NeuroRehabilitation - Volume 32, issue 1

Authors: Katusic, Ana | Alimovic, Sonja | Mejaski-Bosnjak, Vlatka

Article Type: Research Article

Abstract: As the motor system relies heavily on deep sensory stimulation, recent studies have investigated the effect of vibration stimuli. Although research suggests a positive influence of vibration on motor performance in individuals with neurological disorders, there are very limited numbers of studies in children with cerebral palsy (CP). The objective of the present study was to evaluate the effects of sound wave vibration therapy on spasticity and motor function in children with CP. In this 3-month trial, 89 children with spastic CP were randomized to either continue their physiotherapy treatment (PT) or to receive vibration therapy twice …a week in addition to their PT program. The randomization was stratified according to the Gross Motor Function Classification System (GMFCS) level to ensure similar functional ability. Children were assessed at baseline and after the 12-week intervention period. The outcomes measured were spasticity level as assessed by Modified Modified Ashworth Scale (MMAS) and gross motor function as assessed by Gross Motor Function Measurement (GMFM-88). Subgroup analysis was performed for the GMFCS. Significant differences between groups were detected for changes in spasticity level and gross motor function after the three months intervention. In conclusion, vibration therapy may decrease spasticity and improve motor performance in children with CP. The results of the present trial serve as valuable input for evidence-based treatments in paediatric neurorehabilitation. Show more

Keywords: Vibration therapy, cerebral palsy, spasticity, motor function

DOI: 10.3233/NRE-130817

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 1-8, 2013

Authors: Kumban, Wannisa | Amatachaya, Sugalya | Emasithi, Alongkot | Siritaratiwat, Wantana

Article Type: Research Article

Abstract: Background/Purpose: Five-times-sit-to-stand test (FTSST) is a reliable tool for measuring lower limb functional strength and balance ability. However, reports of the reliability of FTSST in children with cerebral palsy have been scarce. The purposes of this study were (1) to investigate the test-retest and inter-rater reliability of the FTSST and (2) to investigate the correlation between the FTSST and standard functional balance tests in children with cerebral palsy. Study Design: Cross-sectional study. Materials and Methods: Thirty-three school children aged from 6 to 18 years with Gross motor functional classification system expanded and revised version (GMFCS-E&R) level …I to III were recruited. Reliability of the FTSST and concurrent validity between FTSST and Timed up and go test (TUG) and Berg balance scale (BBS) were determined using the Pearson product moment correlation. Results: The intra-class correlation coefficient (ICC) for test-retest and inter-rater reliability of FTSST were 0.91 and 0.88 respectively. FTSST showed moderate correlation with TUG (r = 0.552, P < 0.01) and with BBS (r = −0.561, P < 0.01). Conclusion: FTSST is a reliable assessment tool and correlates with functional balance ability tests in children with mild to moderate cerebral palsy. Show more

Keywords: Cerebral palsy, five-times-sit-to-stand test, timed up and go, Berg balance scale

DOI: 10.3233/NRE-130818

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 9-15, 2013

Authors: Lee, Nam Gi | Jeong, Su Ji | You, Joshua (Sung) Hyun | Cho, Kang Hee | Lee, Tae Heon

Article Type: Research Article

Abstract: Purpose: The purpose of this study was to investigate the effects of the progressive walking-to-running technique (PWRT) in a child with spastic diplegic cerebral palsy (CP). Design: A single case study with pre-/post-test. Subject: An 11-year-old male, diagnosed with spastic diplegic CP. Methods: The PWRT was provided for 60 minutes a day, 2 times a week for 12 weeks. Gross motor function tests, ultrasound imaging, hand-held dynamometer, and the Vicon motion capture system were used to determine motor function, muscle size and strength, and gait kinematics. Results: Gross motor function was improved …after the intervention. The size of right and left rectus femoris and tibialis anterior muscles in their contracted states were enhanced by 1.36, 5.09, 83.74, and 54.37%, respectively. Associated muscle strength was also increased by 58.8, 30.8, 28.0, and 118.2% in both rectus femoris and tibialis anterior muscles. Left stride length, walking speed, maximal flexion-extension angular excursion of the hip joint were enhanced by 95.7, 87.8, and 100.4% after PWRT, respectively. Conclusions: Our novel walking-running training paradigm was effective for restoring gait and running ability in a child with spastic diplegic CP. Show more

Keywords: Cerebral palsy, cross-sectional area, gait, gross motor function, running

DOI: 10.3233/NRE-130819

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 17-26, 2013

Authors: Kwon, Hyeok Gyu | Choi, Byung Yeon | Chang, Chul Hoon | Kim, Seong Ho | Jung, Young Jin | Jang, Sung Ho

