bluuebunny/crossref_metadata_2025 huggingface dataset:
Early postnatal point-of-care glucose screening in late preterm neonates of 35-36 weeks gestation
Authors: Raff S.A. , Jackson G.L. , Nguyen R.H. , Manning M.D. , Engle W.D.
Published: December 2019

Background: Late preterm (LPT) neonates have been shown to be at higher risk for hypoglycemia compared with term neonates. Aims: To characterize postnatal values for point-of-care glucose (POCG) screening in late preterm neonates with a gestational age of 35-36 weeks, to assess the impact of additional risk factors in the development of POCG values ≤45 mg/dL in LPT neonates, and to compare laboratory and POCG values. Study design: POCG values were determined during the first 12 hours of life, and percentile trend lines were determined. LPT neonates were assigned to one of two groups: (1) no additional risk factors for POCG values ≤45 mg/dL (≤2.5 mmol/L); (2) at least one additional risk factor. Term neonates with pre-determined risk factors for hypoglycemia were screened at least once. Screening results were compared with laboratory determinations if the samples were obtained with 8 minutes of each other. Subjects: 238 LPT neonates with a gestational age of 35-36 weeks admitted to a newborn nursery. Outcome measures: POCG values and laboratory glucose values related to postnatal age; associated risk factors for POCG values were ≤45 mg/dL. Results: Minimum and 10th percentile values during the study period ranged from 20–48 mg/dL (1.1–2.7 mmol/L) and 36–59 mg/dL (2.0–2.3 mmol/L), respectively. No significant differences in incidence or distribution of POCG values ≤45 mg/dL were noted between the two groups. Values ≤45 mg/dL were noted frequently following an initial value >45 mg/dL. POCG values tended to be higher than laboratory glucose values, particularly in the lower range. The incidence of hypoglycemia in LPT infants was similar to the incidence in full-term infants with risk factors. Conclusions: Given the tendency for POCG to over-estimate laboratory glucose, the actual incidence of hypoglycemia in this cohort may be higher than we have reported. All neonates with gestational age 35-36 weeks should be monitored closely for hypoglycemia, and a single screening value after delivery is inadequate.
Motor imagery training in patients with chronic neglect: A pilot study
Authors: Leifert-Fiebach Gundhild , Welfringer Anouk , Babinsky Ralf , Brandt Tobias
Published: December 2019

Introduction:

Only few studies have investigated the effects of motor imagery training (MIT) on neglect symptoms.

Objective:

To investigate the imagery ability of patients with visuospatial neglect and the behavioral effects of MIT on neglect symptoms.

Methods:

In an intense four-week course 10 patients with chronic visuospatial neglect symptoms resulting from right-hemisphere lesions practiced MIT by mentally envisaging positions and movements of the contralesional upper limb. Visual and kinesthetic MIT abilities as well as neglect-related disability were evaluated prior to and following therapy. Neglect symptoms were as well assessed at three-month follow-up.

Results:

Results suggest that (i) the ability to perform motor imagery is principally retained in patients with neglect and even patients that are seemingly incapable of motor imagery are able to relearn imagined activation via an individualized training approach. Furthermore, imagined activation of the left arm (ii) significantly reduces the severity of neglect in exploration, (iii) enhances temporal and spatial orientation, and (iiii) significantly improves the kinesthetic motor-imagery capacity and ability. These improvements were stable over a three-month period, indicating long-term training effects.

Conclusion:

Our data suggest that active kinesthetic-motor imagery is a feasible and effective training method for patients suffering from chronic visuospatial neglect symptoms.
Family matters: Parental-acquired brain injury and child functioning
Authors: Kieffer-Kristensen Rikke , Siersma Volkert D. , Teasdale Thomas W.
Published: December 2019

Objectives:

To relate illness related to and family factors to emotional and behavioural problems in school-age children (7–14 years old) of parents with acquired brain injury and their healthy spouses.

Participants, Materials/Methods:

Members of 35 families in which a parent had been diagnosed with acquired brain injury participated. Family and brain injury characteristics were reported by the ill and healthy parents. Children self-reported post-traumatic stress symptoms (PSS) using the Child Impact of Events revised (CRIES). Emotional and behavioural problems among the children were also identified by the parents using the Achenbach’s Child Behaviour Checklist (CBCL).

Results:

The family stress variables relating to the healthy spouse in all six comparisons were significant ( p <= 0.05) or nearly so ( p = 0.07) in each case showing higher scores for spouses to be associated with higher CRIES and CBCL total scores for the children. For the adjusted associations, we again found the family stress variables in the healthy spouse to be related to the risk of emotional and behavioral problems in the children.

Conclusions:

The present results suggest that in ABI families, the children’s emotional functioning depends upon family factors and primarily on the level of parental stress in the healthy parent.
A comparison of the PEDro and Downs and Black quality assessment tools using the acquired brain injury intervention literature
Authors: Aubut Jo-Anne L. , Marshall Shawn , Bayley Mark , Teasell Robert W.
Published: December 2019

Objective:

The objective of this study was to examine the correlation between the Physiotherapy Evidence Database (PEDro) and the Downs and Black (D&B) quality assessment scale and the PEDro and a modified D&B assessment scores in a research synthesis of the ABI literature.

