NeuroRehabilitation - Volume 14, issue 3

Authors: Marwitz, Jennifer H.

Article Type: Introduction

DOI: 10.3233/NRE-2000-14301

Citation: NeuroRehabilitation, vol. 14, no. 3, pp. 125-125, 2000

Authors: Benrud-Larson, Lisa M. | Wegener, Stephen T.

Article Type: Research Article

Abstract: Extensive data document the adverse impact chronic pain can have on physical and psychosocial functioning. However, only recently has chronic pain received attention as a secondary complication in neurorehabilitation populations such as spinal cord injury, multiple sclerosis, and cerebral palsy. It is not unreasonable to expect that chronic pain might exacerbate impairments already present due to a chronic, disabling condition. The current paper reviews what is known about the prevalence, severity, and psychosocial impact of chronic pain in neurorehabilitation populations. Although there is variation among different conditions, available data suggest that considerable proportions of these patient populations experience chronic pain …and associated sequelae similar to that reported in the extant chronic pain literature (e.g., psychological distress). Research needs to continue investigating the impact of chronic pain in neurorehabilitation populations and work toward development of effective interventions to manage pain and disability in these patients. It is likely that effective pain management will lead to more effective rehabilitation and improved quality of life. Show more

Keywords: chronic pain, neurological disability, rehabilitation

DOI: 10.3233/NRE-2000-14302

Citation: NeuroRehabilitation, vol. 14, no. 3, pp. 127-137, 2000

Authors: Bailey, Maggie J. | Riddoch, M. Jane | Crome, Peter

Article Type: Research Article

Abstract: Hemineglect is not a single entity, and the syndrome has a number of sensory and motor manifestations. The purpose of this study was a) to measure performance of healthy elderly subjects on a battery of validated tests for hemineglect in order to establish appropriate cut-off scores and b) to assess performance of a large sample of elderly stroke patients in a rehabilitation unit, using the same battery. Tests were selected to identify rate of occurrence of hemineglect in visuo-spatial, representational, pre-motor and personal modalities. The battery was administered to 107 patients with right or left sided brain damage and 43 …age-matched controls. Results showed that 39.2% right-sided brain damage), were ‘neglecters’, scoring below cut-off in one or more tests. Star Cancellation and Line Bisection showed the highest relative sensitivity for visuo-spatial neglect (76.4%) ‘Baking Tray Task’, the ‘Exploratory Motor Task’, and utilisation of common objects test for personal neglect are additionally suggested for use in the clinical situation. ‘Copying a Daisy’ and clock-drawing are not recommended due to low sensitivity and subjectivity in scoring respectively. Show more

Keywords: hemineglect/neglect, stroke, elderly, directional hypokinesia, tests

DOI: 10.3233/NRE-2000-14303

Citation: NeuroRehabilitation, vol. 14, no. 3, pp. 139-150, 2000

Authors: Kolakowsky-Hayner, Stephanie A. | Kreutzer, Jeffrey S. | Miner, K. Dawn

Article Type: Research Article

Abstract: Traumatic brain injury is a leading cause of death and disability in the United States. Limited access to specialized medical and rehabilitation services has been linked to poor outcomes. Literature provides little guidance for assessment of service obstacles and satisfaction with community resources. The present investigation describes the development of a specialized scale to evaluate caregivers’ perceptions of brain injury services in the community. Results indicate good internal consistency and criterion-related validity of the Service Obstacles Scale. Lack of money for services and lack of adequate community resources were the greatest concerns voiced by respondents, while lack of transportation was …the least problematic. Comparisons are made with regard to family needs and respondents’ post-injury life quality. Implications for future research are discussed. Show more

Keywords: service obstacles, traumatic brain injury, family needs, life quality

DOI: 10.3233/NRE-2000-14304

Citation: NeuroRehabilitation, vol. 14, no. 3, pp. 151-158, 2000

Authors: Kollen, Boudewijn J. | Rietberg, Marc B. | Kwakkel, Gert | Emmelot, Cornelis H.

Article Type: Research Article

Abstract: The objective of this pilot study was to investigate the carry-over effects on comfortable walking speed after overloading the lower hemiparetic extremity in chronic stroke patients. A single subject research study was conducted using a withdrawal design (A-B-A-B-A) on three patients with ischaemic middle cerebral artery infarction. Chronic stroke patients were recruited with stage 3 or 4 Fugl-Meyer scores in the lower extremity and the ability to ambulate independently without walking aids. Based on this withdrawal design, the daily procedure included walking at comfortable speeds 5 × 10 meters during the A1 phase and 3 × 10 meters during …all subsequent phases. This procedure was repeated for five consecutive days. Two lbs (B1 ) and 6 lbs (B2 ) weight cuffs were attached to the distal lower hemiparetic extremity and randomized over the two B phases. Control (A1 , A2 , A3 ) and intervention (B1 , B2 ) phases were alternated with brief resting periods. Mean comfortable walking speed for 10 meters constituted the outcome variable. All patients showed significant differences between phases (χ 2 = 34.187 ; p < 0.001 ). However, with the exception of a carry-over effect between the A1 (0.86 m/sec) and A2 (0.89 m/sec) phases in one subject (p = 0.043 ) no significant carry-over effects were found on ensuing A2 and A3 control phases. Although gradual improvements in comfortable walking speed between subsequent days were found the present pilot study did not demonstrate favorable group effects on comfortable walking speed as a result of limb overloading. Show more

Keywords: hemiplegia, stroke rehabilitation, overloading, weights, physical therapy

DOI: 10.3233/NRE-2000-14305

Citation: NeuroRehabilitation, vol. 14, no. 3, pp. 159-164, 2000

Authors: Toole, T. | Hirsch, M.A. | Forkink, A. | Lehman, D.A. | Maitland, C.G.

Article Type: Research Article

Abstract: The purpose of this study was to determine if a balance and strength training program could improve equilibrium and strength in persons with stage I-III Parkinsonism. Subjects were pre-tested on strength and balance (EquiTest) and randomized into either a treatment or a control group. The treatment subjects participated in 10 weeks of lower limb strength training and balance exercises designed to challenge a stable posture and increase limits of stability. Both groups were then posttested on balance, knee flexion, knee extension, and ankle inversion strength. Subjects who received strength and balance training demonstrated significantly improved equilibrium and modest gains …in knee flexion and extension strength, while the control group showed no improvement in conditions of destabilizing balance environments and significant declines in strength. Results indicate that 10 weeks of balance and strength training lead to improved equilibrium by producing positive changes in two different control mechanisms. One, training altered the ability to control the motor system when vestibular cues had to be the primary source of reliable feedback; and two, training helped subjects to override faulty proprioceptive feedback and utilize reliable visual or vestibular cues. Show more

Keywords: falls, Parkinsonism, rehabilitation

DOI: 10.3233/NRE-2000-14306

Citation: NeuroRehabilitation, vol. 14, no. 3, pp. 165-174, 2000