This group of patients received patients with acute stroke. It will be applied somatosensorial and vestibular rehabilitation additional conventional therapy

This Group patients received patient with acute stroke. It will be applied classical physiotherapy and conventional exercises.

Exercise

Acute Stroke

In the experimental group, the subjects who were taken to the somatosensorial and vestibular exercises program after pre- treatment evaluations. The subjects in this group were given classical physiotherapy and somatosensorial combined with vestibular exercise performed 5-7 days a week, 1 set of 10 times with physiotherapist control. In the content of the training, in addition to the general physiotherapy program applied for Brunnstrom and Bobath exercises and spasticity inhibition according to in-bed mobility, Flask and spasticity conditions in the experimental group, a mutual study program was prepared with Cawthorne-Cooksey and Frenkel exercises in the bed, then balance and walking will be performed with the exercises

Somatosensorial and Vestibular Exercises

In the control group, The subjects who were taken into the study were taken to the classical physiotherapy based on Bobath and Brunnstrom will be applied to increase the mobilization and spasticity up to the discharge stage known as 5-7 days a week

Conventional Group

Inonu University

The Effects of Somatosensory and Vestibular Rehabilitation Additional Conventional Therapy on Balance in Patients With Acute Stroke.

Assessment Effects of Somatosensorial and Vestibular Rehabilitation Additional Conventional Therapy on Balance in Patients With Acute Stroke

It used to measure static standing and dynamic balance ability by assessing posture imbalance, which was recorded as the anterior-to-posterior postural sway and the medial-to-lateral sway for 30 s. Kore Balance System facilitates the performance of a 4-way evaluation of the balance of front/left, front/right, behind/left, and behind/right and calculates total score. The total score, including deviations caused by impairment of postural balance, is calculated by the device. An increase in the total score indicates worse balance; that is, higher total scores indicate poorer balance and lower total scores, better balance . When the static and dynamic balance parameters of the hemiplegic participants were evaluated, the ground instability index was set to 5, with the participants' eyes open and their hands on the device. Our study included Kore Balance which evaluate dynamic and static balance with stroke and pressure of flor is arranged by physical therapist.

It used to measure stabilization of body and the maximal distance one can reach forward beyond arm's length, while maintaining a fixed base of support in the sitting and standing positions. The FRT involves positioning the participant next to a wall with their right or dominant arm raised 90°, adjacent and parallel to a yardstick. With the participant's hand in a fist and feet not lifting or moving, the maximum distance a participant is able to reach forward from an initial upright posture to maximal leaning posture is recorded. The position of the knuckle of the third metacarpophalangeal is recorded. The FRT displaces the participant's centre of gravity and gives a measure of stability and postural control. A reach of less than or equal to 15 cm was found to be predictive of a fall in older patients with acute stroke. FRT scores were categorized as less than 25.4 cm (higher risk of falling), as more than 25.4cm (lower risk of falling).

It used to measure level of postural control. PASS scale designed to evaluate and observe postural stability and postural control in patients with acute stroke. This scale contains 12 four-level (0,1,2,3) items of modified difficulty for evaluating ability to maintain or change given lying, sitting ot standing posture. A score of 0 on the PASS indicates can not perform, while score of 36 indicates that patients with acute stroke can perform without help.

It used to measure level of ambulation. Functional Ambulation Scale including nonfunctional(0 point), level 2(1 point), level 1(2 points), controlled dependence (3 points), independence on smooth grade (4 points), independence (5 points). Our patients with acute stroke had high risk of falling so we increase gradually difficulties of exercises and evaluate with FAS. A scores of 0, 1,2 on the FAS indicate can not independence ambulation physically, while scores of 3, 4, 5 indicate can independence ambulation physically.

It used to measure level of pain.The Visual Analogue Scale (VAS) was used to evaluate the hemiplegic upper and lower extremity pain with activation, resting and night associated with spasticity. A score of 0 on the VAS is defined as no pain and a score of 10 as severe pain .

It used to measure muscle tone. The Modified Ashworth Scale (MAS) was used to determine upper and lower extremity spasticity. The MAS uses a five-point scale to score the average resistance to passive movement for each joint. A score of 0 on the MAS indicates no increase in muscle tone, while a score of 4 indicates that the affected part is rigid. MAS scores (0, 1, 1+, 2, 3, and 4) were assigned numerical modified, whereby for example, a score of 1 + was assigned the value of 1.5. Higher total scores indicate higher tone of muscle known as severe.