Methods and Main Outcomes:

A systematic review of the literature from 1980–2007 was conducted looking at treatment interventions following an ABI published in peer-reviewed English language journals. Of the articles chosen for inclusion in the study, 165 were identified as randomised controlled trials (RCT). All RCTs were scored using two quality assessment tools: the PEDro and D&B quality assessment scales. Items from these two scales were compared to identify which questions addressed similar information.

Results:

The association between the overall PEDro and D&B scores was moderately high ( r = 0.71, p < 0.01) indicating a significant relationship between these two quality assessment tools. When considering the modified D& B scores, which contained a subset of questions deemed most comparable to the PEDro scale, the correlation between the two was also moderately high ( r = 0.68, p < 0.01).

Conclusions:

Further analysis is required to investigate the strength of the relationship between these two scales in the assessment of RCTs.
Virtual reality-based prospective memory training program for people with acquired brain injury
Authors: Yip Ben C.B. , Man David W.K.
Published: December 2019

Acquired brain injuries (ABI) may display cognitive impairments and lead to long-term disabilities including prospective memory (PM) failure. Prospective memory serves to remember to execute an intended action in the future. PM problems would be a challenge to an ABI patient's successful community reintegration. While retrospective memory (RM) has been extensively studied, treatment programs for prospective memory are rarely reported. The development of a treatment program for PM, which is considered timely, can be cost-effective and appropriate to the patient's environment. A 12-session virtual reality (VR)-based cognitive rehabilitation program was developed using everyday PM activities as training content. 37 subjects were recruited to participate in a pretest-posttest control experimental study to evaluate its treatment effectiveness. Results suggest that significantly better changes were seen in both VR-based and real-life PM outcome measures, related cognitive attributes such as frontal lobe functions and semantic fluency. VR-based training may be well accepted by ABI patients as encouraging improvement has been shown. Large-scale studies of a virtual reality-based prospective memory (VRPM) training program are indicated.
Repeated sessions of functional repetitive transcranial magnetic stimulation increases motor cortex excitability and motor control in survivors of stroke
Authors: Massie Crystal L. , Tracy Brian L. , Paxton Roger J. , Malcolm Matthew P.
Published: December 2019

Objective:

To determine the impact of a single-session of repetitive transcranial magnetic stimulation (rTMS) and an rTMS intervention on neurophysiology and motor control in survivors of stroke.

Methods:

Twelve stroke survivors were randomized into functional-rTMS or passive-rTMS conditions. Measures of short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF), and force steadiness (coefficient of variation, CV) at 10 and 20% of maximum voluntary contraction were assessed at baseline and after a single-session of rTMS (post single-session), and again following an intervention of 8 rTMS sessions (2 sessions per day; post-intervention). Functional-rTMS required subjects to exceed a muscle activation threshold assessed by surface electromyography to trigger each rTMS train; the passive-rTMS group received rTMS while relaxed.

Results:

ICF scores significantly increased following the single-session of functional-rTMS compared to the decrease following passive-rTMS. The increase in APB SICI and ICF scores following the intervention was significantly greater for the functional-rTMS group compared to the decreases following passive-rTMS. The groups were significantly different in the CV of force (20%) following the single-session of rTMS, and in the 10 and 20% tasks following the intervention. The functional-rTMS group increased steadiness overtime, whereas the passive group demonstrated a return to baseline following the intervention session. No differences were observed in first dorsal interosseus (FDI) measures (SICI and ICF) between groups.

Conclusions:

The functional-rTMS protocol enhanced cortical excitability following a single-session and after repeated sessions and improved steadiness, whereas the passive stimulation protocol tended to decrease excitation and no improvements in steadiness were observed.
Predictors of long-term recovery in complex activities of daily living before discharge from the stroke unit
Authors: Cioncoloni David , Martini Giuseppe , Piu Pietro , Taddei Sabrina , Acampa Maurizio , Guideri Francesca , Tassi Rossana , Mazzocchio Riccardo
Published: December 2019

Background and purpose:

There is a need for individuating those post-stroke patients who may benefit from an optimal and customised rehabilitation plan aiming at early reintegration in community life participation. This study investigated whether the gain of independence in complex Activities of Daily Living (ADL) may be predicted before the discharge from the stroke unit using simple bedside determinants.

Methods:

In 104 first-ever stroke patients with no previous disability, ten determinants at 10 days after stroke were selected. Multivariable logistic regression analysis was applied to identify the prognostic determinants able to predict independence in complex ADL, as measured by modified Rankin Scale grade ≤2.

Results:

The model shows that having a Barthel Index ≥9, a Motricity Index- Upper Limb ≥75, an age ≤70 and being a male resulted in 100% probability of achieving independence in complex ADL. If three of the four determinants were present, the probability was more than 90%. With the presence of two of the four determinants, the probability ranged from 87% to 28%. With the presence of only one determinant, the probability was 13%.

