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London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 793 845 Rehabilitation and reorganisation after stroke Bilateral sensory deficits after unilateral stroke – Quantitative Sensory Testing in patients with and without central post-stroke pain S. Frank1, T. Krause2, B. Taskin3, L. Harnisch4, K. Villringer5, A. Villringer6, G.J. Jungehulsing7 Center for Stroke Research Berlin, Charité Universitätsmedizin zu Berlin, Berlin, GER-MANY1, Center for Stroke Research Berlin, Charité Universitätsmedizin zu Berlin, Berlin, GERMANY2, Center for Stroke Research Berlin, Charité Universitätsmedizin zu Berlin, Berlin, GERMANY3, Center for Stroke Research Berlin, Charité Universitätsmedizin zu Berlin, Berlin, GERMANY4, Center for Stroke Research Berlin, Charité Universitätsmedizin zu Berlin, Berlin, GERMANY5, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Leipzig, GERMANY6, Center for Stroke Research Berlin, Charité Universitätsmedizin zu Berlin, Berlin, GERMANY7 Introduction: Persistent sensory deficits on the contralesional body side are a common symptom af-ter stroke affecting the somatosensory pathway. Some of these patients later develop chronic pain of central origin. Here we analyse differences in associated sensory perception between patients with and without central neuropathic pain following sensory stroke. Methods: Using a standardized Quantitative Sensory Testing protocol (QST) we evaluated thermal and mechanical perception and pain thresholds in patients with chronic sensory deficits after stroke (>6months). We compared patients with central pain (n=25) and patients with non-painful sensory deficits (n=25) to a reference sample of healthy controls. Results: Patients with chronic pain and patients with non-painful sensory symptoms showed de-creased perception of non-painful stimuli, but increased pain-sensibility compared to healthy con-trols on the contra- as well as ipsilesional side of the body (p<0.05). Differences in temperature perception on the contralesional side and pathologic side-differences in wind up ratio are correlated with the incidence of pain (p<0.05). Conclusion: Our study shows that patients with chronic sensory symptoms exhibit alterations in sen-sory perception not only on the contra- but also on the ipsilesional side of the body. This points to more widespread changes in the processing of sensory stimuli and pain perception extending to parts of the somatosensory pathway which are unaffected by the stroke in the first place. 846 Rehabilitation and reorganisation after stroke The effect of Neurofeedback and EMG-biofeedback therapy on improving hand function in stroke patients L. Sedighipour1, S.M. Rayegani2, L. Anghouti3, I. Rezazadeh4, M. Tajziehchi5, M.H. Bahrami6, S.A Raeis sadat7, D. Elyas pour8 Department of Physical Medicine & Rehabilitatio, Shohada Hospital, Shahid Beheshti Medi-cal University, Tehran,Iran, Tehran, IRAN1, Department of Physical Medicine & Rehabilitatio, Shohada Hospital, Shahid Beheshti Medical University, Tehran,Iran, Tehran, IRAN2, Department of Physical Medicine & Rehabilitatio, Shohada Hospital, Shahid Beheshti Medical University, Tehran,Iran, Tehran, IRAN3, engineering department, Azad University,Tehran,Iran, Tehran, IRAN4, engineering department, Azad University,Tehran,Iran, Tehran, IRAN5, Department of Physical Med-icine & Rehabilitatio, Shohada Hospital, Shahid Beheshti Medical University, Tehran,Iran, Teh-ran, IRAN6, Department of Physical Medicine & Rehabilitatio, Modarres hospital, Shahid Beheshti Medical University, Tehran,Iran, Tehran, IRAN7, Department of Physical Medicine & Rehabilitatio, Shohada Hospital, Shahid Beheshti Medical University, Tehran,Iran, Tehran, IRAN8 Background: A major concern in rehabilitation program following stroke is restitution of hand func-tion. Recent researches on brain plasticity have made evolutions in the field of rehabilitation in post stroke patients. The field of neurofeedback and EMG biofeedback is an exciting new area of appli-cation of the principles of biofeedback to stroke rehabilitation. The aim of the present study was to evaluate the effect of adding neurobiofeedback or EMG biofeedback to conventional occupational therapy on improving hand function after stroke. Methods: This study was designed as a pilot randomized clinical trial. Patients with subacute stroke were entered the study. Hand function was evaluated by Jebson hand function test pre and post in-tervention. Patients were randomly allocated to three groups: 1)Occupational therapy(OT ) 2)OT+ EMG biofeedback therapy(BF) 3)OT + neurofeedback therapy(NF) groups. All patients received 10 sessions of OT. Patients in group 2and 3 also received NF and BF respectively. BF therapy aimed at enhancing the opposition. NF training was performed to enhance sensorimotor rhythm (SMR). Results: Thirty patients were first entered the study. Finally 21 patients completed the study. Mean age of patients was 60±7 years old. Male to female ratio was 2.5/1. Hand function was improved significantly in three groups according to general jebson test. Some functional tasks of Jebson test improved more significantly with NF and BF compared with OT group . Most patients found neuro-feedback or biofeedback accompanying OT more enjoyable than OT alone. Conclusion: Neurofeedback and biofeedback therapy are suggested as a complementary therapy to conventional occupational therapy with additional improvement in some aspects of hand recovery. Furthermore, these new therapeutic strategies can increase patients’ compliance to rehabilitation program , also improve their satisfaction from therapy protocol.


Karger_ESC London_2013
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