bluuebunny/crossref_metadata_2025 huggingface dataset:
Can stroke survivors with severe upper arm disability achieve a clinically important change in arm function during inpatient rehabilitation? A multicentre, prospective, observational study
Authors: Hayward Kathryn S. , Kuys Suzanne S. , Barker Ruth N. , Brauer Sandra G.
Published: December 2019

Background:

Severe arm disability is considered to indicate poor potential to recover arm function.

Objective:

Determine if stroke survivors with severe upper arm disability can achieve a clinically important change in arm function on discharge from inpatient rehabilitation.

Methods:

618 stroke survivors from 16 inpatient rehabilitation units were assessed on admission and discharge using the Motor Assessment Scale Item 6 Upper Arm Function (MAS6). Admission scores defined participants with severe (MAS6 ≤2) and mild/moderate (MAS6 >2) upper arm disability. A clinically important change was evaluated according to: 1) statistical significance; 2) minimal clinical importance difference (MCID); and 3) shift in disability status i.e., severe to mild/moderate. Achievers of a MCID and shift were compared to non-achievers.

Results:

Stroke survivors with severe upper arm disability (n = 226) demonstrated a significant improvement in arm function (p < 0.001) at discharge. A MCID was achieved by 68% (n = 155) and a shift from severe to mild/moderate upper arm disability on discharge by 45% (n = 102) of participants. Achievers had a significantly shorter interval from stroke onset to inpatient rehabilitation admission (p < 0.002).

Conclusion:

Stroke survivors with severe upper arm disability can achieve a clinically important change during inpatient rehabilitation.
Working memory training and poetry-based stimulation programs: Are there differences in cognitive outcome in healthy older adults?
Authors: Zimmermann Nicolle , Netto Tania Maria , Amodeo Maria Teresa , Ska Bernadette , Fonseca Rochele Paz
Published: December 2019

Background:

Neuropsychological interventions have been mainly applied with clinical populations, in spite of the need of preventing negative changes across life span. Among the few studies of cognitive stimulation in elderly, surprisingly there is no enough research comparing direct and indirect active stimulation programs.

Objective:

This study aims to verify wheter there are differences between two cognitive interventions approaches in older adults: a structured Working Memory (WM) Training Program versus a Poetry-based Stimulation Program.

Methods:

Fourteen older adults were randomly assigned to participate into one of the two intervention groups. The assessed neurocognitive components were attention, episodic and working memory, communicative and executive functions. WM Training activities were based on Baddeley's model; Poetry-based Stimulation Program was composed by general language activities. Data were analyzed with one-way ANCOVA with Delta scores and pre and post-training tests raw scores.

Results:

WM group improved performance on WM, inhibition, and cognitive flexibility measures, while Poetry group improved on verbal fluency and narrative discourse tasks.

Discussion:

Both approaches presented benefits; however WM Training improved its target function with transfer effects to executive functions, being useful for future studies with a variety of dementias. Poetry-based Stimulation also improved complex linguistic abilities. Both approaches may be helpful as strategies to prevent dysfunctional aging changes.
Is the basic trunk control recovery different between stroke patients with right and left hemiparesis?
Authors: Pappalardo A. , Ciancio M.R. , Patti F.
Published: December 2019

Background:

Basic trunk movement control is often impaired after stroke and its recovery is a “miliary stone” in rehabilitation.

Objective:

In this prospective, observational, parallel-group study, we investigated whether there are differences in terms of post-stroke recovery of basic trunk control between patients with left or with right hemiparesis.

Methods:

We recruited 94 patients with loss of postural trunk control due to stroke. Patients were divided into Group A (48 patients with left hemiparesis) and Group B (46 patients with right hemiparesis). We administered the Trunk Control Test (TCT) and the 13 motor items included on the Functional Independence Measure. Evaluation was performed at admission (To) and discharge (T1).

Results:

TCT increased respectively from 46.7 ± 23.3 to 62.6 ± 19.5 (mean ± standard deviation-SD, p < 0.0001) in Group A and from 49.4 ± 23.2 to 79.1 ± 14.4 (mean ± SD, p < 0.0001) in Group B. TCT resulted significantly higher in Group B than in Group A, at T1 (p < 0.0001). No significant difference was found for motFIM at T1.

Conclusion:

Side of hemiparesis could affect the degree of recovery of basic trunk control after stroke. Patients with right hemiparesis benefit more than those with left hemiparesis. Improvement of basic trunk control was not responsible for an advantage on functional independence.
Temporal recovery of activities of daily living in the first year after ischemic stroke: A prospective study of patients admitted to a rehabilitation unit
Authors: Kong Keng-He , Lee Jeanette
Published: December 2019

Background:

The ability to perform basic activities of daily living (ADL) independently is a marker of functional recovery after a stroke. However, there few studies documenting their long-term recovery.

Objective:

To document temporal recovery of activities of daily living (ADL) and establish predictors of ADL in a cohort of ischemic stroke patients in the first year after stroke.

