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

Authors: Yip, Ben C.B. | Man, David W.K.

Article Type: Research Article

Abstract: Acquired brain injuries (ABI) may display cognitive impairments and lead to long-term disabilities including prospective memory (PM) failure. Prospective memory serves to remember to execute an intended action in the future. PM problems would be a challenge to an ABI patient's successful community reintegration. While retrospective memory (RM) has been extensively studied, treatment programs for prospective memory are rarely reported. The development of a treatment program for PM, which is considered timely, can be cost-effective and appropriate to the patient's environment. A 12-session virtual reality (VR)-based cognitive rehabilitation program was developed using everyday PM activities as training content. 37 subjects …were recruited to participate in a pretest-posttest control experimental study to evaluate its treatment effectiveness. Results suggest that significantly better changes were seen in both VR-based and real-life PM outcome measures, related cognitive attributes such as frontal lobe functions and semantic fluency. VR-based training may be well accepted by ABI patients as encouraging improvement has been shown. Large-scale studies of a virtual reality-based prospective memory (VRPM) training program are indicated. Show more

Keywords: Acquired brain injury, prospective memory, rehabilitation, virtual reality

DOI: 10.3233/NRE-130827

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 103-115, 2013

Authors: Combs, Stephanie A. | Diehl, M. Dyer | Chrzastowski, Casey | Didrick, Nora | McCoin, Brittany | Mox, Nicholas | Staples, William H. | Wayman, Jessica

Article Type: Research Article

Abstract: The purpose of this study was to compare group boxing training to traditional group exercise on function and quality of life in persons with Parkinson disease (PD). A convenience sample of adults with PD (n = 31) were randomly assigned to boxing training or traditional exercise for 24–36 sessions, each lasting 90 minutes, over 12 weeks. Boxing training included: stretching, boxing (e.g. lateral foot work, punching bags), resistance exercises, and aerobic training. Traditional exercise included: stretching, resistance exercises, aerobic training, and balance activities. Participants were tested before and after completion of training on balance, balance confidence, mobility, gait velocity, …gait endurance, and quality of life. The traditional exercise group demonstrated significantly greater gains in balance confidence than the boxing group (p < 0.025). Only the boxing group demonstrated significant improvements in gait velocity and endurance over time with a medium between-group effect size for the gait endurance (d = 0.65). Both groups demonstrated significant improvements with the balance, mobility, and quality of life with large within-group effect sizes (d ≥ 0.80). While groups significantly differed in balance confidence after training, both groups demonstrated improvements in most outcome measures. Supporting options for long-term community-based group exercise for persons with PD will be an important future consideration for rehabilitation professionals. Show more

Keywords: Parkinson disease, boxing, balance confidence, exercise, quality of life

DOI: 10.3233/NRE-130828

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 117-124, 2013

Authors: Poliakoff, Ellen | Galpin, Adam J. | McDonald, Kathryn | Kellett, Mark | Dick, Jeremy P.R. | Hayes, Sue | Wearden, Alison J.

Article Type: Research Article

Abstract: There is accumulating evidence for the benefits of exercise in Parkinson's disease (PD), but less is known about group exercise interventions. We evaluated the effect of gym-training programme on people with PD. Thirty-two adults with mild to moderate PD, not currently exercising formally, were randomised to an immediate 20-week biweekly gym training programme at a local leisure complex, or a 10-week programme starting 10 weeks later. Assessments at baseline (T1), 10 weeks (T2) and 20 weeks (T3) included reaction time, motor performance (UPDRS), quality of life and illness perceptions. Experiences of the programme were assessed via questionnaire and a focus …group. Overall UPDRS motor function score did not change over time. However, gym training was associated with significant improvements in reaction times and some timed tests in the immediate training group (T1-T2). The delayed group showed similar improvements following gym training (T2-T3). Participants reported enjoyment, obtaining social benefits, and increased confidence. However, the questionnaire measures did not show improvements in subjective health ratings or illness perceptions. Although benefits were not apparent in the questionnaire measures or overall UPDRS scores, our findings suggest that a 10-week gym training programme in a community setting can provide some benefits for people with PD. Show more

Keywords: Parkinson's disease, exercise, gym, quality of life, social support

DOI: 10.3233/NRE-130829

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 125-134, 2013

Authors: Müller, Thomas | Pietsch, Angela

Article Type: Research Article

Abstract: Background: A physiotherapy subtype is gait training (GT), which aims on correction of posture and gait re-education in patients with Parkinson’s disease (PD). Osteopathy in the cranial field (OCF) is a gentle manual method to treat dysfunctions of the central nervous system. Therapists may employ GT and OCF to bypass deficient basal ganglia dysfunction, which causes gait disturbances in PD. Objectives: Objectives of this pilot study were to demonstrate the efficacy of both procedures on gait and to compare their effects within a cross over design. Methods: 18 PD patients received on two subsequent days one …GT- and one OCF session each. The ten meter walking test (WT) was performed before and after each therapeutic intervention. Results: GT reduced the number of steps but not the interval in the WT. OCF declined the period but not the step frequency in the WT. The computed differences of WT outcomes before and after each intervention did not vary between both methods. Both sessions together shortened the interval but not number of steps in the WT. Conclusion: GT improves walking behaviour with a specific focus on an optimised performance of the necessary movement sequences regarding their accuracy and amplitude. As OCF decreased the interval, it ameliorates speed of motion execution during gait. GT and OCF enhance different aspects of gait in PD. Show more

