NeuroRehabilitation - Volume 43, issue 4

Authors: Jeng, Brenda | Sandroff, Brian M. | Motl, Robert W.

Article Type: Research Article

Abstract: BACKGROUND: The energetic cost of walking (Cw ) is elevated in persons with multiple sclerosis (MS). This may be explained by spasticity and spatiotemporal parameters of gait. OBJECTIVE: To examine the associations among Cw , spasticity of ankle plantarflexors, and spatiotemporal gait parameters in persons with MS who had moderate disability. METHODS: The sample included 44 persons with MS who had moderate disability. Cw was measured over-ground during the 6-Minute Walk using indirect calorimetry and was calculated based on net oxygen consumption and walking speed (i.e., expressed ml·kg– 1 ·m– 1 ). Participants underwent the …Modified Ashworth Scale as a measurement of spasticity and performed 4 trials of walking on a GAITRite electronic walkway for measurement of spatiotemporal gait parameters. RESULTS: Spasticity was positively correlated with Cw (r  = 0.52, p  < 0.05) and inversely correlated with cadence (r  = –.45, p  < 0.05) and step length (r  = –0.40, p  < 0.05). Cadence (r  = –0.59, p  < 0.05) and step length (r  = –0.56, p  < 0.05) were inversely correlated with Cw . The regression analysis indicated that spasticity explained significant variance in Cw , and cadence and step length accounted for the association. CONCLUSIONS: These results suggest that worse spasticity of the ankle plantarflexors and slower cadence and shorter step length, in turn, are responsible for elevated Cw among persons with MS with moderate disability. This supports the development of therapeutic, rehabilitation interventions delivered by clinicians for managing spasticity and the resulting Cw that may interfere with activities of daily living. Show more

Keywords: Multiple sclerosis, energy expenditure, spasticity, walking, rehabilitation

DOI: 10.3233/NRE-182498

Citation: NeuroRehabilitation, vol. 43, no. 4, pp. 483-489, 2018

Authors: Foley, T. | McKinlay, A. | Warren, N. | Stolwyk, R.J.

Article Type: Research Article

Abstract: INTRODUCTION: While cognitive impairment is a recognised feature of Parkinson’s disease (PD), few studies have evaluated the validity of brief cognitive screening measures compared to a comprehensive neuropsychological assessment. This studies aim was to evaluate the sensitivity and specificity of the Mini-Mental State Examination (MMSE), Modified Mini-Mental State Examination and Dementia Rating Scale (DRS-2) to detect cognitive impairment in individuals with PD. METHOD: Fifty-eight participants were administered the MMSE, 3MS, DRS-2 and a neuropsychological battery. ROC analyses were conducted to assess their effectiveness in classifying cognitive impairment. RESULTS: None of the three measures demonstrated good sensitivity …or specificity to detect single domain cognitive impairment. For detecting impairment on two or more cognitive domains, the MMSE and DRS-2 yielded excellent sensitivity (88%) and specificity (78% and 76% respectively), at cut-off scores of 28 and 136 respectively. The 3MS demonstrated excellent sensitivity (88%) and good specificity (60%) at cut off score of 94. CONCLUSION: The MMSE and DRS-2 have excellent discriminant ability to classify multi-domain cognitive impairment in PD, however, their ability to detect more focal cognitive impairment is limited. Given that focal domain may be an indicator that could be useful in early detection of cognitive impairment for people with PD, this finding has implication for the use of these measures as screening tools in clinical practice. Show more

Keywords: Parkinson’s disease, screening measures, cognitive impairment

DOI: 10.3233/NRE-182433

Citation: NeuroRehabilitation, vol. 43, no. 4, pp. 491-500, 2018

Authors: Al-Jarrah, Muhammed D. | Erekat, Nour S.

