Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 586
Filtrar
1.
NeuroRehabilitation ; 48(2): 209-220, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33664158

RESUMO

BACKGROUND: Acquired brain injuries often cause cognitive impairment, significantly impacting participation in rehabilitation and activities of daily living. Music can influence brain function, and thus may serve as a uniquely powerful cognitive rehabilitation intervention. OBJECTIVE: This feasibility study investigated the potential effectiveness of music-based cognitive rehabilitation for adults with chronic acquired brain injury. METHODS: The control group participated in three Attention Process Training (APT) sessions, while the experimental group participated in three Music Attention Control Training (MACT) sessions. Pre-and post- testing used the Trail Making A & B, Digit Symbol, and Brown-Peterson Task as neuropsychological tests. RESULTS: ANOVA analyses showed no significant difference between groups for Trail A Test, Digit Symbol, and Brown-Peterson Task. Trail B showed significant differences at post-test favouring MACT over APT. The mean difference time between pre-and post-tests for the Trail B Test was also significantly different between APT and MACT in favour of MACT using a two-sample t-test as well as a follow-up nonparametric Mann Whitney U-test. CONCLUSIONS: The group differences found in the Trail B tests provided preliminary evidence for the efficacy of MACT to arouse and engage attention in adults with acquired brain injury.


Assuntos
Lesão Encefálica Crônica/terapia , Disfunção Cognitiva/terapia , Musicoterapia/métodos , Reabilitação Neurológica/métodos , Índice de Gravidade de Doença , Atividades Cotidianas/psicologia , Adulto , Idoso , Lesão Encefálica Crônica/psicologia , Cognição/fisiologia , Disfunção Cognitiva/psicologia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Música/psicologia , Reabilitação Neurológica/psicologia , Testes Neuropsicológicos
2.
NeuroRehabilitation ; 48(2): 155-166, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33579881

RESUMO

BACKGROUND: The plastic nature of the human brain lends itself to experience and training-based structural changes leading to functional recovery. Music, with its multimodal activation of the brain, serves as a useful model for neurorehabilitation through neuroplastic changes in dysfunctional or impaired networks. Neurologic Music Therapy (NMT) contributes to the field of neurorehabilitation using this rationale. OBJECTIVE: The purpose of this article is to present a discourse on the concept of neuroplasticity and music-based neuroplasticity through the techniques of NMT in the domain of neurological rehabilitation. METHODS: The article draws on observations and findings made by researchers in the areas of neuroplasticity, music-based neuroplastic changes, NMT in neurological disorders and the implication of further research in this field. RESULTS: A commentary on previous research reveal that interventions based on the NMT paradigm have been successfully used to train neural networks using music-based tasks and paradigms which have been explained to have cross-modal effects on sensorimotor, language and cognitive and affective functions. CONCLUSIONS: Multimodal gains using music-based interventions highlight the brain plasticity inducing function of music. Individual differences do play a predictive role in neurological gains associated with such interventions. This area deserves further exploration and application-based studies.


Assuntos
Encéfalo/fisiologia , Musicoterapia/métodos , Doenças do Sistema Nervoso/terapia , Reabilitação Neurológica/métodos , Plasticidade Neuronal/fisiologia , Encéfalo/diagnóstico por imagem , Humanos , Potenciação de Longa Duração/fisiologia , Música/psicologia , Doenças do Sistema Nervoso/diagnóstico por imagem , Doenças do Sistema Nervoso/psicologia , Recuperação de Função Fisiológica/fisiologia
3.
BMC Neurol ; 21(1): 69, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33579219