Conclusions:

Accurate prediction of independence in complex ADL can be made before the discharge from the stroke unit. The strength of the paretic upper limb, age, gender, and the ability of performing basic ADL are the significant variables. The probability of favorable prognosis depends on the presence and on the robustness of each single determinant.
Perceptions of stroke recovery: An exclusion of communication and cognition
Authors: Ellis Charles , Focht Kendrea L. , Grubaugh Anouk L.
Published: December 2019

Background:

Perceptions of stroke recovery can differ substantially between stroke survivors and their healthcare providers. Concordance between the two is important for collaborative goal setting to facilitate optimal outcomes.

Objective:

To explore stroke survivors' perceptions of their own recovery and residual impairments with specific emphasis on communication and cognition.

Methods and procedures:

A qualitative analytic approach was used in the study. Nine stroke survivors participated in a focus group discussion as part of a larger study designed to examine post-stroke outcomes.

Results:

Early in the focus group proceedings, a discussion emphasizing how stroke survivors perceive their overall recovery emerged. Six of the nine participants (67%) perceived their overall stroke recovery to be greater than 90%, and only physical impairments were reported. Later in the course of the interview, eight of the nine participants (89%) reported either word retrieval or memory loss deficits which negatively influenced their daily functional activities.

Conclusions:

Stroke survivors in this sample did not include communication and cognitive deficits in their perception of their overall recovery despite later reporting these symptoms and related impairment. Failure of patients to include such persisting deficits in their reports of recovery can cause a mismatch between stroke survivor and provider goals.
Behavioral physiotherapy in post stroke rehabilitation
Authors: Broetz Doris , Birbaumer Niels
Published: December 2019

Introduction:

Behavioral aspects of motor learning such as definition and assessment of patient-centered goals, specific motivation, training in the patients' environment, autonomous training and generalization of newly learned skills to daily life are not an explicit part of physiotherapy in neurorehabilitation.

Behavioral physiotherapy:

Specific goals are defined and applied in a step by step manner. Exercises and application in daily life were trained and anticipated as a “self control cue” for the following week. Motivation was sustained via supervision, feedback after successful trials and reward. Exercises have to occure at a daily basis and have to be implemented in everyday life.

Case description:

A 54 year old man who suffered cerebral bleeding with left hemiparesis 25 years ago. We report goal attainment, change of symptoms and walking capacities over a period of 18 months.

Results:

Back pain and knee pain reduced to zero, rhythmic walking, walking speed increased, left leg less resistance, running possible.

Discussion:

The here described principles of behavioral physiotherapy are crucial for successful outcome in extremely stable and persistent consequences of stroke. Studies with more patients are needed to strengthen our hypothesis.
Relation between cingulum injury and cognition in chronic patients with traumatic brain injury; diffusion tensor tractography study
Authors: Baek Seung Ok , Kim Oh Lyong , Kim Seong Ho , Kim Min Soo , Son Su Min , Cho Yoon Woo , Byun Woo Mok , Jang Sung Ho
Published: December 2019

Objectives:

Many diffusion tensor imaging (DTI) studies have reported an association between cingulum injury and cognition in patients with traumatic brain injury (TBI) using DTI parameters. In this study, we attempted to investigate the relation between cingulum injury and cognition in chronic patients with TBI, using the integrity of the cingulum as well as DTI parameters.

Method:

Thirty five consecutive chronic patients with TBI were recruited. The intelligence quotient (IQ) of the Wechsler Intelligence Scale and Memory Assessment Scale (MAS) was used for assessment of cognition. The patients were classified into three groups, according to continuity to the lower portion of the genu of the corpus callosum: type A-both sides of the cingulum showed intact continuity, type B-either cingulum showed a discontinuation, and, type C-both cingulums showed discontinuation. We measured the fractional anisotropy (FA), apparent diffusion coefficient (ADC), and voxel number of both cingulums.

Results:

The IQ and MAS scores of type A and B were significantly higher than those of type C, respectively (p < 0.05), however, we did not observe a significant difference between type A and type B (p > 0.05). A positive correlation was observed between the FA value of the cingulum, and IQ and MAS, respectively (IQ r = 0.373, p < 0.05, MAS r = 0.357, p < 0.05), and between the voxel number and MAS (r = 0.500, p < 0.05). By contrast, we observed a negative correlation between the ADC value and IQ (r = −0.353, p < 0.05).

Conclusion:

In terms of integrity to the basal forebrain and DTI parameters of the injured cingulum, DTI findings showed a close association with whole cognition and memory in chronic patients with TBI.
Stroke and unsteadiness – A cross-sectional study from primary health care
Authors: Hansson Eva Ekvall , Beckman Anders , Näslund Anna , Persson Sylvia , Janson Sara , Troein Margareta
Published: December 2019

Background:

Dizziness is seldom the only symptom among patients who develop stroke but patients, hospitalized for vertigo are at higher risk of stroke than the general population. The proportions of patients who have remaining dizziness after a stroke seem to be unclear.

