NeuroRehabilitation - Volume 48, issue 3

Authors: Park, Se-Hee | Son, Sung-Min | Choi, Ji-Young

Article Type: Research Article

Abstract: OBJECTIVE: We aimed to determine whether the posture control training in the sitting posture using virtual reality (VR) training program affects sitting balance and trunk stability in children with spastic cerebral palsy (CP). METHODS: The experiment was conducted for 4 weeks by randomly allocating 20 children with CP. The experimental group (n  = 10) performed balance training in the sitting position using a VR training program, and the control group (n  = 10) performed arm reach training in the sitting position. To evaluate static and dynamic sitting balance and trunk stability, the Wii Balance Board and Balancia software, the modified …functional reach test, and the Korean version of the Trunk Control Measurement Scale were used. RESULTS: There were significant differences between the two groups in the changes in speed and postural swing distance before and after training (p  < 0.05). The mFRT measurement showed significant differences in all directions before and after training between the two groups (p  < 0.05). However, there was no significant difference between the two groups in the K-TCMS score. CONCLUSIONS: Posture control training in the sitting position using a VR training program was found to be more effective in improving the sitting balance and trunk stability of children with CP. Show more

Keywords: Cerebral palsy, posture control training, sitting balance, trunk stability.

DOI: 10.3233/NRE-201642

Citation: NeuroRehabilitation, vol. 48, no. 3, pp. 247-254, 2021

Authors: Su, Chien-Ling | Tam, Ka-Wai | Fang, Tien-Pei | Chiang, Ling-Ling | Chen, Hui-Chin

Article Type: Review Article

Abstract: BACKGROUND: Patients with amyotrophic lateral sclerosis (ALS) develop respiratory failure and progressive muscle weakness. The effects of pulmonary rehabilitation on the lung function of patients with ALS are unclear. OBJECTIVE: Through this meta-analysis of randomized controlled trials (RCTs), we evaluated the effects of pulmonary rehabilitation, such as type of treatment, on patients with ALS and compared the effectiveness of this treatment. METHODS: PubMed, EMBASE, Web of Science, and Cochrane databases were searched until December 2020. The methodological quality of each study was assessed using the updated Cochrane Risk of Bias tool (RoB 2.0). Data were analyzed …using Review Manager version 5.4 (Cochrane Collaboration, Oxford, England), and the meta-analysis was performed in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. RESULTS: Of 2168 articles, 10 trials were reviewed; among these trials, two focused on respiratory training and eight on physical exercise, three of which involved a combination of aerobic and resistance training. Our meta-analysis demonstrated no difference in the ALSFRS-R score and % FVC among patients with ALS. CONCLUSIONS: Respiratory training or physical exercise did not significantly affect the ALSFRS-R score and % FVC of patients with ALS. At 12 months after intervention, the ALSFRS-R score in the physical exercise group was higher than that in the usual care group. Further clinical trials are warranted to develop approaches for improving the lung function of patients with ALS. Show more

Keywords: Rehabilitation, amyotrophic lateral sclerosis, respiratory training, physical exercise

DOI: 10.3233/NRE-210052

Citation: NeuroRehabilitation, vol. 48, no. 3, pp. 255-265, 2021

Authors: Kanegusuku, Hélcio | Correia, Marilia de Almeida | Longano, Paulo | Okamoto, Erika | Piemonte, Maria Elisa Pimentel | Cucato, Gabriel Grizzo | Ritti-Dias, Raphael Mendes

Article Type: Brief Report

Abstract: BACKGROUND: Exercise with self-selected intensity (SSI) has emerged as a new strategy for exercise prescription aiming to increase exercise adherence in Parkinson’s disease (PD). OBJECTIVE: We compared the cardiovascular, perceived exertion and affective responses during traditional aerobic exercise and with SSI in PD. METHODS: Twenty patients with PD performed two aerobic exercise sessions in random order with an interval of at least 72 h between them: Traditional session (cycle ergometer, 25 min, 50 rpm) with imposed intensity (II) (60–80% maximum heart rate [HR]) and SSI: (cycle ergometer, 25 min, 50 rpm) with SSI. The HR (Polar V800 monitor), systolic blood …pressure (auscultatory method), rating of perceived exertion (Borg scale 6–20) and affective responses (feeling scale) were assessed during the exercise at 8th and 18th minute. The Generalized Estimating Equation Model was used for comparison between both sessions (P  < 0.05). RESULTS: The exercise intensity was not significantly different between both exercise sessions (8th minute: II –76.3±1.0 vs. SSI –76.5±1.3 % of maximal HR; 18th minute: II –78.9±0.9 vs. SSI –79.1±1.3 % of maximal HR, p  = 0.93). Blood pressure, perceived exertion and affective responses were also not significantly different between both sessions (P  > 0.05). CONCLUSIONS: Cardiovascular and psychophysiological responses were not different during aerobic exercise performed with II and with SSI in patients with PD. Show more

