NeuroRehabilitation - Volume 18, issue 1

Authors: Dayle, Randy

Article Type: Editorial

DOI: 10.3233/NRE-2003-18101

Citation: NeuroRehabilitation, vol. 18, no. 1, pp. 1-2, 2003

Authors: Wilson, Barbara A. | Scott, Helena | Evans, Jonathan | Emslie, Hazel

Article Type: Research Article

Abstract: NeuroPage, a paging service designed to reduce the everyday memory and/or planning problems of people with neurological deficits, is described. Following several research studies carried out to evaluate the system, a British local health authority set up a nationwide commercial NeuroPage service. A report on the first 40 clients recruited to the service is provided. The age range was 14–81 years, the majority of clients were men and the most frequent diagnosis was traumatic brain injury although a number of different diagnostic groups were represented. The types of messages sent and the group's satisfaction with NeuroPage are considered. Three brief …case studies to illustrate the different ways clients used the system are presented. Show more

Keywords: memory, brain injury, rehabilitation, external aids

DOI: 10.3233/NRE-2003-18102

Citation: NeuroRehabilitation, vol. 18, no. 1, pp. 3-8, 2003

Authors: O'Connell, Megan E. | Mateer, Catherine A. | Kerns, Kimberly A.

Article Type: Research Article

Abstract: In this paper we address the practical considerations for rehabilitation of problems with initiation. A variety of rehabilitation strategies for clients who have problems with initiation are discussed, as are our recommendations for the use of an external cueing system with these clients. Available external cueing systems are reviewed, including those that have been shown to be effective for prospective memory deficits. We identify important factors involved in selecting a particular external cueing device, and we provide guidelines for training to both respond to and program external cues. Finally, we discuss ways to monitor the efficacy of rehabilitation of problems …with initiation. Throughout we provide an illustrative case example describing implementation of an external cueing system with a client who has difficulties with initiation, other aspects of executive function, and anterograde amnesia. Show more

Keywords: initiation, executive function, rehabilitation, cognitive prosthetics

DOI: 10.3233/NRE-2003-18103

Citation: NeuroRehabilitation, vol. 18, no. 1, pp. 9-20, 2003

Authors: Man, D.W.K. | Tam, S.F. | Hui-Chan, C.W.Y.

Article Type: Research Article

Abstract: Expert systems (ES), which are a branch of artificial intelligence, has been widely used in different applications, including medical consultation and more recently in rehabilitation for assessment and intervention. The development and validation of an expert system for memory rehabilitation (ES-MR) is reported here. Through a web-based platform, ES-MR can provide experts with better decision making in providing intervention for persons with brain injuries, stroke, and dementia. The application and possible commercial production of a simultaneously developed version for “non-expert” users is proposed. This is especially useful for providing remote assistance to persons with permanent memory impairment when they reach …a plateau of cognitive training and demand a prosthetic system to enhance memory for day-to-day independence. The potential use of ES-MR as a cognitive aid in conjunction with WAP mobile phones, Bluetooth technology, and Personal Digital Assistants (PDAs) is suggested as an avenue for future study. Show more

Keywords: expert systems, memory, rehabilitation, independence, non-expert users

DOI: 10.3233/NRE-2003-18104

Citation: NeuroRehabilitation, vol. 18, no. 1, pp. 21-29, 2003

Authors: Bergman, Marilyn M.

Article Type: Research Article

Abstract: A multifunction cognitive orthotic system is designed to assist people with cognitive disorders in the performance of ecologically relevant activities. This personal computer-based compensatory approach applies neuroscience and technology to the rehabilitation needs and challenges of people with chronic brain damage. The primary goal of this approach is the independent accomplishment of practical, applied tasks integral to daily living, at home, at work, at school and in the community. This paper will describe the “Essential Steps” cognitive orthotic system, and describe its potential to facilitate skill acquisition and enhance self-sufficient life management. The software was designed to guide …and protect the user as he or she progresses through each “essential step” in the progression required for completion of a targeted task. The discussion will explicate the underlying principles promoting skill acquisition with this application of a cognitive orthotic. Data have shown that this compensatory aid can promote rapid skill acquisition and support reliable performance, even long past the time when rapid recovery and progress are customarily expected. Discussion will focus on issues of design for people with brain damage, the significance of this system's prototypical structure, and research findings and clinical observations made with people using “Essential Steps”. Show more

Keywords: cognitive orthotic, assistive technology, compensatory, computers, brain injury rehabilitation