Objectives:

To study the frequency of dizziness among stroke patients referred to rehabilitation in primary health care and to study the relation between dizziness and gender, age, activity and self-rated health.

Methods:

Patients with first-time stroke who were referred to rehabilitation in primary health care after the initial hospital stay were included. Dependence/independence in daily activities and self-rated health was measured. A question about whether the patient had experienced any dizziness or unsteadiness was asked.

Results:

Sixty three patients were included in the study, (39 men, 24 women) aged 36–85 years. The majority of patients were dizzy (70%). Being female increased the risk of being dizzy substantially (OR 9.43). Patients with dizziness had poorer self-rated health than patients without dizziness (p = 0.001).

Conclusion:

Dizziness is a common symptom among patients with stroke, especially among female patients, and is associated with lower self-rated health. Therefore, it is important to address dizziness in the rehabilitation of stroke patients.
Transition planning for youth with traumatic brain injury: Findings from the National Longitudinal Transition Survey-2
Authors: Wehman Paul , Chen Chin-Chih , West Michael , Cifu Gabriella
Published: December 2019

Background:

Despite of a growing body of research on vocational and educational difficulties for students with traumatic brain injury (TBI), only limited empirical studies specifically examined how school transition services facilitate later employment outcomes.

Objective:

This exploratory, prospective longitudinal study examined the prevalence of employment and characteristics of transition planning practices that promoted positive school-to-work transition for students with TBI.

Method:

The participants (n = 200) was drawn from the National Longitudinal Transition Study-2 (NLTS-2), a ten-year study which followed a large nationally representative sample of youth with disabilities through secondary education in into young adulthood. Logistic regression was used to investigate the associations between student, school, and collaborative engagement in the planning process and employment outcomes up to 8 years after high school.

Results:

Among youth with TBI, 51% held current employment at the time of interview and 73% had been employed at any time after high school. Findings showed that students with TBI who had transition goals for postsecondary education were more likely to be employed at some point since leaving high school. The findings also support active student engagement and leadership in the transition planning process, and the inclusion of outside organizations and individuals.

Conclusions:

Findings indicate the impact of student, school and adult service agency engagement in transition planning processes. Implications for educational practices and future research are discussed.
Adult functioning of mothers with traumatic brain injury at high risk of child abuse: A pilot study
Authors: van Vliet-Ruissen Cora , McKinlay Audrey , Taylor Annabel
Published: December 2019

Background:

There is little information regarding the impact that traumatic brain injury (TBI) has on the functioning of mothers at risk of child abuse.

Objective:

This study evaluated adult functioning (e.g. child abuse, substance use, criminal convictions, and mental health problems) of mothers, at high risk for child abuse, who also had a history of TBI compared with those without TBI. It was hypothesised that mothers with a history of TBI would engage in higher rates of dysfunctional behaviour compared to those with no history of TBI.

Method:

Participants were 206 women engaged in a child abuse prevention programme for mothers who are highly socially disadvantaged, and at high risk for child abuse. Using historical data collected as part of the referral, and self report intake process, this study compared child abuse, mental health problems (depression, anxiety, substance use) and rates of criminal offending for mothers with a history of TBI versus those with no history of TBI.

Results:

Mothers with TBI were no more likely than those without TBI to have engaged in child abuse. However, mothers with a history of TBI were significantly more likely to have one or more mental health problems, engage in substance use and have a history of criminal offending.

Conclusions:

Parents with TBI who have been identified as high risk for engaging in child abuse have increased risk for mental health problems and criminal offending. These issues need to be considered when designing parenting programmes in order for intervention strategies to be effective.
Does effect of rehabilitation based on sensory conflicts in patients with vestibular deficits exceed learning effect?
Authors: Pierchała Katarzyna , Lachowska Magdalena , Morawski Krzysztof , Niemczyk Kazimierz
Published: December 2019

Objective:

The purpose was to assess learning and rehabilitation effect and their influence on Sensory Organization Test results in young and elderly patients with peripheral, central and mixed vestibular pathology.

Material and methods:

26 patients with different vestibular system deficits participated in this study. Rehabilitation was held five days a week, for two weeks. To assess learning effect, SOT was administered to each patient twice and compared: 1) on the day preceding the beginning of rehabilitation (SOT1), and 2) on the first day of rehabilitation (SOT2). To evaluate rehabilitation effect, results of SOT2 were compared to SOT3 (administered on the last day of rehabilitation).

Results:

Learning effect showed similar improvement in CS in all groups but young. Rehabilitation caused further improvement in CS in all groups but central pathology. This improvement was similar between those groups. There was no significant difference found between learning and rehabilitation effect in CS.

Conclusions:

The results of our study indicate that none of the groups achieved significant benefit from rehabilitation based on sensory conflicts that would overcome the learning effect. However, the lack of significant advantage of rehabilitation over learning does not mean that it does not exist.
Non-invasive serial casting to treat idiopathic toe walking in an 18-month old child
Authors: Pistilli Emidio E. , Rice Tracy , Pergami Paola , Mandich Mary Beth
Published: December 2019

Background:

Idiopathic toe walking is characterized by persistent toe walking in the absence of clinically diagnosed neuromuscular disease. Treatment options in children diagnosed with idiopathic toe walking include: observation, physical therapy, serial casting, or Achilles tendon (heel cord) lengthening surgery.

