NeuroRehabilitation - Volume 37, issue 2

Authors: Santiago, Lorenna Marques de Melo | de Oliveira, Daniel Antunes | de Macêdo Ferreira, Louise Gabriella Lopes | de Brito Pinto, Hyanne Yasmim | Spaniol, Ana Paula | de Lucena Trigueiro, Larissa Coutinho | Ribeiro, Tatiana Souza | de Sousa, Angélica Vieira Cavalcanti | Piemonte, Maria Elisa Pimentel | Lindquist, Ana Raquel Rodrigues

Article Type: Research Article

Abstract: BACKGROUND: Mental practice has shown benefits in the rehabilitation of neurological patients, however, there is no evidence of immediate effects on gait of individuals with Parkinson’s disease. OBJECTIVE: Determine the effects of mental practice activity added to physical practice on the gait of individuals with Idiopathic Parkinson’s Disease (IPD). METHODS: 20 patients classified with stage 2 and 3, according to the Hoehn and Yahr scale were randomized into 2 groups. The experimental group (N  = 10) was submitted to a single session of mental practice and physical practice gait protocol and the control group (N  = 10) only …to physical practice. The primary outcomes were stride length and total stance and swing time. Secondary outcomes were hip range of motion, velocity and mobility. Subjects were reassessed 10 minutes, 1 day and 7 days after the end of the session. RESULTS: There was no statistically significant difference between the groups. An intragroup difference was observed in velocity, stride length, hip range of motion, and mobility, as well as total stance and swing time. These results were also observed on follow-ups. CONCLUSIONS: Mental practice did not have a greater effect on the gait of individuals with IPD than physical practice, after a single session. Show more

Keywords: Primary parkinsonism, motor imagery, three-dimensional gait analysis

DOI: 10.3233/NRE-151259

Citation: NeuroRehabilitation, vol. 37, no. 2, pp. 263-271, 2015

Authors: Kalron, Alon | Zeilig, Gabi

Article Type: Review Article

Abstract: BACKGROUND: Cognitive impairment is a well-established sequela of people suffering from neurological pathologies. OBJECTIVE: To examine the effects of exercise intervention programs on cognitive performance in participants suffering from stroke, multiple sclerosis and Parkinson’s disease. METHODS: Four online databases (CINAHL, Cochrane Library, MEDLINE, PEDro) were comprehensively searched from their inception through December 2014. The search query was phrased as follows: In people suffering from MS, stroke or Parkinson’s disease, do exercise intervention programs improve cognitive performance? RESULTS: Twelve controlled clinical trials met our inclusion criteria. Studies were classified according to three clinical subgroups: Parkinson’s …disease (n  = 3), stroke (n  = 1) and multiple sclerosis (n  = 8). Eight studies employed an aerobic intervention program; one used an active exercise program based on virtual reality systems, three reports examined the effect of yoga and one compared the intervention program with sport climbing. Significant improvements in cognition were found in nine out of the twelve studies. Nevertheless, the total effect size was non-significant (0.18 (95% CI, – 4.1, 3.8)) for changes in executive functions. CONCLUSION: Due to lack of commonality between measures of cognition, training sequences and intervention period, it remains unclear as to whether exercise training can be effective in improving the cognitive functions of neurological patients. Show more

Keywords: Exercise, cognition, stroke, multiple sclerosis, Parkinson’s disease

DOI: 10.3233/NRE-151260

Citation: NeuroRehabilitation, vol. 37, no. 2, pp. 273-289, 2015

Authors: Brogårdh, Christina | Lexell, Jan

Article Type: Research Article

Abstract: BACKGROUND: Many persons with late effects of polio experience new or increased impairments, which can lead to walking limitations in daily life. No study has comprehensively analyzed how various self-reported impairments are associated with different aspects of self-reported walking limitations. OBJECTIVE: To determine the associations between self-reported impairments and self-reported walking limitations in persons with late effects of polio. METHODS: Three hundred and twenty-five persons (175 women and 150 men) with verified late effects of polio responded to the Self-reported Impairments in Persons with late effects of Polio (SIPP; 13-items) and to the Walking Impact Scale …(Walk-12; 12 items). RESULTS: The overall correlation (rho) between the total sum scores of the SIPP and the Walk-12 was 0.61 (p  <  0.01). Of the 156 correlation coefficients (SIPP vs Walk-12), 151 (97% ) were significant at the 1% level. Self-reported muscle weakness, muscle fatigue, muscle and/or joint pain during physical activity and general fatigue had the strongest correlations (rho: 0.33 to 0.64) to the self-reported walking limitations, whereas memory difficulties, sleep disturbances and concentration difficulties had the weakest correlations (rho: 0.10 to 0.34). CONCLUSION: There are weak to moderate associations between self-reported impairments and walking limitations in persons with late effects of polio. By limiting the impact of those impairments that are strongest associated with walking, clinicians may improve walking ability. However, the strength of the associations implies that other rehabilitation interventions should be considered for improving overall performance in daily activities related to walking. Show more

