bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transitions between SNF and home-based care in patients with multiple sclerosis
Authors: Noyes Katia , Bajorska Alina , Wasserman Erin B. , Weinstock-Guttman Bianca , Mukamel Dana 
Published: December 2019

Objectives: To assess patient characteristics and risk factors associated with care transitions between skilled nursing facility (SNF) and home care for patients with multiple sclerosis (MS) in an effort to improve outcomes and optimize patient care pathways. Background: MS is a chronic neurologic illness of younger adults that is associated with physical disability, cognitive impairment and a high need for supportive services. Methods: The study was based on the 2005 Nursing Home Minimum Data Set and the Outcome and Assessment Information Set data (n = 10,064). We performed multivariate evaluation of patient risk factors for skilled nursing facility (SNF) admission and disposition while controlling for potential patient self-selection and other characteristics that affect care utilization. Results: MS patients with recent history of home care use were less likely to be admitted to an acute care hospital and had higher physical disability at SNF admission than SNF patients who did not use home care. Insurance type (Medicaid) and availability of informal caregivers were associated with the use of homecare services after a SNF stay, while patient demographic and clinical characteristics did not explain SNF disposition. Conclusions: Future studies should explore the association between the local availability and affordability of home-based services and physician attitude about community-based care management of disabled patients.
Effects of a resistance training program and subsequent detraining on muscle strength and muscle power in multiple sclerosis patients
Authors: Medina-Perez Carlos , de Souza-Teixeira Fernanda , Fernandez-Gonzalo Rodrigo , de Paz-Fernandez Jose Antonio 
Published: December 2019

Background: Although resistance training adaptations in multiple sclerosis (MS) patients have been described, the detraining response in this population is largely unknown. Objective: This study was designed to evaluate the effects of a 12-week detraining period on muscle strength (isometric and endurance) and muscle power of multiple sclerosis (MS) patients that had previously carried out a 12-week resistance training program (RTP). Methods: Forty-two MS patients were randomly assigned into two groups: an exercise group (EG) that performed a 12-week RTP for the knee extensors muscles; and a control group (CG), that did not perform any specific training. Knee extension maximal voluntary isometric contraction (MVIC), muscle power and muscle endurance were evaluated before and after the RTP, as well as 12 weeks after training completion. A strain gauge was used to measure the maximal voluntary isometric contraction and muscle power was assessed with a linear encoder. Muscle endurance was interpreted as the number of repetitions that a patient could perform in a single set of knee extension exercise. Results: The EG increased MVIC and muscle power after the training period, although the training did not affect muscle endurance. After 12 weeks of detraining, MVIC returned to pre-training values but muscle power was still greater than pre-training values in the EG. The CG did not present any change in the variables measured during the intervention. Conclusions: A 12-week RTP improved MVIC and muscle power in MS patients. Additionally, 12 weeks of detraining blunted strength training adaptations in MS patients, although muscle power training adaptations were still evident after the detraining period.
The influence of weaning duration on rehabilitative outcome in early neurological rehabilitation
Authors: Ponfick Matthias , Wiederer Ralf , Bösl Kathrin , Neumann Günter , Lüdemann-Podubecka Jitka , Gdynia Hans-Jürgen , Nowak Dennis A. 
Published: December 2019

Background: We investigated if longer weaning is associated with inferior rehabilitative outcome in critical illness polyneuropathy (CIP) and cerebrovascular diseases (CVD). Methods: We analysed retrospectively weaning protocols and medical histories of 171 tracheotomized patients with CIP and CVD. We assessed weaning durations (WD), independence in activities of daily living, as assessed by the functional independence measure (FIM), mortality rates and discharge modalities in each cohort. Weaning was performed using synchronized intermittent mandatory ventilation (SIMV) with Autoflow® and assisted spontaneous ventilation (ASV). Results: WD was significantly longer in CIP compared to CVD (p < 0.001). Despite shorter in-patient treatment and longer WD, patients with CIP acquired significantly greater gains of improvement than CVD (p = 0.015). Independent living at home was possible in 43% of patients with CIP and in 26% of CVD. Mortality was equal in both groups (13% vs. 6%, p > 0.05). Chronic obstructive pulmonary disease (COPD) showed a trend towards longer weaning durations in both entities (p = 0.06). Higher age significantly correlated with longer WD (p = 0.038, r = 0.16). Longer rehabilitation duration (RD) positively correlated with higher Delta-FIM (DFIM) in both entities (p = 0.006, r = 0.21). Conclusion: Longer weaning and its partly negative influence on rehabilitative outcome can be compensated by longer in-patient rehabilitation in CIP and CVD.
Heart rate variability in children with cerebral palsy: Review of the literature and meta-analysis
Authors: Amichai Taly , Katz-Leurer Michal 
Published: December 2019