It used to measure level of sensation. The sensory examination includes pain sensation (with the pin-prick), light touch sensation( with the brush or cotton wool), cold ( stimulated with cold pack), stereognosis, dysdiadochokinesia and tactile stimulation. The regions of sensory testing were check, arm, hand , trunk, leg, foot. When patients with acute stroke were evaluated sensory system, patients's eyes closed and with the needle and brush at intervals approximately 5 seconds. Sensory examination of affected side comprised with contralateral known as asymptomatic side. Sensory impairment was graded as success and unsuccess.

Elisa Çalışgan

The Effects of Somatosensorial and Vestibular Rehabilitation Additional Conventional Therapy on Balance in Patients with Acute Stroke

İnonu University

Experimental, Randomized Controlled Study

Participants didn't know taking which exercise treatment methods.

25 stroke patients between the ages of 18-80, stroke duration of less than 2 months and not more than 2 years whose MMSE scores equal or above the 25 will be included in this study. Oculus Rift and Leap motion will be used to create an immersive interactive environment. Modified Ashworth Scale (MAS), Functional independence scale, self-care questionnaire,Action Research Arm Test, Fugl meyer upper extremity motor evaluations will be applied just before the rehabilitation program, after the application and at the end of 6 weeks.

25 stroke patients between the ages of 18-80, stroke duration of less than 2 months and not more than 2 years whose MMSE scores equal or above the 25 will be included in this study. Oculus Rift a will be used to create an immersive visual environment.Patient will be watching the premade scenarios without interaction. Modified Ashworth Scale (MAS), Functional independence scale, self-care questionnaire, Action Research Arm Test, Fugl meyer upper extremity motor evaluations will be applied just before the rehabilitation program, after the application and at the end of 6 weeks.

Stroke

Rehabilitation

Patients will use virtual reality d4evice to play task oriented games like bowling, arrow shooting and home activity simulations which focuses upper extremity abduction, flexion and rotation movements. Each session will be a total of 45 minutes divided to 3 15 minute games. Sessions will held for 6 weeks each monday, wednesday and friday at same time for each patient.
In addition to the virtual reality treatment program conventional rehabilitation therapies including neurodevelopmental facilitation techniques, physiotherapy, and occupational therapy and, where necessary, speech therapy will be applied according to the needs of the patient.

Intervention

The control group will be included in the virtual reality program only focusing on visual scenes without upper extremity interaction. Bobath therapy, walking exercises, upper extremity active exercises, proprioceptive neuromuscular facial techniques will be applied to the control group for 6 weeks.

Control

Abant Izzet Baysal University

Effect of Immersive Virtual Reality Usage on Upper Extremity Function in Stroke Patients

Effect of Immersive Virtual Reality Usage on Upper Extremity Function in Stroke Patients: A Prospective, Double Blinded, Randomized Controlled Clinical Trial

Evaluates and measures recovery in post-stroke hemiplegic patients. Motor Test requires Tennis ball, A small spherical shaped container, A tool to administer reflex tests, Enough space is needed for a patient to move around freely, if possible space should be a quiet

Measures the level of a patient's disability and indicates how much assistance is needed for the individual to carry out activities of daily living

Purpose of PASS is to demonstrate independence, adequacy, and safety are rated on four-point scales.

Assesses upper limb functioning using observational methods. Focuses on grip, grasp and pinch motions of hand

After publication of article all outcomes will be open to others researches with an excel data sheet. Researchers can contact corresponding researcher with his contact mail and request data.

Patients' information and contact will be obtaioned from neurologist and willing participant's gender, age and stroke onset data will be processed with a random number generator. Patients will divide into two groups as intervention and control with a normal distrubution of gender, age and stroke onset.

Both group will recevie conventional stroke rehabilitation. Intervention group will receive a Oculus Rift+Leap motion tracking supported upper extremity activities and control group will receive a sham virtual reality on focusing visual scenes without interaction.
Outcomes will be recorded by physical therapist using SPSS and groups would not be specified with letter. Statistical analysis will be conducted by another researcher who does not aware of groups given numbers on SPSS.

spinal fluid and blood sample for identification of different factors

Dementia

lumbar puncture

World alzheimer repport 2009: alzheimer's disease association

World Alzheimer repport 2010: alzheimer's disease association

About dementia: Alzheimer's disease association

apraxias/kopfschmerz

The Effects of Somatosensory and Vestibular Rehabilitation Additional Conventional Therapy on Balance in Patients With Acute Stroke.

Effect of Immersive Virtual Reality Usage on Upper Extremity Function in Stroke Patients

IGF and Other Neurotrophic Factors in Patients With Dementia

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