bluuebunny/crossref_metadata_2025 huggingface dataset:
Positive psychology in rehabilitation medicine: A brief report
Authors: Bertisch Hilary , Rath Joseph , Long Coralynn , Ashman Teresa , Rashid Tayyab
Published: December 2019

Background:

The field of positive psychology has grown exponentially within the last decade. To date, however, there have been few empirical initiatives to clarify the constructs within positive psychology as they relate to rehabilitation medicine. Character strengths, and in particular resilience, following neurological trauma are clinically observable within rehabilitation settings, and greater knowledge of the way in which these factors relate to treatment variables may allow for enhanced treatment conceptualization and planning.

Objective:

The goal of this study was to explore the relationships between positive psychology constructs (character strengths, resilience, and positive mood) and rehabilitation-related variables (perceptions of functional ability post-injury and beliefs about treatment) within a baseline data set, a six-month follow-up data set, and longitudinally across time points.

Methods:

Pearson correlations and supplementary multiple regression analyses were conducted within and across these time points from a starting sample of thirty-nine individuals with acquired brain injury (ABI) in an outpatient rehabilitation program.

Results:

Positive psychology constructs were related to rehabilitation-related variables within the baseline data set, within the follow-up data set, and longitudinally between baseline positive psychology variables and follow-up rehabilitation-related data.

Conclusions:

These preliminary findings support relationships between character strengths, resilience, and positive mood states with perceptions of functional ability and expectations of treatment, respectively, which are primary factors in treatment success and quality of life outcomes in rehabilitation medicine settings. The results suggest the need for more research in this area, with an ultimate goal of incorporating positive psychology constructs into rehabilitation conceptualization and treatment planning.
Where are we in terms of poststroke functional outcomes and risk factors
Authors: Caglar Nil Sayiner , Akin Turkan , Erdem Ibrahim Halil , Ozgonenel Levent , Aytekin Ebru , Tutun Sule , Akar Nezihe , Aysar Ozcan
Published: December 2019

Background:

Stroke is acute vascular deterioration of cerebral functions and 2nd leading cause of death. As population gets older, as well as the increasing prevalence of stroke and disability from chronic disease, the demand for rehabilitation care will continue to rise. There is need for evidence based rehabilitation approaches and rehabilitation outcomes should be proved by objective questionnairres to qualify the process.

Objective:

To present the functional outcomes of stroke rehabilitation process among functional impairment measure evaluation. Determine the contributing factors on functional gain.

Material-methods:

Retrospectively assessment of data of 142 posttroke patients performed. In addition to demographical and clinical properties, functional outcomes with functional impairment measurement (FIM) and motor evaluation by Brunnstrom Motricitiy Index were recorded. Risk factors for stroke were questionned also.

Results:

The mean of ages was 64.30 ± 11.9 years, male/female ratios were 47.2%/ 52.8%. The functional gain was 20.4% in M-FIM, 14.7% in C-FIM. Better outcomes gained by the patients who stayed longer than 15 days (ANOVA, p: 0.000) and who had hemorrhagic etiology (MannWhitney U, p: 0.048), meanwhile there was no significant difference in gender and plegic side groups on both Motor-FIM and Cognitive-FIM gains (p > 0.05, MannWhitney U). Regression models exhibited highest impact on the M-FIM gain were the admission M-FIM scores and DM (adjusted Rsquare: 0.173, p: 0.000). Admission C-FIM scores had positive correlation with discharge C-FIM scores (r: 0.917, p: 0.000). Although older age was the negative determinant of C-FIM gain (r: −0.202, p: 0.016). We obtained the risk factor distribution 71.8% for HT, 29.6% for CAD, 25.6% for smoking, 16.2% for TIA and 33.1% for DM. All had negative impact on functional outcomes but DM had significantly (regression analysis p < 0.05).

Conclusion:

Improvement by rehabilitation programme determined by FIM scores. Data provided about the poststroke patients and present risk factors. Still there exists similar ratios of risk factors as studies before eventhough prevention recommendations.
Physical capacity and quality of life in patients with multiple sclerosis
Authors: Kerling A. , Keweloh K. , Tegtbur U. , Kück M. , Grams L. , Horstmann H. , Windhagen A.
Published: December 2019

Background:

Physical capacity (PC) and quality of life (QoL) are both reduced in multiple sclerosis (MS).

Objective:

Aim of our study was to investigate limitations in PC and QoL in response to the severity of MS.

Methods:

The study involved 60 patients (PG) (Expanded Disability Status Scale EDSS 0–3:38, EDSS 3.5–6:22) and 48 healthy controls (CG). Endurance capacity was assessed as peak oxygen uptake (VO2peak) and ventilatory anaerobic threshold (VAT). Maximum force was measured in isokinetic testing. QoL was assessed using the SF-36-questionnaire and HALEMS.

Results:

Patients with MS showed reduced VO2peak and QoL in comparison with CG. Patients with an EDSS >3 showed reduced VO2peak, and maximum force, however at the VAT there was no significant difference independent of the EDSS. The MS-specific QoL HALEMS and subscales 1, 4, 6, 8 and the physical sum score of the SF-36-questionnaire were evaluated to be better in patients with an EDSS ≤3.

