NeuroRehabilitation - Volume 32, issue 2

Authors: Nejati, Vahid | Pouretemad, Hamid Reza | Bahrami, Hajar

Article Type: Research Article

Abstract: Background: Attention and executive function play an important role in fluent speaking. The aim of the present study is to evaluate effect of attention training in rehabilitation of stuttering. Method: In this random clinical trial 30 children with developmental stuttering participate in a random allocation sampling in case or control group. In case group, we trained patient with NEurocognitive Joyful Attentive Training Intervention (NEJATI) in 12 sessions. Riley Stuttering severity instrument-3 (SSI-3), Wisconsin Card Sorting Test (WCST), and Stroop Color Word Test (SCWT) are used for evaluation of executive function before and after intervention. Dependent T -Test was …used for analysis. Results: Comparing case group before and after intervention showed a significant enhancement in executive function and reduced stuttering severity. Conclusion: Attention training propose as a non lingual method of language and speech rehabilitation in developmental stuttering. Show more

Keywords: NEurocognitive Joyful Attentive Training Intervention (NEJATI), cognitive rehabilitation, developmental stuttering

DOI: 10.3233/NRE-130847

Citation: NeuroRehabilitation, vol. 32, no. 2, pp. 297-303, 2013

Authors: Yeo, Sang Seok | Jang, Sung Ho

Article Type: Research Article

Abstract: The main function of the corticospinal tract (CST) is control of the distal musculature used for fine movements, in contrast, the corticoreticular pathway (CRP) innervates the proximal and axial musculature. We report on a patient with an intracerebral hemorrhage (ICH) who showed recovery of an injured CST and an injured CRP by diffusion tensor tractography (DTT). The patient, a 38-year-old man, presented with severe paralysis of the right upper and lower extremities due to a spontaneous ICH in the left corona radiata and basal ganglia. When he started rehabilitation at 3 weeks after onset, he showed more severe weakness in …the proximal joints (shoulder and hip joints) than distal joints (hand and ankle joints). This proximal weakness improved rapidly in parallel with distal weakness over 3 weeks of rehabilitation. DTT performed at 3 and 6 weeks post-ICH revealed that a thin left CST observed at 3 weeks thickened at 6 weeks, and that a discontinuation of the left CRP at the midbrain level at 3 weeks was restored at 6 weeks. In addition, the track volumes of the left CST and CRP increased from 221 and 244 at 3 weeks to 725 and 625 at 6 weeks. In conclusion, we demonstrated the recovery of an injured CST and an injured CRP in a patient with ICH. Show more

Keywords: Diffusion tensor imaging, corticoreticulospinal tract, corticoreticular pathway, corticospinal tract, stroke

DOI: 10.3233/NRE-130848

Citation: NeuroRehabilitation, vol. 32, no. 2, pp. 305-309, 2013

Authors: Jang, Sung Ho

Article Type: Review Article

Abstract: Brain plasticity can be classified as adaptive and maladaptive. Maladaptive plasticity indicates hindered functional recovery or the development of an unwanted symptom. Although a considerable amount is known about adaptive plasticity in stroke, relatively little is known of maladaptive plasticity. In the current study, previous studies on motor function-related maladaptive plasticity in stroke are reviewed in terms of compensatory movement pattern (CMP), delayed-onset involuntary abnormal movements (IAMs), and the ipsilateral motor pathway as a motor recovery mechanism. For successful stroke rehabilitation, it is important that the characteristics of maladaptive plasticity are accurately recognized. However, there is a lack of definitive …evidence regarding the recognition of motor function-related maladaptive plasticity, although it seems that each of the three above-mentioned topics are involved. As for CMP, patients with a good neurological state as much as having a normal movement pattern, should be considered to have maladaptive plasticity, and in terms of the ipsilateral motor pathway, patients with bilateral innervations can be considered to have maladaptive plasticity. On the other hand, IAMs due to delayed neuronal degeneration should be ruled out in patients with delayed-onset IAMs. Therefore, for the accurate recognition of motor function-related maladaptive plasticity in stroke, a thorough evaluation of neurological state using brain mapping techniques is necessary, and subsequently, the prevention or intensive management of maladaptive plasticity is needed. Show more

Keywords: Plasticity, maladaption, adaption, stroke, compensation, motor recovery

