NeuroRehabilitation - Volume 47, issue 2

Authors: Brownlee, Naomi N. M. | Wilson, F. Colin | Curran, David B. | Lyttle, Nigel | McCann, John P.

Article Type: Review Article

Abstract: BACKGROUND: Hypoxic ischemic brain injury (HIBI) occurs as a result of complete or partial disruption of cerebral oxygen supply. The physical and cognitive sequelae of adults following hypoxia varies widely. OBJECTIVE: To systematically review studies exploring the neuropsychological outcomes following hypoxic brain insult in adults. METHODS: Data was sourced using six databases (CINAHL, Cochrane, Embase, Medline, PsycInfo and Web of Science). Initial MESH terms identified 2,962 articles. After a three-stage independent review process, 18 articles, 9 case studies and 9 group studies were available for data synthesis from 1990-2012. Case study data was converted to standardised …scores and compared to available test norms. Cohen’s d was calculated to permit group data interpretation. RESULTS: Intellectual decrement was observed in some studies although difficult to delineate given the lack of use of measures of premorbid ability. Cognitive sequelae varied albeit with predominant disturbance in verbal memory, learning ability and executive function observed across studies. Wechsler Memory Scale Revised (WMS-R) visual memory was comparable to normative data. Impaired Rey Osterrieth Complex Figure (ROCFT) performance was found among group studies. Across visuo-constructional and attention domains, performance varied, although no significant difference relative to reported means was observed. CONCLUSIONS: Future studies should consider the use of standardised assessment protocols, which include measures of premorbid functioning and performance validity. Show more

Keywords: Hypoxia-ischemia, brain injury, adult survivors, neuropsychological outcomes, cognition

DOI: 10.3233/NRE-203135

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 83-97, 2020

Authors: Yoo, I. G.

Article Type: Review Article

Abstract: BACKGROUND: The application of emotional stimuli is beneficial when practicing tasks that must be learned. OBJECTIVE: This scoping review examined related literature to identify the applicability of emotion-based training for therapeutic activities. METHOD: All relevant literature published as of April 1, 2020 in four prominent databases was searched (CINAHL, Embase, PubMed, and PsycINFO) using the five-stage review framework proposed by Arksey and O’Malley. RESULTS: After sophisticated searches and exclusions, ten publications were included for further review. Our results revealed three types of emotion-based stimulation methods that can influence therapeutic effects on stroke patients. However, …the research did not compare the difference between the pros, cons, and effectiveness of each type of sensory stimulation. CONCLUSION: Rehabilitation specialists are encouraged to obtain a broad understanding of therapeutic situations and their possible impacts on a given environment. Show more

Keywords: Emotion-based stimulation, rehabilitation, scoping review, stroke

DOI: 10.3233/NRE-203163

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 99-108, 2020

Authors: Szczepańska-Gieracha, Joanna | Cieślik, Błażej | Rutkowski, Sebastian | Kiper, Paweł | Turolla, Andrea

Article Type: Review Article

Abstract: BACKGROUND: Studies demonstrated the efficacy of virtual reality (VR) as a method supporting the post-stroke neuro-rehabilitation process by activating motor learning processes. Nevertheless, stroke is frequently accompanied by serious psychological problems including depression, which is associated with an increased risk of mortality, lower post-stroke physical activity, and higher disability in stroke patients. OBJECTIVES: To explore the current use of VR as a method supporting the neuro-rehabilitation process, both in physical and psychological dimensions. METHODS: An exploratory review was conducted with a narrative synthesis. PubMed was used for literature search. Search includes the use of VR in …physical rehabilitation, and as support therapy in psychiatric disorders. Both primary research and systematic reviews were included. RESULTS: In neurological disorders rehabilitation, out of 22 studies, 16 concerned stroke survivors. In psychiatric disorders, 44 literature reviews were included. CONCLUSION: The studies confirmed the effectiveness of various forms of VR treatment in the alleviation of psychological and behavioral problems and psychiatric disorders. There is a shortage of VR-based technological solutions that would, besides physical rehabilitation, offer stroke patients therapeutic tools to alleviate psychological disturbance and improve the patient’s mood and motivation. Such solutions will most likely become a field of intensive research in the coming years. Show more

Keywords: Narrative literature review, stroke, depression, post-stroke rehabilitation, total immersion, virtual reality