Objective:

In this case report, we present a non-invasive serial casting protocol to treat severe and persistent toe walking in an 18-month old child, diagnosed as an idiopathic toe walker following neurological examination.

Methods:

A series of below knee casts was used to provide a consistent stretch to the plantar flexor muscles. Upon removal of each set of casts, passive range of motion at the ankles was measured with a goniometer.

Results:

Four sets of casts, each lasting approximately one week, increased passive ankle dorsiflexion to 10° of neutral and established a heel-toe walking gait. Improvements in ankle range of motion and gait were maintained upon repeated examinations at 3, 7, and 12 months post-casting.

Conclusions:

These results demonstrate that non-invasive procedures, such as serial casting, can be successful in very young children diagnosed as idiopathic toe walkers. Early identification and intervention for this diagnosis may eliminate the need for invasive surgeries and associated risks in this population.
Suppression of stimulus artifact contaminating electrically evoked electromyography
Authors: Liu Jie , Li Sheng , Li Xiaoyan , Klein Cliff , Rymer William Z. , Zhou Ping
Published: December 2019

Background:

Electrical stimulation of muscle or nerve is a very useful technique for understanding of muscle activity and its pathological changes for both diagnostic and therapeutic purposes. During electrical stimulation of a muscle, the recorded M wave is often contaminated by a stimulus artifact. The stimulus artifact must be removed for appropriate analysis and interpretation of M waves.

Objectives:

The objective of this study was to develop a novel software based method to remove stimulus artifacts contaminating or superimposing with electrically evoked surface electromyography (EMG) or M wave signals.

Methods:

The multiple stage method uses a series of signal processing techniques, including highlighting and detection of stimulus artifacts using Savitzky-Golay filtering, estimation of the artifact contaminated region with Otsu thresholding, and reconstruction of such region using signal interpolation and smoothing. The developed method was tested using M wave signals recorded from biceps brachii muscles by a linear surface electrode array. To evaluate the performance, a series of semi-synthetic signals were constructed from clean M wave and stimulus artifact recordings with different degrees of overlap between them.

Results:

The effectiveness of the developed method was quantified by a significant increase in correlation coefficient and a significant decrease in root mean square error between the clean M wave and the reconstructed M wave, compared with those between the clean M wave and the originally contaminated signal. The validity of the developed method was also demonstrated when tested on each channel's M wave recording using a linear electrode array.

Conclusions:

The developed method can suppress stimulus artifacts contaminating M wave recordings.
Are there gender differences in longitudinal patterns of functioning in Nigerian stroke survivors during the first year after stroke?
Authors: Vincent-Onabajo Grace Oluwatitofunmi , Hamzat Talhatu Kolapo , Owolabi Mayowa Ojo
Published: December 2019

Background:

Several studies have examined gender differences in various stroke outcomes. There is however little information on the influence of gender on post-stroke functioning in the context of the International Classification of Functioning, Disability and Health (ICF).

Objective:

Gender differences in selected components of functioning, namely motor performance (body function), activity and participation, were examined in a sample of Nigerian stroke survivors.

Methods:

This longitudinal study involved consenting first-incidence stroke survivors who were consecutively recruited from in-patient wards of a University teaching hospital in northern Nigeria. Demographic and clinical data were obtained at recruitment while motor performance, activity and participation were assessed at the 1st, 3rd, 6th, 9th and 12th months using the Simplified Fugl Meyer scale, the Functional Independence Measure Motor Sub-scale and the London Handicap Scale respectively.

Results:

Participants were thirty-three male (60%) and 22 female (40%) stroke survivors who did not significantly differ in age, stroke sub-type, laterality and initial severity (P > 0.05). There were also no significant differences in motor performance, activity and participation between the male and female stroke survivors across the time points.

Conclusion:

Gender differences were not observed in the components of functioning over the first 12 months post-stroke.
Lokomat: A therapeutic chance for patients with chronic hemiplegia
Authors: Erdoğan Uçar Demet , Paker Nurdan , Buğdaycı Derya
Published: December 2019

Background:

Treadmill training with partial body weight support has been suggested as a useful strategy for gait rehabilitation after stroke.

Objectives:

This prospective, randomized, controlled study of gait training tested the feasibility and potential efficacy of using a robotic-assisted gait device, Lokomat, for treadmill training with partial body weight support in subjects with chronic hemiplegia; the device was also compared with conventional home exercise.

Methods:

Twenty-two male ambulatory ischemic or hemorrhagic induced stroke patients with chronic hemiplegia lasting at least 12 months were enrolled in this prospective study. The patients were assigned to either the Lokomat group or the conventional exercise group. The Lokomat group underwent active robotic training for ten sessions (five sessions per week for two weeks). Each session lasted 30 minutes. If a patient missed three consecutive training sessions, he was removed from the study. The Timed Up and Go Test is used to assess mobility and requires both static and dynamic balance. The 10-m Timed Walking Speed Test is designed to determine the patient's overground walking speed. The Mini-Mental State Examination and Hospital Anxiety and Depression Scale were used for mental and psychological evaluation; the Functional Ambulation Categories was used to assess ambulatory status.

