NeuroRehabilitation - Volume 47, issue 2

Authors: Brownlee, Naomi N. M. | Wilson, F. Colin | Curran, David B. | Lyttle, Nigel | McCann, John P.

Article Type: Review Article

Abstract: BACKGROUND: Hypoxic ischemic brain injury (HIBI) occurs as a result of complete or partial disruption of cerebral oxygen supply. The physical and cognitive sequelae of adults following hypoxia varies widely. OBJECTIVE: To systematically review studies exploring the neuropsychological outcomes following hypoxic brain insult in adults. METHODS: Data was sourced using six databases (CINAHL, Cochrane, Embase, Medline, PsycInfo and Web of Science). Initial MESH terms identified 2,962 articles. After a three-stage independent review process, 18 articles, 9 case studies and 9 group studies were available for data synthesis from 1990-2012. Case study data was converted to standardised …scores and compared to available test norms. Cohen’s d was calculated to permit group data interpretation. RESULTS: Intellectual decrement was observed in some studies although difficult to delineate given the lack of use of measures of premorbid ability. Cognitive sequelae varied albeit with predominant disturbance in verbal memory, learning ability and executive function observed across studies. Wechsler Memory Scale Revised (WMS-R) visual memory was comparable to normative data. Impaired Rey Osterrieth Complex Figure (ROCFT) performance was found among group studies. Across visuo-constructional and attention domains, performance varied, although no significant difference relative to reported means was observed. CONCLUSIONS: Future studies should consider the use of standardised assessment protocols, which include measures of premorbid functioning and performance validity. Show more

Keywords: Hypoxia-ischemia, brain injury, adult survivors, neuropsychological outcomes, cognition

DOI: 10.3233/NRE-203135

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 83-97, 2020

Authors: Yoo, I. G.

Article Type: Review Article

Abstract: BACKGROUND: The application of emotional stimuli is beneficial when practicing tasks that must be learned. OBJECTIVE: This scoping review examined related literature to identify the applicability of emotion-based training for therapeutic activities. METHOD: All relevant literature published as of April 1, 2020 in four prominent databases was searched (CINAHL, Embase, PubMed, and PsycINFO) using the five-stage review framework proposed by Arksey and O’Malley. RESULTS: After sophisticated searches and exclusions, ten publications were included for further review. Our results revealed three types of emotion-based stimulation methods that can influence therapeutic effects on stroke patients. However, …the research did not compare the difference between the pros, cons, and effectiveness of each type of sensory stimulation. CONCLUSION: Rehabilitation specialists are encouraged to obtain a broad understanding of therapeutic situations and their possible impacts on a given environment. Show more

Keywords: Emotion-based stimulation, rehabilitation, scoping review, stroke

DOI: 10.3233/NRE-203163

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 99-108, 2020

Authors: Szczepańska-Gieracha, Joanna | Cieślik, Błażej | Rutkowski, Sebastian | Kiper, Paweł | Turolla, Andrea

Article Type: Review Article

Abstract: BACKGROUND: Studies demonstrated the efficacy of virtual reality (VR) as a method supporting the post-stroke neuro-rehabilitation process by activating motor learning processes. Nevertheless, stroke is frequently accompanied by serious psychological problems including depression, which is associated with an increased risk of mortality, lower post-stroke physical activity, and higher disability in stroke patients. OBJECTIVES: To explore the current use of VR as a method supporting the neuro-rehabilitation process, both in physical and psychological dimensions. METHODS: An exploratory review was conducted with a narrative synthesis. PubMed was used for literature search. Search includes the use of VR in …physical rehabilitation, and as support therapy in psychiatric disorders. Both primary research and systematic reviews were included. RESULTS: In neurological disorders rehabilitation, out of 22 studies, 16 concerned stroke survivors. In psychiatric disorders, 44 literature reviews were included. CONCLUSION: The studies confirmed the effectiveness of various forms of VR treatment in the alleviation of psychological and behavioral problems and psychiatric disorders. There is a shortage of VR-based technological solutions that would, besides physical rehabilitation, offer stroke patients therapeutic tools to alleviate psychological disturbance and improve the patient’s mood and motivation. Such solutions will most likely become a field of intensive research in the coming years. Show more

Keywords: Narrative literature review, stroke, depression, post-stroke rehabilitation, total immersion, virtual reality

DOI: 10.3233/NRE-203209

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 109-120, 2020

Authors: Durgut, Elif | Orengul, A. Cahid | Algun, Z. Candan

Article Type: Research Article

Abstract: OBJECTIVE: The aim of this study was to compare the effects of treadmill training (TT) and whole body vibration training (WBVT) on attention, severity of attention deficit hyperactivity disorder (ADHD) symptoms and impairment of executive function behaviors, and quality of life in children with ADHD. METHODS: Thirty children (7–11 years of age) with ADHD were randomly assigned to either the ‘TT’ group or the ‘WBVT in addition to TT’ group (TT + WBVT). Both groups received TT for 8 weeks (3 days/week). The TT + WBWT group also received WBVT for 15 minutes. Stroop Test TBAG form, Behavior Rating Inventory of Executive …Function (BRIEF), Conners’ Rating Scale (CRS) and Pediatric Quality of Life Inventory (PedsQL) were applied at baseline and after 8 weeks of training. RESULTS: All assessment results significantly improved in both groups at the end of the program compared to baseline values (p  < 0,05). There were significant differences between groups regarding improvements in CTRS-R/L and BRIEF-Teacher form in favor of the TT + WBVT group. CONCLUSIONS: The findings suggest that exercise training including TT and WBVT might be used in the treatment of ADHD but further research is required to provide evidence of the effectiveness of the whole body vibration training in the management of ADHD. Show more

