NeuroRehabilitation - Volume 48, issue 3

Authors: Guo, Yun | Gao, Feng | Li, Jianjun | Yang, Mingliang | Li, Jun | Yang, Degang | Du, Liangjie

Article Type: Research Article

Abstract: BACKGROUND: Electromyographic biofeedback (EMG BF) training is an effective method of promoting motor learning and control in neurorehabilitation, but its effect on quadriceps femoris muscle in individuals with spinal cord injury (SCI) is unknown. OBJECTIVE: The aim of the study was to investigate the therapeutic effect of EMG BF training on motor function of quadriceps femoris in patients with incomplete SCI. METHODS: Thirty-three incomplete paraplegic patients with quadriceps femoris strength ranging grade 1 to grade 3 less than 6 months post-injury were enrolled. Control group (n  = 16) received conventional physical therapy to enhance quadriceps femoris strength, …while intervention group (n  = 17) was treated with conventional physical therapy and EMG BF training. All received treatment once a day for 30 days. Surface electromyograph (sEMG), muscle strength and thigh circumference size were assessed to evaluate motor function of quadriceps femoris. Activities of daily living (ADL) was evaluated by Modified Barthel Index (MBI). All the measures evaluated three times in total. RESULTS: Compared to the control group, intervention group significantly improved on sEMG values and strength of quadriceps femoris (PsEMG  < 0.001, Pstrength  < 0.05). sEMG values of quadriceps femoris increased earlier than strength of quadriceps femoris in intervention group (Prest  = 0.07, Pactive  = 0.031). There were no statistical differences in thigh circumference size and ADL scores between groups (Pthigh  > 0.05, PADL  = 0.423). CONCLUSIONS: EMG BF training appeared to be a useful tool to enhance motor function of quadriceps femoris in patients with incomplete SCI. sEMG could quantify the changes of single muscle myodynamia precisely before visible or touchable changes occur. Show more

Keywords: Spinal cord injury, quadriceps femoris, electromyographic biofeedback, rehabilitation

DOI: 10.3233/NRE-201647

Citation: NeuroRehabilitation, vol. 48, no. 3, pp. 345-351, 2021

Authors: Zarkou, Anastasia | Field-Fote, Edelle C.

Article Type: Research Article

Abstract: BACKGROUND: A number of physiological and atmospheric variables are believed to increase spasticity in persons with spinal cord injury (SCI) based on self-reported measures, however, there is limited objective evidence about the influence of these variables on spasticity. OBJECTIVE: We investigated the relationship between physiological/ atmospheric variables and level of spasticity in individuals with SCI. METHODS: In 53 participants with motor-incomplete SCI, we assessed the influence of age, time since injury, sex, injury severity, neurological level of injury, ability to walk, antispasmodic medication use, temperature, humidity, and barometric pressure on quadriceps spasticity. Spasticity was assessed using …the pendulum test first swing excursion (FSE). To categorize participants based on spasticity severity, we performed cluster analysis. We used multivariate stepwise regression to determine variables associated with spasticity severity level. RESULTS: Three spasticity groups were identified based on spasticity severity level: low, moderate, and high. The regression analysis revealed that only walking ability and temperature were significantly related to spasticity severity. CONCLUSIONS: These outcomes validate the self-reported perception of people with SCI that low temperatures worsen spasticity. The findings refine prior evidence that people with motor-incomplete SCI have higher levels of spasticity, showing that those with sufficient motor function to walk have the highest levels of spasticity. Show more

Keywords: Paraplegia, spasms, stiffness, temperature, tetraplegia, walking

DOI: 10.3233/NRE-201625

Citation: NeuroRehabilitation, vol. 48, no. 3, pp. 353-363, 2021

Authors: de los Reyes-Guzmán, Ana | Lozano-Berrio, Vicente | Alvarez-Rodríguez, María | López-Dolado, Elisa | Ceruelo-Abajo, Silvia | Talavera-Díaz, Francisco | Gil-Agudo, Angel

