NeuroRehabilitation - Volume 31, issue 4

Authors: Nathan, Dominic E. | Prost, Robert W. | Guastello, Stephen J. | Jeutter, Dean C. | Reynolds, Norman C.

Article Type: Research Article

Abstract: Objective: To understand neural correlates of upper extremity task performance (functional vs. non-functional) and to understand their influence on neuromotor control strategies. Design: Cross-sectional descriptive study, with repeated measures. Setting: Medical center 1.5T MRI clinical imaging facility. Participants: Neurologically intact individuals, (M = 14 F = 5 mean age = 22.94 ± 3.1 years) all right hand dominant as determined by the Edinburgh handedness survey. Subjects performed upper extremity motor tasks of reaching and grasping in a block paradigm. Whole brain fMRI data was acquired using a 1.5T MRI scanner. Main outcome …measures: Differences in fMRI area of activation and maximum activation intensity for the whole brain were evaluated among the different upper extremity motor tasks. Results: Our results indicate (a) Activations in brain regions are task specific. (b) ANOVA results indicate functional goal oriented movements of reaching and grasping produce higher activation intensity (p < 0.0001) in more regions of the cortex (Somatosensory motor area, primary motor cortex, and parietal region) and cerebellum (p < 0.001) as compared to nonfunctional rhythmic movements of reaching only and grasping only. (c) There is some overlap in cerebellar activations, however areas of activation in the medial cerebellum were observed for reaching-and-grasping, while the grasping-only task produced activation more laterally in the cerebellum. Conclusions: Our findings suggest that (a) neuromotor strategy for functional goal-oriented movements is different from rhythmic movements such as finger tapping or non-functional movements, (b) This difference can be quantified and mapped using fMRI. (c) There are some overlap with activation of movement execution however the cognitive component that mediates the specific movement is not just the linear combination of simple movements rather it is task and context specific. (d) The results support the concept of using goal-oriented tasks in the applications of rehabilitation and therapy for restoration of function. Show more

Keywords: Functional goal-oriented movements, upper extremity neurorehabilitation, functional motor tasks, upper extremity neuromotor control

DOI: 10.3233/NRE-2012-00812

Citation: NeuroRehabilitation, vol. 31, no. 4, pp. 421-428, 2012

Authors: Čakrt, Ondřej | Vyhnálek, Martin | Slabý, Kryštof | Funda, Tomáš | Vuillerme, Nicolas | Kolář, Pavel | Jeřábek, Jaroslav

Article Type: Research Article

Abstract: Few clinical studies have evaluated physiotherapeutic interventions in patients with degenerative cerebellar ataxia. Investigations on the effectiveness of biofeedback-based interventions for training postural control in these patients have not been conducted yet. The aim of the present study was to assess the effectiveness of a 2-week intensive tongue-placed electrotactile biofeedback program for patients with progressive cerebellar ataxia. Subjects were seven adult patients suffering from cerebellar degeneration. Postural control was assessed with static posturography in two sensory conditions eyes open/closed on firm surface. For quantification of postural behavior, we used area, sway path and mean velocity of the centre of foot …pressure (CoP). Effects of treatment were determined by comparing Pre, Post and one month follow-up (Retention) experimental sessions. Analysis of measured CoP parameters for tests on firm surface showed a significant main effect of visual condition and no difference across test sessions under open eyes condition. Under eyes closed condition, there were significant differences between Pre versus Post and Pre versus Retention, while the difference Post versus Retention was not significant. Our results suggest that a balance rehabilitation program with postural exercise performed with a head position-based tongue-placed biofeedback system could significantly improve bipedal postural control in patients suffering from degenerative cerebellar ataxia. Show more

Keywords: Cerebellar ataxia, neurorehabilitation, biofeedback, postural control, physiotherapy, posturography

DOI: 10.3233/NRE-2012-00813

Citation: NeuroRehabilitation, vol. 31, no. 4, pp. 429-434, 2012

Authors: Maslovara, Sinisa | Soldo, Silva Butkovic | Puksec, Mirjana | Balaban, Branka | Penavic, Ivana Pajic

