NeuroRehabilitation - Volume 27, issue 4

Authors: Rogante, Marco | Grigioni, Mauro | Cordella, Daniele | Giacomozzi, Claudia

Article Type: Research Article

Abstract: This paper aims at delivering a structured overview of telerehabilitation literature by analysing the entire set of articles under the search terms “telerehabilitation” or “tele-rehabilitation” to portray “state of the art” ten years after the publication of the first scientific article on the topic. A structured study has been conducted by considering all those articles containing the word “telerehabilitation” or “tele-rehabilitation”. Medline, Embase, Cochrane, UK Centre for Reviews and Dissemination, Canadian Agency for Drugs and Technologies in Health databases have been interrogated for articles between 1998 and 2008. 146 scientific articles were found. 56 articles focus …on patient treatment, 23 are reviews, 3 are to be considered as both patient treatment papers and reviews, 53 are either technical reports, system descriptions or analyses of new approaches; 8 are general discussion on telerehabilitation. The present paper draw the scenario of the first ten years of telerehabilitation, focussing on clinical applications and technologies. Basically, it confirms the lack of comprehensive studies providing evidence for supporting decision and policy-makers in adopting telerehabilitation technologies in the clinical practice. An overall lack of standardisation in the used terminology also results from the analysis of keywords, which is typical of quite recent fields of application. Show more

Keywords: Telerehabilitation, tele-rehabilitation, review, remote treatment, remote rehabilitation technology

DOI: 10.3233/NRE-2010-0612

Citation: NeuroRehabilitation, vol. 27, no. 4, pp. 287-304, 2010

Authors: Giannopulu, Irini | Pradel, Gilbert

Article Type: Research Article

Abstract: Autism is a complex neuropsychological disorder characterized by qualitative alterations in social interaction and interpersonal communication. The aim of this study is to estimate the interaction between autistic children and a mobile toy robot during free spontaneous game play. The duration of different criteria including eye contact, touch, manipulation, and posture have been considered. The variety of interactions of children with autism and the mobile toy robot show that the children take an interest in playing with the robot. This study suggests that the mobile toy robot in an ecological situation such as free, spontaneous game play could be used …as a mediator of social stimuli in order to reduce the impairment of autistic children skills related to social information understanding and interaction. Show more

Keywords: Autism, neural functioning, mobile toy robot, free spontaneous game play

DOI: 10.3233/NRE-2010-0613

Citation: NeuroRehabilitation, vol. 27, no. 4, pp. 305-311, 2010

Authors: Arango-Lasprilla, Juan Carlos | Nicholls, Elizabeth | Olivera, Silvia Leonor | Perdomo, Jose Libardo | Arango, Jose Anselmo

Article Type: Research Article

Abstract: Objective: To assess health-related quality of life (HRQOL) of individuals with Spinal Cord Injury (SCI) in Neiva, Colombia. Design: Cross-sectional. Participants/methods: 40 Colombians with SCI and 42 age- and gender-matched controls completed the SF-36, a self-report measure composed of eight component areas (physical health problems, role limitations due to personal or emotional problems, emotional well-being, social functioning, energy/fatigue, and general health perceptions). Results: Compared to healthy controls, individuals with SCI had significantly lower means on five SF-36 subscales: physical functioning (22.5 vs. 94.0; p < 0.001), role limitations due to physical problems (54.4 …vs. 77.4; p < 0.01), social functioning (67.5 vs. 80.1; p < 0.05), pain (65.4 vs. 79.5; p < 0.01), and general health (54.9 vs. 69.4; p < 0.01). Both groups scored similarly on the SF-36 emotional well-being subscale. Conclusion: Individuals with SCI from Neiva, Colombia report having poorer quality of life across various domains than healthy controls, primarily in the area of physical functioning. These findings suggest the need for rehabilitation health professionals to develop and implement interventions to improve HRQOL in individuals with SCI. Show more

DOI: 10.3233/NRE-2010-0614

Citation: NeuroRehabilitation, vol. 27, no. 4, pp. 313-319, 2010

Authors: Gaber, Tarek A.-Z. K.

