NeuroRehabilitation - Volume 45, issue 3

Authors: Ramos-Usuga, D. | Benito-Sánchez, I. | Pérez-Delgadillo, P. | Valdivia-Tangarife, R. | Villaseñor-Cabrera, T. | Olabarrieta-Landa, L. | Arango-Lasprilla, J.C.

Article Type: Research Article

Abstract: BACKGROUND: Children with traumatic brain injury (TBI) usually displayed substantial neuropsychological impairment at short and long term after injury. OBJECTIVE: To compare the course of cognitive functioning among children with TBI and healthy controls over the first-year post-injury in Guadalajara, Mexico. METHODS: A sample of 46 children with TBI and 46 healthy controls from Guadalajara, Mexico were recruited. Both groups received a comprehensive neuropsychological evaluation at three-time (3, 6, and 12 months) with measures of memory, attention, executive function, processing speed, language, perceptual reasoning, visuo-spatial abilities, and intellectual functioning. Sixteen hierarchical linear models (HLMs) were performed …to examine whether linear trajectories of cognitive functioning differed over time between groups. RESULTS: Trajectories of neuropsychological performance were significantly worse over time among children with TBI than healthy controls across every cognitive domain. HLMs suggested that cognitive performance increased over time in both groups, however, TBI group scored significantly lower at each time point compare to the control group, except in Stroop-Interference. CONCLUSIONS: Cognitive deficits are common during the first-year after pediatric TBI. Thus, it is imperative to implement early rehabilitation programs to mitigate the consequences of these problems in the social, academic, and family reintegration of these children. Show more

Keywords: TBI, children, cognitive function, Mexico, Latin America

DOI: 10.3233/NRE-192834

Citation: NeuroRehabilitation, vol. 45, no. 3, pp. 295-309, 2019

Authors: Lancioni, Giulio E. | Singh, Nirbhay N. | O’Reilly, Mark F. | Sigafoos, Jeff | D’Amico, Fiora | Vincenti, Angelica | Buonocunto, Francesca | Susco, Valentina | Lanzilotti, Crocefissa | Navarro, Jorge

Article Type: Research Article

Abstract: BACKGROUND: Individuals with extensive neuro-motor impairment and lack of speech tend to remain passive and isolated, and to rely on others for communication and leisure. While their problems are known, only limited evidence is available about intervention tools that could help them curb those problems. OBJECTIVE: This study was aimed at upgrading and assessing a smartphone-based technology package, which was recently developed to help those individuals to independently engage in basic communication and leisure. METHODS: The study included 11 non-ambulatory participants who had no speech or functional active communication. They were provided with (a) a Samsung …A3 smartphone with Android 6.0 Operating System, which was fitted with WhatsApp Messenger and programmed via MacroDroid, and (b) cards fitted with radio frequency identification (RFID) tags. By bringing those cards in contact with the back of the smartphone, the participant could start a communication event (e.g., sending a message to a friend) or activate a leisure event (e.g., a song). The smartphone would automatically read to the participant any incoming messages. RESULTS: During the baseline (i.e., when a standard smartphone was available), the participants were unable to engage in communication or leisure. Once the aforementioned technology package was introduced, the participants spent between about 65 and 85% of their session time engaging in communication and leisure. CONCLUSIONS: The smartphone-based technology package seems to be a useful tool to support basic communication and leisure in individuals like those involved in this study. Show more

Keywords: Neuro-motor impairment, communication, leisure, smartphone, technology, messages

DOI: 10.3233/NRE-192811

Citation: NeuroRehabilitation, vol. 45, no. 3, pp. 311-322, 2019

Authors: Etoh, Seiji | Kawamura, Kentaro | Tomonaga, Kei | Miura, Seiji | Harada, Shizuyo | Noma, Tomokazu | Kikuno, Satomi | Ueno, Makoto | Miyata, Ryuji | Shimodozono, Megumi