Article Type: Research Article

Abstract: This prospective clinical study includes 96 BPPV patients with the results of DHI testing ⩾ 40 points. They were segregated to be taken into this study and randomly divided into two therapy groups: 48 patients in Group I were treated pharmacotherapeutically with Betahistine Chloride (BC) and 48 patients in Group II underwent a rehabilitation treatment by performing an Epley maneuver. Total study duration was eight weeks, during which the patients were first examined upon arrival, checked after one, and rechecked after eight weeks. The tests included otoneurological examination and VNG, as well as completing three questionnaires: DHI, SF-36® , and …HADS® . During the first checkup after one week, 86.96% of patients in Group I and 93.33% in Group II had negative results at the Dix-Hallpike test. During the second checkup after an eight weeks' treatment, 95.65% in Group I and 97.78% patients in Group II had a negative result. At the beginning of the study, the values of patients' physical, emotional, and functional health (QoL) were equally distributed in both therapy groups, compared to standardized values of healthy population. During the first checkup, the values were significantly higher and by the second checkup, reached the statistic average, which corresponds with the healthy population. There was an obviously faster and more complete recovery of the patients in Group II, who underwent a rehabilitation treatment. Show more

Keywords: Benign Paroxysmal Positional Vertigo (BPPV), Quality of Life (QoL), Betahistine Chloride (BC), rehabilitation therapy

DOI: 10.3233/NRE-2012-00814

Citation: NeuroRehabilitation, vol. 31, no. 4, pp. 435-441, 2012

Authors: Stevens, Lillian Flores | Arango-Lasprilla, Juan Carlos | Deng, Xiaoyan | Schaaf, Kathryn Wilder | De los Reyes Aragón, Carlos José | Quijano, María Cristina | Kreutzer, Jeffrey

Article Type: Research Article

Abstract: Objective: To determine which factors are highly associated with burden and depression in a group of caregivers of persons with Traumatic Brain Injury (TBI) in Colombia, South America. Design: Prospective. Participants: Fifty-one pairs of individuals with TBI and their caregivers from two major cities in Colombia completed a comprehensive psychosocial evaluation that included information related to patient and caregiver sociodemographic factors, patient factors, and caregiver estimation of patient neurobehavioral functioning. Outcome measures: Caregiver burden (Zarit Burden Interview) and caregiver depression (PHQ-9). Results: Generalized linear models revealed that patient language problems and caregiver …perception of patient functioning on six neurobehavioral domains were related to caregiver burden. Caregiver socioeconomic status and caregiver perception of patient functioning on six neurobehavioral domains were related to caregiver depression. These variables were then selected as candidates for the multiple regression models, which were fit separately for caregiver depression and burden, and revealed that caregivers’ perception of patient depression was the only factor associated with both caregiver burden and depression. Conclusion: Caregivers’ perception of patient depression was the single best predictor of both caregiver burden and depression. Implications for treatment based on these preliminary findings are discussed. Show more

Keywords: Caregivers, depression, burden

DOI: 10.3233/NRE-2012-00815

Citation: NeuroRehabilitation, vol. 31, no. 4, pp. 443-452, 2012

Authors: Pergami, P. | Seemaladinne, N. | Billings, A.

Article Type: Research Article

Abstract: We recently developed a computer-based test that uses a pointing task with multiple levels of difficulty to evaluate upper extremity motor function. The purpose of this study is to report performance data in adults and children, to determine test reliability, and to validate this test against well established scales of motor function (Purdue Pegboard and 9-hole Pegboard tests). We examined 40 healthy right-handed subjects (18 children and 22 adults) to determine the correlation among computer-based test and validated measures. The test is quick to administer, engaging for adults and children, with a steep learning curve to stable performance, and can …be finely tuned to baseline ability. Test-retest reliability was confirmed for all levels of difficulty. The computer-based test demonstrated moderate correlation in healthy adults and children with the Purdue Pegboard test (Spearman, r = 0.52, p = 0.0005; Pearson, r = 0.55, p = 0.0002). Implications: The test is a valid measure of motor skills and could be use for periodic evaluation and monitoring in the clinic setting. Further development of a user-friendly version for self-administration would allow for home based monitoring of treatment/interventions. Show more

Keywords: Assessment of motor and process skills, computers, upper extremity

DOI: 10.3233/NRE-2012-00816

Citation: NeuroRehabilitation, vol. 31, no. 4, pp. 453-461, 2012

Authors: Miotto, Eliane Correa | Teixeira, Manoel Jacobsen

Article Type: Letter

DOI: 10.3233/NRE-2012-00801

Citation: NeuroRehabilitation, vol. 31, no. 4, pp. 463-464, 2012

Article Type: Other

DOI: 10.3233/NRE-2012-31417

Citation: NeuroRehabilitation, vol. 31, no. 4, pp. 465-468, 2012

Article Type: Other

DOI: 10.3233/NRE-2012-31418

Citation: NeuroRehabilitation, vol. 31, no. 4, pp. 469-470, 2012