Article Type: Research Article

Abstract: Background: Cortical blindness is a rare complication of posterior circulation stroke. However, its complex presentation with sensory, physical, cognitive and behavioural impairments makes it one of the most challenging. Appropriate approach from a rehabilitation standpoint was never reported. Aim: Our study aims to discuss the rehabilitation methods and outcomes of a cohort of patients with cortical blindness. Method: The notes of all patients with cortical blindness referred to a local NHS rehabilitation service in the last 6 years were examined. Patients’ demographics, presenting symptoms, scan findings, rehabilitation programmes and outcomes were documented. Results: Seven patients …presented to our service, six of them were males. The mean age was 63. Patients 1, 2 and 3 had total blindness with severe cognitive and behavioural impairments, wandering and akathisia. All of them failed to respond to any rehabilitation effort and the focus was on damage limitation. Pharmacological interventions had a modest impact on behaviour and sleep pattern. The 3 patients were discharged to a nursing facility. Patients 4, 5, 6 and 7 had partial blindness with variable severity. All of them suffered from significant memory impairment. However, none suffered from any behavioural, physical or other cognitive impairment. Rehabilitation efforts on 3 patients were carried out collaboratively between brain injury occupational therapists and sensory disability officers. All patients experienced significant improvement in handicap and they all maintained community placements. Conclusion: This small cohort of patients suggests that the rehabilitation philosophy and outcomes of these 2 distinct groups of either total or partial cortical blindness differ significantly. Show more

Keywords: Cortical blindness, stroke, rehabilitation

DOI: 10.3233/NRE-2010-0615

Citation: NeuroRehabilitation, vol. 27, no. 4, pp. 321-325, 2010

Authors: Ellis, Charles | Dismuke, Clara | Edwards, Kathryn K.

Article Type: Research Article

Abstract: Purpose: Few studies have used national data to characterize the occurrence of aphasia in the U.S. The purpose of this project was to use national hospital discharge data to examine the number and characteristics of patients discharged from U.S. hospitals with a diagnosis of aphasia. Methods: We examined data from the National Inpatient Sample (NIS) (1997–2006) using ICD-9 codes for aphasia to identify the number and demographic characteristics of patients with aphasia. Results: Between 1997 and 2006 the number of individuals with aphasia was approximately 100,000 per year. During the 10-year period, the majority of individuals …with aphasia were 65 years of age and older, female, had Medicare as a primary payer source and resided in the South. Conclusions: The occurrence of aphasia and demographic characteristics of individuals with aphasia has been generally consistent in the U.S. from 1997 to 2006. Future studies are needed to quantify direct and indirect costs of treating individuals with aphasia as well as other factors that determine the true impact of aphasia and other neurologically based disorders of communication. Show more

DOI: 10.3233/NRE-2010-0616

Citation: NeuroRehabilitation, vol. 27, no. 4, pp. 327-333, 2010

Authors: Gall, Carolin | Fedorov, Anton B. | Ernst, Lisa | Borrmann, Antonia | Sabel, Bernhard A.

Article Type: Research Article

Abstract: Background: Visual field defects after optic nerve damage typically show a limited capacity for spontaneous and treatment-induced recovery. Objective: Repetitive transorbital alternating current stimulation (rtACS) was applied to the damaged optic nerve to evaluate visual functions after stimulation. Methods: A 27-years-old male patient suffering left optic nerve atrophy with nearly complete loss of vision 11 years after atypical traumatic damage was treated transorbitally with biphasic 10–15 pulse trains of rtACS (10–30 Hz, < 600 μ A, 30–40 min daily for 10 days) which produced phosphenes. Results: After rtACS treatment detection ability of super-threshold stimuli …increased from 3.44% to 17.75% and mean perimetric threshold from 0 dB to 2.21 dB at final diagnostics. Conclusion: This improvement of vision may be due to increased neuronal synchronization, possibly involving strengthening of synaptic transmission along the central visual pathway. Show more

Keywords: Alternating current, electric stimulation, traumatic optic neuropathy, vision recovery

DOI: 10.3233/NRE-2010-0617

Citation: NeuroRehabilitation, vol. 27, no. 4, pp. 335-341, 2010

Authors: Nolan, Karen J. | Savalia, Krupa K. | Yarossi, Mathew | Elovic, Elie P.