Results:

Within each eight-week interval, the patients undergoing the Lokomat training demonstrated significantly greater improvement on the Timed Up and Go Test and 10-m Timed Walking Speed Test than those undergoing conventional training.

Conclusion:

Despite the small number of patients in the study, the present data suggests that the robotic-assisted device, Lokomat, provides innovative possibilities for gait training in chronic hemiplegia rehabilitation by training at higher intensity levels for longer durations than traditional home exercise.
Montreal-Toulouse Language Assessment Battery for aphasia: Validity and reliability evidence
Authors: Pagliarin Karina Carlesso , Ortiz Karin Zazo , de Mattos Pimenta Parente Maria Alice , Arteche Adriane , Joanette Yves , Nespoulous Jean-Luc , Fonseca Rochele Paz
Published: December 2019

Background:

In Brazil, no standardized instruments are available to assess language in patients with aphasia.

Objective:

The aim of the current study was to search for reliability and validity evidence for the Montreal-Toulouse Language Assessment Battery (MTL-BR).

Methods:

The sample was composed of 537 adults, of whom 463 were healthy individuals and 74 had neurological lesions (25 participants had right hemisphere brain damage, 21 had left hemisphere damage (LHD) with aphasia and 28 had LHD without aphasia). Reliability was assessed by internal consistency (Cronbach's alpha) and test-retest analyses. Test-retest reliability was calculated using the Pearson correlation coefficient, and a repeated measures analysis of variance, with years of education as a covariate. Construct validity was verified by correlations between scores in MTL-BR subtest and similar tasks from other language assessment instruments.

Results:

Internal consistency was satisfactory (Cronbach's alpha between 0.79 and 0.90), as were correlations between test and retest scores (mean 0.52), and between the MTL-BR and scores in similar instruments.

Conclusions:

The present results suggested that the MTL-BR battery had adequate reliability and validity as a method for diagnosing and monitoring aphasia.
Online awareness of functional tasks following ABI: The effect of task experience and associations with underlying mechanisms
Authors: Rotenberg-Shpigelman Shlomit , Rosen-Shilo Lee , Maeir Adina
Published: December 2019

Background:

Self-awareness is a significant predictor of neurorehabilitation process and outcome and encompasses metacognitive knowledge and online awareness. The literature focuses primarily on intellectual awareness and research on online awareness is lacking.

Objective:

To examine online awareness for functional tasks, how it is affected by task experience and its relationships with neurogenic and psychogenic factors.

Methods:

Thirty six adults with ABI attending neurorehabilitation participated in this study. Online awareness was measured as the discrepancy between subjective ratings of performance and performance on functional tasks, as rated by experienced therapists. Participants' ratings were recorded before and immediately after task experience, as well as following a mediated review of task steps. The Impaired Self-Awareness scale (ISA) and the Denial of Disability scale (DD) rated neurogenic and psychogenic mechanisms of unawareness.

Results:

Results indicated significant differences between therapists' and participants' ratings before and after IADL task performance, and following mediation. Participants typically overestimated their functional independence and did not significantly change their ratings after task experience. Significant moderate to strong correlations were found between online awareness measures and both DD and ISA scales.

Conclusions:

Overestimation of functional independence is common in persons with ABI, is related to both neurogenic and psychogenic factors and is not significantly affected by single task experience. Further studies are required to examine the effect of theoretically driven awareness interventions in neurorehabilitation.
Changes in spastic muscle stiffness after botulinum toxin A injections as part of rehabilitation therapy in patients with spastic cerebral palsy
Authors: Boyaci Ahmet , Tutoglu Ahmet , Boyaci Nurefsan , Koca Irfan , Calik Mustafa , Sakalar Ali , Kilicaslan Nihat
Published: December 2019

Objective:

To investigate changes in stiffness in the gastrocnemius (GCM) muscle following rehabilitation therapy and botulinum toxin type A (BTX-A) injections in patients with spastic cerebral palsy (CP).

Methods:

The study included 16 children with spastic CP (Group 1) and 17 healthy children (Group 2). The children with CP received BTX-A injections and underwent rehabilitation therapy. The GCM and soleus muscles of the CP group were evaluated according to the modified Ashworth scale (MAS). The thicknesses of the muscles were measured, and the elasticity score (ELX 2/1) index was calculated.

Results:

The ELX 2/1 indices of the gastromedialis (GM) and gastrolateralis (GL) were significantly higher in Group 1 than in Group 2 (p < 0.05). The ELX 2/1 indices in the GM and GL muscles in the CP group were found to have decreased 4 weeks after the procedure (p < 0.05). Furthermore, the mean MAS score of the ankle decreased, from 3.4 to 2.6 (p < 0.05). GM ELX 2/1 in Group 1 (post-treatment) was significantly different from Group 2 (p < 0.05).