Article Type: Research Article

Abstract: BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) and Repetitive facilitative exercise (RFE) improves motor impairment after stroke. OBJECTIVE: To investigate whether neuromuscular electrical stimulation (NMES) can facilitate the effects of rTMS and RFE on the function of the hemiparetic hand in stroke patients. METHODS: This randomized double-blinded crossover study divided 20 patients with hemiparesis into two groups and provided treatment for 4 weeks at 5 days/week. NMES-before-sham group and NMES-following-sham group performed NMES sessions and sham NMES sessions for each 2 weeks. Patients received NMES or sham NMES for the affected extensor muscle concurrently with 1 Hz rTMS …for the unaffected motor cortex for 10 min and performed RFE for 60 min. The Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT), Box and Block Test (BBT) and Modified Ashworth Scale (MAS) were used for evaluation. RESULTS: FMA and ARAT improved significantly during both sessions. The gains in the BBT during an NMES session were significantly greater than those during a sham NMES session. MAS for the wrist and finger significantly decreased only during an NMES session. CONCLUSIONS: NMES combined with rTMS might facilitate, at least in part, the beneficial effects of RFE on motor function and spasticity of the affected upper limb. Show more

Keywords: Neuromuscular electrical stimulation, hemiparesis, repetitive facilitative exercise, repetitive transcranial magnetic stimulation, stroke

DOI: 10.3233/NRE-192800

Citation: NeuroRehabilitation, vol. 45, no. 3, pp. 323-329, 2019

Authors: Berardi, Anna | Saffioti, Marco | Tofani, Marco | Nobilia, Marta | Culicchia, Greta | Valente, Donatella | Servadio, Annamaria | Galeoto, Giovanni

Article Type: Research Article

Abstract: PURPOSE: The aim of this study was to evaluate the internal consistency and validity of the Italian version of the Jebsen– Taylor Hand Function Test (JTHFT-IT) in Italian post-stroke adults with chronic hemiplegia or hemiparesis. METHODS: The test’s internal consistency and validity were assessed by following international guidelines. Its internal consistency was examined using Cronbach’s alpha (α ) coefficient. Pearson’s correlation coefficient was calculated for concurrent validity in comparison with a dynamometer instrument, whereas for construct validity, it was calculated in comparison with the mean execution time of the Wolf Motor Function Test time subscale (WMFT-IT-TIME). …RESULTS: The test was administrated to 48 people with chronic stroke. Cronbach’s alpha reported a value of 0.96 for the dominant hand and 0.92 for the non-dominant hand. To define the validity of the scale, Pearson’s correlation as measured using the WMFT-IT-TIME, and the dynamometer showed statistically significant results. CONCLUSIONS: The present study supports the use of the JTHFT-IT as a measure of hand functionality in post-stroke adults with chronic hemiplegia or hemiparesis. It is an important tool for Italian professionals, and it can be useful both in clinical practice to evaluate improvement after rehabilitation treatments and for research in hand rehabilitation. Show more

Keywords: Italian, outcome measure, stroke, upper limb, validation

DOI: 10.3233/NRE-192867

Citation: NeuroRehabilitation, vol. 45, no. 3, pp. 331-339, 2019

Authors: Faria-Fortini, Iza | Polese, Janaine C. | Faria, Christina D.C.M. | Teixeira-Salmela, Luci F.

Article Type: Research Article

Abstract: BACKGROUND: Reduced walking speed (WS) may lead to restrictions in participation of individuals with stroke, however, the relationships between WS and participation still need to better clarified. OBJECTIVE: To evaluate the relationships between WS and participation and compare the levels of participation of individuals with chronic stroke, who were stratified according to their walking status. METHODS: One-hundred and five individuals with stroke (58±12 years; 61 men) participated. WS was measured by the 10-meter walking test and reported in m/s. The participants were stratified into three walking status groups: household (WS <0.4 m/s), limited-community (0.4 m/s–0.8 m/s), and full-community ambulation …(>0.8 m/s). Participation was assessed by the Brazilian version of the Assessment of Life Habits 3.1 (LIFE-H 3.1-Brazil). RESULTS: Between-group analyses revealed statistically significant differences between the household, limited-community, and full-community ambulators regarding the LIFE-H 3.1 total (F = 17.5; p  < 0.0001), as well the daily activity (F = 12.3; p  < 0.0001) and social role (F = 19.0; p  < 0.0001) domain scores. Measures of WS were correlated with the daily activity (r  = 0.50, p  < 0.0001), social role (r  = 0.53, p  < 0.0001), total LIFE-H scores (r  = 0.53, p  < 0.0001), and most of the LIFE-H categories (r  = 0.23–0.56). CONCLUSIONS: WS was significantly correlated with participation and was able to distinguish between individuals with stroke, who had different levels of participation. Show more

Keywords: Walking speed, social participation, stroke

DOI: 10.3233/NRE-192805

Citation: NeuroRehabilitation, vol. 45, no. 3, pp. 341-348, 2019

Authors: Krch, Denise | Lequerica, Anthony | Aguayo Arelis, Adriana | Rábago Barajas, Brenda Viridiana | Arango-Lasprilla, Juan Carlos | Chiaravalloti, Nancy D.

