NeuroRehabilitation - Volume 42, issue 1

Authors: Andrenelli, Elisa | Galli, Federica Lucia | Gesuita, Rosaria | Skrami, Edlira | Logullo, Francesco Ottavio | Provinciali, Leandro | Capecci, Marianna | Ceravolo, Maria Gabriella | Coccia, Michela

Article Type: Research Article

Abstract: BACKGROUND: Dysphagia is a critical symptom of Neuromuscular Diseases and is often associated with considerable morbidity and mortality. OBJECTIVE: This study is designed to investigate the prevalence of dysphagia and to identify different clinical profiles of swallowing disorders in Myotonic Dystrophy type 1 (DM1) and Amyotrophic Lateral Sclerosis (ALS), the most common Neuromuscular Diseases in the adult age. METHODS: Consecutive DM1 and ALS patients from 2013 to 2015 referred to a Centre for Neuromuscular Disease were enrolled. A comprehensive assessment of swallowing function with a Clinical Swallowing Examination and Fluid and Food Trials was performed. …RESULTS: 157 patients were included: 86 ALS, 71 DM1. The dysphagic patients affected by ALS and DM1 (79% and 86% of the respective samples) showed two different profiles. ALS patients with dysphagia were older and underweight. They experienced a global dysfunction of the oral and pharyngeal phases with more difficulty in swallowing thin liquids. Conversely, DM1 patients with dysphagia were younger and tended to obesity. Most of them showed impairment of oral phase and had more frequently difficulty in swallowing solid bolus. CONCLUSION: The recognition of specific clinical profiles supports and guides the detection of swallowing disorders in patients with neuromuscular diseases. Show more

Keywords: Swallowing, dysphagia, Amyotrophic Lateral Sclerosis, Myotonic Dystrophy, neuromuscular diseases

DOI: 10.3233/NRE-172272

Citation: NeuroRehabilitation, vol. 42, no. 1, pp. 93-102, 2018

Authors: Nolvi, Maria | Brogårdh, Christina | Jacobsson, Lars | Lexell, Jan

Article Type: Research Article

Abstract: BACKGROUND: Sense of Coherence (SOC) is important for successful adaptation and mental well-being in people with life-long medical conditions. Late effects of polio (LEoP) often lead to a life-long disability, but no study has assessed SOC in this population. OBJECTIVE: To assess SOC in persons with LEoP and to explore the association between SOC, demographics (age, gender, marital status and level of education) and variables related to LEoP (age at polio onset, number of years from polio until onset of LEoP and self-rated disability). METHOD: Ninety-three community-dwelling persons with clinically verified LEoP responded to a postal …survey with the Sense of Coherence Scale (SOC-13). A hierarchical multiple regression analysis was performed to explore the associations with SOC. RESULTS: SOC varied considerably among the participants. The mean and median SOC-13 total sum score was 71.8 and 76 points, which is similar to age-matched non-disabled people. The number of years before onset of LEoP and self-rated disability together with the participants’ marital status and level of education explained 37% (p  < 0.001) of the variance in SOC. CONCLUSION: Persons with LEoP have a level of SOC indicating that they generally have the ability to understand, handle and being motivated when dealing with stressful events and problems arising in their lives as a result of their disability. Being married and having a higher education, living many years before onset of LEoP and perceiving a mild to moderate disability contributed to a strong SOC. Show more

Keywords: Adaptation, psychological, disabled persons, Postpoliomyelitis syndrome, rehabilitation, Sense of Coherence

DOI: 10.3233/NRE-172198

Citation: NeuroRehabilitation, vol. 42, no. 1, pp. 103-111, 2018

Authors: Milicin, Cristian | Sîrbu, Elena

Article Type: Research Article

Abstract: INTRODUCTION: Lower motor neurons are the only neurons of the central nervous system (CNS) with the ability to regenerate without any intervention after an axotomy. AIM: This present study was conducted to analyze clinical and electrophysiological parameters in four groups of upper limb peripheral neuropathies, before and after treatment, comparing the results obtained after three cures of complex rehabilitation therapy. MATERIALS AND METHODS: We selected a number of 107 patients (66 women and 41 men) aged between 29 and 77 years (mean age = 49.6). Clinical (muscular strength, sensitivity) and electrophysiological parameters (accommodation coefficient α , nerve conduction …velocity) were analyzed. All patients received 3 comprehensive treatment cures, each cure of 14 days and a rest period of 3 months between the cures. RESULTS: From the total of 107 patients included in the study, 52 were diagnosed with brachial plexus palsy, 27 with radial nerve palsy, 18 with median nerve palsy and 10 with ulnar nerve palsy. We did not observe a statistically significant difference between the mean age of males (47.2) and females (51.2) (p  = 0.07), but peripheral neuropathies were more common in young males. At the end of the rehabilitation treatment all patients achieved better outcomes in muscle strength, sensitivity, adjustment coefficient α and nerve conduction velocity (p  < 0.001). CONCLUSION The intervention of a physical therapy program in patients with peripheral neuropathies provided significantly better outcomes in clinical and electrophysiological parameters. Our rehabilitation protocol can be considered an alternative in order to stimulate and accelerate the nerve regeneration process. Show more

Keywords: Motor neurons, muscle strength, sensitivity, nerve conduction velocity

DOI: 10.3233/NRE-172220

Citation: NeuroRehabilitation, vol. 42, no. 1, pp. 113-119, 2018

Authors: Swinnen, Eva | Lefeber, Nina | Werbrouck, Amber | Gesthuizen, Yelena | Ceulemans, Lisa | Christiaens, Sofie | De Wael, Lise | Buyl, Ronald | Ilsbroukx, Stephan | Van Nieuwenhoven, Johan | Michielsen, Marc | Lafosse, Christophe | Kerckhofs, Eric

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVE: Because user-satisfaction and acceptance may partly determine the grade of compliance to an orthotic device (OD), the aim of this multicentre observational study was to inquire the reasons for acceptance and the user-satisfaction of an OD of the lower limb in male and female central neurological movement disorders (CNMD) patients. METHODS: Persons with CNMD having at least one prescribed OD of the lower limb were included. Two questionnaires were used: the MIRAD-ACCORT-II (reasons for acceptance) and a modified version of the D-QUEST 2.0 (user-satisfaction). Descriptive analyses were performed and to analyse the differences between the …males’ and females’ answers Chi2 - and Mann-Whitney U tests were used. RESULTS: Twenty-six stroke and 23 multiple sclerosis patients participated (53% males). “Comfort”, “safety”, “effectiveness” and “ease of use” were reported as most important aspects. 86% of the patients were (very) satisfied about their OD. Only for the aspect safety, compared to males, significant more females reported that if the OD is not safe enough they will not use it. CONCLUSION: For both, males and females, aspects related to comfort and functionality were reported as much more important than the esthetical aspects, and in general they are quite satisfied with the OD and the process of providing the OD. Orthopaedic technicians and health care providers can take these aspects into account when developing, constructing and providing OD’s. Show more

Keywords: Stroke, multiple sclerosis, satisfaction, acceptation, ankle-foot-orthotics, gait

DOI: 10.3233/NRE-172214

Citation: NeuroRehabilitation, vol. 42, no. 1, pp. 121-130, 2018