NeuroRehabilitation - Volume 40, issue 3

Authors: Ahn, Si-nae | Yoo, Eun-young | Jung, Min-ye | Park, Hae-yean | Lee, Ji-yeon | Choi, Yoo-im

Article Type: Research Article

Abstract: BACKGROUND: Cognitive Orientation to daily Occupational Performance (CO-OP) approach based on cognitive strategy in occupational therapy. OBJECTIVES: To investigate the effects of CO-OP approach on occupational performance in individuals with hemiparetic stroke. METHODS: This study was designed as a 5-week, randomized, single-blind. Forty-three participants who had a diagnosis of first stroke were enrolled in this study. The participants were randomly assigned to the experimental group (n  = 20) or the control group (n  = 23). The experimental group conducted CO-OP approach while the control group conducted conventional occupational therapy based on occupational performance components. This study measured …Canadian Occupational Performance Measure (COPM) and Performance Quality Rating Scale (PQRS). Outcome measurements were performed at baseline and post-intervention. RESULTS: After training, the scores of COPM and PQRS in trained task were significantly higher for the score in the experimental group than the control group. In addition, the non-trained task was significantly higher for the score in the experimental group than the control group in COPM and the PQRS. CONCLUSIONS: This study suggests that the CO-OP approach is beneficial effects on the occupational performance to improvement in individuals with hemiparetic stroke, and have positive effects on generalization and transfer of acquired skills. Show more

Keywords: Cognitive Orientation to daily Occupational Performance (CO-OP), occupational therapy, stroke, transfer

DOI: 10.3233/NRE-161416

Citation: NeuroRehabilitation, vol. 40, no. 3, pp. 285-292, 2017

Authors: Bae, Seahyun | Kim, Kyung-Yoon

Article Type: Research Article

Abstract: BACKGROUND: Stimulation through afferent sensory input is necessary to improve voluntary functional movement in stroke patients. OBJECTIVES: Dual-afferent sensory input, which combines electromyography-triggered functional electric stimulation (ETFES) and action observation, was investigated to determine its effects on voluntary movements in stroke patients. METHODS: This study was conducted on 18 patients with left hemiplegia diagnosed between 6 and 24 months prior. The 9 subjects in the dual-afferent sensory input (DASI) group underwent ETFES with action observation training for 4 weeks (20 min/d, 5 d/wk), while the 9 control group subjects underwent functional electric stimulation (FES) for the same …duration. The outcome measures were the movement-related cortical potential (MRCP), H-reflex, electromyography (EMG), and balance. RESULTS: The control and DASI groups showed significant increases in MRCP, muscle activity, and balance, while H-reflex was significantly decreased. MRCP and balance showed significant differences between DASI and control groups. CONCLUSIONS: DASI stimulates voluntary movement in patients, causes rapid activation of the cerebral cortex, and reduces excessive excitation of spinal motor neurons. Therefore, DASI, which stimulates voluntary movement, has a greater effect on brain activation in stroke patients. Show more

Keywords: Action observation, afferent sensory input, electromyography-triggered functional electric stimulation, stroke rehabilitation

DOI: 10.3233/NRE-161417

Citation: NeuroRehabilitation, vol. 40, no. 3, pp. 293-300, 2017

Authors: Lee, Yejin | Kim, Moon Young | Park, Ji-Hyuk | Park, Hae Yean

Article Type: Research Article

Abstract: BACKGROUND: The differential effects of bilateral and unilateral training on upper extremity (UE) function remain unclear. OBJECTIVE: To compare the effectiveness of bilateral and unilateral training on UE function and activities of daily living (ADL) after stroke. METHODS: Randomized controlled trials (RCTs) were selected for inclusion by two reviewers after searching the following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and KoreaMed. Methodological qualities were assessed using the PEDro scale. Effect size was estimated by calculating the standardized mean difference (SMD). RESULTS: Eleven RCTs of sufficient quality were included in …our meta-analysis. The effect size on UE capacity was statistically significant in favor of the Constraint-Induced Movement Therapy (CIMT) groups (SMD [fixed], g: – 0.34; 95% CI: – 0.59–0.08; p  = 0.01; I2  = 0%). No other SMDs were significant. CONCLUSION: The CIMT tasks were more effective than bilateral training with regard to increased UE capacity; however, this result should be cautiously interpreted since the evaluation tools were designed for assessment of unilateral UE function, not bilateral UE function. Further, the effect of the CIMT tasks on UE capacity was not translated into ADL. Considering the disadvantages of CIMT such as fatigue, bilateral training may be more appropriate for improving ADL. Show more

