TY  - BOOK
AU  - Gehad Mohamed Mohamdeen Ali Mohamed,
AU  - Nahed Ahmed Salem
AU  - Enas Elasyed Mohamed
AU  - Amr Hassan Elhosny
AU  - Abdelaziz Abdelaziz  Mohammed ELSherif
TI  - Cognitive Multisensory Rehabilitation on Upper Limb Functions and Fatigue  in different grades of Spasticity in Stroke Patients
U1  - 615.82 
PY  - 2024///
KW  - Physical Therapy
KW  - qrmak
KW  - Stroke
KW  - Upper limb functions
KW  - Cognitive multi-sensory rehabilitation
KW  - brain-derived neurotrophic factors
N1  - Thesis (M.Sc.)-Cairo University, 2024.; Bibliography: pages 88-103.; Issued also as CD
N2  - Background: Stroke is one of the most common causes of disability worldwide 
and upper limb dysfunction is the most challenging morbidity among stroke 
patients. Upper limb rehabilitation lacks focus on the multi-sensory aspects to 
optimize the motor functional output. 
Objective: To assess the impact of cognitive-multisensory rehabilitation (CMR) on 
upper extremities functions and fatigue in different grades of spasticity in stroke 
patients. 
Subjects and Methods: Forty chronic stroke were selected (1,1+, and 2 according 
to the Modified Ashworth Scale). The patients were randomly assigned into two 
equal groups GI and GII. Group I (n = 20) received CMR and conventional 
physical therapy program. Group II (n = 20) received the same conventional 
physical therapy program. This study was performed for four weeks; three sessions 
every week. Upper limb function was evaluated utilizing the Fugl Myer Scale, box 
and blocks test for gross manual dexterity, and an electronic dynamometer for hand 
grip strength. Brain-derived neurotrophic factor level was assessed to determine 
the effect of CMR on motor learning. Fatigue was evaluated utilizing the Fatigue 
Assessment Scale. 
Results: Both mild and moderate spastic stroke patients in the study group gained 
a significant increase in BBT scores, FMA scores, and BDNF levels as well as a 
significant reduction of the FAS scores. Moderate spastic patients in the study 
group showed a significant improvement in the hand grip strength scores. 
There was a significant increase in mild spastic patients scores in both pre-and 
post-treatment in the BBT, FMA, and hand grip strength scores upon moderate. 
There was no significant effect of spasticity in FAS and BDNF in both pre- and 
post-treatment. 
Conclusion: Cognitive multi-sensory rehabilitation improved functional recovery 
of the upper extremities, and the moderate spastic patients gained a significant 
improvement over the mild spastic patients. So, CMR could be beneficial in severe 
spasticity. The level of BDNF increased after cognitive multisensory rehabilitation. 
Post-stroke fatigue decreased after cognitive multi-sensory rehabilitation in chronic 
stroke patients. Post-stroke spasticity could affect upper limb function scores in 
BBT, FMA, and hand grip strength, but could not affect BDNF levels or FAS 
levels.; شملت الدراسة أربعون مريضا من الذكور يعانون من  سكته دماغيه و شد تشنجي خفيف ومتوسط.  و تراوحت مده الاصابه ما بين 6: 18 شهرا. وقسمت الحالات عشوائيا إلى مجموعتين. تلقت المجموعة الأولى ( مجموعه الدراسه و عددها عشرون مريضا) التأهيل الإدراكي متعدد الحواس على وظائف الأطراف العلوية وبرنامج  مختار من العلاج الطبيعي لتاهيل السكته الدماغيه ، والمجموعة الثانية( المجموعه الضابطه  و عددها عشرون مريضا) تلقت نفس البرنامج مختار من العلاج الطبيعي لتاهيل السكته الدماغيه. أجريت هذه الدراسة لمدة أربعة أسابيع ، ثلاث جلسات كل أسبوع. تم تقييم وظيفة الطرف العلوي باستخدام مقياس لوظيفه الطرف العلوي و اختبار الصندوق والكتل للبراعة اليدوية الإجمالية وقوة قبضة اليد باستخدام مقياس ديناميكي إلكتروني و تم ايضا قياس منسوب عوامل التغذية العصبية  لتدل علي قدره المخ علي التعلم الحركي و ايضا تم تقييم التعب باستخدام مقياس تقييم الاجهاد. خلصت الدراسة إلي أن إعادة التأهيل المعرفي متعدد الحواس  يحسن  وظائف الطرف العلوي   في حالات السكتة الدماغية و يقلل من  الشعور بالاجهاد
ER  -