Yea‐Ru Yang

National Yang Ming Chiao Tung University

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Ray‐Yau Wang

National Yang Ming Chiao Tung University

Shih‐Jung Cheng

National Taiwan University

Kwong-Kum Liao

National Yang Ming Chiao Tung University

Nai-Chen Yeh

National Yang Ming Chiao Tung University

Chia‐Feng Lu

National Yang Ming Chiao Tung University

Shih-Jung Cheng

Mackay Memorial Hospital

Pei‐Ling Wong

National Yang Ming Chiao Tung University

Yih‐Ru Wu

Beijing Anding Hospital

Heng-Chih Chang

Asia University

Pei-Yi Lin

National Cheng Kung University

Cooperative Institutions

National Yang Ming Chiao Tung University

137

Taipei Veterans General Hospital

National Taiwan University

National Yang Ming University Hospital

National Taiwan University Hospital

National Taipei University

China Medical University

National Cheng Kung University

Cheng Hsin General Hospital

Chang Gung University

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Motor Performance Improved by Exercises in Cerebral Ischemic Rats

Journal of Motor Behavior (2012)

Yea‐Ru Yang Heng-Chih Chang Paulus S. Wang Ray‐Yau Wang

ABSTRACT Physical exercise may induce neuroprotective effects against brain damage after stroke. The authors aimed to investigate the effects of various exercises on motor function, striatal angiogenesis, and infarct volume in cerebral ischemic rats. Adult male Sprague Dawley rats were subjected to middle cerebral artery occlusion and randomly assigned to 1 of the 4 groups: Rota-rod training, lower speed treadmill training, higher speed treadmill training, or no exercise control. Motor function, striatal angiogenesis, and infarct volume were evaluated before or after motor training. After training, motor function and striatal angiogenesis changed significantly in Rota-rod and higher speed treadmill training groups as compared with the control group. Improvement in motor function significantly correlated with striatal angiogenesis after motor training. Infarct volumes were significantly decreased in lower and higher speed treadmill training groups. The results indicated that both motor training procedures can be used as effective training programs in stroke rehabilitation.

Treadmill

Stroke

10.1080/00222895.2012.654524

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Citations (31)

Altered corticospinal excitability of scapular muscles in individuals with shoulder impingement syndrome

PLoS ONE (2022)

Ya-Chu Chung Chao‐Ying Chen Chia‐Ming Chang Yin‐Liang Lin Kwong‐Kum Liao

The purpose of this study is to assess and compare corticospinal excitability in the upper and lower trapezius and serratus anterior muscles in participants with and without shoulder impingement syndrome (SIS). Fourteen participants with SIS, and 14 without SIS were recruited through convenient sampling in this study. Transcranial magnetic stimulation assessment of the scapular muscles was performed while the participants were holding their arm at 90 degrees scaption. The motor-evoked potential (MEP), active motor threshold (AMT), latency of MEP, cortical silent period (CSP), activated area and center of gravity (COG) of cortical mapping were compared between groups using the Mann-Whitney U tests. The SIS group demonstrated following significances, higher AMTs of the lower trapezius (SIS: 0.60 ± 0.06; Comparison: 0.54 ± 0.07, p = 0.028) and the serratus anterior (SIS: 0.59 ± 0.04; Comparison: 0.54 ± 0.06, p = 0.022), longer CSP of the lower trapezius (SIS: 62.23 ± 22.87 ms; Comparison: 45.22 ± 14.64 ms, p = 0.019), and posteriorly shifted COG in the upper trapezius (SIS: 1.88 ± 1.06; Comparison: 2.76 ± 1.55, p = 0.048) and the serratus anterior (SIS: 2.13 ± 1.02; Comparison: 3.12 ± 1.88, p = 0.043), than the control group. In conclusion, participants with SIS demonstrated different organization of the corticospinal system, including decreased excitability, increased inhibition, and shift in motor representation of the scapular muscles.

