Newborns who are born premature or suffer brain injury at birth are at risk for motor problems that may cause weakness in reaching and grasping on one side of the body. In older children, therapists may use a hand mitt and restraint for the stronger arm, to encourage use of the weaker side, called constraint-induced movement therapy (CIMT). Even with the high intensity therapy of CIMT, it typically takes between 40-120 hours total treatment time for most children to improve their motor skills. A non-invasive form of nerve stimulation, transcutaneous auricular vagus nerve stimulation (taVNS), stimulates a nerve by the ear that enhances learning motor skills. taVNS stimulation will be triggered by EMG sensors which detect muscle activity. The purpose of this study is to evaluate the safety and effectiveness of taVNS to improve motor skills when paired with CIMT in infants with one-sided weakness at 6-24 months of age.
The purpose of this study is to compare the effect of a combination of art therapy (AT) and physical therapy (PT) to PT only in children undergoing hematopoietic cell transplant (HCT). Each child will receive daily AT and PT or only PT for 5 days per week for 2 weeks. These sessions will begin approximately on day 15 following the transplant. Prior to starting the sessions and following 2-weeks of sessions, we will measure your self-care and mobility skills. During each session, heart rate variability (i.e., time between heart beats) using a small monitor on the chest (about the size of a quarter), walking distance using an accelerometer (similar to wearing a watch), and self-reported happiness and excitability will be measured. Although results cannot be guaranteed, it is expected each group will benefit and demonstrate improvements in emotional state, self-care, and mobility skills.
This study will consist of patients 12 years and older undergoing ACL reconstruction using a quadriceps or bone-patella tendon bone (BTB) graft. The patients will be randomized to adductor canal block alone, or adductor canal block + iPACK block. The primary goal will be to determine the differences in postoperative pain during the first 72 hours when comparing the two groups. Secondary outcomes will include opioid utilization during the first 72 hours postoperatively and range of motion including terminal knee extension at postoperative follow-up visits.
The purpose of this research study is to study four treatments for chronic low-back pain to learn whether or not certain treatments work better for people with certain characteristics.The study's main goal is to find a way to match treatments to low-back pain patients based on their characteristics and how they responded to treatments they have used before.
This study is a multi-site, sequential, multiple assignment randomized trial (SMART) designed to meet the primary objective of estimating an algorithm for optimally assigning evidence-based interventions for chronic low-back pain. The trial is based on an individual patient's phenotypic markers and response to treatment. Interventions being evaluated in this trial are: (1) acceptance and commitment therapy (ACT), (2) duloxetine, (3) enhanced self-care (ESC), and (4) evidence-based exercise and manual therapy (EBEM).
Approximately 80% of stroke survivors have hand impairment. A majority do not fully recover their hand function despite completing standard rehabilitation. Limited hand function results in learned non-use not only of the hand but also of the whole arm. This limited upper limb movement results in decreased independence and poor quality of life. It is known that training for proper movement patterns is important especially early in rehabilitation. The purpose of this project is to determine if training using hand exoskeleton to improve finger movement is feasible in stroke patients. Stroke survivors will receive training with 4 different control strategies to improve finger joint coordination.
Constraint-induced movement therapy (CIMT) is the most efficacious treatment for children with hemiparesis from a perinatal arterial stroke but instead, weekly low-dose OT and/or PT is typical. The aims of this study are to compare 2 high doses of treatment to usual care in helping infants improve skills on the hemiplegic hand/arm and to improve bimanual activities. In addition, the association with gross motor, language and cognition will be explored.
Newborns who are born premature or suffer brain injury at birth are at risk for motor problems that may cause weakness in reaching and grasping on one side of the body. In older children, therapists may use a hand mitt and restraint for the stronger arm, to encourage use of the weaker side, called constraint-induced movement therapy (CIMT). Even with the high intensity therapy of CIMT, it typically takes between 40-120 hours total treatment time for most children to improve their motor skills. A non-invasive form of nerve stimulation, transcutaneous auricular vagus nerve stimulation (taVNS), stimulates a nerve by the ear that enhances learning motor skills. The purpose of this study is to evaluate the safety and effectiveness of taVNS to improve motor skills when paired with CIMT in infants with one-sided weakness at 6-18months of age.
The study team is recruiting 20 adults with spasticity due to chronic stroke and 20 adults with no neurological injuries for a 4 day study over 1 week. In people with chronic stroke, one of the most common and disabling problems is spasticity (increased muscle tone or muscle stiffness). The purpose of this research study is to examine effects of dry needling on the nervous system (pathways between the muscle, spinal cord, and brain) in people with spasticity due to chronic stroke. Dry needling is a procedure in which a thin, stainless steel needle is inserted into your skin to produce a muscle twitch response. It is intended to release a knot in your muscle and relieve pain.
The total study duration is 4 visits over one week. The first visit will take about 1.5 hours, during which the study team will determine the best electrode placement and create a removeable cast of your arm or leg to aid in placing electrodes in the next visits. The second visit will take about 3 hours, during which dry needling will take place, and the fourth and fifth visits will take about 1.5 hour. During all visits you will be asked to participate in examinations of reflexes (muscle responses to non-invasive nerve stimulation) and arm/leg function.
Patients of age ≥40 to <85 years diagnosed with a rotator cuff tear (with MRI confirmation) who are fit for either arthroscopic rotator cuff surgery or physical therapy will be recruited. The study will compare pain and function in patients undergoing operative versus non-operative treatment of Non traumatic rotator cuff tears at 12 months of follow-up.
Hand disability after stroke has a profound negative impact on functional ability and independence. Hand therapy may be augmented with sensory stimulation for better outcomes. We have developed a novel sensory stimulation - unfelt vibration applied via a wristwatch. In this study, we will determine if combining this stimulation with hand task practice is superior to hand task practice alone.