Conclusions:

The combined use of clinical scales and sonoelastography can provide valuable information for determining structural changes in the GCM muscle following rehabilitation therapy and BTX-A injections.
Shoulder strapping for stroke-related upper limb dysfunction and shoulder impairments: Systematic review
Authors: Appel Caroline , Perry Lin , Jones Fiona
Published: December 2019

Background:

Shoulder impairments are common after stroke, resulting in reduced upper limb function. Shoulder strapping may be beneficial as an adjunct to conventional therapy and warrants further investigation.

Objectives:

To determine i) the efficacy and ii) any adverse effects of shoulder strapping used to reduce stroke-related upper limb and shoulder impairments and to improve function.

Methods:

Three reviewers independently searched CINAHL, Ovid MEDLINE, EMBASE, AMED and PEDro databases and extracted data. Results were synthesized using descriptive methods and meta-analysis and interpreted in relation to potential risk of bias.

Results:

Eight studies met inclusion criteria, recruiting 340 stroke participants. Studies predominantly included people with shoulder paralysis and examined shoulder strapping within four weeks of stroke onset for outcomes of increased upper limb function, reduced subluxation and pain. Strapping interventions, outcomes and measures were diverse, some studies encountered high risk of bias and findings were generally inconclusive with some indication of benefit in terms of delaying onset of shoulder pain.

Conclusions:

There is insufficient evidence of efficacy or inefficacy with shoulder paralysis but shoulder strapping demonstrated minimal adverse effects and should be rigorously tested with shoulder paresis as well as paralysis after stroke.
Optimising resource management in neurorehabilitation
Authors: Wood Richard M. , Griffiths Jeff D. , Williams Janet E. , Brouwers Jakko
Published: December 2019

Background:

To date, little research has been published regarding the effective and efficient management of resources (beds and staff) in neurorehabilitation, despite being an expensive service in limited supply.

Objective:

To demonstrate how mathematical modelling can be used to optimise service delivery, by way of a case study at a major 21 bed neurorehabilitation unit in the UK.

Methods:

An automated computer program for assigning weekly treatment sessions is developed. Queue modelling is used to construct a mathematical model of the hospital in terms of referral submissions to a waiting list, admission and treatment, and ultimately discharge. This is used to analyse the impact of hypothetical strategic decisions on a variety of performance measures and costs. The project culminates in a hybridised model of these two approaches, since a relationship is found between the number of therapy hours received each week (scheduling output) and length of stay (queuing model input).

Results:

The introduction of the treatment scheduling program has substantially improved timetable quality (meaning a better and fairer service to patients) and has reduced employee time expended in its creation by approximately six hours each week (freeing up time for clinical work). The queuing model has been used to assess the effect of potential strategies, such as increasing the number of beds or employing more therapists.

Conclusions:

The use of mathematical modelling has not only optimised resources in the short term, but has allowed the optimality of longer term strategic decisions to be assessed.
Effect of exercise on balance in persons with mild cognitive impairment
Authors: Jeon Seo Young , Han Soo Jeong , Jeong Jee Hyang , Fregni Felipe
Published: December 2019

Background:

Individuals with definite cognitive impairment and mild cognitive impairment (MCI) show motor dysfunction.

Objective:

This study aimed to investigate whether exercise changes balance and whether the effects of exercise on balance are different in patients with MCI as compared to the control group.

Methods:

Posturography was used to assess balance by measuring the mediolateral and anteroposterior sway distance and sway speed. After the baseline balance test (T1), subjects received exercise instruction. Follow-up balance tests were performed at 6 months (T2) and 12 months (T3).

Results:

When comparing persons with MCI (n = 17) with control group (n = 12), four indices of posturography showed differences between groups (p < 0.05). Also, there were improvements in more indices between T1 and T3, rather than between T1 and T2, in both MCI and control groups (p < 0.05). After receiving guidance concerning exercises, the sway values at 12 months were lower than values at the 6-month follow-up (p < 0.05). However, this trend in the sway values did not show a difference between the groups (p > 0.05).

Conclusion:

Persons with MCI had poorer balance control ability as compared with normal healthy persons. More than one year of steady exercise can be helpful for the improvement of balance in both MCI and normal persons.
Spinal cord injury rehabilitation: Which way forward?
Authors: Karimi Mohammad , Omar Abdul Hafidz Haji , Fatoye Francis
Published: December 2019

Background:

Spinal cord injury (SCI), damage to spinal cord, influences the ability of the subjects to stand and walk. Moreover, they have some problems such as osteoporosis, muscle spasm, joint contracture and bowel and bladder function. These subjects use various orthoses and undergo different rehabilitation programmes to restore their ability. It is controversial whether use of aforementioned methods improves the physiological health of SCI individuals and improves their ability to ambulate or not. Therefore, the aim of this review was to investigate the effectiveness of assistive devices to restore their physiological health and their functional ability in patients with SCI.

Method:

A search was done in some databases such as Medline, Embasco, and ISI Web of sciences between 1960 and 2013. The quality of studies was assessed using the Down and Black tool.