Methods:

Prospective cohort study of 163 patients with first-ever ischemic stroke admitted to a rehabilitation centre. The Modified Barthel Index (MBI) was used to measure the patient's ability to perform the following 10 ADLs: feeding, grooming, dressing, bathing, toileting, bladder and bowel continence, transfers, ambulation and stair climbing. It was assessed on rehabilitation admission, discharge, and at 3, 6 and 12 months after stroke. The Motricity Index was used to measure motor power of the hemiplegic limb.

Results:

The mean age was 63.8 (10.7) years, with 111 males and 52 females. The mean total MBI scores on rehabilitation admission, rehabilitation discharge, 3, 6 and 12 months after stroke were 41.3 (24.6), 72.9 (20.5), 88.4 (18.6), 90.5 (17.2) and 84.2 (20.4) respectively. Median scores of feeding, grooming, toileting, bladder/bowel continence, transfers and ambulation plateaued by 3 months after stroke. Median scores of dressing and stair climbing plateaued at 6 months and that for bathing, 12 months after stroke. None of the patients were functionally independent (defined as MBI score of 100) on rehabilitation admission, but this improved to 8.6% on discharge, and 32.1%, 41.4% and 50.3% at 3, 6 and 12 months after stroke respectively. The MBI and Motricity scores were strongly correlated at all periods of follow up (r = 0.67 to 0.69, p < 0.0001). Univariate analysis showed that age, neglect, a cortical stroke, admission MBI, NIHSS, Motricity Index and Abbreviated Mental Score scores were predictors of functional independence at 12 months after stroke. On logistic regression, only age remained significant, younger patients being more likely than older patients to be functionally independent.

Conclusion:

Most recovery of ADL occurs by 3 months after stroke. For individual ADLs, dressing, stair climbing and bathing appear to take a longer time to recover. Older age was a negative predictor of functional dependence at 12 months after stroke.
Metacognitive knowledge and online awareness in persons with multiple sclerosis
Authors: Goverover Yael , Genova Helen , Griswold Hali , Chiaravalloti Nancy , DeLuca John
Published: December 2019

Background:

Recent models of self-awareness draw a distinction between intellectual awareness (metacognitive knowledge of disabilities) and online awareness of errors (emergent and anticipatory awareness).

Objective:

The present study compared these two types of self-awareness (metacognitive knowledge of disabilities and online awareness) in individuals with multiple sclerosis (MS) and healthy participants. The relationship between self-awareness and functional performance was also examined.

Methods:

Participants included 18 individuals with MS and 16 healthy controls (HC) between the ages of 27 and 60. Intellectual awareness was assessed via discrepancy scores on the Functional Behavior Profile (FBP) between participants and their informants. Online Awareness was examined using self-prediction and self-assessment of performance on a functional task.

Results:

Participants with MS had significantly lower levels of intellectual awareness relative to HCs. The MS group demonstrated worse prediction online awareness than HCs. However, assessment online awareness did not differ between groups, indicating that experience with a task can improve online awareness in persons with MS.

Conclusion:

This study highlights the necessity of adopting a multidimensional approach to assessing the multifaceted phenomenon of self-awareness in MS. In addition, it provides initial evidence to support a self-awareness treatment model for persons with MS.
Variability of respiration and sleep during polysomnography in individuals with TBI
Authors: Lu William , Cantor Joshua , Aurora R. Nisha , Nguyen Michael , Ashman Teresa , Spielman Lisa , Ambrose Anne , Krellman Jason W. , Gordon Wayne
Published: December 2019

Background:

Obstructive sleep apnea (OSA) is commonly found in individuals with traumatic brain injury (TBI) and may exacerbate TBI-related symptoms. Nocturnal polysomnography (NPSG) is considered the gold standard for detecting the presence of sleep apnea. However, there is a limitation with its use known as the “first-night effect” (aberrant polysomnography findings on the first night in a sleep lab).

Objective:

The primary objectives were to investigate the night-to-night consistency of diagnosing and classifying obstructive sleep apnea in individuals with TBI, and ascertain if individuals with TBI are prone to a first-night effect.

Methods:

47 community-dwelling adults with self-reported mild-to-severe TBI underwent two nights of in-laboratory NPSG to examine variability between the first and second night with regards to OSA diagnosis and severity as well as sleep architecture.

Results:

OSA detection and severity were consistent from night-to-night in 89% of participants with TBI. Participants with TBI demonstrated longer REM latency on the first night compared to the second night of sleep study.

Conclusions:

These findings indicate that two nights of in-laboratory NPSG are generally consistent in reliably diagnosing OSA in individuals with TBI and that first-night effects are minimal. One night of NPSG has diagnostic utility in the evaluation of sleep disorders in individuals with TBI.
Relationship between postural alignment in sitting by photogrammetry and seated postural control in post-stroke subjects
Authors: Iyengar Y.R. , Vijayakumar K. , Abraham J.M. , Misri Z.K. , Suresh B.V. , Unnikrishnan B.
Published: December 2019

Background & objective:

This study was executed to find out correlation between postural alignment in sitting measured through photogrammetry and postural control in sitting following stroke.

Methods:

A cross-sectional study with convenient sampling consisting of 45 subjects with acute and sub-acute stroke. Postural alignment in sitting was measured through photogrammetry and relevant angles were obtained through software MB Ruler (version 5.0). Seated postural control was measured through Function in Sitting Test (FIST). Correlation was obtained using Spearman's Rank Correlation co-efficient in SPSS software (version 17.0).

