NeuroRehabilitation - Volume 44, issue 1

Authors: Zhang, Lili | Liu, Yimei | Zhou, Ziyun | Wei, Yan | Wang, Jie | Yang, Jie | Wu, Yanling | Sun, Yan

Article Type: Research Article

Abstract: BACKGROUND: Autism spectrum disorders are complex neurodevelopmental disorders. Early intervention training is a very important treatment strategy. Under the current background of rehabilitation supply in China, the long-term efficacy of intervention is unexplored. OBJECTIVE: This study aimed to investigate the effects of long-term rehabilitation and related factors affecting the recovery of autistic children. METHODS: A total of 137 autistic children were followed up for 3 years. They received two neuropsychological assessments at the first visit and 3 years after referral. Assessments included Childhood Autism Rating Scale (CARS), Autism Behavior Checklist (ABC), and Developmental Diagnostic Scale of …Children Aged 0–6 Years. All children were asked to visit rehabilitation centers for rehabilitation training. In the study, 105 children with autism spectrum disorders (ASD) received rehabilitation training according to the physician’s orders (the rehabilitation group), and 32 patients did not receive rehabilitation training (the nonrehabilitation group). RESULTS: The ABC, CARS, and developmental quotient scores of the rehabilitation group were statistically significant between initial assessment and reassessment. No significant difference was observed in the nonrehabilitation group. CONCLUSIONS: Rehabilitation training significantly improved the core symptoms and cognitive function in children with ASD, exerting a long-term rehabilitation effect. The initial language development quotient, children’s training time, and parental participation time of autistic children significantly impacted the change in ABC. Show more

Keywords: Autism spectrum disorders, effect, influential factors, rehabilitation training

DOI: 10.3233/NRE-182502

Citation: NeuroRehabilitation, vol. 44, no. 1, pp. 1-7, 2019

Authors: Simão, Camila R. | Regalado, Isabelly Cristina R. | Spaniol, Ana Paula | Fonseca, Débora O.S. | Ribeiro, Tatiana de Souza | Lindquist, Ana R.

Article Type: Research Article

Abstract: BACKGROUND: Children with hemiparetic cerebral palsy are often characterized by reduced speed progression, shorter step length, and increased support base. These kinematic alterations result in inefficient gait. OBJECTIVE: To assess the immediate effects of treadmill training with additional lower limb loading on kinematic gait parameters in children with Cerebral Palsy (CP). METHODS: This cross-sectional, observational study, involved 20 children with hemiparetic CP that underwent single treadmill session with ankle loading. Kinematic gait data were collected by the Qualisys Motion Capture System during baseline (PRE), immediately after training (POST) and 5 minutes after post session (FOLLOW …UP). RESULTS: The results demonstrated increase in knee (p = 0.001) and hip (p = 0.005) range of motion, maximum knee (p <.0.001) and hip (p =.001) flexion in swing and paretic foot height during swing (p <0.001) when PRE x POST were compared. CONCLUSION: Treadmill gait training with additional lower limb loading was a disturbance capable of modifying the locomotor strategy of these population. The increase in hip flexion during swing phase allowed higher paretic foot clearance which may favor the improvement of gait function. Show more

Keywords: Cerebral palsy, gait, kinematics, weight-bearing, rehabilitation, lower extremity

DOI: 10.3233/NRE-182516

Citation: NeuroRehabilitation, vol. 44, no. 1, pp. 9-17, 2019

Authors: Iwatsuki, Katsuyuki | Hoshiyama, Minoru | Oyama, Shintaro | Shimoda, Shingo | Hirata, Hitoshi

Article Type: Research Article

Abstract: BACKGROUND: The effect of tacit learning systems (TLSs) on brain plasticity are as of yet unknown. We developed a myoelectric hand prosthesis equipped with a TLS to auto-regulate forearm rotation in response to upper extremity movement patterns. OBJECTIVE: To evaluate the effects of tacit learning on the central nervous system during a prosthesis control exercise. METHODS: The experienced prosthetic user performed a series of simple mechanical tasks with the TLS inactivated (the baseline condition) and then with it activated (the enhanced, experimental condition). The process was video recorded. Subsequently, the participant viewed video recordings of each …condition (baseline and experimental) during magnetoencephalography and electroencephalography recordings. RESULTS: Stronger connections between the motor area and other cortical areas were observed, as indicated by a significant increase in coherence values. CONCLUSIONS: Integration and interoperability may underlie tacit learning and promote motor function-related adaptive neuroplasticity. Show more