Objective: A systematic review which aims to assess the evidence regarding the function of the autonomic heart rate regulation system among children with cerebral palsy (CP). Methods: The target population included children with CP of diverse severity, aged 1.5 to 18 years. Databases searched for English language studies from 1960 to 2013: PubMed, EMBASE, CINAHL, Cochrane Library, The Physiotherapy Evidence Database (PEDro), and ClinicalTrials.gov site. Search terms included ‘cerebral palsy’ or ‘spastic diplegia’ or ‘hemiplegia’ or ‘quadriplegia’ and ‘autonomic nervous system’ or ‘heart rate variability’ or ‘sympathetic’ or ‘para sympathetic’. Twenty five articles were identified and included if (1) participants were less than 18 years of age, (2) diagnosis of CP was made after the age of 18 months (3) more than 80% of cases had a diagnosis of CP and (4) autonomic cardiac heart rate regulation system state or response to a stimuli was described for all the participants. Six articles met the criteria for inclusion. Results: Evidence suggests that reduced Heart Rate Variability (HRV) time domain parameters close to birth are associated with a CP diagnosis at the age of three years. In addition, HRV parameters' mean values, are significantly lower among children with CP compared to typically developed (TD) control. While performing head up, tilt or standing position, HRV was significantly reduced only among TD control, but no effect was seen in those variables among children with CP. Conclusion: Further studies are needed to assess the potential to predict CP by assessing HRV parameters among newborn children. In addition, assessing HRV among children with CP may improve our understanding of the heart rate autonomic system and its response to different stimulus such as muscle contraction, paced breathing and aerobic training.
College and combat trauma: An insider's perspective of the post-secondary education experience shared by service members managing neurobehavioral symptoms
Authors: Ness Bryan M. , Rocke Maya R. , Harrist Christopher J. , Vroman Kerryellen G. 
Published: December 2019

Background: Enrolling in post-secondary education is common among military service members returning from combat deployments, but recent research shows service members who present with neurobehavioral symptoms consistent with traumatic brain injury (TBI) and/or post-traumatic stress disorder (PTSD) are at risk for psychosocial and academic difficulty. Objective: This exploratory study was conducted to examine the academic experiences of service members through in-depth qualitative analysis. Methods: An initial survey was conducted at a public university to measure self-reported academic achievement and neurobehavioral symptoms experienced by service members (n = 48). Then, follow-up interviews were solicited from a sub-sample (n = 5) of participants to gain an in-depth understanding of their transition, social, and academic experiences. Results: The results revealed both the day-to-day challenges participants faced while adjusting to post-secondary life and how neurobehavioral symptoms associated with combat trauma interacted with their learning experiences. The findings indicated participants did not perceive neurobehavioral symptoms as particularly deleterious to their learning thereby highlighting the potentially integral role of coping strategies and motivation in post-secondary success. Conclusions: This study underscores the importance of understanding not only the adverse impact of neurobehavioral symptoms but the factors that promote resilience among military service members in post-secondary education.
Long-time average spectrum in individuals with Parkinson disease
Authors: Smith Lindsey K. , Goberman Alexander M. 
Published: December 2019

Background: Various methods of acoustic analysis have been used to describe phonatory deficits in Parkinson disease (PD), including long-time average spectrum (LTAS) analysis. Objective: The aim of this study was to utilize the LTAS to investigate laryngeal deficits in individuals with PD. Methods: Twenty-eight individuals with idiopathic PD and 10 controls were participants for this study. An LTAS was generated from a standard reading sample and analyzed using the following measurements: Mean spectral energy (MSE), first spectral peak, spectral tilt (ST), three spectral slope (SS) measures (i.e., SSF0-1kHz, SS1-5kHz, and SS ratio) and four spectral moments (mean, standard deviation, skewness, and kurtosis). Results: Individuals with PD were found to demonstrate significantly lower MSE, spectral mean and spectral SD, along with higher spectral skewness compared to control speakers. Furthermore, ST was positively correlated with self-rated symptom severity and self-rated medication effectiveness for individuals with PD. Conclusions: The LTAS findings were consistent with either reduced vocal fold adduction or vocal fold bowing in individuals with PD compared to control speakers. Additionally, vocal fold adductory changes were one possible explanation for correlations between LTAS and self-ratings of medication effectiveness and disease severity.
Behavioral scales used in severe and moderate traumatic brain injury
Authors: Castaño Monsalve B. , Laxe Sara , Bernabeu Guitart M. , Bulbena Vilarrasa Antoni , Quemada Jose Ignacio 
Published: December 2019

