NeuroRehabilitation - Volume 47, issue 4

Authors: Rahayu, Umi Budi | Wibowo, Samekto | Setyopranoto, Ismail | Hibatullah Romli, M.

Article Type: Research Article

Abstract: BACKGROUND: Brain injuries such as strokes cause damage and death of the neuron cells. Physiotherapy interventions help to improve patient’s performance and ability. However, this is only theorized but the impact of the physiotherapy intervention on brain plasticity is not known. OBJECTIVE: The present study aimed to investigate the effect of physiotherapy interventions on brain neuroplasticity by evaluating the brain plasticity regeneration, balance and functional ability. METHODS: A randomized controlled trial was conducted with 64 stroke patients from three hospitals in the Surakarta region, Indonesia. Control groups (n  = 32) received conventional physiotherapy and intervention groups (n … = 32) received neurorestoration protocol, which both lasted for seven days. Efficacy of the interventions were measured on brain-derived neurotropic factor serum analysis, Berg Balance Scale and Barthel Index, respectively. RESULTS: Both groups showed improvements in all parameters but only balance and functional performance had a statistically significant outcome. CONCLUSION: Neurorestoration protocol that combined several established physiotherapy interventions was effective in improving balance and functional ability of stroke patients in only a seven days period. Show more

Keywords: Activities of daily living, cerebrovascular accident, early intervention, ischemic, neuroplasticity, physiotherapy, rehabilitation, stroke

DOI: 10.3233/NRE-203210

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 463-470, 2020

Authors: Yoon, Hyun Sik. | Cha, Young Joo. | You, Joshua (Sung) Hyun

Article Type: Research Article

Abstract: BACKGROUND: Neurodevelopmental treatment (NDT) and dynamic core-postural chain stabilization (DCS)- based exercise is effective for improving core stability and postural control in stroke patients. However, no study has reported respiratory function, increased fatigue and ADL function in subacute stroke patients by training using NDT and DCS exercises. OBJECTIVE: To compare the effects of DCS and NDT exercises on respiratory function, fatigue and activities of daily living in individuals with hemiparetic stroke. METHODS: Thirty-one participants with hemiparetic stroke (17 male, 14 female; mean age 60.4±14.58 years; post-stroke duration, 7.2±2.2 weeks) participated in this study. The participants were …randomly allocated into DCS (n  = 16) and NDT (n  = 15). Respiratory function was determined using forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP). The fatigue severity scale (FSS) and functional independent measure (FIM) were used to evaluate fatigue severity and activities of daily living (ADL). Analysis of covariance (ANCOVA) was used to evaluate post-test differences in the DCS and NDT exercise groups. RESULTS: ANCOVA revealed the superior effects of DCS in respiratory function, as well as clinical FSS and FIM tests, compared with those of NDT (p  < 0.05). CONCLUSIONS: The results suggest that DCS training was more effective than NDT training at improving respiratory function, fatigue severity and ADL via balanced co-activation of the diaphragm and increased diaphragm movement in individuals with hemiparetic stroke. Show more

Keywords: Respiratory function, dynamic core-postural chain stabilization, core stabilization, hemiparetic stroke

DOI: 10.3233/NRE-203231

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 471-477, 2020

Authors: Kondo, Yuki | Bando, Kyota | Ariake, Yosuke | Katsuta, Wakana | Todoroki, Kyoko | Nishida, Daisuke | Mizuno, Katsuhiro | Takahashi, Yuji

Article Type: Research Article

Abstract: BACKGROUND: The reliability of the evaluation of the Balance Evaluation Systems Test (BESTest) and its two abbreviated versions are confirmed for balance characteristics and reliability. However, they are not utilized in cases of spinocerebellar ataxia (SCA). OBJECTIVE: We aimed to examine the test-retest reliability and minimal detectable change (MDC) of the BESTest and its abbreviated versions in persons with mild to moderate spinocerebellar ataxia. METHODS: The BESTest was performed in 20 persons with SCA at baseline and one month later. The scores of the abbreviated version of the BESTest were determined from the BESTest scores. The …interclass correlation coefficient (1,1) was used as a measure of relative reliability. Furthermore, we calculated the MDC in the BESTest and its abbreviated versions. RESULTS: The intraclass correlation coefficients (1,1) and MDC at 95% confidence intervals were 0.92, 8.7(8.1%), 0.91, 4.1(14.5%), and 0.81, 5.2(21.6%) for the Balance, Mini-Balance, and Brief-Balance Evaluation Systems Tests, respectively. CONCLUSIONS: The BESTest and its abbreviated versions had high test-retest reliability. The MDC values of the BESTest could enable clinicians and researchers to interpret changes in the balance of patients with SCA more precisely. Show more