Keywords: Bilateral training, unilateral training, CIMT, upper extremity, stroke, meta-analysis

DOI: 10.3233/NRE-161418

Citation: NeuroRehabilitation, vol. 40, no. 3, pp. 301-313, 2017

Authors: Jung, Kyoungsim | Jung, Jinhwa | In, Taesung | Kim, Taehoon | Cho, Hwi-young

Article Type: Research Article

Abstract: OBJECTIVES: This study investigated the efficacy of Task-Related Training (TRT) Combined with Transcutaneous Electrical Nerve Stimulation (TENS) on the improvement of upper limb muscle activation in chronic stroke survivors with mild or moderate paresis. METHODS: A single-blind, randomized clinical trial was conducted with 46stroke survivors with chronic paresis. They were randomly allocated two groups: the TRT+TENS group (n  = 23) and the TRT+ placebo TENS (TRT+PLBO) group (n  = 23). The TRT+TENS group received 30 minutes of high-frequency TENS on wrist and elbow extensors, while the TRT+PLBO group received placebo TENS that was not real ES. Both groups did …30 minutes of TRT after TENS application. Intervention was given five days a week for four weeks. The primary outcomes of upper limb muscle activation were measured by integrated EMG (IEMG), a digital manual muscle tester for muscle strength, active range of motion (AROM) and Fugl-Meyer Assessment of the upper extremity (FMA-UE). The measurements were performed before and after the 4 weeks intervention period. RESULTS: Both groups demonstrated significant improvements of outcomes in IEMG, AROM, muscle strength and FMA-UE during intervention period. When compared with the TRT+PLBO group, the TRT+TENS group showed significantly greater improvement in muscle activation (wrist extensors, P  = 0.045; elbow extensors, P  = 0.004), muscle strength (wrist extensors, P  = 0.044; elbow extensors, P  = 0.012), AROM (wrist extension, P  = 0.042; elbow extensors, P  = 0.040) and FMA-UE (total, P  < 0.001; shoulder/elbow/forearm, P  = 0.001; wrist, P  = 0.002; coordination, P  = 0.008) at the end of intervention. CONCLUSIONS: Our findings indicate that TRT Combined with TENS can improve paretic muscle activity in upper limb paresis, highlighting the benefits of somatosensory stimulation from TENS. Show more

Keywords: Transcutaneous Electrical Nerve Stimulation (TENS), arm motor function, Task–Related Training

DOI: 10.3233/NRE-161419

Citation: NeuroRehabilitation, vol. 40, no. 3, pp. 315-323, 2017

Authors: Fakhari, Zahra | Ansari, Noureddin Nakhostin | Naghdi, Soofia | Mansouri, Korosh | Radinmehr, Hojjat

Article Type: Research Article

Abstract: BACKGROUND: Spasticity is a common complication after stroke. Dry needling (DN) is suggested as a novel method for treatment of muscle spasticity. OBJECTIVE: To explore the effects of DN on wrist flexors spasticity poststroke. METHODS: A single group, pretest-posttest clinical trial was used. Twenty nine patients with stroke (16 male; mean age 54.3 years) were tested at baseline (T0), immediately after DN (T1), and one hour after DN (T2). DN was applied for flexor carpi radialis (FCR) and flexor carpi ulnaris on the affected arm for single session, one minute per muscle. The Modified Modified …Ashworth Scale (MMAS), passive resistance force, wrist active and passive range of motion, Box and Block Test, and FCR H-reflex were outcome measures. RESULTS: Significant reductions in MMAS scores were seen both immediately after DN and at 1-hour follow-up (median 2 at T0 to 1 at T1 and T2). There were significant improvements in other measures between the baseline values at T0 and those recorded immediately after the DN at T1 or one hour later at T2. CONCLUSIONS: This study suggests that DN reduced wrist flexors spasticity and alpha motor neuron excitability in patients with stroke, and improvements persisted for one hour after DN. Show more

