NeuroRehabilitation - Volume 26, issue 4

Authors: van Mil, Saskia G.M. | de la Parra, Nora M. | Reijs, Rianne P. | van Hall, Mariette H.J.A. | Aldenkamp, Albert P.

Article Type: Research Article

Abstract: The aim of this study is to investigate psychomotor- and motor functioning in children with cryptogenic localization related epilepsy (CLRE) and to explore possible relationships between these two functions. Eighty-nine children were included. Results of reaction times measurements and motor functioning tasks were compared to age-related normative values. Correlations between the psychomotor and motor tasks were computed. Manual dexterity and balance problems are present in about 35% of CLRE-children. Ball skills are problematic in approximately 55% of the children. Simple reaction time measurements showed significantly slowing for CLRE children relative to the reference values. Also, performance on the …m-ABC was significantly lower than the reference values. The better the child's performance on the simple reaction time measurements, the better the performance on the m-ABC. Show more

Keywords: Cryptogenic localization related epilepsy, children, psychomotor functioning, motor functioning, epilepsy

DOI: 10.3233/NRE-2010-0565

Citation: NeuroRehabilitation, vol. 26, no. 4, pp. 291-297, 2010

Authors: Hong, Ji Heon | Jang, Sung Ho

Article Type: Research Article

Abstract: 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. Show more

Keywords: Cerebellar peduncle, diffusion tensor imaging, cerebral infarct, stroke, cerebellum

DOI: 10.3233/NRE-2010-0566

Citation: NeuroRehabilitation, vol. 26, no. 4, pp. 299-305, 2010

Authors: Oh, Duck-Won | Kim, Jin-Seop | Kim, Suhn-Yeop | Yoo, Eun-Young | Jeon, Hye-Seon

Article Type: Research Article

Abstract: Objective: To investigate the effect of motor imagery training (MIT) on the symmetrical use of knee extensors during sit-to-stand and stand-to-sit tasks. Methods: We measured the electromyographic (EMG) data in the knee extensor on the affected side of 3 volunteers with post-stroke hemiparesis. We used a single-subject multiple-baseline research design across individuals. The EMG data were collected from knee extensors while performing the sit-to-stand and stand-to-sit tasks. The EMG activation and onset time ratios for the knee extensors were calculated by dividing the EMG activation and onset time of knee extensor action on the affected side by these …on the unaffected side. MIT consisted of a 10-min detailed description of 5 stages: preparation, sit-to-stand tasks, weight shifting during standing, stand-to-sit tasks, and completion. Results: During MIT, the EMG activation ratios of participants 1, 2, and 3 increased by 11.24%, 18.07%, and 26.91%, respectively, in the sit-to-stand task and by 12.11%, 14.31%, and 25.92%, respectively, in the stand-to-sit task. During MIT, the onset time of participants 1, 2, and 3 decreased by 36.09%, 24.27%, and 25.61%, respectively, in the sit-to-stand task and by 26.81%, 27.20%, and 22.83%, respectively, for the stand-to-sit task. Conclusion: These findings suggest that MIT has a positive effect on the symmetrical use of knee extensors during sit-to-stand and stand-to-sit tasks. Show more

Keywords: Motor imagery training, hemiplegia, symmetrical use, knee extensor, quadriceps

DOI: 10.3233/NRE-2010-0567

Citation: NeuroRehabilitation, vol. 26, no. 4, pp. 307-315, 2010

Authors: Duarte, Esther | Marco, Ester | Muniesa, Jose M. | Belmonte, Roser | Aguilar, Juan Jacobo | Escalada, Ferran

Article Type: Research Article

Abstract: The aim of this study was to evaluate prospectively early predictors for ambulation and motor outcome 6~months after stroke occurrence. Sixty-eight consecutive, first-ever, stroke survivors were prospectively studied from the second week to the sixth month post stroke. Sex, age, stroke type, urinary incontinence, National Institutes of Health Stroke Scale (NIHSS), and Trunk Control Test (TCT) scores were taken as independent variables. Gait ability and motor functional outcome at 6 months post-stroke were assessed. Age, sex, urinary incontinence, TCT and NIHSS were significantly related to final modified Rankin Scale (mRS), motor portion of the Functional Independence Measure (FIM™) and Berg …Balance Scale (BBS). Age and early TCT alone accounted for 61.1% of the variance in the motor FIM™ rating (at 6 months post-stroke). TCT ⩽ 50 on day 14 predicts non-independent walkers (Functional Ambulation Categories (FAC) < 4): sensitivity 83.3%, specificity 85.7%), OR: 30.0, 95% CI: 4.7–247.3. In conclusion, early administered TCT predicts independent walking ability and motor functional outcome at six months post-stroke. Show more

Keywords: Stroke, musculoskeletal equilibrium, disability evaluation, recovery of function