DOI: 10.3233/NRE-203209

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 109-120, 2020

Authors: Durgut, Elif | Orengul, A. Cahid | Algun, Z. Candan

Article Type: Research Article

Abstract: OBJECTIVE: The aim of this study was to compare the effects of treadmill training (TT) and whole body vibration training (WBVT) on attention, severity of attention deficit hyperactivity disorder (ADHD) symptoms and impairment of executive function behaviors, and quality of life in children with ADHD. METHODS: Thirty children (7–11 years of age) with ADHD were randomly assigned to either the ‘TT’ group or the ‘WBVT in addition to TT’ group (TT + WBVT). Both groups received TT for 8 weeks (3 days/week). The TT + WBWT group also received WBVT for 15 minutes. Stroop Test TBAG form, Behavior Rating Inventory of Executive …Function (BRIEF), Conners’ Rating Scale (CRS) and Pediatric Quality of Life Inventory (PedsQL) were applied at baseline and after 8 weeks of training. RESULTS: All assessment results significantly improved in both groups at the end of the program compared to baseline values (p  < 0,05). There were significant differences between groups regarding improvements in CTRS-R/L and BRIEF-Teacher form in favor of the TT + WBVT group. CONCLUSIONS: The findings suggest that exercise training including TT and WBVT might be used in the treatment of ADHD but further research is required to provide evidence of the effectiveness of the whole body vibration training in the management of ADHD. Show more

Keywords: Attention deficit hyperactivity disorder, treadmill training, whole body vibration training, ADHD symptoms, executive functions, quality of life

DOI: 10.3233/NRE-203040

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 121-131, 2020

Authors: Hegazy, Fatma A. | Aboelnasr, Emad A. | Salem, Yasser T.

Article Type: Research Article

Abstract: BACKGROUND: Gait deviations and spasticity are common impairments seen in children with cerebral palsy (CP) and may interfere with functional performance and effective walking pattern. Lidocaine iontophoresis is effective for reducing muscle spasticity in adults. PURPOSE: To investigate the effect of lidocaine epinephrine iontophoresis combined with exercises on gait and spasticity in children with spastic hemiplegic cerebral palsy (HCP). METHODS: Thirty children with spastic HCP aged 4–6 (5.20±0.32) years were randomly assigned to the experimental group (n  = 15) and control group (n  = 15). Children in both groups received one hour of exercises, three times a week …for three months. Children in the experimental group received 2% lidocaine iontophoresis immediately before the exercises. The lidocaine iontophoresis was delivered for 20 minutes (1mA/min). Spatio-temporal gait parameters were assessed within one week before and after the intervention using 3D motion analysis. Surface electromyography was used to assess muscle tone using H/M ratio of the soleus muscle. ANOVA was used to investigate the differences between experimental and control groups. Statistical significance was set at P value less than 0.05. RESULTS: There was no difference between groups at baseline. Post-intervention, the experimental group showed significant improvements when compared to the control group for gait speed (p  = 0.03), stride length (p  = 0.04), cadence (p  = 0.0001), cycle time (p  = 0.0001), and H/M ratio (p  = 0.02). CONCLUSION: Lidocaine iontophoresis combined with exercises was effective in improving gait spatiotemporal parameters and reducing spasticity in children with CP. Show more

Keywords: Cerebral palsy, lidocaine iontophoresis, gait analysis, EMG, spasticity, exercises

DOI: 10.3233/NRE-203152

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 133-141, 2020

Authors: Kokkinou, M. | Kyprianou, T.C. | Kyriakides, E. | Constantinidou, F.

Article Type: Research Article

Abstract: BACKGROUND: Traumatic Brain Injury (TBI) is characterized by a highly heterogenous profile in terms of pathophysiology, clinical presentation and outcome. OBJECTIVE: This is the first population study investigating the epidemiology and outcomes of moderate-to-severe TBI in Cyprus. Patients treated in the Intensive Care Unit (ICU) of Nicosia General Hospital, the only Level 1 Trauma Centre in the country, were recruited between January 2013 and December 2016. METHODS: This was an observational cohort study, using longitudinal methods and six-month follow-up. Patients (N = 203) diagnosed with TBI were classified by the Glasgow Coma Scale at the Emergency Department as …moderate or severe. RESULTS: Compared to international multicentre studies, the current cohort demonstrates a different case mix that includes older age, more motor vehicle collisions and lower mortality rates. There was a significantly higher proportion of injured males. Females were significantly older than males. There were no sex differences in the type, severity or place of injury. Sex did not yield differences in mortality or outcomes or on injury indices predicting outcomes. In contrast, older age was a predictor of higher mortality rates and worse outcomes. CONCLUSION: Trends as described in the study emphasize the importance of continuous evaluation of TBI epidemiology and outcome in different countries. Show more