Keywords: Dry needling, spasticity, stroke, H-reflex

DOI: 10.3233/NRE-161420

Citation: NeuroRehabilitation, vol. 40, no. 3, pp. 325-336, 2017

Authors: Dell’Uomo, Daniela | Morone, Giovanni | Centrella, Antonio | Paolucci, Stefano | Caltagirone, Carlo | Grasso, Maria Grazia | Traballesi, Marco | Iosa, Marco

Article Type: Research Article

Abstract: BACKGROUND: Despite upper limb rehabilitation is widely investigated in patients with stroke, the effects of scapulohumeral rehabilitation on trunk stabillization are mainly unknown. OBJECTIVE: To test the effects of scapulohumeral rehabilitation protocol on trunk control recovery in patients with subacute stroke. METHODS: A pilot randomized controlled trial with two groups of 14 patients each one performing 20 minutes per day, 5 days a week, for 6 weeks in add on to standard therapy. Experimental group performed a specific scapulohumeral rehabilitation protocol aiming to improve trunk competencies whereas control group performed conventional arm rehabilitation. Clinical scale …tests and accelerometric evaluations were performed pre- and post-treatment. RESULTS: Experimental groups showed better scores at discharge at Trunk impairment Scale (p  < 0.001), Barthel Index (p  = 0.024), Trunk Control Test (p  = 0.002), Sitting Balance Scale (p  = 0.002), but neither at Fugl-Meyer Scale (p  = 0.194) nor Modified Ashworth Scale (p  = 0.114). Accelerometric analysis showed higher stability of trunk for experimental group especially during static and dynamic items. CONCLUSIONS: The recovery of scapulohumeral functions also acts on trunk stabilization post-stroke. Show more

Keywords: Scapulohumeral rehabilitation, trunk stability, stroke, rehabilitation, accelerometry

DOI: 10.3233/NRE-161421

Citation: NeuroRehabilitation, vol. 40, no. 3, pp. 337-343, 2017

Authors: Ribeiro, Tatiana Souza | Chaves da Silva, Tállyta Camyla | Carlos, Renata | de Souza e Silva, Emília Márcia Gomes | Lacerda, Matheus Oliveira | Spaniol, Ana Paula | Lindquist, Ana Raquel Rodrigues

Article Type: Research Article

Abstract: BACKGROUND: Although exercises involving both lower limbs are indicated for aerobic training, stroke patients have shown expressive asymmetry between the paretic and non-paretic lower limb (NPLL). Performing activities that stimulate the paretic limb during aerobic exercise may optimize training results. OBJECTIVE : To evaluate if there is influence of load addition on NPLL during treadmill training on cardiovascular parameters and gait performance of subacute stroke patients. METHODS: Thirty-eight stroke subjects with gait deficits were randomized into experimental group, which underwent treadmill training with a mass attached on NPLL, and control group, which underwent only treadmill training. …Interventions lasted 2 weeks (9 sessions). Main outcomes were heart rate, arterial blood pressure, gait speed and distance covered. Assessments occurred at rest, 10th and 20th minutes of the session and immediately after each session. RESULTS: There was improvement in speed and walking distance in both groups. All cardiovascular parameters had showed no changes compared to 1st and 9th sessions and there were no differences between groups within each session. CONCLUSIONS: Load addition on NPLL did not alter cardiovascular parameters and gait training provide better gait performance of subacute stroke patients, which indicates this therapy can be considered useful and safe for these patients. Show more

Keywords: Gait, aerobic exercise, cardiovascular system, rehabilitation

DOI: 10.3233/NRE-161422

Citation: NeuroRehabilitation, vol. 40, no. 3, pp. 345-354, 2017

Authors: Joshua, Abraham M. | Karnad, Shreekanth D. | Nayak, Akshatha | Suresh, B.V. | Mithra, Prasanna | Unnikrishnan, B.

