NeuroRehabilitation - Volume 52, issue 2

Authors: Claessen, Lára Ósk Eggertsdóttir | Kristjánsdóttir, Hafrún | Jónsdóttir, María K. | Lund, Sigrún Helga | Kristensen, Ingunn S.U. | Sigurjónsdóttir, Helga Ágústa

Article Type: Research Article

Abstract: BACKGROUND: Studies on hypopituitarism (HP) following mild traumatic brain injury (mTBI) have focused on male populations although women may be more susceptible to the sequelae of mTBI. This is, to the best of our knowledge, the first all-female study screening for HP following mTBI. OBJECTIVE: Screening for possible HP in female athletes reporting a history of one or more mTBI. METHODS: Pituitary hormone screening blood tests (SBT) were performed in 133 of the 151 female athletes included. Repeated results outside the reference value (O-RV) were considered abnormal necessitating further endocrinological evaluation. RESULTS: Repeated SBT …were O-RV in 88 women (66.2%). Decreased levels of serum insulin growth factor 1 (S-IGF1) were found in 55.6% of participants and elevated levels of serum prolactin (S-prolactin) in 22.6%. Serum cortisol levels were below the RV in 6.0% and thyroid hormonal levels in 11.3%. Lower age and increased number of mTBI symptoms correlated significantly with the risk of hormonal results O-RV. CONCLUSION: The majority of the study population had SBT O-RV, warranting further workup of possible HP. Decreased levels of S-IGF1 were most commonly observed followed by elevated S-prolactin possibly indicating hypothalamic-pituitary impairment. Lower age and increased number of symptoms of mTBI may indicate the need to screen for HP. Show more

Keywords: Head trauma, sport-related concussion (SRC), female athletes, pituitary hormones, hormone deficiency

DOI: 10.3233/NRE-220194

Citation: NeuroRehabilitation, vol. 52, no. 2, pp. 259-271, 2023

Authors: Kalderon, Liran | Chaimoff, Moshe | Katz-Leurer, Michal

Article Type: Research Article

Abstract: BACKGROUND: Vestibulo-sympathetic reflexes (VSR) demonstrate the autonomic interaction between the vestibular system and the cardiovascular system, however little is known about this interaction in patients with benign paroxysmal positional vertigo (BPPV). Although the main complaint of patients with BPPV is vertigo, additional symptoms such as nausea and sweating raise questions whether patients with BPPV have impaired VSR. OBJECTIVE: The aim of this study is to assess the cardiac autonomic control system (CACS) response to vestibular stimulation in subjects with BPPV compared with healthy controls. METHODS: This is a case-control study. Heart-rate variability (HRV) parameters were monitored …in two groups (30–70 years old)- subjects with BPPV (N = 18) and gender and age-matched healthy controls (N = 18), at rest and during vestibular stimulation. RESULTS: No significant differences were found between groups in HRV parameters during rest. Both groups demonstrated an autonomic response to vestibular stimulation, yet no differences were found between groups. CONCLUSIONS: Patients with BPPV seem to have an intact cardiac response to vestibular stimulation. Over-activation of the Vestibular Semicircular Canals, as shown in BPPV, doesn’t seem to alter the VSR in the cardiac autonomic control system. Show more

Keywords: Benign paroxysmal positional vertigo (BPPV), vestibulo-sympathetic reflex (VSR), heart rate variability (HRV), autonomic nervous system (ANS)

DOI: 10.3233/NRE-220021

Citation: NeuroRehabilitation, vol. 52, no. 2, pp. 273-278, 2023

Authors: David, Eytan A. | Shahnaz, Navid

Article Type: Research Article

Abstract: BACKGROUND: Unilateral vestibular deficits are associated with postural instability and loss of quality of life. Common treatments frequently fail to achieve satisfactory outcomes. OBJECTIVE: To assess the durability of changes in participant-reported disability and objective posturography after computerized vestibular retraining. METHODS: This was a single-group study. Individuals with persistent symptoms of an objectively determined unilateral vestibular deficit completed questionnaires and posturography assessments before and after twelve sessions of computerized retraining, and 4–6 months and 10–12 months after treatment. RESULTS: 13 participants completed the post-treatment assessments; 9 completed the follow up. Mean improvements in perceived …disability at 4–6 months after retraining were: DHI 14.3 points (95% confidence interval 4.0 to 24.5), ABC scale 14.9 points (4.3 to 25.6), FES-I 11.6 points (–3.2 to 26.5). The SOT composite score increased by 11.4 points (95% CI 1.9 to 20.9; p  = 0.0175) immediately after treatment, 8.9 points (–2.9 to 20.7; p  = 0.1528) at 4–6 months, and 10.6 points (2.2 to 19.0; p  = 0.0162) after 10–12 months. At the 10–12 month time point, the areas of the functional stability region increased significantly for both endpoint excursion (p  = 0.0086) and maximum excursion (p  = 0.0025). CONCLUSION: Computerized vestibular retraining was associated with improved participant reported disability and objective measures of postural stability. Show more