Keywords: Traumatic Brain Injury, epidemiology, cohort study, mortality, sex differences

DOI: 10.3233/NRE-203111

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 143-152, 2020

Authors: Allataifeh, Eman | Khalil, Hanan | Almhdawi, Khader | Al-Shorman, Alham | Hawamdeh, Ziad | El-Salem, Khalid | Bumin, Gonca

Article Type: Research Article

Abstract: BACKGROUND: Multiple sclerosis (MS) has a huge impact on patients and affects their ability to participate in meaningful activities. OBJECTIVE: To identify motor and non-motor factors that are associated with the participation level in instrumental activities of daily living (IADL), leisure, social and religious activities in people with MS. METHOD: This is a cross-sectional study conducted on 110 individuals with MS. The used outcome measures are: Arabic version of the Activity Card Sort, Berg Balance Scale, Modified Fatigue Impact Scale, Nine Hole Peg Test, 6-Minute Walk Test, Brief International Cognitive Assessment for Multiple Sclerosis, Stroop test …and Hospital Anxiety and Depression Scale. RESULTS: Hand function, balance, gender and cognitive status can predict the participation in IADL (R2  = 0.425, P  < 0.0001); depression, age, and cognitive status can predict the participation in leisure activities (R2  = 0.372, P  < 0.0001), and fatigue, balance and cognitive status can predict social activities participation (R2  = 0.492, P  < 0.000). CONCLUSION: Balance, cognition and fatigue affect the level of participation in instrumental activities of daily living, leisure, and religious and social activities. Show more

Keywords: Participation, multiple sclerosis, instrumental activities of daily living, leisure, quality of life

DOI: 10.3233/NRE-203131

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 153-160, 2020

Authors: Singh, Meenakshi | Sarkar, Aparna | Kataria, Chitra

Article Type: Research Article

Abstract: BACKGROUND: Injury to the spinal cord results in standing balance impairment following variable sensorimotor loss. Standing balance training is a realistic goal for the majority of individuals with spinal cord injury (SCI) for which therapists need valid measures to assess standing ability in people with SCI that are relevant to functionality. Objective: The objective of the study was to develop an all inclusive Standing Balance Assessment for Individuals with Spinal Cord Injury (SBASCI) measure and to establish its initial psychometric properties. Methods: The study was carried out in three phases: Item development, scale development and scale …evaluation. Literature review, focus group discussions and evaluation by experts resulted in the development of a 22-item SBASCI scale. The scale was administered on 120 participants with SCI. Exploratory factor analysis and item analysis were used to determine construct validity and internal consistency of the scale. Results: Content validity was established qualitatively and quantitatively. The scale shows high internal consistency reliability (Cronbach’s alpha 0.96). The results of the exploratory factor analysis suggested a four factor structure retaining all the 22 items. Conclusion: SBASCI is a valid and reliable scale to measure the standing balance of individuals with SCI. Further studies are required to establish other psychometric properties. Show more

Keywords: Spinal cord injury, standing balance, validity, reliability

DOI: 10.3233/NRE-203148

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 161-169, 2020

Authors: Pongratanakul, Rinlada | Thitisakulchai, Poungkaew | Kuptniratsaikul, Vilai

Article Type: Research Article

Abstract: OBJECTIVES: To identify factors that are independently related to interrupted stroke rehabilitation due to acute care transfer or death. METHODS: Medical records of stroke inpatients admitted from 2012 to 2017 were reviewed. Stroke inpatients with interrupted stroke rehabilitation due to acute care transfer or death were enrolled into the case group. Those without interruption admitted in the same month were randomly selected into the control group (case to control ratio of 1 : 5). Ten clinical factors were studied. RESULTS: Among stroke inpatients, 3.2% were transferred to acute care facilities and 0.2% died. The most common causes of …acute care transfer were respiratory tract infection, intracranial hemorrhage, recurrent ischemic stroke, ischemic heart disease, and seizure. Three factors were found to be significantly associated with interrupted stroke rehabilitation, i.e. presence of feeding tube, presence of anemia and age. Our results also revealed significant association between presence of feeding tube and respiratory tract infection (p  = 0.005). CONCLUSION: Feeding tube, anemia and old age were identified as independent predictors of interrupted stroke rehabilitation due to acute care transfer or death. Interventions to reduce severe complications should be implemented in order to prevent interruption of rehabilitation process and to reduce the patient transfer rate. Show more