Conclusions:

There are limitations within PC in patients with MS in comparison with a healthy CG; within the PG there are notes on a similar aerobic capacity but worsened anaerobic capacity in patients with an EDSS >3. This should be taken into account in future treatment strategies for training therapy.
Brief report: Effects of exercise and self-affirmation intervention after traumatic brain injury
Authors: Lee Yuen Shan Christine , Ashman Teresa , Shang Andrea , Suzuki Wendy
Published: December 2019

Background:

Physical exercise has been proven to be an effective method for improving cognition and mood, but little is known about its benefits among individuals with traumatic brain injury.

Objective:

This pilot study investigated the feasibility of a combined exercise and self-affirmation intervention (IntenSati) for enhancing cognition and mood in individuals with TBI. It was hypothesized that this intervention would improve individuals' cognition and mood following the completion of the program.

Method:

This intervention was held at an outpatient rehabilitation department in an urban medical center. A wait-list control design was conducted. Twenty-one adult participants—at least 12-months post-TBI—enrolled in the study. Twelve of them completed the study. Assessment was conducted at three time-points throughout the study using neuropsychological and self-report measures to evaluate participants' cognition and mood. Following initial evaluation, participants were assigned into either the immediate intervention group or the waitlist control group. During the intervention, participants attended the program twice a week over the course of 8 weeks. Debriefing was conducted following the completion of the program.

Results:

Both independent t tests and paired t tests were utilized. Results indicated that the intervention group experienced less depressive symptoms following the completion of the IntenSati program compared to the waitlist control group. Participants also reported having less depressive symptoms, experienced more positive affect, and had a higher quality of life following the completion of the program. Moderate-to-large effect sizes were found on decrease in negative affect. However, results associated with cognitive benefits were mixed. The participants tolerated the program well and reported satisfaction with the program.

Conclusions:

Results from this study indicated that the IntenSati exercise program is a feasible and beneficial intervention for individuals with TBI as supported by the positive impact on their mood and quality of life.
Comparison of the immediate effect of the training with a virtual reality game in stroke patients according side brain injury
Authors: Fernandes Aline Braga Galvão Silveira , Oliveira dos Passos Jacilda , Paiva de Brito Deyvson , Fernandes Campos Tania
Published: December 2019

Background:

Stroke is a major cause of motor disability in adults and needs interventions that contribute to motor recovery.

Objective:

This study aimed to compare the immediate effect of the training with virtual reality game in stroke patients according side brain injury.

Methods:

The participants included 20 patients (10 right brain injury), mean age of 50.6 ± 9.2 years, and 20 healthy subjects of 50.9 ± 8.8 years. All participants made a kinematic evaluation of drinking a cup of water before and after training with the table tennis game of the XBOX 360 Kinect®, in two series of 10 tries of 45 s, with 15 minutes rest between them, a total of 30 minutes. Data were analyzed by ANOVA.

Results:

There was a significant difference in the number of hits between patients and healthy subjects groups, in which patients had a lower performance in all the trials (p = 0.008). After the training, only patients with right brain injury improved their shoulder and elbow angles, approaching the left upper limb movement pattern of healthy subjects (p < 0.05).

Conclusion:

Patients with right brain injury responded better to the virtual reality game, suggesting introduction of new treatment techniques that promote neurorehabilitation.
The Four Square Step Test in individuals with Parkinson's disease: Association with executive function and comparison with older adults
Authors: McKee Kathleen E. , Hackney Madeleine E.
Published: December 2019

Background:

In Parkinson's disease (PD), motor and cognitive impairments interact to affect functional performance adversely. A valid mobility test, the Four Square Step Test (FSST) involves multidirectional stepping over obstacles. FSST performance may also be associated with cognitive performance.

Objectives:

This study determined the feasibility and reliability of an obstacle-based FSST in older individuals with versus without PD, and evaluated the association of PD performance of FSST with tests of cognition.

Methods:

Thirty-one individuals with mild-moderate PD, evaluated while ON medications, completed the obstacle-based FSST, other mobility and cognitive measures. FSST performance was compared between a PD participant sub-set (n = 24) and 24 age-matched older adults. Data were analyzed with independent t-tests, correlations, and linear regression.

Results:

Obstacle-based FSST was feasible and reliable within sessions in those with PD. Median best FSST time among individuals with PD was 11.72 s (9.99, 13.98) and FSST had concurrent validity with tests of mobility, and cognitive dual-tasking. Among cognitive tests, Trails Making Test B, which evaluates executive function, emerged as a sole contributor (49%) of variance. FSST performance did not differ between those with PD and older adults.

Conclusion:

The obstacle-based FSST is feasible and reliable in those with PD. The relationship between cognitive status and performance on the FSST did not appear to be strongly disease-stage dependent. Using FSST in the clinic may help assess the health status of a motor-cognitive interaction in individuals with PD.
Maintenance of treatment effects of an occupation-based intervention with video feedback for adults with TBI
Authors: Schmidt Julia , Fleming Jennifer , Ownsworth Tamara , Lannin Natasha A.
Published: December 2019

BACKGROUND: Video feedback interventions have been found to improve self-awareness and occupational performance to a greater extent than other feedback interventions after traumatic brain injury (TBI). However, it is unclear whether the effects of video feedback are maintained over time.

