NeuroRehabilitation - Volume 47, issue 2

Authors: McIntyre, Amanda | Janzen, Shannon | Iruthayarajah, Jerome | Saikaley, Marcus | Sequeira, Dan | Teasell, Robert

Article Type: Research Article

Abstract: BACKGROUND: Stroke rehabilitation research is important for informing clinical practice and directing health care resources. OBJECTIVE: To examine how motor- and cognitive-based stroke rehabilitation randomized controlled trials (RCTs) vary by world region, overall and over time, with respect to 1) publication volume, 2) sample size, and 3) methodological quality. METHODS: Using the Evidence-Based Review of Stroke Rehabilitation (EBRSR), all motor- and cognitive-based stroke rehabilitation RCTs were identified. The following data were extracted: first author, year of publication, country of origin, and sample size. Countries were categorized into seven regions, as defined by the World Bank. …RESULTS: In total 1410 motor-based RCTs and 293 cognitive-based RCTs were published between 1972–2018. For motor RCTs, the East Asia/Pacific region accounted for the largest volume of RCTs (n  = 530; 37.6%), followed closely by the Europe/Central Asia region (n  = 445; 31.6%). Conversely, the largest producer for cognitive RCTs was Europe/Central Asia (n  = 167; 57.0%), followed by East Asia/Pacific (n  = 62; 21.2%). For both motor and cognitive RCTs, there was no significant difference between world regions with respect to mean sample size or methodological quality. CONCLUSIONS: Efforts should be directed towards improving methodological quality and increasing sample sizes of stroke rehabilitation-related studies. Show more

Keywords: Stroke, rehabilitation, randomized controlled trial, motor, cognitive, global, geography, worldwide, world, publication rate, country, world region, trend

DOI: 10.3233/NRE-203168

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 191-199, 2020

Authors: Verna, Valeria | De Bartolo, Daniela | Iosa, Marco | Fadda, Lucia | Pinto, Gianluca | Caltagirone, Carlo | De Angelis, Sara | Tramontano, Marco

Article Type: Research Article

Abstract: BACKGROUND: Recently, the potential rehabilitation value of music has been examined and music-based interventions and techniques such as the Negative Mismatch (MMN) have been increasingly investigated in the neurological rehabilitation context. OBJECTIVE: The aim of this study was to investigate the effectiveness of a negative mismatch-based therapy on the disability and quality of life in patients with stroke in sub-acute phase. METHODS: Thirty patients with a stroke diagnosis in sub-acute phase were randomly assigned to one of two groups: Mismatch (Mg) or Control (CTRLg) group. Both groups used an innovative Android application: Temporal Musical Patterns Organisation …(Te.M.P.O). The Disability Rating Scale (DRS), the Modified Barthel Index (MBI) and the Stroke Specific Quality of Life scale (SSQoL) were used at the baseline (T0) and after four weeks of training (T1), in order to assess changes over time. RESULTS: Statistical analysis was performed using the data of 24 (Mg = 12, CTRLg = 12) subjects. The results show a major improvement of the Mg with respect to the CTRLg in all clinical scales score. CONCLUSION: The temporal negative mismatch-based therapy performed with the Te.M.P.O. application could be useful in improving the disability and the quality of life in stroke survivors in a sub-acute phase. Show more

Keywords: Stroke, mismatch, music rehabilitation, cognitive rehabilitation

DOI: 10.3233/NRE-203126

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 201-208, 2020

Authors: Xu, Quan | Li, Chong | Pan, Yu | Li, Wei | Jia, Tianyu | Li, Zhibin | Ma, Di | Pang, Xue | Ji, Linhong

Article Type: Research Article

Abstract: OBJECTIVE: To explore the impact of rehabilitation robot training (RRT) on upper limb motor function and daily activity ability in patients with stroke. METHODS: Forty patients meeting the inclusion criteria were randomly divided into the treatment group (TRE) and the control group (CON). Group TRE was trained with an upper limb rehabilitation robot and group CON was trained with traditional occupational therapy. The training time was six weeks, and the upper limb function and daily activities were then assessed. RESULTS: (1) There was no statistical significance in the Fugl-Meyer (FM) score, Wolf Motor Function Test (WMFT) …score, and Modified Barthel Index (MBI) score between the two groups before treatment (P  > 0.05). (2) After treatment, the FM score, WMFT score, and MBI score were significantly higher than before treatment (P  < 0.01). (3) There was no significant significance between the two groups after treatment (P  > 0.05). CONCLUSIONS: Both RRT and traditional occupational therapy training are useful for the recovery of upper limb motor function and daily life ability in the sub-acute stage of stroke. Show more

Keywords: Rehabilitation, robotics, stroke, upper limb motor function

DOI: 10.3233/NRE-203130

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 209-215, 2020

Authors: Jung, Dohee | Yi, Chunghwi | Choi, Woochol Joseph | You, Joshua Sung H.

