NeuroRehabilitation - Volume 35, issue 1

Authors: Tramonti, Francesco | Fanciullacci, Chiara | Giunti, Giulia | Rossi, Bruno | Chisari, Carmelo

Article Type: Research Article

Abstract: Background: While the positive effects of rehabilitation on physical functioning are well documented in stroke literature, more controversial results arise from the evaluation of the impact on quality of life. Objective: The aim of the present study is to examine the associations among functional status and different measures of quality of life in a sample of inpatients undergoing rehabilitation programmes, and to consider the role of psychological distress, coping strategies and social support. Methods: Twenty-nine stroke survivors were evaluated at the admission to a hospital-based Rehabilitation Unit and just before discharge. Questionnaires for the evaluation of …functional status, health-related QoL, individualised QoL, psychological distress, coping strategies and social support were administered to them. Results: While functional status improves significantly after treatment, individualised evaluations of QoL seem to be less affected. Adaptive coping strategies and social support showed significant correlations with positive outcomes on specific QoL domains, whereas psychological distress was associated with negative outcomes. Conclusions: The data from the present study support the evidence that different measures of QoL and functional status are not strongly associated one another, and that psychological distress, coping strategies and social support can be significantly related to specific outcome measures. Show more

Keywords: Stroke, functional status, quality of life, coping, family, social support

DOI: 10.3233/NRE-141092

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 1-7, 2014

Authors: Finch, Emma | Fleming, Jennifer | Clark, Kathy | Hayward, Kathryn S.

Article Type: Case Report

Abstract: Background: Thrombolysis with recombinant tissue plasminogen activator (rtPA) is part of routine acute stroke clinical practice worldwide. Yet, it is unclear how rtPA influences specific rehabilitation outcomes, such as motor, cognitive and communication function. Objective: The present study aimed to collect pilot data about the effects of rtPA on communication and motor recovery during the first three months post-rtPA. Methods: Four individuals who received thrombolysis with rtPA for a single left hemisphere ischaemic stroke completed an assessment battery two weeks and three months post-stroke. Information pertaining to allied health service usage was also investigated. …Results: Reliable changes in assessment scores were observed for lower limb function in two participants with severe functional limitations. There was no reliable change in lower limb function for the two milder participants, or for any participants in upper limb or language function. Service usage varied between participants. Two participants required extensive inpatient rehabilitation. Three participants required outpatient or community rehabilitation. Conclusions: Tailoring of the service delivery approach may be required for individuals who receive rtPA based on functional limitations evident post-rtPA. Future research into the impact of rtPA on motor, cognitive and communication recovery after stroke is vital to inform rehabilitation programs and optimize outcomes. Show more

Keywords: Thrombolysis, interdisciplinary, rehabilitation, stroke, outcome, tissue plasminogen activator

DOI: 10.3233/NRE-141091

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 9-16, 2014

Authors: Hayward, Kathryn S. | Kuys, Suzanne S. | Barker, Ruth N. | Brauer, Sandra G.

Article Type: Research Article

Abstract: Background: Severe arm disability is considered to indicate poor potential to recover arm function. Objective: Determine if stroke survivors with severe upper arm disability can achieve a clinically important change in arm function on discharge from inpatient rehabilitation. Methods: 618 stroke survivors from 16 inpatient rehabilitation units were assessed on admission and discharge using the Motor Assessment Scale Item 6 Upper Arm Function (MAS6). Admission scores defined participants with severe (MAS6 ≤2) and mild/moderate (MAS6 >2) upper arm disability. A clinically important change was evaluated according to: 1) statistical significance; 2) minimal clinical importance difference (MCID); …and 3) shift in disability status i.e., severe to mild/moderate. Achievers of a MCID and shift were compared to non-achievers. Results: Stroke survivors with severe upper arm disability (n = 226) demonstrated a significant improvement in arm function (p < 0.001) at discharge. A MCID was achieved by 68% (n = 155) and a shift from severe to mild/moderate upper arm disability on discharge by 45% (n = 102) of participants. Achievers had a significantly shorter interval from stroke onset to inpatient rehabilitation admission (p < 0.002). Conclusion: Stroke survivors with severe upper arm disability can achieve a clinically important change during inpatient rehabilitation. Show more

