bluuebunny/crossref_metadata_2025_split huggingface dataset:
A hippotherapy simulator is effective to shift weight bearing toward the affected side during gait in patients with stroke
Authors: Sung Yun-Hee , Kim Chang-Ju , Yu Byong-Kyu , Kim Kyeong-Mi 
Published: December 2019

Aim: We investigated whether a hippotherapy simulator has influence on symmetric body weight bearing during gait in patients with stroke. Method: Stroke patients were divided into a control group (n = 10) that received conventional rehabilitation for 60 min/day, 5 times/week for 4 weeks and an experimental group (n = 10) that used a hippotherapy simulator for 15 min/day, 5 times/week for 4 weeks after conventional rehabilitation for 45 min/day. Temporospatial gait assessed using OptoGait and trunk muscles (abdominis and erector spinae on affected side) activity evaluated using surface electromyography during sit-to-stand and gait. Prior to starting the experiment, pre-testing was performed. At the end of the 4-week intervention, we performed post-testing. Result: Activation of the erector spinae in the experimental group was significantly increased compared to that in the control group (p < 0.01), whereas activation of the rectus abdominis decreased during sit-to-stand. Of the gait parameters, load response, single support, total double support, and pre-swing showed significant changes in the experimental group with a hippotherapy simulator compared to control group (p < 0.05). Moreover, activation of the erector spinae and rectus abdominis in gait correlate with changes of gait parameters including load response, single support, total double support, and pre-swing in experimental group. Conclusion: These findings suggest that use of a hippotherapy simulator to patients with stroke can improve asymmetric weight bearing by influencing trunk muscles.
Effects of Ai-Chi on balance, functional mobility, strength and fatigue in patients with multiple sclerosis: A pilot study
Authors: Bayraktar Deniz , Guclu-Gunduz Arzu , Yazici Gokhan , Lambeck Johan , Batur-Caglayan Hale Zeynep , Irkec Ceyla , Nazliel Bijen 
Published: December 2019

Background: Multiple Sclerosis (MS) patients are often referred to aquatic physical therapy, but unfortunately, researches on the effects of aquatic therapy in MS patients are limited. Objective: The purpose of this study was to investigate the effects of Ai-Chi on balance, functional mobility, strength and fatigue in ambulatory patients with MS. Methods: Twenty-three ambulatory female patients were divided into two groups as experimental (n = 15) or control (n = 8) for an 8-week treatment program. The experimental group underwent Ai-Chi exercises in a swimming pool and the control group performed active arm and leg exercises combined with abdominal breathing exercises at home. Static standing balance was measured with duration of one-leg stance, functional mobility was evaluated with Timed-up and Go test and 6 minute walk test, upper and lower muscle strength was assessed with hand-held dynamometer and fatigue was evaluated with Fatigue Severity Scale. Results: Improvements were observed in static standing balance, functional mobility, upper and lower extremity muscle strength and fatigue in the Ai-Chi group (p < 0.05), but no significant differences in any outcome measures were observed in the control group (p > 0.05) after the intervention. Conclusions: According to these findings Ai-Chi may improve balance, functional mobility, upper and lower extremity muscle strength and fatigue in patients with MS.
Evaluation of intrarater and interrater reliability of the Wisconsin Gait Scale with using the video taped stroke patients in a Turkish sample
Authors: Yaliman A. , Kesiktas N. , Ozkaya M. , Eskiyurt N. , Erkan O. , Yilmaz E. 
Published: December 2019