Article Type: Research Article

Abstract: BACKGROUND & OBJECTIVE: Timed up and go (TUG) test is been used as a screening tool for the assessment of risk of falling in individuals following stroke. Though TUG test is a quick test, it has fair sensitivity compared to other tests. This study was carried out to obtain and compare test scores for different types of foot placements during sit to stand transition in stroke subjects. METHOD: A Cross-sectional study with purposive sampling included 28 post stroke subjects who were able to walk 6 meter with or without assistance. Timed Up and Go test was carried …out with four different types of foot placements and scores were recorded. The data were compared using Kruskal-Wallis One way analysis of variance and Wilcoxon signed ranks test. RESULT: There were comparable differences between asymmetric 1 test strategy which involved affected extremity to be placed behind the unaffected and other test strategies (Z  = –4.457,–3.848,–4.458; p  = 0.000). CONCLUSION: The initial foot placements during sit to stand transition influenced the time taken to complete the test which was significantly higher in asymmetric 1 strategy, Incorporation of the initial foot placement mainly asymmetric 1 strategy into conventional TUG test would help in identifying accurately the subject’s functional mobility and postural stability. Show more

Keywords: TUG, foot placement, stroke

DOI: 10.3233/NRE-161423

Citation: NeuroRehabilitation, vol. 40, no. 3, pp. 355-362, 2017

Authors: Watanabe, Hiroki | Goto, Ryohei | Tanaka, Naoki | Matsumura, Akira | Yanagi, Hisako

Article Type: Research Article

Abstract: BACKGROUND: Gait training using the Hybrid Assistive Limb® (HAL® ) may have beneficial effects on post-stroke gait function and independent walking. However, the long-term and medium-term efficacies of gait training using HAL® in stroke patients remain unclear. OBJECTIVE: To compare the medium-term efficacy of gait training using a single-leg version of the Hybrid Assistive Limb® (HAL® ) on the paretic side with conventional gait training (CGT) in recovery-phase stroke patients. METHODS: Twenty-four post-stroke participants (HAL® group: n  = 12, CGT group: n  = 12) completed the trial. Over 4 weeks, all participants received …twelve 20-min sessions of either HAL® (using the single-leg version of HAL® on the paretic side) or conventional (performed by skilled and experienced physical therapists) gait training. Outcome measures were evaluated prior to training, after 12 sessions, and at 8 and 12 weeks after intervention initiation. Functional Ambulation Category (FAC) was the primary outcome measure. RESULTS: The HAL® group showed significant improvement in FAC after 12 sessions, and at 8 and 12 weeks compared to the conventional group (P  = 0.02). CONCLUSIONS: The results suggested that a gait training program based on HAL® may improve independent walking more efficiently than CGT at 1 and 2 months after intervention. Show more

Keywords: Exoskeleton device, rehabilitation, robotics, stroke, walking

DOI: 10.3233/NRE-161424

Citation: NeuroRehabilitation, vol. 40, no. 3, pp. 363-367, 2017

Authors: Bindawas, Saad M. | Vennu, Vishal | Moftah, Emad

Article Type: Research Article

Abstract: BACKGROUND: to examine the effects of inpatient rehabilitation programs on function and length of stay in older adults with stroke METHODS: A total of five electronic databases were searched for relevant randomized controlled trials that examined the effects of inpatient rehabilitation programs on functional recovery, as measured by the functional independence measure and length of stay, which was measured in days. We included full-text articles written in English, and no time limit. The methodological quality and risk of bias were assessed using the Physiotherapy Evidence Database Scale and the Cochrane collaboration tools respectively. The effect sizes and …confidence intervals were estimated using fixed-effect models RESULTS: Eight randomized controlled trials involving 1,910 patients with stroke were included in the meta-analysis showed that patients who participated in the inpatient rehabilitation programs had significantly (p less than 0.05) higher functional independence measure scores (effect size = 0.10; 95 percent confidence interval = 0.01, 0.22) and shorter length of stay (effect size = 0.14; 95 percent confidence interval = 0.03, 0.22). CONCLUSIONS: This systematic review provided evidence that inpatient rehabilitation programs have beneficial effects, improving functionality and reducing length of stay for older adults with stroke. Show more