Keywords: Parkinson's disease, osteopathy, gait training, physiotherapy

DOI: 10.3233/NRE-130830

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 135-140, 2013

Authors: Al-Jarrah, Muhammed | Obaidat, Heyam | Bataineh, Ziad | Walton, Lori | Al-Khateeb, Ahed

Article Type: Research Article

Abstract: Objectives: Parkinson’s disease (PD) is a neurodegenerative disorder, caused by the gradual loss of cells in substantia nigra. Nitric oxide (NO) plays an important role in a variety of signal transduction pathways that are crucial for maintaining the physiologic functions of nervous system. The aims of this study are: 1) To investigate the expression of the inducible form of NO (iNOS), and compare it to neuronal nitric oxide (nNOS) in the brain of a chronic mouse model of PD and 2) To study the effect of endurance exercise training on the expression of these markers. Method: Mouse models …of PD were obtained using 10 doses of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) (25 mg/kg) and probenecid (250 mg/kg) over 5 weeks. Forty C57BL /6 albino mice were randomly divided into four groups: sedentary control (SC, N = 10), exercise control (EC, N = 10), sedentary PD (SPD, N = 10), exercise PD (EPD, N = 10). At the end of training program, nNOS and iNOS were evaluated in the striatum in all animal groups using immunohistochemistry. Results: nNOS showed significant increases in striatum (ST) of SPD mice compared to SC mice (P > 0.03). There was also decreased expression of nNOS in EC group compared to SC mice, but this decrease was not significant (P > 0.8). Exercise training significantly decreased the level of nNOS in the EPD compared to SPD, (P > 0.04). Although, iNOS expression followed almost the same trend as nNOS, but exercise training did not significantly decrease the expression of iNOS in both EC and EPD groups, P > 0.2 and 0.3 respectively. Discussion: The data from this study suggests that 4 weeks of treadmill exercise has a positive impact on the expression of nNOS and iNOS in the striatum of a PD model. This might clear in part the pathogenicity of the diseases and the positive impact of training on PD. Show more

Keywords: Exercise, Parkinson's disease, nitric oxide

DOI: 10.3233/NRE-130831

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 141-147, 2013

Authors: Schorl, Martin | Valerius-Kukula, Seung Ja | Kemmer, Thomas P.

Article Type: Research Article

Abstract: Introduction: Critical-Illness-Polyneuropathy (CIP) is common in critically ill patients. In contrast to CIP arousing from primary non-neurological causes, studies dealing with CIP following a primary neurological illness are rare. This mono-center, retrospective study was performed to examine a) the incidence of CIP in patients after severe neurological illnesses and b) the impact on ventilator therapy. Material and Methods: Retrospective analysis of all patients, admitted for early (post-acute) neurological rehabilitation following severe neurological diseases between 01.01.2006 and 31.12.2010. Patients routinely underwent standard electrophysiological evaluation (nerve conduction studies of 8 motor and 6 sensory nerves; needle electromyography of 6 muscles). …Diagnosis of CIP required a) pathological spontaneous activity in at least two muscles and b) reduced compound muscle activity potentials (CMAP) in at least two motor nerves of different extremities. Results: CIP was diagnosed in 430 of 623 patients (69.0%). Patients with proven CIP required significantly (p < 0.001) longer ventilator therapy (33.1 days) in contrast to patients without CIP (21.5 days). Conclusion: CIP is common in patients suffering from primary severe neurological diseases. Due to CIP, duration of ventilator therapy is significantly prolonged. In patients with severe neurological diseases electrophysiology is crucial to establish the correct diagnosis. Show more

Keywords: Critical-lllness-Polyneuropathy, ventilator therapy, early neurological rehabilitation, nerve conduction studies, electromyography

DOI: 10.3233/NRE-130832

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 149-156, 2013

Authors: Calis, Funda Atamaz | On, Arzu Yagiz | Durmaz, Berrin

Article Type: Research Article

Abstract: Due to the fact that the phonetic, morphological and syntactic structures of the Turkish language differ significantly from other European languages, the translated forms of the currently available aphasia assessment batteries are not adequate for Turkish-speaking aphasic patients. The aim of this study was to assess the validity and reliability of the Ege Aphasia Test that we have developed. The test, which includes the 8 subtests of praxia, spontaneous language, auditory and verbal comprehension, repetition, naming, reading, writing and calculating, was applied into 100 aphasic patients, 40 dysarthric patients and 40 healthy subjects. All test-retest intra-class correlation coefficients were found …to be excellent (ICC = 0.99). The Cronbach's coefficients ranged from 0.71 to 0.91. All the subtests showed significantly greater scores in aphasic patients (p < 0.05). Significant correlations were found between the subtests and corrected total score (p < 0.05). Finally, the Ege Aphasia Test has an acceptable validity and reliability. It seems to be a promising battery for evaluation of aphasia in the Turkish language, which is spoken mainly in Turkey and in the surrounding regions. We believe that this study will pioneer the development of aphasia rehabilitation in these countries and contribute to future studies. Show more