RESUMO

BACKGROUND: Prolonged disorders of consciousness (PDOC) may occur after severe brain injury. Two diagnostic entities are distinguished within PDOC: unresponsive wakefulness syndrome (UWS, previously known as vegetative state) and minimally conscious state (MCS). Patients with PDOC may benefit from early intensive neurorehabilitation (EIN). In the Netherlands, the EIN programme is provided by one designated expert rehabilitation centre and forms the starting point of a dedicated chain of specialised rehabilitation and care for this group. This study project, called DOCTOR: Disorders of Consciousness; Treatment and Outcomes Registry, sets up a registry and systematically investigates multiple short- and long-term outcomes of patients with PDOC who receive EIN. METHODS: Single-centre prospective cohort study with a 2-year follow-up period. Patients with PDOC due to acute brain injury who receive EIN, aged 16 years and older are included. Measurements will take place at start EIN, in week 5, 10, and at discharge from the EIN programme (duration = max 14 weeks) and at week 28, 40, 52, and 104 after admission to the EIN programme, following patients through the health-care chain. Outcome measures are the changes over time in level of consciousness, using the Coma Recovery Scale-Revised; the frequency and type of medical complications; the mortality rate; level of disability, including the level of motor, cognitive, behavioural and emotional functioning; participation; and quality of life. Secondary outcomes include self-efficacy of caregivers, caregivers' strain and cost-effectiveness of the programme. DISCUSSION: The DOCTOR study will provide insight in the recovery patterns and predictors of recovery for multiple outcomes in PDOC patients after following EIN. The results of the study will enable us to benchmark and improve EIN and the organisation of the health-care chain, both for patients with PDOC and for their families. TRIAL REGISTRATION: Netherlands Trial Register, NL 8138 . Retrospectively registered 6 November 2019.


Assuntos
Lesões Encefálicas/complicações , Lesões Encefálicas/reabilitação , Transtornos da Consciência/reabilitação , Reabilitação Neurológica/métodos , Resultado do Tratamento , Adolescente , Adulto , Transtornos da Consciência/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Prognóstico , Estudos Prospectivos , Qualidade de Vida
4.
Rev. neurol. (Ed. impr.) ; 72(2): 43-50, 16 ene., 2021. tab
Artigo em Espanhol | IBECS | ID: ibc-199583

RESUMO

INTRODUCCIÓN: El déficit de uso de la extremidad superior afectada, así como la calidad del movimiento, influyen en la ejecución de un agarre funcional (acción de agarrar-liberar un objeto) y, por tanto, reducen las posibilidades de ejecución de las actividades cotidianas del niño diagnosticado de hemiplejía infantil. La habilidad manual (movimientos de los dedos, agarre global y distal, manipulación, movimiento preciso, fluido) podría ser un factor que determine si la ejecución de terapia de movimiento inducido por restricción favorece el incremento de la funcionalidad de la extremidad superior afectada. OBJETIVO: Estudiar la influencia de la terapia de movimiento inducido por restricción en la funcionalidad de la extremidad superior afectada en hemiplejía infantil con una habilidad manual moderada de 2 a 16 años. PACIENTES Y MÉTODOS: Se realizó una búsqueda bibliográfica de los trabajos publicados entre 2014 y 2019 en las bases de datos PubMed, PEDro y The Cochrane Library. RESULTADOS: Tras aplicar los criterios de inclusión y exclusión, se obtuvieron siete estudios, de un total de 203, para ser analizados, en los que se compara la terapia de movimiento inducido por restricción con otras intervenciones. CONCLUSIONES: La comparativa de resultados resulta compleja debido a la falta de unanimidad en la aplicación de dosis y herramientas de evaluación del segmento afectado. La terapia de movimiento inducido por restricción aplicada de manera exclusiva permite mayores beneficios en la funcionalidad en cuanto a destreza manipulativa de la extremidad superior afectada en hemiplejía infantil con habilidad manual moderada que la terapia convencional u otras terapias


INTRODUCTION: The deficit of use on the upper limb affects, as well as the quality of movement, influences the execution of a functional grasp (action of grasping-releasing an object) and therefore, reduces the possibilities of execution of the child’s daily activities diagnosed with infantile hemiplegia. Manual ability (finger movements, global and distal grasp, handling, precise movement, fluid...) could be a factor that determines whether the execution of constraint induced movement therapy favors the increase in functionality of the upper limb affected. AIM: To study the constraint induced movement therapy influence on the functionality of the affected upper limb in infantile hemiplegia with moderate manual ability from 2 to 16 years of age. PATIENTS AND METHODS: A bibliographic search of the works published between 2014 and 2019 was performed in the PubMed, PEDro and The Cochrane Library databases. RESULTS: After applying the inclusion/exclusion criteria, seven studies were obtained from a total of 203 to be analyzed, comparing constraint induced movement therapy with other interventions. CONCLUSIONS: The results comparison is complex due to the lack of unanimity in the doses application and evaluation tools of the affected segment. The exclusive application of constraint induced movement therapy allows greater benefits in functionality, at the level of manual ability on affected upper limb in infantile hemiplegia with moderate manual ability than conventional therapy or other therapies