Keywords: Tacit learning, prosthesis, magnetoencephalography, artificial intelligence, neuroplasticity, amputation

DOI: 10.3233/NRE-182514

Citation: NeuroRehabilitation, vol. 44, no. 1, pp. 19-23, 2019

Authors: Jung, Dohee | Park, Ji-Won | Kim, Yun-Hee | You, Joshua (Sung) Hyun

Article Type: Research Article

Abstract: BACKGROUND: Intermanual transfer of learning is an important movement basis for a keyboard and instrument playing movement. However, the issue of where neural plastic mechanism occurs in the brain after intermanual transfer training remains both controversial and unresolved. OBJECTIVE: The aim of present study is to investigate the neuroplastic mechanism associated with the interlimb transfer learning from non-dominant hand to dominant hand. METHODS: Twenty healthy right-handed adults were classified into either the control group (no-training) or the experimental group (training serial button-press motor task, SPMT), 5 days a week for two consecutive weeks. SPMT involved pressing …the numbers 1, 2, 3, and 4 in a random sequence, which was presented in the monitor screen. Outcome measures included movement accuracy (MA), movement time (MT), and the fMRI data using a 3T MRI scanner. Repeated measures of analysis of variance (ANOVA) and non-parametric tests were used at p <0.05. RESULTS: Motor performances in the MA and MT were significantly more improved in the experimental group than in the control group (p <0.05). Neuroimaging data revealed a distributed subcortical and cortical motor network including the SMA–thalamus (VL/VL)–basal ganglia–cerebellum loop, suggesting a differential and time-dependent neural network utilized during intermanual transfer learning. CONCLUSION: Pre-training intermanual transfer learning involved a form of declarative (or explicit) motor learning, which was primarily mediated by the cortical motor network, whereas post-training involved a form of procedural knowledge, which activated subcortical and cortical motor network regions, including the SMA–thalamus (VL/VL)–basal ganglia–cerebellum loop. Show more

Keywords: Intermanual transfer, non-dominant hand, brain, fMRI

DOI: 10.3233/NRE-182550

Citation: NeuroRehabilitation, vol. 44, no. 1, pp. 25-35, 2019

Authors: Park, Jin | Kim, Tae-Ho

Article Type: Research Article

Abstract: BACKGROUND: Stroke patients have a lower quality of life than other people. OBJECTIVE: The purpose of this study was to examine the effect of balance and gait function of stroke patients on their quality of life. METHODS: Twenty-seven subjects participated in the experiment. Balance ability was assessed using a SpaceBalance 3D and a Berg Balance Scale (BBS). Gait function was measured with a Biodex Gait Trainer 2 treadmill system. The quality of life of the subjects was assessed through the Stroke specific Quality of Life Scale (SS-QOL). RESULTS: Correlation analysis between balance and quality …of life showed that weight bearing distribution and BBS are positive correlated with quality of life. In addition, gait speed, step length of the paretic limb, and step length of the non-paretic limb were also found to be correlated with quality of life. CONCLUSION: Balance and gait function must all be considered in order to improve the quality of life of stroke patients. Show more

Keywords: Balance, gait, quality of life, stroke

DOI: 10.3233/NRE-182467

Citation: NeuroRehabilitation, vol. 44, no. 1, pp. 37-41, 2019

Authors: De Keersmaecker, Emma | Lefeber, Nina | Geys, Marion | Jespers, Elise | Kerckhofs, Eric | Swinnen, Eva