Results:

Moderate positive correlation (r = 0.385; p < 0.01) was found between angle of lordosis and angle between acromion, lateral epicondyle and point between radius and ulna. Strong negative correlation (r = −0.435; p < 0.01) was found between cranio-vertebral angle and kyphosis. FIST showed moderate positive correlation (r = 0.3446; p < 0.05) with cranio-vertebral angle and strong positive correlation (r = 0.4336; p < 0.01) with Brunnstrom's stage of recovery in upper extremity.

Conclusion:

Degree of forward head posture in sitting correlates directly with seated postural control and inversely with degree of kyphosis in sitting post-stroke. Postural control in sitting post-stroke is directly related with Brunnstrom's stage of recovery in affected upper extremity in sitting.
A single case study of computerised cognitive training for older persons with mild cognitive impairment
Authors: Finn Maurice , McDonald Skye
Published: December 2019

The results of a multiple baseline single case study using computerised cognitive training in older adults with Amnestic Mild Cognitive Impairment (aMCI) are reported. Two participants each completed 40 sessions of training in two phases: an initial phase that trained attention, processing speed and cognitive flexibility, followed by a mixed memory and execution functions phase. It was hypothesised that participants would improve with practice on the trained tasks, that the benefits of training would generalise to non-trained neuropsychological probe measures, and that training would result in improved perceptions of memory and mood. Results indicated that one participant showed improved performance on untrained measures of attention and reasoning. On pre/post measures both participants reported less frequent cognitive failures in everyday life and improved mood following training. The results are discussed along with suggestions for future research.
Does additional exercise improve trunk function recovery in stroke patients? A meta-analysis
Authors: Sorinola I.O. , Powis I. , White C.M.
Published: December 2019

Background:

The restoration of trunk function following stroke is a key component of rehabilitation, however there is limited evidence of the efficacy of additional trunk training.

Objectives:

To evaluate the efficacy of trunk exercises added to conventional rehabilitation on functional outcomes.

Methods:

Relevant randomised controlled trials (RCTs), published up to July 2012, evaluating the effect of the addition of trunk exercises to conventional rehabilitation on functional outcomes were identified in Medline, Cinahl, Embase, Pubmed, PEDro, Web of Science and Scopus databases. Findings were summarised across studies as mean or standardised mean differences (MD or SMD) with 95% confidence intervals.

Results:

Six RCTs with 155 participants and a mean PEDro score of 6.5 (range 6 to 8) were included. Data from two to five studies were pooled in meta-analyses that showed a moderate, non-significant effect of additional trunk exercise on trunk performance, (SMD = 0.50; 95% CI −0.25, 1.25; P = 0.19); large effects on standing balance, SMD = 0.72 (95% CI −0.01, 1.45 P = 0.05); and walking ability, (SMD = 0.81; 95% CI 0.30, 1.33. P = 0.002) and a small, non-significant effect, MD = 10.03 (95% CI −15.70, 35.75. P = 0.44) on functional independence.

Conclusions:

There is moderate evidence that the addition of specific trunk exercise to conventional early stroke rehabilitation significantly improve standing balance and mobility after stroke; however the evidence was weak for the effect of additional trunk exercise on trunk performance and in functional independence.
EMG of the tibialis anterior demonstrates a training effect after utilization of a foot drop stimulator
Authors: Pilkar Rakesh , Yarossi Mathew , Nolan Karen J.
Published: December 2019

Background:

Functional Electrical Stimulation (FES) applied through a foot drop stimulator (FDS) is a rehabilitation intervention that can stimulate the common peroneal nerve to provide dorsiflexion at the correct timing during gait.

Objective:

To determine if FES applied to the peroneal nerve during walking through a FDS would effectively retrain the electromyographic temporal activation of the tibialis anterior in individuals with stroke.

Methods:

Surface electromyography (EMG) were collected bilaterally from the tibialis anterior (TA) while participants (n = 4) walked with and without the FDS at baseline and 4 weeks. Comparisons were made between stimulation timing and EMG activation timing to produce a burst duration similarity index (BDSI).

Results:

At baseline, participants displayed variable temporal activation of the TA. At 4 weeks, TA activation during walking without the FDS more closely resembled the pre-programmed FDS timing demonstrated by an increase in BDSI scores in all participants (P = 0.05).

Conclusions:

Continuous use of FDS during a task specific movement can re-train the neuromuscular system. After 4 weeks of utilization the FDS trained the TA to replicate the programmed temporal activation patterns. These findings begin to establish the FDS as a rehabilitation intervention that may facilitate recovery rather than just compensate for stroke related gait impairments due to foot drop.
Satisfaction with service needs among people living with multiple sclerosis
Authors: McCabe Marita , Ebacioni Katherine J. , Simmons Rex , McDonald Elizabeth , Melton Lisa
Published: December 2019

BACKGROUND: Multiple sclerosis (MS) is a demyelinating disease of the central nervous system and can cause difficulties in a number of areas of a person’s life, including their ability to function in the community. Employment, finances, and transport are important elements to ensure continued functioning in the community and ongoing rehabilitation.

