NeuroRehabilitation - Volume 48, issue 4

Authors: da Rosa Pinheiro, Douglas Rafael | Cabeleira, Maria Eduarda Parcianello | da Campo, Luigi Antonio | Gattino, Laís Andrielli Ferreira | de Souza, Kellen Sábio | dos Santos Burg, Laura | Gamarra Blauth, Ariane Haydeé Estrada | Corrêa, Philipe Souza | Cechetti, Fernanda

Article Type: Research Article

Abstract: BACKGROUND: Studies demonstrate the benefits of upper limbs cycle ergometer (ULCE) in subacute and chronic stroke subjects, but the literature still needs to explore the acute phase of the disease. OBJECTIVE: Verify the effects of ULCE on muscular strength, trunk control and independence of post-stroke subjects in hospital acute phase. METHODS: In this randomized clinical trial participants were allocated into two groups. The control group (CG) performed two daily sessions of conventional physiotherapy, while the intervention group (IG) had one daily session of conventional physiotherapy and one of ULCE. The interventions were carried out for 20 …minutes for five days. Both groups were assessed before and after the treatment for upper limbs strength by manual dynamometer, trunk control by Trunk Impairment Scale and level of independence by the Modified Rankin Scale. RESULTS: Twenty subjects with mean ages of 63.5±4.5 were enrolled. There was a significant intra-group difference of palmar grip, shoulder abductors, elbow flexor and wrist extensor strength, trunk control and functional independence only in IG. Inter-group difference for all variables showed superiority in IG. CONCLUSIONS: ULCE is an effective device for increasing muscle strength, trunk control and consequently improving the independence of post-stroke subjects in the acute hospital phase. Show more

Keywords: Ergometry, exercise therapy, hospitalization, stroke, stroke rehabilitation, upper extremity

DOI: 10.3233/NRE-210022

Citation: NeuroRehabilitation, vol. 48, no. 4, pp. 533-542, 2021

Authors: Bondi, Moshe | Engel-Haber, Einat | Wolff, Julie | Grosman-Rimon, Liza | Bloch, Ayala | Zeilig, Gabi

Article Type: Research Article

Abstract: BACKGROUND: Treatment with either Intravenous immunoglobulin (IVIg) or plasma exchange (PE) in patients with Guillain-Barré Syndrome (GBS) showed equivalent efficacy as attested by a commonly used disability scale. However, it has been suggested that this scale may not be sensitive enough to detect subtle functional changes between the two treatments since it mainly focuses on walking capability and respiratory function. OBJECTIVE: To evaluate functional outcomes following treatment with IVIg or PE using comprehensive scales that incorporate parameters of basic activities of daily living. METHODS: A retrospective cohort study was conducted between 2007 and 2013 in an …inpatient neurologic rehabilitation department. The study group included 70 individuals with GBS: 39 were treated with PE and 31 with IVIg. A comparison of functional outcomes was performed using Functional Independence Measure (FIM), rehabilitation efficiency (REy), rehabilitation effectiveness (REs), and the GBS disability scale (GDS). RESULTS: Both treatments had a comparable effect on the various functional outcomes. Patients showed a significant increase in total FIM scores (30 points on average) during rehabilitation mainly as a result of an increase in motor sub-scores. A mean improvement of 1.23 (SD 0.9) in GDS was also observed. On average, individuals with GBS spent 20 days combined in the acute departments and 61 days in the rehabilitation department, with length of stay being similar for both treatments. CONCLUSIONS: IVIg and PE treatments have similar basic activities of daily living (ADL) functional outcomes. Nevertheless, due to the different mechanism of actions of these treatments and the multitude of GBS variants, it is possible that further comprehensive assessment tools may demonstrate differences in activity and participation of individuals with GBS. Show more

Keywords: Guillain-Barré syndrome, outcome assessment, rehabilitation, intravenous, immunoglobulins, plasma exchange

DOI: 10.3233/NRE-201640

Citation: NeuroRehabilitation, vol. 48, no. 4, pp. 543-551, 2021

Authors: Bian, Xiaoyi | Wang, Yuanli | Zhao, Xiaohu | Zhang, Zhihua | Ding, Chengbiao

