NeuroRehabilitation - Volume 51, issue 1

Authors: Lindsey, Hannah M. | Lazar, Mariana | Mercuri, Giulia | Rath, Joseph F. | Bushnik, Tamara | Flanagan, Steven | Voelbel, Gerald T.

Article Type: Research Article

Abstract: BACKGROUND: Traumatic brain injury (TBI) often results in chronic impairments to cognitive function, and these may be related to disrupted functional connectivity (FC) of the brain at rest. OBJECTIVE: To investigate changes in default mode network (DMN) FC in adults with chronic TBI following 40 hours of auditory processing speed training. METHODS: Eleven adults with chronic TBI underwent 40-hours of auditory processing speed training over 13-weeks and seven adults with chronic TBI were assigned to a non-intervention control group. For all participants, resting-state FC and cognitive and self-reported function were measured at baseline and at a …follow-up visit 13-weeks later. RESULTS: No significant group differences in cognitive function or resting-state FC were observed at baseline. Following training, the intervention group demonstrated objective and subjective improvements on cognitive measures with moderate-to-large effect sizes. Repeated measures ANCOVAs revealed significant (p  < 0.001) group×time interactions, suggesting training-related changes in DMN FC, and semipartial correlations demonstrated that these were associated with changes in cognitive functioning. CONCLUSIONS: Changes in the FC between the DMN and other resting-state networks involved in the maintenance and manipulation of internal information, attention, and sensorimotor functioning may be facilitated through consistent participation in plasticity-based auditory processing speed training in adults with chronic TBI. Show more

Keywords: Chronic traumatic brain injury, functional magnetic resonance imaging, functional connectivity, cognitive rehabilitation, neuronal plasticity

DOI: 10.3233/NRE-210264

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 133-150, 2022

Authors: Kim, Heejun | Park, Chanhee | You, Joshua (Sung) H.

Article Type: Research Article

Abstract: BACKGROUND: Accurately diagnosing dynamic postural sway (DPS) is essential for effective and sustainable intervention in children with cerebral palsy (CP). We developed an accurate, inexpensive, and wearable DPS measurement system to measure DPS accurately and consistently during walking and functional activities of daily living. OBJECTIVE: We investigated the validity and reliability of this PostureRite system in children with CP, and the link between PostureRite and clinical measures including gross motor function measure (GMFM), pediatric balance scale (PBS), and fall efficacy scale (FES). METHODS: Twenty-one participants were categorized as follows: 11 healthy adults (3 females, mean age, …25.00±1.00 years) and 10 children with CP (mean age, 11.10±6.28 years). We determined the concurrent validity of PostureRite by comparing DPS data to the gold standard accelerometer measurement results. We determined test-retest reliability by measuring DPS data on three occasions at 2-h intervals. We assessed PostureRite measurement sensitivity to ascertain differences between healthy children and children with CP DPS measurements. RESULTS: Random and mixed intraclass correlation coefficients (ICC2,k and ICC3,k ) were obtained; an independent T -test was performed (P  < 0.05). Concurrent validity analysis showed a good relationship between the gold standard accelerometer and PostureRite (ICC2,k  = 0.973, P  < 0.05). Test-retest reliability demonstrated a good relationship across the three repeated measures of the DPS data (ICC3,k  = 0.816–0.924, P  < 0.05). Independent T -test revealed a significant difference in DPS data between healthy adults and children with CP (P  < 0.05). CONCLUSIONS: We developed a portable, wireless, and affordable PostureRite system to measure DPS during gross motor function associated with daily activity and participation, and established the concurrent validity, test-retest reliability as sensitivity, and clinical relevance by comparing the DPS obtained from the participants with and without CP. Show more

Keywords: Validity, reliability, sensitivity, dynamic postural sway, cerebral palsy

