NeuroRehabilitation - Volume 47, issue 4

Authors: Song, Jessica Z. | Catizzone, Margot | Arbour-Nicitopoulos, Kelly P. | Luong, Dorothy | Perrier, Laure | Bayley, Mark | Munce, Sarah E.P.

Article Type: Review Article

Abstract: BACKGROUND: People with childhood-onset disabilities face unique physical and social challenges in adulthood. Exercise interventions may improve physical performance in children, but there is a lack of research on adults. OBJECTIVE: To describe studies that investigate exercise interventions and to evaluate the quality of physical performance outcome measures for adults with childhood-onset disabilities. METHODS: Eligible studies reported on exercise interventions for adults (ages 16+) with cerebral palsy, spina bifida, or acquired brain injuries. Only randomized controlled trials published in English from 2008 to 2019 were included. MEDLINE, CINAHL, PEDro, EMBASE, and Cochrane Central Register of Controlled …Trials were searched. Two reviewers independently screened studies and abstracted data. RESULTS: This scoping review included 4 trials reporting on cerebral palsy only. Three strength training programs found significant improvements in gait, and one mixed training program found significant improvements in strength and fitness. Only two outcome measures used are valid/reliable for adults (6 Minute Walk Test and Borg-20 Grades ). CONCLUSION: Certain interventions may improve physical performance, but there is a lack of research on appropriate exercise interventions and physical performance outcome measures for adults with childhood-onset disabilities. Different exercise interventions should be investigated using larger sample sizes and outcome measures should be standardized. Show more

Keywords: Childhood-onset disabilities, adults, spina bifida, cerebral palsy, acquired brain injury, exercise interventions, outcome measures, reliability and validity

DOI: 10.3233/NRE-203250

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 359-380, 2020

Authors: Moggio, Lucrezia | Petraroli, Annalisa | Marotta, Nicola | Demeco, Andrea | Pino, Ilaria | Marinaro, Cinzia | Barletta, Marianna | Ammendolia, Antonio

Article Type: Case Report

Abstract: BACKGROUND: Primary lateral sclerosis (PLS) is an upper motor neurons disease that on rare occasions may determine bradykinesia and motor fatigue. To date, no rehabilitative treatment has been described as useful for these patients. CASE PRESENTATION: A 68-year-old male developed dysarthria, spastic laugh, impairments of handwriting and fine motor, gait and dysphagia disorders for both solids and liquids over the period from 2015 to December 2018, with normal DaT scans and no clinical benefits from therapy with levodopa, pramipexole and baclofen. The patient underwent exercises for gait training and balance control with sensory treadmill and stabilometric platform and …kinesiotherapy to improve fine motor skills of both hands and postural changes, five days a week for two weeks. Based on our data, the patient showed an improvement in balance and gait parameters in T2 compared to T1. CONCLUSION: Thanks to the synergistic action of a combined treatment of physical and instrumental therapy, despite the rare pathology and complex disability, the patient had important benefits in terms of performance and independence in daily activity. Show more

Keywords: Primary lateral sclerosis, parkinsonism, rehabilitation, motor neuron disease

DOI: 10.3233/NRE-201527

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 381-386, 2020

Authors: Frenkel, Maya | Eckstein, Nava | Frenkel-Toledo, Silvi

Article Type: Research Article

Abstract: BACKGROUND: BEITI is a comprehensive test of a wide range of basic and extended daily functioning. It was developed for physiotherapists in the community to enable increased sensitivity in detecting changes in the functioning of patients with different diagnoses. BEITI was found to be valid, reliable and valuable in terms of the time and effort involved. Its clinical properties as a measurement in inpatients with brain lesions is yet to be determined. OBJECTIVE: To translate BEITI from Hebrew into English, and explore its psychometric properties in inpatients with brain lesions in the subacute phase. METHODS: The …admission and discharge records of 131 patients hospitalized in a neurological rehabilitation department were reviewed retrospectively. The internal consistency, responsiveness, and floor and ceiling effects of BEITI were assessed. RESULTS: Excellent internal consistency was found for BEITI at admission and discharge (Cronbach’s α  ≥ 0.964). BEITI had high effect sizes (effect size = 1.11, standardized response mean = 1.54). Significant changes over time were found for the BEITI (p  < 0.001). No floor or ceiling effects were observed. CONCLUSIONS: BEITI is a reliable and responsive scale for assessing basic and extended daily functioning in inpatients with brain injuries in the subacute phase. Show more

