NeuroRehabilitation - Volume 53, issue 4

Authors: Zhang, Qingfang | Wang, Yulong | Zhou, Mingchao | Li, Dongxia | Yan, Jie | Liu, Quanquan | Wang, Chunbao | Duan, Lihong | Hou, Dianrui | Long, Jianjun

Article Type: Research Article

Abstract: BACKGROUND: Robotic solutions for ankle joint physical therapy have extensively been researched. The optimal frequency and intensity of training for patients when using the ankle robot is not known which can affect rehabilitation outcome. OBJECTIVE: To explore the optimal ankle robot training protocol on foot drop in stroke subjects. METHODS: Subjects were randomly divided into four groups, with 9 in each group. The subjects received different intensities (low or high intensity) with frequencies (1 session/day or 2 sessions/day) of robot combination training. Each session lasted 20 minutes and all subjects were trained 5 days a week …for 3 weeks. RESULTS: After 3 weeks of treatment, all groups showed an improvement in passive and active ankle dorsiflexion range of motion (PROM and AROM) and Fugl-Meyer Assessment for lower extremity (FMA-LE) compared to pre-treatment. When training at the same level of intensity, patients who received 2 sessions/day of training had better improvement in ankle dorsiflexion PROM than those who received 1 session/day. In terms of the improvement in dorsiflexion AROM and FMA-LE, patients who received 2 sessions/day with high intensity training improved better than other protocols. CONCLUSION: High frequency and high intensity robot training can be more effective in improving ankle dysfunction. Show more

Keywords: Ankle joint, foot drop, robotics, stroke rehabilitation

DOI: 10.3233/NRE-230173

Citation: NeuroRehabilitation, vol. 53, no. 4, pp. 567-576, 2023

Authors: Tosto-Mancuso, Jenna | Rozanski, Gabriela | Patel, Nehal | Breyman, Erica | Dewil, Sophie | Jumreornvong, Oranicha | Putrino, David | Tabacof, Laura | Escalon, Miguel | Cortes, Mar

Article Type: Research Article

Abstract: BACKGROUND: Advanced technologies are increasingly used to address impaired mobility after neurological insults, with growing evidence of their benefits for various populations. However, certain robotic devices have not been extensively investigated in specific conditions, limiting knowledge about optimal application for healthcare. OBJECTIVE: To compare effectiveness of conventional gait training with exoskeleton-assisted walking for non-traumatic brain injury during early stage rehabilitation. METHODS: Clinical evaluation data at admission and discharge were obtained in a retrospective case-control design. Patients received standard of care physical therapy either using Ekso GT or not. Within- or between-group statistical tests were performed to …determine change over time and interventional differences. RESULTS: This study analyzed forty-nine individuals (33% female), 20 controls and 29 Ekso participants who were equivalent at baseline. Both groups improved in Functional Independence Measure scores and ambulation ability (p  < .00001 and p  < .001, respectively). Control subjects demonstrated significantly different distance walked and assistance level values at discharge from those who were treated with the exoskeleton (p  < .01). CONCLUSION: Robotic locomotion is non-inferior for subacute functional recovery after non-traumatic brain injury. Conventional therapy produced larger gait performance gains during hospitalization. Further research is needed to understand specific factors influencing efficacy and the long-term implications after rehabilitation. Show more

Keywords: Rehabilitation, robotics, brain injury, gait, physical therapy, functional status

DOI: 10.3233/NRE-230168

Citation: NeuroRehabilitation, vol. 53, no. 4, pp. 577-584, 2023

Authors: Rojas-Sosa, María del Carmen | Zárate, José Antonio | de la Rosa-Peña, Norma | Olvera-Gómez, José Luis | Rojano-Mejía, David | Delgado-García, José | Garduño-Espinosa, Juan