Article Type: Research Article

Abstract: Most of the motor recovery in stroke occurs within 3 months after stroke onset and this period has been regarded as critical for motor recovery. Little is known about the motor recovery process during the critical period of stroke. We report on a patient with intracerebral hemorrhage (ICH) who showed recovery of an injured corticospinal tract (CST) during the critical period for motor recovery. A 43-year-old woman underwent conservative management for a spontaneous ICH in the right corona radiata and basal ganglia. She presented with complete left hemiplegia at the onset of ICH. She showed continuous and slow recovery, and …consequently, she was able to flex her left fingers without gravity at 6 weeks after onset and extend the left fingers without gravity at 12 weeks. The 3- and 6-week DTTs showed that the right CST was discontinued around the hematoma. However, the 12-week DTT revealed that the right CST was originated from the right primary motor cortex and descended along the CST pathway. No motor evoked potential (MEP) was evoked from the right hemisphere on the 3- and 6-week TMS study. However, on the 12-week TMS study, an MEP which had the characteristics of the CST was evoked from the right hemisphere to the left abductor pollicis brevis muscle. Our results indicate that the injured right CST had been recovered between 6 weeks and 12 weeks after ICH onset. Consequently, we believe that this case demonstrated the recovery process of a severely injured CST during the critical period for motor recovery after ICH. Show more

Keywords: Diffusion tensor imaging, brain plasticity, stroke, corticospinal tract, rehabilitation

DOI: 10.3233/NRE-130820

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 27-32, 2013

Authors: Tsai, Pei-Luen | Chen, Mei-Ching | Huang, Yu-Ting | Lin, Keh-Chung

Article Type: Research Article

Abstract: Recent studies suggest that the positive emotion induced by pleasant music may improve cognitive functions. We used the single-subject design to study whether listening to preferred music may reduce unilateral neglect in two participants with post-stroke neglect. These participants were instructed to listen to their preferred music every day for 5 weeks, followed by 2 weeks of follow-up assessment. Outcome measures involved the Star Cancellation Test, the Line Bisection Test, and the visual exploration task. A combination of visual analysis and the two-standard-deviation band method was used for data analysis. Both participants showed significant intervention-related improvements on all outcome measures …except the Line Bisection Test, on which one participant showed no improvement. The therapeutic effects were maintained during the follow-up phase. The findings suggest that positive emotion, evoked by preferred music, may be used to ameliorate unilateral neglect. Further research using controlled trials is warranted to validate the findings. Show more

Keywords: Neglect, music, attention, stroke, rehabilitation

DOI: 10.3233/NRE-130821

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 33-42, 2013

Authors: Leifert-Fiebach, Gundhild | Welfringer, Anouk | Babinsky, Ralf | Brandt, Tobias

Article Type: Research Article

Abstract: Introduction: Only few studies have investigated the effects of motor imagery training (MIT) on neglect symptoms. Objective: To investigate the imagery ability of patients with visuospatial neglect and the behavioral effects of MIT on neglect symptoms. Methods: In an intense four-week course 10 patients with chronic visuospatial neglect symptoms resulting from right-hemisphere lesions practiced MIT by mentally envisaging positions and movements of the contralesional upper limb. Visual and kinesthetic MIT abilities as well as neglect-related disability were evaluated prior to and following therapy. Neglect symptoms were as well assessed at three-month follow-up. Results: Results …suggest that (i) the ability to perform motor imagery is principally retained in patients with neglect and even patients that are seemingly incapable of motor imagery are able to relearn imagined activation via an individualized training approach. Furthermore, imagined activation of the left arm (ii) significantly reduces the severity of neglect in exploration, (iii) enhances temporal and spatial orientation, and (iiii) significantly improves the kinesthetic motor-imagery capacity and ability. These improvements were stable over a three-month period, indicating long-term training effects. Conclusion: Our data suggest that active kinesthetic-motor imagery is a feasible and effective training method for patients suffering from chronic visuospatial neglect symptoms. Show more

Keywords: Neglect rehabilitation, motor imagery training, visuospatial training, spatial neglect, right-hemispheric brain lesion, stroke

DOI: 10.3233/NRE-130822

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 43-58, 2013

Authors: Kieffer-Kristensen, Rikke | Siersma, Volkert D. | Teasdale, Thomas W.