Keywords: Measure of daily functioning, brain lesions, rehabilitation, physiotherapy, BEITI

DOI: 10.3233/NRE-203122

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 387-392, 2020

Authors: Jones, Kate Fiona | Pryor, Julie | Care-Unger, Candice | Descallar, Joseph | Simpson, Grahame Kenneth

Article Type: Research Article

Abstract: BACKGROUND: Spirituality may play an important role in neurorehabilitation, however research findings indicate that rehabilitation professionals do not feel well equipped to deliver spiritual care. OBJECTIVE: To evaluate a spiritual care training program for rehabilitation professionals. METHODS: An exploratory controlled trial was conducted. Participants enrolled in a two-module spiritual care training program. Spiritual care competency was measured with the Spiritual Care Competency Scale. Confidence and comfort levels were measured using the Spiritual Care Competency Scale domains. The Spirituality and Spiritual Care Rating Scale assessed participant attitudes and knowledge. Measures were administered three times: pre-program, post-program and …six weeks follow-up. RESULTS: The training (n  = 41) and control (n  = 32) groups comprised rehabilitation professionals working in spinal cord or traumatic brain injury units. No between-group differences were observed on the study variables at the pre-program time point. Multilevel models found that levels of spiritual care competency, confidence, comfort, and ratings on existential spirituality increased significantly for the training group (versus control) post-program (p  < 0.05) and these significant differences were maintained at follow-up. CONCLUSIONS: A brief spiritual care training program can be effective in increasing levels of self-reported competency, confidence and comfort in delivery of spiritual care for rehabilitation professionals. Show more

Keywords: Spirituality, spiritual care, health professionals, spinal cord injury, traumatic brain injury, rehabilitation

DOI: 10.3233/NRE-203221

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 393-403, 2020

Authors: Chow, Beverley | Feloiu, Florin | Berardocco, Assunta | Ceglie, David | Nesathurai, Shanker

Article Type: Research Article

Abstract: BACKGROUND: Parkinson’s disease (PD) is a progressive neurodegenerative disorder with manifestations such as tremors, rigidity and bradykinesia. OBJECTIVE: The objective of this study was to evaluate the efficacy of outpatient multidisciplinary rehabilitation. METHODS: 179 patients participated in the six-week program. The following outcomes were measured: Timed Up and Go (TUG), sit to stand five times (STSx5) and in 30 seconds (STS30), six minute walk distance (6MWD) and gait velocity (6MWV), MOCA, bilateral grip strength, 360-degree turn (360 R, 360 L) and bilateral nine hole peg test. Pre- and post- data was analyzed via paired t -tests. …Multiple regression was used to determine age- or gender-affected outcomes. RESULTS: Patients showed a statistically significant improvement (p  < 0.05) in all outcomes. Mean TUG improved by 1.63 seconds (s), STSx5 by 4.19s, STS30 by 2.37 repetitions, 6MWD by 66.8 metres, 6MWV by 0.15 m/s, MOCA by 1.50 points, 360 R by 1.17s, 360 L by 1.60s, Grip R by 0.78 kg, Grip L by 0.95 kg, 9HP R by 1.71s and 9HP L by 1.58s. Gender had no influence. Age was a statistically significant predictor in STSx5 and 6MW. CONCLUSIONS: An outpatient multidisciplinary program successfully decreased motor impairment and increased overall functional independence in PD. Show more

Keywords: Parkinson’s disease rehabilitation, outpatient rehabilitation, neurorehabilitation, motor outcomes

DOI: 10.3233/NRE-203218

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 405-414, 2020

Authors: Chang, Hsiu-Chen | Chen, Chiung-Chu | Weng, Yi-Hsin | Chiou, Wei-Da | Chang, Ya-Ju | Lu, Chin-Song