OBJECTIVE: To evaluate the maintenance of gains in self-awareness achieved with a video feedback intervention in people with TBI.

METHODS: There were 32 participants with TBI and impaired self-awareness who had completed a randomized controlled trial with three feedback conditions (video plus verbal, verbal and experiential). Eight to ten weeks after the final feedback intervention session, a follow-up assessment was conducted. The primary outcome was maintenance of gains in online awareness measured by the number of errors made during a meal preparation task. Group outcomes were compared using an unstructured linear mixed regression model.

RESULTS: The video plus verbal feedback group continued to demonstrate significantly greater gains in online awareness compared to the verbal feedback group (mean difference 20.6, 95% CI 8.8 to 32.3) and the experiential feedback group (mean difference 14.4, 95% CI 3.1 to 25.6). There was no significant impact of the interventions on participants’ emotional status at the 8 to 10 week follow-up.

CONCLUSIONS: A combination of video plus verbal feedback is an effective technique for achieving maintained gains in self-awareness in people with TBI.
Effects of constraint-induced movement therapy on hand skills and muscle recruitment of children with spastic hemiplegic cerebral palsy
Authors: Stearns Ginny E. , Burtner Patricia , Keenan Kristina M. , Qualls Clifford , Phillips John
Published: December 2019

Background:

Constraint-Induced Movement Therapy (CIMT) is a therapeutic intervention using constraint of the less-affected limb and intensive use of the hemiplegic extremity in individuals with hemiplegia. The purpose of this study was to determine whether children with cerebral palsy (CP) who have undergone a 2-week function-based CIMT show improved hand function and underlying muscle activation changes associated with functional gains.

Methods:

Six children with hemiplegic CP participated in the study, receiving 4 hours of therapy 5 days a week coupled with bi-valve casts worn 8–12 hours for 14 days. Outcome measures of grip strength, pinch strength, dexterity tests and electromyography (EMG) were compared before, immediately post- and 3 months post-intervention.

Results:

Repeated measures ANOVA and post hoc paired t-tests showed significant group improvements in all strength and dexterity measures ( p < 0.05). EMG analysis showed significant increases in muscle activation on pinch measures ( p = 0.05). Visual inspection of the EMG data suggested increased muscle activation during grip and a decrease in the muscle activation required during dexterity tasks.

Conclusions:

Our preliminary results support CIMT for improving strength and dexterity in children with hemiplegic CP. Further studies with greater sample sizes and longer study periods are recommended to determine muscle activation changes post CIMT.
Measuring processing speed after traumatic brain injury in the outpatient clinic
Authors: Fong Kenneth N.K. , Chan Marko K.L. , Ng Peggie P.K. , Ng Serena S.W.
Published: December 2019

Objectives:

To evaluate processing speed performance in outpatients with moderate-to-severe traumatic brain injury (TBI).

Design:

Prospective cross-sectional observational study.

Participants:

Twenty outpatients with traumatic brain injury (TBI) were compared with 20 matched healthy subjects.

Measure:

Measurement by six instruments in the domains of simple reaction time (SRT), movement time (MT), and mental processing speed at a single time occasion.

Results:

Significant differences were found in speed but not accuracy of work between outpatients with TBI and healthy subjects. Simple reaction time was sensitive to predicting patients with moderate-to-severe TBI as opposed to healthy counterparts.

Conclusion:

Outpatient clinics should consider measuring SRT.
Orthostatic hypotension following spinal cord injury: Impact on the use of standing apparatus
Authors: Chelvarajah Ramesh
Published: December 2019

Introduction:

Upright posture confers numerous medical and social benefits to a spinal cord injured (SCI) patient. Doing so is limited by symptoms of orthostatic hypotension. This is a common secondary impairment among tetraplegic sufferers.

Objective:

Establish the proportion of SCI patients who are restricted from using standing apparatus, such as standing frames and standing wheelchairs, because of inducing symptomatic orthostatic hypotension or the fear of developing these disabling symptoms.

Study Design:

Survey conducted by Internet-accessible electronic questionnaire. Questionnaire validated for reliability and accuracy.

Results:

293 respondents. Mean age 44.6; 76% male. Median time from injury: 7 years. 38% suffered with orthostatic hypotension; majority were complete injuries and all (except one – T12) were T5 or above level. 52% replied that they were using standing wheelchairs or frames. Of these, 59 (20% of total) stated that orthostatic hypotension symptoms were limiting the use of their upright apparatus. Of those who did not use standing wheelchairs or frames, 16 (5.5% of total) reported that this was because of the fear of worsening their orthostatic hypotension.

