bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.