Article Type: Research Article

Abstract: BACKGROUND: Recent studies have suggested that cognitive-motor dual-task (DT) training might improve gait performance, locomotion automaticity, balance, and cognition in patients with Parkinson’s disease (PD). OBJECTIVE: We aimed to investigate the efficacy of cognitive-cycling DT training in patients with early-stage PD. METHODS: Participants were scheduled to perform cognitive tasks simultaneously with the cycling training twice per week for eight weeks for a total of 16 sessions during their on-states. Clinical assessments were conducted using the unified Parkinson’s disease rating scale (UPDRS), modified Hoehn and Yahr stage, Timed Up and Go (TUG) test, gait and cognitive performances …under dual-task paradigm, the new freezing of gait questionnaire, Schwab and England Activities of Daily Living scale, 39-item Parkinson’s disease questionnaire, and cognitive performance. RESULTS: Thirteen eligible patients were enrolled in the study. The mean age was 60.64±5.32 years, and the mean disease duration was 7.02±3.23 years. Twelve PD patients completed 16 serial cognitive-cycling sessions for two months. After 16 sessions of training (T2), the UPDRS III scores improved significantly in both the off- and on-states, and TUG were significantly less than those at pretraining (T0). During both the single-task and the DT situations, gait performance and spatial memory cognitive performance significantly improved from T0 to T2. CONCLUSION: The present study demonstrated that cognitive-cycling DT training improves the motor functions, gait and cognitive performances of PD patients. Show more

Keywords: Parkinson’s disease, cycling, cognitive, dual-task, gait

DOI: 10.3233/NRE-203090

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 415-426, 2020

Authors: El-Tamawy, Mohammed S. | Darwish, Moshera H. | Elkholy, Saly H. | Moustafa, Engy BadrEldin S. | Abulkassem, Shimaa T. | Khalifa, Heba A.

Article Type: Research Article

Abstract: BACKGROUND: Cortical reorganization between both cerebral hemispheres plays an important role in regaining the affected upper extremity motor function post-stroke. OBJECTIVES: The purpose of the current study was to investigate the recommended number of contra-lesion low frequency repetitive transcranial magnetic stimulation (LF-rTMS) sessions that could enhance cortical reorganization post-stroke. METHODS: Forty patients with right hemiparetic subacute ischemic stroke with an age range between 50–65 yrs were randomly assigned into two equal groups: control (GA) and study (GB) groups. Both groups were treated with a selected physical therapy program for the upper limb. Sham and real contra-lesion LF-rTMS …was conducted for both groups daily for two consecutive weeks. Sequential changes of cortical excitability were calculated by the end of each session. RESULTS: The significant enhancement in the cortical excitability was observed at the fourth session in favor of the study group (GB). Sequential rate of change in cortical excitability was significant for the first eight sessions. From the ninth session onwards, no difference could be detected between groups. CONCLUSION: The pattern of recovery after stroke is extensive and not all factors could be controlled. Application of LF-rTMS in conjugation with a selected physical therapy program for the upper limb from four to eight sessions seems to be efficient. Show more

Keywords: Cortical excitability, cortical reorganization, sequential changes, single pulse TMS, transcranial magnetic stimulation, upper limb motor performance.

DOI: 10.3233/NRE-203156

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 427-434, 2020

Authors: Lee, Jiyeon | Jeon, Jeongwoo | Lee, Dongyeop | Hong, Jiheon | Yu, Jaeho | Kim, Jinseop

Article Type: Research Article

Abstract: BACKGROUND: Trunk stability has been identified as an important prerequisite of functional movement. OBJECTIVE: To investigate the effectiveness of core muscle contraction training on abdominal muscle thickness, balance, and gait ability in stroke patients. METHODS: Thirty patients with stroke were randomly assigned to two experimental groups and a control group. All groups received conventional therapeutic exercise program for six weeks. The experimental groups additionally trained trunk stability exercise with abdominal hollowing or bracing maneuvers within training time. Primary outcome measures were evaluated abdominal muscle thickness using the sonography. Secondary outcome measures were evaluated by the Functional …Reach Test (FRT), Berg Balance Scale (BBS), 10-meter walk test (10MWT), and Timed Up and Go test (TUG). RESULTS: Compared with the control group, the effect of trunk stability training for the experimental groups on the abdominal muscles thickness change was observed (p  < 0.05). The values in balance and gait measures, BBS, FRT, 10MWT, and TUG, showed significant improvement after the intervention periods (p  < 0.05), although no significant differences were found in scores of gait and balance scales among groups. CONCLUSIONS: Trunk stability training with selective abdominal muscles activation has beneficial effects on abdominal muscles, balance, and mobility in stroke patients. Our findings might provide support for introducing stroke rehabilitation. Show more

Keywords: Stroke, rehabilitation, abdominal muscles, balance, gait

DOI: 10.3233/NRE-203133

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 435-442, 2020

Authors: Moftah, Emad | Vennu, Vishal | Abdulrahman, Tariq A. | Alnahdi, Ali H. | Balubaid, Hashim | Alghamdi, Ghalib | Alonazi, Sultana | Abunassif, Sondos | Bindawas, Saad M.