Keywords: Stroke, length of stay, rehabilitation

DOI: 10.3233/NRE-161425

Citation: NeuroRehabilitation, vol. 40, no. 3, pp. 369-390, 2017

Authors: Pacheco, Thaiana Barbosa Ferreira | Oliveira Rego, Isabelle Ananda | Campos, Tania Fernandes | Cavalcanti, Fabrícia Azevedo da Costa

Article Type: Research Article

Abstract: BACKGROUND: Virtual Reality (VR) has been contributing to Neurological Rehabilitation because of its interactive and multisensory nature, providing the potential of brain reorganization. Given the use of mobile EEG devices, there is the possibility of investigating how the virtual therapeutic environment can influence brain activity. OBJECTIVE: To compare theta, alpha, beta and gamma power in healthy young adults during a lower limb motor task in a virtual and real environment. METHODS: Ten healthy adults were submitted to an EEG assessment while performing a one-minute task consisted of going up and down a step in a …virtual environment – Nintendo Wii virtual game “Basic step” – and in a real environment. RESULTS: Real environment caused an increase in theta and alpha power, with small to large size effects mainly in the frontal region. VR caused a greater increase in beta and gamma power, however, with small or negligible effects on a variety of regions regarding beta frequency, and medium to very large effects on the frontal and the occipital regions considering gamma frequency. CONCLUSIONS: Theta, alpha, beta and gamma activity during the execution of a motor task differs according to the environment that the individual is exposed – real or virtual – and may have varying size effects if brain area activation and frequency spectrum in each environment are taken into consideration. Show more

Keywords: Virtual Reality exposure therapy, physiotherapy, EEG

DOI: 10.3233/NRE-161426

Citation: NeuroRehabilitation, vol. 40, no. 3, pp. 391-400, 2017

Authors: Lewis, Frank D. | Horn, Gordon J.

Article Type: Research Article

Abstract: BACKGROUND: A need exists to better understand the impact of depression on functional outcomes following TBI. OBJECTIVES: To evaluate the prevalence and severity of depression among a large group of chronic TBI adults; to determine the impact of depression on outcomes of post-hospital residential rehabilitation programs; and to assess effectiveness of post-hospital residential rehabilitation programs in treating depression. METHODS: 820 adults with moderate to severe traumatic brain injury (TBI) were assigned to one of four groups based on MPAI- 4 depression ratings: (1) Not Depressed, (2) Mildly Depressed, (3) Moderately Depressed, and (4) Severely Depressed. …Functional status was assessed at admission and discharge with the MPAI-4 Participation Index. Differences among groups were evaluated using conventional parametric tests. Rasch analysis established reliability and validity of MPAI-4 data. RESULTS: Rasch analysis demonstrated satisfactory construct validity and internal consistency (Person reliability = 0.89–0.92, Item reliability = 0.99). Of the 820 subjects, 39% presented with moderate to severe depressive symptoms at admission, These subjects demonstrated significantly higher MPAI-4 Participation scores than the mild and not depressed groups. Depressed groups realized significant improvement in symptoms, but, those remaining depressed at discharge had significantly greater disability than those who improved. CONCLUSIONS: Depressive symptoms had a deleterious impact on outcome. Remediation of symptoms during rehabilitation significantly improved outcomes. Show more

Keywords: Traumatic brain injury, outcomes, depression, MPAI-4, Rasch analysis, post-hospital rehabilitation

DOI: 10.3233/NRE-161427

Citation: NeuroRehabilitation, vol. 40, no. 3, pp. 401-410, 2017

Authors: Wallace, Sarah E. | Donoso Brown, Elena V. | Fairman, Andrea D. | Beardshall, Koren | Olexsovich, Anna | Taylor, Alicia | Schreiber, James B.

