NeuroRehabilitation - Volume 45, issue 4

Authors: Anggelis, Emily | Powell, Elizabeth Salmon | Westgate, Philip M. | Glueck, Amanda C. | Sawaki, Lumy

Article Type: Research Article

Abstract: BACKGROUND: Contemporary goals of rehabilitation after traumatic brain injury (TBI) aim to improve cognitive and motor function by applying concepts of neuroplasticity. This can be challenging to carry out in TBI patients with motor, balance, and cognitive impairments. OBJECTIVE: To determine whether use of dynamic body-weight support (DBWS) would allow safe administration of intensive motor therapy during inpatient rehabilitation and whether its use would yield greater improvement in functional recovery than standard-of-care (SOC) therapy in adults with TBI. METHODS: Data in this retrospective cohort study was collected from patients with TBI who receive inpatient rehabilitation incorporating …DBWS (n  = 6) and who received inpatient rehabilitation without DBWS (SOC, n  = 6). The primary outcome measure was the change in Functional Independence Measures (FIM) scores from admission to discharge. RESULTS: There was significant improvement in total FIM scores at discharge compared to admission for both the DBWS (p  = 0.001) and SOC (p  = 0.005) groups. Overall, the DBWS group had greater improvement in total FIM score and FIM subscales compared to the SOC group. CONCLUSIONS: Our results suggest DBWS has the potential to allow a greater intensity of therapy during inpatient rehabilitation and yield better outcomes compared to SOC in patients with TBI. Show more

Keywords: Rehabilitation, inpatient, neuroplasticity, trauma, humans, assistive technology

DOI: 10.3233/NRE-192898

Citation: NeuroRehabilitation, vol. 45, no. 4, pp. 519-524, 2019

Authors: Jakobsen, D. | Poulsen, I. | Schultheiss, C. | Riberholt, C.G. | Curtis, D.J. | Petersen, T.H. | Seidl, R.O.

Article Type: Research Article

Abstract: BACKGROUND: There is little high-level evidence for the effect of the nonverbal facilitation of swallowing on swallowing ability in the subacute stage of rehabilitation following severe acquired brain injury (ABI). OBJECTIVE: To pilot test a randomised controlled trial to determine the effect of an intensification of the nonverbal facilitation of swallowing on dysphagia. METHODS: Ten patients with severe ABI and dysphagia were randomised into two groups at a highly specialised neurorehabilitation clinic. The intervention group received an intensification of the nonverbal facilitation of swallowing and the control group received basic care of the face and mouth …in addition to treatment as usual for two sessions of 20 minutes per day for three weeks. Outcomes were Functional Oral Intake Scale (FOIS), Penetration Aspiration Scale (PAS), and electrophysiological swallowing specific parameters (EMBI). RESULTS: The intensified intervention was feasible. PAS and FOIS scores improved in both groups, with no differences between groups. The swallowing specific parameters reflected clinically observed changes in swallowing. CONCLUSIONS: PAS and FOIS are feasible instruments to measure dysphagia. It is possible and valid to measure swallowing frequency and kinematics using electromyography and bioimpedance. The definitive study should have widened inclusion criteria and optimise intervention timing to maintain patient arousal. Show more

Keywords: Deglutition disorders, dysphagia, acquired brain injury, Facial Oral Tract Therapy (F.O.T.T.®), neurorehabilitation, facilitation of swallowing, Bioimpedance Electromyography Measurement (EMBI)

DOI: 10.3233/NRE-192901

Citation: NeuroRehabilitation, vol. 45, no. 4, pp. 525-536, 2019

Authors: Fujino, Yuji | Takahashi, Hidetoshi | Fukata, Kazuhiro | Inoue, Masahide | Shida, Kohei | Matsuda, Tadamitsu | Makita, Shigeru | Amimoto, Kazu

Article Type: Research Article

Abstract: BACKGROUND: Pusher behavior (PB) is a posture disorder due to a subjective bias in verticality perception. However, muscle activity characteristics in this disorder and the effective treatments are not known. OBJECTIVE: To investigate electromyographic (EMG) activity and the effect of electrical stimulation (ES) in PB. METHODS: Two PB patients were enrolled. The EMG activity was measured over the upper and lower limb muscles on the non-paretic side, and over the trunk muscles on both sides during sitting. We used a modified ABA single-case design consisting of consecutive baseline, intervention, and follow-up, each phase lasting 2 d. …During the intervention, together with conventional treatment, the patient received ES for 5 min/d on the muscle antagonist to the muscle where excessive activity was observed. PB was assessed before and after each phase using the scale for contraversive pushing and the Burke lateropulsion scale. Truncal balance was evaluated using the trunk control test. RESULTS: In both patients, electromyography of the non-paretic triceps brachii muscle revealed excessive activity. To inhibit the excessive activity, ES was applied to the non-paretic biceps muscle. All scores improved after the intervention and follow-up phases. CONCLUSION: ES based on EMG activity is therapeutic for PB. Show more

