Effects of spatial working memory in balance during dual tasking in traumatic brain injury and healthy controls.

OBJECTIVES: The aim of this research was to assess cognitive-motor interactions though dual tasks of working memory in patients with traumatic brain injury (TBI) and control subjects. Methods: Twenty patients with chronic TBI with good functional level and 19 matched healthy controls performed dual working memory tasks (1-back numeric and 1-back spatial (S)) while sitting, standing, and walking. The center of pressure (COP) displacement amplitude, cadence, and error percentage (PER) were recorded as dependent variables. Results: The results revealed main effects of Group (TBI, controls) (p = .011) and Task factors (Single, Dual Standing 1-back, Dual Standing 1-back (S); p = .0001) for the COP. Patients showed greater displacement than controls (p = .011), and an analysis of the Task factor showed a minor displacement for the dual 1-back (S) task compared with the 1-back and single task (p = .002 and p = .001, respectively). Conclusions: Postural control during both standing and walking improved during performance of the spatial working memory task. In the dual task, both patients and controls showed a postural prioritization as an adaptive response to the increase in cognitive demand.

Quantitative Ultrasound Imaging Pixel Analysis of the Intrinsic Plantar Muscle Tissue between Hemiparesis and Contralateral Feet in Post-Stroke Patients.

Quantitative ultrasound imaging of the muscle tissue may be applied in the neurology field, due to B-mode grayscale pixels values could be used as potential biomarkers for disease progression and intervention effects in poststroke patients. Thus, the study aim was to compare and analyze the ultrasound imaging B-mode pixels differences between the intrinsic plantar muscles cross-sectional area (CSA) in hemiparetic and contralateral feet from poststroke patients by means of the Image J software. A case-control design and a convenience sampling method were used in order to recruit 22 feet from 11 poststroke patients. This total sample was divided into 11 hemiparetic feet and 11 contralateral feet. The Image J software was used in order to evaluate the interface distance, CSA as well as measure the pixels mean, standard deviation (SD) and count from all offline images in the flexor digitorum brevis, abductor hallucis (AbH), and flexor hallucis brevis muscles. Statistically significant differences (p = 0.003) were only shown for the pixels count in the AbH muscle. The rest of outcome measurements did not show any statistically significant difference (p > 0.05). Therefore, B-mode ultrasound imaging Image J software differences for the pixels count reduction were shown in the AbH muscle between hemiparetic and contralateral feet from poststroke patients. Further studies are necessary in order to apply our findings as potential biomarkers during the stroke disease course.

Rehabilitative ultrasound imaging of the bilateral intrinsic plantar muscles and fascia in post-stroke survivors with hemiparesis: A case-control study.

Purpose: The study main aim was to compare the cross-sectional area (CSA) and thickness of the plantar muscles and fascia in the hemiparesis and contralateral feet of poststroke survivors with respect to healthy feet of matched controls. Methods: A case-control observational study was performed using B-mode rehabilitative ultrasound imaging. A convenience sampling method was used to select 60 feet. The sample was divided into 20 feet ipsilateral and 20 feet contralateral to the hemiparesis lower limb from poststroke survivors, as well as 20 healthy feet from matched controls. The CSA and thickness of the abductor hallucis, flexor digitorum brevis and flexor hallucis brevis, as well as the thickness for the posterior, middle and anterior plantar fascia portions were measured. Comparisons and multivariate predictive analyses were carried out for ultrasound measurements. In all analyses, a P-value<.01 with a 99% confidence interval was considered as statistically significant. Results: Statistically significant differences (P<.01) were shown for a flexor hallucis brevis thickness increase as well as middle and anterior plantar fascia thickness decrease of the hemiparesis feet and contralateral feet with respect to the healthy matched control feet. The rest of measurements did not show any statistically significant difference (P>.01). Conclusions: The thickness of the flexor hallucis brevis muscle as well as the middle and anterior plantar fascia portions of the hemiparesis and contralateral feet from poststroke survivors presented morphology changes with respect to the healthy matched control feet.

[Effects of an hydrotherapy program in the treatment of cervical dystonia. A pilot study]. / Efectos de un programa de hidroterapia en el tratamiento de la distonía cervical. Estudio piloto.