Article Type: Research Article

Abstract: BACKGROUND: Memory impairments commonly afflict individuals with MS. While evidence-based cognitive rehabilitation treatments are available in English, the lack of such interventions in Spanish is an important barrier to care for Hispanics with MS. There is class I evidence that the modified Story Memory Technique (mSMT) improves learning in English. This intervention has been translated and adapted into Spanish. OBJECTIVE: To examine the preliminary efficacy of the Spanish mSMT to improve learning in Mexicans with MS. METHODS: Twenty individuals with relapsing-remitting MS were randomized to treatment (n  = 10) or placebo control (n  = 10) groups. The Spanish …mSMT is a 10-session intervention that teaches imagery and context to facilitate learning. The control condition was matched to the treatment condition in treatment duration, and stimulus content and presentation. Participants completed baseline and post-treatment neuropsychological assessments. RESULTS: Individuals who received the Spanish mSMT showed significant improvements in learning and life satisfaction relative to the control group. Also observed were a near-moderate effect size on perceived memory complaints and a moderate-to-large effect size on the family’s perception of the patient’s competency. CONCLUSIONS: The Spanish mSMT showed preliminary efficacy in improving learning deficits in Mexicans with MS, and such improvements may extend to other domains. Show more

Keywords: Rehabilitation intervention, relapsing-remitting MS, verbal learning, cognitive rehabilitation, translated and adapted

DOI: 10.3233/NRE-192808

Citation: NeuroRehabilitation, vol. 45, no. 3, pp. 349-358, 2019

Authors: Snyder, Kaitlyn J. | Patsakos, Eleni | White, John | Ditor, David S.

Article Type: Research Article

Abstract: BACKGROUND: Although exercise training has benefits for individuals with multiple sclerosis (MS), research regarding the type of exercise equipment that requires the greatest aerobic demand, and consumer-based preferences, is lacking. OBJECTIVE: To determine the aerobic demands of various pieces of accessible exercise equipment and consumer-based preferences on several domains. METHODS: Ten individuals with moderate-severity MS had their VO2 measured during 10 minutes of moderate-intensity arm ergometry (AE), body-weight support treadmill training (BWSTT), recumbent arm-leg exercise (NuStep), FES-arm exercise (RT300), FES-leg exercise (RT300) and FES arm-leg exercise (RT200). VO2peak test was also measured on the …NuStep and the RT200. Equipment preferences were determined by questionnaire after moderate exercise sessions. RESULTS: AE required a lower VO2 compared to the NuStep (p  = 0.02), and FES-arm exercise required a lower VO2 compared to the NuStep (p  = 0.01) and FES arm-leg exercise (p  = 0.04). There was no difference in VO2peak when using the NuStep or FES arm-leg exercise. AE was perceived as safer than BWSTT, but otherwise there were no preferences for any equipment. CONCLUSIONS: For individuals with moderate-severity MS, arm-only exercise requires less aerobic demands than combined arm-leg exercise at a moderate intensity. Perceived risks may be greater when exercise requires a transfer, upright positioning, or assistance. Show more

Keywords: Exercise equipment, aerobic demand, consumer-based preferences, multiple sclerosis

DOI: 10.3233/NRE-192861

Citation: NeuroRehabilitation, vol. 45, no. 3, pp. 359-367, 2019

Authors: Sivaramakrishnan, Anjali | Datta, Abhishek | Bikson, Marom | Madhavan, Sangeetha