Conclusion:

Orthostatic hypotension restricts standing apparatus use in a large proportion (a total of 25.5% of respondents in this survey) of SCI patients.
An ultrasound study of brain tissue biomechanics in patients following craniectomy
Authors: Trnovec Svorad , Halatsch Marc-Eric , Behnke-Mursch Julianne , Mursch Kay
Published: December 2019

So far, little attention has been paid to the biomechanical aspects of decompressive craniectomy. The brain tissue deformation occurring in these patients is difficult to quantify. Twenty-six patients suffering from a large bone defect after craniectomy were examined in supine position. The third ventricle's axial diameter was measured by transcranial ultrasound. Subsequently, the patient was brought into a sitting position. After 5 minutes, another measurement was taken. This procedure was repeated about 7 days after cranioplasty. The patients were grouped according to “early cranioplasty” (cranioplasty within 40 days after craniectomy, median 30 days) and “late cranioplasty”, (cranioplasty more than 40 days, median 80 days).

Data of 13 healthy volunteers were used as a reference standard.

In the healthy volunteers, the third ventricle was enlarging after reaching the sitting position. The median diameter was 2.35 mm in the lying and 2.9 mm in the sitting position ( p > 0.05). In the patients before early cranioplasty, a decrease of the diameter after reaching the sitting position was observed. The mean diameter was 7.0 mm in the lying and 5.9 mm in the sitting position ( p > 0.01). This difference was not significant in patients before late cranioplasty (9.7 vs. 9.4 mm).

After cranioplasty, the mean diameter was 6.6 and 6.2 mm in the early cranioplasty group and 9.2 mm and 9.4 mm in the late cranioplasty group (lying and sitting position, respectively).

This data demonstrate for the first time that unphysiological orthostatic brain tissue deformation occurs in patients after craniectomy.
Clinical application of diffusion tensor tractography for elucidation of the causes of motor weakness in patients with traumatic brain injury
Authors: Jang Sung Ho , Kim Dae-Shik , Son Su Min , Cho Yun Woo , Kim Seong Ho , Kim Oh Lyong , Ahn Sang Ho
Published: December 2019

Diffusion tensor tractography (DTT) is useful for elucidating the status of the corticospinal tract (CST). The purpose of this study was to investigate the usefulness of DTT for determining the causes of motor weakness in patients with traumatic brain injury (TBI). Five patients with TBI were recruited for this study. DTT was performed using 1.5-T with a Synergy-L Sensitivity Encoding (SENSE) head coil. DTT was obtained with termination criteria of FA < 0.2 and an angle change > 45°. On the DTT of patient 1, who had diffuse axonal injury, the focal lesion was detected in the left pons, and was not detected on routine brain images. In patients with deep cerebral hemorrhage, the integrity of the CST of patient 3 was preserved, although the lesion was more extensive than that of patient 2, who showed severe degeneration with the disruption of the CST at the lesion site. In patient 4, the integrity of the left CST was disrupted by a left transtentorial herniation. Although the CST of the affected hemisphere was connected at the cortex level in patient 5, who had a cortical contusional hemorrhage, the motor function of the lower extremity was worse than that of the upper extremity according to the involvement of the somatotopic area of the primary motor cortex. DTT would be useful in elucidating the causes of motor weakness in patients with TBI at the subcortical level, including conditions such as diffuse axonal injury, deep intracerebral hemorrhage, and transtentorial herniation.
Effects of vocalization on elbow motion during reaching in persons with hemiparetic stroke
Authors: Park Ji-Hyuk , Yoo Eunyoung , Chung Boin , Jung Minye
Published: December 2019

Aim:

To observe the effect of self-vocalization on the quality of movement of each arm during a reaching task in people with left hemiparetic stroke.

Method:

The design of this study is a single-blinded, within subject, repeated measures design. Fourteen right-handed participants with left hemiparetic stroke were requested to perform a reaching task with each arm, with and without self-vocalization. A 3-D motion analysis system measured the peak angular velocity, time to peak angular velocity, and movement unit in elbow motion.

Results:

In the unaffected dominant right arm, movements during the reaching task with vocalization were faster, smoother, and more efficient than without vocalization. The peak angular velocity ( p < 0.05) and time to peak angular velocity ( p > 0.05) increased. The movement unit decreased significantly ( p < 0.05). However, in the affected non-dominant left arm, the movement with vocalization was slower, rougher, and less efficient. The peak angular velocity decreased ( p > 0.05). Time to peak angular velocity ( p < 0.05) and the movement unit increased significantly ( p < 0.05).

Conclusion:

Self-vocalization provided a positive effect on reaching movement of the dominant side but a negative effect on reaching movement of the non-dominant side in right handed persons with left hemiparetic stroke.
Effects of age, gender, and cognitive, functional and motor status on functional outcomes of stroke rehabilitation
Authors: Öneş Kadriye , Yalçinkaya Ebru Yilmaz , Toklu Banu Çetinkaya , Çağlar Nil
Published: December 2019

Our objective was to evaluate the relation between age, gender, initial functional, cognitive and motor condition, spasticity, diabetes mellitus, and functional outcome after rehabilitation of stroke patients. Eighty-eight patients who had suffered stroke were administered in this study. Participants were stroke patients undergoing rehabilitation in Istanbul Physical Treatment and Rehabilitation Training and Research Hospital. Functional condition (Functional Independence Measurement (FIM)), spasticity (Ashworth Scale), cognitive condition (Mini Mental State Evaluation (MMSE)), post-treatment FIM were measured.

