NeuroRehabilitation - Volume 30, issue 4

Authors: Rozen, Todd D.

Article Type: Research Article

Abstract: Objective/Background: Delayed post-hypoxic leukoencephalopathy is a rare condition marked by the development of neuropsychiatric symptoms, parkinsonism and akinetic mutism days to weeks after an individual has recovered from a prolonged cerebral hypoxic event. This syndrome can cause significant long-term neurologic dysfunction. At present there are no acute treatment strategies that have been identified that have been shown to alter the natural course of this disorder. In most instances all that can be offered to patients is early supportive care and then subsequent rehabilitation services. Methods: Case Report. Results: A patient is presented who developed new onset …encephalopathy, extrapyramidal symptoms and akinetic mutism three weeks after being discharged for a respiratory arrest from a drug overdose. MRI showed the development of extensive white matter and bilateral globus pallidus lesions. She had rapid resolution of akinetic mutism with intravenous magnesium sulfate as well as improvement in her other associated neurologic symptoms. Conclusion: The case report suggests the use of intravenous magnesium sulfate as an acute treatment for the akinetic mutism associated with delayed post-hypoxic leukoencephalopathy. In addition it also may improve the extrapyramidal and neuropsychiatric symptoms associated with this syndrome. This may be the first potential acute treatment for this rare neurologic condition. Show more

Keywords: Delayed post-hypoxic leukoencephalopathy, magnesium, akinetic mutism

DOI: 10.3233/NRE-2012-0763

Citation: NeuroRehabilitation, vol. 30, no. 4, pp. 329-332, 2012

Authors: Ghanbari, Ali | Rahimijaberi, Abbas | Mohamadi, Marzieh | Abbasi, Leila | Sarvestani, Fahimeh Kamali

Article Type: Research Article

Abstract: Objective: The aim of this study was to compare the effectiveness of trigger points’ management by Positional Release Therapy (PRT) and routine medical therapy in treatment of Tension Type Headache. Background: Tension Type Headache is the most frequent headache with the basis of myofascial and trigger point disorders. PRT is an indirect technique that treats trigger points. Method: 30 Patients with active trigger points in cervical muscles entered to the study. They were randomly assigned to PRT or medical therapy group. Headache frequency, intensity and duration and tablet count were recorded by use of a daily …headache diary. Sensitivity of trigger points was assessed by numeric pain intensity and by use of a digital force gauge (FG 5020). Results: Both groups showed significant reduction in headache frequency and duration and tablet count after treatment phase. However, the reduction of study variables was persisted only in PRT group after follow up phase. There was no significant reduction in headache intensity, neither in PRT and nor in medication group. Sensitivity of trigger points was significantly reduced. In comparison of the two study groups, there was no significant difference in headache frequency, intensity, duration and tablet count (p > 0.05). Conclusion: Both procedures were equally effective according to the study. Thus, PRT can be a treatment choice for patients with T.T.H. Show more

Keywords: Tension Type Headache, trigger point, positional release therapy

DOI: 10.3233/NRE-2012-0764

Citation: NeuroRehabilitation, vol. 30, no. 4, pp. 333-339, 2012

Authors: Massie, Crystal L. | Malcolm, Matthew P.

Article Type: Research Article

Abstract: Background: Stroke severely compromises the capacity for skilled motor control including the ability to reach with the stroke-affected upper-extremity. Research incorporating intensive motor therapies has broadly demonstrated the ability to improve hemiparetic reaching post-stroke, yet the role of specific task parameters has received less attention. These task parameters, such as speed-of-performance, may be important to the structure and delivery of motor rehabilitation. The objective of the study was to determine the influence of task pacing demands on hemiparetic reaching strategies in survivors of stroke. Methods: Kinematic motion analysis was used to examine upper-extremity reaching patterns in 11 survivors …of stroke. Participants were instructed to reach between two targets at a self-selected pace and as fast as possible. Outcome measures included maximal movement speed, accuracy, movement smoothness, and reaching strategies (anterior trunk flexion, elbow extension, and shoulder flexion). Results: Participants reached significantly faster and smoother during the task that emphasized speed while maintaining target accuracy. Participants used significantly less anterior trunk displacement during the fast condition, yet no change in shoulder flexion. Conclusion: Task parameters that emphasize speed positively influence reaching strategies with the more-affected upper-extremity. Survivors of stroke were able to respond to changes in pacing demands while significantly reducing reliance on compensatory trunk movement. This outcome highlights the need to further understand the impact of task parameters during intensive motor therapies. Show more

Keywords: Stroke, kinematic motion analysis, reach, impairment, instructions, motor control