Article Type: Research Article

Abstract: BACKGROUND: Although several studies have shown an association of muscle weakness with gait speed (GS), no study has explored the relationship of muscle strength with swing phase duration and GS after stroke among the elderly in Saudi Arabia. OBJECTIVE: To examine the association of affected ankle dorsiflexor and hip flexor muscle strength with swing phase duration and GS in the elderly with different stroke chronicity. METHODS: In this cross-sectional study, we included a total of 60 post-stroke patients aged ≥55 years who were admitted in neurorehabilitation units between May 2017 and August 2018. Linear regression was …employed to examine the association of muscle strength (measured using a handheld dynamometer) with swing phase duration and GS (both measured using the computerized Zebris–Mat). RESULTS: The chronicity of the stroke was negatively associated (p  < 0.05 ) with swing phase duration. The ankle dorsiflexor muscle strength was significantly associated with GS (β= 0.656, p  = 0.041 ). In contrast, hip flexor muscle strength was significantly associated with GS (β= 0.574, p  < 0.0001 ) even after adjusting for stroke chronicity (β= 0.561, p  < 0.0001 ). CONCLUSIONS: Stroke chronicity was the predictor that reduced swing phase duration. The ankle dorsiflexor muscle strength was associated with GS. However, the hip flexor muscle strength was associated with GS even after adjusting for stroke chronicity. Show more

Keywords: Ankle dorsiflexion, hip flexion, muscle torque, rehabilitation, stroke

DOI: 10.3233/NRE-203150

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 443-450, 2020

Authors: Martins, Júlia Caetano | Nadeau, Sylvie | Aguiar, Larissa Tavares | Scianni, Aline Alvim | Teixeira-Salmela, Luci Fuscaldi | De Morais Faria, Christina Danielli Coelho

Article Type: Research Article

Abstract: BACKGROUND: Impaired mobility is related to low physical activity (PA) levels observed after stroke. Therapeutic approaches, such as task-specific circuit training (TSCT), used to improve mobility in individuals with stroke, could also improve PA levels. OBJECTIVE: To investigate the efficacy of TSCT, focused on both upper (UL) and lower (LL) limbs, in improving PA levels and mobility (primary outcomes), as well as muscle strength, exercise capacity, and quality of life (secondary outcomes) in subjects with stroke. METHODS: A randomized controlled trial with 36 subjects with chronic stroke was conducted. Experimental group: TSCT, involving both UL and …LL. Control group: global stretching, memory exercises, and education sessions. Both groups received 60 minute sessions/week over 12 weeks. Outcomes were measured at baseline, post-intervention and 16 week follow-up. RESULTS: No changes were found for primary and secondary outcomes (0.11≤p≤0.99), except for quality of life, which improved in the experimental group post-intervention and 16 week follow-up (p  = 0.02). CONCLUSION: TSCT focused on both UL and LL was not effective on PA levels and mobility of individuals with chronic stroke, however, improvements in quality of life were observed. Since this is the first study to investigate this combined training aimed at improving PA levels, future studies are necessary to better understand the impact of this type of intervention. Show more

Keywords: Stroke, physical activity, mobility, task-specific training, quality of life

DOI: 10.3233/NRE-203207

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 451-462, 2020

Authors: Rahayu, Umi Budi | Wibowo, Samekto | Setyopranoto, Ismail | Hibatullah Romli, M.