Article Type: Review Article

Abstract: BACKGROUND: During gait training in persons with central nervous system (CNS) movement disorders, virtual reality (VR) can offer added value by providing task-specific gait training in more interactive and motivating environments. OBJECTIVE: To summarize current evidence for the effectiveness of VR-enhanced gait training in persons with CNS movement disorders. METHODS: PubMed, Web of Science and CENTRAL were systematically searched for studies using VR during walking to improve gait outcomes (spatiotemporal, functional, kinematic and kinetic). Meta-analyses were performed to estimate pooled effects. RESULTS: Eighteen studies with in total 337 patients were included (12 studies with …people post-stroke, 4 with multiple sclerosis, 1 with Parkinson’s disease, 1 with traumatic brain injury). Spatiotemporal and functional parameters significantly improved in each population after the VR training. Compared to gait training without VR, differences in favor of VR were found for spatiotemporal and functional parameters only in people post-stroke. CONCLUSION: VR-enhanced gait training is an effective method to improve spatiotemporal and functional parameters in persons with CNS movement disorders. Current evidence supports that, in comparison to training without VR, for people post-stroke VR-enhanced gait training is more effective to improve gait function. Future research regarding other outcome measures and other CNS movement disorders is necessary. Show more

Keywords: Virtual reality, gait, central nervous system movement disorder

DOI: 10.3233/NRE-182551

Citation: NeuroRehabilitation, vol. 44, no. 1, pp. 43-66, 2019

Authors: Sahin, Ilknur Ezgi | Guclu-Gunduz, Arzu | Yazici, Gokhan | Ozkul, Cagla | Volkan-Yazici, Melek | Nazliel, Bijen | Tekindal, Mustafa Agah

Article Type: Research Article

Abstract: BACKGROUND: Balance disorders cause disability in stroke and increase risk of falls. The Balance Evaluation Systems Test (BESTest), examines balance, determines parameters causing balance disorders, provides information on risk factors for falls. OBJECTIVE: To investigate the sensitivity and specificity of the BESTest in determining the risk of falls in stroke patients. METHODS: Fifty patients with chronic stroke were included in the study. Balance was assessed using BESTest, Berg Balance Scale (BBS), Activity Specific Balance Confidence scale (ABC) and Biodex-BioSway Balance System. To examine the content validity of BESTest, the relationship between BESTest and other balance assessment …methods was examined. The internal consistency reliability of BESTest was evaluated by Cronbach’s α coefficient. Analysis of receiver operating characteristics (ROC) was performed to determine cut-off point, sensitivity and specificity. RESULTS: BESTest, BBS, ABC and Biodex-BioSway Balance System results of faller stroke patients were worse than that of non-faller (p <0.05). Internal consistency of BESTest was found to be Cronbach’s α = 0.960. The BESTest value of area under curve (AUC) was 0.844, with a cut-off point of 69.44%, a sensitivity of 75% and a specificity of 84.6% (p < 0.01). CONCLUSION: BESTest is reliable and valid with high sensitivity and specificity in determining the risk of fall in stroke patients. Show more

Keywords: Stroke, balance, BESTest, risk of falls

DOI: 10.3233/NRE-182558

Citation: NeuroRehabilitation, vol. 44, no. 1, pp. 67-77, 2019

Authors: Alwardat, Mohammad | Schirinzi, Tommaso | Di Lazzaro, Giulia | Franco, Donatella | Imbriani, Paola | Sinibaldi Salimei, Paola | Mercuri , Nicola Biagio | Pisani, Antonio

Article Type: Research Article

Abstract: BACKGROUND: Trunk alignment is thought to contribute to neck function. However, this common assumption is not clear in patients with Parkinson’s disease (PwPD) suffering from different postural deformities such as: Pisa syndrome (PS), Camptocormia & Antecollis (C&A). OBJECTIVES: to investigate the effect of different postural deformities including PS and C&A on neck function and pain in patient (PwPD). METHODS: Forty-five participants belonging to three groups: 15 PD patients without postural disorders (PD), 15 with PS, and 15 with C&A. The function, disability and pain were assessed by Neck Disability Index (NDI), and Brief Pain Inventory (BPI) …which used to assess the pain severity (BPI-PS) and Pain Interference (BPI-PI). All groups completed clinical assessments by the Unified Parkinson’s Disease Rating Scale (UPDRS), Modified Hoenh & Yahr (mH&Y) staging and the Levodopa Equivalent Daily Dose (LEDD). RESULTS: PD group compared with PS and C&A groups showed differences in NDI, BPI-PS, BPI-PI, LEDD and mH&Y staging (P  < 0.001), but no differences found in PD duration, UPDRS-II and III in the same groups. Moreover, no differences were observed between PS and C&A groups in the mentioned scales. DISCUSSION AND CONCLUSION: These results demonstrated that PS and C&A are associated with severe impairment of neck functions, and pain in PwPD. Show more