OBJECTIVE: This study examined satisfaction with the extent to which the above needs were addressed by service providers.

METHODS: It examined the role of gender, age, and symptom severity. A total of 2721 people with MS aged 19 and 92 years ( M = 52.10, SD = 11.80) completed the study.

RESULTS: Areas of need included information about eligibility for services from government and local councils, for financial assistance and understanding welfare and benefits.

CONCLUSIONS: The results indicated that younger and mildly affected participants were least satisfied. Other areas of unmet need included transportation for the people more severely affected by MS and financial assistance to help people purchase mobility aids.
A comparison of self-generated versus taught internal strategies for working memory
Authors: Dirette Diane Powers
Published: December 2019

BACKGROUND: Internal strategies are effective for improving working memory. These internal working memory strategies can be taught or self-generated.

OBJECTIVE: This study compares working memory performance using taught versus self-generated internal working memory strategies and explores the quantity, type and carry-over of the use of these strategies.

METHODS: An experimental cohort design with randomly assigned groups compared the performances among 120 participants on 5 memory tests given prior, immediately following and at 1 month post intervention.

RESULTS: There were no significant differences in the number or type of internal memory strategies used by the groups with chunking, repetition and association used most commonly. The group that self-generated strategies performed significantly better on a contextual memory test and the group that was taught strategies performed better on a face/name recall test for which a specific strategy was taught. The group that was taught strategies performed significantly worse on contextual memory tests from pre-test to follow-up.

CONCLUSIONS: Participants who generated their own strategies or used a specific strategy for a specific task did as well as participants who were taught myriad internal WM strategies. Teaching too many strategies may overwhelm participants or may distract them from using the context that is available in such tasks.
Novel computer tests for identification of mental fatigue after traumatic brain injury
Authors: Johansson Birgitta , Rönnbäck Lars
Published: December 2019

BACKGROUND: Mental fatigue is one of the most significant post-traumatic brain injury symptoms. It is currently not possible to objectively identify.

OBJECTIVE: This study investigated whether a complex computer cognitive test with load on endurance, processing speed and attention were more demanding for participants suffering from mental fatigue after brain injury compared with a control group.

METHOD: Seventy-six subjects of mild traumatic brain injury (mTBI) and 45 healthy controls were included in the study. All subjects with mTBI had been suffering from mental fatigue for six months or more. Mental fatigue was screened using the Mental Fatigue Scale (MFS). Cognitive function was measured for information processing speed and working memory, and with a novel computer test.

RESULTS: The mTBI group rated MFS significantly higher than the control group. The results revealed a significantly slower information processing speed for the mTBI subjects and a poorer performance on the working memory test. The computer test revealed a less efficient performance over time for the TBI subjects compared to the control group.

CONCLUSIONS: The results indicate a less efficient performance over time in complex and demanding cognitive tasks for individuals experiencing from mental fatigue after brain injury.
Family needs after brain injury: A cross cultural study
Authors: Norup Anne , Perrin Paul B. , Cuberos-Urbano Gustavo , Anke Audny , Andelic Nada , Doyle Sarah T. , Cristina Quijano Maria , Caracuel Alfonso , Mar Dulce , Guadalupe Espinosa Jove Irma , Carlos Arango-Lasprilla Juan
Published: December 2019

OBJECTIVE: The objective of this study was to explore differences by country in the importance of family needs after traumatic brain injury (TBI), as well as differences in met/unmet needs.

METHOD: Two hundred and seventy-one family members of an individual with TBI in Mexico, Colombia, Spain, Denmark, and Norway completed the Family Needs Questionnaire.

RESULTS: Eight of the ten needs rated as most important globally were from the Health Information subscale. Importance ratings on the Health Information, Professional Support, and Involvement With Care subscales were similar across countries, but Mexican family members rated Instrumental Support needs as less important than Colombian, Spanish, and Danish family members, and also rated their Community Support needs as less important than Danish and Spanish family members. Mexican family member’s rated emotional support needs as less important than Colombian, Spanish, and Danish family members. Globally, the needs rated as most often met were from the Health Information subscale, and the most unmet needs were from the Emotional Support subscale.

CONCLUSION: Despite some similarities across countries several differences were identified, and these can help professionals to provide more culturally appropriate rehabilitation services for family members in order to improve informal care for TBI.
Comprehensive Hand Repetitive Intensive Strengthening Training (CHRIST)-induced morphological changes in muscle size and associated motor improvement in a child with cerebral palsy: An experimenter-blind study
Authors: Lee Dong Ryul , You Joshua H. , Lee Nam Gi , Oh Jin Hwan , Cha You Jin
Published: December 2019

Purpose:

This case study was conducted to determine Comprehensive Hand Repetitive Intensive Strengthening Training (CHRIST)-induced morphological changes in the commonly affected extensor carpi radialis (ECR) and triceps brachii (TRI) muscle and associated muscle strength and motor performance in a child with hemiparetic cerebral palsy (CP) using standardized clinical tests and ultrasound imaging.

Design:

A single case study with pre-/post-test.