Keywords: Parkinsonism, cardiovascular system, aerobic exercise, pleasure, adherence

DOI: 10.3233/NRE-201569

Citation: NeuroRehabilitation, vol. 48, no. 3, pp. 267-272, 2021

Authors: Hüche Larsen, Helle | Frisk, Rasmus Feld | Willerslev-Olsen, Maria | Nielsen, Jens Bo

Article Type: Research Article

Abstract: BACKGROUND: Cerebral palsy (CP) is a neurodevelopmental disturbance characterized by impaired control of movement. Function often decreases and 15% of adults are classified as severely affected (Gross Motor Function Classification Scale III-V). Little is known about interventions that aim to improve functional abilities in this population. OBJECTIVE: To evaluate a 12-week intervention based on motor learning principles on functional ability in adults with severe CP. METHODS: 16 adults (36±10 years, GMFCS III-V) were enrolled and divided into an intervention group (Active group) and a standard care group (Control group). Primary outcome measure was Gross Motor Function …Measure (GMFM-88). Secondary measures were neurological status. The Active group were measured at baseline, after the intervention and at one-month follow-up. The Control group were measured at baseline and after one month. RESULTS: Analysis showed statistically significant improvement in GMFM-88 for the Active group from baseline to post assessment compared with the Control group (group difference: 5 points, SE 14.5, p  = 0.008, CI: 1.2 to 8.7). Improvements were maintained at follow-up. Results from the neurological screening showed no clear tendencies. CONCLUSIONS: The study provides support that activities based on motor learning principles may improve gross motor function in adults with severe CP. Show more

Keywords: Motor learning, motor function, neurorehabilitation, rehabilitation, training, neuroplasticity, cerebral palsy

DOI: 10.3233/NRE-201581

Citation: NeuroRehabilitation, vol. 48, no. 3, pp. 273-283, 2021

Authors: Kamel, Roshdy M. | Mehrem, Elsayed S. | Mounir, Samir M. | Essa, Mohamed M. | Fergany, Lamyaa A. | Elbedewy, Mohamed A.

Article Type: Research Article

Abstract: BACKGROUND: Sensorineural hearing loss is the most common type of permanent hearing impairment and results in balance and motor deficits in children which may affect and/or delay all developmental indicators. OBJECTIVE: The purpose of this study was to investigate the consequences of sensorineural hearing loss regarding fine motor skills in children and adolescents. METHODS: Two hundred children with an age range between 7 to 18 years and diagnosed with sensorineural hearing loss were selected from the Public School for the Deaf and Hard of Hearing in El-Minia district, Minia governorate, Egypt. The outcome was assessed by …the use of Bruininks-Oseretsky Test of Motor Proficiency Second Edition scale (BOT-2) to measure fine motor skills. RESULTS: There was a statistically significant difference between the scores of Fine Motor Precision and Fine Motor Integration subtests of each study subgroup and its counterpart subgroup in the control group (normative values according to the scale) which has the same age and gender characteristics where p value equals (0.0008 or less, 0.0009 or less) respectively, with a large effect size less than –0.83. CONCLUSION: The findings of this study suggest that children with sensorineural hearing loss have a defect in their fine motor skills when compared to normal children of the same gender and age groups according to Bruininks-Oseretsky scale. Show more

Keywords: Sensorineural hearing loss, fine motor skills, BOT-2, pediatric

DOI: 10.3233/NRE-201589

Citation: NeuroRehabilitation, vol. 48, no. 3, pp. 285-292, 2021

Authors: Xia, Weili | Bai, Zhongfei | Dai, Rongxia | Zhang, Jiaqi | Lu, Jiani | Niu, Wenxin