Keywords: Attention deficit hyperactivity disorder, treadmill training, whole body vibration training, ADHD symptoms, executive functions, quality of life

DOI: 10.3233/NRE-203040

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 121-131, 2020

Authors: Hegazy, Fatma A. | Aboelnasr, Emad A. | Salem, Yasser T.

Article Type: Research Article

Abstract: BACKGROUND: Gait deviations and spasticity are common impairments seen in children with cerebral palsy (CP) and may interfere with functional performance and effective walking pattern. Lidocaine iontophoresis is effective for reducing muscle spasticity in adults. PURPOSE: To investigate the effect of lidocaine epinephrine iontophoresis combined with exercises on gait and spasticity in children with spastic hemiplegic cerebral palsy (HCP). METHODS: Thirty children with spastic HCP aged 4–6 (5.20±0.32) years were randomly assigned to the experimental group (n  = 15) and control group (n  = 15). Children in both groups received one hour of exercises, three times a week …for three months. Children in the experimental group received 2% lidocaine iontophoresis immediately before the exercises. The lidocaine iontophoresis was delivered for 20 minutes (1mA/min). Spatio-temporal gait parameters were assessed within one week before and after the intervention using 3D motion analysis. Surface electromyography was used to assess muscle tone using H/M ratio of the soleus muscle. ANOVA was used to investigate the differences between experimental and control groups. Statistical significance was set at P value less than 0.05. RESULTS: There was no difference between groups at baseline. Post-intervention, the experimental group showed significant improvements when compared to the control group for gait speed (p  = 0.03), stride length (p  = 0.04), cadence (p  = 0.0001), cycle time (p  = 0.0001), and H/M ratio (p  = 0.02). CONCLUSION: Lidocaine iontophoresis combined with exercises was effective in improving gait spatiotemporal parameters and reducing spasticity in children with CP. Show more

Keywords: Cerebral palsy, lidocaine iontophoresis, gait analysis, EMG, spasticity, exercises

DOI: 10.3233/NRE-203152

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 133-141, 2020

Authors: Kokkinou, M. | Kyprianou, T.C. | Kyriakides, E. | Constantinidou, F.

Article Type: Research Article

Abstract: BACKGROUND: Traumatic Brain Injury (TBI) is characterized by a highly heterogenous profile in terms of pathophysiology, clinical presentation and outcome. OBJECTIVE: This is the first population study investigating the epidemiology and outcomes of moderate-to-severe TBI in Cyprus. Patients treated in the Intensive Care Unit (ICU) of Nicosia General Hospital, the only Level 1 Trauma Centre in the country, were recruited between January 2013 and December 2016. METHODS: This was an observational cohort study, using longitudinal methods and six-month follow-up. Patients (N = 203) diagnosed with TBI were classified by the Glasgow Coma Scale at the Emergency Department as …moderate or severe. RESULTS: Compared to international multicentre studies, the current cohort demonstrates a different case mix that includes older age, more motor vehicle collisions and lower mortality rates. There was a significantly higher proportion of injured males. Females were significantly older than males. There were no sex differences in the type, severity or place of injury. Sex did not yield differences in mortality or outcomes or on injury indices predicting outcomes. In contrast, older age was a predictor of higher mortality rates and worse outcomes. CONCLUSION: Trends as described in the study emphasize the importance of continuous evaluation of TBI epidemiology and outcome in different countries. Show more

Keywords: Traumatic Brain Injury, epidemiology, cohort study, mortality, sex differences

DOI: 10.3233/NRE-203111

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 143-152, 2020

Authors: Allataifeh, Eman | Khalil, Hanan | Almhdawi, Khader | Al-Shorman, Alham | Hawamdeh, Ziad | El-Salem, Khalid | Bumin, Gonca

Article Type: Research Article

Abstract: BACKGROUND: Multiple sclerosis (MS) has a huge impact on patients and affects their ability to participate in meaningful activities. OBJECTIVE: To identify motor and non-motor factors that are associated with the participation level in instrumental activities of daily living (IADL), leisure, social and religious activities in people with MS. METHOD: This is a cross-sectional study conducted on 110 individuals with MS. The used outcome measures are: Arabic version of the Activity Card Sort, Berg Balance Scale, Modified Fatigue Impact Scale, Nine Hole Peg Test, 6-Minute Walk Test, Brief International Cognitive Assessment for Multiple Sclerosis, Stroop test …and Hospital Anxiety and Depression Scale. RESULTS: Hand function, balance, gender and cognitive status can predict the participation in IADL (R2  = 0.425, P  < 0.0001); depression, age, and cognitive status can predict the participation in leisure activities (R2  = 0.372, P  < 0.0001), and fatigue, balance and cognitive status can predict social activities participation (R2  = 0.492, P  < 0.000). CONCLUSION: Balance, cognition and fatigue affect the level of participation in instrumental activities of daily living, leisure, and religious and social activities. Show more