Subject:

A 4.9-year-old female, diagnosed with hemiparetic CP.

Method:

The child received a 5-week course of CHRIST course, comprising of 60-minute periods a day, five times a week. A real-time ultrasound imaging was performed to determine the CHRIST-induced changes in cross-sectional area (CSA) of the ECR and TRI. Clinical tests including the modified Wolf Motor function test (WMFT), the modified Jebsen-taylor hand function test (Jebsen hand) and the modified Pediatric Motor Activity Log (PMAL) questionnaire were used to compare the intervention-related changes in motor performance in upper extremity.

Results:

Ultrasound imaging data showed that the CSAs of both ECR and TRI muscles of the affected upper limb at relaxation and contraction states were enhanced and these therapy-induced morphological changes were associated with enhanced muscle strength and gross motor performance in reaching and grasping skills.

Conclusions:

Our results suggest that the CHRIST is effective in treating muscle weakness and motor function in a child with hemiparetic CP. This is the first evidence in literature that might shed light on the therapeutic efficacy of our novel intervention on muscle size, associated muscle strength and motor improvement.
Predictors and moderators of the disablement process in persons with multiple sclerosis
Authors: Stuifbergen Alexa , Brown Adama , Phillips Lorraine
Published: December 2019

The purpose of this study is to explore how selected behavioral and psychological factors may influence the disablement process in persons with multiple sclerosis. Specifically, we explored what contextual factors (age, length of diagnosis, comorbidities), resources (social support, adequacy of assistive devices), barriers, and health behaviors predict functional limitations, disability, and quality of life and what factors might moderate the relationship between functional limitation and disability and disability and quality of life. A sample of 442 persons with multiple sclerosis (371 females, 71 males; mean age 56, mean time since diagnosis 19 years) completed measures of demographic and disease-related variables, barriers, social support, health behaviors, functional limitations, disability and perceived quality of life. Using regression analyses, the predictors explained significant amounts of variance in functional limitations (R2 = 0.37), disability (R2 = 0.36) and quality of life (R2 = 0.68), but there were no significant moderators of the relationship between functional limitations and disability and disability and quality of life. A model testing the indirect effects of functional limitations and direct effects of disability and the proposed moderators explained 66% of the variance in quality of life (CFI = 0.95, TLI = 0.89, RMSEA = 0.10). Barriers, social support and health behaviors were consistent predictors of the outcome variables.
Assessment and rehabilitation of acquired visuospatial and proprioceptive deficits associated with visuospatial neglect
Authors: Proto Daniel , Pella Russell D. , Hill B.D. , Gouvier Wm. Drew
Published: December 2019

Visuoperceptual disruptions are among the most common, and most debilitating, of the aftereffects following stroke or head injury. Visuospatial neglect in particular, which frequently occurs as a result of insult to the right cerebral hemisphere, has a variety of implications for patient welfare and outcome. And while there exists a great deal of useful information in the area of visual neglect, it is spread out amongst near-countless journal articles, book chapters, and workshop summaries. Thus, it is the purpose of this paper to provide an overview of various topics relating to visuospatial disturbances. Areas covered include theories on sequelae and neuropathology, common direct and indirect complications, rates and types of recovery, past and current trends in assessment and rehabilitation techniques, and thoughts on directions for future research.
Comparison of the CIQ and chart short form in assessing community integration in individuals with chronic spinal cord injury: A pilot study
Authors: Gontkovsky Samuel T. , Russum Paula , Stokic Dobrivoje S.
Published: December 2019

Objective:

To examine the validity of the Community Integration Questionnaire (CIQ) in measuring community integration in persons with chronic spinal cord injury (SCI) through its comparison with the Craig Handicap Assessment and Reporting Technique Short Form (CHART-SF).

Design:

Correlational analysis.

Setting:

Tertiary care rehabilitation hospital.

Participants:

Twenty-eight individuals with chronic SCI who completed the CIQ and CHART-SF during annual follow-up evaluation.

Main outcome measures:

The CIQ quantifies community integration based on subscales of Home Integration, Social Integration, and Productive Activity. The CHART-SF provides scores of community integration according to subscales of Physical Independence, Cognitive Independence, Mobility, Occupation, Social Integration, and Economic Self-Sufficiency.

Results:

CIQ Home Integration was significantly correlated with CHART-SF Physical Independence, Cognitive Independence, Mobility, Occupation, and Social Integration (r’s = 0.47–0.57). CIQ Social Integration was significantly correlated with CHART-SF Cognitive Independence, Mobility, Occupation, and Social Integration (r’s = 0.43–0.77). CIQ Productive Activity was significantly correlated only with CHART-SF Mobility and Occupation (r’s = 0.39–0.41).

