NeuroRehabilitation - Volume 32, issue 3

Authors: Waldman, Genna | Yang, Chung-Yong | Ren, Yupeng | Liu, Lin | Guo, Xin | Harvey, Richard L. | Roth, Elliot J. | Zhang, Li-Qun

Article Type: Research Article

Abstract: Objectives: To investigate the effects of controlled passive stretching and active movement training using a portable rehabilitation robot on stroke survivors with ankle and mobility impairment. Methods: Twenty-four patients at least 3 months post stroke were assigned to receive 6 week training using the portable robot in a research laboratory (robot group) or an instructed exercise program at home (control group). All patients underwent clinical and biomechanical evaluations in the laboratory at pre-evaluation, post-evaluation, and 6-week follow-up. Results: Subjects in the robot group improved significantly more than that in the control group in reduction in spasticity …measured by modified Ashworth scale, mobility by Stroke Rehabilitation Assessment of Movement (STREAM), the balance by Berg balance score, dorsiflexion passive range of motion, dorsiflexion strength, and load bearing on the affected limb during gait after 6-week training. Both groups improved in the STREAM, dorsiflexion active range of motion and dorsiflexor strength after the training, which were retained in the follow-up evaluation. Conclusion: Robot-assisted passive stretching and active movement training is effective in improving motor function and mobility post stroke. Show more

Keywords: Stretching, movement training, robotics, stroke, rehabilitation

DOI: 10.3233/NRE-130885

Citation: NeuroRehabilitation, vol. 32, no. 3, pp. 625-634, 2013

Authors: McGuinness, Siobhan | Hillan, Josephine | Caldwell, Sheena B.

Article Type: Research Article

Abstract: Objectives: Our purpose is to assess the effectiveness of Botulinum toxin (Btx) on gait dysfunction due to ankle clonus in neurological patients. Methods: We use a retrospective case note review of 11 patients attending the Regional Acquired Brain Injury Unit (RABIU), Musgrave Park Hospital, Belfast, Northern Ireland. All patients had received Btx for the treatment of ankle clonus. Demographic data including diagnosis and time since neurological insult was collected. Information regarding walking speed and assistance required to walk before and after Btx treatment was analysed. Results: In 10 of 11 patients, walking speed was significantly improved …at 4–6 weeks post Btx injections (P = 0.006) and at 14–16 weeks post Btx injections (P = 0.005). Eight patients reduced their level of dependency on assistance. Subjective improvements in levels of pain, gait pattern and ‘toe clawing’ were also reported. Conclusions: Our findings suggest that Botulinum toxin has a role in treating ankle clonus in neurological patients, where it interferes in gait. Walking speed and level of dependence on others improved in this group. Show more

Keywords: Botulinum toxin, ankle clonus, gait, ambulation, patients, rehabilitation

DOI: 10.3233/NRE-130886

Citation: NeuroRehabilitation, vol. 32, no. 3, pp. 635-647, 2013

Authors: Bang, Young-Im | Min, Kyunghoon | Sohn, Young H. | Cho, Sung-Rae

Article Type: Research Article

Abstract: The purpose of this study was to define the acoustic voice and speech characteristics of patients with Parkinson disease (PD). Seven female patients with PD and seven female healthy controls participated in this study. Each subject was instructed to vocalize extended corner vowels (/a/, /e/, /i/, /u/) three times for at least 5 seconds at a comfortable voice loudness and tone. The voice was analyzed using the Praat program. As a result, female patients with PD showed a significant increase in jitter and noise-to-harmonics ratio (NHR). In addition, F1 and F2 among the PD patients demonstrated asymmetric centralization of unrounded …vowels (/a/, /e/, /i/) in high/low/front/back positions of the tongue, consequently leading to a significant decrease in vowel space area, compared to healthy controls. This study showed the acoustic characteristics of vowel sounds not only by laryngeal variables such as abnormal jitter and NHR, but also by articulatory variables such as asymmetric centralization and reduced vowel space area in female patients with PD. Therefore, it is important to use these objective and sensitive variables to evaluate the status or severity of hypokinetic dysarthria in patients with PD. Show more

Keywords: Parkinson disease, acoustic analysis, vowel space area, centralization

DOI: 10.3233/NRE-130887

Citation: NeuroRehabilitation, vol. 32, no. 3, pp. 649-654, 2013

Authors: Hilgers, Christoph | Mündermann, Annegret | Riehle, Hartmut | Dettmers, Christian

