NeuroRehabilitation - Volume Pre-press, issue Pre-press

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: 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. Pre-press, no. Pre-press, pp. 1-10, 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

DOI: 10.3233/NRE-230153

Citation: NeuroRehabilitation, vol. Pre-press, no. Pre-press, pp. 1-4, 2023

Authors: Bevilacqua, Zachary W. | Rich, Jason | Henry, Timothy J.

Article Type: Research Article

Abstract: BACKGROUND: College faculty are receiving attention as influential members of the Return to Learn (RTL) process for students with concussion. Investigators continue to learn more about how faculty can assist students throughout recovery, yet we must also strive to determine whether such evidence is isolated or is in fact exhibited by faculty elsewhere. OBJECTIVE: We sought to determine if successive faculty cohorts demonstrate similar perspectives and RTL decision-making profiles as those from initial investigations. METHODS: Two universities in New York State were recruited to participate in a two-stage cross-sectional study. College faculty with teaching responsibilities were …given the opportunity to complete an online Qualtrics survey followed by a private interview discussing their thoughts, perspective, and/or experiences with managing students with concussion. RESULTS: Accommodations for students were allowed more often when some form of documentation was present (disability services note = 100% ; multiple types of proof = 91% ; doctor/medical notes = 90% ; and no note = 75%). Three factors consistently scored as influential to faculty RTL decision-making: documentation, teacher-student relationship, and empathy. No significant differences in scoring were seen between male and female faculty participants. Follow-up interviews revealed two themes: legitimacy and empathy. Legitimacy outlines why faculty seek verification of concussion prior to allowing accommodations and includes two subthemes: i) note/documentation, and ii) fairness/protecting integrity. Empathy discusses how and why faculty empathetically assist students with concussion, and includes two subthemes: i) personality, and ii) past experiences/understanding of concussion. CONCLUSION: Our findings indicate that faculty from different universities display similar RTL decision-making tendencies and perspectives towards students with concussion as those from initial investigations. These data allow RTL stakeholders to better understand and appreciate the potential for faculty to act as facilitators to concussion support. As gatekeepers of the classroom environment, understanding how to produce faculty cooperation will ensure a reproducible and positive outcome for students recovering from concussion. Show more

Keywords: Brain concussion, universities, return to school, faculty, education, neurological rehabilitation, health services for persons with disabilities

DOI: 10.3233/NRE-230177

Citation: NeuroRehabilitation, vol. Pre-press, no. Pre-press, pp. 1-17, 2023

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. Pre-press, no. Pre-press, pp. 1-10, 2023

Authors: Zheng, Ruizhe | Qi, Zengxin | Thibaut, Aurore | Wang, Zhe | Xu, Zeyu | Di, Haibo | Wu, Xuehai | Mao, Ying | Laureys, Steven

Article Type: Research Article

Abstract: BACKGROUND: The number of patients with disorders of consciousness (DoC) has increased dramatically with the advancement of intensive care and emergency medicine, which brings tremendous economic burdens and even ethical issues to families and society. OBJECTIVE: To evaluate the effectiveness of neuromodulation therapy for patients with DoC. METHODS: First, we conducted a literature review of individual patient data (IPD) on PubMed, EMBASE, and Cochrane-controlled trials following PRISMA guidelines. Then, we collected neuromodulation cases from our institution. Finally, we conducted a pooled analysis using the participants from the medical literature (n  = 522) and our local institutions (n … = 22). RESULTS: In this pooled analysis of 544 patients with DoC with a mean age of 46.33 years, our results revealed that patients have improved CRS-R scores [1.0 points (95% CI, 0.57–1.42)] after neuromodulation. Among them, patients have better effectiveness in traumatic than non-traumatic etiology (P  < 0.05). The effectiveness of consciousness improvement could be affected by the age, baseline consciousness state, and duration of stimulation. Compared with non-invasive intervention, an invasive intervention can bring more behavioral improvement (P  < 0.0001) to MCS rather than UWS/VS patients. Importantly, neuromodulation is a valuable therapy even years after the onset of DoC. CONCLUSION: This pooled analysis spotlights that the application of neuromodulation can improve the behavioral performance of patients with DoC. A preliminary trend is that age, etiology, baseline consciousness state, and stimulation duration could impact its effectiveness. Show more

Keywords: Neuromodulation, brain injury, disorder of consciousness, pooled analysis

DOI: 10.3233/NRE-230103

Citation: NeuroRehabilitation, vol. Pre-press, no. Pre-press, pp. 1-13, 2023

Authors: Bachar Kirshenboim, Yishai | Weitzer, Tal | Rand, Debbie

Article Type: Review Article

Abstract: BACKGROUND: Dual-task involves performing cognitive and motor tasks together, which requires executive functions that may be impaired in individuals with neurological conditions. Therefore, it is important to accurately assess executive functions to plan a therapeutic intervention. OBJECTIVE: To characterize the use of upper extremity-cognitive dual-task assessment and to describe variables correlated with dual-task ability. METHODS: An electronic search of databases (MEDLINE, EMBASE, CINAHL, and PsycINFO) was carried out using a combination of the following terms: upper-extremity, dual/concurrent task, and cognitive/motor tasks. Two reviewers independently completed data extraction and assessed study quality. RESULTS: 1,946 studies …were identified; 25 studies met the inclusion criteria. The purpose of using an upper extremity-cognitive dual-task assessment varied between studies as well as the upper extremity motor tasks used: pegboard (N = 14), Arm Curl (N = 9), finger-tapping (N = 3), and reaching (N = 1) tests. Dual-task ability was reported as the motor-cognitive interference (N = 15) and as motor cost (N = 12). Dual-task ability correlated to cognition, brain activity, and daily function, and was significantly different between healthy and neurological individuals. CONCLUSION: Upper extremity cognitive dual-task paradigm is gaining popularity in clinical research, but lacks standardized tools, testing procedures, and calculations. A structured assessment procedure is needed for clinical use and future research. Show more

Keywords: Upper extremity, dual-task, motor-cognitive interference, motor cost, executive functions

DOI: 10.3233/NRE-230076

Citation: NeuroRehabilitation, vol. Pre-press, no. Pre-press, pp. 1-13, 2023