DOI: 10.3233/NRE-210331

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 151-159, 2022

Authors: Xie, Huan | Gao, Min | Lin, Yan | Yi, Yaping | Liu, Ye

Article Type: Research Article

Abstract: BACKGROUND: The optimization and standardization of emergency nursing and monitoring procedures are of great significance for thrombolytic treatment of acute cerebral infarction. OBJECTIVE: Studies on the emergency nursing and monitoring procedure on cognitive impairment and neurological function in patients with acute cerebral infarction are still limited. METHODS: The study was a randomized controlled trial and 134 patients with acute cerebral infarction were recruited. They were randomly arranged into the control group (n  = 67) receiving normal nursing procedure and the intervention group (n  = 67) receiving emergency nursing and monitoring procedure after pre-intervention assessment. The cognitive …impairment, neurological function and levels of inflammatory biomarkers and neuron-specific enolase of the participants were evaluated and analyzed. RESULTS: Emergency nursing and monitoring procedure improved Mini-mental State Examination and Montreal Cognitive Assessment scores of patients with cerebral infraction compared with the control group. It also improved the scores of National Institutes of Health Stroke Scale, activities of daily living scale, Fugl-Meyer scale in the participants. Emergency nursing and monitoring procedure led to significantly decreased neuron-specific enolase and inflammatory cytokines in the serum of the participants. CONCLUSION: Emergency nursing and monitoring procedure are beneficial for cognitive impairment and neurological function recovery in patients with acute cerebral infarction. Show more

Keywords: Emergency nursing and monitoring procedure, cerebral infraction, cognitive impairment, neuron-specific enolase

DOI: 10.3233/NRE-210310

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 161-170, 2022

Authors: Cheng, Ju-Yu | Yang, Yea-Ru | Yeh, Nai-Chen | Cho, Hsin | Wang, Vinchi | Li, Jui-Chang | Wang, Ray-Yau

Article Type: Research Article

Abstract: BACKGROUND: Inadequate ankle control influences walking ability in people after stroke. Walking on inclined surface activates ankle muscles and movements. However, the effect of inclined treadmill training on ankle control is not clear. OBJECTIVE: To investigate the effects of inclined treadmill training on ankle control in individuals with inadequate ankle control after chronic stroke. METHODS: This was a randomized single-blinded study. Eighteen participants were randomly assigned to receive 12 sessions of 30 min inclined (n  = 9) or regular (n  = 9) treadmill training and 5 min over-ground walking training. The outcomes included ankle control during walking, muscle strength of …affected leg, walking performance, and stair climbing performance. RESULTS: Inclined treadmill training significantly improved ankle dorsiflexion at initial contact (p  = 0.002), increased tibialis anterior activities (p  = 0.003 at initial contact, p  = 0.006 in swing phase), and decreased dynamic plantarflexors spasticity (p  = 0.027) as compared with regular treadmill training. Greater improvements were also shown in stair climbing with affected leg leading (p  = 0.006) and affected knee extensors strength (p  = 0.002) after inclined treadmill training. CONCLUSIONS: Inclined treadmill training was proposed to improve inadequate ankle control after chronic stroke. Inclined treadmill training also improved the stair climbing ability accompanied with increased muscle strength of the affected lower extremity. Show more

Keywords: Rehabilitation, ankle, inclined treadmill training, stroke, walking

DOI: 10.3233/NRE-220002

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 171-180, 2022

Authors: Afridi, Ayesha | Rathore, Farooq Azam

Article Type: Other

Abstract: BACKGROUND: Stroke and other traumatic brain injuries are the leading causes of global disability in adults. Environmental enrichment for neurological diseases is a relatively new concept within rehabilitation. These are interventions to enhance the level of somatic and social stimulation by providing an engaging environment. OBJECTIVE: To assess the effects of environmental enrichment on well-being, functional recovery, activity levels and quality of life in people who have stroke or non-progressive brain injury. METHODS: Multiple global databases were searched on 26 October 2020. Aim was to include only the randomized controlled trials that compared environmental enrichment with …standard services. RESULTS: A single RCT study with 53 participants with stroke was included. It compared the environmental enrichment (physical, cognitive and social activities such as reading material, board and card games, gaming technology, music, artwork, and computer with Internet) with standard services in an inpatient rehabilitation setting. The evidence was of very low quality and follow up was of 3 months only. CONCLUSIONS: The current data are inconclusive and there is a need for well-designed large-scale trials to study the role of environmental enrichment in the functional recovery of neurological diseases. Show more

Keywords: Environmental enrichment, rehabilitation, stroke, recent advances

DOI: 10.3233/NRE-228021

Citation: NeuroRehabilitation, vol. 51, no. 1, pp. 181-183, 2022