NeuroRehabilitation - Volume 50, issue 4

Authors: Takagi-Stewart, Julian | Johnson, Ashleigh M. | Smith, Mallory B. | Wang, Jin | Marcynyszyn, Lyscha A. | Zatzick, Douglas F. | McCarty, Carolyn A. | Rivara, Frederick P. | Vavilala, Monica S.

Article Type: Research Article

Abstract: BACKGROUND: Post-concussion return-to-learn (RTL) guidelines include implementation of school accommodations. Yet, little is known about physician recommendations for school accommodations and their impact, particularly among youth experiencing persistent post-concussive symptoms (PPCS). OBJECTIVE: We examined the association between physician recommended school accommodations and student outcomes among youth experiencing PPCS. METHODS: Data from a randomized comparative effectiveness trial was used. Physician recommended school accommodations (≤90 days post-injury) were collected via chart abstraction. Grade point average was extracted from school records. Reports of problems at school, concussion symptoms, health-related quality of life (HRQOL), anxiety symptoms, and depressive symptoms were …collected by survey (at baseline, three months, and 12 months post study entry). RESULTS: Of 200 participants (Mage  = 14.7, 62% female), 86% were recommended school accommodations. Number of recommended school accommodations was positively associated with number of school problems at three months (aRR 1.18, 95% CI:1.12–1.24) and 12 months (aRR 1.11, 95% CI:1.05–1.18). No significant associations were found between recommended school accommodations and GPA, HRQOL, anxiety symptoms, or depressive symptoms. CONCLUSIONS: Physicians recommend more school accommodations for students experiencing more school problems post-concussion. Appropriate implementation of RTL recommendations made by physicians by fostering partnerships among physicians, students, and schools may be needed to achieve student-centered RTL. Show more

Keywords: Traumatic brain injury, concussion, school accommodations, physician recommendations, return to learn

DOI: 10.3233/NRE-210324

Citation: NeuroRehabilitation, vol. 50, no. 4, pp. 467-476, 2022

Authors: Andrews, Addison Williams | Vallabhajosula, Srikant | Ramsey, Crystal | Francis, Jhonelle | Jaffe, Whitney

Article Type: Research Article

Abstract: BACKGROUND: The clinimetric properties of the Wheelchair Propulsion Test (WPT) have not been developed thoroughly. OBJECTIVE: To determine inter-rater reliability and reference values for the Wheelchair Propulsion Test (WPT) for active wheelchair users and to compare WPT performance between various types of manual wheelchairs at different paces. METHODS: This was a cross-sectional, descriptive study. Participants propelled a manual wheelchair 10 m while time and the number of pushes were recorded. Trials were performed in three different manual wheelchairs (a lightweight wheelchair (LW), an ultralightweight wheelchair (ULW), and the participant’s personal, customized wheelchair) at a comfortable pace and …a fast pace. RESULTS: The ICC values ranged from 0.861 to 0.999 for both speed and number of pushes. Comfortable wheelchair propulsion speed ranged from 1.51 (0.31) m/s to 1.65 (0.33) m/s depending on the wheelchair utilized. Across both pace conditions, participants were significantly faster when using their personal wheelchair compared to the ULW (P  < 0.001) and LW (P  < 0.001). Push frequency was significantly greater during the fast pace condition compared to the comfortable pace condition (P  < 0.001). CONCLUSIONS: Reference values for the WPT in active wheelchair users have been identified. Participants who utilize their personal wheelchair demonstrate faster wheelchair propulsion speeds complemented by greater push frequencies. Show more

Keywords: Locomotion, mobility limitation, reference values, wheelchairs

DOI: 10.3233/NRE-210315

Citation: NeuroRehabilitation, vol. 50, no. 4, pp. 477-483, 2022

Authors: Schmidt, Simone B. | Boltzmann, Melanie | Rollnik, Jens D.