Keywords: Participation, multiple sclerosis, instrumental activities of daily living, leisure, quality of life

DOI: 10.3233/NRE-203131

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 153-160, 2020

Authors: Singh, Meenakshi | Sarkar, Aparna | Kataria, Chitra

Article Type: Research Article

Abstract: BACKGROUND: Injury to the spinal cord results in standing balance impairment following variable sensorimotor loss. Standing balance training is a realistic goal for the majority of individuals with spinal cord injury (SCI) for which therapists need valid measures to assess standing ability in people with SCI that are relevant to functionality. Objective: The objective of the study was to develop an all inclusive Standing Balance Assessment for Individuals with Spinal Cord Injury (SBASCI) measure and to establish its initial psychometric properties. Methods: The study was carried out in three phases: Item development, scale development and scale …evaluation. Literature review, focus group discussions and evaluation by experts resulted in the development of a 22-item SBASCI scale. The scale was administered on 120 participants with SCI. Exploratory factor analysis and item analysis were used to determine construct validity and internal consistency of the scale. Results: Content validity was established qualitatively and quantitatively. The scale shows high internal consistency reliability (Cronbach’s alpha 0.96). The results of the exploratory factor analysis suggested a four factor structure retaining all the 22 items. Conclusion: SBASCI is a valid and reliable scale to measure the standing balance of individuals with SCI. Further studies are required to establish other psychometric properties. Show more

Keywords: Spinal cord injury, standing balance, validity, reliability

DOI: 10.3233/NRE-203148

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 161-169, 2020

Authors: Pongratanakul, Rinlada | Thitisakulchai, Poungkaew | Kuptniratsaikul, Vilai

Article Type: Research Article

Abstract: OBJECTIVES: To identify factors that are independently related to interrupted stroke rehabilitation due to acute care transfer or death. METHODS: Medical records of stroke inpatients admitted from 2012 to 2017 were reviewed. Stroke inpatients with interrupted stroke rehabilitation due to acute care transfer or death were enrolled into the case group. Those without interruption admitted in the same month were randomly selected into the control group (case to control ratio of 1 : 5). Ten clinical factors were studied. RESULTS: Among stroke inpatients, 3.2% were transferred to acute care facilities and 0.2% died. The most common causes of …acute care transfer were respiratory tract infection, intracranial hemorrhage, recurrent ischemic stroke, ischemic heart disease, and seizure. Three factors were found to be significantly associated with interrupted stroke rehabilitation, i.e. presence of feeding tube, presence of anemia and age. Our results also revealed significant association between presence of feeding tube and respiratory tract infection (p  = 0.005). CONCLUSION: Feeding tube, anemia and old age were identified as independent predictors of interrupted stroke rehabilitation due to acute care transfer or death. Interventions to reduce severe complications should be implemented in order to prevent interruption of rehabilitation process and to reduce the patient transfer rate. Show more

Keywords: Case-control studies, patient transfer, stroke rehabilitation, inpatients, stroke

DOI: 10.3233/NRE-203187

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 171-179, 2020

Authors: Bilek, Furkan | Deniz, Gulnihal | Ercan, Zubeyde | Cetisli Korkmaz, Nilufer | Alkan, Gokhan

Article Type: Research Article

Abstract: OBJECTIVE: The aim of this study was to investigate the effects of neuromuscular electric stimulation applied to the erector spinae on balance, motor function and functional capacity in patients with stroke in a randomized controlled trial. METHODS: Sixty patients with stroke were recruited and randomly distributed into two groups: control group and neuromuscular electric stimulation group. All participants underwent conventional physical therapy five times a week for six weeks. The neuromuscular electric stimulation group received additional electrical stimulation. Outcome measures were evaluated with Brunnel Balance Assessment, Stroke Rehabilitation Movement Assessment, Functional Ambulation Classification, Adapted Patient Evaluation and Conference …System, Postural Assesment Scale for Stroke patients, Short Form-36, and Minimental State Examination scales. RESULTS: Significant differences were observed in all scores at the end of the study in both groups. Postural Assesment Scale for Stroke patients and Stroke Rehabilitation Movement Assessment scores were higher in the neuromuscular electric stimulation group compared to the control group (p  < 0.05). All the other scores were not statistically significant. CONCLUSION: It is recommended to evaluate and treat trunk muscle, which is usually neglected in treatment, and to consider the combination of conventional treatment and neuromuscular electric stimulation when designing an ideal rehabilitation program. Show more

Keywords: Neuromuscular electrical stimulation, erector spinae, stroke, functional capacity, balance, mobility

DOI: 10.3233/NRE-203114

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 181-189, 2020