Keywords: Stroke, inpatient rehabilitation, functional recovery, severe, motor

DOI: 10.3233/NRE-141096

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 17-23, 2014

Authors: Rousseaux, Marc | Daveluy, Walter | Kozlowski, Odile | Allart, Etienne

Article Type: Research Article

Abstract: Background: Hemiplegic patients with supraspinal spasticity can present with a flexor pattern at the hip and knee that hampers both passive and active functions. Objective: To investigate the efficacy of OnabotulinumtoxinA injections on this flexor scheme. Methods: This open-label observational study included eleven patients who had suffered a unilateral stroke or traumatic brain injury. All had impairment in the activities of daily living caused by severe hip and knee flexion. OnabotulinumtoxinA injections of 300–400U (total dose) were administered to the iliopsoas (iliacus) and knee flexors and, when necessary, to other muscles of the hip and knee. …Evaluations were performed pre-treatment (weeks −4 to −8, and day 1) and post-treatment (week 10 and week 21): spasticity, range of motion, limb positioning, passive functions and pain. Results: A modest improvement in hip and knee extension was observed, as evidenced by the Modified Ashworth Score and range of passive extension movements. Limb positioning was also improved. Clear benefits were found on passive functioning, including toileting, dressing and bed facilities, as well as pain levels. Active functions remained unchanged. More definite improvement was found in patients with severe difficulties. Conclusions: OnabotulinumtoxinA injection can contribute to reducing the consequences of disabling lower limb flexion. Show more

Keywords: Botulinum toxin type-A, lower limb, muscle spasticity, onabotulinumtoxinA

DOI: 10.3233/NRE-141093

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 25-30, 2014

Authors: Nakamura, Junji | Kita, Yorihiro | Yuda, Tomohisa | Ikuno, Koki | Okada, Yohei | Shomoto, Koji

Article Type: Case Report

Abstract: Background: A recent study investigated the effects of galvanic vestibular stimulation (GVS) on pusher behavior (PB) in post-stroke patients. However, there have been no reports about the effects of multisession GVS on PB. Objective: The purpose of this study was to investigate the feasibility and effects of multisession GVS combined with physical therapy for PB in stroke patients. Methods: Two stroke patients who showed PB were enrolled. The ABAB single-case design was used. Each phase lasted 1 wk. In phases A1 and A2, the patients underwent a 60-min-long physical therapy session 5 days a week. In …phases B1 and B2, they underwent GVS for 20 min before each physical therapy session, and then the same physical therapy program as in phases A1 and A2 were performed. PB was evaluated using the Scale for Contraversive Pushing (SCP) and the Burke Lateropulsion Scale (BLS). Outcomes were tested at the baseline and after each phase. Results: In both patients, the SCP scores were reduced only during phase B2. Although the BLS scores improved at the A1 phase, a larger improvement was seen at the two B phases. Conclusions: Multisession GVS combined with physical therapy may have positive effects on PB in clinical setting. Show more

Keywords: Pusher behavior, galvanic vestibular stimulation, stroke, rehabilitation, electrical stimulation, posture control

DOI: 10.3233/NRE-141094

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 31-37, 2014

Authors: Fernandes, Aline Braga Galvão Silveira | Oliveira dos Passos, Jacilda | Paiva de Brito, Deyvson | Fernandes Campos, Tania

Article Type: Research Article

Abstract: Background: Stroke is a major cause of motor disability in adults and needs interventions that contribute to motor recovery. Objective: This study aimed to compare the immediate effect of the training with virtual reality game in stroke patients according side brain injury. Methods: The participants included 20 patients (10 right brain injury), mean age of 50.6 ± 9.2 years, and 20 healthy subjects of 50.9 ± 8.8 years. All participants made a kinematic evaluation of drinking a cup of water before and after training with the table tennis game of the XBOX 360 Kinect® , in …two series of 10 tries of 45 s, with 15 minutes rest between them, a total of 30 minutes. Data were analyzed by ANOVA. Results: There was a significant difference in the number of hits between patients and healthy subjects groups, in which patients had a lower performance in all the trials (p = 0.008). After the training, only patients with right brain injury improved their shoulder and elbow angles, approaching the left upper limb movement pattern of healthy subjects (p < 0.05). Conclusion: Patients with right brain injury responded better to the virtual reality game, suggesting introduction of new treatment techniques that promote neurorehabilitation. Show more