Article Type: Review Article

Abstract: BACKGROUND: Peripheral nerve injury can result in both sensory and motor deficits, and these impairments can last for a long period after nerve repair. OBJECTIVE: To systematically review the effects of sensory re-education (SR) on facilitating hand function recovery after peripheral nerve repair. METHODS: This systematic review was limited to articles published from 1970 to 20 December 2020. Electronic searching was performed in CINAHL, Embase, PubMed, Web of Science, and Medline databases to include trials investigating the effects of SR training on hand function recovery after peripheral nerve repair and included only those studies with controlled …comparisons. RESULTS: Sixteen articles were included in final data synthesis. We found that only four studies could be rated as having good quality and noted obvious methodological limitations in the remaining studies. The current evidence showed that early SR with mirror visual feedback and the combinational use of classic SR and topical temporary anesthetic seemed to have long- and short-term effects, respectively on improving the sensibility and reducing the disabilities of the hand. The evidence to support the effects of conventional classical SR on improving hand functions was not strong. CONCLUSIONS: Further well-designed trials are needed to evaluate the effects of different SR techniques on hand function after nerve repair over short- and long-term periods. Show more

Keywords: Hand injury, peripheral nerve injury, nerve repair, sensory reeducation, hand function

DOI: 10.3233/NRE-201612

Citation: NeuroRehabilitation, vol. 48, no. 3, pp. 293-304, 2021

Authors: Gandolfi, Marialuisa | Riello, Marianna | Bellamoli, Veronica | Bombieri, Federica | Geroin, Christian | Di Vico, Ilaria A. | Tinazzi, Michele

Article Type: Research Article

Abstract: BACKGROUND: Rehabilitation has proven effective in improving motor symptoms (i.e., weakness, tremor, gait and balance disorders) in patients with Functional Motor Disorders (FMDs). Its effects on non-motor symptoms (NMSs) such as fatigue, pain, depression, anxiety and alexithymia, have not been explored yet. OBJECTIVE: To explore the effects of a validated inpatient 5-day rehabilitation program, followed by a home-based self-management plan on functional motor symptoms, NMSs, self-rated perception of change, and quality of life (QoL). METHODS: 33 FMD patients were enrolled. Measures for motor symptoms and NMSs were primary outcomes. Secondary outcomes included measures of self-perception of …change and QoL. Patients were evaluated pre-treatment (T0), post-treatment (T1), and 3-month follow-up (T2). RESULTS: There was an overall significant decrease in functional motor symptoms, general, physical, and reduced-activity fatigue (for all, p  < 0.001). Post hoc comparison showed significant improvements at T1, whereas effects remained significant at T2 for motor symptoms and physical fatigue. Gait and balance, alexithymia, and physical functioning (QoL) significantly improved at T2. More than 50% of patients reported marked improvement at T1 and T2. CONCLUSIONS: Our study suggests the benefits of rehabilitation and self-management plan on functional motor symptoms and physical fatigue in the medium-term. More actions are needed for the management of pain and other distressing NMSs in FMDs. Show more

Keywords: Functional motor disorders, fatigue, pain, non-motor symptoms, physiotherapy, rehabilitation

DOI: 10.3233/NRE-201617

Citation: NeuroRehabilitation, vol. 48, no. 3, pp. 305-314, 2021

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

Article Type: Research Article

Abstract: BACKGROUND We have shown elevated levels of p53 and active caspase-3 in the heart with Parkinson disease (PD). The main aim of this study is to examine the effect of treadmill training on the cardiac expression of p53 and active caspase-3 in the mouse with induced Parkinsonism. METHODS: Thirty randomly selected normal albino mice were equally divided into the following 3 groups: sedentary control (SC), sedentary Parkinson diseased (SPD), and exercised Parkinson diseased (EPD). 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and probenecid (MPTP/p) were used to induce chronic Parkinson disease in the SPD and EPD animals. The expression of p53 and active caspase-3 …was investigated, using immunohistochemistry, in the heart in each animal group. RESULTS: Both p53 and active caspase-3 expression was significantly (p value < 0.05) reduced in the PD heart following endurance exercise training. CONCLUSION: Our present data suggest that chronic exercise training reduced PD-induced upregulation of p53 and active caspase-3 in the heart. Thus, our study suggests that inhibiting p53 and/or active caspase-3 may be considered as a therapeutic approach to ameliorate PD cardiomyopathy. Show more

