NeuroRehabilitation - Volume 51, issue 3

Authors: Ma, Ting-Ting | Zhang, Qi | Zhou, Tian-Tian | Zhang, Yan-Qing | He, Yan | Li, Si-Jia | Liu, Qian-Jin

Article Type: Research Article

Abstract: BACKGROUND: Spinal cord injury (SCI) results in neurological dysfunction of the spinal cord below the injury. OBJECTIVE: To explore the immediate and long-term effects of robotic-assisted gait training (RAGT) on the recovery of motor function and walking ability in children with thoracolumbar incomplete SCI. METHODS: Twenty-one children with thoracolumbar incomplete SCI were randomly divided into the experimental (n  = 11) and control groups (n  = 10). The control group received 60 min of conventional physical therapy, and the experimental group received 30 min of RAGT based on 30 minutes of conventional physical therapy. Changes in walking speed and distance, physiological …cost index (PCI), lower extremity motor score (LEMS), SCI walking index and centre-of-pressure (COP) envelope area score were observed in both groups of children before and after eight weeks of training. The primary outcome measures were the 10-metre walk test (10MWT) and six-minute walk distance (6MWD) at preferred and maximal speeds. In addition, several other measures were assessed, such as postural control and balance, lower limb strength and energy expenditure. RESULTS: Compared with control group, the self-selected walk speed (SWS), maximum walking speed (MWS), 6MWD, PCI, LEMS, COP, and Walking Index for Spinal Cord injury II (WISCI II) of experimental group were improved after treatment. The 6MWD, PCI, COP, and WISCI II after eight weeks of treatment were improved in experimental group. All indicators were not identical at three different time points when compared between two groups. Pairwise comparisons in experimental group suggested that the SWS, MWS, 6MWD, PCI, LEMS, COP, and WISCI II after treatment were higher than those before treatment. The 6MWD, LEMS, COP, and WISCI II after treatment were higher than at the one-month follow-up appointment. The SWS, PCI, LEMS, COP, and WISCI II at the eight-week follow-up appointment were improved. CONCLUSION: Robotic-assisted gait training may significantly improve the immediate motor function and walking ability of children with thoracolumbar incomplete SCI. Show more

Keywords: Robotic-assisted gait training (RAGT), spinal cord injury (SCI), motor function, walking ability

DOI: 10.3233/NRE-220124

Citation: NeuroRehabilitation, vol. 51, no. 3, pp. 499-508, 2022

Authors: Royer, Nicolas | Duboeuf, Marine | Camdessanché, Jean-Philippe | Millet, Guillaume Y.

Article Type: Research Article

Abstract: BACKGROUND: Fatigue is the most prevalent symptom among people with multiple sclerosis (PwMS). Although exercise effectively reduces fatigue, the relationship between daily physical activity and fatigue has only recently been demonstrated. OBJECTIVE: The aim of this study was to evaluate the prevalence of fatigue and to understand the relationship with several variables in French PwMS. METHODS: Data were collected from 191 PwMS using Modified Fatigue Impact Scale (MFIS) and Fatigue Severity Scale (FSS) for fatigue, and the Godin Leisure-Time Exercise Questionnaire (GLTEQ) for physical activity. RESULTS: 110 PwMS (57%), 35 PwMS (18%) and 46 …PwMS (24%) were considered as fatigued, non-fatigued and in the grey zone, respectively. Greater physical activity was observed in non-fatigued PwMS (20.2±19.8) compared to fatigued PwMS (12.5±14.1). FSS and MFIS scores were associated with physical activity (r  = –0.28 and r  = –0.25, respectively, p  < 0.05). Using multivariate analysis, disability, physical activity and being unemployed explained 21% of the variance of the MFIS. CONCLUSIONS: The present study confirms that physical activity and fatigue are associated. Disability and unemployment status should also to be consider when assessing fatigue. Activity-oriented health policies should be redesigned to improve fatigue among PwMS. Show more

Keywords: Fatigue, physical activity, FSS, MFIS, multiple sclerosis, employment, neurological disorder, physical therapy, quality of life

DOI: 10.3233/NRE-220111

Citation: NeuroRehabilitation, vol. 51, no. 3, pp. 509-517, 2022

Authors: Sasaki, Nobuyuki | Sato, Tomoo | Yamatoku, Masato | Yamano, Yoshihisa

Article Type: Research Article

Abstract: BACKGROUND: Human T-cell leukemia virus type 1 (HTLV-1) associated myelopathy (HAM) can damage the spinal cord, causing paraplegia, spasticity, and gait disturbance. Currently, there are few effective treatments. OBJECTIVE: We investigated the efficacy of repetitive transcranial magnetic stimulation (rTMS) on gait disturbance in patients with HAM. METHODS: rTMS at 10 Hz was applied to HAM patients aged 30–80 years with an Osame’s Motor Disability Score between 3 and 6. The stimulation site on the skull was the position where motor evoked potentials were most evidently elicited and leg motor areas were stimulated. Resting motor thresholds (minimum stimulation …to induce motor evoked potential) were also determined. Each participant underwent 10 sessions of 2400 stimuli. Clinical measurements, including walking speed and stride length, were obtained. RESULTS: From 119 patients with HAM recruited, 12 were included in the rTMS group and 18 who did not undergo rTMS comprised the control group. rTMS significantly improved walking speed and stride length compared to controls. Particularly, resting motor thresholds decreased after 10 sessions of rTMS. CONCLUSIONS: rTMS improves walking speed in patients with HAM and may be an effective alternative for treating gait disturbance in patients with HAM. Show more