Neurobehavioral disorders are common consequences of traumatic brain injury (TBI) that should be objectively assessed in this population. The use of scales allows us to unify terms both in clinical practice and investigative work; it also constitutes a useful guide in clinical interviews and makes it possible to see outcome changes in patients with or without intervention. The aim of this study is to review the most frequently neurobehavioral scales used to measure the non-cognitive disorders of conduct in TBI patients. Method: A systematic and descriptive literature review was done in Medline, without time limit, which focused on scales applied to behavioral disorders in moderate and severe TBI patients. Results: Ninety articles were selected for the final review and thirty-seven different scales were identified. Seven of these instruments represent sixty-five percent of all behavioral scales applied in the studies collected and were selected for the present review. There are scales that are more general and include a wide range of neurobehavioral symptoms, like the Neurobehavioral Rating Scale and the Neuropsychiatric Inventory. On the opposite, there are questionnaires that focus on specific symptoms like aggressiveness, agitation and apathy such as the Agitated Behavior Scale or the Apathy Evaluation Scale. The forms for caregiver or staff were the most prevalent in our review. The most representative behavioral scales applied to moderate and severe TBI patients were analyzed using clinical useful, covered domains, item descriptions, administration procedures and psychometric properties.
Predictors of functional outcome in patients with traumatic spinal cord injury after inpatient rehabilitation: In Saudi Arabia
Authors: Abdul-Sattar Amal B. 
Published: December 2019

Objective: To identify the possible factors influencing motor functional outcome of patients with traumatic spinal cord injury (T-SCI) after inpatient rehabilitation. Methods: 90 patients with T-SCI consecutively admitted for inpatient SCI rehabilitation unit was studied. Demographic characteristics, level and completeness of SC injury using American Spinal Injury Association (ASIA) Impairment Scale, disability level using Functional Independence Measure (FIM), psychological state using Hospital Anxiety and Depression Scale (HADS), and SCI-related medical complications were assessed and recorded at admission. The main measure of functional outcome was the motor FIM gain score at discharge. The univariate and multiple linear regression analyses were performed. Results: The Mean admission motor FIM score was 35.3 (20.1), the mean discharge motor FIM score was 65.3 (22.5), and the mean motor FIM gain score was 30.0 (20.9). Univariate analyses indicated that the significant factors influencing motor functional outcome included age, motor FIM score at admission, level and severity of injury, anxiety/depression score, time between injury and admission to rehabilitation, length of stay, destination at discharge, and family caregiver. However, in multiple linear regression analyses, age, destination at discharge, family caregiver were not significant predictors. Conclusion: Age was not predictor of motor functional outcome and rehabilitation can be effective in elderly SCI patients. Rehabilitation intervention should begin as soon as possible. The admission motor FIM score, level and severity of injury, interval between onset and admission, anxiety/depression score, and length of stay can be used to predict functional outcomes of rehabilitation in SCI patients.
Focused low-energy extracorporeal shock waves with distally symmetric polyneuropathy (DSPNP): A pilot study
Authors: Lohse-Busch H. , Marlinghaus E. , Reime U. , Möwis U. 
Published: December 2019

Background: Incidental observations led to the question whether ESWT could alleviate the still difficult-to-improve symptoms of DSPNP. Methods: In a pilot study, out of an original 24 patients with DSPNP, 10 patients with diabetes mellitus were excluded because of their inhomogeneous performances. Of the 14 patients remaining, 6 received one sham treatment at the beginning. All 14 patients were then treated with ESWT to the soles of the feet using the Duolith® shock wave generator (Storz Medical) 3 times weekly for 2 weeks. The assessments were carried out before and after the sham treatment, the first ESWT (question: before and after the first ESWT or only after?) and after 2, 4 and 8 weeks. Results: The placebo treatment did not influence pain or paraesthesia. After the 2 weeks of ESWT, intensity decreased from 100% to 23.6%, rising again after 8 weeks to 45.7% of the original state (p < 0.01). The placebo treatment did however have a great effect on walking abilities. The results of ESWT did not become significant until the 8th week. Step length improved by 14.6% (p < 0.001), walking speed by 24.8% (p < 0.001) and time of dual support during the stance phase of the gait declined by 12.2% (p < 0.009). Conclusions: Despite the small number of cases, it appears that ESWT can alleviate some of the symptoms of DSPNP.
Perceptual characteristics of Parkinsonian speech: A comparison of the pharmacological effects of levodopa across speech and non-speech motor systems
Authors: Plowman-Prine E.K , Okun M.S. , Sapienza C.M. , Shrivastav R. , Fernandez H.H. , Foote K.D. , Ellis C. , Rodriguez A.D. , Burkhead L.M. , Rosenbek J.C. 
Published: December 2019

