Implementation outcomes of a sensory integration therapy program with computerized dynamic posturography in patients with balance and sensory dysfunction.

Objective: We describe the first-year implementation experience of an Instrumented Sensory Integration Therapy Program in Audiological & Balance Center patients. Design: This is a retrospective descriptive study. Participants included Seventy-three adults with diagnoses of acute, episodic, or chronic vestibular syndromes. They were classified into the following two groups: group 1 included 46 individuals treated with ISIT plus VRT, and group 2 included 27 individuals treated only with ISIT. Results: The Sensory Organization Test (SOT) for both groups showed a statistical significance for all three sensory inputs; visual systems (G1: p = 0.0003; G2: p = 0.0337), vestibular system (G1: p < 0.0001; G2: p = 0.0003), and balance as demonstrated by compound balance score (G1: p < 0.0001; G2: p = 0.0035), and balance percentage deficit (G1: p < 0.0001; G2: p = 0.0078). Conclusions: The severity and complexity of functional neurological disorders in the context of vestibular syndromes seem to require between 10 and 20 therapy sessions, and combined ISIT plus VRT appears to be more effective than ISIT as a monotherapy.

Atención del Trastorno del Espectro Autista y epilepsia a través de Sistemas Aumentativos/Alternativos de Comunicación / Care of Autism Spectrum Disorder and Epilepsy through Augmentative/

El incremento de la prevalencia de los perfiles clínicos de personas con TEA y epilepsia en la etapa infantil ha aumentado en los últimos años, describiendo una problemática en su evaluación e intervención en las competencias lingüísticas. Esta población muestra graves alteraciones en el lenguaje expresivo que abarcan diferentes dimensiones de este como la fonología, la semántica, la morfosintaxis, la pragmática y la comprensión auditiva. Todo ello hace que estos usuarios muestren alteraciones significativas en su comunicación y expresión del lenguaje, lo que dificulta significativamente su autonomía y calidad de vida. Por ello, según la literatura científica, uno de los planes de intervención más efectivo que disponemos en la actualidad es el uso de los Sistemas Aumentativos y/o Alternativos de Comunicación (SAAC), los cuales han demostrado en esta población que permiten aumentar su capacidad comunicativa y resolver situaciones lingüísticas con éxito. Es por lo que los profesionales de la salud deben tener un plan de evaluación e intervención adecuado que permita solventar las necesidades comunicativas de las personas con TEA y epilepsia en la etapa infantil. Por ende, este trabajo tuvo el objetivo de reflexionar y proporcionar una revisión de la atención de la población infantil con TEA y epilepsia a través del uso de los SAACs. Para ello, se llevó a cabo una revisión narrativa de la literatura científica publicada hasta el momento, con la lectura de 51 artículos de investigación sobre la atención de la población infantil con TEA y epilepsia. Los resultados indicaron que el protocolo de evaluación para su implementación debe seguir una serie de pasos como son: Recogida de información, Valoración de la persona, Valoración del entorno cercano, Selección del vocabulario, Selección de los reforzadores, Análisis de los sistemas de comunicación, Toma de decisiones y Evaluación de la efectividad del sistema de comunicación. Asimismo, el uso de SAACs en este colectivo mejora de forma significativa la comunicación funcional en diferentes contextos y entornos. En conclusión, se debe llevar a cabo una atención multidisciplinar para mejorar las competencias lingüísticas de las personas con TEA y epilepsia.

The increasing prevalence of clinical profiles of individuals with ASD and epilepsy in childhood has grown in recent years, describing a challenge in their assessment and intervention in language competencies. This population exhibits severe impairments in expressive language that encompass various dimensions of language, such as phonology, semantics, morphosyntax, pragmatics, and auditory comprehension. All of this results in these individuals showing significant disruptions in their communication and language expression, significantly impacting their autonomy and quality of life. Therefore, according to scientific literature, one of the most effective intervention plans currently available is the use of Augmentative and Alternative Communication Systems (AAC), which have shown in this population to increase their communicative capacity and successfully address language-related situations. Hence, healthcare professionals should have an appropriate assessment and intervention plan to address the communication needs of children with ASD and epilepsy. Therefore, this work aimed to reflect on and provide a review of the care for children with ASD and epilepsy through the use of AACs. To achieve this, a narrative review of the scientific literature published up to now was conducted, with the reading of 51 research articles on the care of children with ASD and epilepsy. The results indicated that the assessment protocol for its implementation should follow a series of steps, including: Gathering information, Assessing the individual, Assessing the immediate environment, Selecting vocabulary, Choosing reinforcers, Analyzing communication systems, Making decisions, and Evaluating the effectiveness of the communication system. Furthermore, the use of AACs in this group significantly improves functional communication in various contexts and environments. In conclusion, a multidisciplinary approach should be taken to enhance the language competencies of individuals with ASD and epilepsy.

Can Individuals Poststroke Improve Their Performance in Reaction and Movement Times in a Nonimmersive Serious Game with Practice? A Cross-Sectional Study.

Objective: To verify if individuals' poststroke and healthy controls would improve their performance in reaction and movement times practicing a serious game task using the upper limb movements. Materials and Methods: We evaluated 30 individuals poststroke and 30 healthy controls, matched for age and sex. We used the "Association Game for Rehabilitation" (AGaR) where participants played by matching a pair of images whose meanings were similar. Hand movements were captured by a Kinect system and poststroke participants used their nonparetic upper limb. Reaction time and movement times (time to select an image and movement time to the target) were measured. Data were analyzed using multiple analysis of variance. Results: Performance improved for both groups across all variables with better performance in movement times than reaction time only for poststroke individuals. Conclusions: Upper limb movements using nonimmersive serious games enhanced motor performance in reaction and movement times for healthy controls and individuals poststroke. ReBEC Trial Registration: RBR-4m4pk; Registeted on 08/24/2018.

Current concepts in the treatment of hereditary ataxias / Conceitos atuais no tratamento das ataxias hereditárias

ABSTRACT Hereditary ataxias (HA) represents an extensive group of clinically and genetically heterogeneous neurodegenerative diseases, characterized by progressive ataxia combined with extra-cerebellar and multi-systemic involvements, including peripheral neuropathy, pyramidal signs, movement disorders, seizures, and cognitive dysfunction. There is no effective treatment for HA, and management remains supportive and symptomatic. In this review, we will focus on the symptomatic treatment of the main autosomal recessive ataxias, autosomal dominant ataxias, X-linked cerebellar ataxias and mitochondrial ataxias. We describe management for different clinical symptoms, mechanism-based approaches, rehabilitation therapy, disease modifying therapy, future clinical trials and perspectives, genetic counseling and preimplantation genetic diagnosis.

RESUMO As ataxias hereditárias representam um grupo complexo de doenças neurodegenerativas, e se caracterizam por ataxia cerebelar progressiva, associada a sinais e sintomas extra-cerebelares e sistêmicos, os quais incluem: neuropatia periférica, sinais piramidais, distúrbios do movimento, convulsões e disfunção cognitiva. Não existe um tratamento efetivo para a cura das ataxias hereditárias. Até o momento os tratamentos disponíveis são apenas sintomáticos. Nesta revisão vamos abordar tratamento sintomático das principais ataxias autossômicas recessivas, ataxias autossômicas dominantes, ataxias ligadas ao X e ataxias mitocondriais. Descrevemos os diferentes sintomas, abordagens terapêuticas baseadas no mecanismo fisiopatológico, terapia de reabilitação, terapia modificadora da doença, futuros ensaios clínicos, perspectivas, níveis de evidência, aconselhamento genético e diagnóstico genético pré-implantacional.