Keywords: Stroke, brain injury, hemiparesis, motor disability

DOI: 10.3233/NRE-141105

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 39-45, 2014

Authors: Rotenberg-Shpigelman, Shlomit | Rosen-Shilo, Lee | Maeir, Adina

Article Type: Research Article

Abstract: Background: Self-awareness is a significant predictor of neurorehabilitation process and outcome and encompasses metacognitive knowledge and online awareness. The literature focuses primarily on intellectual awareness and research on online awareness is lacking. Objective: To examine online awareness for functional tasks, how it is affected by task experience and its relationships with neurogenic and psychogenic factors. Methods: Thirty six adults with ABI attending neurorehabilitation participated in this study. Online awareness was measured as the discrepancy between subjective ratings of performance and performance on functional tasks, as rated by experienced therapists. Participants' ratings were recorded before and immediately …after task experience, as well as following a mediated review of task steps. The Impaired Self-Awareness scale (ISA) and the Denial of Disability scale (DD) rated neurogenic and psychogenic mechanisms of unawareness. Results: Results indicated significant differences between therapists' and participants' ratings before and after IADL task performance, and following mediation. Participants typically overestimated their functional independence and did not significantly change their ratings after task experience. Significant moderate to strong correlations were found between online awareness measures and both DD and ISA scales. Conclusions: Overestimation of functional independence is common in persons with ABI, is related to both neurogenic and psychogenic factors and is not significantly affected by single task experience. Further studies are required to examine the effect of theoretically driven awareness interventions in neurorehabilitation. Show more

Keywords: Online awareness, task performance, neurorehabilitation, ABI

DOI: 10.3233/NRE-141101

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 47-56, 2014

Authors: Lee, Yuen Shan Christine | Ashman, Teresa | Shang, Andrea | Suzuki, Wendy

Article Type: Research Article

Abstract: Background: Physical exercise has been proven to be an effective method for improving cognition and mood, but little is known about its benefits among individuals with traumatic brain injury. Objective: This pilot study investigated the feasibility of a combined exercise and self-affirmation intervention (IntenSati) for enhancing cognition and mood in individuals with TBI. It was hypothesized that this intervention would improve individuals' cognition and mood following the completion of the program. Method: This intervention was held at an outpatient rehabilitation department in an urban medical center. A wait-list control design was conducted. Twenty-one adult participants—at least …12-months post-TBI—enrolled in the study. Twelve of them completed the study. Assessment was conducted at three time-points throughout the study using neuropsychological and self-report measures to evaluate participants' cognition and mood. Following initial evaluation, participants were assigned into either the immediate intervention group or the waitlist control group. During the intervention, participants attended the program twice a week over the course of 8 weeks. Debriefing was conducted following the completion of the program. Results: Both independent t tests and paired t tests were utilized. Results indicated that the intervention group experienced less depressive symptoms following the completion of the IntenSati program compared to the waitlist control group. Participants also reported having less depressive symptoms, experienced more positive affect, and had a higher quality of life following the completion of the program. Moderate-to-large effect sizes were found on decrease in negative affect. However, results associated with cognitive benefits were mixed. The participants tolerated the program well and reported satisfaction with the program. Conclusions: Results from this study indicated that the IntenSati exercise program is a feasible and beneficial intervention for individuals with TBI as supported by the positive impact on their mood and quality of life. Show more

Keywords: Traumatic brain injury, physical exercise, cognition, mood

DOI: 10.3233/NRE-141100

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 57-65, 2014

Authors: Castaño Monsalve, B. | Laxe, Sara | Bernabeu Guitart, M. | Bulbena Vilarrasa, Antoni | Quemada, Jose Ignacio