Article Type: Case Report

Abstract: This investigation utilized a single case design to evaluate the effects of a dynamic AFO on ambulation in post stroke hemiplegia. A single patient with stroke related hemiplegia using a dynamic AFO underwent gait analysis while walking on level ground. Outcome measures included temporal-spatial gait parameters and bilateral kinematic joint angles at the ankle, knee, and hip with and without AFO. Walking speed, stride length, step length and cadence increased with the dynamic AFO. Step width and double support decreased, while single support remained unchanged on the affected limb with the dynamic AFO. With the dynamic AFO there was increased …hip flexion at foot strike and toe-off, increased hip sagittal plane angular velocity during swing, and decreased abduction. The dynamic AFO had a positive effect on the participant's overall gait which included improved temporal-spatial parameters and gait velocity which is likely due to a decrease in the overall energy cost of walking. Kinematic angles at the hip were most notably affected by brace utilization and this effect should be more fully explored. Further research with a larger sample utilizing dynamic AFOs is indicated to explore the generalizability of these findings and to determine the potential utility of these braces as an alternative to the traditionally prescribed solid AFO. Show more

DOI: 10.3233/NRE-2010-0618

Citation: NeuroRehabilitation, vol. 27, no. 4, pp. 343-350, 2010

Authors: Leung, Ada W.S. | Cheng, Stephen K.W. | Mak, Amanda K.Y. | Leung, Kwok-Keung | Li, Leonard S.W. | Lee, Tatia M.C.

Article Type: Research Article

Abstract: Background and purpose: Few studies have addressed factors that contribute to functional recovery in people with hemorrhagic stroke. We assessed the value of using pre-training functional level and cognitive abilities measured at admission in order to predict functional gain in a sample of stroke patients. Methods: The Functional Independence Measure (FIM) was administered to 85 hemorrhagic stroke patients. Three multiple regression models were constructed using total gain in FIM scores, gain in scores in the cognitive domain of FIM, and gain in scores in the motor domain of FIM as outcome variables. Predictor variables were age; scores on …the Digit Span Forward Test (DSF), Digit Span Backward Test (DSB), and Chinese Auditory Verbal Learning Test (CAVLT); and the FIM scores measured at admission. Results: All regression models were significant, Ps < 0.001, and each explained over 73% of the variance in the FIM gains. Age and admission FIM scores were both significant predictors in each of the three models. The DSB span score was a significant predictor of the total FIM and the cognitive FIM gains. The CAVLT recognition score was also a significant predictor of the cognitive FIM gain. Conclusions: Functional improvement in patients with hemorrhagic stroke after in-patient rehabilitation was predicted by age, pre-training functional level, and cognitive abilities measured at admission. Show more

Keywords: Stroke, FIM, functional recovery, learning, memory

DOI: 10.3233/NRE-2010-0619

Citation: NeuroRehabilitation, vol. 27, no. 4, pp. 351-358, 2010

Authors: Tojo, Hidenori | Kanno, Nami | Nakamura, Takeshi | Mizumoto, Yasuko | Yamanaka, Midori | Tajima, Fumihiro