Article Type: Research Article

Abstract: Objective: The aim of this randomized controlled trial was to test the hypothesis that a three-week whole body vibration (WBV) training in addition to a standard rehabilitation program improves walking ability in patients with Multiple Sclerosis (MS). Patients and Method: Sixty patients with definite MS were randomly allocated to the intervention or control group. Training sessions were performed three times per week for three weeks. Patients adopted a moderate squat position on a vibration platform. The training sessions comprised series of 3 × 60-sec exercise sets with increasing amplitude between sessions from 1 to 2 mm. During the …exercise series, the vibration platform was turned on for the intervention group and switched off for the control group. A mixed factor ANOVA was used to compare sit to stand test, timed up and go test, 10-meter walk test, and 6-min walk test data between patient groups and between baseline and follow-up. Results: All outcome measures improved from baseline to follow-up (P < 0.001). The 6-minute walk test showed significantly greater improvements from baseline to follow-up for the intervention than for the control group (P < 0.001). Conclusion: Determinants of walking ability in patients with MS that are specific to walking endurance tasks are most affected by vibration training designed to improve strength endurance. Show more

Keywords: Walking ability, endurance, fatigue, rehabilitation, multiple sclerosis, whole body vibration, vibration platform, WBV

DOI: 10.3233/NRE-130888

Citation: NeuroRehabilitation, vol. 32, no. 3, pp. 655-663, 2013

Authors: Yeo, Sang Seok | Kim, Seong Ho | Jang, Sung Ho

Article Type: Research Article

Abstract: Background: The corticoreticular pathway (CRP) innervates the proximal muscles of extremities and axial muscles; therefore, it is involved in postural control and gait. We report on a patient who exhibited proximal weakness due to a CRP injury, which was evaluated using diffusion tensor tractography (DTT). Methods: A 62-year-old male patient who had been injured in a traffic accident underwent conservative management for a contusional hemorrhage in the right frontotemporal lobes, and a subdural and epidural hematoma in the right temporoparietal lobes. The patient exhibited right proximal weakness (shoulder: 3+ , hip: 3+ ) at two weeks after onset. …Findings on brain MRI revealed encephalomalactic lesions in both frontal lobes. Results: Findings on DTT of the left CRP showed discontinuation at the midbrain level; in contrast, the integrities of the corticospinal tract in both hemispheres were maintained from the cerebral cortex to the medulla along the known pathway of the corticospinal tract. Conclusion: The proximal weakness of the right shoulder and hip observed in this patient appeared to be attributed to injury of the left CRP. Show more

Keywords: Diffusion tensor imaging, corticoreticulospinal tract, corticoreticular pathway, corticospinal tract, stroke

DOI: 10.3233/NRE-130889

Citation: NeuroRehabilitation, vol. 32, no. 3, pp. 665-669, 2013

Authors: Foy, Catherine M.L. | Somers, Julian S.

Article Type: Research Article

Abstract: Objectives: To characterize and determine the pre-injury and injury-related variables that are linked to the extent of functional recovery following rehabilitation at a mixed therapy and educational residential programme and whether these variables differ for traumatic brain injury (TBI) and non traumatic brain injury (nonTBI). Methods: 106 young adults (age 16–36 years) with moderate-to-severe TBI who had attended and been discharged from the centre since 2002 were included. Clients received 5 hours of education and/or therapy each day. Functional level was assessed using the FIM + FAM. Regression analysis was used to determine possible predictors of functional independence …at discharge. Main Outcomes and Results: Clients with TBI and nonTBI made clinically and statistically significant improvements in their functional abilities during their neurorehabilitation. For the combined TBI and nonTBI group, FIM + FAM scores at discharge were predicted by FIM + FAM at admission and length of stay. These two predictors explained 80% of the variance in the FIM + FAM score at discharge. Conclusion: Both clients with TBI and nonTBI benefited from a mixed inpatient neurorehabilitation programme. This benefit was predicted by their functional abilities at admission and the length of stay. These findings are of importance as it becomes increasingly necessary to demonstrate who will benefit from residential intensive neurorehabilitation as opposed to community therapy. Show more

Keywords: Traumatic brain injury, functional independence measure, outcomes, education

DOI: 10.3233/NRE-130890

Citation: NeuroRehabilitation, vol. 32, no. 3, pp. 671-678, 2013

Authors: Perrin, Paul B. | Stevens, Lillian Flores | Villaseñor Cabrera, Teresita | Jimenez-Maldonado, Miriam | Martinez-Cortes, Maria Luisa | Arango-Lasprilla, Juan Carlos