Keywords: Case-control studies, patient transfer, stroke rehabilitation, inpatients, stroke

DOI: 10.3233/NRE-203187

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 171-179, 2020

Authors: Bilek, Furkan | Deniz, Gulnihal | Ercan, Zubeyde | Cetisli Korkmaz, Nilufer | Alkan, Gokhan

Article Type: Research Article

Abstract: OBJECTIVE: The aim of this study was to investigate the effects of neuromuscular electric stimulation applied to the erector spinae on balance, motor function and functional capacity in patients with stroke in a randomized controlled trial. METHODS: Sixty patients with stroke were recruited and randomly distributed into two groups: control group and neuromuscular electric stimulation group. All participants underwent conventional physical therapy five times a week for six weeks. The neuromuscular electric stimulation group received additional electrical stimulation. Outcome measures were evaluated with Brunnel Balance Assessment, Stroke Rehabilitation Movement Assessment, Functional Ambulation Classification, Adapted Patient Evaluation and Conference …System, Postural Assesment Scale for Stroke patients, Short Form-36, and Minimental State Examination scales. RESULTS: Significant differences were observed in all scores at the end of the study in both groups. Postural Assesment Scale for Stroke patients and Stroke Rehabilitation Movement Assessment scores were higher in the neuromuscular electric stimulation group compared to the control group (p  < 0.05). All the other scores were not statistically significant. CONCLUSION: It is recommended to evaluate and treat trunk muscle, which is usually neglected in treatment, and to consider the combination of conventional treatment and neuromuscular electric stimulation when designing an ideal rehabilitation program. Show more

Keywords: Neuromuscular electrical stimulation, erector spinae, stroke, functional capacity, balance, mobility

DOI: 10.3233/NRE-203114

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 181-189, 2020

Authors: McIntyre, Amanda | Janzen, Shannon | Iruthayarajah, Jerome | Saikaley, Marcus | Sequeira, Dan | Teasell, Robert

Article Type: Research Article

Abstract: BACKGROUND: Stroke rehabilitation research is important for informing clinical practice and directing health care resources. OBJECTIVE: To examine how motor- and cognitive-based stroke rehabilitation randomized controlled trials (RCTs) vary by world region, overall and over time, with respect to 1) publication volume, 2) sample size, and 3) methodological quality. METHODS: Using the Evidence-Based Review of Stroke Rehabilitation (EBRSR), all motor- and cognitive-based stroke rehabilitation RCTs were identified. The following data were extracted: first author, year of publication, country of origin, and sample size. Countries were categorized into seven regions, as defined by the World Bank. …RESULTS: In total 1410 motor-based RCTs and 293 cognitive-based RCTs were published between 1972–2018. For motor RCTs, the East Asia/Pacific region accounted for the largest volume of RCTs (n  = 530; 37.6%), followed closely by the Europe/Central Asia region (n  = 445; 31.6%). Conversely, the largest producer for cognitive RCTs was Europe/Central Asia (n  = 167; 57.0%), followed by East Asia/Pacific (n  = 62; 21.2%). For both motor and cognitive RCTs, there was no significant difference between world regions with respect to mean sample size or methodological quality. CONCLUSIONS: Efforts should be directed towards improving methodological quality and increasing sample sizes of stroke rehabilitation-related studies. Show more

Keywords: Stroke, rehabilitation, randomized controlled trial, motor, cognitive, global, geography, worldwide, world, publication rate, country, world region, trend

DOI: 10.3233/NRE-203168

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 191-199, 2020

Authors: Verna, Valeria | De Bartolo, Daniela | Iosa, Marco | Fadda, Lucia | Pinto, Gianluca | Caltagirone, Carlo | De Angelis, Sara | Tramontano, Marco

