in the left visual field could not activate the visual word form area (VWFA), such as left mid-fusiform cortex. All the above neuropsychological and fMRI findings have provided evidences against the assumption of left hemineglect dyslexia. Instead, they support the mechanism of disconnection of visual word form processing pathway. In conclusion, the evidences suggested that the visual information transmission of characters in the left visual field from right occipital area to the VWFA in the left hemisphere was interrupted by the splenium lesion.