Results:

Two hundred articles were found based on the selected key words. Sixty papers were selected for final analysis, of which 35 and 45 focused on benefits of standing and walking, performance of SCI during standing and walking with various systems, respectively.

Conclusion:

Although there was lots of variation between the studies based on the number of subjects, level of lesion, type of lesion and time post injury, it can be concluded that use of various orthoses neither improve the abilities of subjects to stand and walk nor improve their physiological health. It may be concluded that the use of other methods of exercise may have more physiological benefits for SCI subjects.
EMG-force relation in the first dorsal interosseous muscle of patients with amyotrophic lateral sclerosis
Authors: Jahanmiri-Nezhad Faezeh , Hu Xiaogang , Suresh Nina L. , Rymer William Z. , Zhou Ping
Published: December 2019

Background and purpose:

The relationship between surface electromyography (EMG) and muscle force is essential to assess muscle function and its deficits. However, few studies have explored the EMG-force relation in patients with amyotrophic lateral sclerosis (ALS). The purpose of this study was to examine the EMG-force relation in ALS subjects and its alteration in comparison with healthy control subjects.

Methods:

Surface EMG and force signals were recorded while 10 ALS and 10 age-matched healthy control subjects produced isometric voluntary contractions in the first dorsal interosseous (FDI) muscle over the full range of activation. A linear fit of the EMG-force relation was evaluated through the normalized root mean square error (RMSE) between the experimental and predicted EMG amplitudes. The EMG-force relation was compared between the ALS and the healthy control subjects.

Results:

With a linear fit, the normalized RMSE between the experimental and predicted EMG amplitudes was 9.6 ± 3.6% for the healthy control subjects and 12.3 ± 8.0% for the ALS subjects. The slope of the linear fit was 2.9 ± 2.2 μVN−1 for the ALS subjects and was significantly shallower (p < 0.05) than the control subjects (5.1 ± 1.8 μVN−1). However, after excluding the four ALS subjects who had very weak maximum force, the slope for the remaining ALS subjects was 3.5 ± 2.2 μVN−1 and was not significantly different from the control subjects (p > 0.05).

Conclusions:

A linear fit can be used to well describe the EMG-force relation for the FDI muscle of both ALS and healthy control subjects. A variety of processes may work together in ALS that can adversely affect the EMG-force relation.
Motor imagery training improves precision of an upper limb movement in patients with hemiparesis
Authors: Grabherr Luzia , Jola Corinne , Berra Gilberto , Theiler Robert , Mast Fred W.
Published: December 2019

BACKGROUND: In healthy participants, beneficial effects of motor imagery training on movement execution have been shown for precision, strength, and speed. In the clinical context, it is still debated whether motor imagery provides an effective rehabilitation technique in patients with motor deficits.

OBJECTIVE: To compare the effectiveness of two different types of movement training: motor imagery vs. motor execution.

METHODS: Twenty-five patients with hemiparesis were assigned to one of two training groups: the imagery or the execution-training group. Both groups completed a baseline test before they received six training sessions, each of which was followed by a test session. Using a novel and precisely quantifiable test, we assessed how accurately patients performed an upper limb movement.

RESULTS: Both training groups improved performance over the six test sessions but the improvement was significantly larger in the imagery group. That is, the imagery group was able to perform more precise movements than the execution group after the sixth training session while there was no difference at the beginning of the training.

CONCLUSIONS: The results provide evidence for the benefit of motor imagery training in patients with hemiparesis and thus suggest the integration of cognitive training in conventional physiotherapy practice.
Health related quality of life and mental health in children with SCI/D from Neiva, Colombia
Authors: Leibach Gillian G. , Perrin Paul B. , Nicholls Elizabeth , Leonor Olivera Silvia , Medina Quintero Lorena , Mauricio Velasco Trujillo Diego , Carlos Arango-Lasprilla Juan
Published: December 2019

OBJECTIVE: To date, no research has been published on the health related quality of life (HRQOL) and mental health of children with spinal cord injury and disorders (SCI/D) in Latin America, although limited previous research in Western countries has demonstrated the debilitating and chronic nature of these conditions in children. The aim was to examine the connections between HRQOL and mental health in children with SCI/D from Neiva, Colombia.

STUDY DESIGN: Thirty children (8– 17 years) were recruited from the Hospital Universatario Hernando Mocaleano Perdomo in Neiva, Colombia. Participants completed self-report measures administered verbally by trained research staff.

RESULTS: A correlation matrix generally suggested that higher HRQOL was robustly associated with better mental health. A series of multiple regressions found that HRQOL explained 50.5% of the variance in children’s depression, 31.5% of the variance in worry, and 41.9% of the variance in social anxiety. Within these regressions, emotional and social functioning were uniquely associated with depression, and emotional functioning was uniquely associated with social anxiety.

CONCLUSION: This is the first published study to examine psychosocial outcomes in children with SCI/D in Latin America, and its findings suggest that future research and interventions for children with SCI/D in Colombia – and possibly in other regions of Latin America – would benefit from emphasizing emotional and social functioning.