The purpose of this study was to: (1) define perceptual speech characteristics of idiopathic Parkinson disease (IPD) across 35 speech dimensions adapted from Darley et al. [19] and grouped under six speech-sign clusters (respiration, phonation, resonance, articulation, prosody and rate); (2) examine the effects of levodopa on the 35 perceptual speech dimensions and speech-sign clusters; and (3) to compare the relative effectiveness of levodopa on global motor functioning vs. speech production. Sixteen patients with IPD read the ‘Grandfather Passage’ both ‘on’ and ‘off’ levodopa. Three blinded speech-language pathologists performed perceptual speech analyses using a seven-point scale. The diagnosis of IPD was made by a movement disorders fellowship trained neurologist who applied UK Brain bank criteria and administered the Unified Parkinson Disease Rating Scale. Concordant with previous studies, the results of this experiment indicated that IPD disrupted multiple speech production subsystems, with prosody being the most severely affected domain. The perceptual dimensions that were most severely affected included: (1) sound imprecision; (2) mono-loudness; (3) mono-pitch; (4) reduced stress and (5) harsh voice. No significant differences were obtained between medicated states (‘on’/‘off’) for any of the 35 individual speech dimensions and speech-sign clusters. Global motor function significantly improved following dopaminergic medications.
Self-generated expressions of residual complaints following brain injury
Authors: Brown D. , Rose D. , Lyons E. 
Published: December 2019

Following brain injury there is often a prolonged period of deteriorating psychological condition, despite neurological stability or improvement. This is presumably consequent to the remission of anosognosia and the realisation of permanently worsened status. This change is hypothesised to be directed partially by the socially mediated processes which play a role in generating self-awareness and which here direct the reconstruction of the self as a permanently injured person. However, before we can understand this process of redevelopment, we need an unbiassed technique to monitor self-awareness. Semi-structured interviews were conducted with 30 individuals with long-standing brain injuries to capture their spontaneous complaints and their level of insight into the implications of their difficulties. The focus was on what the participants said in their own words, and the extent to which self-knowledge of difficulties was spontaneously salient to the participants. Their responses were subjected to content analysis. Most participants were able to say that they had brain injuries and physical difficulties, many mentioned memory and attentional problems and a few made references to a variety of emotional disturbances. Content analysis of data from unbiassed interviews can reveal the extent to which people with brain injuries know about their difficulties. Social constructionist accounts of self-awareness and recovery are supported.
Sentence planning following traumatic brain injury
Authors: Ellis Charles , Peach Richard K. 
Published: December 2019

Background: Current descriptions of the language problems following traumatic brain injury (TBI) generally emphasize evaluating discourse production and explaining the observed outcomes in terms of disruptions to executive processes. The notion of sentence production impairments at the sentence level has generally been ignored. To respond to this issue, we examined patterns of intrasentential pausing and sentence planning during sentences produced by normal and TBI speakers. Methods: Seven individuals with TBI functioning at Rancho Level V-VI and seven age-matched controls participated in this pilot experiment. Group performances were compared for pause time and verbal initiation time during the production of sentences varying in syntactic complexity under two conditions (reading and repetition). Results: Significant group differences were observed in pausing during both conditions. Pausing patterns of the participants with TBI were strongly correlated with the syntactic complexity of sentences. No significant group differences were observed on verbal initiation time of repeated sentences, although increased initiation times were present among the TBI participants. Conclusions: These findings of this pilot project suggest that the deficits in language production following TBI may include specific impairments to sentence planning. This evidence suggests that the language profile of TBI may be one of both microlinguistic and macrolinguistic impairments.
Electrical stimulation improves gait in children with spastic diplegic cerebral palsy
Authors: AlAbdulwahab Sami Saleh 
Published: December 2019

Background: Electrical stimulation (ES) of proximal muscles during gait training has not previously been reported as a management option for improving muscle tone and gait in spastic diplegic children. Objective: To investigate the effects of simultaneous continuous ES of both hip abductors and adductors during walking on muscle tone, knee alignment and gait characteristics in children with spastic diplegic cerebral palsy (CP). Subject: Three groups of children participated in this project: the study group, consisting of 17 ambulant children with spastic diplegic CP; a control group of 15 ambulant children with spastic diplegic CP; and another control group, with 17 healthy children. Methods: The study group underwent two different ES management programs. The first was a one-time trial management program that involved ongoing ES of bilateral hip adductor and abductor muscles at the sensory and motor levels, respectively, during walking for a predetermined distance. The second ES program lasted for one week and involved 15 minutes of ongoing ES of bilateral hip adductor and abductor muscles at the sensory and motor levels, respectively, during walking for three sessions a day for the week. Results: Marked improvement in gait performance ( p < 0.001), muscle tone ( p < 0.01) and knee position of the study group was observed. Conclusion: ES to the hip adductor and abductor muscles simultaneously at the sensor and motor levels, respectively, improved gait in spastic diplegic CP children.