NeuroRehabilitation - Volume 32, issue 1

Authors: Yip, Ben C.B. | Man, David W.K.

Article Type: Research Article

Abstract: Acquired brain injuries (ABI) may display cognitive impairments and lead to long-term disabilities including prospective memory (PM) failure. Prospective memory serves to remember to execute an intended action in the future. PM problems would be a challenge to an ABI patient's successful community reintegration. While retrospective memory (RM) has been extensively studied, treatment programs for prospective memory are rarely reported. The development of a treatment program for PM, which is considered timely, can be cost-effective and appropriate to the patient's environment. A 12-session virtual reality (VR)-based cognitive rehabilitation program was developed using everyday PM activities as training content. 37 subjects …were recruited to participate in a pretest-posttest control experimental study to evaluate its treatment effectiveness. Results suggest that significantly better changes were seen in both VR-based and real-life PM outcome measures, related cognitive attributes such as frontal lobe functions and semantic fluency. VR-based training may be well accepted by ABI patients as encouraging improvement has been shown. Large-scale studies of a virtual reality-based prospective memory (VRPM) training program are indicated. Show more

Keywords: Acquired brain injury, prospective memory, rehabilitation, virtual reality

DOI: 10.3233/NRE-130827

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 103-115, 2013

Authors: Combs, Stephanie A. | Diehl, M. Dyer | Chrzastowski, Casey | Didrick, Nora | McCoin, Brittany | Mox, Nicholas | Staples, William H. | Wayman, Jessica

Article Type: Research Article

Abstract: The purpose of this study was to compare group boxing training to traditional group exercise on function and quality of life in persons with Parkinson disease (PD). A convenience sample of adults with PD (n = 31) were randomly assigned to boxing training or traditional exercise for 24–36 sessions, each lasting 90 minutes, over 12 weeks. Boxing training included: stretching, boxing (e.g. lateral foot work, punching bags), resistance exercises, and aerobic training. Traditional exercise included: stretching, resistance exercises, aerobic training, and balance activities. Participants were tested before and after completion of training on balance, balance confidence, mobility, gait velocity, …gait endurance, and quality of life. The traditional exercise group demonstrated significantly greater gains in balance confidence than the boxing group (p < 0.025). Only the boxing group demonstrated significant improvements in gait velocity and endurance over time with a medium between-group effect size for the gait endurance (d = 0.65). Both groups demonstrated significant improvements with the balance, mobility, and quality of life with large within-group effect sizes (d ≥ 0.80). While groups significantly differed in balance confidence after training, both groups demonstrated improvements in most outcome measures. Supporting options for long-term community-based group exercise for persons with PD will be an important future consideration for rehabilitation professionals. Show more

Keywords: Parkinson disease, boxing, balance confidence, exercise, quality of life

DOI: 10.3233/NRE-130828

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 117-124, 2013

Authors: Poliakoff, Ellen | Galpin, Adam J. | McDonald, Kathryn | Kellett, Mark | Dick, Jeremy P.R. | Hayes, Sue | Wearden, Alison J.

Article Type: Research Article

Abstract: There is accumulating evidence for the benefits of exercise in Parkinson's disease (PD), but less is known about group exercise interventions. We evaluated the effect of gym-training programme on people with PD. Thirty-two adults with mild to moderate PD, not currently exercising formally, were randomised to an immediate 20-week biweekly gym training programme at a local leisure complex, or a 10-week programme starting 10 weeks later. Assessments at baseline (T1), 10 weeks (T2) and 20 weeks (T3) included reaction time, motor performance (UPDRS), quality of life and illness perceptions. Experiences of the programme were assessed via questionnaire and a focus …group. Overall UPDRS motor function score did not change over time. However, gym training was associated with significant improvements in reaction times and some timed tests in the immediate training group (T1-T2). The delayed group showed similar improvements following gym training (T2-T3). Participants reported enjoyment, obtaining social benefits, and increased confidence. However, the questionnaire measures did not show improvements in subjective health ratings or illness perceptions. Although benefits were not apparent in the questionnaire measures or overall UPDRS scores, our findings suggest that a 10-week gym training programme in a community setting can provide some benefits for people with PD. Show more

Keywords: Parkinson's disease, exercise, gym, quality of life, social support

DOI: 10.3233/NRE-130829

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 125-134, 2013

Authors: Müller, Thomas | Pietsch, Angela

Article Type: Research Article

Abstract: Background: A physiotherapy subtype is gait training (GT), which aims on correction of posture and gait re-education in patients with Parkinson’s disease (PD). Osteopathy in the cranial field (OCF) is a gentle manual method to treat dysfunctions of the central nervous system. Therapists may employ GT and OCF to bypass deficient basal ganglia dysfunction, which causes gait disturbances in PD. Objectives: Objectives of this pilot study were to demonstrate the efficacy of both procedures on gait and to compare their effects within a cross over design. Methods: 18 PD patients received on two subsequent days one …GT- and one OCF session each. The ten meter walking test (WT) was performed before and after each therapeutic intervention. Results: GT reduced the number of steps but not the interval in the WT. OCF declined the period but not the step frequency in the WT. The computed differences of WT outcomes before and after each intervention did not vary between both methods. Both sessions together shortened the interval but not number of steps in the WT. Conclusion: GT improves walking behaviour with a specific focus on an optimised performance of the necessary movement sequences regarding their accuracy and amplitude. As OCF decreased the interval, it ameliorates speed of motion execution during gait. GT and OCF enhance different aspects of gait in PD. Show more