Conclusions:

The CIQ may serve as a valid measure for examining community integration in persons with chronic SCI and may be particularly appealing given its relative brevity/simplicity in administration and scoring.
The effects of constraint-induced movement therapy for a child less than one year of age
Authors: Coker Patty , Lebkicher Carisa , Harris Lauren , Snape Jamie
Published: December 2019

The aim of this single case study was to determine the effectiveness of a modified version of constraint-induced movement therapy (mCIMT) on a child less than one year of age with a diagnosis of hemiplegic cerebral palsy. A single-subject ABAB design with a 6-month follow-up evaluation used repeated measures of gross and fine motor skills to determine changes at each phase of the study. Measures included the Peabody Developmental Motor Scale-2 (PDMS-2), the Gross Motor Fine Motor Measure-88 (GMFM-88) and videotape analysis of specific motor skills typically seen in children less than one year of age. The child in this study participated in a conventional occupational and physical therapy for 2 hours a week during the 2 baseline phases, A1 and A2, and mCIMT during the 2 intervention phases, B1 and B2. The mCIMT involved constraint of the non-affected limb for 1-hour a day for 30 consecutive days as the child was engaged in developmentally appropriate, task specific activities implemented by therapists and parents. Following participation in this mCIMT, the child demonstrated clinical improvements in both gross and fine motor skills as measured by standardized assessments and videotape analysis of motor behaviors. He was completing developmental motor tasks at his chronological age despite motor deficits resulting from a right-sided hemiparesis. The results of this study supports the use of mCIMT for children less than one year of age and could shift the focus of future research studies to determining the age in which to implement mCIMT before patterns of learned non-use begin to affect the normal development of skilled motor movements in children with hemiplegic CP.
Neuromuscular electrical stimulation of the gluteus medius improves the gait of children with cerebral palsy
Authors: Al-Abdulwahab Sami S. , Al-Khatrawi Wafa M.
Published: December 2019

Neuromuscular electrical stimulation (NMES) of the gluteus medius muscles using a surface electrode during functional walking training has never been reported as a management option to improve gait in spastic diplegic children.

Purpose:

This study was investigates the short and longer term effects of simultaneous continuous NMES of both hip abductors during walking on the temporal-spatial gait characteristics and hip adductor muscle tone in children with spastic diplegia caused by cerebral palsy (CP).

Subjects:

Three groups of subjects participated: an experimental group of twenty-one ambulant spastic diplegic children; a CP control group containing ten ambulant spastic diplegic children; and a healthy control group with twenty normal children.

Method:

The experimental group received three different NMES management programs. The first NMES program was designed to evaluate the immediate short-term effects of simultaneous continuous NMES of both gluteus medius muscles during walking. The second NMES program aimed to evaluate the effect of 15 minutes of simultaneous and continuous NMES of both gluteus medius muscles during walking, three sessions a day for a week. The third program was similar to the first and was designed to detect any additional changes in gait after full adaptation to NMES and completion of the second program. A dual channel stimulator with self-adhesive electrodes at the tolerable motor threshold level was used with a frequency of 20 Hz and pulse width of 50 μs. The effect of NMES programs was assessed using a three-dimensional gait analysis system and the Modified Ashworth Scale.

Results:

Significant improvement in the temporal-spatial parameters and hip adductor muscle tone of the experimental group (p < 0.001–0.05) was observed.

Conclusion:

The NMES management programs used in this study improved the gait of spastic diplegic CP children.
A novel method improving motor disturbance in Parkinson disease: Application of glycerin poultice to the flexor digitorum profundus in the middle phalanx of the little finger
Authors: Yasuda Yuzuru
Published: December 2019

Objective:

To investigate whether the application of glycerin poultice to the flexor digitorum profundus in the middle phalanx of the little finger (GFML) improves motor disturbance in Parkinson Disease (PD).

Methods:

Dorsiflexion of the little finger and diameter of the pupil in 22 patients with PD and 23 control subjects was evaluated before and after application of GFML. Motor disturbance in patients with PD was evaluated before and after application of GFML.

Results:

The application of GFML increased dorsiflexion of the little finger and constricted the pupil in all subjects, which suggests that application of GFML caused the decreased tension of the flexor digitorum profundus and lowered sympathetic nerve activity. With application of GFML, motor disturbance in patients with PD was improved.

Conclusions:

The application of GFML improves motor disturbance in PD which might be caused by reversing the mechanism of the muscle mechanosensitive reflex.
Development and validation of the Online Rivermead Behavioral Memory Test (OL-RBMT) for people with stroke
Authors: Man David W.K. , Chung Jenny C.C. , Mak Margaret K.Y.
Published: December 2019

The purpose of this paper was to examine the reliability and validity (concurrent and construct) of a newly developed online Chinese version of the Rivermead Behavioral Memory Test (OL-RBMT) and its equivalence with the face-to-face version (FTF-RBMT). The OL-RBMT and FTF-RBMT were administered to 30 subjects with stroke in a two-week interval to establish their test-retest reliability, as well as to compare the two tests' equivalence. The OL-RBMT was further compared with another 30 age- and gender-matched, non-stroke patients to establish its construct validity. Its concurrent validity was established by computing scores with that of the Chinese version of Neurobehavioral Cognitive Status Examination (NCSE or Cognistat). The intra-class correlation for test-retest reliability of the OL-RBMT was 0.94 ( P < 0.01). Pearson's correlation coefficients between the subscores of OL-RBMT and FTF-RBMT ranged from 0.84 to 0.93 ( P < 0.01). Statistically significant correlation was found between OL-RBMT and NCSE scores (R = 0.797, P < 0.001), as well as in the differences in OL-RBMT scores between the stroke and non-stroke groups (Z = −4.041, P < 0.001). We consider that the reliability and validity of this newly developed online version of RBMT was established. Usability of the OL-RBMT was also discussed.
A review of corticospinal tract location at corona radiata and posterior limb of the internal capsule in human brain
Authors: Jang Sung Ho
Published: December 2019