Article Type: Research Article

Abstract: BACKGROUND: Some research suggests that post-stroke aphasia can recover “on its own”, however, there is evidence of a common neural substrate for motor and language systems. We hypothesize, that motor neurorehabilitation of hemiparesis could be related to simultaneous improvement in aphasia. OBJECTIVE: To measure changes in post-stroke aphasia and its relation with hemiparesis treated with different therapies. METHODS: Database information (n  = 32) on post-stroke hemiparesis (Fugl-Meyer Scale evaluated) managed with virtual reality (VR) versus modified constraint-induced movement therapy (mCIMT) or regular therapy (rPT/OT) was analyzed. None received logotherapy (LT) by appointment at four months. Inclusion criteria: …< 3 months after the stroke, aphasia severe (Boston Aphasia Intensity Scale), and all three evaluations. RESULTS: Twenty-one patient records met inclusion criteria (71,4% women and mean age 66,67±3,13 years) who received VR, mCIMT, or rPT/OT (n  = 6, 8, and 7, respectively). There was continuous intra-groups improvement in aphasia (p  < 0.05), but inter-groups the greater aphasia recovery (p  = 0.05) and hemiparesis (p  = 0.02) were in VR, with a high correlation in evolution between them (r  = 0.73; p  = 0.047). CONCLUSION: High clinical correlation between aphasia, without LT, and hemiparesis evolution during motor neurorehabilitation would support common neural connections stimulation. We will conduct a clinical trial, with a larger sample size to contrast our hypothesis. Show more

Keywords: Aphasia, hemiparesis, modified constraint-induced movement therapy, neurorehabilitation, satisfaction, virtual reality

DOI: 10.3233/NRE-230183

Citation: NeuroRehabilitation, vol. 53, no. 4, pp. 585-594, 2023

Authors: Shavelle, Robert | DeVivo, Michael | Savic, Gordana | Brooks, Jordan | Strauss, David

Article Type: Brief Report

Abstract: BACKGROUND: Long-term survival after spinal cord injury (SCI) has been extensively studied in the US and UK. OBJECTIVE: To compare SCI epidemiology and survival results between the US and UK for the same time period and patient groups. METHODS: We restricted attention to persons injured at ages 18 and older who had survived at least 2 years post injury and were not ventilator dependent. We performed survival analysis using logistic regression on person-year data with time-dependent covariates. The resulting mortality rates were used to construct life tables in order to obtain life expectancies. RESULTS: …The average age at injury, percentage male, and level/grade of injury were rather similar between the two countries. After adjustment for risk factors, UK mortality was 85% of that in the US (95% c.i. 80% to 91%, p  < 0.0001). Mortality increased by 0.3% per year over the 1980 to 2012 study period (HR = 1.003); this was not statistically significant (p  = 0.44). The US and UK life expectancies are nearly the same percentage of their respective general population values, differing by at most 2%. CONCLUSION: Long-term mortality after SCI in the UK is roughly 15% lower than that in the US. The general population mortality in the UK is also approximately 15% lower, however, and thus the percentages of normal life expectancy in the two countries prove to be strikingly similar. Show more

Keywords: Military, telehealth, rehabilitation, brain injury, TBI, outcomes, satisfaction, head injury, improvement, physical therapy, psychotherapy, speech therapy, interdisciplinary

DOI: 10.3233/NRE-230153

Citation: NeuroRehabilitation, vol. 53, no. 4, pp. 595-598, 2023

Authors: Todhunter-Brown, Alex

Article Type: Other

Abstract: BACKGROUND: Effective trunk control is an essential component of sitting and standing balance, and is a key requirement for movement of the head and limbs, and for carrying out functional tasks. A stroke can result in impaired trunk control, affected by stroke-related deficits in balance, muscle function, coordination and position sense. Recovery of trunk control is recognised as a key goal of stroke rehabilitation. OBJECTIVE: To evaluate the effectiveness of trunk training interventions in people with stroke. METHODS: A summary of the Cochrane Review by Thijs et al. (2023), with comments from a rehabilitation perspective. …RESULTS: 68 studies (2585 participants) were included in the Cochrane review. Trunk training was not found to have any benefit on measures of ADL, when compared to other dose-matched therapies, but did improve trunk function and other outcomes. Trunk training was more beneficial than non-dose-matched therapies for measures of ADL, trunk function, and other outcomes. The certainty of these findings is very low. CONCLUSION: Evidence supports the use of trunk training as part of stroke rehabilitation. However certainty in these findings is very low due to volume, quality and heterogeneity of the evidence. Show more

Keywords: Stroke rehabilitation, trunk control, trunk training, balance, activities of daily living, systematic review

DOI: 10.3233/NRE-236007

Citation: NeuroRehabilitation, vol. 53, no. 4, pp. 599-602, 2023