NeuroRehabilitation - Volume 33, issue 3

Authors: Saunders, Lee L. | Ekoja, Ene | Whitlock, Chelsea S. | DiPiro, Nicole D. | Gregory-Bass, Rosalind | Krause, James S.

Article Type: Research Article

Abstract: Objective: The purpose of this study is to identify whether protective and risk health behaviors are more common among African Americans with spinal cord injury (SCI) compared with African Americans in the general population. Methods: Mail-in surveys were collected from 252 adult participants with SCI. Behavioral Risk Factor Surveillance System data from 2009 was downloaded. Results: Participants with SCI were more likely to report currently smoking. Among those who reported currently smoking, persons with SCI were less likely to report ever trying to quit. Those with SCI were also more likely to report consuming alcohol and …binge drinking in the past month. Participants with SCI were more likely to receive a flu shot/spray in the past year and to have ever received a pneumonia vaccine. Conversely, those with SCI were less likely to report ever having their blood cholesterol checked. Conclusions: Results of this study suggest that, consistent with previous research, individuals with SCI focused their preventive health behaviors on conditions consistent with SCI prophylactic standard of care (e.g., flu shots and pneumonia vaccines), as compared to behaviors intended to prevent chronic diseases consistent with the overall population. Show more

Keywords: Spinal cord injury, behaviors, disparities, risk, prevention

DOI: 10.3233/NRE-130976

Citation: NeuroRehabilitation, vol. 33, no. 3, pp. 449-456, 2013

Authors: Flansbjer, Ulla-Britt | Brogårdh, Christina | Lexell, Jan

Article Type: Research Article

Abstract: Objective: To assess muscle strength in the knee extensors, knee flexors and ankle dorsiflexors in persons with late effects of polio, and determine how much muscle strength, gender, age and BMI are related to gait performance. Methods: Ninety community-dwelling ambulant persons (47 men and 43 women; mean age 64 years SD 8) with late effects of polio participated. Isokinetic concentric knee extensor and flexor muscle strength was measured at 60°/s and ankle dorsiflexor muscle strength at 30°/s. Gait performance was assessed by the Timed “Up & Go”, the Comfortable and Fast Gait Speed tests, and the 6-Minute Walk …test. Results: There were significant correlations between knee extensor and flexor muscle strength and gait performance (p < 0.01), and between ankle dorsiflexor muscle strength and gait performance (p < 0.05), for both lower limbs. Muscle strength in the knee extensors and flexors explained 7% to 37% and 9% to 47%, respectively, of the variance in gait performance. Strength in the ankle dorsiflexors explained 4% to 24%, whereas gender, age and BMI contributed at most an additional 9%. Conclusion: Knee muscle strength, and to some extent ankle dorsiflexor muscle strength, are predictors of gait performance in persons with late effects of polio, but the strength of the relationships indicates that other factors are also important. Show more

Keywords: Post poliomyelitis syndrome, gait, muscle strength

DOI: 10.3233/NRE-130978

Citation: NeuroRehabilitation, vol. 33, no. 3, pp. 457-464, 2013

Authors: Baek, Seung Ok | Kim, Oh Lyong | Kim, Seong Ho | Kim, Min Soo | Son, Su Min | Cho, Yoon Woo | Byun, Woo Mok | Jang, Sung Ho

Article Type: Research Article

Abstract: Objectives: Many diffusion tensor imaging (DTI) studies have reported an association between cingulum injury and cognition in patients with traumatic brain injury (TBI) using DTI parameters. In this study, we attempted to investigate the relation between cingulum injury and cognition in chronic patients with TBI, using the integrity of the cingulum as well as DTI parameters. Method: Thirty five consecutive chronic patients with TBI were recruited. The intelligence quotient (IQ) of the Wechsler Intelligence Scale and Memory Assessment Scale (MAS) was used for assessment of cognition. The patients were classified into three groups, according to continuity to the …lower portion of the genu of the corpus callosum: type A-both sides of the cingulum showed intact continuity, type B-either cingulum showed a discontinuation, and, type C-both cingulums showed discontinuation. We measured the fractional anisotropy (FA), apparent diffusion coefficient (ADC), and voxel number of both cingulums. Results: The IQ and MAS scores of type A and B were significantly higher than those of type C, respectively (p < 0.05), however, we did not observe a significant difference between type A and type B (p > 0.05). A positive correlation was observed between the FA value of the cingulum, and IQ and MAS, respectively (IQ r = 0.373, p < 0.05, MAS r = 0.357, p < 0.05), and between the voxel number and MAS (r = 0.500, p < 0.05). By contrast, we observed a negative correlation between the ADC value and IQ (r = −0.353, p < 0.05). Conclusion: In terms of integrity to the basal forebrain and DTI parameters of the injured cingulum, DTI findings showed a close association with whole cognition and memory in chronic patients with TBI. Show more

Keywords: Cognition, memory, traumatic brain injury, cingulum, diffusion tensor imaging