The corticospinal tract (CST) is the most important motor pathway in the human brain, therefore, the accurate estimation of the CST state following brain injury would enable us to predict the motor outcome or enable accurate surgical planning. The corona radiata (CR) and the posterior limb of the internal capsule (PL) are important locations because they are related to poor motor outcome. In this study, we reviewed the available literature regarding the location of the CST at the CR and PL in the human brain. The results of this review indicate that the CST is located in the posterior portion of the CR and PL. However, a direct comparison of the results of previous studies would be impossible because many of the previous studies did not define the exact boundary or analytic standards used to locate the CR or PL. Therefore, further complementary studies that define these in detail are warranted.
Long-term treadmill exercise-induced neuroplasticity and associated memory recovery of streptozotocin-induced diabetic rats: An experimenter blind, randomized controlled study
Authors: Yoon Bum Chul , Kim Mee Young , Byun Yong Gwon , Ha So Young , Han Bong Suk , You Joshua (Sung) H. , Kim Chung-Ju
Published: December 2019

We investigated a long-term exercise-induced neuroplasticity and spatial memory recovery in 15 rats in a treadmill as follows: normal control rats (NC), streptozotocin (STZ)-induced diabetic control rats (DC), and STZ-induced diabetic rats exercising in a treadmill (DE). As per the DE group, the running exercise in a treadmill was administered for 30 minutes a day for 6 weeks. Neuronal immediate-early gene (IEG) expression (c-Fos) in the hippocampus and radial arm maze (RAM) tests were measured and revealed that the c-Fos levels in DE were significantly higher than those in NC and DC ( p < 0.05). Behavioral data analysis indicated that spatial memory performance scores, obtained from the RAM test, were significantly different among the three groups ( p < 0.05). The memory scores of NC and DE were higher than those of DC ( p < 0.05). These findings suggest that exercising in the treadmill increased neuronal immediate-early gene expression associated with neuroplasticity, thereby improving spatial memory. This is the first experimental evidence in literature that supports the efficacy of exercise-induced neuroplasticity and spatial motor memory in diabetes care.
Pilot study of a fall risk management program for middle aged and older adults with MS
Authors: Finlayson Marcia , Peterson Elizabeth W. , Cho Chi
Published: December 2019

Objective:

To present the outcomes of a pilot study of “ Safe at Home BAASE”, a fall risk management program designed for middle-aged and older adults with multiple sclerosis.

Methods:

Thirty people with multiple sclerosis (mean age = 56.7 ± 7.4) started the manualized program that was delivered by an occupational therapist over six-two hour sessions. A pre/post intervention design with a set of 6 outcome tools was used to evaluate the extent to which the program increased knowledge of fall risk factors, increased knowledge and skills to manage falls and falls risk, and promoted changes in behavior to reduce personal fall risk.

Results:

Significant improvements were observed across all tools for participants attending ⩾ 5:6 program sessions as well as participants attending ⩽ 4 sessions, although some instruments exhibited poor internal consistency in this sample. Participants reported knowledge gains and using new fall prevention and management strategies after attending the program.

Conclusion:

“ Safe at Home BAASE” appears to have potential to foster changes in knowledge, skills and behavior associated with reduced personal fall risk.

Practice implications:

Findings suggest that additional research is needed on fall-related assessment tools for this population before a large scale controlled investigation of the intervention can be pursued.
Profiles of functional outcomes in stroke rehabilitation for Chinese population: A cluster analysis
Authors: Louie Stephanie Wai-Shan , Wong Simon Kam-Man , Wong Cynthia Mei-Yuk
Published: December 2019

The objectives of study were to identify longitudinal ADL profiles and to investigate profiles characteristics of participants in stroke rehabilitation programme. 496 stroke rehabilitation records in one year were retrieved. Patients' demographics, admission scores of Cantonese version of Mini-mental State Examination and line cancellation test were retrieved. Chinese version of the Modified Barthel Index (MBI-C) records for the first four successive weeks were also obtained for cluster analysis. Four functional profiles were yielded after cluster analysis. Repeated measures ANOVA showed that Profile 1 ( n = 168) with oldest age, lowest baseline MBI-C and line cancellation test scores had improvement only at the last two measurement points ( p < 0.001). Profile 4 ( n = 100) with youngest age and highest baseline MBI-C showed progress for the first two assessment points then slowing down progressively, while the other two profiles showed improvement on all measurement points ( p < 0.001) but with different baseline MBI-C and increments. One-way ANOVA further revealed significant differences in demographics, cognitive-perceptual and receptive speech functions among the profiles. The present study revealed different recovery potential among people with stroke. The higher the initial ADL performance, younger age and the absence of unilateral neglect appeared to relate to better functional recovery.
Corticospinal tract injury in patients with diffuse axonal injury: A diffusion tensor imaging study
Authors: Jang Sung Ho , Kim Seong Ho , Kim Oh Lyong , Byun Woo Mok , Ahn Sang Ho
Published: December 2019