Article Type: Research Article

Abstract: BACKGROUND: Portable electronic devices are increasingly being used for clinical assessment of individuals with cognitive deficits. Prior to implementation of tablet-based assessments, comparison with other standard measures is needed. OBJECTIVE: The study purpose was to compare an iPad administered cognitive assessment known as the Standardized Touchscreen Assessment of Cognition (STAC) to the Cognitive Linguistic Quick Test (CLQT) and the Cognitive Assessment of Minnesota (CAM). METHODS: Eighty-eight neurotypical participants completed the STAC, CAM, and CLQT in a randomized order. The researchers compared the participants’ responses across similar subtests. Performance across iPad comfort levels was also explored. …RESULTS: Findings revealed moderate correlations in some areas of assessment: generative naming and immediate visual memory. The correlations varied across age groups within each area of assessment with no consistent pattern. Additionally, people with comfort using an iPad performed significantly better on three areas of STAC assessment (generative naming category and first letter, and auditory working memory) compared to people who reported no iPad comfort. CONCLUSIONS: Initial testing of the STAC in a neurotypical population identified moderate correlations with standard measures in some subtests; however, additional testing of the STAC is needed to determine the clinical utility and validity of assessing populations with cognitive impairments. Show more

Keywords: Cognitive assessment, computerized assessment, wireless or mobile technology, iPad, self-administered

DOI: 10.3233/NRE-161428

Citation: NeuroRehabilitation, vol. 40, no. 3, pp. 411-420, 2017

Authors: Cioncoloni, David | Martelli, Lodovica | Rosignoli, Deborah | Mazzocchio, Riccardo

Article Type: Research Article

Abstract: BACKGROUND: Postural instability may result from altered sequencing of automatic motor programs for anticipatory postural corrections and/or impaired motor learning in Parkinson Disease (PD) patients. Comorbid white matter disease is a major determinant of axial motor impairment, leading to poorer stability than nigrostriatal dopaminergic denervation per se. OBJECTIVE: To assess differences in anticipatory control of postural stability function between subjects affected by PD with comorbid leukoaraiosis (LPD), idiopathic Parkinson disease (IPD) and elderly healthy subjects (EHS) as control group. METHODS: Eight patients with IPD, eight patients with LPD and eight age/weight matched elderly …healthy subjects (EHS) were tested in standing position by measuring the Center of Pressure (CoP) along the anteroposterior axis (CoP-Y) while subjects were expecting three repeated backward surface translation. RESULTS: LPD patients positioned the CoP-Y significantly backward while waiting for the second and third platform translations, with respect to their COP-Y position in preparation for the first translation. The IPD and EHS showed no significant differences in the COP-Y position among the repeated perturbation trials. CONCLUSIONS: LPD patients show inability to rescale an effective preparatory postural pattern to known, repeated postural perturbations suggesting impaired sensory-motor strategies in anticipating perturbations. Anticipatory postural patterns remain effective in IPD patients. Show more

Keywords: Parkinson disease, leukoaraiosis, rehabilitation, postural balance, prognosis

DOI: 10.3233/NRE-161429

Citation: NeuroRehabilitation, vol. 40, no. 3, pp. 421-427, 2017

Authors: Piazza, Stefano | Serrano-Muñoz, Diego | Gómez-Soriano, Julio | Torricelli, Diego | Segura-Fragosa, Antonio | Pons, José Luis | Taylor, Julian

Article Type: Research Article

Abstract: OBJECTIVE: Appropriate afferent feedback delivery during the execution of motor tasks is important for rehabilitation after incomplete spinal cord injury (iSCI). However, during leg-cycling therapy, the plantar afferent feedback is minimal. We hypothesize that the augmentation of sensory input by combining cycling with a locomotor-like stimulation of plantar cutaneous innervations (ES-cycling), might help to restore proper spinal processing of sensorimotor function. METHODS: Thirteen non-injured subjects and 10 subjects with iSCI performed 10 minutes of cycling and, on another session, of ES-cycling. To assess spinal processing of sensorimotor function, soleus H-reflex response was tested following a conditioning plantar …electrical stimulation applied at 25–100 ms inter-stimulus intervals (ISI’s), measured before and after the execution of the tasks. RESULTS: Before tasks execution, the conditioned H-reflex response was modulated in non-injured subjects, and absent in subjects with iSCI; after cycling, modulation profiles were unchanged. However, after ES-cycling a significant increase in H-reflex excitability was observed in the non-injured group at 100 ms ISI (p  < 0.05), and in the iSCI group between 50–75 ms ISI (p  < 0.001). CONCLUSION: The loss of reflex modulation in subjects with iSCI suggests reduced spinal processing of sensorimotor function. Reflex modulation recovery after ES-cycling may indicate the partial reactivation of these mechanisms. Show more