Keywords: Parkinson's disease, osteopathy, gait training, physiotherapy

DOI: 10.3233/NRE-130830

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 135-140, 2013

Authors: Al-Jarrah, Muhammed | Obaidat, Heyam | Bataineh, Ziad | Walton, Lori | Al-Khateeb, Ahed

Article Type: Research Article

Abstract: Objectives: Parkinson’s disease (PD) is a neurodegenerative disorder, caused by the gradual loss of cells in substantia nigra. Nitric oxide (NO) plays an important role in a variety of signal transduction pathways that are crucial for maintaining the physiologic functions of nervous system. The aims of this study are: 1) To investigate the expression of the inducible form of NO (iNOS), and compare it to neuronal nitric oxide (nNOS) in the brain of a chronic mouse model of PD and 2) To study the effect of endurance exercise training on the expression of these markers. Method: Mouse models …of PD were obtained using 10 doses of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) (25 mg/kg) and probenecid (250 mg/kg) over 5 weeks. Forty C57BL /6 albino mice were randomly divided into four groups: sedentary control (SC, N = 10), exercise control (EC, N = 10), sedentary PD (SPD, N = 10), exercise PD (EPD, N = 10). At the end of training program, nNOS and iNOS were evaluated in the striatum in all animal groups using immunohistochemistry. Results: nNOS showed significant increases in striatum (ST) of SPD mice compared to SC mice (P > 0.03). There was also decreased expression of nNOS in EC group compared to SC mice, but this decrease was not significant (P > 0.8). Exercise training significantly decreased the level of nNOS in the EPD compared to SPD, (P > 0.04). Although, iNOS expression followed almost the same trend as nNOS, but exercise training did not significantly decrease the expression of iNOS in both EC and EPD groups, P > 0.2 and 0.3 respectively. Discussion: The data from this study suggests that 4 weeks of treadmill exercise has a positive impact on the expression of nNOS and iNOS in the striatum of a PD model. This might clear in part the pathogenicity of the diseases and the positive impact of training on PD. Show more

Keywords: Exercise, Parkinson's disease, nitric oxide

DOI: 10.3233/NRE-130831

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 141-147, 2013

Authors: Schorl, Martin | Valerius-Kukula, Seung Ja | Kemmer, Thomas P.

Article Type: Research Article

Abstract: Introduction: Critical-Illness-Polyneuropathy (CIP) is common in critically ill patients. In contrast to CIP arousing from primary non-neurological causes, studies dealing with CIP following a primary neurological illness are rare. This mono-center, retrospective study was performed to examine a) the incidence of CIP in patients after severe neurological illnesses and b) the impact on ventilator therapy. Material and Methods: Retrospective analysis of all patients, admitted for early (post-acute) neurological rehabilitation following severe neurological diseases between 01.01.2006 and 31.12.2010. Patients routinely underwent standard electrophysiological evaluation (nerve conduction studies of 8 motor and 6 sensory nerves; needle electromyography of 6 muscles). …Diagnosis of CIP required a) pathological spontaneous activity in at least two muscles and b) reduced compound muscle activity potentials (CMAP) in at least two motor nerves of different extremities. Results: CIP was diagnosed in 430 of 623 patients (69.0%). Patients with proven CIP required significantly (p < 0.001) longer ventilator therapy (33.1 days) in contrast to patients without CIP (21.5 days). Conclusion: CIP is common in patients suffering from primary severe neurological diseases. Due to CIP, duration of ventilator therapy is significantly prolonged. In patients with severe neurological diseases electrophysiology is crucial to establish the correct diagnosis. Show more

Keywords: Critical-lllness-Polyneuropathy, ventilator therapy, early neurological rehabilitation, nerve conduction studies, electromyography