Objective: To establish the intrarater and interrater reliability of Wisconsin Gait Scale (WGS) in hemiplegic patients. Design: Repeated-measures reliability study using video data of stroke patients. Setting: Rehabilitation department of the university hospital. Participitants: Nineteen hemiplegic patients with 3–9 months stroke history and two physiatrists and two physical therapists. Interventions: Video recordings were assessed twice, at an interval of 2 days, by the two physiatrists and two physical therapists. Main outcome measure: Wisconsin Gait Scale. Results: Internal consistency coefficients for the WGS were excellent; Cronbach scores were 0.91 and 0.94 for the first and third days. Coefficient of Repeatability (CR) for observers' WGS assessments were ranged between 4.23–5.76 and intraclass correlation coefficients for total WGS score were indicated very high interrater reliability at the begining and end, respectively 0.91 and 0.96. Intraclass correlation coefficients for fourteen items of WGS ranged from 0.81 to 1. “Hip hiking at mid-swing”, “Circumduction at mid-swing” and “Hip extension of the affected leg” were the items with lowest correlation coefficients. Intrarater reliability for total WGS scores ranged from 0.75 to 0.90. Conclusion: WGS was found excellent in reliability and may provide an objective means to document the findings from observational gait analysis, which is frequently used in clinical practice by rehabilitation teams.
Feasibility study of a combined treatment of electromyography-triggered neuromuscular stimulation and mirror therapy in stroke patients: A randomized crossover trial
Authors: Kojima Kosuke , Ikuno Koki , Morii Yuta , Tokuhisa Kentaro , Morimoto Shigeru , Shomoto Koji 
Published: December 2019

Background: Mirror therapy (MT) and electromyography-triggered neuromuscular stimulation (ETMS) are both effective treatments for impaired upper limbs following stroke. A combination of these two treatments (ETMS-MT) may result in greater gain than either treatment alone. Objectives: The feasibility and possible effects of ETMS-MT upon upper extremity function were investigated in stroke patients. Methods: Thirteen post-acute stroke patients were randomly assigned to an immediate ETMS-MT group or a delayed ETMS-MT group and then underwent an 8-week training program. The immediate ETMS-MT group received ETMS-MT in addition to physical and occupational therapy (PT+OT) for 4 weeks. They then received only PT+OT for the next 4 weeks. In the delayed ETMS-MT group, interventions were provided in the reverse order. The main outcome measure was the Fugl-Meyer Assessment (FMA). Results: The immediate ETMS-MT group showed significantly greater gain in FMA in the first 4 weeks. The delayed ETMS-MT group showed significantly greater gain in active range of motion during the latter 4 weeks. No adverse effects were reported following ETMS-MT. Conclusion: ETMS-MT might be as effective as independent MT or ETMS without causing any side effects. Future research should focus upon the direct comparisons between independent and combined interventions.
Cognitive dysfunction and functional limitations are associated with major depression in stroke survivors attending rehabilitation in Nigeria
Authors: Ojagbemi Akin , Akinyemi Rufus , Baiyewu Olusegun 
Published: December 2019

Background: The frequency and predictors of post-stroke depression diagnosed according to codified criteria remain unknown in Nigeria. Objectives: We report on the predictors of post-stroke major depressive disorder (MDD) in Nigeria using standardized assessment methods. Method: Using a case-control design, we consecutively recruited 260 participants. Among them were 130 stroke survivors attending rehabilitation. Along with historical details, an exploration for MDD meeting criteria in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders was carried out using a semi-structured interview. Cognition was assessed using both the Mini Mental State Examination and the modified Indiana University Token test, while disability was assessed using the modified Rankin Scale. Associations were explored using univariate and multivariate analyses. Results: The diagnosis of MDD was more frequently present in the stroke survivors (41.5%, p < 0.001). It was strongly associated with female gender (p < 0.001, O.R = 3.77, 95% C.I = 1.78–8.00), disability (p = 0.001, O.R = 3.27, 95% C.I = 1.57–6.83), and cognitive dysfunction (p < 0.001, O.R = 5.28, 95% C.I = 2.25–12.41). Female gender (p = 0.037, O.R = 2.65, 95% C.I = 1.06–6.62) and cognitive dysfunction (P = 0.03, O.R = 4.58, 95% C.I = 1.68–12.46) were independent predictors of post-stroke MDD. Conclusion: Post stroke MDD is common in Nigerian survivors attending rehabilitation. The high rates reported in this population may be the result of factors affecting the efficient management of stroke in developing countries.
Effectiveness of a novel community exercise transition program for people with moderate to severe neurological disabilities
Authors: Ploughman Michelle , Shears Jennifer , Harris Chelsea , Hogan Stephen H. , Drodge Olivia , Squires Sherry , McCarthy Jason 
Published: December 2019

