JMIR Publications

ABSTRACT

Background:

Walking recovery post-stroke can be slow and incomplete. Determining effective stroke rehabilitation frequency requires assessment of neuroplasticity changes. Neurobiological signals from electroencephalogram (EEG) can measure neuroplasticity through incremental changes of these signals after rehabilitation. However, changes seen with different frequency of rehabilitation require further investigation. It is hypothesised that the association between the incremental changes from EEG signals and the improved functional outcome measure scores are greater in higher rehabilitation frequency, implying enhanced neuroplasticity changes.

Objective:

The purpose of this study is to identify the changes in the neurobiological signals from EEG, to associate these with functional outcome measures scores, and to compare their associations in different therapy frequency for gait rehabilitation among subacute stroke individuals.

Methods:

A randomised, single-blinded controlled study among subacute stroke patients with two groups: interventional group (IG) and control group (CG). Each participant in IG and CG will receive three times a week (high frequency) and once a week (low frequency) therapy sessions respectively, for a total of 12 consecutive weeks. Each session will last for an hour with strengthening, balance and gait training. Main variables to be assessed are the 6-Minute Walk Test (6MWT), Motor Assessment Scale (MAS), Berg Balance Scale (BBS), Modified Barthel Index (MBI), and brainwave pattern from EEG signals recordings in the form of delta to alpha ratio (DAR) and delta-plus-theta to alpha-plus-beta ratio (DTABR). These will be measured at pre-intervention (R0) and post-intervention (R1).

Results:

Key analyses are to determine the changes in 6MWT, MAS, BBS, MBI, DAR, and DTABR at R0 and R1 for CG and IG. The changes in the DAR and DTABR will be analysed for association with the changes in the 6MWT, MAS, BBS and MBI to measure neuroplasticity changes for both CG and IG.

Conclusions:

These associations are expected to be positive in both groups, but the IG group would demonstrate higher correlation compared to the CG group, reflecting enhanced neuroplasticity changes and objective evalution on dose-response relationship. Clinical Trial: This study has received the ethics approval from National Medical Research Register of Malaysia, which is the formal and statutory body that governed all medical-related studies in Malaysia, with ID no. NMRR-19-3840-51591 (IIR).