DOI: 10.3233/NRE-130832

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 149-156, 2013

Authors: Calis, Funda Atamaz | On, Arzu Yagiz | Durmaz, Berrin

Article Type: Research Article

Abstract: Due to the fact that the phonetic, morphological and syntactic structures of the Turkish language differ significantly from other European languages, the translated forms of the currently available aphasia assessment batteries are not adequate for Turkish-speaking aphasic patients. The aim of this study was to assess the validity and reliability of the Ege Aphasia Test that we have developed. The test, which includes the 8 subtests of praxia, spontaneous language, auditory and verbal comprehension, repetition, naming, reading, writing and calculating, was applied into 100 aphasic patients, 40 dysarthric patients and 40 healthy subjects. All test-retest intra-class correlation coefficients were found …to be excellent (ICC = 0.99). The Cronbach's coefficients ranged from 0.71 to 0.91. All the subtests showed significantly greater scores in aphasic patients (p < 0.05). Significant correlations were found between the subtests and corrected total score (p < 0.05). Finally, the Ege Aphasia Test has an acceptable validity and reliability. It seems to be a promising battery for evaluation of aphasia in the Turkish language, which is spoken mainly in Turkey and in the surrounding regions. We believe that this study will pioneer the development of aphasia rehabilitation in these countries and contribute to future studies. Show more

Keywords: Aphasia, validity, reliability, battery

DOI: 10.3233/NRE-130833

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 157-163, 2013

Authors: Lewis, Fiona M. | Murdoch, Bruce E.

Article Type: Research Article

Abstract: Up to 85% of children treated for brain tumor survive beyond five years; hence optimizing quality of life in survivorship has become a priority. As multiple factors contribute to the heterogeneity of neurocognitive and language outcomes for individual children following treatment, a means of monitoring subsequent development is needed for the individual child, particularly when pre-morbid performance indices are not available. The current study investigated the use of developmental language trajectories as a means of monitoring language development subsequent to treatment for tumors located within the posterior fossa. The language skills of four children treated for posterior fossa tumor (PFT) …were monitored over time (range of monitoring: 2–6 years) and the resultant trajectories were plotted against the trajectories based on tests' normative data as well as the trajectories of control children drawn from each child's local community. Each child's trajectory was considered in terms of age-appropriate developmental gains and discussed regarding the need for ongoing clinical monitoring of emerging, developing or established language skills. The study's findings highlight the heterogeneity of language outcomes following PFT. The utility of the application of developmental trajectories for the provision of individualized post-treatment support is discussed. Show more

Keywords: Posterior fossa tumor, language trajectory, risk-adapted treatments

DOI: 10.3233/NRE-130834

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 165-183, 2013

Authors: Kim, Soo Ji | Jo, Uiri

Article Type: Research Article

Abstract: Based on the anatomical and functional commonality between singing and speech, various types of musical elements have been employed in music therapy research for speech rehabilitation. This study was to develop an accent-based music speech protocol to address voice problems of stroke patients with mixed dysarthria. Subjects were 6 stroke patients with mixed dysarthria and they received individual music therapy sessions. Each session was conducted for 30 minutes and 12 sessions including pre- and post-test were administered for each patient. For examining the protocol efficacy, the measures of maximum phonation time (MPT), fundamental frequency (F0 ), average intensity (dB), jitter, …shimmer, noise to harmonics ratio (NHR), and diadochokinesis (DDK) were compared between pre and post-test and analyzed with a paired sample t -test. The results showed that the measures of MPT, F0 , dB, and sequential motion rates (SMR) were significantly increased after administering the protocol. Also, there were statistically significant differences in the measures of shimmer, and alternating motion rates (AMR) of the syllable /Kə/ between pre- and post-test. The results indicated that the accent-based music speech protocol may improve speech motor coordination including respiration, phonation, articulation, resonance, and prosody of patients with dysarthria. This suggests the possibility of utilizing the music speech protocol to maximize immediate treatment effects in the course of a long-term treatment for patients with dysarthria. Show more

Keywords: Accent-based, music-speech protocol development, mixed types of dysarthria, stroke patients

DOI: 10.3233/NRE-130835

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 185-190, 2013

Authors: Kwon, Jung Won | Nam, Seok Hyun | Lee, Na Kyung | Son, Sung Min | Choi, Yong Won | Kim, Chung Sun

Article Type: Research Article

Abstract: Purpose: This study examined whether transcranial direct current stimulation (tDCS) of the primary motor cortex alters the response time in motor suppression using the stop-signal task (SST). Methods: Forty healthy subjects were enrolled in this study. The subjects were assigned randomly to either the tDCS condition or sham control condition. All subjects performed a stop-signal task in three consecutive phases: without, during or after the delivery of anodal tDCS on the primary motor cortex (the pre-tDCS motor phase, on-tDCS motor phase, and after-tDCS motor phase). Results: The response times of the stopping process were significantly lower …in each SST motor phase during or after tDCS (p < 0.05) and shorter immediately during delivery of the tDCS, whereas there was no change after the delivery of tDCS compared to sham condition. In contrast, the response times of the going process were similar under the two conditions (p > 0.05). No subjects complained of any adverse symptoms or signs. Conclusion: Anodal tDCS enhances voluntary going and stopping of movement in executive control. tDCS appears to be an effective modality to modulate motor suppression and its related dynamic behavioral changes in motor sequential learning. Show more

Keywords: Transcranial direct current stimulation, stop-signal task, motor suppression, primary motor cortex

DOI: 10.3233/NRE-130836

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 191-196, 2013