NeuroRehabilitation - Volume 22, issue 5

Authors: Neufeld, Jacob A.

Article Type: Introduction

DOI: 10.3233/NRE-2007-22501

Citation: NeuroRehabilitation, vol. 22, no. 5, pp. 339-340, 2007

Authors: Hyder, Adnan A. | Wunderlich, Colleen A. | Puvanachandra, Prasanthi | Gururaj, G. | Kobusingye, Olive C.

Article Type: Research Article

Abstract: Traumatic brain injury (TBI), according to the World Health Organization, will surpass many diseases as the major cause of death and disability by the year 2020. With an estimated 10 million people affected annually by TBI, the burden of mortality and morbidity that this condition imposes on society, makes TBI a pressing public health and medical problem. The burden of TBI is manifest throughout the world, and is especially prominent in Low and Middle Income Countries which face a higher preponderance of risk factors for causes of TBI and have inadequately prepared health systems to address the associated health …outcomes. Latin America and Sub Saharan Africa demonstrate a higher TBI-related incidence rate varying from 150–170 per 100,000 respectively due to RTIs compared to a global rate of 106 per 100,000. As highlighted in this global review of TBI, there is a large gap in data on incidence, risk factors, sequelae, financial costs, and social impact of TBI. This should be addressed through planning of comprehensive TBI prevention programs in LMICs through well-established surveillance systems. Greater resources for research and prioritized interventions are critical to promote evidence-based policy for TBI. Show more

Keywords: Traumatic brain injury, injury epidemiology, injuries, developing countries, brain trauma

DOI: 10.3233/NRE-2007-22502

Citation: NeuroRehabilitation, vol. 22, no. 5, pp. 341-353, 2007

Authors: Karunanayaka, Prasanna R. | Holland, Scott K. | Yuan, Weihong | Altaye, Mekibib | Jones, Blaise V. | Michaud, Linda J. | Walz, Nicolay Chertkoff | Wade, Shari L.

Article Type: Research Article

Abstract: The present study examined whether functional MRI (fMRI) can identify changes in the neural substrates of language in young children following traumatic brain injury (TBI). Eight children with TBI (F/M = 3/5, age (Mean ± SD) = 7.98 ± 1 years, range = 6–9 years) and a comparison group of nine children with orthopedic injuries (OI) (F/M = 4/5, age (Mean ± SD) = 7.4 ± 1 years, range = 6–9 years) participated in an fMRI study of covert verb generation (VG). Results revealed significantly different BOLD signal activation in perisylvian language areas between the groups, after accounting for …potential confounders such as verbal fluency and executive function. We also found significant associations between the BOLD signal activation and performance on language-specific neuropsychological tests (NEPSY verbal fluency score, Verbal IQ) and Glasgow Coma Scale (GCS) score. This study suggests that children with TBI have significantly different brain activation patterns in language circuitry compared to children with orthopedic injuries. Although we found clear differences in brain activation between the two groups, conventional MR images showed no evidence of structural abnormalities in five of eight children with TBI. Our study demonstrates the feasibility and potential utility of fMRI as a means of quantifying changes associated with language deficits in future pediatric TBI studies. Show more

DOI: 10.3233/NRE-2007-22503

Citation: NeuroRehabilitation, vol. 22, no. 5, pp. 355-369, 2007

Authors: Kirton, Adam | Westmacott, Robyn | deVeber, Gabrielle

Article Type: Research Article

Abstract: This review provides an overview of pediatric ischemic stroke to serve as a foundation for the discussion of rehabilitation strategies following focal injury in the developing brain. Cerebrovascular disease is an important cause of acquired brain injury in neonates and children. Ischemic strokes are caused by a multitude of risk factors and advances in neuroimaging have improved diagnosis and understanding of pathophysiology. Pediatric stroke provides the ideal model for the study of injury and recovery in a plastic nervous system. Though their brains likely posses greater potential and unique reorganizational skills, most children suffer neurological morbidity after stroke. An improved …understanding of these systems is helping us understand, validate, and improve traditional approaches to rehabilitation while opening the door to new opportunities to improve outcome. All aspects of a patient's function, from the physical to psychological, including issues unique to children and their families, must be addressed and are reviewed. New advances and future directions for research are highlighted. Show more

Keywords: Cerebrovascular disease, pediatric stroke, child, rehabilitation, hemiplegia

DOI: 10.3233/NRE-2007-22504

Citation: NeuroRehabilitation, vol. 22, no. 5, pp. 371-382, 2007

Authors: Clawson, Elizabeth P. | Kuchinski, Kimberly S. | Bach, Robert

Article Type: Research Article

Abstract: The purpose of this study was to assess the effectiveness of an intensive day patient pediatric feeding program using oral motor exercises, behavioral interventions, and parental education to increase the oral feeding of children with spastic diplegic cerebral palsy. Eight children between the ages of 18 months to 4.7 years participated in the feeding program for an average of 5.8 weeks. The program consisted of structured oral motor exercises, rewards for reinforcement of appropriate feeding behaviors such as accepting food, chewing, and swallowing, as well as extinction for inappropriate feeding responses. Results show improvement in mealtime skills and behaviors necessary …for increasing oral intake. There was improvement in ability to open the mouth for the presentation of the food as well as improved timeliness of swallowing without gagging, expelling or holding food in the mouth. The children were able to tolerate longer meal sessions and consume a greater quantity of food resulting in greater caloric consumption. The children who were tube fed at admission were able to decrease the amount of tube supplementation due to their improved oral intake. Caregivers improved in their ability to feed their children by providing appropriate instructions, prompts and consequences (IPC) during meals. Show more

Keywords: Cerebral palsy, neuromuscular disorders, feeding, nutrition, malnutrition, dysphagia

DOI: 10.3233/NRE-2007-22506

Citation: NeuroRehabilitation, vol. 22, no. 5, pp. 397-406, 2007