A significant positive association between MMSE at admission and the functional discharge measures was observed. A significant positive association Brunnstrom (upper lower extremity assessment) scores and the functional discharge measures was observed. A significant positive association between spasticity at admission and the functional discharge measures was observed.

In conclusions, the admission functional, motor, cognition condition, age, spasticity were a significant predictors of total and motor FIM score at discharge, but not gender and diabetes mellitus.
Enhancing quality of life through Universal Design
Authors: Joines Sharon
Published: December 2019

Objectives:

To inform clinicians, caregivers and researchers involved with assessing and treating individuals with neurological disabilities of the benefits of universal design in enhancing quality of life. The improvement of quality of life has the potential to benefit the individuals with neurological disabilities and those whose lives overlap and intersect with those individuals.

Methods:

Literature and design reviews are used as a foundation for a model for incorporating and leveraging universal design to the benefit of the patient’s social sphere, which includes caregivers, family members and medical staff. By matching patients varied abilities with universal design solutions, the model of universal design benefitting the patients’ social sphere will be demonstrated.

Recommendations:

Recommendations are made for clinicians and researchers that they may use in their practices and investigations in three areas: 1) educating patients about the benefits of universal design, 2) helping inform patients how to leverage universally designed products and approaches in their lives and living spaces and 3) understanding how to incorporate universal design principles into research and clinical spaces as demonstration pieces for patients.
The usefulness of DTI for estimating the state of cerebellar peduncles in cerebral infarct
Authors: Hong Ji Heon , Jang Sung Ho
Published: December 2019

Elucidation of the state of cerebellar peduncles (CPs) is difficult because CPs are not completely isolated from adjacent structures and long structures. We attempted to investigate the usefulness of diffusion tensor tractography (DTT) in patients with CP lesions resulting from cerebral infarct. We recruited 6 patients with CP infarct and 6 age-and sex-matched control subjects. Diffusion tensor images (DTIs) were acquired using a sensitivity-encoding head coil at 1.5 T. Three cerebellar peduncles, namely, the superior cerebellar peduncle (SCP), the middle cerebellar peduncle (MCP), and the inferior cerebellar peduncle (ICP) were evaluated using DTI-Studio software. We were able to determine the state of the CP, which could not be detected by conventional brain MRI, according to the following aspect: 1) the presence of a CP lesion resulted from an infarct, 2) the completeness of a CP lesion, and 3) in case of incomplete injury to the CP, the location where integrity was preserved. Therefore, we believe that DTT can give us useful informations on the state of CPs which can not get from conventional brain MRI in patients with cerebral infarct.
Effect of task related circuit training on walking ability in a Multiple Sclerosis subject. A single case study
Authors: Sethy Damayanti , Bajpai Pankaj , Kujur Eva Snehlata
Published: December 2019

Objective:

To investigate the effectiveness of task related circuit training on walking ability in a Multiple Sclerosis subject.

Design:

Single case study of a man diagnosed with moderate primary progressive type of multiple sclerosis.

Method:

Baseline measurement of lower limb muscle strength, speed test, Timed “Up and Go” test and 6-minute walk test, Modified fatigue impact scale and Expanded Disability Status Score were taken. After baseline measurement, subject was explained the sequence of tasks to be used in circuit training and the subject was given task related circuit training for 12 weeks. Post training measurements for all the outcome measures were taken.

Setting:

Department of Occupational Therapy, NIOH, Kolkata, West Bengal, India.

Participant:

A 34 -year -old male.

Intervention:

Task related Circuit training for a session of 45 minutes, 3 days per week for 12 weeks.

Results:

The subject showed improvement in speed test, step test, 6-minute Walk Test. Also, fatigue was reduced. The walking ability of the subject improved, with increase in muscle strength, endurance, and physical fitness.

Conclusion:

Task-related circuit training is effective in improving muscle strength and endurance, and in decreasing the fatigue of the subject thereby improving the subject’s ability to walk.
Acute effects of locomotor training on neuromuscular and metabolic profile after incomplete spinal cord injury
Authors: Gorgey Ashraf S. , Poarch Hunter , Harnish Christopher , Miller Joshua M. , Dolbow David , Gater David R.
Published: December 2019

Objectives:

Locomotor training (LT) enhances walking in individuals with spinal cord injuries (SCIs). We tested the acute effects of 4 days of LT using BWSTT combined with Robotic Locomotor therapy compared to BWSTT twice weekly.

Design:

Two non-ambulatory participants with an American Spinal Injury Association Impairment Scale (AIS) D. Both received LT for 2 weeks as a portion of their clinical inpatient rehabilitation program and both used wheelchairs as their primary method of mobility. Over a 2 week period, one participant received a total of 8 visits consisting of manual BWSTT (twice weekly) combined with Robotic locomotor therapy (twice weekly). The other participant preformed manual BWSTT (twice weekly) for a total of 4 visits. Resting energy expenditure, body composition, muscle strength, submaximal oxygen consumption (VO2) and blood lactate during LT were measured pre and post-training.