Trapezius muscle

Cog

10.1371/journal.pone.0268533

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Citations (7)

Gait Training—Induced Change in Corticomotor Excitability in Patients With Chronic Stroke

Neurorehabilitation and neural repair (2007)

Chu-Ling Yen Ray‐Yau Wang Kwong-Kum Liao Chia-Chi Huang Yea‐Ru Yang

Background. Numerous studies have reported the effects of gait training on motor performance after stroke. However, there is limited information on treatment-induced changes in corticomotor excitability. Objectives. The purpose of the study was to investigate the effects of additional gait training on motor performance and corticomotor excitability and to demonstrate the relationship between motor improvement and corticomotor excitability change in patients with chronic stroke. Methods. Fourteen patients were randomly assigned to the experimental or control group. Participants in both groups participated in general physical therapy. Those in the experimental group received additional body weight− supported treadmill training for 4 weeks. All participants received baseline and posttreatment assessments. The outcome measures included assessment of the Berg Balance Scale (BBS) and gait parameters. Focal transcranial magnetic stimulation was used to measure the motor threshold, map size, and location of the amplitude-weighted center of gravity of the motor map for the tibialis anterior (TA) and abductor hallucis (AH) muscles. Results . After general physical therapy, we noted that the patients showed an improvement only in walking speed and cadence, and there were no significant changes in corticomotor excitability. After additional gait training, participants improved significantly on BBS score, walking speed, and step length. Moreover, the motor threshold for TA decreased significantly in the unaffected hemisphere. The map size for TA was increased in both hemispheres, whereas that for AH was increased only in the affected hemisphere. There were significant differences between the change scores of the groups in terms of walking speed, step length, and motor threshold for TA in the unaffected hemisphere and map size for AH in the affected hemisphere. Additionally, the changes in corticomotor excitability correlated with functional improvement. Conclusions . Additional gait training may improve balance and gait performance and may induce changes in corticomotor excitability.

Berg Balance Scale

Cadence

Treadmill

Stroke

Tibialis anterior muscle

10.1177/1545968307301875

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Citations (136)

Virtual reality-based training improves community ambulation in individuals with stroke: A randomized controlled trial

Gait & Posture (2008)

Yea‐Ru Yang Meng-Pin Tsai Tien‐Yow Chuang Wen-Hsu Sung Ray‐Yau Wang

Stroke

Treadmill

10.1016/j.gaitpost.2007.11.007

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Citations (315)

Novel gait training alters functional brain connectivity during walking in chronic stroke patients: a randomized controlled pilot trial

Journal of NeuroEngineering and Rehabilitation (2019)

I‐Hsuan Chen Yea‐Ru Yang Chia‐Feng Lu Ray‐Yau Wang

A recent study has demonstrated that a turning-based treadmill program yields greater improvements in gait speed and temporal symmetry than regular treadmill training in chronic stroke patients. However, it remains unknown how this novel and challenging gait training shapes the cortico-cortical network and cortico-spinal network during walking in chronic stroke patients. The purpose of this study was to examine how a novel type of gait training, which is an unfamiliar but effective task for people with chronic stroke, enhances brain reorganization. Subjects in the experimental and control groups received 30 min of turning-based treadmill training and regular treadmill training, respectively. Cortico-cortical connectivity and cortico-muscular connectivity during walking and gait performance were assessed before and after completing the 12-session training. Eighteen subjects (n = 9 per group) with a mean age of 52.5 ± 9.7 years and an overground walking speed of 0.61 ± 0.26 m/s consented and participated in this study. There were significant group by time interactions for gait speed, temporal gait symmetry, and cortico-cortical connectivity as well as cortico-muscular connectivity in walk-related frequency (24–40 Hz) over the frontal-central-parietal areas. Compared with the regular treadmill training, the turning-based treadmill training resulted in greater improvements in these measures. Moreover, the increases in cortico-cortical connectivity and cortico-muscular connectivity while walking were associated with improvements in temporal gait symmetry. Our findings suggest this novel turning-based treadmill training is effective for enhancing brain functional reorganization underlying cortico-cortical and corticomuscular mechanisms and thus may result in gait improvement in people with chronic stroke. ACTRN12617000190303 . Registered 3 February 2017, retrospectively registered.