Keywords: Parkinson disease, MPTP, heart, active caspase-3, p53, exercise

DOI: 10.3233/NRE-201650

Citation: NeuroRehabilitation, vol. 48, no. 3, pp. 315-320, 2021

Authors: Franck, Johan Anton | Smeets, Rob Johannes Elise Marie | Elmanowski, Jule | Renders, Karolien | Seelen, Henk Alexander Maria

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVE: Stroke patients with a moderately to severely affected hand may be impeded in exploiting their full arm-hand training potential during rehabilitation due to spasticity. Reducing early signs of spasticity in sub-acute stroke patients may lead to improvements in arm-hand-function and arm-hand-skill-performance. METHODS: Single-case-experimental-design and meta-analysis. Ten sub-acute stroke patients (Modified-Ashworth-Scale:1 + to 3) participated. Training: 2x6 weeks, using a well-described arm-hand regime (therapy-as-usual). Botulinum-toxin was administered once within 5 weeks after onset of therapy-as-usual. Measures: Action-Research-Arm-Test, ABILHAND, Fugl-Meyer-Assessment, grip-strength, Motricity-Index. RESULTS: At group level, after baseline trend correction, adjusting for spontaneous recovery and therapy-as-usual effects, …the added-value of botulinum-toxin-A on arm-hand-function and arm-hand-skill-performance was not confirmed. However, non-detrended data revealed significant improvements over time on arm-hand-function and arm-hand-skill-performance level (p ≤0.037). Conversely, at individual level, after baseline trend correction, 7/10 patients improved on arm-hand-function: Fugl-Meyer-Assessment (N = 4; p ≤0.019), grip-strength (N = 3; p ≤0.014), Motricity-Index (N = 4; p ≤0.002), whereas 6/10 patients improved on arm-hand-skill-performance: Action-Research-Arm-Test (N = 3; p ≤0.042), ABILHAND (N = 5; p ≤0.034). CONCLUSION: Application of botulinum-toxin-A may have an added-value in a substantial part of sub-acute stroke patients suffering from spasticity early post-stroke and who, at the point of therapy admission, display no dexterity. It may improve their arm-hand performance when combined with a well– defined therapy-as-usual. Show more

Keywords: Stroke, spasticity, arm-hand, task-oriented training, motor impairment, motor performance, rehabilitation

DOI: 10.3233/NRE-201622

Citation: NeuroRehabilitation, vol. 48, no. 3, pp. 321-336, 2021

Authors: Lee, Ya-Chen | Chiu, En-Chi

Article Type: Research Article

Abstract: BACKGROUND: Nutritional status could affect functional capacity and reduce quality of life in patients with stroke. Although the associations between nutritional status, basic activities of daily living (BADL)/Instrumental ADL, and quality of life (QOL) in older people have been identified, the relationships have not yet been examined in patients with stroke, using the full Mini Nutritional Assessment (MNA) or MNA-short form (MNA-SF). OBJECTIVE: This study aimed to examine the relationship between nutritional status (using full MNA and MNA-SF), comprehensive ADL function, and QOL in patients with stroke. METHODS: Eighty-two patients with ischemic stroke participated in this …cross-sectional design study. Each participant was assessed with the full MNA, MNA-SF, comprehensive ADL function (including Barthel Index and Frenchay Activities Index), and WHO Quality of Life Questionnaire (WHOQOL-BREF) once. RESULTS: The MNA-SF was only significantly correlated with the comprehensive ADL function (rho = 0.27, p  = 0.013), whereas, the full MNA was found to be significantly correlated with the comprehensive ADL function and WHOQOL-BREF (rho = 0.24, p  = 0.029 and rho = 0.30, p  = 0.005, respectively). The MNA-SF was a significant predictor of comprehensive ADL function, accounting for 44% of the variance. The full MNA was the only significant predictor of the WHOQOL-BREF, explaining 17% of the variance. CONCLUSIONS: This study has revealed a relationship between nutritional status, comprehensive ADL function, and QOL among patients with stroke. Patients with stroke with better nutritional status had higher ADL function as well as better QOL. The MNA-SF was useful in predicting comprehensive ADL, whereas, the full MNA could be used to predict QOL. Knowledge and evidence of the association and predictive power of the MNA-SF and full MNA could guide clinicians to choose tools for assessing the nutritional status of patients with stroke more effectively. Show more

Keywords: Nutritional status, activities of daily living, quality of life, stroke

DOI: 10.3233/NRE-201540

Citation: NeuroRehabilitation, vol. 48, no. 3, pp. 337-343, 2021