Results:

The average maximum voluntary contraction of both knee extensor muscle groups increased by 28–34% with associated reduction in spasticity to the BWSTT participant. Two week interventions resulted in a downward shift of the lactate concentrations for both participants, increase in resting energy expenditure and shift in substrate utilization.

Discussion and conclusion:

A clinical paradigm of incorporating BWSTT with robotic locomotor therapy for 4 days/ week did not provide additional physiological benefits to skeletal muscle strength, spasticity or metabolic profile compared to twice weekly of LT using BWSTT.
Prognostic factors for motor outcome in patients with compressed corticospinal tract by intracerebral hematoma
Authors: Kwak So Young , Son Soo Min , Choi Byung Yeon , Chang Chul Hoon , Byun Woo Mok , Kim Seong Ho , Cho Yoon Woo , Jang Sung Ho
Published: December 2019

Little is known about prognostic factors associated with motor outcome when the corticospinal tract (CST) was compressed by hematoma. Using diffusion tensor tractography (DTT), we attempted to investigate prognostic factors for motor outcome in patients whose affected CST was compressed by hematoma. The study included 51 consecutive severe hemiparetic patients with a hematoma involving the corona radiata and basal ganglia. Integrities of the affected CSTs were preserved to the cerebral cortex and were found to be compressed by a hematoma on DTT. Patients were classified into four groups according to the region which the CST was originated from the precentral gyrus (type A), postcentral gyrus (type B), posterior parietal cortex (type C), and premotor cortex (type D). We measured the ratios of DTT parameters between affected/unaffected hemispheres.The motor function of the affected extremities at 6-month after onset was better with the following order: DTT type A, type B, type C, and type D patients. The 6-month motor function for DTT type A patients was higher than that of DTT type D patients ( p = 0.008). The fractional anisotropy ratio between the affected and unaffected CST was positively correlated with the 6-month motor function of the affected extremities (Pearson's correlation coefficient, p = 0.025, r = 0.313). We found that motor outcome differed according to the originated area of the affected CST and the degree of injury of the affected CST in patients whose affected CST was compressed by hematoma.
Different cortical activation patterns during voluntary eccentric and concentric muscle contractions: An fMRI study
Authors: Kwon Yong-Hyun , Park Ji-Won
Published: December 2019

Concentric and eccentric muscle contractions have distinct differences in their neuromuscular and neurophysiologic characteristics. However, although many evidences regarding the features of these types of muscle contraction have emerged, there have been few neuroimaging studies to compare the two types of contractions. Therefore, we investigated whether cortical activity associated with eccentric contraction of the wrist extensors differed from that of concentric contraction, using functional MRI (fMRI). Fifteen right-handed healthy subjects were enrolled in this study. During 4 repeating blocks of eccentric and concentric muscle contraction paradigms, the brain was scanned with fMRI. The differences in the BOLD signal intensities during the performance of eccentric and concentric exercise were compared in the predetermined regions of interest. Our findings revealed that many cortical areas associated with motor performance were activated, including the primary motor area, the inferior parietal lobe, the pre-supplementary area (pre-SMA), the anterior cingulate cortex, the prefrontal area, and the cerebellum. In addition, lower signal intensities were seen in the right primary motor cortex and right cerebellum during eccentric contractions compared with concentric contractions, whereas higher signal intensities were detected in other cortical areas during eccentric contractions. In the study, we demonstrated that eccentric and concentric muscle contractions induced quite different patterns of cortical activity respectively. These findings might be attributed to different strategy of neuro-motor processing and a higher level of cognitive demand for the performance of motor task with a higher degree of difficulty such as that required during eccentric contractions in comparison of concentric contractions.
The effects of spinal cord injury and exercise on bone mass: A literature review
Authors: Dolbow D.R. , Gorgey A.S. , Daniels J.A. , Adler R.A. , Moore J.R. , Gater D.R.
Published: December 2019

Introduction:

Bone loss is a common and often debilitating condition that accompanies spinal cord injury. Because bone loss after spinal cord injury is multifactorial, it can be difficult to assess and treat. This process becomes even more complex as secondary conditions associated with aging are introduced.

Purpose:

There are two purposes of this literature review. The first is to summarize information concerning the mechanisms of bone loss and osteoporosis after spinal cord injury. The second is to summarize existing data concerning the effects of exercise on bone loss after spinal cord injury.

Method:

Literature was reviewed concerning the bone loss process and the non-pharmacological treatment options for ameliorating bone loss after spinal cord injury.

Results:

(Part One) Osteoporosis is universal in persons with chronic complete spinal cord injury, which increases the risk of bone fracture. Bone loss after spinal cord injury is both sublesional and regional with the greatest areas of bone demineralization being in the sublesional trabecular laden areas of the distal and proximal epiphyses of the femur and tibia. (Part Two) While passive weight bearing of paralyzed lower extremities appears to be ineffective, stressing the bones through muscular contractions initiated by electrical stimulation (FES) have yielded positive results in some cases. The intensity, frequency, and duration of stress to the bones appear to be important determinants of improved bone parameters. Although further quantification of these components is needed, some generalized guidelines can be deduced from completed research. Intensities showing positive results have been loads of one to one and a half times body weight for FES exercise or having participants FES cycle at their highest power output. Safety precautions must be used to decrease risk of bone fracture. Generally, the frequency is effective with three or more weekly exercise sessions. Studies of duration suggest that several months to one or more years of FES are necessary.