Article Type: Research Article

Abstract: BACKGROUND: Navicular drop is a common plantar deformity which makes the plantar medial longitudinal arch (MLA) collapse and leads to other deformities in lower extremities. Active structures are from intrinsic and extrinsic foot muscle activities such as abductor hallucis (AbdH), tibialis anterior (TA), tibialis posterior, flexor hallucis brevis, flexor digitorum brevis during dynamic situations. As AbdH plays a role as a dynamic elevator of MLA, the importance of AbdH has been emphasized and the proper recruitment of both intrinsic and extrinsic muscle is crucial for stabilization of MLA during dynamic weight bearing condition. Because the short foot (SF) exercise is …difficult to perform and tends to activate the intrinsic muscles concentrically rather than a natural coordination of concentric-isometric-eccentric activation, we have developed the guidance-tubing SF gait (GFG) exercise. OBJECTIVE: We investigated the effect of GFG exercise on muscle activity, AbdH:TA activity ratio, MLA angle, and foot pressure distribution during walking compared to SF gait (SFG) exercise. METHODS: Thirty-two subjects with flexible flat feet were divided into two groups and performed SFG exercise with (GFG) and without guidance-tubing (SFG) for seven serial days. RESULTS: AbdH muscle activity significantly increased from foot flat to heel rise in the GFG group (p  = 0.006). The AbdH:TA activity ratio significantly increased in both the SFG (p  = 0.015) group and GFG group (p  = 0.006). MLA angles significantly decreased in both the SFG group (p  = 0.001) and GFG group (p  = 0.000), and the decrement was significantly higher in the GFG group (p  = 0.001). The foot pressure distribution did not show any statistically significant change. CONCLUSIONS: The result of this study provides a clinical implication for training MLA supporter muscles in individuals with flat feet. The overactive muscle must be inhibited first, then facilitation and strengthening are followed respectively. Show more

Keywords: Flexible flat foot, guidance-tubing, short foot exercise, medial longitudinal arch

DOI: 10.3233/NRE-203106

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 217-226, 2020

Authors: Sestak, Anamarija | Maslovara, Sinisa | Zubcic, Zeljko | Vceva, Andrijana

Article Type: Research Article

Abstract: BACKGROUND: Only a few studies in the literature demonstrate the effect of vestibular rehabilitation (VR) on all vestibular receptor organs. Furthermore, very little evidence of the effect of VR on isolated otolith dysfunction (IOD) is available. OBJECTIVE: The study aimed to investigate the effect of VR on all vestibular receptor organs in patients with different types of unilateral vestibular hypofunction (UVH). METHODS: We enrolled 80 patients with three different types of UVH; combined and isolated loss of semicircular canal and otolith organ function. All patients performed a 12-week customized program of VR and received a full …battery of vestibular function tests, before and after the VR. The DHI and SF-36 were performed before, after 6 weeks, and 12 weeks of the VR. RESULTS: Parameters of the caloric test, video head impulse test, ocular and cervical vestibular evoked myogenic potentials were significantly improved after VR. A total of 59 (74%) patients fully recovered, with no significant difference in recovery regarding the type (p  = 0.13) and stage of UVH (p  = 0.13). All patients reported significantly lower disability and a better quality of life after the VR based on the DHI and SF-36 score. CONCLUSIONS: Vestibular rehabilitation has a positive effect on the recovery of all vestibular receptor organs and it should be used in patients with IOD. Show more

Keywords: Unilateral vestibular hypofunction, vestibular rehabilitation, semicircular canals, otolith organs

DOI: 10.3233/NRE-203113

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 227-235, 2020

Authors: Yasmin, Natasha | Riley, Gerard Anthony

Article Type: Case Report

Abstract: BACKGROUND: Following a brain injury, caregiving spouses/partners differ in their perceptions of relationship continuity/discontinuity (i.e. whether the relationship is experienced as similar or different to the pre-injury relationship). Perceptions of continuity are associated with better psychological wellbeing and a better relationship. OBJECTIVE: To conduct a pilot test of an intervention aimed at exploring the possibility of supporting caregiving partners to experience greater continuity within their relationship post-stroke. METHODS: A post-stroke couple was provided with integrated behavioural couples therapy for three months, which aimed to increase relationship continuity alongside addressing individual goals identified by the couple. Before …and after measures were taken using a battery of six questionnaires evaluating changes in perceptions of continuity, relationship quality, and stress. RESULTS: Quantitative and qualitative data showed post-therapy improvement in all the measures. CONCLUSIONS: The study suggested that perceptions of relationship continuity can be improved by therapy, and that such an improvement might have a beneficial impact in terms of relationship quality and psychological wellbeing. The intervention is currently being further developed and evaluated. Show more

Keywords: Stroke, brain injury, marital relations, couples therapy, relationship continuity

DOI: 10.3233/NRE-203173

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 237-245, 2020

Authors: Iolascon, Giovanni

Article Type: Other

Abstract: BACKGROUND: The role of systemic use of local anesthetics in the treatment of neuropathic pain (NP) is still unclear. OBJECTIVE: To assess the efficacy and safety of systemic local anesthetics for NP. METHODS: To summarize and to discuss the rehabilitation perspective on the published Cochrane Systematic Review “Systemic administration of local anesthetic agents to relieve neuropathic pain” by Challapalli V et al. RESULTS: The review included 30 RCTs including patients with NP treated with iv lidocaine, oral mexiletine, lidocaine and mexiletine, or oral tocainide. Low-to-moderate quality of the evidence suggest that intravenous lidocaine or …oral mexiletine may slightly reduce NP vs placebo, but the efficacy of these drugs is comparable to anticonvulsants or morphine. CONCLUSIONS: Systemic administration of local anesthetics is not supported by scientific evidence for pain relief as well as for functional improvement. Show more

Keywords: Neuropathic pain, Cochrane Systematic Review, local anesthetics, lidocaine

DOI: 10.3233/NRE-209006

Citation: NeuroRehabilitation, vol. 47, no. 2, pp. 247-249, 2020