Purpose: To determine the effectiveness of a community re-integration exercise initiative on function, mood, participation, and exercise adherence for persons with moderate to severe neurological conditions (stroke, multiple sclerosis, etc.). Methods: We recruited 29 adults (able to walk at least 3 m with assistance) discharged from an outpatient rehabilitation program for the 10 week intervention which was comprised of two components: circuit training and guided transition to a standard gym setting. We evaluated participants before and after the intervention and at four month follow up, including functional balance and mobility using the Timed Up and Go Test, walking endurance using the 6 Minute Walk Test, health related quality of life (HR QoL) using a visual analogue scale, activity and participation using the Frenchay Activities Index and mood using the Hospital Anxiety and Depression Scale. Results: Twenty-seven participants completed the intervention. The only significant improvement was in HR QoL. Forty-four percent of participants continued to exercise after cessation of the program. Those who continued to exercise (Exercisers n = 12) experienced more improvement in HR QoL than Non-Exercisers (n = 15). Conclusions: This re-integration initiative for people with neurological impairments improved HR QoL and facilitated independent exercise for 44% of participants. The novel component of the program, which facilitated transition to standard gym equipment, likely contributed to improved exercise adherence in the longer term.
Interdisciplinary rehabilitation outcomes following thrombolysis for acute ischaemic stroke: A case series
Authors: Finch Emma , Fleming Jennifer , Clark Kathy , Hayward Kathryn S. 
Published: December 2019

Background: Thrombolysis with recombinant tissue plasminogen activator (rtPA) is part of routine acute stroke clinical practice worldwide. Yet, it is unclear how rtPA influences specific rehabilitation outcomes, such as motor, cognitive and communication function. Objective: The present study aimed to collect pilot data about the effects of rtPA on communication and motor recovery during the first three months post-rtPA. Methods: Four individuals who received thrombolysis with rtPA for a single left hemisphere ischaemic stroke completed an assessment battery two weeks and three months post-stroke. Information pertaining to allied health service usage was also investigated. Results: Reliable changes in assessment scores were observed for lower limb function in two participants with severe functional limitations. There was no reliable change in lower limb function for the two milder participants, or for any participants in upper limb or language function. Service usage varied between participants. Two participants required extensive inpatient rehabilitation. Three participants required outpatient or community rehabilitation. Conclusions: Tailoring of the service delivery approach may be required for individuals who receive rtPA based on functional limitations evident post-rtPA. Future research into the impact of rtPA on motor, cognitive and communication recovery after stroke is vital to inform rehabilitation programs and optimize outcomes.
Factors influencing interest in providing MS patient care among physiatry residents
Authors: Kane Heather , Halpern Michael T. , Teixeira-Poit Stephanie , Frost Corey , Keating Michael , Olmsted Murrey , Johnson Shana 
Published: December 2019

Background: Rehabilitation care is an important part of comprehensive care for MS patients. Little is known about the number of physiatry residents who are interested in providing care to individuals with multiple sclerosis [MS]. Objective: This study examines factors that influence physiatry residents' interest in providing care to MS patients. Methods: We randomly sampled half of all Accreditation Council for Graduate Medical Education-certified physical medicine and rehabilitation residency programs in the continental United States and Puerto Rico. Surveys were received from 74% of programs (Stage 1 response rate) and from 221 residents (45% Stage 2 response rate). Results: Residents expressing interest in providing MS care were more likely to be female, Asian, and to select statements emphasizing multidisciplinary care approaches and a community of dedicated professional colleagues as positive features of MS patient care. Residents interested in teaching and with more education debt were marginally more likely to express interest in MS care. Conclusions: Medical education should emphasize the need for physical medicine and rehabilitative care among individuals with MS, the ability of physiatrists to improve the functional status and quality of life for MS patients, and the team-based nature of MS care.
The role of cognitive training in the neurorehabilitation of a patient who survived a lightning strike. A case study
Authors: Tánczos Tímea , Zádori Dénes , Jakab Katalin , Hnyilicza Zsuzsanna , Klivényi Péter , Keresztes László , Engelhardt József , Németh Dezső , Vécsei László 
Published: December 2019