DOI: 10.3233/NRE-130979

Citation: NeuroRehabilitation, vol. 33, no. 3, pp. 465-471, 2013

Authors: Kammersgaard, Lars Peter | Linnemann, Mia | Tibæk, Maiken

Article Type: Research Article

Abstract: Objective: To investigate timing and clinical predictors that might predict hydrocephalus emerging during rehabilitation until 1 year following severe traumatic brain injury (TBI). Background: Posttraumatic hydrocephalus (PTH) may lead to clinical deterioration and poor outcome if untreated. However, PTH can be successfully treated if detected. Nevertheless, PTH is easily overlooked during rehabilitation, particularly in severe cases. Method: We prospectively followed all patients (n = 444) in Eastern Denmark (population 2.5 mill) sustaining severe TBI, who required lengthy rehabilitation between 2000 and 2010. All patients with PTH were tracked retrospectively. Demographics, surgery, injury severity, consciousness level, and …disability were compared for patients with versus without PTH. Independent predictors of PTH during rehabilitation were identified through multiple logistic regression models. Results: PTH occurred in 14.2% and 3/4 emerged during rehabilitation. Patients with PTH were older, had more severe brain injuries, were more frequently in vegetative state, and needed longer rehabilitation stays. After adjusted analyses, however, only older age and low level of consciousness were independently associated with PTH. Conclusion: Most cases of PTH emerge during rehabilitation. Therefore, attention towards this complication should be present also beyond the acute stage after TBI, particularly among older patients and patients with severe disordered consciousness. Show more

Keywords: Brain injury, traumatic, hydrocephalus, rehabilitation, prediction

DOI: 10.3233/NRE-130980

Citation: NeuroRehabilitation, vol. 33, no. 3, pp. 473-480, 2013

Authors: Worthen-Chaudhari, Lise | Whalen, Cara N. | Swendal, Catherine | Bockbrader, Marcia | Haserodt, Sarah | Smith, Rashana | Bruce, Michael Kelly | Mysiw, W. Jerry

Article Type: Research Article

Abstract: Background: Interactive arts technologies, designed to augment the acute neurorehabilitation provided by expert therapists, may overcome existing barriers of access for patients with low motor and cognitive function. Objectives: Develop an application prototype to present movement feedback interactively and creatively. Evaluate feasibility of use within acute neurorehabilitation. Methods: Record demographics and Functional Independent Measure™ scores among inpatients who used the technology during physical, occupational or recreational therapy. Record exercises performed with the technology, longest exercise duration performed (calculated from sensor data), user feedback, and therapist responses to a validated technology assessment questionnaire. Results: Inpatients …(n = 21) between the ages of 19 and 86 (mean 57 ± 18; 12 male/9 female) receiving treatment for motor deficits associated with neuropathology used the application in conjunction with occupational, recreational, or physical therapy during 1 to 7 sessions. Patients classified on the Functional Independence Measure™ as requiring 75%+ assistance for cognitive and motor function were able to use the interactive application. Conclusions: Customized interactive arts applications are appropriate for further study as a therapeutic modality. In addition to providing interactivity to individuals with low motor function, interactive arts applications might serve to augment activity-based medicine among inpatients with low problem-solving and memory function. Show more

Keywords: Movement, therapy, patient compliance, neuromuscular diseases, virtual reality, interactive art, biomechanics

DOI: 10.3233/NRE-130981

Citation: NeuroRehabilitation, vol. 33, no. 3, pp. 481-490, 2013

Authors: Miljković, Nadica | Milovanović, Ivana | Dragin, Aleksandra | Konstantinović, Ljubica | Popović, Dejan B.

Article Type: Research Article

Abstract: Background: The main clinical measures of walking recovery in stroke patients were compared for training assisted by Walkaround® postural support (WPS) and conventional (CON) support by a cane/therapist. Objective: We attributed the differences between the trainings to modified muscular synergies that occurred during assistance by WPS. Methods: We studied the muscle activities of the primary knee and ankle joint movers in the paretic and non-paretic legs of sub-acute stroke patients during assisted walking with WPS and CON. Recorded signals were compared to normative data that were recorded during speed-matched gait trials in healthy subjects. The specific …measures were the relative contribution of individual muscles, levels of cocontraction, and the timing of the maximum electromyography (EMG) activity during the walking sessions. Results: We found that, for most patients, the individual contribution of muscles were more similar to the healthy with the WPS assistance. In parallel, the cocontraction of the rectus femoris muscles in both legs was lower (by up to 39 %) during walking assisted by WPS than by cane/therapist gait support); the results from this case series (10 patients) showed that WPS might be the superior training scheme. Conclusions: These findings indicated that assistance by WPS changed the motor control output relative to CON assistance in most patients. Show more

Keywords: EMG, posture, rehabilitation, stroke, synergy

DOI: 10.3233/NRE-130982

Citation: NeuroRehabilitation, vol. 33, no. 3, pp. 491-501, 2013