NeuroRehabilitation - Volume 2, issue 2

Article Type: Other

DOI: 10.3233/NRE-1992-2201

Citation: NeuroRehabilitation, vol. 2, no. 2, pp. 4-4, 1992

Authors: Roth, Elliot J.

Article Type: Introduction

DOI: 10.3233/NRE-1992-2202

Citation: NeuroRehabilitation, vol. 2, no. 2, pp. 6-6, 1992

Authors: Roth, Elliot J. | Mueller, Karen | Green, David

Article Type: Research Article

Abstract: Heart disease is a frequent concomitant to stroke. This study was designed to determine the utility of a noninvasive, continuous, dynamic cardiovascular monitoring procedure to evaluate 106 stroke patients during physical therapy, and to provide information from which to determine the cardiovascular response of stroke patients to physical therapy activities. A history of cardiac disease was present in 88% of the patients, and resting electrocardiographic changes were present in 83%. During the physical therapy session, significant increases were noted in mean heart rate (from 82 to 110 beats/min), blood pressure (from 129/76 to 146/81 mm Hg), and rate-pressure product (from …10,699 to 12,528). Stair climbing, walking, stationary bicycle riding, and kneeling activities had the greatest effects on heart rate response. More than one-half of the patients demonstrated abnormalities of heart rate, rhythm, blood pressure, or electrocardiographic response during therapy. Patients with congestive heart failure were significantly more likely to demonstrate these abnormalities than were those without congestive heart failure. Some patients underwent changes in their medical and rehabilitation regimens based on results of the procedure. The technique used in this study is a simple, safe, and noninvasive method that can provide useful information about the cardiovascular effects of specific functional activities in patients with stroke. Show more

DOI: 10.3233/NRE-1992-2203

Citation: NeuroRehabilitation, vol. 2, no. 2, pp. 7-15, 1992

Authors: Werner, Robert A. | Priebe, Michael M. | Davidoff, Gary N.

Article Type: Research Article

Abstract: The reflex sympathetic dystrophy syndrome (RSDS) is a clinical entity characterized by diffuse limb pain, swelling, and vasomotor instability. Estimates of its incidence after cerebrovascular accident range from 10 to 25%. RSDS usually presents in the first three months following the stroke. The clinical feature that is most prominent in stroke patients is tenderness of the small joints of the fingers, hand, and wrist of the paretic limb. Three phase technetium scintigraphy in this patient population is both sensitive and specific. If RSDS is diagnosed early after onset, most patients respond to therapeutic intervention with excellent results. The first choice …of treatment is the use of oral corticosteroids together with physical and/or occupational therapy. Other therapeutic interventions include stellate ganglion blockade, regional intravenous sympathetic blockade, other oral vasoactive medications, sympathectomy, and spinal cord stimulation. Show more

DOI: 10.3233/NRE-1992-2204

Citation: NeuroRehabilitation, vol. 2, no. 2, pp. 16-22, 1992

Authors: Linsenmeyer, Todd A. | Zorowitz, Richard D.

Article Type: Research Article

Abstract: Voiding dysfunction resulting in incontinence commonly occurs after cerebrovascular accident (CVA). There is often spontaneous resolution of incontinence over the first six months to one year. This study evaluated urodynamic findings in 33 patients less than three months after CVA. A wide variety of causes of urinary incontinence was found. Urodynamics allows characterization and provides guidance on bladder management strategies for urinary incontinence following CVA.

DOI: 10.3233/NRE-1992-2205

Citation: NeuroRehabilitation, vol. 2, no. 2, pp. 23-26, 1992

Authors: Ring, Haim | Mizrahi, Joseph

Article Type: Research Article

Abstract: Bilateral postural sway measurements were made for 15 stroke patients (8 men and 7 women) aged 41 to 78 years, from 5 to 42 weeks after they sustained their first stroke. From the measured foot-ground reaction forces, biomechanical parameters were defined, including total sway activity, asymmetry, and relative sequence of the tangential forces. These parameters were correlated to the patients’ clinical data. The results determine the conditions and extent to which these mechanical parameters can be used as indicators for monitoring and prognosis of the locomotor functional outcome of stroke patients.