Article Type: Research Article

Abstract: BACKGROUND: Studies have shown that music therapy can improve a variety of symptoms of patients with dementia. The impact of music therapy on the global cognition of patients with dementia is controversial now. OBJECTIVE: To explore whether music therapy has an effect on the global cognitive function of patients with dementia. METHODS: PubMed, Web of Science, Embase, Google Academy and National Knowledge Infrastructure were systematically searched to collect all literature studies published since the establishment of the database until November 2020. All randomized controlled trials that met the criteria of music therapy in the intervention group …and standard care in the control group with outcome measures of Mini-mental State Examination (MMSE) were included. Analysis was performed using Stata 16.0. RESULTS: The results showed that compared with the control group, the MMSE score in the music therapy group was generally higher (MD = 0.86, 95% CI: 0.07–1.66, P  = 0.03). CONCLUSIONS: The result of this study differs from those of previous relevant meta-analyses, suggesting that music therapy is likely to improve the global cognitive function of patients with dementia, but more rigorous clinical trials are still needed to provide more sufficient and real evidence. Show more

Keywords: Music therapy, dementia, Alzheimer’s disease, cognitive function, meta-analysis

DOI: 10.3233/NRE-210018

Citation: NeuroRehabilitation, vol. 48, no. 4, pp. 553-562, 2021

Authors: Carrasco, Aline Cristina | Silva, Mariana Felipe | Dela Bela, Laís Faganello | Paixão, Luana | Pelegrinelli, Alexandre Roberto Marcondes | Dias, Josilainne Marcelino | Kawano, Marcio Massao | Facci, Ligia Maria | Cardoso, Jefferson Rosa

Article Type: Case Report

Abstract: BACKGROUND: Aquatic exercises are among the treatments available to improve the quality of life after stroke. OBJECTIVES: To investigate changes in the quality of life after 8-week of aquatic exercises in post-stroke individuals. METHODS: A case series study was designed, including four male participants. Exclusive aquatic exercise was performed for 8-week, 50 minutes per session, 2×/week. Their quality of life was evaluated before and after the intervention using the Stroke Impact Scale (SIS). RESULTS: Participant 1 improved in the mobility domain, achieving a Clinically Important Difference (CID). Participant 2 improved in the strength and …mobility domain, achieving CID; his stroke recovery was 6%, and it reached 50% post-intervention. Participant 3 improved in the mobility domain, achieving a CID and a Minimal Detectable Change (MDC); his stroke recovery increased from 45 to 60% post-intervention. Participant 4 improved the strength, mobility, and activities of daily living domains, achieving a CID and a MDC, but his stroke recovery remained unchanged at 80%. CONCLUSIONS: All participants achieved a CID in the mobility domain; thus, the aquatic exercise intervention was considered meaningful. Moreover, the SIS is able to evaluate aspects of the recovery process regarding health-related quality of life after stroke, as demonstrated by the results of the overall recovery after aquatic exercises. Show more

Keywords: Case report, stroke, aquatic exercises, hydrotherapy, quality of life

DOI: 10.3233/NRE-210008

Citation: NeuroRehabilitation, vol. 48, no. 4, pp. 563-570, 2021

Authors: Gimigliano, Francesca

Article Type: Other

Abstract: BACKGROUND: Familial amyloid polyneuropathies (FAPs) are a group of rare autosomal dominant transmitted disorders that can progressively lead to disability from neuropathy, autonomic failure and other system involvement. OBJECTIVE: The aim of this commentary is to discuss Cochrane evidence on the efficacy and safety of disease-modifying drugs (DMDs) for the treatment of FAPs from a rehabilitation perspective. METHODS: To summarize and discuss from a rehabilitation perspective the published Cochrane Review “Pharmacological treatment for familial amyloid polyneuropathy” by Magrinelli et al. RESULTS: This Cochrane review included 4 randomized controlled trials (RCTs) involving 655 adults with …FAP. These four trials compared four different DMDs with placebo. The Cochrane Systematic Review reported that current evidence is limited. CONCLUSIONS: FAPs are a group of chronic disabling conditions in which a multidisciplinary approach, including an adequate rehabilitation programme along with a long-term effective pharmacological therapy, should always be envisaged. Show more

Keywords: Familial amyloid polyneuropathies, disease-modifying drugs, rehabilitation, disability

DOI: 10.3233/NRE-218002

Citation: NeuroRehabilitation, vol. 48, no. 4, pp. 571-573, 2021