Recent Advances in PT Management of Vascular Brain Diseases

Recommended Articles for Presentation

🧠 SECTION 1: ANEURYSM - PT Management

Article 1 - Case Report (Direct PT Focus)

• Authors: Thamke MV, Samal S, Vaidya BP
• Journal: Cureus | Year: 2024 | PMID: 38686235
• Key Points:
  • 65-year-old female post DACA aneurysm clipping developed right-side disability
  • PT intervention: therapeutic exercises, gait training, balance exercises, and functional training
  • Significant improvements in motor function, mobility, and functional independence
  • Highlights the value of early and focused physiotherapy post-aneurysm clipping
• Why present it: This is the most directly relevant paper - it shows a complete PT program after cerebral aneurysm surgery with measurable outcomes.

Article 2 - RCT (Neurostimulation for Aneurysmal Vasospasm)

• Authors: Rigoard P, Billot M, Moens M et al.
• Journal: Int J Environ Res Public Health | Year: 2023 | PMID: 37239562
• Key Points:
  • Prospective double-blind RCT (n=60)
  • Tested transcutaneous electrical trigeminal nerve stimulation (TNS) - a non-invasive PT modality - to reduce cerebral vasospasm after aneurysmal SAH
  • TNS did not significantly reduce infarction rate vs. sham at 3 months (23% vs. 27%)
  • Raises an important discussion: negative RCT results are publishable and useful - they refocus research
• Why present it: Great for discussing how physical/electrotherapeutic modalities are being tested in the acute aneurysm phase, and the importance of evidence-based PT.

🫀 SECTION 2: CEREBRAL THROMBOSIS/STROKE - PT Advances

Article 3 - Cochrane Review (Highest Level of Evidence)

• Authors: Laver KE, Lange B, George S, Deutsch JE, Saposnik G et al.
• Journal: Cochrane Database of Systematic Reviews | Year: 2025 | PMID: 40537150
• Key Points:
  • 190 RCTs, 7,188 participants - the largest VR rehabilitation meta-analysis to date
  • VR slightly improves upper limb function vs. alternative therapy (SMD 0.20, low certainty)
  • VR moderately reduces activity limitation (SMD 0.21, moderate certainty)
  • VR slightly improves balance (SMD 0.26, low certainty)
  • Little to no effect on gait speed or quality of life
• Why present it: This is the gold-standard Cochrane review - shows VR as a promising but not yet definitive tool in PT; excellent for showing where the field stands in 2025.

Article 4 - Systematic Review (Robotic Rehabilitation & Neuroplasticity)

• Authors: Calabrò RS, Calderone A, Simoncini L et al.
• Journal: Neuroscience and Biobehavioral Reviews | Year: 2026 | PMID: 41213447
• Key Points:
  • 25 studies reviewed (2014-2025) using neurophysiology/neuroimaging to confirm neuroplasticity
  • Robot-Assisted Gait Training (RAGT) and exoskeletons improve gait, balance, and cortical activation in stroke
  • BCI (Brain-Computer Interface) + VR + neuromodulation combinations show additive benefit
  • Changes in corticospinal excitability documented
• Why present it: Best evidence linking robotic PT directly to brain neuroplasticity - shows the mechanism behind advanced rehabilitation tech.

Article 5 - Meta-Analysis (Acupuncture + Robot Therapy)

• Authors: Li G, Wang Q, Li L et al.
• Journal: Frontiers in Neurology | Year: 2026 | PMID: 42037705
• Key Points:
  • Meta-analysis of 20 RCTs, 1,594 patients
  • Combination therapy (acupuncture + robot) significantly superior to robot alone on:
    • Fugl-Meyer Upper Extremity: +9.80 points (95% CI: 8.04-11.56)
    • Fugl-Meyer Lower Extremity: +4.00 points
    • Barthel Index: +8.29 points
  • Patients with poorer baseline function benefited most (FMA-UE < 20)
• Why present it: Shows that combining traditional (acupuncture) and advanced (robotic) PT modalities produces superior outcomes - relevant to integrative PT.

Article 6 - RCT (Robotic Bilateral vs. Unilateral Rehab)

• Authors: Mauro MC, Fasano A, Germanotta M et al.
• Journal: IEEE Trans Neural Syst Rehabil Eng | Year: 2024 | PMID: 39269794
• Key Points:
  • Pilot RCT using quantitative EEG to measure brain symmetry during robot rehab
  • Bilateral robotic training restored interhemispheric symmetry in delta/theta bands (not maintained at follow-up)
  • Both groups showed clinical improvement; bilateral group showed neural reorganization
• Why present it: Bridges the gap between clinical PT outcomes and neuroimaging evidence - great for a neuro-PT presentation.

Article 7 - Systematic Review (Early Mobilization - Timing)

• Authors: Miranda JMA, Borges VM, Bazan R et al.
• Journal: Topics in Stroke Rehabilitation | Year: 2023 | PMID: 34927568
• Key Points:
  • 7 studies, 8,663 patients
  • Optimal timing: >24 hours post-stroke (not ultra-early) for safe mobilization
  • Duration: 15-45 minutes/session, 1-3 times/day
  • Priority activities: sitting → standing → walking (progressive mobilization)
  • Reduces complications and improves functional capacity
• Why present it: Establishes the evidence base for when and how to start PT after stroke - foundational and clinically actionable.

Article 8 - RCT (Early Mobilization Post-Thrombolysis/Thrombectomy)

• Authors: Yen HC, Pan GS, Jeng JS, Chen WS
• Journal: Neurorehabilitation and Neural Repair | Year: 2024 | PMID: 38426480
• Key Points:
  • RCT of 122 patients treated with IVT or mechanical thrombectomy
  • Early mobilization (30 min/day, 5 days/week) was safe after both procedures
  • IVT + early mobilization group showed significantly better FIM-motor scores within 1 month
  • Key finding: PT is safe even after thrombolysis and thrombectomy for cerebral thrombosis
• Why present it: Directly addresses PT management after the main medical treatment for cerebral thrombosis (thrombolysis/thrombectomy) - very clinically relevant.

Suggested Presentation Structure