Article Type: Research Article

Abstract: Neurobehavioral disorders are common consequences of traumatic brain injury (TBI) that should be objectively assessed in this population. The use of scales allows us to unify terms both in clinical practice and investigative work; it also constitutes a useful guide in clinical interviews and makes it possible to see outcome changes in patients with or without intervention. The aim of this study is to review the most frequently neurobehavioral scales used to measure the non-cognitive disorders of conduct in TBI patients. Method: A systematic and descriptive literature review was done in Medline, without time limit, which focused on …scales applied to behavioral disorders in moderate and severe TBI patients. Results: Ninety articles were selected for the final review and thirty-seven different scales were identified. Seven of these instruments represent sixty-five percent of all behavioral scales applied in the studies collected and were selected for the present review. There are scales that are more general and include a wide range of neurobehavioral symptoms, like the Neurobehavioral Rating Scale and the Neuropsychiatric Inventory. On the opposite, there are questionnaires that focus on specific symptoms like aggressiveness, agitation and apathy such as the Agitated Behavior Scale or the Apathy Evaluation Scale. The forms for caregiver or staff were the most prevalent in our review. The most representative behavioral scales applied to moderate and severe TBI patients were analyzed using clinical useful, covered domains, item descriptions, administration procedures and psychometric properties. Show more

Keywords: Brain injury, neurobehavioral, emotional, scales, instruments, measure, assessment, disability, neurorehabilitation, outcome

DOI: 10.3233/NRE-141103

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 67-76, 2014

Authors: Smith, Lindsey K. | Goberman, Alexander M.

Article Type: Research Article

Abstract: Background: Various methods of acoustic analysis have been used to describe phonatory deficits in Parkinson disease (PD), including long-time average spectrum (LTAS) analysis. Objective: The aim of this study was to utilize the LTAS to investigate laryngeal deficits in individuals with PD. Methods: Twenty-eight individuals with idiopathic PD and 10 controls were participants for this study. An LTAS was generated from a standard reading sample and analyzed using the following measurements: Mean spectral energy (MSE), first spectral peak, spectral tilt (ST), three spectral slope (SS) measures (i.e., SSF0-1kHz , SS1-5kHz , and SS ratio) and four …spectral moments (mean, standard deviation, skewness, and kurtosis). Results: Individuals with PD were found to demonstrate significantly lower MSE, spectral mean and spectral SD, along with higher spectral skewness compared to control speakers. Furthermore, ST was positively correlated with self-rated symptom severity and self-rated medication effectiveness for individuals with PD. Conclusions: The LTAS findings were consistent with either reduced vocal fold adduction or vocal fold bowing in individuals with PD compared to control speakers. Additionally, vocal fold adductory changes were one possible explanation for correlations between LTAS and self-ratings of medication effectiveness and disease severity. Show more

Keywords: Parkinson disease, long-time average spectrum, LTAS, voice, phonation

DOI: 10.3233/NRE-141102

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 77-88, 2014

Authors: Kane, Heather | Halpern, Michael T. | Teixeira-Poit, Stephanie | Frost, Corey | Keating, Michael | Olmsted, Murrey | Johnson, Shana

Article Type: Research Article

Abstract: Background: Rehabilitation care is an important part of comprehensive care for MS patients. Little is known about the number of physiatry residents who are interested in providing care to individuals with multiple sclerosis [MS]. Objective: This study examines factors that influence physiatry residents' interest in providing care to MS patients. Methods: We randomly sampled half of all Accreditation Council for Graduate Medical Education-certified physical medicine and rehabilitation residency programs in the continental United States and Puerto Rico. Surveys were received from 74% of programs (Stage 1 response rate) and from 221 residents (45% Stage 2 response …rate). Results: Residents expressing interest in providing MS care were more likely to be female, Asian, and to select statements emphasizing multidisciplinary care approaches and a community of dedicated professional colleagues as positive features of MS patient care. Residents interested in teaching and with more education debt were marginally more likely to express interest in MS care. Conclusions: Medical education should emphasize the need for physical medicine and rehabilitative care among individuals with MS, the ability of physiatrists to improve the functional status and quality of life for MS patients, and the team-based nature of MS care. Show more

Keywords: Multiple sclerosis, physical and rehabilitation medicine, physiatry, education, medical

DOI: 10.3233/NRE-141095

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 89-95, 2014

Authors: Kerling, A. | Keweloh, K. | Tegtbur, U. | Kück, M. | Grams, L. | Horstmann, H. | Windhagen, A.