Treadmill

Gait training

Stroke

Chronic stroke

10.1186/s12984-019-0503-2

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Citations (19)

Treadmill Training Effects on Neurological Outcome After Middle Cerebral Artery Occlusion in Rats

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques (2003)

Yea‐Ru Yang Ray‐Yau Wang Paulus Shyi-Gang Wang Shang-Ming Yu

Treadmill training is used for promoting rhythmical vigorous walking and for task-related training in patients with stroke. The neurological impact of treadmill training has not been established. The present investigation is aimed at (1) examining neurological changes over a four-week period after middle cerebral artery occlusion (MCAO) in rats and (2) assessing the impact of one-week, two-week and four-week treadmill training in MCAO rats.Male Sprague-Dawley rats were subjected to 60-minute right MCAO. All rats were randomly assigned to one of seven groups. Infarct volume and neurological score were measured.Rats sacrificed 24 hours post MCAO had the largest infarct volumes (171.4 +/- 14.4 mm3) and the highest neurological score (median: 2, range: 1-3). We noted that without treadmill training, infarct sizes and neurological score diminished with time. Treadmill training for at least one week further reduced infarct volume and significantly improved neurologic function in MCAO rats.Treadmill training after focal cerebral ischemia significantly improves neurological outcome in MCAO rats. Treadmill training may be beneficial for ischemic brain recovery.

Treadmill

10.1017/s0317167100002687

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Citations (45)

Positive Effects of Specific Exercise and Novel Turning-based Treadmill Training on Turning Performance in Individuals with Parkinson’s disease: A Randomized Controlled Trial

Scientific Reports (2016)

Fang-Yu Cheng Yea‐Ru Yang Li-Mei Chen Yih‐Ru Wu Shih‐Jung Cheng

Abstract Two different training strategies to improve turning performance in individuals with Parkinson’s disease (PD) were designed and investigated in this study. Subjects were randomly assigned to a specific exercise group, turning-based training group, or control group to receive training that emphasized balance and strengthening, turning-based treadmill training, and general exercise training, respectively. A total of 12 30-min training sessions followed by 10 min of turning training on a level surface were administered over 4 to 6 weeks. The results (n = 12 for each group) showed that both the specific exercise and turning-based training group experienced improved turning performance, the primary outcome, compared with the control group (specific exercise, 33% change, p = 0.016; turning-based training, 35% change, p = 0.021). For the secondary outcomes, the specific exercise group performed better than the control group on the Tinetti balance scale, limit of stability test and lower extremity extensor and abductor strength. The turning-based training groups performed better than the control group in sensory organization and ankle plantar flexor strength. In summary, specific exercise training and turning-based treadmill training were both effective in improving turning performance in participants with PD. However, the improvements in turning performance of these two groups resulted from improving different aspects of impairment in individuals with PD.

Tinetti test

Posturography

Treadmill

10.1038/srep33242

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Citations (31)

Effects of inclined treadmill training on inadequate ankle control during walking in individuals after stroke: A pilot randomized controlled trial

Neurorehabilitation (2022)

Ju-Yu Cheng Yea‐Ru Yang Nai-Chen Yeh Hsin Cho Vinchi Wang

BACKGROUND: Inadequate ankle control influences walking ability in people after stroke. Walking on inclined surface activates ankle muscles and movements. However, the effect of inclined treadmill training on ankle control is not clear. OBJECTIVE: To investigate the effects of inclined treadmill training on ankle control in individuals with inadequate ankle control after chronic stroke. METHODS: This was a randomized single-blinded study. Eighteen participants were randomly assigned to receive 12 sessions of 30 min inclined (n = 9) or regular (n = 9) treadmill training and 5 min over-ground walking training. The outcomes included ankle control during walking, muscle strength of affected leg, walking performance, and stair climbing performance. RESULTS: Inclined treadmill training significantly improved ankle dorsiflexion at initial contact (p = 0.002), increased tibialis anterior activities (p = 0.003 at initial contact, p = 0.006 in swing phase), and decreased dynamic plantarflexors spasticity (p = 0.027) as compared with regular treadmill training. Greater improvements were also shown in stair climbing with affected leg leading (p = 0.006) and affected knee extensors strength (p = 0.002) after inclined treadmill training. CONCLUSIONS: Inclined treadmill training was proposed to improve inadequate ankle control after chronic stroke. Inclined treadmill training also improved the stair climbing ability accompanied with increased muscle strength of the affected lower extremity.