Discussion:

In order to promote healthy and independent aging in patients with spinal cord injury, it is important to understand the processes, consequences and effective treatments involved with bone loss.
Delayed neural degeneration following gamma knife radiosurgery in a patient with an arteriovenous malformation: A diffusion tensor imaging study
Authors: Yeo Sang Seok , Jang Sung Ho
Published: December 2019

Gamma knife surgery (GKS) is a proven modality for the treatment of arteriovenous malformations (AVMs), but neural degeneration is a serious complication of GKS. In this study, we report on a patient who displayed delayed neural degeneration following GKR, using diffusion tensor imaging (DTI). A 43-year-old male patient was diagnosed with an intraventricular hemorrhage (IVH) due to rupture of an AVM in the right middle cerebellar peduncle, and exhibited cognitive impairment, quadriparesis, and ataxia after IVH onset. He underwent GKS 5 weeks after onset. Brain MRIs performed at 6 weeks, 7 months, and 21 months post-onset revealed encephalomalactic lesions in the right pons, middle cerebellar peduncle, and medulla oblongata. DTI at 6 weeks post-onset suggested neural injuries of the right corticospinal tract (CST), right middle cerebellar peduncle (MCP), and right inferior cerebellar peduncle (ICP). DTI at 7 months suggested that the right CST and right ICP had recovered to some extent, which concurred with improved clinical manifestations. However, at 21 months, four neural tracts (right CST, right MCP, and both ICPs) appeared to have degenerated, which was in-line with aggravation of corresponding clinical manifestations. Experiences of this patient suggest DTI is a useful technique for the detection of neural degeneration after GKS.
An adolescent with intact motor skills and intelligence after infant hemorrhagic stroke without rehabilitation therapy: A case report
Authors: Lee Shenghuo , Yan Tiebin , Lu Xiao
Published: December 2019

Devastating intracerebral hemorrhagic stroke is rarely encountered in children, but it has a high mortality rate. The case of a 15-year-old boy who survived a major stroke at 40 days old is described. He showed no significant motor or intelligence impairment in adolescence until he was hospitalized for transient left had tremors and slight left hand weakness caused by a cyst. The patient's almost complete motor recovery highlights the power of neural plasticity in young patients. The pediatric stroke was huge, but this did not affect his adolescent movement or intelligence, demonstrating the great neuroplastic potential of the developing human brain. These observations may help increase our knowledge about stroke in children and improve the treatment of pediatric stroke patients.
Reliability of the Functional Reach Test and the influence of anthropometric characteristics on test results in subjects with hemiparesis
Authors: Martins Emerson Fachin , de Menezes Lidiane Teles , de Sousa Pedro Henrique Côrtes , de Araujo Barbosa Paulo Henrique Ferreira , Costa Abraão Souza
Published: December 2019

First designed as an alternative method of assessing balance and susceptibility to falls among elderly, the Functional Reach Test (FR) has also been used among patients with hemiparesis. Then this study aimed to describe the intra- and inter-rater and the test/re-test reliability of the FR measure in subjects with and without hemiparesis while verifying anthropometric influences on the measurements. The FR was administered to a sample of subjects with hemiparesis and to a control group that was matched by gender and age. A two-way analysis of variance was used to verify the intra-rater reliability. It was calculated using the differences between the averages of the measures obtained during single, double or triple trials. The intra-class correlation coefficient (ICC) was utilized and data plotted using the Bland-Altman method. Associations were analyzed using Pearson's correlation coefficient. In general, the intra-rater analysis did not show significant differences between the measures for the single, double or triple trials. Excellent ICC values were observed, and there were no significant associations with anthropometric parameters for the hemiparesis and control subjects. FR showed good reliability for patients with and without hemiparesis and the test measurements were not significantly associated with the anthropometric characteristics of the subjects.
Treatment of hemispatial neglect in patients with post-hemiparesis: A single-subject experimental design study using a whole-body tilt exercise plus mental practice
Authors: Kang Tae-Woo , Oh Duck-Won
Published: December 2019

Purpose:

To investigate the effect of whole-body tilt exercise for treating hemispatial neglect and to identify the effects of incorporating mental practice into the exercise.

Methods:

We used a single-subject experimental design alternating with multiple baselines. Three stroke patients with hemispatial neglect participated in this study. The severity of hemispatial neglect and balance function were measured during baseline and intervention sessions. The whole-body tilt exercise was performed by using a device that allows the body to tilt 20° from the neutral upright position. Mental practice consisted of 5 min of relaxation, main whole-body tilt imagination, and normalization phases.

Results:

When the whole-body tilt exercise alone was performed, the average severity score of hemispatial neglect in subjects 1, 2, and 3 decreased by 7.54, 10.02, and 8.24, respectively; their respective average balance function score increased by 35.95%, 28.13%, and 15.33% under the open-eye condition and 34.66%, 20.33%, and 13.77% under the closed-eye condition. For subjects 1, 2, and 3, the respective average hemispatial neglect score decreased by 9.07, 11.35, and 10.13 after the whole-body tilt exercise with mental practice; their average balance function scores increased by 40.15%, 33.38%, and 24.22% under the open-eye condition and by 38.93%, 27.08%, and 11.88% under the closed-eye condition, respectively.