Article Type: Research Article

Abstract: BACKGROUND: Brain injuries such as strokes cause damage and death of the neuron cells. Physiotherapy interventions help to improve patient’s performance and ability. However, this is only theorized but the impact of the physiotherapy intervention on brain plasticity is not known. OBJECTIVE: The present study aimed to investigate the effect of physiotherapy interventions on brain neuroplasticity by evaluating the brain plasticity regeneration, balance and functional ability. METHODS: A randomized controlled trial was conducted with 64 stroke patients from three hospitals in the Surakarta region, Indonesia. Control groups (n  = 32) received conventional physiotherapy and intervention groups (n … = 32) received neurorestoration protocol, which both lasted for seven days. Efficacy of the interventions were measured on brain-derived neurotropic factor serum analysis, Berg Balance Scale and Barthel Index, respectively. RESULTS: Both groups showed improvements in all parameters but only balance and functional performance had a statistically significant outcome. CONCLUSION: Neurorestoration protocol that combined several established physiotherapy interventions was effective in improving balance and functional ability of stroke patients in only a seven days period. Show more

Keywords: Activities of daily living, cerebrovascular accident, early intervention, ischemic, neuroplasticity, physiotherapy, rehabilitation, stroke

DOI: 10.3233/NRE-203210

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 463-470, 2020

Authors: Yoon, Hyun Sik. | Cha, Young Joo. | You, Joshua (Sung) Hyun

Article Type: Research Article

Abstract: BACKGROUND: Neurodevelopmental treatment (NDT) and dynamic core-postural chain stabilization (DCS)- based exercise is effective for improving core stability and postural control in stroke patients. However, no study has reported respiratory function, increased fatigue and ADL function in subacute stroke patients by training using NDT and DCS exercises. OBJECTIVE: To compare the effects of DCS and NDT exercises on respiratory function, fatigue and activities of daily living in individuals with hemiparetic stroke. METHODS: Thirty-one participants with hemiparetic stroke (17 male, 14 female; mean age 60.4±14.58 years; post-stroke duration, 7.2±2.2 weeks) participated in this study. The participants were …randomly allocated into DCS (n  = 16) and NDT (n  = 15). Respiratory function was determined using forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP). The fatigue severity scale (FSS) and functional independent measure (FIM) were used to evaluate fatigue severity and activities of daily living (ADL). Analysis of covariance (ANCOVA) was used to evaluate post-test differences in the DCS and NDT exercise groups. RESULTS: ANCOVA revealed the superior effects of DCS in respiratory function, as well as clinical FSS and FIM tests, compared with those of NDT (p  < 0.05). CONCLUSIONS: The results suggest that DCS training was more effective than NDT training at improving respiratory function, fatigue severity and ADL via balanced co-activation of the diaphragm and increased diaphragm movement in individuals with hemiparetic stroke. Show more

Keywords: Respiratory function, dynamic core-postural chain stabilization, core stabilization, hemiparetic stroke

DOI: 10.3233/NRE-203231

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 471-477, 2020

Authors: Kondo, Yuki | Bando, Kyota | Ariake, Yosuke | Katsuta, Wakana | Todoroki, Kyoko | Nishida, Daisuke | Mizuno, Katsuhiro | Takahashi, Yuji

Article Type: Research Article

Abstract: BACKGROUND: The reliability of the evaluation of the Balance Evaluation Systems Test (BESTest) and its two abbreviated versions are confirmed for balance characteristics and reliability. However, they are not utilized in cases of spinocerebellar ataxia (SCA). OBJECTIVE: We aimed to examine the test-retest reliability and minimal detectable change (MDC) of the BESTest and its abbreviated versions in persons with mild to moderate spinocerebellar ataxia. METHODS: The BESTest was performed in 20 persons with SCA at baseline and one month later. The scores of the abbreviated version of the BESTest were determined from the BESTest scores. The …interclass correlation coefficient (1,1) was used as a measure of relative reliability. Furthermore, we calculated the MDC in the BESTest and its abbreviated versions. RESULTS: The intraclass correlation coefficients (1,1) and MDC at 95% confidence intervals were 0.92, 8.7(8.1%), 0.91, 4.1(14.5%), and 0.81, 5.2(21.6%) for the Balance, Mini-Balance, and Brief-Balance Evaluation Systems Tests, respectively. CONCLUSIONS: The BESTest and its abbreviated versions had high test-retest reliability. The MDC values of the BESTest could enable clinicians and researchers to interpret changes in the balance of patients with SCA more precisely. Show more

Keywords: Minimal detectable change, neurological rehabilitation, postural balance, rare diseases, reproducibility of results, Spinocerebellar ataxias