Article Type: Research Article

Abstract: BACKGROUND: There is a growing interest in the use of technology in the field of neurorehabilitation in order to quantify and generate knowledge about sensorimotor disorders after neurological diseases, understanding that the technology has a high potential for its use as therapeutic tools. Taking into account that the rehabilitative process of motor disorders should extend beyond the inpatient condition, it’s necessary to involve low-cost technology, in order to have technological solutions that can approach the outpatient period at home. OBJECTIVE: to present the virtual applications-based RehabHand prototype for the rehabilitation of manipulative skills of the upper limbs in …patients with neurological conditions and to determine the target population with respect to spinal cord injured patients. METHODS: Seven virtual reality applications have been designed and developed with a therapeutic sense, manipulated by means of Leap Motion Controller. The target population was determined from a sample of 40 people, healthy and patients, analyzing hand movements and gestures. RESULTS: The hand movements and gestures were estimated with a fitting rate between the range 0.607–0.953, determining the target population by cervical levels and upper extremity motor score. CONCLUSIONS: Leap Motion is suitable for a determined sample of cervical patients with a rehabilitation purpose. Show more

Keywords: Rehabilitation, upper extremity, neurological disorders, spinal cord injury, virtual reality, leap motion controller

DOI: 10.3233/NRE-201598

Citation: NeuroRehabilitation, vol. 48, no. 3, pp. 365-373, 2021

Authors: Ahn, So-Young | Lee, Nam-Gi | Lee, Tae-Heon

Article Type: Research Article

Abstract: BACKGROUND: Impaired motor control, balance, muscle strength, and respiratory function may affect the exercise capacity related to motor performance and activities in individuals with stroke. OBJECTIVE: To identify a physical parameter that the exercise capacity has the most significant relationship among physical parameters related to motor function, trunk control, balance, and motor performance and activities in individuals with ischemic stroke. METHODS: In total, 241 ischemic stroke patients were recruited in this retrospective study. The clinical measurements included the 6-minute walk test (6 MWT), Montreal cognitive assessment (MoCA), Fugl-Meyer assessment-lower extremity motor function (FMA-LE), trunk impairment scale (TIS), …Berg balance scale (BBS), timed up and go test (TUG), 10-meter walk test (10 MWT), functional ambulation category (FAC), and functional independence measure (FIM). RESULTS: The 6 MWT was significantly correlated with the FMA-LE, BBS, TUG, 10 MWT, FAC, and FIM, indicating negative or positive moderate correlations. Additionally, the FMA-LE, TIS, BBS, TUG, 10 MWT, FAC, and FIM, excluding the 6 MWT, showed moderate to strong correlations with all of the other outcome measures, whereas the MoCA showed significant correlations only with the BBS and FIM. CONCLUSIONS: In this study, the exercise capacity has the most significant relationship with the TUG parameter in stroke patients. Additionally, we suggest that significant relationships between 6 MWT and other comprehensive physical functions measurements are closely related to walking ability in individuals with stroke. Show more

Keywords: Exercise capacity, stroke, 6-minute walk test

DOI: 10.3233/NRE-201630

Citation: NeuroRehabilitation, vol. 48, no. 3, pp. 375-383, 2021

Authors: Loetscher, Tobias

Article Type: Other

Abstract: BACKGROUND: The majority of people living with Parkinson’s disease will develop impairments in cognition. These impairments are associated with a reduced quality of life. OBJECTIVE: The Cochrane Review aimed to investigate whether cognitive training improves cognition in people with Parkinson’s disease and mild cognitive impairments or dementia. METHODS: A Cochrane Review by Orgeta et al. was summarized with comments. RESULTS: The review included seven studies with a total of 225 participants. There was no evidence for improvements in global cognition when cognitive training was compared to control conditions. Observed improvements in attention and verbal …memory measures after cognitive training could not be confirmed in a subsequent sensitivity analysis. There was no evidence for benefits in other cognitive domains or quality of life measures. The certainty of the evidence was low for all comparisons. CONCLUSIONS: The effectiveness of cognitive training for people with Parkinson’s disease and cognitive impairments remains inconclusive. There is a pressing need for adequately powered trials with higher methodological quality. Show more

Keywords: Parkinson’s disease, cognitive training, training, dementia, mild cognitive impairment

DOI: 10.3233/NRE-218001

Citation: NeuroRehabilitation, vol. 48, no. 3, pp. 385-387, 2021