Keywords: Impairments, postpoliomyelitis syndrome, questionnaires, rehabilitation, walking

DOI: 10.3233/NRE-151261

Citation: NeuroRehabilitation, vol. 37, no. 2, pp. 291-298, 2015

Authors: Ebata, Shigeto | Hatsushika, Kyousuke | Ohba, Tetsuro | Nitta, Kyohko | Akaike, Hiroshi | Masuyama, Keisuke | Haro, Hirotaka

Article Type: Research Article

Abstract: BACKGROUND: Some patients develop dysphagia after OC arthrodesis with RA. A previous report has indicated that establishing appropriate occipito-C2 is important for avoiding these side effects. However, a more recent report has demonstrated that the O-C2 angle did not have a significant effect on the incidence of postoperative dysphagia. OBJECTIVE: To investigate the swallowing function of patients with rheumatoid arthritis (RA) before and after they underwent occipitocervical (OC) fusion. METHODS: The study was performed in collaboration with the Departments of Orthopaedic, Otorhinolaryngology, and Rehabilitation. Seven consecutive patients (3 men and 4 women; mean age, 66.4 years) …with RA-induced upper cervical deformity were enrolled from 2013 to 2014. The patients underwent deglutition analysis, which was performed by otorhinolaryngologists, before and after surgery, and comprised videofluoroscopy and fiberoptic endoscopy. We examined the relationship between imaging studies and swallowing function. RESULTS: Preoperatively, subjective dysphagia was reported by 2 patients. Videofluoroscopy identified dysmotility of the epiglottis and incomplete closure of the laryngeal inlet in 2 patients, with contrast medium entering the larynx, and endoscopy identified food residue in the larynx of 1 patient during swallowing evaluation. Postoperatively, 2 patients with preoperative impaired deglutition showed dysphagia. Imaging examinations of the 2 patients revealed a 10°-reduction in the O-C2 angle of 1 patient, but the angle was unchanged in the other patient. CONCLUSIONS: To the best of our knowledge, this is the first report to evaluate swallowing function before and after O-C3 arthrodesis. The preoperative O-C2 angle was unchanged after surgery. Impairment of deglutition may be closely associated with air leakage from the oropharynx due to impaired mobility of the soft palate. Because the precise mechanism of dysphagia has not been fully elucidated, further study using dynamic videofluoroscopy and videoendoscopy is needed to examine the swallowing mechanism. Show more

Keywords: Rheumatoid arthritis, cervical deformity, occipitocervical arthrodesis, deglutition, videofluoroscopic examination, videoendoscopic examination

DOI: 10.3233/NRE-151262

Citation: NeuroRehabilitation, vol. 37, no. 2, pp. 299-304, 2015

Authors: Padula, William V. | Subramanian, Prem | Spurling, April | Padula, William V. | Jenness, Jonathan

Article Type: Research Article

Abstract: BACKGROUND: Following a neurologic event such as traumatic brain injury (TBI), cerebrovascular accident (CVA), and chronic neurological conditions including Parkinson’s disease, multiple sclerosis, and cerebral palsy a shift in the visual midline (egocenter) can directly affect posture, balance and spatial orientation. As a consequence, this increases the risk of fall (RoF) and injury that imposes a major financial burden on the public health system. OBJECTIVE: To determine if there is a statistically significant change in balance with the intervention of yoked prisms to reduce the risk of fall in subjects with neurological impairments. METHODS: Ambulation of …thirty-six subjects was evaluated on a pressure sensitive mat before and after intervention with yoked prisms. Changes in gait and balance were analyzed in the anterior-posterior (AP) and medial-lateral (ML) axes during ambulation. RESULTS: T -tests for each measure comparing the difference-of-differences to a zero change at baseline returned statistically significant reductions in both AP (p  <  0.0001; 95% CI: 1.368– 2.976) and ML (p  = 0.0002; 95% CI: 1.472– 4.173) imbalances using specifically directed yoked prisms to correct the visual midline deviation. CONCLUSION: These findings demonstrate that yoked prisms have the potential to provide a cost-effective means to restore the visual midline thereby improving balance, reduce RoF and subsequent injury. Show more

Keywords: Visual midline shift syndrome, yoked prisms, balance, spatial visual process, visual egocenter

DOI: 10.3233/NRE-151263

Citation: NeuroRehabilitation, vol. 37, no. 2, pp. 305-314, 2015