NeuroRehabilitation - Volume 27, issue 2

Authors: Castaño, Beatriz | Capdevila, Elisabet

Article Type: Research Article

Abstract: Background: raumatic brain injury (TBI) can lead to changes in eating behavior patterns with significant clinical manifestations. Methods: Medical records of four patients with severe TBI and eating disorders attending the neurorehabilitation program of our brain injury unit were reviewed. Conclusions: Several eating disorders observed among the four cases, may be present from early phases and remain years after the lesion. Symptoms do not adhere to the typical forms of anorexia and bulimia. Factors influencing the weight changes experienced by patients with brain injury included reduction in physical activity, metabolic disorders and treatment with psychotropic drugs.

Keywords: Brain injury, eating disorder, anorexia, hyperphagia, obesity, behavior disorder

DOI: 10.3233/NRE-2010-0586

Citation: NeuroRehabilitation, vol. 27, no. 2, pp. 113-116, 2010

Authors: Khan, A.A. | Birks-Agnew, I. | Bullock, P. | Rushton, D.

Article Type: Research Article

Keywords: Baclofen, intrathecal, multiple sclerosis, spasm, spasticity

DOI: 10.3233/NRE-2010-0587

Citation: NeuroRehabilitation, vol. 27, no. 2, pp. 117-120, 2010

Authors: Ratchford, John N. | Shore, Wendy | Hammond, Edward R. | Rose, J. Gregory | Rifkin, Robert | Nie, Pingting | Tan, Kevin | Quigg, Megan E. | de Lateur, Barbara J. | Kerr, Douglas A.

Article Type: Research Article

Abstract: Background: Functional electrical stimulation (FES) cycling is used by spinal cord injury patients to facilitate neurologic recovery and may also be useful for progressive MS patients. Objective: To evaluate the safety and preliminary efficacy of home FES cycling in progressive MS and to explore how it changes cerebrospinal fluid (CSF) cytokine levels. Methods: Five patients with primary or secondary progressive MS were given an FES cycle for six months. Main outcome measures were: Two Minute Walk Test, Timed 25-foot Walk, Timed Up and Go Test, leg strength, Expanded Disability Status Scale (EDSS) score, and Multiple Sclerosis …Functional Composite (MSFC) score. Quality-of-life was measured using the Short-Form 36 (SF-36). Cytokines and growth factors were measured in the CSF before and after FES cycling. Results: Improvements were seen in the Two Minute Walk Test, Timed 25-foot Walk, and Timed Up and Go tests. Strength improved in muscles stimulated by the FES cycle, but not in other muscles. No change was seen in the EDSS score, but the MSFC score improved. The physical and mental health subscores and the total SF-36 score improved. Conclusions: FES cycling was reasonably well tolerated by progressive MS patients and encouraging improvements were seen in walking and quality-of-life. Larger studies of FES cycling in progressive MS are indicated. Show more

Keywords: Multiple sclerosis, electric stimulation, rehabilitation, cerebrospinal fluid, physical therapy modalities

DOI: 10.3233/NRE-2010-0588

Citation: NeuroRehabilitation, vol. 27, no. 2, pp. 121-128, 2010

Authors: Nandoe Tewarie, Rishi D.S. | Hurtado, Andres | Bartels, Ronald H.M.A. | Grotenhuis, J. André | Oudega, Martin

Article Type: Research Article

Abstract: Spinal cord injury (SCI) results in loss of nervous tissue in the spinal cord and consequently loss of motor and sensory function. The impairments are permanent because endogenous repair events fail to restore the damaged axonal circuits that are involved in function. There is no treatment available that restores the injury-induced loss of function. The consequences of SCI are devastating physically and socially. The assessment of functional loss after SCI has been standardized in the larger part of the world. For medical care however there are no standards available. During the early phase, treatments that stabilize the patient's health and …attempt to limit further neurological deterioration need to be implemented. During the later phase of SCI, the focus needs to be on prevention and/or treatment of secondary complications such as pain, pressure ulcers, and infections. Neuroprotective, axon growth-promoting and rehabilitative repair approaches are currently being tested but, so far, none of these has emerged as an effective treatment that reverses the consequences of SCI. Promising new repair approaches have emerged from the laboratory during the last years and entered the clinical arena including stem cell transplantation and functional electrical stimulation. Show more

Keywords: Contusion, secondary injury, clinical care, neuroprotection, clinical trials