Article Type: Research Article

Abstract: BACKGROUND: Falls are highly frequent among neurological patients during rehabilitation and subsequent risk assessments are crucial to prevent falls. OBJECTIVE: This study aims to determine the predictive values of the Hessisch Oldendorf Risk of Falling Scale (HOSS, “Hessisch Oldendorfer Sturzrisiko Skala”) for two timeframes: the first month of rehabilitation and from the second month to the end of rehabilitation. METHODS: Scale performances were assessed for 512 patients during inpatient neurological rehabilitation by calculating the sensitivity and the specificity. HOSS items were entered into a binary logistic regression model. Fall rates were calculated and used for correlation …analyses and group comparisons. RESULTS: Initial HOSS assessment showed a sensitivity of 80.4% and a specificity of 60.7%. The HOSS re-assessment resulted in a sensitivity of 67.3% and a specificity of 69.5%. Only a non-somnolent state was identified to increase the risk of falling in both timeframes. Patients with a moderate impaired functional status (Barthel-Index between 20 and 50 points) showed the highest fall rates. CONCLUSION: The predictive validity of the HOSS decreases during the rehabilitation course. This might be caused by an altered relevance of the HOSS items during the re-assessment compared to the initial assessment for which the HOSS was developed for. Show more

Keywords: Hessisch oldendorf risk of falling scale, HOSS, risk of falling, neurological rehabilitation, risk assessment, re-assessment, rehabilitation course

DOI: 10.3233/NRE-210228

Citation: NeuroRehabilitation, vol. 50, no. 4, pp. 485-491, 2022

Authors: Grozdek Čovčić, Gordana | Jurak, Ivan | Telebuh, Mirjana | Maček, Zdravko | Bertić, Želimir | Žura, Nikolino | Grubišić, Mihaela | Matić, Hrvoje | Tišlar, Marina Horvat | Jakuš, Lukrecija

Article Type: Research Article

Abstract: BACKGROUND: After a stroke, patients experience sensorimotor damage, balance disorders, loss of selective movement, hypotonia and/or hypertonia, and hypersensitivity, all of which affect gait. OBJECTIVE: The aim of the study was to establish the effectiveness of Bobath therapy with additional specific soft tissue mobilizations versus standard Bobath intervention. METHODS: Subjects were randomly divided into two groups (S1 and S2) of 20 people each. Both groups underwent the same intervention (Bobath concept) over a 5-week period, while the second study group (S2) also received additional, specific soft tissue mobilization. The Berg Balance Scale (BBS), Timed Up and …Go Test (TUGT), Active Range of Motion (AROM) of dorsiflexion and knee flexion and extension were used as clinical variables to assess the efficacy of therapy modalities. Data was analysed using a mixed model ANOVA. RESULTS: A significant interaction of group and time was found. The experimental (S2) group had a larger improvement of balance and AROM than the control (S1) group. There was no clear advantage of one group over the other for TUGT. CONCLUSION: The findings demonstrate that a combination of Bobath treatment and additional specific soft tissue mobilizations are more effective in increasing AROM and balance and mobility. Show more

Keywords: Stroke, Bobath concept, specific mobilizations, balance, gait

DOI: 10.3233/NRE-210326

Citation: NeuroRehabilitation, vol. 50, no. 4, pp. 493-500, 2022

Authors: Mazlan, Mazlina | Engkasan, Julia Patrick

Article Type: Other

Abstract: BACKGROUND: Persons with primary brain tumour can suffer from depression. Depression may hinder rehabilitation intervention leading to further deterioration of patient’s health and functioning. OBJECTIVE: The Cochrane Review aimed to assess the effectiveness and adverse effects of pharmacological treatment of depression in people with a primary brain tumour. METHODS: A Cochrane Review by Beevers et al. was summarized with comments. RESULTS: The review did not find any eligible studies from the 2090 studies screened which included randomized controlled trials, cohort studies and case-control studies. CONCLUSIONS: There is no high-quality evidence as to …whether pharmacological treatments for depression in people with primary brain tumours are either effective or harmful. Show more

Keywords: Brain tumour, depression, medications, pharmacology

DOI: 10.3233/NRE-228019

Citation: NeuroRehabilitation, vol. 50, no. 4, pp. 501-503, 2022

Article Type: Correction

DOI: 10.3233/NRE-228009

Citation: NeuroRehabilitation, vol. 50, no. 4, pp. 505-505, 2022

Article Type: Correction

DOI: 10.3233/NRE-228018

Citation: NeuroRehabilitation, vol. 50, no. 4, pp. 507-507, 2022