DOI: 10.3233/NRE-1992-2206

Citation: NeuroRehabilitation, vol. 2, no. 2, pp. 27-35, 1992

Authors: Gonen, J. | Ring, H. | Stern, M. | Soroker, N.

Article Type: Research Article

Abstract: This article describes the aims, tools, and techniques of art therapy in the treatment of adult stroke patients. Sixty-five patients admitted for initial inpatient rehabilitation after acute stroke were treated either individually (15 patients) or as part of a group (50 patients). The patients’ ability to cope with the different experiences and exercises was examined, and improvements in their self-image, self-acceptance, and quality of interpersonal relationships were assessed. Beneficial effects were noted by both therapist and patients. However, sensitive assessment tools are yet to be developed for determining the specific contribution of art therapy in the general rehabilitation milieu.

DOI: 10.3233/NRE-1992-2207

Citation: NeuroRehabilitation, vol. 2, no. 2, pp. 36-44, 1992

Authors: Wagner, Mark T. | Cushman, Laura A.

Article Type: Research Article

Abstract: Subcortical structures have been implicated in higher cortical syndromes; however, the role of subcortical structures in cognition has been understudied in patients with vascular lesions and in the rehabilitation setting. The purpose of the present study was to examine the effect of cortical and subcortical vascular lesions on intellectual and memory functions. Thirty-six patients consecutively admitted to an acute neurorehabilitation stroke unit who met screening criteria for this study were classified based on radiologically confirmed lesion locations into either a cortical (n = 15 ) or a subcortical (n = 21 ) group and were administered …batteries of intellectual and memory tests. An analysis of variance showed that the subcortical group was significantly more impaired on global measures of higher cortical function when compared with the cortical group. Although the subcortical group showed expected attentional, mental control, and psychomotor slowing deficits, a separate analysis of the timed subtests failed to demonstrate that mental slowing was the sole factor responsible for higher level cognitive deficits. Results are discussed in terms of the rehabilitative implications of these findings. A structure/function relationship suggested that subcortical lesions, especially in the early stages of recovery, may include complex neurocognitive psychological processes and, therefore, warrant appropriate assessment and treatment in rehabilitative planning. Show more

DOI: 10.3233/NRE-1992-2208

Citation: NeuroRehabilitation, vol. 2, no. 2, pp. 45-52, 1992

Authors: Davidoff, Gary N. | Keren, Ofer | Ring, Haim | Solzi, Pablo

Article Type: Research Article

Abstract: The purpose of this study was to develop a simple protocol for use in screening “middle band” stroke patients to determine who would most likely achieve discharge to an independent community setting after intensive inpatient rehabilitation. A case-control comparison was made of patients who were discharged from inpatient rehabilitation after an initial middle band stroke, either to home (n = 141 ) or to an extended care facility (n = 51 ), on the basis of demographic characteristics, functional indices, and neurological assessment on admission to rehabilitation. Other factors taken into account included past medical history …and social support system. Univariate odds ratios were determined for neurological findings on admission, and for gender and marital status. Parametric analysis was used to compare groups for age at onset of stroke and for length of rehabilitation hospitalization. All significant findings were then loaded into a stepwise logistic regression model. Four factors explained 70% of the variance in discharge disposition: admission self-care assessment, presence of a spouse or significant other, history of cardiovascular disease, and presence of a visual field deficit. It is expected that the use of this system will allow for better predictions of the ultimate disposition and functional potential of middle band stroke patients. Show more

DOI: 10.3233/NRE-1992-2209

Citation: NeuroRehabilitation, vol. 2, no. 2, pp. 53-62, 1992

Article Type: Other

DOI: 10.3233/NRE-1992-2210

Citation: NeuroRehabilitation, vol. 2, no. 2, pp. 63-65, 1992