Article Type: Research Article

Abstract: Background: Physical capacity (PC) and quality of life (QoL) are both reduced in multiple sclerosis (MS). Objective: Aim of our study was to investigate limitations in PC and QoL in response to the severity of MS. Methods: The study involved 60 patients (PG) (Expanded Disability Status Scale EDSS 0–3:38, EDSS 3.5–6:22) and 48 healthy controls (CG). Endurance capacity was assessed as peak oxygen uptake (VO2peak ) and ventilatory anaerobic threshold (VAT). Maximum force was measured in isokinetic testing. QoL was assessed using the SF-36-questionnaire and HALEMS. Results: Patients with MS showed reduced VO2peak …and QoL in comparison with CG. Patients with an EDSS >3 showed reduced VO2peak , and maximum force, however at the VAT there was no significant difference independent of the EDSS. The MS-specific QoL HALEMS and subscales 1, 4, 6, 8 and the physical sum score of the SF-36-questionnaire were evaluated to be better in patients with an EDSS ≤3. Conclusions: There are limitations within PC in patients with MS in comparison with a healthy CG; within the PG there are notes on a similar aerobic capacity but worsened anaerobic capacity in patients with an EDSS >3. This should be taken into account in future treatment strategies for training therapy. Show more

Keywords: Multiple sclerosis, quality of life, VO2peak, EDSS, ventilatory anaerobic threshold (VAT)

DOI: 10.3233/NRE-141099

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 97-104, 2014

Authors: Ploughman, Michelle | Shears, Jennifer | Harris, Chelsea | Hogan, Stephen H. | Drodge, Olivia | Squires, Sherry | McCarthy, Jason

Article Type: Research Article

Abstract: Purpose: To determine the effectiveness of a community re-integration exercise initiative on function, mood, participation, and exercise adherence for persons with moderate to severe neurological conditions (stroke, multiple sclerosis, etc.). Methods: We recruited 29 adults (able to walk at least 3 m with assistance) discharged from an outpatient rehabilitation program for the 10 week intervention which was comprised of two components: circuit training and guided transition to a standard gym setting. We evaluated participants before and after the intervention and at four month follow up, including functional balance and mobility using the Timed Up and Go Test, walking …endurance using the 6 Minute Walk Test, health related quality of life (HR QoL) using a visual analogue scale, activity and participation using the Frenchay Activities Index and mood using the Hospital Anxiety and Depression Scale. Results: Twenty-seven participants completed the intervention. The only significant improvement was in HR QoL. Forty-four percent of participants continued to exercise after cessation of the program. Those who continued to exercise (Exercisers n = 12) experienced more improvement in HR QoL than Non-Exercisers (n = 15). Conclusions: This re-integration initiative for people with neurological impairments improved HR QoL and facilitated independent exercise for 44% of participants. The novel component of the program, which facilitated transition to standard gym equipment, likely contributed to improved exercise adherence in the longer term. Show more

Keywords: Community-based, multiple sclerosis, Parkinson's disease, stroke, neurological disorders, participation, quality of life

DOI: 10.3233/NRE-141090

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 105-112, 2014

Authors: Amichai, Taly | Katz-Leurer, Michal

Article Type: Research Article

Abstract: Objective: A systematic review which aims to assess the evidence regarding the function of the autonomic heart rate regulation system among children with cerebral palsy (CP). Methods: The target population included children with CP of diverse severity, aged 1.5 to 18 years. Databases searched for English language studies from 1960 to 2013: PubMed, EMBASE, CINAHL, Cochrane Library, The Physiotherapy Evidence Database (PEDro), and ClinicalTrials.gov site. Search terms included ‘cerebral palsy’ or ‘spastic diplegia’ or ‘hemiplegia’ or ‘quadriplegia’ and ‘autonomic nervous system’ or ‘heart rate variability’ or ‘sympathetic’ or ‘para sympathetic’. Twenty five articles were identified and included if …(1) participants were less than 18 years of age, (2) diagnosis of CP was made after the age of 18 months (3) more than 80% of cases had a diagnosis of CP and (4) autonomic cardiac heart rate regulation system state or response to a stimuli was described for all the participants. Six articles met the criteria for inclusion. Results: Evidence suggests that reduced Heart Rate Variability (HRV) time domain parameters close to birth are associated with a CP diagnosis at the age of three years. In addition, HRV parameters' mean values, are significantly lower among children with CP compared to typically developed (TD) control. While performing head up, tilt or standing position, HRV was significantly reduced only among TD control, but no effect was seen in those variables among children with CP. Conclusion: Further studies are needed to assess the potential to predict CP by assessing HRV parameters among newborn children. In addition, assessing HRV among children with CP may improve our understanding of the heart rate autonomic system and its response to different stimulus such as muscle contraction, paced breathing and aerobic training. Show more