DOI: 10.3233/NRE-2003-18105

Citation: NeuroRehabilitation, vol. 18, no. 1, pp. 31-46, 2003

Authors: Prigatano, George P. | Kime, Susan

Article Type: Research Article

Abstract: Twenty five (25) out of 29 patients (86%) with unequivocal memorydisorders who received Memory Compensation Training (MCT) completed both a brief survey regarding their use of memory compensations and the Memory Compensation Questionnaire. Twenty-two (22) of the 25 patients (88%) reported daily use of memory compensation several months to years after the onset of their memory problems. The benefits included, by their report, being more productive, less disorganized, and less confused. Patients with memory disorders, who received MCT, also reported more frequent use of compensations than older normal adults studied by Dixon et al. [6]. The present sample of patients …report proportionally spending more time to remember and greater reliance on those around them to help them to remember. The findings suggest that patients who are taught memory compensations tend to use them after the training period and show a different pattern of compensatory activities compared to normal older adults. Show more

Keywords: memory disorder, Memory Compensation Training, subjective reports, use and benefits of compensations

DOI: 10.3233/NRE-2003-18106

Citation: NeuroRehabilitation, vol. 18, no. 1, pp. 47-55, 2003

Authors: Gorman, Patrick | Dayle, Randy | Hood, Carrie-Ann | Rumrell, Linda

Article Type: Research Article

Abstract: Cognitive rehabilitation has the capacity to empower persons with brain-injuries and help them achieve heightened functional, personal, and social interactions within their environments. Interventions aimed at compensation for deficits and adaptation to cognitive disability can be aided through the use of assistive technology devices (ATD's). ATDs allow for their users to experience greater levels of independence, as well as social and vocational participation, which leads to a higher quality of life. The ISAAC system is a small, individualized, wearable cognitive prosthetic assistive technology system. Being fully individualized and very easy to use makes this system adaptable to, and appropriate for, …patients with a wide variety of cognitive disabilities ranging from individuals with developmental disabilities to high functioning survivors of brain injury. The current article will discuss two cases that illustrate the effectiveness of the ISAAC system in assisting patients with generalization of rehabilitation to their home environments. Both patients incurred significant cognitive impairment, for which they were able to successfully compensate with the assistance of their ISAAC systems. These two case studies are typical examples of the functional independence that can be achieved through the use of the ISAAC system. When patients are properly selected for use of this system, appropriate content is authored, and sufficient training on the system is provided, the ISAAC system can prove very effective at improving patients' functional independence. Show more

Keywords: brain injury, cognitive rehabilitation, assistive technology devices, cognitive prosthetic devices

DOI: 10.3233/NRE-2003-18107

Citation: NeuroRehabilitation, vol. 18, no. 1, pp. 57-67, 2003

Authors: Struppler, A. | Havel, P. | Müller-Barna, P.

Article Type: Research Article

Abstract: A new therapeutic method for the rehabilitation of central paresis of the upper extremity, especially of fine skilled finger movements, is presented. The therapeutic concept is the activation of reorganization processes in the CNS. These processes are elicited by the induction of proprioceptive input to the CNS which corresponds physiologically to the lost input during active movements. The input is generated by repetitive peripheral magnetic stimulation (RPMS) at the innervation zone of the paretic muscles. The stimulation leads to a motion of the activated muscles. The proprioceptive input is generated by two mechanisms: adequately by activation of mechanoreceptors of the …stimulated muscles during the induced contractions and relaxations and inadequately by direct activation of the involved sensorimotor afferents. The method has been applied to 52 patients suffering from spastic paresis of the upper extremity. A simple clinical quantification using the Ashworth scale revealed that spasticity could be remarkably (1–2 points) reduced already by one session of RPMS lasting 15 minutes. In order to get an objective insight into the improvement of active motor performances, a neurophysiological investigation of active finger extensions was performed in eight patients suffering from a central hemiparesis. Following RPMS of the paretic finger extensors, the patients could perform rapid finger extensions with larger displacement and velocity at diminished amounts of EMG activity. Show more

Keywords: cerebral palsy, hemiplegia, muscle spasticity, therapeutics, repetitive peripheral magnetic stimulation, neuronal reorganization, motor learning

DOI: 10.3233/NRE-2003-18108

Citation: NeuroRehabilitation, vol. 18, no. 1, pp. 69-82, 2003

Authors: McKinley, William | Cifu, David | Seel, Ronald | Huang, Mark | Kreutzer, Jeffrey | Drake, David | Meade, Michelle

Article Type: Research Article

Abstract: Etiology and level of injury often discriminate between age groups for persons with spinal cord injury, complicating the understanding of what role age actually has on outcomes. The age of the patient is sometimes used as a factor in determining the appropriateness of a referral to inpatient rehabilitation. When role of age is unclear or misunderstood, though, the referral and admission decision is subject to discrimination and ageism. This paper presents information that may assist in making more appropriate decisions. By reviewing the results of four studies examining the role of age-at-injury on the outcomes of persons with spinal cord …injury, including such factors of functional improvement and discharge disposition, the overall effects of age can better be understood and more appropriate conclusions drawn. Show more

Keywords: spinal cord injury, age, outcome, rehabilitation

DOI: 10.3233/NRE-2003-18109

Citation: NeuroRehabilitation, vol. 18, no. 1, pp. 83-90, 2003