DOI: 10.3233/NRE-2010-0568

Citation: NeuroRehabilitation, vol. 26, no. 4, pp. 317-323, 2010

Authors: Lee, Mi Young | Kwon, Yong Hyun | Park, Ji Won | Choi, Jin Ho | Son, Su Min | Ahn, Sang Ho | Cho, Yoon Woo | Jang, Sung Ho

Article Type: Research Article

Abstract: It is well-known that sound production can affect the motor system. We investigated whether a short, loud phonation affected cortical activation caused by a motor task using functional MRI. Fifteen right-handed healthy subjects were recruited for this study. We compared the cortical activation caused by the performance of a motor task (right hand grasp-release movements) to that caused by the performance of the motor task with phonation(“ah” sound). We found that performance of the motor task with phonation resulted in less activation in the primary sensori-motor cortex than did the performance of the motor task alone. It seemed that phonation …during the motor task enhanced the efficiency of cortical activation compared to that caused by the motor task alone. Show more

Keywords: Corticospinal tract, functional MRI, language, sound, motor function

DOI: 10.3233/NRE-2010-0569

Citation: NeuroRehabilitation, vol. 26, no. 4, pp. 325-329, 2010

Authors: Sethy, Damayanti | Bajpai, Pankaj | Kujur, Eva Snehlata

Article Type: Research Article

Abstract: 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. Show more

Keywords: Fatigue, Multiple Sclerosis, strength, endurance

DOI: 10.3233/NRE-2010-0570

Citation: NeuroRehabilitation, vol. 26, no. 4, pp. 331-337, 2010

Authors: Chang, Min Cheol | Jang, Sung Ho

Article Type: Research Article

Abstract: Little is known about diffusion tensor image (DTI) findings of corpus callosum (CC) injury in patients with diffuse axonal injury (DAI). In the present study, we investigated the presence and extent of CC injury in patients with DAI. Twenty patients with DAI and 20 age-and sex-matched normal healthy controls subjects were recruited. Patients were divided into two groups according to the presence of a CC lesion on conventional brain MRI, namely, the CC (+) group (8 patients) and the CC (-) group (12 patients). DTIs were acquired using a sensitivity-encoding head coil at 1.5 T. The CC was divided into …six mid-sagittal segments: the genu, rostral midbody, anterior midbody, posterior midbody, isthmus, and splenium. Fractional anisotropies (FA) and apparent diffusion coefficients (ADCs) were measured. FA values of all CC segments in DAI patients were significantly lower than those of controls (p < 0.001); whereas ADC values were either similar or marginally higher. FA values of the six sagittal segments in the CC (-) and (+) groups were significantly lower than those of controls, and ADC values were slightly higher, or showed no change. CC lesions may be present in DAI patients, irrespective of detection on conventional brain MRI. The authors suggest the probability that in cases of corpus callosum injury, DTI can offer a powerful means of detecting DAI. Show more

Keywords: Diffuse axonal injury, diffuse tensor imaging, corpus callosum, brain injury

DOI: 10.3233/NRE-2010-0571

Citation: NeuroRehabilitation, vol. 26, no. 4, pp. 339-345, 2010

Authors: Chang, Min Cheol | Kim, Seong Ho | Kim, Oh Lyong | Bai, Dai Seg | Jang, Sung Ho

Article Type: Research Article

Abstract: Little is known about the relation between fornix injury and memory impairment in diffuse axonal injury (DAI). In the current study, we attempted to investigate fornix injury in patients with memory impairment following DAI, using diffusion tensor imaging (DTI). Nine patients with DAI and nine age-and sex-matched control subjects were recruited. The DTIs were acquired using a sensitivity-encoding head coil on a 1.5 T. Five regions of interest (ROI) were drawn manually on a color fractional anisotropy (FA) map: two ROIs for each column, one ROI for the body, and two ROIs for each crus. The FA and apparent diffusion …coefficient (ADC) were measured in each of the ROIs. Cognitive function was evaluated using the Memory Assessment Scale, Wechsler Intelligence Scale, and Mini-Mental State Exam. In the DAI group, the FA value in the fornix body was significantly decreased compared with that of the control group. In contrast, we did not find significant differences in the column and crus of the fornix. Among all of the cognitive function scales, only the Memory Assessment Scale scores were significantly correlated with the FA values of the fornix body in the DAI group. We found that memory impairment in patients with DAI is closely related to neuronal injury of the fornix body among the three fornix regions that we assessed. DTI could be useful in the evaluation of patients with memory impairment following DAI. Show more

Keywords: Diffuse axonal injury, memory, diffuse tensor imaging, fornix, brain injury