Background: Lightning-related injuries most often involve impairment of the functions of the central and peripheral nervous systems, usually including cognitive dysfunctions. We evaluated the cognitive deficit of a patient who had survived a lightning strike and measured the improvement after her cognitive training. This therapeutic method appears to be a powerful tool in the neurorehabilitation treatment. Objective: The aim of this case study was to prove the beneficial effects of cognitive training as part of the neurorehabilitation after a lightning strike. Methods: Six neuropsychological functions were examined in order to test the cognitive status of the patient before and after the 2-month cognitive training: phonological short-term memory (digit span test and word repetitions test), visuo-spatial short-term memory (Corsi Block Tapping Test), working memory (backward digit span test and listening span test), executive functions (letter and semantic fluencies), language functions (non-word repetition test, Pléh-Palotás-Lörik (PPL) test and sentence repetition test) and episodic memory (Rivermead Behavioral Memory Test and Mini Mental State Examination). We also utilized these tests in aged-matched healthy individuals so as to be able to characterize the domains of the observed improvements more precisely. Results: The patient exhibited a considerable improvement in the backward digit span, semantic fluency, non-word repetition, PPL, sentence repetition and Rivermead Behavioral Memory tests. Conclusions: The cognitive training played an important role in the neurorehabilitation treatment of this lightning injury patient. It considerably improved her quality of life through the functional recovery.
Assistive technology to promote leisure and constructive engagement by two boys emerged from a minimal conscious state
Authors: Stasolla Fabrizio , De Pace Claudia 
Published: December 2019

Background: Post-coma persons with multiple disabilities may represent a challenge to rehabilitation centers, due to their clinical conditions. Moreover, they can failed to engage adaptive responses aimed at the self-management of environmental stimuli. Objectives: To assess the impact and social rating of a new assistive technology set-up for promoting constructive engagement by two post-coma boys emerged from a minimal conscious state. Method: During baseline sessions, the participants were provided with a mouse to manage the computer system. During intervention phases, a new technology was implemented, allowing both participants to manage environmental stimuli with a microswitch instead of the mouse. Furthermore, a social validation assessment was carried out, involving students as raters. Results: Data showed an increasing of constructive engagement by both participants during intervention phases. Sixty psychology students (social raters) favoured the new technology on a six items questionnaire (i.e. enjoyment, suitability, rehabilitation, independence, daily context and support). Conclusions: The new technology was suitable, affordable, effective and socially preferable.
Symptomatic treatment of unresponsive wakefulness syndrome with transcranially focused extracorporeal shock waves
Authors: Lohse-Busch H. , Reime U. , Falland R. 
Published: December 2019

Objective: Can stimulation of nerve growth factors by focused transcranial extracorporeal shock wave therapy (TESWT) be made effective for persons within unresponsive wakefulness syndrome (apallic syndrome)? Design: Between eight and 18 years after the brain lesion, five patients with unresponsive wakefulness syndrome of differing severity received TESWT with the device Duolith (Storz Medical) during four-week physicomedical complex therapies. In the previous years they had been treated with the same complex therapies without TESWT. The vigilance did not change. Results: After two-four years and an average of 5.2 treatment series, the patients' abilities improved by 135.9% on the German Coma Remission Scale (KRS) and by 43.6% on the Glasgow Coma Scale. In the motor area of the KRS, the patients improved by 64.3%. Three PEG feeding tubes could be removed, nonverbal communication initiated four times. Conclusion: In this longitudinal observation study, focused TESWT stimulated vigilance in patients with unresponsive wakefulness syndrome. The precise neurophysiological effects remain to be verified by a study of the clinical results.
The impact of high intensity physical training on motor and non-motor symptoms in patients with Parkinson's disease (PIP): A preliminary study
Authors: Morberg Bo M. , Jensen Joakim , Bode Matthias , Wermuth Lene 
Published: December 2019