Keywords: Aphasia, validity, reliability, battery

DOI: 10.3233/NRE-130833

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 157-163, 2013

Authors: Lewis, Fiona M. | Murdoch, Bruce E.

Article Type: Research Article

Abstract: Up to 85% of children treated for brain tumor survive beyond five years; hence optimizing quality of life in survivorship has become a priority. As multiple factors contribute to the heterogeneity of neurocognitive and language outcomes for individual children following treatment, a means of monitoring subsequent development is needed for the individual child, particularly when pre-morbid performance indices are not available. The current study investigated the use of developmental language trajectories as a means of monitoring language development subsequent to treatment for tumors located within the posterior fossa. The language skills of four children treated for posterior fossa tumor (PFT) …were monitored over time (range of monitoring: 2–6 years) and the resultant trajectories were plotted against the trajectories based on tests' normative data as well as the trajectories of control children drawn from each child's local community. Each child's trajectory was considered in terms of age-appropriate developmental gains and discussed regarding the need for ongoing clinical monitoring of emerging, developing or established language skills. The study's findings highlight the heterogeneity of language outcomes following PFT. The utility of the application of developmental trajectories for the provision of individualized post-treatment support is discussed. Show more

Keywords: Posterior fossa tumor, language trajectory, risk-adapted treatments

DOI: 10.3233/NRE-130834

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 165-183, 2013

Authors: Kim, Soo Ji | Jo, Uiri

Article Type: Research Article

Abstract: Based on the anatomical and functional commonality between singing and speech, various types of musical elements have been employed in music therapy research for speech rehabilitation. This study was to develop an accent-based music speech protocol to address voice problems of stroke patients with mixed dysarthria. Subjects were 6 stroke patients with mixed dysarthria and they received individual music therapy sessions. Each session was conducted for 30 minutes and 12 sessions including pre- and post-test were administered for each patient. For examining the protocol efficacy, the measures of maximum phonation time (MPT), fundamental frequency (F0 ), average intensity (dB), jitter, …shimmer, noise to harmonics ratio (NHR), and diadochokinesis (DDK) were compared between pre and post-test and analyzed with a paired sample t -test. The results showed that the measures of MPT, F0 , dB, and sequential motion rates (SMR) were significantly increased after administering the protocol. Also, there were statistically significant differences in the measures of shimmer, and alternating motion rates (AMR) of the syllable /Kə/ between pre- and post-test. The results indicated that the accent-based music speech protocol may improve speech motor coordination including respiration, phonation, articulation, resonance, and prosody of patients with dysarthria. This suggests the possibility of utilizing the music speech protocol to maximize immediate treatment effects in the course of a long-term treatment for patients with dysarthria. Show more

Keywords: Accent-based, music-speech protocol development, mixed types of dysarthria, stroke patients

DOI: 10.3233/NRE-130835

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 185-190, 2013

Authors: Kwon, Jung Won | Nam, Seok Hyun | Lee, Na Kyung | Son, Sung Min | Choi, Yong Won | Kim, Chung Sun

Article Type: Research Article

Abstract: Purpose: This study examined whether transcranial direct current stimulation (tDCS) of the primary motor cortex alters the response time in motor suppression using the stop-signal task (SST). Methods: Forty healthy subjects were enrolled in this study. The subjects were assigned randomly to either the tDCS condition or sham control condition. All subjects performed a stop-signal task in three consecutive phases: without, during or after the delivery of anodal tDCS on the primary motor cortex (the pre-tDCS motor phase, on-tDCS motor phase, and after-tDCS motor phase). Results: The response times of the stopping process were significantly lower …in each SST motor phase during or after tDCS (p < 0.05) and shorter immediately during delivery of the tDCS, whereas there was no change after the delivery of tDCS compared to sham condition. In contrast, the response times of the going process were similar under the two conditions (p > 0.05). No subjects complained of any adverse symptoms or signs. Conclusion: Anodal tDCS enhances voluntary going and stopping of movement in executive control. tDCS appears to be an effective modality to modulate motor suppression and its related dynamic behavioral changes in motor sequential learning. Show more

Keywords: Transcranial direct current stimulation, stop-signal task, motor suppression, primary motor cortex

DOI: 10.3233/NRE-130836

Citation: NeuroRehabilitation, vol. 32, no. 1, pp. 191-196, 2013