Keywords: Minimal detectable change, neurological rehabilitation, postural balance, rare diseases, reproducibility of results, Spinocerebellar ataxias

DOI: 10.3233/NRE-203154

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 479-486, 2020

Authors: Park, Hyun-Ju | Lee, Nam-Gi | Kang, Tae-Woo

Article Type: Research Article

Abstract: BACKGROUND: As the severity of dementia progresses over time, cognition and motor functions such as muscle strength, balance, and gait are disturbed, and they eventually increase the risk of fall in patients with dementia. OBJECTIVE: To determine the relationship between the fall risk and cognition, motor function, functional ability, and depression in older adults with dementia. METHODS: Seventy-four older adults diagnosed with dementia were recruited. Clinical measurements included the Fall Risk Scale by Huh (FSH), Korean version of the Mini-Mental State Examination (MMSE-K), hand grip strength (HGS), Tinetti Performance Oriented Mobility Assessment (POMA), 10-m walk test …(10-MWT), Korean version of the Modified Barthel Index (MBI-K), and the Geriatric Depression Scale (GDS). RESUTLS: The MMSE-K was significantly correlated with the FSH, HGS, and the MBI-K, and FSH was significantly correlated with all of the other outcome measures. In particular, the MMSE-K, HGS, POMA, and the MBI-K were negatively correlated with fall history among the FHS sub-items. Additionally, the MMSE sub-item, attention/concentration was associated with the FSH, HGS, POMA, and the MBI-K. CONCLUSIONS: These findings suggest that falling is significantly related to impaired cognition, reduced muscle strength, impaired balance, gait, and activities of daily living abilities, and depression in older adults with dementia. Show more

Keywords: Dementia, depression, cognition, falling, motor function, older adults

DOI: 10.3233/NRE-203249

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 487-494, 2020

Authors: Klobucká, Stanislava | Klobucký, Robert | Kollár, Branislav

Article Type: Research Article

Abstract: BACKGROUND: Robot-assisted gait training (RAGT) allows an intensive gait training in patients with cerebral palsy (CP). There are few evidences on the effectiveness of RAGT in adults with CP. OBJECTIVE: To assess the effect of RAGT on gross motor function in adolescent and adult patients with bilateral spastic CP and to compare the effect of RAGT with conventional kinesiotherapy. METHODS: Forty-seven patients (mean age 21.2±5.33 years) with bilateral spastic CP were divided into two groups. Twenty-one patients underwent 20 therapeutic units of RAGT and 26 patients underwent 20 therapeutic units of conventional therapy/training (CON). The following …parameters were evaluated before (V1) and after the therapy (V2): dimension A (lying and rolling), B (sitting), C (crawling and kneeling), D (standing), E (walking, running and jumping) of the Gross Motor Function Measure (GMFM-88). In patients in the experimental RAGT group, these parameters were also evaluated 3–4 months later (V3). RESULTS: Comparing the mean improvements in endpoints in both groups (RAGT vs. CON) after 20 TUs, we observed the statistically significant difference (p  < 0.001) and large effect size in all GMFM dimensions and total GMFM improvement in favour of the RAGT group. In RAGT patients, the improvement persisted even 3–4 months after RAGT (p  < 0.001). CONCLUSION: We demonstrated that the intensive RAGT regimen is more effective than conventional therapy in terms of improvements in gross motor functions in adolescent and adult patients with bilateral spastic CP. Show more

Keywords: Rehabilitation, robot-assisted gait training, cerebral palsy, gross motor function

DOI: 10.3233/NRE-203102

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 495-508, 2020

Authors: Negrini, Francesco

Article Type: Other

Abstract: BACKGROUND: Epidural corticosteroid injection is one of the most common non-surgical procedures for lumbosacral radicular pain. OBJECTIVE: To assess efficacy and safety of epidural corticosteroid injections compared with placebo injections in patients with lumbosacral radicular pain. METHODS: A summary and commentary of a Cochrane Review by Oliveira et al. RESULTS: 25 studies with a total of 2740 participants were included in the review. Moderate quality evidence pointed out a small effect on leg pain at immediate and short-term follow-up and on disability at short-term and intermediate follow-up. Adverse events were not different between corticosteroid …and placebo injections. CONCLUSIONS: Epidural corticosteroid injection is slightly more effective than placebo for leg pain and disability at short-term follow up. Clinicians and patients however should be informed of the small effect size of the treatment. Show more

Keywords: Epidural corticosteroid injections, lumbosacral radicular pain, sciatica, low back pain

DOI: 10.3233/NRE-209008

Citation: NeuroRehabilitation, vol. 47, no. 4, pp. 509-511, 2020