DOI: 10.3233/NRE-141097

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 113-122, 2014

Authors: Boyaci, Ahmet | Tutoglu, Ahmet | Boyaci, Nurefsan | Koca, Irfan | Calik, Mustafa | Sakalar, Ali | Kilicaslan, Nihat

Article Type: Research Article

Abstract: Objective: To investigate changes in stiffness in the gastrocnemius (GCM) muscle following rehabilitation therapy and botulinum toxin type A (BTX-A) injections in patients with spastic cerebral palsy (CP). Methods: The study included 16 children with spastic CP (Group 1) and 17 healthy children (Group 2). The children with CP received BTX-A injections and underwent rehabilitation therapy. The GCM and soleus muscles of the CP group were evaluated according to the modified Ashworth scale (MAS). The thicknesses of the muscles were measured, and the elasticity score (ELX 2/1) index was calculated. Results: The ELX 2/1 indices of …the gastromedialis (GM) and gastrolateralis (GL) were significantly higher in Group 1 than in Group 2 (p < 0.05). The ELX 2/1 indices in the GM and GL muscles in the CP group were found to have decreased 4 weeks after the procedure (p < 0.05). Furthermore, the mean MAS score of the ankle decreased, from 3.4 to 2.6 (p < 0.05). GM ELX 2/1 in Group 1 (post-treatment) was significantly different from Group 2 (p < 0.05). Conclusions: The combined use of clinical scales and sonoelastography can provide valuable information for determining structural changes in the GCM muscle following rehabilitation therapy and BTX-A injections. Show more

Keywords: Cerebral palsy, elasticity score index, gastrocnemius muscle, rehabilitation, spasticity

DOI: 10.3233/NRE-141107

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 123-129, 2014

Authors: Lee, Dong Ryul | Kim, Yun Hee | Kim, Dong A. | Lee, Jung Ah | Hwang, Pil Woo | Lee, Min Jin | You, Sung (Joshua) Hyun

Article Type: Research Article

Abstract: Background: In children with cerebral palsy (CP), the never-learned-to-use (NLTU) effect and underutilization suppress the normal development of cortical plasticity in the paretic limb, which further inhibits its functional use and increases associated muscle weakness. Objective: To highlight the effects of a novel comprehensive hand repetitive intensive strengthening training system on neuroplastic changes associated with upper extremity (UE) muscle strength and motor performance in children with spastic hemiplegic CP. Method: Two children with spastic hemiplegic CP were recruited. Intervention with the comprehensive hand repetitive intensive strengthening training system was provided for 60 min a day, three …times a week, for 10 weeks. Neuroplastic changes, muscle size, strength, and associated motor function were measured using functional magnetic resonance imaging (MRI), ultrasound imaging, and standardized motor tests, respectively. Results: The functional MRI data showed that the comprehensive hand repetitive intensive strengthening training intervention produced measurable neuroplastic changes in the neural substrates associated with motor control and learning. These neuroplastic changes were associated with increased muscle size, strength and motor function. Conclusions: These results provide compelling evidence of neuroplastic changes and associated improvements in muscle size and motor function following innovative upper extremity strengthening exercise. Show more

Keywords: Neuroplasticity, cerebral palsy, functional magnetic resonance imaging, strength training, muscle size

DOI: 10.3233/NRE-131036

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 131-136, 2014

Authors: Tánczos, Tímea | Zádori, Dénes | Jakab, Katalin | Hnyilicza, Zsuzsanna | Klivényi, Péter | Keresztes, László | Engelhardt, József | Németh, Dezső | Vécsei, László