Article Type: Research Article

Abstract: Objectives: To relate illness related to and family factors to emotional and behavioural problems in school-age children (7–14 years old) of parents with acquired brain injury and their healthy spouses. Participants, Materials/Methods: Members of 35 families in which a parent had been diagnosed with acquired brain injury participated. Family and brain injury characteristics were reported by the ill and healthy parents. Children self-reported post-traumatic stress symptoms (PSS) using the Child Impact of Events revised (CRIES). Emotional and behavioural problems among the children were also identified by the parents using the Achenbach’s Child Behaviour Checklist (CBCL). Results: …The family stress variables relating to the healthy spouse in all six comparisons were significant (p <= 0.05) or nearly so (p = 0.07) in each case showing higher scores for spouses to be associated with higher CRIES and CBCL total scores for the children. For the adjusted associations, we again found the family stress variables in the healthy spouse to be related to the risk of emotional and behavioral problems in the children. Conclusions: The present results suggest that in ABI families, the children’s emotional functioning depends upon family factors and primarily on the level of parental stress in the healthy parent. Show more

Keywords: Family health, parental ABI, child problems, parent's functioning, illness-related variables

DOI: 10.3233/NRE-130823

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 59-68, 2013

Authors: Moreno, Jhon Alexander | Arango Lasprilla, Juan Carlos | Gan, Caron | McKerral, Michelle

Article Type: Research Article

Abstract: Brain injury can directly and indirectly affect important aspects related to sexuality and sexual function. In this critical review of the literature, traumatic brain injury (TBI) and sexuality are examined. A general review of the concept of sexuality and the neurological correlates of sexual function are proposed as a framework to understand the cognitive, behavioral and physical effects of TBI on sexuality and sexual function. Studies are then classified according to the participants enrolled and findings are presented from the professional's, the survivor's, the patient/partner's, and the non-injured spouse's perspectives. Results are discussed taking into account methodological limitations and knowledge …gaps. Next, implications for sexual rehabilitation for individuals with TBI are discussed. Finally, suggestions for future research and their pertinence for improving rehabilitation outcomes are considered. Show more

Keywords: Traumatic brain injury, sexuality, sexual function, disability, rehabilitation, sexual therapy

DOI: 10.3233/NRE-130824

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 69-85, 2013

Authors: Koyama, Tetsuo | Marumoto, Kohei | Miyake, Hiroji | Ohmura, Takehisa | Domen, Kazuhisa

Article Type: Research Article

Abstract: We assessed the relationship between fractional anisotropy (FA) values of magnetic resonance–diffusion tensor imaging (DTI) and long-term outcome (3–7 months after onset) in patients with hemiparesis after intracerebral hemorrhage (N = 12). DTI data were obtained on days 14–18. FA values within the cerebral peduncle were analyzed using a computer-automated method. Motor outcome of hemiparesis was evaluated using Brunnstrom stage (six-point scale: severe to normal) for separate shoulder/elbow/forearm, wrist/hand, and lower extremity functions when patients were discharged from a long-term rehabilitation facility 3–7 months after onset. In addition, the motor component of the functional independence measure (FIM-motor) was scored. …The ratio of FA values in the affected hemisphere to those in the unaffected hemisphere (rFA) was assessed in relation to the clinical data (Spearman's rank correlation test, P < 0.05). Analysis revealed a statistically significant relationship between rFA and upper extremity function (R = 0.863 for shoulder/elbow/forearm; 0.834 for wrist/hand). Although statistically significant, the relationship between rFA and lower extremity function was less evident (R = 0.609). In contrast, analysis of rFA and FIM-motor scores did not reveal statistical significance. FA values within the cerebral peduncle are tightly associated with long-term outcomes of upper extremity function. Show more

Keywords: Hematoma, paresis, prognosis, recovery, stroke

DOI: 10.3233/NRE-130825

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 87-94, 2013

Authors: Aubut, Jo-Anne L. | Marshall, Shawn | Bayley, Mark | Teasell, Robert W.

Article Type: Research Article

Abstract: Objective: The objective of this study was to examine the correlation between the Physiotherapy Evidence Database (PEDro) and the Downs and Black (D&B) quality assessment scale and the PEDro and a modified D&B assessment scores in a research synthesis of the ABI literature. Methods and Main Outcomes: A systematic review of the literature from 1980–2007 was conducted looking at treatment interventions following an ABI published in peer-reviewed English language journals. Of the articles chosen for inclusion in the study, 165 were identified as randomised controlled trials (RCT). All RCTs were scored using two quality assessment tools: the PEDro …and D&B quality assessment scales. Items from these two scales were compared to identify which questions addressed similar information. Results: The association between the overall PEDro and D&B scores was moderately high (r = 0.71, p < 0.01) indicating a significant relationship between these two quality assessment tools. When considering the modified D& B scores, which contained a subset of questions deemed most comparable to the PEDro scale, the correlation between the two was also moderately high (r = 0.68, p < 0.01). Conclusions: Further analysis is required to investigate the strength of the relationship between these two scales in the assessment of RCTs. Show more

Keywords: Quality assessment tools, PEDro, Downs and Black, brain injury literature

DOI: 10.3233/NRE-130826

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 95-102, 2013