Keywords: Dizziness, balance, rehabilitation, vestibular

DOI: 10.3233/NRE-220241

Citation: NeuroRehabilitation, vol. 52, no. 2, pp. 279-287, 2023

Authors: Niewiadomski, Wiktor | Gąsiorowska, Anna | Żyliński, Marek | Karbowniczek, Aleksandra | Cebrat, Justyna | Stępniewska, Anna

Article Type: Research Article

Abstract: BACKGROUND: Reduced muscle strength is one symptom of Parkinson’s disease (PD). Strength can be increased by strength training, which may cause exaggerated blood pressure (BP) rise. It is believed that exercises performed on vibrating platform can strengthen leg muscles without excessive BP increase. OBJECTIVE: To measure the pressor response to static exercises performed during whole body vibration in PD patients. METHODS: Twenty-four aged PD patients and twelve healthy young volunteers participated in the study. PD subjects performed six repetitions of deep-, semi-squat, and calves at vibration frequency of 30 Hz. Each 30 s exercise was followed by 30 s …rest. The young volunteers performed two sessions of above-mentioned exercises with and without vibration. BP was measured continuously. RESULTS: In PD patients, the highest BP values were observed during deep squat; systolic blood pressure rose 10 mmHg in ‘weak responders’, and 50 mmHg in ‘strong responders’. This difference correlated with the rise in pulse pressure suggesting indirectly the role of stoke volume in individual response. In healthy subjects pressor response was also individually differentiated and not influenced by vibration. CONCLUSION: Deep and semi squat can evoke a strong cardiovascular response in some PD and healthy subjects. Low-magnitude vibrations likely did not affect pressor response. Show more

Keywords: Pressor response, static exercises, whole body vibration, Parkinson’s disease

DOI: 10.3233/NRE-220234

Citation: NeuroRehabilitation, vol. 52, no. 2, pp. 289-298, 2023

Authors: Olesiejuk, Maciej | Marusiak, Jarosław | Chalimoniuk, Małgorzata

Article Type: Research Article

Abstract: BACKGROUND: Migraine is a primary headache disorder. Studies have shown that 93% of people with migraine have an increased number of active Ischemic Compression Myofascial Trigger Points (IC-MTrPs) therapy. OBJECTIVE: To examine the effects of the IC-MTrPs therapy on: (1) mechanical properties of the upper trapezius muscle (UTM), (2) shoulder girdle and neck (SGN) muscles pain and (3) headaches characteristics in episodic migraine patients without aura. METHODS: Thirty-one adult, female, migraine patients without aura underwent seven IC-MTrPs therapy sessions and were tested during maximally five measurement sessions (pre- and post-1’st, post-4’th, post-7’th therapy and 1-month follow-up). …Myotonometric measurements of the UTM’s tone, stiffness and elasticity, subjective SGN muscles pain, as well as headache’s level, frequency and duration were analyzed. RESULTS: Myotonometric tone and stiffness of the UTM significantly decreased in post-1’st, post-4’th therapy and in 1-month follow-up measurements versus pre-1’st therapy testing session. The scores for the SGN muscles’ pain significantly decreased: (i) in post-4’th and post-7’th therapy versus post-1’st therapy session, and (ii) in post-7’th versus post-4’th therapy measurements. Headache’s level, frequency and duration significantly decreased in post-7’th therapy versus pre-1’st therapy measurement session. CONCLUSION: IC-MTrPs therapy resulted in a decrease of upper trapezius muscle tone and stiffness, with simultaneous alleviation of shoulder girdle and neck muscle pain and the headaches characteristics in episodic migraine patients without aura. Show more

Keywords: Migraine, Myofascial Trigger Points (MTrPs), upper trapezius muscle, myotonometry, muscle mechanical properties

DOI: 10.3233/NRE-220237

Citation: NeuroRehabilitation, vol. 52, no. 2, pp. 299-310, 2023

Authors: Ilieva, Elena | Ilieva, Aleksandra

Article Type: Other

Abstract: BACKGROUND: Many stroke survivors are both sedentary and physically inactive, even those who have adequate mobility. This increases cardiometabolic risk and has impacts on physical and other functions. OBJECTIVE: The aim of this Cochrane Review summary is to discuss from a rehabilitation perspective the results of the Cochrane review investigating the effects of the interventions designed to reduce sedentary behavior after stroke on mortality, secondary vascular events, cardiovascular risk, adverse events and sedentary behavior. METHODS: The review authors searched for randomized controlled trials that had been published up to December 2019, comparing the effects of the …interventions aimed to reduce sedentary behavior in patients after stroke with usual care, no intervention, sham intervention. RESULTS: The results of the review showed that the interventions included did not affect the number of deaths or the incidence of recurrent cardiovascular or cerebrovascular events, falls or other adverse events in stroke patients. Evidence for their impact on sedentary behavior is currently inconclusive. CONCLUSIONS: The evidence about reducing sedentary behavior in patients after stroke is incomplete, since research in this field is relatively new. Practitioners may also encourage reduction in sitting during daytime by considering interventions for other therapeutic targets (e.g. increasing physical activity and mobility), besides the studied interventions that proved to be safe and harmless. Show more

Keywords: Sedentary behavior, stroke

DOI: 10.3233/NRE-230000

Citation: NeuroRehabilitation, vol. 52, no. 2, pp. 311-313, 2023