Article Type: Case Report

Abstract: Background: Lightning-related injuries most often involve impairment of the functions of the central and peripheral nervous systems, usually including cognitive dysfunctions. We evaluated the cognitive deficit of a patient who had survived a lightning strike and measured the improvement after her cognitive training. This therapeutic method appears to be a powerful tool in the neurorehabilitation treatment. Objective: The aim of this case study was to prove the beneficial effects of cognitive training as part of the neurorehabilitation after a lightning strike. Methods: Six neuropsychological functions were examined in order to test the cognitive status of the …patient before and after the 2-month cognitive training: phonological short-term memory (digit span test and word repetitions test), visuo-spatial short-term memory (Corsi Block Tapping Test), working memory (backward digit span test and listening span test), executive functions (letter and semantic fluencies), language functions (non-word repetition test, Pléh-Palotás-Lörik (PPL) test and sentence repetition test) and episodic memory (Rivermead Behavioral Memory Test and Mini Mental State Examination). We also utilized these tests in aged-matched healthy individuals so as to be able to characterize the domains of the observed improvements more precisely. Results: The patient exhibited a considerable improvement in the backward digit span, semantic fluency, non-word repetition, PPL, sentence repetition and Rivermead Behavioral Memory tests. Conclusions: The cognitive training played an important role in the neurorehabilitation treatment of this lightning injury patient. It considerably improved her quality of life through the functional recovery. Show more

Keywords: Lightning injury, neurorehabilitation, neuropsychological tests, cognitive training

DOI: 10.3233/NRE-141106

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 137-146, 2014

Authors: Ness, Bryan M. | Rocke, Maya R. | Harrist, Christopher J. | Vroman, Kerryellen G.

Article Type: Research Article

Abstract: Background: Enrolling in post-secondary education is common among military service members returning from combat deployments, but recent research shows service members who present with neurobehavioral symptoms consistent with traumatic brain injury (TBI) and/or post-traumatic stress disorder (PTSD) are at risk for psychosocial and academic difficulty. Objective: This exploratory study was conducted to examine the academic experiences of service members through in-depth qualitative analysis. Methods: An initial survey was conducted at a public university to measure self-reported academic achievement and neurobehavioral symptoms experienced by service members (n = 48). Then, follow-up interviews were solicited from a sub-sample …(n = 5) of participants to gain an in-depth understanding of their transition, social, and academic experiences. Results: The results revealed both the day-to-day challenges participants faced while adjusting to post-secondary life and how neurobehavioral symptoms associated with combat trauma interacted with their learning experiences. The findings indicated participants did not perceive neurobehavioral symptoms as particularly deleterious to their learning thereby highlighting the potentially integral role of coping strategies and motivation in post-secondary success. Conclusions: This study underscores the importance of understanding not only the adverse impact of neurobehavioral symptoms but the factors that promote resilience among military service members in post-secondary education. Show more

Keywords: Neurobehavioral symptoms, post-secondary experience, service member/veteran, combat, TBI/PTSD

DOI: 10.3233/NRE-141098

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 147-158, 2014

Authors: Zimmermann, Nicolle | Netto, Tania Maria | Amodeo, Maria Teresa | Ska, Bernadette | Fonseca, Rochele Paz

Article Type: Research Article

Abstract: Background: Neuropsychological interventions have been mainly applied with clinical populations, in spite of the need of preventing negative changes across life span. Among the few studies of cognitive stimulation in elderly, surprisingly there is no enough research comparing direct and indirect active stimulation programs. Objective: This study aims to verify wheter there are differences between two cognitive interventions approaches in older adults: a structured Working Memory (WM) Training Program versus a Poetry-based Stimulation Program. Methods: Fourteen older adults were randomly assigned to participate into one of the two intervention groups. The assessed neurocognitive components were attention, …episodic and working memory, communicative and executive functions. WM Training activities were based on Baddeley's model; Poetry-based Stimulation Program was composed by general language activities. Data were analyzed with one-way ANCOVA with Delta scores and pre and post-training tests raw scores. Results: WM group improved performance on WM, inhibition, and cognitive flexibility measures, while Poetry group improved on verbal fluency and narrative discourse tasks. Discussion: Both approaches presented benefits; however WM Training improved its target function with transfer effects to executive functions, being useful for future studies with a variety of dementias. Poetry-based Stimulation also improved complex linguistic abilities. Both approaches may be helpful as strategies to prevent dysfunctional aging changes. Show more

Keywords: Cognitive training, older adults, transfer, working memory

DOI: 10.3233/NRE-141104

Citation: NeuroRehabilitation, vol. 35, no. 1, pp. 159-170, 2014