Article Type: Research Article

Abstract: BACKGROUND: Recently, the potential rehabilitation value of music has been examined and music-based interventions and techniques such as the Negative Mismatch (MMN) have been increasingly investigated in the neurological rehabilitation context. OBJECTIVE: The aim of this study was to investigate the effectiveness of a negative mismatch-based therapy on the disability and quality of life in patients with stroke in sub-acute phase. METHODS: Thirty patients with a stroke diagnosis in sub-acute phase were randomly assigned to one of two groups: Mismatch (Mg) or Control (CTRLg) group. Both groups used an innovative Android application: Temporal Musical Patterns Organisation …(Te.M.P.O). The Disability Rating Scale (DRS), the Modified Barthel Index (MBI) and the Stroke Specific Quality of Life scale (SSQoL) were used at the baseline (T0) and after four weeks of training (T1), in order to assess changes over time. RESULTS: Statistical analysis was performed using the data of 24 (Mg = 12, CTRLg = 12) subjects. The results show a major improvement of the Mg with respect to the CTRLg in all clinical scales score. CONCLUSION: The temporal negative mismatch-based therapy performed with the Te.M.P.O. application could be useful in improving the disability and the quality of life in stroke survivors in a sub-acute phase. Show more

Keywords: Stroke, mismatch, music rehabilitation, cognitive rehabilitation

DOI: 10.3233/NRE-203126

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 201-208, 2020

Authors: Xu, Quan | Li, Chong | Pan, Yu | Li, Wei | Jia, Tianyu | Li, Zhibin | Ma, Di | Pang, Xue | Ji, Linhong

Article Type: Research Article

Abstract: OBJECTIVE: To explore the impact of rehabilitation robot training (RRT) on upper limb motor function and daily activity ability in patients with stroke. METHODS: Forty patients meeting the inclusion criteria were randomly divided into the treatment group (TRE) and the control group (CON). Group TRE was trained with an upper limb rehabilitation robot and group CON was trained with traditional occupational therapy. The training time was six weeks, and the upper limb function and daily activities were then assessed. RESULTS: (1) There was no statistical significance in the Fugl-Meyer (FM) score, Wolf Motor Function Test (WMFT) …score, and Modified Barthel Index (MBI) score between the two groups before treatment (P  > 0.05). (2) After treatment, the FM score, WMFT score, and MBI score were significantly higher than before treatment (P  < 0.01). (3) There was no significant significance between the two groups after treatment (P  > 0.05). CONCLUSIONS: Both RRT and traditional occupational therapy training are useful for the recovery of upper limb motor function and daily life ability in the sub-acute stage of stroke. Show more

Keywords: Rehabilitation, robotics, stroke, upper limb motor function

DOI: 10.3233/NRE-203130

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 209-215, 2020

Authors: Jung, Dohee | Yi, Chunghwi | Choi, Woochol Joseph | You, Joshua Sung H.

Article Type: Research Article

Abstract: BACKGROUND: Navicular drop is a common plantar deformity which makes the plantar medial longitudinal arch (MLA) collapse and leads to other deformities in lower extremities. Active structures are from intrinsic and extrinsic foot muscle activities such as abductor hallucis (AbdH), tibialis anterior (TA), tibialis posterior, flexor hallucis brevis, flexor digitorum brevis during dynamic situations. As AbdH plays a role as a dynamic elevator of MLA, the importance of AbdH has been emphasized and the proper recruitment of both intrinsic and extrinsic muscle is crucial for stabilization of MLA during dynamic weight bearing condition. Because the short foot (SF) exercise is …difficult to perform and tends to activate the intrinsic muscles concentrically rather than a natural coordination of concentric-isometric-eccentric activation, we have developed the guidance-tubing SF gait (GFG) exercise. OBJECTIVE: We investigated the effect of GFG exercise on muscle activity, AbdH:TA activity ratio, MLA angle, and foot pressure distribution during walking compared to SF gait (SFG) exercise. METHODS: Thirty-two subjects with flexible flat feet were divided into two groups and performed SFG exercise with (GFG) and without guidance-tubing (SFG) for seven serial days. RESULTS: AbdH muscle activity significantly increased from foot flat to heel rise in the GFG group (p  = 0.006). The AbdH:TA activity ratio significantly increased in both the SFG (p  = 0.015) group and GFG group (p  = 0.006). MLA angles significantly decreased in both the SFG group (p  = 0.001) and GFG group (p  = 0.000), and the decrement was significantly higher in the GFG group (p  = 0.001). The foot pressure distribution did not show any statistically significant change. CONCLUSIONS: The result of this study provides a clinical implication for training MLA supporter muscles in individuals with flat feet. The overactive muscle must be inhibited first, then facilitation and strengthening are followed respectively. Show more