DOI: 10.3233/NRE-2012-0765

Citation: NeuroRehabilitation, vol. 30, no. 4, pp. 341-350, 2012

Authors: Kara, Bilge | Genc, Arzu | Colakoglu, Beril Donmez | Cakmur, Raif

Article Type: Research Article

Abstract: Background/Aim: The aim of the this study was to examine the effects of supervised exercises on measures of static and dynamic balance Parkinson’s disease (PD) patients. Material and Methods: The study used a before–after study design. Seventeen PD patients with mild and moderate levels of disability were enrolled in the study. Patients followed an exercise program under a physiotherapist’s supervision one day a week for 12 weeks. The standard Balance Master protocol was used before and after exercise to assess static and dynamic balance. Results: A statistically significant difference was observed in the unilateral balance test, …one of the static balance assessments performed while standing on the left or right leg with eyes closed (p < 0.05). With respect to dynamic balance, a statistically significant difference in the maximum excursion of limits of stability (LOS), one of the balance tests used in the supervised exercise programs for patient with Parkinson’s disease, between measurements taken before and after exercises was also detected (p < 0.05). Conclusions: The change of LOS revealed that dynamic balance improved due to the exercises. Thus, our supervised exercise program provided improvement in dynamic balance of PD patients. Show more

Keywords: Parkinson's disease, exercise, static balance, dynamic balance, physiotherapy

DOI: 10.3233/NRE-2012-0766

Citation: NeuroRehabilitation, vol. 30, no. 4, pp. 351-357, 2012

Authors: Park, Soon-Ah | Park, Hyo-In | Kim, DongHyun | Yang, Chung-Yong | Zhang, Li-Qun

Article Type: Research Article

Abstract: The purpose of this study was to evaluate the relationship between the recovery of gross motor function and cerebrovascular reserve (CVR) capacity measured by brain perfusion single-photon emission computed tomography (SPECT) in patients with first-ever supratentorial infarction. Gross motor function was assessed according to the locomotor and mobility subset of the functional independence measure. The CVR was measured as the difference in the regional cerebral blood flow (rCBF) after acetazolamide (ACZ)-challenged 99m Tc-ECD perfusion SPECT from baseline rCBF. All 22 hemiplegic patients (mean age, 60.97 years) enrolled were admitted at a mean of 20.86 days from onset and received rehabilitation …care for an average of 38.82 days. The recovery of gross motor function was significantly correlated with baseline rCBF and CVR of ACZ-SPECT in the areas of affected supratentorial hemisphere (r = 0.447 and r = 0.444, respectively, p < 0.05). Analysis of the linear regression model, adjusted for time to SPECT testing, revealed that the CVR in the affected supratentorial hemisphere was a significant predictor of the gross motor outcome (p < 0.05). In conclusion, the CVR of the affected supratentorial hemisphere may be employed along with other parameters to predict the gross motor recovery of patients with subacute infarction. Show more

Keywords: Stroke, prognosis, SPECT, cerebrovascular reserve, gross motor function

DOI: 10.3233/NRE-2012-0767

Citation: NeuroRehabilitation, vol. 30, no. 4, pp. 359-367, 2012

Authors: Guclu-Gunduz, Arzu | Citaker, Seyit | Nazliel, Bijen | Irkec, Ceyla

Article Type: Research Article

Abstract: The purpose of this study was to investigate the relationships between the upper extremity functions, upper extremity strength and hand sensation in patients with Multiple Sclerosis (MS). Twenty-two patients with MS (mean age: 38.5 ± 8.31 years, median Expanded Disability Status Scale (EDSS): 2) and 10 healthy subjects were included. Upper extremity function was measured with the Nine-hole peg test, upper extremity strength (shoulder flexion-abduction, elbow flexion, pinch and grip) with hand-held dynamometer, hand grip dynamometer and manual pinch meter, threshold of light touch-pressure with Semmes-Weinstein monofilament, duration of vibration with 128-Hz frequency tuning fork, and distance of two-point discrimination …with an aesthesiometer. Strength and functional level of the upper extremity, light touch-pressure, two-point discrimination, vibration sensations of the hand were lower in patients with MS compared with healthy controls (p < 0.05). Light touch-pressure sensation of thumb and index fingers, two-point discrimination of index finger and elbow flexion strength were found to be related with upper extremity function in patients with MS (p < 0.05). These results indicate that the hand sensation, upper extremity strength and function were affected in MS patients. Additionally upper extremity functions seem to be related with light touch-pressure and two-point discrimination sensations of the hand and elbow flexion strength. Upper extremity strengthening and sensorial training of the hand may contribute to the upper extremity function in patients with MS. Show more

Keywords: Multiple sclerosis, sensation, strength, functions, hand

DOI: 10.3233/NRE-2012-0768

Citation: NeuroRehabilitation, vol. 30, no. 4, pp. 369-374, 2012

Article Type: Other

DOI: 10.3233/NRE-2012-30417

Citation: NeuroRehabilitation, vol. 30, no. 4, pp. 375-378, 2012

Article Type: Other

DOI: 10.3233/NRE-2012-30417

Citation: NeuroRehabilitation, vol. 30, no. 4, pp. 379-381, 2012