NeuroRehabilitation - Volume 36, issue 3

Authors: Kraft, Eduard | Schaal, Matthias C. | Lule, Dorothee | König, Eberhard | Scheidtmann, Klaus

Article Type: Research Article

Abstract: BACKGROUND: The neural correlates of motor imagery (MI) are tightly coupled with the cortical motor control network. Therefore MI may have therapeutic potential for patients with motor deficits after an ischemic stroke. OBJECTIVE: The aim of our study was to assess the hemispheric balance of the cortical motor network during motor imagery (MI) in patients recovering from stroke in the sub-acute stage. METHODS: We studied 17 patients after cerebral ischemic stroke (sub-acute stage) and 12 healthy subjects using functional Magnetic Resonance Imaging (fMRI) during motor imagery and performance of isometric grip force …movements (5 Newton). Laterality indices (LI) were calculated from regional activation analysis to assess hemispheric distribution of activity in pre-specified motor areas. RESULTS: Laterality index (LI) revealed a more balanced cortical activity in MI for both controls (−0.03) and patients (−0.12) in the premotor cortex compared to movement execution (0.48 controls; 0.12 patients) and a trend towards a shift in contra-lesional activity in stroke patients. CONCLUSIONS: Our results indicate a preserved interhemispheric balance of patients in the sub-acute stage when activating the cortical motor areas during MI. This could provide a reasonable physiologic baseline for using MI as an additional rehabilitative therapy for improving functional recovery in the sub-acute stage after stroke. Show more

Keywords: Motor imagery, stroke, fMRI, motor recovery, motor cortex, premotor cortex

DOI: 10.3233/NRE-151221

Citation: NeuroRehabilitation, vol. 36, no. 3, pp. 329-337, 2015

Authors: Celik, Canan | Can, Asli Gencay | Yalbuzdag, Seniz Akcay | Ozer, Mustafa

Article Type: Research Article

Abstract: BACKGROUND: Sleep disorders and nocturnal hypoxia are common in patients with cerebrovascular disease. Sleep-disordered breathing is associated with a poor functional outcome in stroke patients. OBJECTIVE: We investigated the relationship between nocturnal hypoxia and functional outcome in the rehabilitation phase of stroke patients. METHODS: Thirty patients with stroke and 20 controls were included. Functional status was evaluated with the Functional Independence Measure (FIM). Pulse oximetry was performed overnight from 21.00 h to 07.00 h. Baseline awake oxygen saturation, nocturnal oxygen saturation, the lowest nocturnal oxygen saturation, and the >4% Oxygen Desaturation Index (ODI) were …calculated. RESULTS: The mean oxygen saturation measurements were not significantly different among the groups (p  >  0.05). There was no significant relationship between the FIM scores and the oxygen saturation measurements of the stroke patients (p  >  0.05). The baseline oxygen saturation in patients with disease duration of 3 months or less was 94.67, and it was 96.56 (p  = 0.016) in those with disease duration of more than 3 months. CONCLUSION: This study showed that nocturnal oxygen saturation was not associated with functional outcome in therehabilitation phase of stroke patients. Show more

Keywords: Nocturnal hypoxia, oxygen saturation, stroke, functional outcome

DOI: 10.3233/NRE-151222

Citation: NeuroRehabilitation, vol. 36, no. 3, pp. 339-343, 2015

Authors: Yazici, Gokhan | Guclu-Gunduz, Arzu | Bayraktar, Deniz | Aksoy, Songul | Nazliel, Bijen | Kilinc, Muhammed | Yildirim, Sibel Aksu | Irkec, Ceyla

Article Type: Research Article

Abstract: BACKGROUND: We thought that the application of Kinesio Tape (KT) on the foot and ankle in stroke patients may improve the quality of somatosensory information and may activate ankle muscles which have an important role in postural control and that ultimately balance could be improved in stroke patients. OBJECTIVE: The purpose of this study was to evaluate the effects of KT on balance in stroke patients. METHODS: Nineteen stroke patients and 16 healthy controls were included in the study. The study group was evaluated with and without KT. Balance of the all …subjects was evaluated Sensory Organization Tests (SOT) by using the Computerized Dynamic Posturography. Equilibrium, Strategy Analysis and Composite Equilibrium Scores were investigated in SOT. RESULTS: Statistically significant differences were observed in all of the SOT parameters between stroke patients and healthy controls (p  <  0.05). When the results with and without KT application were compared, the Equilibrium Scores in the conditions 3, 4, 6, Strategy Analysis Score in the conditions 2, 4, 6 and the Composite Equilibrium Score of the SOT were found to be improved in stroke patents (p  <  0.05). CONCLUSIONS: The results obtained from KT application are promising in improving balance in stroke patients. Show more