DOI: 10.3233/NRE-2010-0589

Citation: NeuroRehabilitation, vol. 27, no. 2, pp. 129-139, 2010

Authors: Karataş, Gülçin Kaymak | Günendi, Zafer

Article Type: Research Article

Abstract: Objective: To assess if oxybutynin and tolterodine have an effect on simple reaction time in healthy volunteers. Methods: Simple reaction time was evaluated before and 90 minutes after the oral administration of oxybutynin and tolterodine in a cross-over design. Twenty seven healthy volunteers, aged 26 to 48 years, were included in the study. The electromyographic activity of the flexor digitorum superficialis muscle that was used for the response was recorded, and premotor time was measured. Results: The mean age of the study group was 33.1 ± 7.4 years. Mean premotor times before oxybutynin and before tolterodine …administration were statistically non-significant. Mean premotor times after the administration of oxybutynin and tolterodine were significantly longer than the initial premotor times (p = 0.003). Conclusions: The results of the study showed that oxybutynin and tolterodine prolonged the simple reaction time. The prolonged simple reaction time may suggest a perceptive impairment. The potential for perceptive impairment as a side effect of oxybutynin and tolterodine might suggest a negative impact on the rehabilitation interventions and the activities of daily living because of central nervous system effects. Show more

Keywords: Reaction time, cholinergic antagonists, oxybutynin, tolterodine

DOI: 10.3233/NRE-2010-0590

Citation: NeuroRehabilitation, vol. 27, no. 2, pp. 141-145, 2010

Authors: Arakawa, Takuya | Katada, Akihiro | Shigyo, Hiroshi | Kishibe, Kan | Adachi, Masaaki | Nonaka, Satoshi | Harabuchi, Yasuaki

Article Type: Research Article

Abstract: The purpose of this study was to investigate the hypothesis that electrical stimulation regulates the levels of gene expression related to apoptosis in denervated muscle and prevents muscle atrophy after denervation. Nineteen rats were used in this study. To denervate soleus muscle, sciatic nerve was resected under aseptic condition. Electrical stimulation with 4 mA rectangular pulses of 0.5 ms duration at 2 Hz lasting for 1 hour was delivered to lower limb including the soleus muscle using two surface electrodes. After the stimulation periods of 4 weeks, the levels of gene expression related to apoptosis were evaluated. …Electrical stimulation increased valosin-containing protein (VCP) expression and decreased cleaved caspase-12 expression in denervated muscles. These results indicated that electrical stimulation to denervated muscle suppresses ER-specific apoptosis by enhancing VCP expression. We proposed that electrical stimulation would be a potential treatment for preventing atrophy of denervated skeletal muscles. Show more

Keywords: Denervation, muscle atrophy, apoptosis, electrical stimulation, valosin-containing protein

DOI: 10.3233/NRE-2010-0591

Citation: NeuroRehabilitation, vol. 27, no. 2, pp. 147-154, 2010

Authors: Rondeau, Lynda | Corriveau, Hélène | Bier, Nathalie | Camden, Chantal | Champagne, Noël | Dion, Chantale

Article Type: Research Article

Abstract: Introduction: Gait retraining approaches and walking aids currently used for patients with recent stoke present limitations regarding their utilization in clinical and real life settings. A rehabilitation facility implemented an innovative approach using a rehabilitation dog for gait retraining and as a walking aid. Objective: To explore the effectiveness of rehabilitation dog, both as a gait retraining approach and as a walking aid, to improve walking speed and gait pattern. Methods: Four participants, post recent stroke with hemiparesis, were recruited in a rehabilitation unit. A multiple singlecase ABA design was used. The threeweek training period focused …on gait retraining using a rehabilitation dog. For each session, walking speed with the rehabilitation dog and the cane was documented. In each phase (ABA), the gait pattern was analyzed. Results: Mean (SD) age of the participants was 58 (3.2) years old; time since stroke was 88 (61.41) days. For three participants, walking speed was significantly increased after retraining with the dog. The four participants showed improvement of their gait pattern across phases and walked significantly faster with the dog than with the cane. Conclusion: This pilot study suggests that a rehabilitation dog is an interesting gait retraining approach for a clinical setting and an effective walking aid following stroke. Show more

Keywords: Gait training, rehabilitation dog, stroke, walking speed, gait pattern

DOI: 10.3233/NRE-2010-0592

Citation: NeuroRehabilitation, vol. 27, no. 2, pp. 155-163, 2010

Authors: Shiraishi, Hideki | Muraki, Toshiaki | Ayaka Itou, Yuka Sampei | Hirayama, Kaori

Article Type: Research Article

Abstract: Purpose: To investigate the sustainability of effect and the changes in basic and instrumental activities of daily living (ADL and IADL) after long-term prism intervention, we carried out a follow-up assessment on five subjects with hemispatial neglect in the chronic stage. Method: At 2–3.5 years after the end of prism intervention, we measured six parameters: 1) eye movement of the neglect side when watching three different video clips, 2) center of gravity as an index of subjective internal midline bias, 3) star and letter cancellation tests, 4) the line bisection test, and ADL scales: 5) Barthel Index and …6) Lawton’s IADL scale. In addition, we interviewed and observed the subjects’ present ADL performance at home. Results: The eye movement on the neglect side significantly increased compared with that before intervention. The center of gravity was shifted significantly to the left side and forward. The improvement in cancellation and line bisection tests was also observed. All subjects showed improvement in ADL performance. Two of the subjects could return to work after intervention. Conclusion: The results suggested that long-term prism intervention might effectively exert long-lasting effects and bring benefits to ADL performance for subjects with hemispatial neglect. Show more

Keywords: Prism intervention, hemispatial neglect, ADL performance, follow-up

DOI: 10.3233/NRE-2010-0593

Citation: NeuroRehabilitation, vol. 27, no. 2, pp. 165-172, 2010

Authors: Poggel, Dorothe A. | Mueller, Iris | Kasten, Erich | Bunzenthal, Ulrike | Sabel, Bernhard A.