DOI: 10.3233/NRE-130849

Citation: NeuroRehabilitation, vol. 32, no. 2, pp. 311-316, 2013

Authors: Hwang, Young-In | Yoo, Won-Gyu | An, Duk-Hyun

Article Type: Research Article

Abstract: This study investigated how stroke patients improve the walking patterns by using the Elastic Walking Band, which was included with a long elastic band and four pierced plastics as fixed points. Fifteen patients with stroke were recruited. Participants were nine males and six females. Gait parameters were measured with the GAITRite system to analyze the spatial and temporal parameters of walking by stroke patients. The Elastic Walking Band had no significance in cadence, swing time and stance on both limbs. However, the Elastic Walking Band significantly improved velocity in stroke patients. Furthermore, there was a significant difference in step length …of the less-affected limb between the two conditions, but no significant difference in the affected side. When the patients walked with the Elastic Walking Band, affected and less-affected stride length were also significantly increased as compared with barefoot walking. There were significant differences of velocity, less-affected step length, both stride length between walking with and without the Elastic Walking Band. Consequently, the Elastic Walking Band can be used as an assistive walking device that is lighter and less expensive for stroke patient gait training in the clinic. Show more

Keywords: AFO, orthosis, assistive device, Thera-band, gait training

DOI: 10.3233/NRE-130850

Citation: NeuroRehabilitation, vol. 32, no. 2, pp. 317-322, 2013

Authors: Jijimol, G. | Fayaz, R.K. | Vijesh, P.V.

Article Type: Research Article

Abstract: Objective: To evaluate the correlation between the trunk impairment and balance in patients with chronic stroke. Methods: Thirty subjects with chronic stroke participated in the study. The subjects were evaluated with the trunk impairment scale (TIS) and Tinetti balance scale (TBS). Result: Spearman’s correlation showed highly significant correlation between TIS and TBS scores (rho = 0.911). Conclusion: The study reveals that the trunk impairment and balance in subjects with stroke are positively correlated with each other.

Keywords: Trunk impairment, balance, chronic stroke

DOI: 10.3233/NRE-130851

Citation: NeuroRehabilitation, vol. 32, no. 2, pp. 323-325, 2013

Authors: Jin, Hong | Jiang, Yibo | Wei, Qin | Chen, Long | Ma, Genshan

Article Type: Research Article

Abstract: Objective: Using heart rate recovery (HRR) after exercise as an index of autonomic function, we evaluate the effects of aerobic cycling training on HRR and cardiovascular fitness (peak VO2 ) in chronic stroke patients and investigate the relationship between changes in HRR and those in peak VO2 . Methods: 128 participants with chronic stroke were randomized to a 12-week (5×/week) progressive aerobic cycling training group (n = 65) or a control group (n = 63). Peak VO2 , muscle strength, 6-minute walking distance (6MWD) and HRR were measured before and after the intervention. Results: …Cycling training leads to significant increase in peak VO2 , HRR, muscle strength and 6MWD. In the cycling group, percent changes in peak VO2 were positively associated with those in paretic and nonparetic muscle strength and HRR. Linear regression revealed that percent increases in peak VO2 were significantly correlated with percent changes in HRR when controlling for pre-peak VO2 , age, gender, duration since stroke and improved muscle strength. Conclusion: Aerobic cycling training can favorably modify HRR in stroke survivors. Rapid HRR, as an indicator of enhanced autonomic function, is useful for predicting gains in cardiovascular fitness. These findings indicate the underlying importance of autonomic modulation on cardiovascular adaptations to stroke exercise rehabilitation. Show more

Keywords: Exercise, physical fitness, heart rate recovery, autonomic dysfunction, stroke

DOI: 10.3233/NRE-130852

Citation: NeuroRehabilitation, vol. 32, no. 2, pp. 327-335, 2013

Authors: Cavalcanti, Paula Regina Aguiar | Campos, Tania Fernandes | Araüjo, John Fontenele