Keywords: Stroke, Kinesio Taping, balance

DOI: 10.3233/NRE-151223

Citation: NeuroRehabilitation, vol. 36, no. 3, pp. 345-353, 2015

Authors: Lancioni, Giulio E. | Simone, Isabella L. | De Caro, Maria F. | Singh, Nirbhay N. | O’Reilly, Mark F. | Sigafoos, Jeff | Ferlisi, Gabriele | Zullo, Valeria | Schirone, Simona | Denitto, Floriana | Zonno, Nadia

Article Type: Research Article

Abstract: BACKGROUND: Eye-tracking communication devices and brain-computer interfaces are the two resources available to help people with advanced amyotrophic lateral sclerosis (ALS) avoid isolation and passivity. OBJECTIVE: This study was aimed at assessing a technology-aided program (i.e., a third possible resource) for five patients with advanced ALS who needed support for communication and leisure activities. METHODS: The participants were exposed to baseline and intervention conditions. The technology-aided program, which was used during the intervention, (a) included the communication and leisure options that each participant considered important for him or her (e.g., music, videos, …statements/requests, and text messaging) and (b) allowed the participant to access those options with minimal responses (e.g., finger movement or eyelid closure) monitored via microswitches. RESULTS: The participants started leisure and communication engagement independently only during the intervention (i.e., when the program was used). The mean percentages of session time spent in those forms of engagement were between about 60 and 80. Preference checks and brief interviews indicated that participants and families liked the program. CONCLUSIONS: The program might be viewed as an additional approach/resource for patients with advanced ALS. Show more

Keywords: Amyotrophic lateral sclerosis, communication, leisure, technology-aided program, microswitches

DOI: 10.3233/NRE-151224

Citation: NeuroRehabilitation, vol. 36, no. 3, pp. 355-365, 2015

Authors: Virk, Sohaib | Williams, Tracey | Brunsdon, Ruth | Suh, Flora | Morrow, Angie

Article Type: Review Article

Abstract: BACKGROUND: Attention deficits are common after acquired brain injury (ABI) and adversely impact academic, vocational and social outcomes. The role of cognitive interventions in post-ABI attention rehabilitation remains unclear. OBJECTIVE: To evaluate effectiveness of cognitive interventions in treating attention deficits following ABI and to explore differences in treatment effect between ABI etiologies. METHODS: MEDLINE, EMBASE, PsycINFO and CENTRAL databases were searched for randomized controlled trials (RCTs). Studies were selected by three reviewers. Study quality was assessed using Cochrane Collaboration tool for RCTs. Effect sizes (Hedge’s g) for each attentional domain were …meta-analyzed with subgroup analysis by ABI etiology. RESULTS: Twelve RCTs with 584 participants were included, representing individuals with stroke, traumatic brain injury (TBI) and CNS-impacting malignancy. Cognitive rehabilitation improved divided attention in stroke survivors (g 0.67; 95% confidence interval, 0.35–0.98; p  <  0.0001) but not other ABI populations. Sustained, selective and alternating attention, and inhibition were not significantly improved in any ABI population. Follow-up data showed no evidence of long-term benefit. CONCLUSION: Cognitive rehabilitation resulted in short-term improvements in divided attention following stroke, but not after TBI or CNS-impacting malignancy. Cognitive interventions did not significantly improve other attentional domains in participants with stroke, TBI or CNS-impacting malignancy. Show more

Keywords: Acquired brain injury, cognitive rehabilitation, attention, meta-analysis, systematic review

DOI: 10.3233/NRE-151225

Citation: NeuroRehabilitation, vol. 36, no. 3, pp. 367-377, 2015

Authors: Shavelle, Robert M. | Brooks, Jordan C. | Strauss, David J. | Paculdo, David R.

Article Type: Research Article

Abstract: BACKGROUND: Much is known about survival after traumatic brain injury (TBI), yet relatively little about survival after anoxic brain injury (ABI). OBJECTIVE: To determine whether long-term survival after ABI is comparable to that after TBI. METHODS: We identified 237 patients with ABI and 1,620 with TBI in California who were aged 15 to 35, survived at least 1 year post injury, and were injured in 1986 or later. We analyzed the long-term follow-up data using the Cox Proportional Hazards Regression Model, controlling for age, sex, and severity of disability. RESULTS: …After adjustment for risk factors, no significant differences in long-term survival between ABI and TBI were found (hazard ratio = 0.97; 95% c.i. 0.57–1.65). CONCLUSIONS: In adolescents and young adults, long-term survival after ABI appears to be similar to that after TBI. Show more

Keywords: Survival, traumatic brain injury, life expectancy

DOI: 10.3233/NRE-151226

Citation: NeuroRehabilitation, vol. 36, no. 3, pp. 379-382, 2015