NeuroRehabilitation - Volume 40, issue 2

Authors: Mavaddat, Nahal | Ross, Sheila | Dobbin, Alastair | Williams, Kate | Graffy, Jonathan | Mant, Jonathan

Article Type: Research Article

Abstract: BACKGROUND: Post-stroke psychological problems predict poor recovery, while positive affect enables patients to focus on rehabilitation and may improve functional outcomes. Positive Mental Training (PosMT), a guided self-help audio shows promise as a tool in promoting positivity, optimism and resilience. OBJECTIVE: To assess acceptability of training in positivity with PosMT for prevention and management of post-stroke psychological problems and to help with coping with rehabilitation. METHODS: A modified PosMT tool consisted of 12 audio tracks each lasting 18 minutes, one listened to every day for a week. Survivors and carers were asked to listen for …4 weeks, but could volunteer to listen for more. Interviews took place about experiences of the tool after 4 and 12 weeks. Subjects: 10 stroke survivors and 5 carers from Stroke Support Groups in the UK. RESULTS: Three stroke survivors did not engage with the tool. The remainder reported positive physical and psychological benefits including improved relaxation, better sleep and reduced anxiety after four weeks. Survivors who completed the programme gained a positive outlook on the future, increased motivation, confidence and ability to cope with rehabilitation. No adverse effects were reported. CONCLUSIONS: The PosMT shows potential as a tool for coping with rehabilitation and overcoming post-stroke psychological problems including anxiety and depression. Show more

Keywords: Stroke, rehabilitation, rehabilitation interventions, positivity, depression, anxiety, qualitative analysis, semistructured interviews

DOI: 10.3233/NRE-161411

Citation: NeuroRehabilitation, vol. 40, no. 2, pp. 259-270, 2017

Authors: Lander, Joshua J. | Moran, Matthew F.

Article Type: Research Article

Abstract: BACKGROUND: Evidence suggests treadmill training (TT) and body weight-supported treadmill training (BWSTT) are effective strategies to improve gait in Parkinson’s disease (PD) patients. However, few researchers have investigated the spatiotemporal parameters during TT or BWSTT. OBJECTIVE: The goal of this study is to determine gait adaptations in PD and healthy subjects during positive pressure BWSTT and post-intervention overground walking. METHODS: Ten PD and ten healthy individuals participated in this study. Baseline spatiotemporal parameters were assessed using a six meter instrumented mat. A 10-min progressive BWSTT trial from 10% to 40% body weight support (BWS) was …then completed. Video capture and analysis of 10-min BWSTT trials were performed to determine spatiotemporal gait parameters. Three (5-min, 10-min, and 15-min) post-intervention overground assessments were obtained. RESULTS: During positive pressure BWSTT there was a significant effect of BW support on step length(SL) increase (p  < 0.01) and cadence decrease (p  < 0.001) in the healthy group but not in the PD group (p  = 0.45 SL, p  = 0.21 cadence). In post-intervention assessments there was a significant effect of time on velocity (p  < 0.002 non-PD, p  < 0.001 PD) and cadence (p  < 0.05 non-PD, p  < 0.01 PD) in both groups. CONCLUSIONS: There appears to be a generalized effect of TT on overground gait mechanics after a single session of positive pressure BWSTT regardless of PD impairment. Show more

Keywords: Parkinson’s disease, treadmill training, central pattern generator, proprioception

DOI: 10.3233/NRE-161412

Citation: NeuroRehabilitation, vol. 40, no. 2, pp. 271-276, 2017

Authors: Galea, Mary P. | Cofré Lizama, L. Eduardo | Butzkueven, Helmut | Kilpatrick, Trevor J.

Article Type: Research Article

Abstract: BACKGROUND AND PURPOSE: It is not currently known whether gait and balance measures are responsive to deterioration of motor function in multiple sclerosis (MS) patients with low EDSS scores (≤3.0). The aim of this study was to quantify MS-related gait and balance deterioration over a 12-month period. METHODS: Thirty-eight participants with MS (33 female, mean age: 41.1 ± 8.3 years), mean time since diagnosis 2.2 ± 4.1 years, EDSS score ≤3.0 and without clinical evidence of gait deterioration, were recruited. Participants performed walking trials and Functional and Lateral Reach Tests. Kinematics of the ankle and knee, and …electromyography of the tibialis anterior and medial gastrocnemius muscles were also measured. RESULTS: Three participants reported relapses with worsening EDSS scores and 4 non-relapsing participants had worse EDSS scores at 12 months. There were significant decreases in mean gait speed, stride length and balance scores, and a significant increase in double support. Marked changes in ankle kinematics, with decreased medial gastrocnemius activity were observed. CONCLUSION: Gait and balance performance of non-disabled RRMS participants may progressively decline, even in the absence of both acute clinical relapse and change in clinical status measured by the EDSS. Show more

Keywords: Gait, balance, multiple sclerosis

DOI: 10.3233/NRE-161413

Citation: NeuroRehabilitation, vol. 40, no. 2, pp. 277-284, 2017