DOI: 10.3233/NRE-203154

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 479-486, 2020

Authors: Park, Hyun-Ju | Lee, Nam-Gi | Kang, Tae-Woo

Article Type: Research Article

Abstract: BACKGROUND: As the severity of dementia progresses over time, cognition and motor functions such as muscle strength, balance, and gait are disturbed, and they eventually increase the risk of fall in patients with dementia. OBJECTIVE: To determine the relationship between the fall risk and cognition, motor function, functional ability, and depression in older adults with dementia. METHODS: Seventy-four older adults diagnosed with dementia were recruited. Clinical measurements included the Fall Risk Scale by Huh (FSH), Korean version of the Mini-Mental State Examination (MMSE-K), hand grip strength (HGS), Tinetti Performance Oriented Mobility Assessment (POMA), 10-m walk test …(10-MWT), Korean version of the Modified Barthel Index (MBI-K), and the Geriatric Depression Scale (GDS). RESUTLS: The MMSE-K was significantly correlated with the FSH, HGS, and the MBI-K, and FSH was significantly correlated with all of the other outcome measures. In particular, the MMSE-K, HGS, POMA, and the MBI-K were negatively correlated with fall history among the FHS sub-items. Additionally, the MMSE sub-item, attention/concentration was associated with the FSH, HGS, POMA, and the MBI-K. CONCLUSIONS: These findings suggest that falling is significantly related to impaired cognition, reduced muscle strength, impaired balance, gait, and activities of daily living abilities, and depression in older adults with dementia. Show more

Keywords: Dementia, depression, cognition, falling, motor function, older adults

DOI: 10.3233/NRE-203249

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 487-494, 2020

Authors: Klobucká, Stanislava | Klobucký, Robert | Kollár, Branislav

Article Type: Research Article

Abstract: BACKGROUND: Robot-assisted gait training (RAGT) allows an intensive gait training in patients with cerebral palsy (CP). There are few evidences on the effectiveness of RAGT in adults with CP. OBJECTIVE: To assess the effect of RAGT on gross motor function in adolescent and adult patients with bilateral spastic CP and to compare the effect of RAGT with conventional kinesiotherapy. METHODS: Forty-seven patients (mean age 21.2±5.33 years) with bilateral spastic CP were divided into two groups. Twenty-one patients underwent 20 therapeutic units of RAGT and 26 patients underwent 20 therapeutic units of conventional therapy/training (CON). The following …parameters were evaluated before (V1) and after the therapy (V2): dimension A (lying and rolling), B (sitting), C (crawling and kneeling), D (standing), E (walking, running and jumping) of the Gross Motor Function Measure (GMFM-88). In patients in the experimental RAGT group, these parameters were also evaluated 3–4 months later (V3). RESULTS: Comparing the mean improvements in endpoints in both groups (RAGT vs. CON) after 20 TUs, we observed the statistically significant difference (p  < 0.001) and large effect size in all GMFM dimensions and total GMFM improvement in favour of the RAGT group. In RAGT patients, the improvement persisted even 3–4 months after RAGT (p  < 0.001). CONCLUSION: We demonstrated that the intensive RAGT regimen is more effective than conventional therapy in terms of improvements in gross motor functions in adolescent and adult patients with bilateral spastic CP. Show more

Keywords: Rehabilitation, robot-assisted gait training, cerebral palsy, gross motor function

DOI: 10.3233/NRE-203102

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 495-508, 2020

Authors: Negrini, Francesco

Article Type: Other

Abstract: BACKGROUND: Epidural corticosteroid injection is one of the most common non-surgical procedures for lumbosacral radicular pain. OBJECTIVE: To assess efficacy and safety of epidural corticosteroid injections compared with placebo injections in patients with lumbosacral radicular pain. METHODS: A summary and commentary of a Cochrane Review by Oliveira et al. RESULTS: 25 studies with a total of 2740 participants were included in the review. Moderate quality evidence pointed out a small effect on leg pain at immediate and short-term follow-up and on disability at short-term and intermediate follow-up. Adverse events were not different between corticosteroid …and placebo injections. CONCLUSIONS: Epidural corticosteroid injection is slightly more effective than placebo for leg pain and disability at short-term follow up. Clinicians and patients however should be informed of the small effect size of the treatment. Show more

Keywords: Epidural corticosteroid injections, lumbosacral radicular pain, sciatica, low back pain

DOI: 10.3233/NRE-209008

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 509-511, 2020