Keywords: Spinal cord injury, sensorimotor processing, soleus H-reflex, leg-cycling, afferent feedback

DOI: 10.3233/NRE-161430

Citation: NeuroRehabilitation, vol. 40, no. 3, pp. 429-437, 2017

Authors: Wouda, Eva M.N. | Stienstra, Ymkje | van der Werf, Tjip S. | Kerstjens, Huib | de Lange, Wiel C.M. | Coppes, Maarten | Kuijlen, Jos | Tepper, Marga | Akkerman, Onno W.

Article Type: Research Article

Abstract: BACKGROUND: Spinal tuberculosis (TB) accounts for approximately 1% to 3% of all TB cases and it can cause a wide range of neurological symptoms, from none to a complete spinal cord injury (SCI), resulting in complete paraplegia or tetraplegia. OBJECTIVES: To describe the functional and neurological outcome of SCI caused by TB. METHODS: Retrospective data on the admission period was combined with prospectively collected data on long-term follow-up. Primary outcome was neurological outcome in terms of motor function. Secondary outcome measures were functional outcome in terms of level of independence and community participation. Results were …compared to the outcome in patients with SCI due to trauma. RESULTS: Six TB patients with complete motor SCI (American Spinal Injury Association Impairment Scale (AIS) A or B) were compared to eighteen patients with traumatic SCI. Most TB patients regained almost full neurological function (median motor score improved from 50 to 100), and reached high levels of independence, whereas trauma patients did not improve neurologically (median motor score remained 50) and reached a plateau in level of independence. CONCLUSIONS: SCI due to tuberculosis in the Netherlands shows remarkable improvement in both neurological and functional outcome, especially compared with traumatic SCI. Show more

Keywords: Tuberculosis, spinal tuberculosis, spinal cord injuries, rehabilitation, treatment outcome

DOI: 10.3233/NRE-161431

Citation: NeuroRehabilitation, vol. 40, no. 3, pp. 439-445, 2017

Authors: Tavernese, E. | Petrarca, M. | Rosellini, G. | Di Stanislao, E. | Pisano, A. | Di Rosa, G. | Castelli, E.

Article Type: Research Article

Abstract: BACKGROUND: Hemiplegic Celebral Palsy (CP) children commonly use AFO orthoses as walking aids. It is known that AFOs may have a detrimental effect on gait. To enhance mechanical properties of AFOs we developed an innovative, custom-made, carbon, ankle-foot orthosis (Ca.M.O) which offers the opportunity to tune its response to the patient’s gait characteristics and/or functional maturity. OBJECTIVE: To assess the efficacy of Ca.M.O. in improving gait in a group of hemiplegic CP children and to compare its performances with those of commonly prescribed AFO. METHODS: A clinical and instrumental gait analysis was performed on a …group of 15 spastic hemiplegic children (WINTERS-GAGE type I-II) walking barefoot, with commonly prescribed AFOs and with Ca.M.O. Temporal, kinematic and kinetic data were collected with an 8 cameras optoelectronic system and 2 force plates. RESULTS: Studied variables were comparable walking with Ca.M.O. and with the commonly prescribed AFO and are significantly different (p  < 0.01) with respect to barefoot condition. CONCLUSIONS: Both types of orthoses normalize the kinematics of the first and second ankle rocker. The main advantage of Ca.M.O. is its modularity that allows to tune its effect on gait in relationship with the progress or involution of the child’s functional development. Show more

Keywords: Cerebral Palsy, monoplegic, infantile, orthotic devices, carbon fiber, Stereophotogrammetry

DOI: 10.3233/NRE-161432

Citation: NeuroRehabilitation, vol. 40, no. 3, pp. 447-457, 2017