Keywords: Flexible flat foot, guidance-tubing, short foot exercise, medial longitudinal arch

DOI: 10.3233/NRE-203106

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 217-226, 2020

Authors: Sestak, Anamarija | Maslovara, Sinisa | Zubcic, Zeljko | Vceva, Andrijana

Article Type: Research Article

Abstract: BACKGROUND: Only a few studies in the literature demonstrate the effect of vestibular rehabilitation (VR) on all vestibular receptor organs. Furthermore, very little evidence of the effect of VR on isolated otolith dysfunction (IOD) is available. OBJECTIVE: The study aimed to investigate the effect of VR on all vestibular receptor organs in patients with different types of unilateral vestibular hypofunction (UVH). METHODS: We enrolled 80 patients with three different types of UVH; combined and isolated loss of semicircular canal and otolith organ function. All patients performed a 12-week customized program of VR and received a full …battery of vestibular function tests, before and after the VR. The DHI and SF-36 were performed before, after 6 weeks, and 12 weeks of the VR. RESULTS: Parameters of the caloric test, video head impulse test, ocular and cervical vestibular evoked myogenic potentials were significantly improved after VR. A total of 59 (74%) patients fully recovered, with no significant difference in recovery regarding the type (p  = 0.13) and stage of UVH (p  = 0.13). All patients reported significantly lower disability and a better quality of life after the VR based on the DHI and SF-36 score. CONCLUSIONS: Vestibular rehabilitation has a positive effect on the recovery of all vestibular receptor organs and it should be used in patients with IOD. Show more

Keywords: Unilateral vestibular hypofunction, vestibular rehabilitation, semicircular canals, otolith organs

DOI: 10.3233/NRE-203113

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 227-235, 2020

Authors: Yasmin, Natasha | Riley, Gerard Anthony

Article Type: Case Report

Abstract: BACKGROUND: Following a brain injury, caregiving spouses/partners differ in their perceptions of relationship continuity/discontinuity (i.e. whether the relationship is experienced as similar or different to the pre-injury relationship). Perceptions of continuity are associated with better psychological wellbeing and a better relationship. OBJECTIVE: To conduct a pilot test of an intervention aimed at exploring the possibility of supporting caregiving partners to experience greater continuity within their relationship post-stroke. METHODS: A post-stroke couple was provided with integrated behavioural couples therapy for three months, which aimed to increase relationship continuity alongside addressing individual goals identified by the couple. Before …and after measures were taken using a battery of six questionnaires evaluating changes in perceptions of continuity, relationship quality, and stress. RESULTS: Quantitative and qualitative data showed post-therapy improvement in all the measures. CONCLUSIONS: The study suggested that perceptions of relationship continuity can be improved by therapy, and that such an improvement might have a beneficial impact in terms of relationship quality and psychological wellbeing. The intervention is currently being further developed and evaluated. Show more

Keywords: Stroke, brain injury, marital relations, couples therapy, relationship continuity

DOI: 10.3233/NRE-203173

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 237-245, 2020

Authors: Iolascon, Giovanni

Article Type: Other

Abstract: BACKGROUND: The role of systemic use of local anesthetics in the treatment of neuropathic pain (NP) is still unclear. OBJECTIVE: To assess the efficacy and safety of systemic local anesthetics for NP. METHODS: To summarize and to discuss the rehabilitation perspective on the published Cochrane Systematic Review “Systemic administration of local anesthetic agents to relieve neuropathic pain” by Challapalli V et al. RESULTS: The review included 30 RCTs including patients with NP treated with iv lidocaine, oral mexiletine, lidocaine and mexiletine, or oral tocainide. Low-to-moderate quality of the evidence suggest that intravenous lidocaine or …oral mexiletine may slightly reduce NP vs placebo, but the efficacy of these drugs is comparable to anticonvulsants or morphine. CONCLUSIONS: Systemic administration of local anesthetics is not supported by scientific evidence for pain relief as well as for functional improvement. Show more

Keywords: Neuropathic pain, Cochrane Systematic Review, local anesthetics, lidocaine

DOI: 10.3233/NRE-209006

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 247-249, 2020