DOI: 10.3233/NRE-2010-0572

Citation: NeuroRehabilitation, vol. 26, no. 4, pp. 347-353, 2010

Authors: Wiseman-Hakes, Catherine | MacDonald, Sheila | Keightley, Michelle

Article Type: Research Article

Abstract: Growing evidence suggests that acquired brain injury (ABI) rehabilitation and research should be guided by a philosophy that focuses on: restoration, compensation, function and participation in all aspects of daily life. Such a broad, more pluralistic approach influences ABI rehabilitation research at a number of levels, including both the generation of evidence, and in searching for, critiquing and applying the evidence to practice. The objective of evidence based medicine/practice (EBM/EBP) is to apply and integrate clinical expertise with evidence gained through systematic research and scientific inquiry to medical/clinical practice. While there is abundant literature debating the practical and sociological implications …of EBP, there has been limited examination of EBP within the inherently complex nature of ABI rehabilitation and rehabilitation research. This paper provides a framework for clinical decision making regarding evidence based practice in the context of ABI rehab including: 1. A discussion of the purpose of evidence based practice, 2. Levels of evidence relevant to ABI rehabilitation research, and 3. A rationale for incorporating a broader, more pluralistic concept of evidence or “person-centred EBP”. We conclude with a series of key questions for the evaluation and application of systematic reviews of the evidence in the context of ABI rehabilitation. Show more

Keywords: Acquired brain injury rehabilitation, traumatic brain injury rehabilitation, evidence based practice, evidence based medicine, rehabilitation research, treatment evidence, outcome, intervention

DOI: 10.3233/NRE-2010-0573

Citation: NeuroRehabilitation, vol. 26, no. 4, pp. 355-368, 2010

Authors: Al-Jarrah, Muhammed | Jamous, Mohammad | Al Zailaey, Khalid | Bweir, Salameh O.

Article Type: Research Article

Abstract: Goals and objectives: The main goal of this study is to evaluate the effect of treadmill exercise on the angiogenesis markers in the striatum (ST) of chronic/progressive parkinsonian mice. Materials and Methods: Forty 57BL/6 albino mice were randomly divided into four groups. Sedentary control (SC, n = 10), exercise control (ExC, n = 10), sedentary Parkinson’s (SPD, n = 10), and exercised Parkinson’s (ExPD, n = 10). Parkinsonism was induced by the injection with 10 doses of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine, (25 mg/kg) and probenecid (250 mg/kg) over 5 weeks, three days and half a part. Following …the induction of parkinsonism, ExPD and ExC animal groups were trained on a modified human treadmill at a speed of 18 m/min, 0° of inclination, 40 min/day, 5 days/week for 4 weeks. The remaining two groups (SPD and SC) were housed in cages for the same period. At the end of the experiment, the angiogenesis markers; Vascular Endothelial Growth Factor (VEGF) and CD34 were examined in the striatum in the four animal groups. Results: PD resulted in a significant decrease in blood vessel density with the comparison between the sedentary control and PD model animals (p < 0.005). Four weeks of treadmill exercise training significantly increased angiogenesis in the striatum in ExPD groups (p < 0.05). Exercise also induced an increase in blood vessel density in the striatum of the control animals, but the change was not significant (P < 0.3). Conclusion: These data suggest that 4 weeks of treadmill exercise promoted angiogenesis in the brain of chronic Parkinsonian mice, which can partially explain the beneficial role exercise in patients with PD. Further studies are required to determine the mechanism of exercise-induced angiogenesis in PD. Show more

Keywords: VEGF, angiogenesis, parkinson's disease

DOI: 10.3233/NRE-2010-0574

Citation: NeuroRehabilitation, vol. 26, no. 4, pp. 369-373, 2010

Authors: Johnston, Maureen | Chu, Eli

Article Type: Research Article

Abstract: A systematic review was conducted of the evidence for the effectiveness of the outcomes from treatment by multidisciplinary outpatient rehabilitation programs which were provided by more than one allied health or nursing discipline for people diagnosed with Parkinson's disease (PD). The search yielded only 4 studies ranging from poor to good quality, on the outcomes of multidisciplinary rehabilitation. There were no available random controlled trials on short term outcomes although some limited evidence from lower quality studies suggested significant short term gains are achieved in gait speed and step length. No consistent evidence is available for other outcome measures. From …the available evidence for longer term outcomes over a period of 4–6 months post intervention the improvements in outcome measures for gait are not significant. The results of this systematic review suggest that there is limited evidence to suggest short term gains in outcomes for people with PD attending multidisciplinary programs but over a 4–6 month period these gains are no longer significant. Overall, there is very limited high level evidence available to show whether multidisciplinary out-patient programs produce effective, either short or long term, outcomes for PD and further research is needed. Show more

Keywords: Parkinson's disease, multidisciplinary team, rehabilitation program, effects, outcomes, trial, evaluation, functional status, quality of life, allied health

DOI: 10.3233/NRE-2010-0575

Citation: NeuroRehabilitation, vol. 26, no. 4, pp. 375-383, 2010