Background: Parkinson's disease (PD) is a neurodegenerative disease caused by loss of dopaminergic nigrostriatal neurons. Several studies have investigated various physical interventions on PD. The effects of a high intensity exercise program with focus on resistance; cardio; equilibrium; and flexibility training have not been evaluated previously. Objective: The aim of this study was to investigate the effects of a complex, high intensity physical training program, with a long duration, on motor and non-motor symptoms in patients with PD. Method: 24 patients with PD Hoehn and Yahr stage 1–3 were non-randomly allocated to an intervention group (n = 12) and a control group (n = 12). The intervention group underwent 32 weeks of high intensity personalized physical training twice a week, with an optional extra training session once a week. The control group received general recommendations regarding physical activity. The primary outcomes were the change in Unified Parkinson's Disease Rating Scale Subscores (UPDRS) and the Parkinson's Disease Questionnaire (PDQ-39). Results: At week 32, the training significantly improved both UPDRS motor subscores (p = 0.045), activities of daily living subscores (ADL) (p = 0.006), mentation subscores (p = 0.004) and complication subscores (p = 0.019). The effect on the PDQ39 total score was not statistically significant. The intervention group however experienced a substantial improvement of the PDQ39 items emotional well-being (−11.0) and bodily discomfort (−7.14). Conclusion: The results suggest that a personal high intensity exercise program may favorably influence both motor and non-motor symptoms in patients with mild to moderate PD. More studies with both higher methodology in study design and a follow-up examination are recommended.
FES-propelled cycling of SCI subjects with highly spastic leg musculature
Authors: Szecsi J. , Schiller M. 
Published: December 2019

Background: The presence of spasms precludes the use of artificial electrical activation of the muscles to restore mobility. The prospect of using an electrical stimulus that produces motor activation without causing unwanted reflex activation in patients with high levels of spasticity is an appealing one. Objective: The purpose of the study was to determine the efficacy of modulated middle frequency alternating current (MFAC) muscle stimulation compared to the conventional method of standard low frequency rectangular pulse (LFRP) stimulation used in cycling of persons with spinal cord injury (SCI) and pronounced spasticity. Methods: To evaluate cycling-relevant differences between stimulation modes, 13 subjects with SCI (ASIA-A), 11 of them with strong spasticity, underwent isometric and cycling measurements using both 20 Hz LFRP and 4 KHz modulated with 50 Hz MFAC. The isometric long-lasting reflex torque response in the quadriceps and hamstrings muscles, and the dynamic work during 1000 sec of ergometric cycling as well as the number of involuntary stops caused by hyperreflexia were recorded. Results: The long-lasting reflex torque response was significantly lower when using MFAC than with LFRP stimulation. During MFAC stimulation work generated was on average 374% higher ( p = 0.002) and the number of involuntary stops was on average 32% lower ( p < 0.001) than during standard LFRP stimulation-propelled cycling. Conclusion: These findings suggest that MFAC-stimulated cycling of strongly spastic SCI subjects is more effective in terms of generated isometric torque and power than stimulation with LFRP. Thus, more health benefits, e.g., cardiovascular and muscular training and spasticity-decreasing effects, can be expected faster using MFAC instead of LFRP in stimulation-propelled cycling.
Cortical activation pattern of compensatory movement in stroke patients
Authors: Lee Mi Young , Park Ji Won , Park Rae Joon , Hong Ji Heon , Son Su Min , Ahn Sang Ho , Cho Yoon Woo , Jang Sung Ho 
Published: December 2019

Objective: Little is known about the cortical activation pattern of compensatory movement (CM) in stroke patients. We attempted to investigate the cortical activation pattern of compensatory movement in stroke patients, using functional MRI (fMRI). Methods: Eight hemiparetic stroke patients were recruited for this study. We measured the shoulder abduction angle when each subject was simulating eating in a sitting position, which was considered as the degree of CM. The fMRI was performed at 1.5T using an elbow motor task at a frequency of 0.5 Hz. Results: There was an inverse correlation between the shoulder abduction angle of the affected side and the LI (Laterality Index) ( r = −0.745; p < 0.05). The shoulder abduction angle of the affected side was significantly related to the sum of activated voxels in all regions of interest ( r = 0.776; p < 0.05) and the activated voxels of the supplementary motor area ( r = 951; p < 0.05). However, we did not find any correlation between the shoulder abduction angle and the activated voxels of other brain areas. Conclusions: We demonstrated that a greater shoulder abduction angle on the affected side requires more cortical activation. Therefore, CM appears to be related to the change of the cortical motor control toward greater recruitment of cortical neurons.