NeuroRehabilitation - Volume 15, issue 3

Authors: Marwitz, Jennifer H.

Article Type: Introduction

DOI: 10.3233/NRE-2000-15301

Citation: NeuroRehabilitation, vol. 15, no. 3, pp. 155-155, 2000

Authors: Muramatsu, Hikaru | Nathan, Richard D. | Shimura, Toshiro | Teramoto, Akira

Article Type: Research Article

Abstract: Objective: We evaluated quantitatively the further recovery from impairment and disability in the hemiplegic stroke survivors who required neurosurgical intervention, i.e. cranioplasty or ventriculoperitoneal (V-P) shunt, in chronic stage. Setting: Rehabilitation (RH) ward affiliated with university hospitals. Patients: Eleven first-ever stroke patients with hemiplegia (mean age, 56.3 ± 2.5 years) out of 498 survivors required delayed (between 4 and 10 months after the onset) neurosurgical intervention during continuous RH therapy. Six patients received cranioplasty for preexisting hemicraniectomy, and five required V-P shunt for normal pressure hydrocephalus with later complications. Main outcome measures: Recovery grade …(1–12) of hemiplegia and Barthel index were assessed monthly before (the 1st RH) and after the intervention (the 2nd RH). Results: The recovery grade of upper and lower extremity movements significantly increased both in the 1st and 2nd RH. Changes in the upper and lower extremity grades were significantly larger in the 2nd RH (0.5 ± 0.3 in the 1st vs. 2.5 ± 0.6 in the 2nd RH for upper extremity, p <0.005; 0.9 ± 0.3 in the 1st vs. 3.4 ± 0.5 in the 2nd RH for lower extremity, p <0.001). Barthel index increased significantly only in the 2nd RH (from 48 ± 7 to 90 ± 3, p <0.001); all patients regained the ability to walk independently. Conclusions: Significant recovery of functional grade and recovery from disability occurred after the neurosurgical intervention in the chronic stage (⩾4 months) of stroke. Show more

Keywords: stroke, hemiplegia, activities of daily living, cranioplasty, ventriculoperitoneal shunt

DOI: 10.3233/NRE-2000-15302

Citation: NeuroRehabilitation, vol. 15, no. 3, pp. 157-166, 2000

Authors: Kuhtz-Buschbeck, Johann P. | Dreesmann, Mona | Gölge, Mukaddes | Stephani, Ulrich

Article Type: Research Article

Abstract: Extensive cortical-subcortical damage of the left hemisphere, most likely due to prenatal infarction of the left middle cerebral artery, was accidentally detected in a 12-year-old left-handed girl. Since clinical symptoms were minimal, the lesion had not been discovered for more than a decade. Meticulous examination revealed some slowness and somatosensory deficits of the right hand. Yet, independent finger movements were preserved, and functional skills such as reaching and grasping were unimpaired, as documented with optoelectronic motion analysis. There were no mirror movements. Transcranial magnetic stimulation indicated that the right hand was controlled by spared cortical areas of the damaged hemisphere. …Gait was normal. Neuropsychological examination confirmed regular development of language, intellect, and visuospatial abilities. This case report demonstrates exceptionally good functional outcome after early brain damage. Show more

Keywords: hemiparesis, children, dexterity, cerebral palsy, outcome

DOI: 10.3233/NRE-2000-15303

Citation: NeuroRehabilitation, vol. 15, no. 3, pp. 167-173, 2000

Authors: Inge, Katherine J. | Strobel, Wendy | Wehman, Paul | Todd, Jennifer | Targett, Pam

Article Type: Research Article

Abstract: Clearly, the need for a skilled labor pool is great in today's economy. Yet, many people with significant disabilities are struggling to find jobs with the majority of them unemployed or underemployed [6]. There is a need to develop strategies that can effectively empower these individuals to become part of the nation's labor force. This article describes one model project that used person-centered career plans, supported employment, and on-the-job assistive technology assessment and training to assist 21 individuals to become competitively employed. Customers worked an average of 15.66 months earning an average of $7,271 in total wages. They were …hired by both small and large businesses to do a variety of tasks to include data entry, customer service, clerical assistance, as well as food prep. While the findings are preliminary, the results indicate that individuals with severe physical disabilities can maintain employment by combining supported employment and assistive technology within the workplace. Show more

Keywords: physical disability, workplace supports, assistive technology, jobs, supported employment

DOI: 10.3233/NRE-2000-15304

Citation: NeuroRehabilitation, vol. 15, no. 3, pp. 175-187, 2000

Authors: Laatsch, Linda | Stress, Maureen

Article Type: Research Article

Abstract: Results from a retrospective chart review of thirty-seven patients completing an individualized cognitive rehabilitation therapy (CRT) program, using a Developmental Metacognitive approach, are reported. Neuropsychological functioning was used as the measure of progress in CRT. Demographic data, number of CRT sessions, and number of months post-injury were used to predict overall improvement in neuropsychological status. Eighty-nine percent of the patients in the CRT program experienced significant change on at least one neuropsychological measure administered. Despite considerable sample diversity, demographic and treatment variables were not predictive of overall neuropsychological change. Individualizing the CRT approach can maximize the chance of improvement in …a diverse patient sample. Show more

Keywords: cognitive rehabilitation, brain injury, neuropsychology

DOI: 10.3233/NRE-2000-15305

Citation: NeuroRehabilitation, vol. 15, no. 3, pp. 189-197, 2000

Authors: Paul, Robert H. | Cohen, Ronald A. | Ott, Brian R. | Zawacki, Tricia | Moser, David J. | Davis, Jennifer | Gordon, Norman | Stone, William

Article Type: Research Article

Abstract: In the present study we examined cognitive function, radiographic features, and functional ability in individuals with vascular dementia (VaD). Subjects were subdivided into individuals with only white matter involvement (WM) and individuals with evidence of a cortical infarction in addition to white matter ischemic change (C+WM). Results revealed that both groups of subjects were impaired across cognitive functions. Cognitive performance was more severely impaired among the C+WM group, but the general pattern of deficits did not differ between the two groups. Hachinski scores were significantly higher and instrumental activities of daily living were more severely affected in the C+WM group …compared to the WM group. No significant differences were evident between the two groups on overall dementia severity or the extent of white matter involvement. These findings indicate that cognitive function in VaD may be globally impaired, and that cortical infarction in addition to white matter ischemia results in greater impairment, but the differences are largely quantitative rather than qualitative. Show more

Keywords: vascular dementia, neuropsychology, activities of daily living

DOI: 10.3233/NRE-2000-15306

Citation: NeuroRehabilitation, vol. 15, no. 3, pp. 199-205, 2000