Diffusion tensor imaging (DTI) can be useful in detecting corticospinal tract (CST) injury at the subcortical white matter level. In the current study, we attempted to investigate the incidence and distribution of CST injury in patients with diffuse axonal injury (DAI), using DTI. Fourteen patients who showed motor weakness without any specific lesion along the CST pathway on conventional brain MRI, and twelve age-matched, normal healthy control subjects were recruited. DTI was performed using 1.5 T with a synergy-L Sensitivity Encoding (SENSE) head coil. Fractional anisotropy was measured using the region of interest method. A CST injury was defined as the FA value of a certain area being decreased two standard deviations below that of normal controls. All 14 patients had more than one lesion at the CST injury, and the mean number of CST injuries was 3.6 (range: 2–7). The CSTs were involved at the following locations: the pons (61%), the cerebral peduncle (39%), the corona radiata (21%), the medulla (14%), and the posterior limb (11%). The pons was the most prevalent area of CST injury in patients with weakness caused by DAI at the subcortical level. We found that DTI is a useful technique for detecting a DAI of the CST at the subcortical level.
A case report on the use of a novel optokinetic chart stimulation intervention for the restoration of voluntary movement and mobility in a patient with an acute hemorrhagic stroke
Authors: Chitambira Benjamin
Published: December 2019

Background and Purpose:

The objective of this case report is to report on the use of novel optokinetic chart stimulation to achieve recovery of affected upper limb and affected lower limb voluntary movements and full recovery of mobility in a patient with an acute hemorrhagic stroke.

Method:

An optokinetic chart was moved in front of the patient: from side to side, up and down and finally forwards and backwards. Specific active-assisted exercises of affected shoulder anti-gravity muscles were also carried out. These were external rotation, abduction, flexion and a combination of these through the D2F proprioceptive neuromuscular facilitation (PNF) pattern.

Results:

Oxford score improved from 0/5 on admission to 3/5 on discharge, after 8 weeks, while Barthel Index improved from 0/20 to 20/20. STREAM scores improved from 1/70 on admission to 18/70 a month after admission and 70 /70 at follow-up 3 months after discharge.

Discussion:

Optokinetic chart stimulation led to restoration of voluntary movement on the affected side as well as restoration of independent mobility. Further research on the use of the optokinetic chart to enhance neural plasticity for restoration of voluntary movement and mobility is recommended.
Body weight supported treadmill training at very low treatment frequency for a young adult with incomplete cervical spinal cord injury
Authors: Young Daniel L. , Wallmann Harvey W. , Poole Iris , Threlkeld A. Joseph
Published: December 2019

Introduction:

Body weight supported treadmill training (BWSTT) using high treatment frequency has been shown to improve gait after spinal cord injury (SCI). This case report describes the use of BWSTT at a very low treatment frequency.

Subject:

The subject was a 19 y.o. female with an incomplete C6 SCI, one year post-injury, with multiple gait deficits.

Intervention:

BWSTT was combined with conventional rehabilitation. Mean treatment frequency was 1.16 days/wk over 28.5 wks. A BWSTT progression algorithm based on observational gait analysis guided progressive changes in support levels, treadmill speed, and session length.

Outcomes:

During the first 3 sessions, the subject tolerated an average of 15.7 minutes of BWSTT with 26% BWS at 0.8 m/s, improving to an average of 28 minutes of BWSTT with 10% BWS at 1.6 m/s in the last 3 sessions. Following 28.5 wks of very low frequency BWSTT, the subject displayed improved kinematics, walking speed, endurance, and distance during overground gait.

Conclusion:

Very low frequency BWSTT combined with conventional treatment improved quality and endurance of walking for a person with incomplete cervical SCI. Further work is needed to evaluate the long-term outcome of very low frequency BWSTT and the interaction of BWSTT with other interventions.
Age-related comparisons of people with multiple sclerosis: Demographic, disease, and treatment characteristics
Authors: Buchanan Robert J. , Chakravorty Bonnie J. , Tyry Tuula , Hatcher William , Vollmer Timothy
Published: December 2019

Objective:

To determine if the demographic characteristics and health care needs of younger people with MS differ from older people with MS.

Participants:

The study analyzed enrollment data from the NARCOMS Registry to compare 1,987 younger adults with MS (30 years and younger) to 29,245 other adults with MS (over 30 years).

Methods:

Analyses of the NARCOMS data focused on descriptive characteristics of these adults with MS, using a t-test to identify any statistically significant age-related differences in means and a chi-squared test to identify any statistically significant age-related differences in proportions.

Results:

A significantly larger proportion of younger adults with MS were female and African American compared to other adults with MS. We found significant age-related differences in the expression of physical disability domains but few significant age-related differences in symptoms of depression. We also observed significant age-related differences in the utilization of health providers, with larger proportions of other adults with MS treated by internists, urologists, rehabilitation specialists, and physical and occupational therapists.

Conclusions:

The comprehensive care of younger adults with MS should include monitoring for mental health conditions and the availability of mental health services.