INTRODUCTION: Cervical dystonia may also cause limitation in articulation mobility and alteration of the balance, both accompanied with pain. AIM. To evaluate if hydrotherapy produces decrease of pain, increase in mobility and balance in patients diagnosed with cervical dystonia. PATIENTS AND METHODS: A pre-post treatment pilot study was carried out without group control, with a sample of 16 patients (13 female and 3 male) diagnosed with cervical dystonia. The patients received an hydrotherapy treatment consisted of three individual sessions and three grupal sessions of aquatic exercises. In the pre-treatment phase the disability, severity and pain were evaluated by means of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS); the balance was evaluated by means of the Get up and Go and Tinetti tests. In addition, the range of active mobility of the neck was measured with tape. The test were measured pre and post-treatment. RESULTS: The Student t showed a significant difference (p < 0, 01) in all the values. The range of active mobility of the neck improved in all movements: flexion (1.3 ± 1.0 cm), right lateralization (3.4 ± 1.7 cm) and left (4.0 ± 3.0 cm) and right rotation (1.6 ± 2.5 cm) and left (2.2 ± 1.5 cm). At the same time, all test improved too: Tinetti (3.0 ± 2.2), Get up and Go (2.3 ± 1.6) and TWSTRS (8.4 ± 5.4). CONCLUSIONS: The outcomes of this pilot study show that hydrotherapy can be related a positive influence in cervical dystonia, producing neck mobility and balance improvements and pain decrease. Future studies are necessary.

Eficacia de los programas de educación terapéutica y de rehabilitación respiratoria en el paciente con asma / Effectiveness of Therapeutic Education and Respiratory Rehabilitation Programs for the Patient with Asthma

El asma es una enfermedad crónica compleja, heterogénea, con una gran variabilidad y que tiene un enorme impacto, no sólo en los pacientes que la padecen sino también en sus familias y en la sociedad en general. La educación del paciente asmático y su familia son el elemento esencial para la intervención terapéutica. A través de la educación, entendida como un proceso continuo, dinámico y adaptado, se van a poder conseguir cambios en las actitudes y conductas del paciente y su familia, que habrán de llevar, sin duda, a mejorar la calidad de vida de los mismos. Entre otras intervenciones no farmacológicas, la rehabilitación respiratoria representa una alternativa de tratamiento, y está dirigida fundamentalmente a los pacientes que padecen asma moderada y severa. Puesto que las últimas guías de práctica clínica publicadas en la literatura científica recomiendan ambas estrategias de tratamiento, pero los resultados de las publicaciones al respecto son diversos, el objetivo del presente trabajo fue describir la eficacia de los programas de educación terapéutica y el papel de la de rehabilitación respiratoria en el tratamiento del paciente asmático(AU)

Asthma is a chronic complex and heterogeneous disease, with great variability and has a huge impact, not only on patients who suffer the disease but also their families and society in general. The education of the asthmatic patient and their families is essential for therapeutic intervention. Through continuous, dynamic and adaptive education, changes in attitudes and behaviours of the patient and family can be achieved, and will undoubtedly lead to an improvement in their quality of life. Among other non-pharmacological interventions, respiratory rehabilitation is an alternative treatment, and is primarily aimed at patients with moderate to severe asthma. Although the latest clinical practice guidelines published in the scientific literature recommend two strategies for treatment, the results of relevant publications are diverse. The objective of this study was to describe the effectiveness of therapeutic and educational programs in respiratory rehabilitation of the asthmatic patient(AU)

[Effectiveness of therapeutic education and respiratory rehabilitation programs for the patient with asthma]. / Eficacia de los programas de educación terapéutica y de rehabilitación respiratoria en el paciente con asma.

Asthma is a chronic complex and heterogeneous disease, with great variability and has a huge impact, not only on patients who suffer the disease but also their families and society in general. The education of the asthmatic patient and their families is essential for therapeutic intervention. Through continuous, dynamic and adaptive education, changes in attitudes and behaviours of the patient and family can be achieved, and will undoubtedly lead to an improvement in their quality of life. Among other non-pharmacological interventions, respiratory rehabilitation is an alternative treatment, and is primarily aimed at patients with moderate to severe asthma. Although the latest clinical practice guidelines published in the scientific literature recommend two strategies for treatment, the results of relevant publications are diverse. The objective of this study was to describe the effectiveness of therapeutic and educational programs in respiratory rehabilitation of the asthmatic patient.