Keywords: Pusher behavior, electrical stimulation, reciprocal inhibition

DOI: 10.3233/NRE-192911

Citation: NeuroRehabilitation, vol. 45, no. 4, pp. 537-545, 2019

Authors: Sunna, Tarek | Elias, Elias | Summaka, Marwa | Zein, Hiba | Elias, Charbel | Nasser, Zeina

Article Type: Research Article

Abstract: BACKGROUND: Spinal cord injury (SCI) is a permanent disability which negatively affects individuals’ health and particularly their quality of life. OBJECTIVE: To assess the quality of life (QoL) among Lebanese men with spinal cord injury and to compare it to a healthy control group. METHODS: A case control study was conducted. Fifty-one Lebanese patients with spinal cord injury and 51 age– sex-matched healthy persons were included in the study. RESULTS: Compared to healthy controls, the mean scores of eight domains of SF-36 were significantly lower in SCI group: physical functioning (PF) (26.5 vs 87; …p value <0.0001), role limitations due to physical (RP) (57.8 vs 93.6; p value <0.0001), bodily pain (BP) (60.5 vs 90.7; p value, 0.0001), general health (GH) (49.5 vs 76.6; p value <0.0001), vitality (VT) (51.2 vs 71.3; p value <0.0001), social functioning (SF) (68.9 vs 91.2; p value <0.0001), role limitations due to emotional problems (RE) (71.2 vs 91.5; p value 0.003) and mental health (MH) (62.9 vs 79; p value <0.0001). Concerning PCS and MCS scores, SCI patients reported significantly lower scores than control group (p value <0.0001). CONCLUSION: Participants with SCI reported reduced QoL in comparison with normal individuals. Show more

Keywords: Spinal cord injury, Lebanon, case control, quality of life, SF-36

DOI: 10.3233/NRE-192916

Citation: NeuroRehabilitation, vol. 45, no. 4, pp. 547-553, 2019

Authors: Burak, Mustafa | Kavlak, Erdoğan

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVE: The aim of this study is to examine the relationship between quality of life, activity-participation and environmental factors in adolescents with cerebral palsy. METHODS: Seventy-five (75) adolescents (M:45, F:30) aged between 14–18 years (mean: 15.52±1.60 yrs) were included in the study. Participants were divided into three groups: Level I, Level II and Level III according to the Gross Motor Function Classification System. Gross Motor Function Classification System, Gross Motor Function Measure, Functional Independence Scale, Manual Ability Classification System, Pediatric Quality of Life Inventory and International Classification of Functioning, Disability and Health Child-Youth version Short Form …(ICF-CY) (14–18 yrs) were used for assessments. RESULTS: It is found that there is a moderate and high level of correlation between quality of life and activity participation and body functions, a moderate and high level of correlation between quality of life and activity participation and body functions with gross motor function levels, and a moderate and low level correlation between environmental factors and gross motor function levels (p  < 0.05). CONCLUSIONS: The fact that the ICF-CY short form used for cerebral palsied children is compatible with other assessment scales suggests that the use of ICF-CY short forms may be useful in assessing the health status of individuals. Show more

Keywords: Cerebral palsy, quality of life, ICF- CY, activity participation, environmental factors

DOI: 10.3233/NRE-191288

Citation: NeuroRehabilitation, vol. 45, no. 4, pp. 555-565, 2019

Authors: Cecchi, Francesca

Article Type: Other

Abstract: BACKGROUND: Dystonia is the third common motor disorder; deep brain stimulation (DBS) has been reported as beneficial in selected dystonia patients. OBJECTIVE: To assess the effects of DBS in adults with dystonia. METHODS: Cochrane Review conducted by Rodrigues et al. searching for RCTs with a parallel design, comparing DBS versus placebo, sham intervention, or best medical/surgical treatment was summarized and discussed from a rehabilitation perspective. RESULTS: Only two RCTs, at high risk of bias, and comparing DBS with sham intervention, were selected; low quality evidence was found that DBS may improve specific symptoms and …functionality in adults with cervical or segmental/generalized dystonia; no conclusion was reached on DBS safety and tolerability. CONCLUSIONS: High quality studies are needed to verify DBS effects in dystonia; more types of dystonia and other control interventions also need to be addressed. Show more

Keywords: Dystonia, deep brain stimulation

DOI: 10.3233/NRE-199010

Citation: NeuroRehabilitation, vol. 45, no. 4, pp. 567-569, 2019