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Paresia/terapia , Técnicas de Exercício e de Movimento/métodos , Paralisia Cerebral/terapia , Reabilitação Neurológica/métodos , Braço/fisiopatologia , Técnicas de Exercício e de Movimento/classificação , Paralisia Cerebral/complicações , Extremidade Superior/fisiopatologia
6.
Tog (A Coruña) ; 17(2): 112-121, nov. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-198809

RESUMO

OBJETIVOS: el uso de la realidad virtual representa un enfoque metodológico prometedor como intervención terapéutica en neurorrehabilitación. En este estudio se analizó el uso de la RV en terapia ocupacional con pacientes neurológicos. MÉTODOS: se llevó a cabo un estudio descriptivo transversal con terapeutas ocupacionales de centros de neurorrehabilitación de la provincia de Alicante, entre febrero y mayo de 2017. La información se recogió online con un cuestionario de 36 preguntas. RESULTADOS: De 23 participantes, la mayoría eran mujeres (82.6%) y con edad media de 31.4 (DE: 4.1) años. La mitad (52.2%) usaba la realidad virtualcomo herramienta de tratamiento, principalmente con personas de 46-65 años (75.0%), con daño cerebral adquirido (75.0%) y alteraciones cognitivas (91.7%). Las áreas principales de intervención fueron: atención (83.3%), visión (75.0%), miembro superior (75.0%), comunicación verbal (66.7%), alimentación (50.0%), compras (41.7%) y participación social con amigos (41.7%). Los sistemas de RV más utilizados fueron la plataforma NeuronUp (50.0%) y el ordenador y/o tableta junto con los dispositivos Kinect y Wii (33.3%). CONCLUSIONES: Sólo la mitad de lo/as terapeutas ocupacionales usaban la realidad virtual como complemento al tratamiento convencional. Son necesarios más estudios sobre el uso de estas técnicas en terapia ocupacional con personas con afecciones neurológicas


OBJECTIVE: We aimed to analyze the use of virtual reality among occupational therapists working with neurological patients. Methods. A descriptive cross-sectional study was conducted on occupational therapists working in neurorehabilitation centers in the Alicante province between February and May 2017. The information was collected using an online questionnaire made up of 36 questions. RESULTS: Of the 23 participants, the majority of them were women (82.6%) with an average age of 31.4 years (SD: 4.1). Approximately half of them (52.2%) used virtual reality as a treatment tool, mainly with adults aged 46-65 (75.0%) affected by acquired brain damage (75.0%) and with cognitive alterations (91.7%). The intervention areas targeted were: attention (83.3%), vision (75.0%), upper limb mobility (75.0%), verbal communication (66.7%), eating (50.0%), shopping (41.7%), and social participation with friends (41.7%). The most used virtual reality systems in occupational therapy treatments were the NeuronUp platform (50.0%) and Xbox Kinect (R) / Nintendo Wii (R) (33.3%) used with a computer or a tablet. CONCLUSIONS: Only half of the occupational therapists in the study used virtual reality as a complementary tool for conventional treatment. Further studies exploring the use of these techniques in occupational therapy with people affected by neurological conditions are required


Assuntos
Humanos , Masculino , Feminino , Adulto , Terapia Ocupacional/métodos , Realidade Virtual , Centros de Reabilitação/organização & administração , Reabilitação Neurológica/métodos , Doenças do Sistema Nervoso/reabilitação , Terapia Ocupacional/instrumentação , Terapia Ocupacional/educação , Estudos Transversais , Serviços de Reabilitação , Reabilitação Neurológica/educação , Jogos de Vídeo , Inquéritos e Questionários
7.
PLoS One ; 15(10): e0238506, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33002026