Keywords: HTLV-1 associated myelopathy, transcranial magnetic stimulation, spastic paraplegia, gait disturbance, rehabilitation

DOI: 10.3233/NRE-220105

Citation: NeuroRehabilitation, vol. 51, no. 3, pp. 519-526, 2022

Authors: Lv, You-Kui | Huang, Li-Ping | Fang, Zhuang-Wei | Wang, Gang | Wang, Li-Kang | Zhou, Ming | Su, Xin-Ling | Ding, Dan-Yang | Wang, Xing-Lin

Article Type: Research Article

Abstract: BACKGROUND: The lesions besides lateral ventricle and motor recovery following rehabilitation have hardly been studied. OBJECTIVE: To explore the relationship between the size, location of infarction beside the lateral ventricle and motor recovery following rehabilitation. METHODS: A prospective cohort of 55 patients submitted to a Rehabilitation Medical Center between January 2015 and June 2019 who suffered a single cerebral infarction beside the lateral ventricle were included in the study. The size and distance between the posterior margin and the frontal-middle line (FML) of the lesion were measured. Follow-up was conducted until the recovery was no longer …progressing. Barthel index and Brunstrom stages were used to evaluate the outcome (full recovery, partial recovery and poor recovery). Variance analysis and nonparametric test were used for the comparison between groups. Multivariate logistic regression analysis was used to screen the factors affecting the outcomes. The Pearson correlation coefficient was used to compare the volume of infarction, behind the FML and the outcomes. RESULTS: Among the 55 patients, the outcome was full recovery (n  = 28), partial recovery (n  = 13) and poor recovery (n  = 14). Multivariate logistic regression analysis showed that volume and location of the infarction were significantly correlated with the outcome (p  = 0.039, 0.050). The lesion volume in the full recovery patients was significantly smaller than that in the poor recovery patients (p  < 0.01). The posterior edge of the lesion in the full recovery patients behind the FML was statistically significant compared with that in the poor recovery patients (p  < 0.01). Spearman correlation analysis showed that the motor recovery was negative correlation to lesion volume (r = –0.508, P  < 0.01) and location (r = –0.450, P  < 0.01) of the infarction. CONCLUSION: The motor recovery of patients with cerebral infarction beside lateral ventricle is related to the volume and location of the lesion. The larger the volume of the lesion, and the farther the posterior margin of the lesion to the FML, the worse the motor recovery. Show more

Keywords: Cerebral infarction, motor recovery, prognosis, brain injury

DOI: 10.3233/NRE-220132

Citation: NeuroRehabilitation, vol. 51, no. 3, pp. 527-532, 2022

Authors: Kiekens, Carlotte | Tognonato, Carlo

Article Type: Other

Abstract: BACKGROUND: Dysphagia is a common impairment in patients with acute stroke and is associated with an increased risk of complications such as aspiration pneumonia, malnutrition and dehydration, as well as with poor outcome and higher mortality. Therefore, immediate screening for aspiration risk is recommended, using a bedside swallow screening tool. OBJECTIVE: To determine the diagnostic accuracy and the sensitivity and specificity of bedside screening tests for detecting risk of aspiration associated with dysphagia in people with acute stroke. METHODS: A summary of the Cochrane Review by Boaden et al. 2021, with comments from a rehabilitation perspective. …RESULTS: The review included 25 studies with 3953 participants and 37 screening tests. No single study demonstrated 100% sensitivity and specificity with low risk of bias for all domains. The best performing swallow screening tools were the Bedside Aspiration test (combined water swallow and instrumental tool), the Gugging Swallowing Screen (GUSS, water plus other consistencies) and the Toronto Bedside Swallowing Screening Test (TOR-BSST, water only). However, these tests were based on single studies with small sample sizes. It was not possible to explore the influence of sources of heterogeneity. CONCLUSIONS: No single swallow screening tool with high accuracy as well as good quality evidence could be identified, but recommendations for further high-quality research are offered. Show more

Keywords: Deglutition disorders, respiratory aspiration, stroke, diagnosis, systematic review

DOI: 10.3233/NRE-228024

Citation: NeuroRehabilitation, vol. 51, no. 3, pp. 533-535, 2022