Treadmill

Stair climbing

Stroke

Climbing

10.3233/nre-220002

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Citations (0)

Brain Activation and Gait Alteration During Cognitive and Motor Dual Task Walking in Stroke—A Functional Near-Infrared Spectroscopy Study

IEEE Transactions on Neural Systems and Rehabilitation Engineering (2018)

Yan‐Ci Liu Yea‐Ru Yang Yun‐An Tsai Ray‐Yau Wang Chia‐Feng Lu

This paper investigated the effects of cognitive and motor dual tasks on gait performance and brain activities in stroke; 23 stroke subjects performed single walking (SW), walking while performing cognitive task (WCT), and walking while performing motor task (WMT) at self-selected speed. The gait performance was recorded, including speed, cadence, stride time, stride length, and dual task cost (DTC). Brain activities in prefrontal cortex, premotor cortex (PMC), and supplementary motor areas (SMAs) were measured by functional near-infrared spectroscopy during walking. Results showed significant decrease in speed, cadence, and stride length, and increase in stride time was noted in both WCT and WMT compared with SW condition. There was no significant difference in DTC between WCT and WMT. The non-lesioned SMA and most channels of bilateral PMCs exhibited significant increases in the index of hemoglobin differential during WCT and WMT compared with SW. Moreover, gait performance was negatively correlated with bilateral PMCs and lesioned SMA during different walking tasks. In conclusion, deteriorated gait performance was noted in stroke attempting dual tasks. There is no significant difference between the two dual tasks on gait performance. Nevertheless, SMA and especially PMC were crucial in cognitive and motor dual task walking after stroke.

Cadence

STRIDE

Supplementary motor area

Premotor cortex

Stroke

Functional near-infrared spectroscopy

10.1109/tnsre.2018.2878045

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Citations (54)

Effects of neuromuscular electrical stimulation on gait performance in chronic stroke with inadequate ankle control - A randomized controlled trial

PLoS ONE (2018)

Yea‐Ru Yang Pei-Ling Mi Shih-Fong Huang Shiu-Ling Chiu Yan-Ci Liu

Neuromuscular electrical stimulation (NMES) has been used to improve muscle strength and decrease spasticity of the ankle joint in stroke patients. However, it is unclear how NMES could influence dynamic spasticity of ankle plantarflexors and gait asymmetry during walking. The study aimed to evaluate the effects of applying NMES over ankle dorsiflexors or plantarflexors on ankle control during walking and gait performance in chronic stroke patients. Twenty-five stroke participants with inadequate ankle control were recruited and randomly assigned to an experimental or a control group. The experimental group received 20 minutes of NMES on either the tibialis anterior muscle (NMES-TA) or the medial gastrocnemius muscle (NMES-MG). The control group received 20 minutes of range of motion and stretching exercises. After the 20 minutes of NMES or exercises, all participants received ambulation training for 15 minutes. Training sessions occurred 3 times per week for 7 weeks. The pre- and post-training assessments included spatio-temporal parameters, ankle range of motion, and dynamic spasticity of ankle plantarflexors during walking. Muscle strength of ankle dorsiflexors and plantarflexors as well as static spasticity of ankle plantarflexors were also examined. The results showed that the static and dynamic spasticity of ankle plantarflexors of the NMES-TA group were significantly decreased after training. Reduction in dynamic spasticity of ankle plantarflexors of the NMES-TA group was significantly greater than that of the NMES-MG group. When compared to the control group, the NMES-TA group had greater improvements in spatial asymmetry, ankle plantarflexion during push off, and muscle strength of ankle dorsiflexors, and the NMES-MG group showed a significant decrease in temporal asymmetry. In summary, NMES on ankle dorsiflexors could be an effective management to enhance gait performance and ankle control during walking in chronic stroke patients. NMES on ankle plantarflexors may improve gait symmetry.

Stroke

10.1371/journal.pone.0208609

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Citations (45)