NeuroRehabilitation - Volume 37, issue 1

Authors: Bang, Dae-Hyouk | Shin, Won-Seob | Choi, Ho-Suk

Article Type: Research Article

Abstract: BACKGROUND: Reducing the compensatory mechanism by restraining the unnecessary movement may be helpful in relearning the upper-limb movement. OBJECTIVE: To investigate the effects of a modified constraint-induced movement therapy (mCIMT) with trunk restraint (TR) in chronic stroke patients with moderate impairment. METHODS: Eighteen participants with hemiparesis were randomly assigned to mCIMT + TR or mCIMT. Each group underwent 20 (1 h/d) intervention session (5 d/wk for 4 weeks). Patients were assessed with the action research arm test (ARAT), the Fugl-Meyer assessment upper extremity (FMA-UE), the modified Barthel index (MBI), and the motor activity log (MAL-AOU …and MAL-QOM). RESULTS: The mCIMT combined with trunk restraint group exhibited greater changes in the ARAT, FMA, MBI, and MAL (MAL-AOU and MAL-QOM) compared with the mCIMT group. Statistical analyses showed significantly different in ARAT (Z  = –2.17, P  = 0.03), FMA-UE (Z  = –2.49, P  = 0.01), MBI (Z  = –2.44, P  = 0.02), MAL-AOU (Z  = –2.17, P  = 0.03), and MAL-QOM (Z  = –2.17, P  = 0.03) between groups. CONCLUSION: These finding suggest that mCIMT combined with trunk restraint is more helpful to improve upper-extremity function than mCIMT only in patient with chronic stroke. Show more

Keywords: Modified constraint-induced movement therapy, trunk restraint, upper-extremity function

DOI: 10.3233/NRE-151245

Citation: NeuroRehabilitation, vol. 37, no. 1, pp. 131-137, 2015

Authors: van Vliet, Rob | Hoang, Phu | Lord, Stephen | Gandevia, Simon | Delbaere, Kim

Article Type: Research Article

Abstract: BACKGROUND: Concern about falling can have devastating physical and psychological consequences in people with multiple sclerosis (MS). However, little is known about physical and cognitive determinants for increased concern about falling inthis group. OBJECTIVE: To investigate direct and indirect relationships between MS severity and concern about falling using structural equation modelling (SEM). METHODS: Two hundred and ten community-dwelling people (21–73 years) with MS Disease Steps 0–5 completed several physical, cognitive and psychological assessments. Concern about falling was assessed using the Falls Efficacy Scale-International. RESULTS: Concern about falling was significantly …associated with MS Disease Step and also balance, muscle strength, disability, previous falls, and executive functioning. SEM revealed a strong direct path between MS Disease Step and concern about falling (r  = 0.31, p  <  0.01), as well as indirect paths explained by impaired physical ability (r  = 0.25, p  <  0.01) and reduced cognitive function (r  = 0.13, p  <  0.01). The final model explained 51% of the variance of concern about falling in people with MS and had an excellent goodness-of-fit. CONCLUSIONS: The relationship between MS severity and increased concern about falling was primarily mediated by reduced physical ability (especially if this resulted in disability and falls) and less so by executive functioning. This suggests people with MS have a realistic appraisal of their concern about falling. Show more

Keywords: Accidental falls, multiple sclerosis, anxiety, depression, disease progression, activity avoidance

DOI: 10.3233/NRE-151246

Citation: NeuroRehabilitation, vol. 37, no. 1, pp. 139-147, 2015

Authors: Sandroff, Brian M. | Pilutti, Lara A. | Motl, Robert W.

Article Type: Research Article

Abstract: BACKGROUND: There is psychometric evidence that supports the six-minute walk (6MW) as a measure of walking performance, whereas other psychometric data support it as a submaximal measure of physical fitness in persons with MS. OBJECTIVE: The current cross-sectional study compared measures of walking performance and physical fitness as head-to-head predictors of 6MW distance in a sample of persons with MS across the disability spectrum. METHODS: All participants completed the 6MW test, as well as other measures of walking performance (i.e., timed-25 foot walk, gait velocity captured by a GaitRitetrademark electronic walkway) and …physical fitness (i.e., peak aerobic capacity, lower limb muscular strength). RESULTS: 6MW distance was strongly associated with measures of walking performance and physical fitness, though the correlations were significantly stronger for measures of walking performance than physical fitness (z  >  4.04, p  <  0.01). Walking performance explained a large portion of variance in 6MW distance (R 2  >  0.85), and measures of physical fitness explained minimal variance in 6MW distance over-and-above that of measures of walking performance (ΔR2  <  0.06). CONCLUSIONS: The current results suggest that 6MW distance is primarily a measure of walking performance rather than aerobic and muscular fitness in MS. Show more

Keywords: Six-minute walk, walking, physical fitness, multiple sclerosis, ambulation, walking speed

DOI: 10.3233/NRE-151247

Citation: NeuroRehabilitation, vol. 37, no. 1, pp. 149-155, 2015

Authors: Ghanbari, Ali | Askarzadeh, Saghar | Petramfar, Peyman | Mohamadi, Marzieh

Article Type: Research Article

Abstract: BACKGROUND: Migraine is one of the most frequent headaches. Cervical myofascial and trigger point disorders are effective factors on accession of this type of headache. PRT is an indirect technique that treats trigger points. OBJECTIVE: The purpose of this study was to compare the effectiveness of trigger points’ management by positional release therapy (PRT) combined with routine medical therapy and routine medical therapy alone in treatment of migraine headache. METHODS: Forty-four patients with active trigger points in cervical muscles entered to the study. They were randomly assigned to PRT-medical therapy or medical …therapy group. Headache frequency, intensity, duration and tablet count were recorded by use of a daily headache diary. The sensitivity of trigger points was assessed by the use of a digital force gauge (Wagner-FDIX). Cervical range of motion was measured by a goniometer. RESULTS: Both groups showed significant reduction in headache intensity, frequency, duration and tablet count after 4 months follow up. The sensitivity of trigger points and all cervical range of motions significantly increased in PRT-medical group after 4 months follow up; however in medication group except cervical right lateral flexion, right and left rotation the other factors showed no change after 4 months follow up. In comparison of the two study groups, there was no significant difference in headache-related variables. Apart from the headache intensity and tablet count, the trends of other factors were significantly different between the two groups (p  <  0.05). CONCLUSIONS: The combined PRT-medical therapy is more effective than the medical therapy alone. Thus, the combination of PRT and medical therapy is suggested as a treatment choice for patients with migraine headache. Show more

Keywords: Migraine headache, trigger point, positional release therapy

DOI: 10.3233/NRE-151248

Citation: NeuroRehabilitation, vol. 37, no. 1, pp. 157-163, 2015