Article Type: Research Article

Abstract: Background and Purpose: The main objective of this study was to compare the hand and finger performance of stroke patients in standing and sitting positions. Methods: The study subjects were 11 males and 3 females with history of stroke (age, 68.6 ± 6.3 years, mean ± SD). Inclusion criteria were right-handedness before stroke, right hemiparesis due to left hemisphere lesion induced by stroke, at least 4 months between stroke and study enrollment, and ability to stand for more than 10 minutes. Tests of dexterity (peg board test), attention, unilateral spatial neglect, and cognition were conducted in comfortable sitting …and standing positions. Seven subjects started in standing position, and the other seven subjects were tested first in sitting position. Tests in the first position were performed on one day, and repeated one week later but performed in a different position. Results: The mean performance time on the peg board test in standing position was significantly faster than in sitting position (p = 0.022). However, the results of the Trail making test-part A, line cancellation test, line bisection and Mini Mental State conducted in standing position were similar to those of sitting position. There were no differences between the first and second trial tests. Conclusions: Our results showed that standing position improved the functional performance of hand and arm on the un-affected side in stroke patients, but had no effects on consistent attention, unilateral spatial neglect, or cognition. Show more

Keywords: Activity of daily living, postural effects, hand performance

DOI: 10.3233/NRE-2010-0620

Citation: NeuroRehabilitation, vol. 27, no. 4, pp. 359-365, 2010

Authors: Jang, Sung Ho

Article Type: Research Article

Abstract: We reviewed relevant diffusion tensor imaging (DTI) studies on prediction of motor outcome in hemiparetic stroke patients in order to evaluate the following objectives: characteristics of DTI for prediction of motor outcome in stroke patients, previous DTI studies, and future direction. DTI offers the unique advantage of visualization and estimation of the corticospinal tract, which is the most important neural tract for motor function. Although prediction of motor outcome is a very important topic for clinicians, only about a dozen DTI studies have been reported on this topic. These studies can be classified into two groups: 1) studies for adoption …of DTI parameters as a potential marker for prediction of motor outcome in stroke patients, and 2) studies for analysis of the integrity of the corticospinal tract in prediction of motor outcome. In order to increase the predictability of motor outcome, studies according to the somatotopy and studies combined with transcranial magnetic stimulation are necessary. Other additional studies on optimal DTI scanning time for motor prediction will also be required. Show more

Keywords: Stroke, motor function, diffusion tensor imaging, hemiparesis

DOI: 10.3233/NRE-2010-0621

Citation: NeuroRehabilitation, vol. 27, no. 4, pp. 367-372, 2010

Authors: Yeo, Sang Seok | Jang, Sung Ho

Article Type: Research Article

Abstract: We investigated red nucleus (RN) changes in patients with a cerebral infarct, using diffusion tensor imaging (DTI). Forty-nine consecutive stroke patients with pyramidal tract(PT) injury (mean age, 62.1 years; range, 41 to 75) and 46 age-matched normal healthy control subjects (mean age, 58.9 years; range, 41 to 75) with no history of neurologic disease were recruited. DTI was performed using a 1.5-T system during the early stage, after cerebral infarct (8–l21 days after onset). DTIs were acquired using a sensitivity-encoding head coil at 1.5 T. We measured fractional anisotropies (FAs) and apparent diffusion coefficients (ADCs) of RNs in the upper …midbrain, and assessed the motor function of affected extremities. Mean FA of RNs in affected hemispheres was higher than in unaffected hemispheres (P < 0.05), however, no difference was observed between the unaffected control hemispheres (P > 0.05). However, mean ADC values of RNs were no different between control hemispheres and a patient's affected and unaffected hemispheres (P > 0.05). It appears that RN in affected hemispheres show elevated levels of neuronal activity during the early stage in patients with a corona radiata infarct, which suggests that RNs in affected hemispheres are used to compensate for PT injury. Show more

Keywords: Diffusion tensor imaging, stroke, red nucleus, hemiparesis, pyramidal tract

DOI: 10.3233/NRE-2010-0622

Citation: NeuroRehabilitation, vol. 27, no. 4, pp. 373-377, 2010

Article Type: Other

DOI: 10.3233/NRE-2010-0623

Citation: NeuroRehabilitation, vol. 27, no. 4, pp. 379-379, 2010