Article Type: Research Article

Abstract: BACKGROUND: Transcranial direct current stimulation (tDCS) has been investigated as a therapeutic neuromodulation tool in several neurological disorders. However, evidence supporting its efficacy in disorders such as amyotrophic lateral sclerosis (ALS) is limited possibly due to limited patient accessibility for research, particularly for individuals with advanced disease progression. Telerehabilitation using home-based protocols allows for remote supervision of tDCS over longer durations, thereby increasing participation, compliance and adherence. In this study, we explored the safety, feasibility and preliminary effects of a remotely supervised tDCS (RS-tDCS) protocol in ALS. MATERIAL AND METHODS: In this pre-post case series study, two individuals …with ALS completed 24 remotely supervised anodal tDCS sessions (20 minutes, 2 mA). Outcomes included adherence, compliance, disease progression, walking speed, risk of fall, endurance, fatigue and depression. RESULTS: Both participants successfully completed the study without any major adverse effects. Minor side effects included mild sensations of itching and throbbing under the electrodes during stimulation. Clinical outcomes showed minimal to no change for any of the measures. CONCLUSIONS: Preliminary findings suggest that the RS-tDCS protocol is safe and feasible in individuals with ALS. Our protocol serves as a model for future long-term studies to evaluate the clinical and neurophysiological effects of tDCS using a telerehabilitation protocol in ALS. Show more

Keywords: Transcranial direct current stimulation, telerehabilitation, amyotrophic lateral sclerosis, remotely supervised tDCS, home-based tDCS

DOI: 10.3233/NRE-192851

Citation: NeuroRehabilitation, vol. 45, no. 3, pp. 369-378, 2019

Authors: Chang, Min Cheol | Chun, Min Ho

Article Type: Research Article

Abstract: BACKGROUND: Balance impairment is a major clinical concern in patients with parkinsonism. Balance training with tetra-ataxiometric posturography (Tetrax) is known to improve balance function through visual biofeedback effects. OBJECTIVE: In this study, we evaluated the effects of balance training with Tetrax in patients with parkinsonism. METHODS: Patients with parkinsonism (idiopathic Parkinson’s disease, multiple systemic atrophy, and multiple systemic atrophy) who were able to stand with or without an assistive device were recruited for the study. Twenty patients with parkinsonism were randomly assigned to one of the following two groups: (1) the Tetrax group, in which patients …received Tetrax biofeedback balance training for 30 min/day for 2 weeks (10 sessions); and (2) the control group, in which patients received conventional balance training for 30 min/day for 2 weeks (10 sessions). One day before and after training, we measured patients’ balance parameters using the Berg balance scale (BBS) and fall index (FI). RESULTS: The BBS and FI scores of the Tetrax group showed significant improvements after compared to before training. However, the scores in the control group were not significantly changed after vs. before conventional balance training. CONCLUSIONS: For patients with parkinsonism, Tetrax biofeedback balance training had a positive effect on balance function. Show more

Keywords: Parkinsonism, balance, feedback

DOI: 10.3233/NRE-192850

Citation: NeuroRehabilitation, vol. 45, no. 3, pp. 379-384, 2019

Authors: Baird, Amee | Harris, Celia B. | Harris, Sophia A. | Sutton, John | Miller, Laurie A. | Barnier, Amanda J.

Article Type: Research Article

Abstract: BACKGROUND: Intimate couples can become cognitively interdependent over time. If one member of the couple has a neurological condition with associated cognitive impairments, their partner can support or ‘scaffold’ their cognitive functioning through collaboration. OBJECTIVE: We explored the phenomenon of ‘collaborative memory’ in a case series of 9 couples in which one member had a neurological condition, specifically an acquired brain injury (ABI; n  = 7) or epilepsy (n  = 2). METHODS: To investigate collaborative memory, we compared the performance of the patient when remembering alone versus their performance in collaboration with their partner on three memory tasks, …assessing anterograde, semantic, and autobiographical memory. RESULTS: We found that across all tasks and participants, collaboration typically increased overall memory performance (total score), but the patient’s contribution to the task was typically lower when they collaborated compared with when they performed the task alone. We identified two distinct styles of collaboration which we termed ‘survival scaffolding’ (where the healthy partner ‘takes over’ memory recall) and ‘stability scaffolding’ (where the healthy partner cues and structures the patient’s recall). CONCLUSION: This exploratory case series contributes to the sparse literature on memory collaboration in people with neurological conditions. Our findings suggest that there are different styles of collaboration that can both help and hinder memory performance. Show more

Keywords: Acquired brain injury, epilepsy, relationship, memory, collaboration, scaffolding

DOI: 10.3233/NRE-192849

Citation: NeuroRehabilitation, vol. 45, no. 3, pp. 385-400, 2019