Conclusion:

These findings suggest that a whole-body tilt exercise alone may be beneficial in enhancing hemispatial neglect symptoms but the addition of mental practice produces a greater positive effect.
Design of a semi-passive UHF RFID tag IC with freight security monitoring function
Authors: Wang Yao , Liu Jiaxin , Xie Liangbo , Chen Jian , Wen Guangjun
Published: December 2019

A semi-passive ultra-high-frequency-band radio frequency identification tag IC with freight security monitoring function is proposed. The tag can record the number of times a container has been opened during transport and is compatible with Electronic Product Code Class-1 Generation-2 protocol. A switch-state monitoring unit is presented with power control logic that makes the tag return to sleep mode after each recording operation. An optimized differential rectifier is designed after the analysis and comparison of the different rectifier architectures. The rectifier is designed along with a voltage regulator and a wake-up circuit to comprise a power management unit for generating two output voltages of 1 and 1.8 V at 915 MHz. A baseband processor with a jitter suppression module is employed to improve system reliability. The tag chip is designed in TSMC 0.18 μm CMOS process and simulated with Spectre. According to the simulation results, the power consumption of the tag is 9.56 μW under activation mode, and the sleep current is only 645 pA under the typical condition.
Reducing out of stock, shrinkage and overstock through RFID in the fresh food supply chain: Evidence from an Italian retail pilot
Authors: Bertolini Massimo , Ferretti Gino , Vignali Giuseppe , Volpi Andrea
Published: December 2019

The paper shows how to leverage RFID technology in fresh fast moving consumer goods (FMCG) industry, and, in particular, to optimally manage stock levels on shelves, shelves replenishment, and shrinkage prevention for fresh perishable products. We deployed a pilot project on a FMCG retail supply chain, encompassing a distribution centre and two stores of a major Italian retailer. About 60 products have been RFID tagged at case level. We real time tracked cases of products for 4 months, through the distribution chain all the way to the stores, where the RFID deployment made it possible to punctually monitor shelves stock levels, backroom stock levels and product shrinkage. We demonstrate that the out of stock (OOS) problem is just one piece of a broader picture, that is shelves stock optimization. The higher the stock level on the shelves, the lower the need for shelf replenishment, and thus the likelihood of an OOS. However, the capital holding costs and the risk for product shrinkage increase. The latter issue is particularly relevant for fresh perishable products. This pilot demonstrates that a retailer could reduce OOS, shrinkage and capital holding costs all together, by means of efficient RFID data management. Potential savings for fresh products account approx 1.7% of sale turnover. This study is the first pilot project which assesses the impact of RFID technology on the supply chain of fresh perishable products; a full roll-out of the project is being planned for the next future.
Evaluating RFID opportunity through process analysis
Authors: Busato Davide , Fera Marcello , Iannone Raffaele , Mancini Vincenzo , Schiraldi Massimiliano M.
Published: December 2019

Current literature agrees that one of the main results obtained by adopting RFID lies in an improved efficiency increase in material handling operations, especially regarding reductions in the time required to perform certain procedural steps. However, by evaluating only the advantages that can be easily quantified and definitely achieved may lead to limited results. This paper presents a business case of a large European Consumer Packaged Goods (FMCG) company in the cosmetics and beauty sector. Eleven processes in receiving, handling, storage and delivery procedures in one of the main distribution centres of the company were analysed and modelled using a detailed Business Process Modelling (BPM) approach. Since savings were evaluated only in terms of the reduction of resources used - achieved through process acceleration - despite the company dealing in huge volumes of high-margin products, the feasibility study turned out to be negative. Thus, the paper concludes with a brief discussion of how companies should take on this challenge if process timing benefits are insufficient. The detailed process analysis reported in this paper may be useful for operation practitioners or any manufacturing company or distribution centre about to start an as-is versus to-be comparison of their material handling procedures for RFID implementation.
Pervasiveness of RFID technology: A survey based on case studies analysis
Authors: Elia V. , Gnoni M.G.
Published: December 2019

RFID technology is no longer an experimental technology but is now widely applied in business processes aiming to increase performance both in public and private sectors. Together with traditional sectors (e.g. logistics, retail), the large potentiality of this technology is supporting its adoption in completely new emerging sectors (e.g. entertainment, payment). Thus, several challenges are still open: one critical point is the application cost; furthermore, as several research studies have pointed out operational as well as strategic benefits, this is yet an open research topic. The aim of the proposed study is to “measure” the adoption level of RFID technology by critically analyzing field study applications: a survey has been performed on case studies published by RFID Journal – a well-known media company – in two years (from January 2010 to January 2012). A specific taxonomy – based on main critical points characterizing RFID application – has been proposed in order to support potential RFID adopters in designing their own application. Results have showed as RFID technology is really pervasive in several sectors and geographical areas, even if the level of diffusion is quite different from one area to another.