Predicting Improved Daily Use of the More Affected Arm Poststroke Following Constraint-Induced Movement Therapy.
Background Constraint-induced movement therapy (CI therapy) produces, on average, large and clinically meaningful improvements in the daily use of a more affected upper extremity in individuals with hemiparesis. However, individual responses vary widely. Objective The study objective was to investig...
| Publicado en: | Physical Therapy Vol. 99; no. 12; pp. 1667 - 1679 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Dec2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=140381942&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 140381942 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00319023 PTH jtl: Physical Therapy issn: 00319023 maglogo: N pubinfo: dt: Dec2019 vid: 99 iid: 12 pid: 10398 pub: Oxford University Press / USA artinfo: ui: 140381942 140381942 140381942 10.1093/ptj/pzz121 140381942 ppf: 1667 ppct: 12 formats: tig: atl: Predicting Improved Daily Use of the More Affected Arm Poststroke Following Constraint-Induced Movement Therapy. aug: au: Rafiei, Mohammad H Kelly, Kristina M Borstad, Alexandra L Adeli, Hojjat Gauthier, Lynne V affil: Whiting School of Engineering, Johns Hopkins University, Baltimore, Maryland sug: subj: Constraint-Induced Therapy Stroke Therapy Arm Physiology Treatment Outcomes Motor Skills Human Retrospective Design Hemiplegia Clinical Assessment Tools Male Female Adult Middle Age Aged Aged, 80 and Over Funding Source Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Background Constraint-induced movement therapy (CI therapy) produces, on average, large and clinically meaningful improvements in the daily use of a more affected upper extremity in individuals with hemiparesis. However, individual responses vary widely. Objective The study objective was to investigate the extent to which individual characteristics before treatment predict improved use of the more affected arm following CI therapy. Design This study was a retrospective analysis of 47 people who had chronic (> 6 months) mild to moderate upper extremity hemiparesis and were consecutively enrolled in 2 CI therapy randomized controlled trials. Methods An enhanced probabilistic neural network model predicted whether individuals showed a low, medium, or high response to CI therapy, as measured with the Motor Activity Log, on the basis of the following baseline assessments: Wolf Motor Function Test, Semmes-Weinstein Monofilament Test of touch threshold, Motor Activity Log, and Montreal Cognitive Assessment. Then, a neural dynamic classification algorithm was applied to improve prognostic accuracy using the most accurate combination obtained in the previous step. Results Motor ability and tactile sense predicted improvement in arm use for daily activities following intensive upper extremity rehabilitation with an accuracy of nearly 100%. Complex patterns of interaction among these predictors were observed. Limitations The fact that this study was a retrospective analysis with a moderate sample size was a limitation. Conclusions Advanced machine learning/classification algorithms produce more accurate personalized predictions of rehabilitation outcomes than commonly used general linear models. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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