Article Type: Research Article

Abstract: The present study aimed to assess changes in the circadian and homeostatic control of the sleep-wake pattern in stroke patients and correlations with quality of life. Participants were 22 patients (55 ± 12 years) and 24 healthy subjects (57 ± 11 years). Instruments used were: the Pittsburgh Sleep Quality Index, SF-36 Questionnaire and Actigraphy. Data were analyzed by Mann-Whitney test and Spearman's correlation. Results identified a significant difference in sleep quality and quality of life between patients and healthy subjects, with patients on average exhibiting poor sleep quality (patients: 8.4 ± 3.4; healthy subjects: 6.2 ± 2.5; p = …0.0001) and low quality of life scores (p < 0.001). Correlation analysis detected an association between circadian variables (total activity, start and finish times of activity) and quality of life (p < 0.001). Associations between homeostatic variables (sleep duration, latency and efficiency) and quality of life were also significant (p < 0.001). In conclusion, results in this study showed compromised sleep quality and quality of life in the patients evaluated, associated with circadian and homeostatic alterations. This suggests that complaints regarding poor sleep quality be taken into consideration when planning the rehabilitation of stroke patients. Show more

Keywords: Quality of life, sleep-wake, circadian rhythm, stroke

DOI: 10.3233/NRE-130853

Citation: NeuroRehabilitation, vol. 32, no. 2, pp. 337-343, 2013

Authors: Kong, Keng-He | Lee, Jeanette

Article Type: Research Article

Abstract: Objective: To document temporal recovery of upper extremity dexterity and establish predictors of limb dexterity in a cohort of stroke patients in the first year after stroke. Design: Prospective cohort study. Subjects: One hundred patients with a first-ever ischemic stroke admitted to a rehabilitation centre. Methods: Assessment of upper extremity dexterity, motor power and selfcare function using the Motor Assessment Scale (MAS), Upper Extremity Motor Index (UEMI) and Modified Barthel Index (MBI) respectively. Results: Eighteen percent, 25.5% and 31.6% of patients recovered limb dexterity at 3, 6 and 12 months after stroke …respectively. Patients who recovered dexterity late (⩾6 months after stroke) were significantly younger with lower rehabilitation admission UEMI scores than those who recovered dexterity early. The UEMI score was the most significant correlate of limb dexterity at all follow up periods. Recovery of limb dexterity at 12 months was predicted by UEMI (OR1.54, 95% CI 1.13–2.10) and MBI (OR 1.03, 95% CI 1.00–1.07) scores on admission to rehabilitation. Conclusions: In this study, 31.6% of patients recovered upper extremity dexterity at 12 months after stroke. Although late recovery of dexterity occurs only in a small proportion of patients, this finding is still pertinent given the significant impact of dexterity on upper limb and selfcare function. Show more

Keywords: Stroke, upper extremity, prognosis

DOI: 10.3233/NRE-130854

Citation: NeuroRehabilitation, vol. 32, no. 2, pp. 345-350, 2013

Authors: Jones, Ciara | O'Keeffe, Kiadhnait | Kingston, Craig | Carroll, Aine

Article Type: Research Article

Abstract: Introduction: A high incidence of depression following a stroke has been reported. Many studies exclude those with communication impairments. However, there is an increased risk of psychosocial issues for individuals with communication difficulties. Psychosocial issues have a significant impact on the individual and their families. There is very limited research in this area. Methods: A retrospective case review of the assessment and intervention with three individuals with significant communication difficulties following stroke was completed. Key interdisciplinary intervention factors were identified. Results: Psychosocial issues were identified in all three cases. The assessment of cognitive difficulties, interdisciplinary intervention …targeting communication between family members, facilitation of emotional expression and liaison with appropriate community services were identified as key interventions. These interventions targeted at psychosocial issues resulted in a positive outcome for the individuals and their family. Discussion and Conclusion: Psychosocial issues are prevalent in individuals and their families with significant communication impairments following stroke. Clinically, these issues may be overlooked. The complexity of working with individuals with cognitive and communication impairments also contributes to poor identification of psychosocial issues. This case series clearly highlights that intervening at the psychosocial level through interdisciplinary working can facilitate meaningful outcomes for the individual and their family. Show more

Keywords: Communication disorders, stroke, psychosocial issues, interdisciplinary assessment and interventions, carer stress

DOI: 10.3233/NRE-130855

Citation: NeuroRehabilitation, vol. 32, no. 2, pp. 351-358, 2013

Authors: Cha, Yu-Jin | Kim, Hee

Article Type: Research Article

Abstract: This article has been retracted. You can find the retraction notice here: (http://content.iospress.com/articles/neurorehabilitation/nre1288 ).

DOI: 10.3233/NRE-130856

Citation: NeuroRehabilitation, vol. 32, no. 2, pp. 359-368, 2013