Article Type: Research Article

Abstract: Objective: To compare the mental health of family caregivers of individuals with Traumatic brain injury (TBI) to an age-matched healthy control from Guadalajara, Mexico. Setting: Hospital Civil Fray Antonio Alcade, a public medical facility in Guadalajara, Mexico. Participants: Ninety family caregivers of individuals with TBI and 89 healthy controls (n = 179) did not differ with respect to age, sex, marital status, education, or household income. Main Outcome Measures: Outcome measures assessed satisfaction with life (Satisfaction with Life Scale), depression (Patient Health Questionnaire-9), social support (Interpersonal Support Evaluation List), self-esteem (Rosenberg Self-Esteem Scale), …and anxiety (State-Trait Anxiety Inventory). Results: A multivariate analysis of variance found that in comparison to controls, TBI caregivers reported substantially lower mental health scores across all indices, as well as lower social support in two out of three comparisons. The effect sizes of the social support differences were small; two out of five mental health differences reached medium-sized effects; and the other three reached large-sized effects. Conclusions: Because TBI caregivers’ mental health influences the quality of informal care they can provide, mental health interventions for family caregivers are an extremely important part of TBI rehabilitation in Latin America, especially considering familism as a core value in Latino culture. Show more

Keywords: TBI caregivers, Latin America, mental health

DOI: 10.3233/NRE-130891

Citation: NeuroRehabilitation, vol. 32, no. 3, pp. 679-686, 2013

Authors: Kim, Hyung-Sik | Choi, Mi-Hyun | Kim, Hyun-Joo | Yeon, Hong-Won | Yoon, Hee-Jeong | Lee, In-Hwa | Hong, Sang-Pyo | Yu, Na-Rae | Choi, Jin-Seung | Yi, Jeong-Han | Chung, Young-Sun | Lim, Dae-Woon | Chung, Soon-Cheol

Article Type: Research Article

Abstract: Background: This study attempted to identify the effect of administration of highly concentrated oxygen on simple visual matching task performance, blood oxygen saturation [SpO2 (%)], and heart rate [HR (bpm)] of intellectually and developmentally disabled people. Methods: Nineteen intellectually and developmentally disabled people (mean age 30.6 ± 5.7 years) participated in an experiment consisting of a simple visual matching task performed under 21% and 92% oxygen. SpO2 and HR were measured under both oxygen conditions. Results: When 92% oxygen was supplied, the response time decreased, SpO2 increased, and HR decreased compared to the …vales obtained using 21% oxygen. The response time decreased for subjects with a high SpO2 and HR during the simple visual matching task phase. Conclusion: This result supports the hypothesis that administration of highly concentrated oxygen can positively affect the cognitive performance of intellectually and developmentally disabled people. Show more

Keywords: Highly concentrated oxygen, cognitive performance, blood oxygen saturation, heart rate, intellectually and developmentally disabled people

DOI: 10.3233/NRE-130892

Citation: NeuroRehabilitation, vol. 32, no. 3, pp. 687-692, 2013

Authors: Eichstaedt, Katie E. | Kovatch, Keith | Maroof, David Aaron

Article Type: Research Article

Abstract: Background: The traditional Bonferroni method is a commonly used post hoc hypothesis test to adjust for familywise error rate inflation; however, a less well-known derivative of this test, the Holm’s sequential procedure, provides an alternative method for familywise error rate correction. This less conservative approach is particularly relevant to studies investigating neuropsychological functioning because of the extent to which neuropsychological datasets tend to include interrelated outcome measures, reducing the relevance of the universal null hypothesis assumption, on which the traditional Bonferroni method relies. Methods: Mathematical illustrations demonstrating how to compute the two adjustments are provided. The two …methods are compared using a simple hypothetical dataset. Results: By using the divisors (n − j + 1) in lieu of n , Holm’s sequential procedure is guaranteed to never reject fewer hypotheses than the traditional Bonferroni adjustment. Conclusions: The Holm’s sequential procedure corrects for Type I error as effectively as the traditional Bonferroni method while retaining more statistical power. Although the Holm’s sequential procedure is more complicated to compute than the traditional Bonferroni method, the Holm’s sequential procedure may be a more appropriate method for adjusting familywise error rate inflation in many types of neuropsychological research. Show more

Keywords: Holm's sequential, Bonferroni, Type I error, neuropsychology

DOI: 10.3233/NRE-130893

Citation: NeuroRehabilitation, vol. 32, no. 3, pp. 693-696, 2013