Article Type: Research Article

Abstract: BACKGROUND: Induction of Parkinson disease (PD) causes interleukin-1 beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) upregulation in gastrocnemius skeletal muscles. Endurance exercise suppresses iNOS and HSP90 overexpression in PD skeletal muscle. The purpose of this study is to test the impact of treadmill exercise training on PD-associated IL-1β and TNF-α upregulation in the gastrocnemius muscle. METHODS: Thirty normal albino mice were randomly selected and divided into three equal groups: sedentary control (SC), sedentary PD (SPD), and Exercised PD (EPD). Chronic Parkinsonism was induced by treating mice in the SPD and EPD groups with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and probenecid (MPTP/p). …Gastrocnemius muscles were examined for the expression of IL-1β and TNF-α using immunohistochemistry in the three different groups. RESULTS: Endurance exercise training significantly decreased both IL-1β and TNF-α expression in skeletal muscle in EPD (P value < 0.01) compared with that in the SPD. CONCLUSION: Our present data suggest that PD-induced upregulation of IL-1β and TNF-α in the gastrocnemius muscle could be reversed following endurance exercise training. Accordingly, IL-1β and TNF-α might be considered therapeutically to ameliorate skeletal muscle abnormalities characterizing PD. Show more

Keywords: Parkinson disease, interleukin 1β, gastrocnemius muscle, exercise, immunohistochemistry

DOI: 10.3233/NRE-182492

Citation: NeuroRehabilitation, vol. 43, no. 4, pp. 501-507, 2018

Authors: Sung, Wen-Hsu | Liu, Cheng-Chun | Wei, Shun-Hwa | Chuang, Long-Ren | Chuang, Eric | Wang, Kevin A. | Wang, Jia-Chi

Article Type: Research Article

Abstract: BACKGROUND: Traditional Tai Chi is too complex for most elderly individuals. There have been few reports regarding the development of simplified Tai Chi programs to suit the physical needs of elderly adults. However, these programs were not individualized according to the participants’ balance control abilities. OBJECTIVE: Purpose of this study is to develop an individualized Tai Chi program and report the feasibility of the program. METHODS: Phase 1: Five Tai Chi masters performed the Tai Chi movements on a force platform. Based on the results of center of pressure displacement and the individual’s balance abilities, an …individualized program was developed. Phase 2: Ten community-dwelling older adults received 24 half-hour-sessions, using the individualized Tai Chi exercise program. The Berg Balance Scale (BBS) score, Timed Up & Go (TUG) test, forward reach, and strength of the knee extensor were determined before and after intervention. RESULTS: Participants achieved improved performance on balance control as measured with BBS (p ≤0.001), TUG (p  = 0.004) and forward reach (p  = 0.035) as well as knee extensor strength (p  = 0.002) after the program. CONCLUSIONS: This preliminary result suggests that the individualized Tai Chi program is potentially effective to improve balance function and knee extensor strength of the elderly. Show more

Keywords: Exercise therapy, postural balance, rehabilitation, Tai Chi

DOI: 10.3233/NRE-162061

Citation: NeuroRehabilitation, vol. 43, no. 4, pp. 509-518, 2018

Authors: dos Santos, Adriana Neves | Rocha, Nelci Adriana Cicuto Ferreira

Article Type: Research Article

Abstract: BACKGROUND: Kinesiotaping (KT) has been commonly used in clinical setting. However, beneficial KT effects have not been proved yet. OBJECTIVE: We aimed to verify the effects of KT in knee extensor torque in children with CP. METHODS: We evaluated three children diagnosed as spastic CP, classified as level I, II and III, according with GMFCS. Knee extensor peak torque was analyzed by isokinetic evaluation (Biodex Multi Joint System). The test was performed at 60°/s in the concentric passive mode and the children performed maximal contractions. Children with CP were evaluated with and without KT under rectus …femoris. RESULTS: After KT application, knee peak torque of the affected limb increased in children with CP. CONCLUSION: KT may increase muscle strength in children with CP. Show more

Keywords: Taping, rehabilitation, strength, isokinetic

DOI: 10.3233/NRE-161921

Citation: NeuroRehabilitation, vol. 43, no. 4, pp. 519-523, 2018

Authors: Oral, Aydan

Article Type: Research Article

DOI: 10.3233/NRE-189002

Citation: NeuroRehabilitation, vol. 43, no. 4, pp. 525-528, 2018