Keywords: Parkinson disease, postural deformity, trunk alignment, neck function, rehabilitation

DOI: 10.3233/NRE-182505

Citation: NeuroRehabilitation, vol. 44, no. 1, pp. 79-84, 2019

Authors: Schell, Wendy E. | Mar, Victoria S. | Da Silva, Carolyn P.

Article Type: Research Article

Abstract: BACKGROUND: Persons diagnosed with Amyotrophic Lateral Sclerosis (ALS) often demonstrate neurological deficits that predispose them to repeated falls and associated adverse consequences. Determining contributing factors to falls in this population is critical to improve safety and patient outcomes. OBJECTIVE: The purpose of this study was to correlate clinical measures of gait speed, balance, strength, spasticity, and a self-reported rating scale of function with fall incidence in individuals with ALS. METHODS: Thirty-one participants with a confirmed ALS diagnosis were recruited from an outpatient clinic. Each participant performed the following tests: timed gait speed, Berg Balance Scale (BBS), …manual muscle testing (MMT) for lower extremity (LE) strength, Modified Ashworth Scale (MAS) for LE spasticity, and the ALS Functional Rating Scale-Revised (ALSFRS-R). Each participant reported number of falls that occurred in the past three months. Pearson correlation coefficients were calculated to determine correlations between variables. RESULTS: Significant correlation was found between fall incidence and composite LE strength score (r p = 0.385, p = 0.032). CONCLUSIONS: There is a relationship between LE weakness and number of falls in the ALS population. Preventing disuse-related LE muscle weakness and education of need for external support may decrease the number of falls experienced by individuals with ALS. Show more

Keywords: Amyotrophic Lateral Sclerosis, falls, gait speed, strength, spasticity, Berg Balance Scale, Amyotrophic Lateral Sclerosis Functional Rating Scale - Revised

DOI: 10.3233/NRE-182531

Citation: NeuroRehabilitation, vol. 44, no. 1, pp. 85-93, 2019

Authors: Maslovara, Sinisa | Butkovic-Soldo, Silva | Peric, Mihaela | Pajic Matic, Ivana | Sestak, Anamarija

Article Type: Research Article

Abstract: BACKGROUND: The minimal number of studies have documented the impact of Vestibular rehabilitation (VR) on the recovery rate of patients with Chronic Unilateral Vestibular Hypofunction (CUVH) and Bilateral Vestibular Hypofunction (BVH). OBJECTIVES: The goal of the study was to show and compare the impact of vestibular rehabilitation (VR) in patients with CUVH and BVH. METHODS: We analysed the data of 30 patients with CUVH and 20 with BVH treated with VR. The patients with CUVH during their eight-week treatment were controlled every two weeks, while the patients with BVH were controlled every three months during their …one-year treatment; they filled in the DHI and ABC questionnaires every time. RESULTS: In both groups of patients, there was significantly less disablement between the initial and final DHI scores (from 59-20 in CUVH and 74-41 in BVH group). There was a significant increase in the balance confidence between the initial and final ABC Scale in both groups of patients (from 49.5-90% in CUVH and 42-73% in BVH group). CONCLUSIONS: Well-planned and individually adjusted system of vestibular exercises leads to a significant decrease in clinical symptoms and improvement of functioning and confidence in activities in both the CUVH and the BVH patients. Show more

Keywords: Vestibular rehabilitation therapy, chronic unilateral vestibular hypofunction, bilateral vestibular hypofunction, outcome

DOI: 10.3233/NRE-182524

Citation: NeuroRehabilitation, vol. 44, no. 1, pp. 95-102, 2019