Article Type: Research Article

Abstract: Objective: To determine the relationship of objective and subjective outcome measures of Vision Restoration Training (VRT) for visual field recovery in partially blind patients. This is of interest because the patient’s subjective improvement cannot be inferred from objective changes in visual field charts. Design: Nineteen patients with visual system lesions underwent visual field tests (objective measure) before and after six months of VRT. Subjective outcome was determined by pre- and post-training interviews (open narration, questions on activities of daily living, ratings). Interview content was quantified by determining the response frequency for relevant content categories. Drawings of perceived visual …field size were used as a subjective topographical measure. Subjective training results were compared to objective visual field size (perimetry). Results: Visual field size increased significantly over the training period. Patients’ subjective evaluations depended on the size and location of regained areas, but also on specific evaluation of safe navigation, mobility, reading, and communication. Patients with objective increase of visual field size also reported subjective improvements in daily life. Conclusions: Computer-based training can improve visual field size as well as subjective visual performance. The patients’ subjective experience should be included in treatment evaluation to ensure the meaningfulness of training beyond perimetric measures. Show more

Keywords: Blindness, neuronal plasticity, visual field, activities of daily living, quality of life

DOI: 10.3233/NRE-2010-0594

Citation: NeuroRehabilitation, vol. 27, no. 2, pp. 173-187, 2010

Authors: Gaber, Tarek A.-Z. K. | Gautam, Vidushi | Azer, Ashraf

Article Type: Case Report

Abstract: Proximal muscle weakness is a common association of muscular dystrophies. Knees and hip extensor weakness limit the patients' ability to counteract flexor knee joints' moments. Therefore, patients try to toe walk to move the ground reaction force (GRF) anteriorly to help to stabilise the knee. We report a case of a patient with Becker's muscular dystrophy who lost his ability to walk completely following a bilateral Achilles tendons operation. The patient's ability to heel-strike moved his GRF posteriorly resulting in creation of excessive knees flexion moments. Three years following the operation and following a lengthy rehabilitation programme, the patient managed …to mobilise using an orthosis. Show more

DOI: 10.3233/NRE-2010-0595

Citation: NeuroRehabilitation, vol. 27, no. 2, pp. 189-191, 2010

Authors: Lapeyre, Eric | Kuks, Jan B.M. | Meijler, Willem J.

Article Type: Research Article

Abstract: Though in the last few decades only a few new drugs have come available for the treatment of spasticity, new insights may revise the role and individual value of several pharmacological treatments. Diazepam, baclofen and tizanidine are the most prescribed drugs for the treatment of spasticity. Intrathecal baclofen and local infiltration of botulin toxin are added values in selective patients. Gabapentin is a novelty, and the working mechanism of cannabis has been elucidated. Dantrolene sodium appears to owe its selectivity from the recently discovered ryanodine receptor, with a peripheral effect in muscles. In this review the pathophysiology and epidemiology of …spasticity, pharmacology, clinical efficacy and unwanted effects of the different drugs for spasticity are updated. Show more

Keywords: Spasticity, review, pharmacology, treatments

DOI: 10.3233/NRE-2010-0596

Citation: NeuroRehabilitation, vol. 27, no. 2, pp. 193-200, 2010

Authors: Thomas, Raji | Barnes, Michael

Article Type: Research Article

Abstract: This article reviews the literature on life expectancy in the disabled population. The literature is surveyed with regard to the main elements that reduce life expectancy for people with disabilities. These are immobility, cognitive and intellectual impairment, swallowing problems and tube feeding, epilepsy and incontinence. The article discusses various improvements in survival in the last few years and discusses the possibility of further improvements in the future. The difficulties are discussed with regard to early prediction of life expectancy both in childhood and after an acute neurological event in adulthood. The literature is then reviewed with regard to the cohort …studies on quantification of life expectancy in disabled people. The literature is discussed and pragmatic clinical conclusions are drawn. Show more

Keywords: Life expectancy, people with disabilities, prediction

DOI: 10.3233/NRE-2010-0597

Citation: NeuroRehabilitation, vol. 27, no. 2, pp. 201-209, 2010

Article Type: Correction

DOI: 10.3233/NRE-2010-0598

Citation: NeuroRehabilitation, vol. 27, no. 2, pp. 211-211, 2010