RESUMO

The aim of the study is to investigate how time and uncertainties of clinical action and decision-making plays out in the practical work of early neurorehabilitation in order to present new analytical ways to understand the underlying logics and dynamic social processes that take place during professional treatment of patients with severe acquired brain injury. Drawing on ethnographic fieldwork in a Danish neuro-intensive step-down unit (NISU) specialising in early neurorehabilitation, we found that negotiation of futures takes place in the modern ICU in the present by strategically building upon past experiences. We have argued that the clinical programme therefore cannot be understood only from a "here and now perspective", since the early neurorehabilitation practice is embedded in overlapping temporalities of the past, the present, and desired futures. The study discusses the underlying logics-often hidden or unnoticed-that impact clinical practice of early neurorehabilitation, in what we have termed a logic of clinical reenactment, a logic of future negotiation and a logic of paradox.


Assuntos
Lesões Encefálicas/reabilitação , Reabilitação Neurológica/métodos , Antropologia Cultural , Lesões Encefálicas/fisiopatologia , Lesões Encefálicas/psicologia , Tomada de Decisões , Dinamarca , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Reabilitação Neurológica/ética , Fatores de Tempo , Incerteza
8.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 55(5): 258-265, sept.-oct. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-199480

RESUMO

ANTECEDENTES Y OBJETIVO: Aproximadamente un tercio de los pacientes que han sufrido un ictus desarrollan espasticidad. Ante la impresión clínica por parte de los autores de menor proporción de pacientes espásticos entre la población de mayor edad tras un ictus y la falta de consenso en la literatura, se procedió a contrastar aquellas variables que influyen en el desarrollo de espasticidad a partir de los datos de dos centros de neurorrehabilitación. El objetivo del estudio es determinar los factores que influyen en el desarrollo de la espasticidad a los tres meses de evolución del ictus y la prevalencia de espasticidad en los pacientes que han sufrido un ictus y que requieren tratamiento rehabilitador intensivo. MATERIAL Y MÉTODO: Estudio retrospectivo observacional de 554 pacientes atendidos en dos centros de neurorrehabilitación. Se recogieron datos sociodemográficos; naturaleza, etiología y localización del ictus; déficit motóricos, sensitivos, del lenguaje y deglución; incontinencia; estado cognitivo y anímico. El grado de espasticidad se evaluó al ingreso y al tercer mes en 462 pacientes mediante la escala de Ashworth. Se empleó el análisis de regresión multivariante para determinar qué variables influyen en la evolución de la espasticidad al tercer mes de la instauración del ictus. RESULTADOS: Edad media: 67,3 años; 67,1%, de estos eran hombres; 76,5% tuvo un origen isquémico. Al ingreso el 31,4% de los pacientes presentaban espasticidad y a los tres meses el 54,8%. Los pacientes con un mayor índice motor al ingreso, mejoraban en mayor proporción su espasticidad a los tres meses (OR 1,04; IC 95% 1,03-1,05). En el caso de no tener en cuenta el índice motor, las variables relacionadas con la evolución de la espasticidad fueron: edad < 75 años (OR 0,52; IC 95% 0,30-0,90), alteración sensitiva (OR 0,66; IC 95% 0,37-1,20) e índice de Barthel (OR 1,02; IC 95% 1,01-1,03). No se encontró la existencia de relación significativa para las variables sexo, mecanismo fisiopatológico (isquémico/hemorrágico), localización del ictus, presencia de afasia o deterioro cognitivo. CONCLUSIONES: La prevalencia de espasticidad en pacientes que han sufrido un ictus es del 54,8% al tercer mes de evolución. El índice motor al ingreso es predictor independiente de espasticidad a los tres meses de evolución. Los pacientes menores de 75 años, con alteración sensitiva y bajo índice de Barthel tienen más probabilidad de empeorar la espasticidad a los tres meses


OBJECTIVE: Approximately one third of patients who have suffered a stroke develop spasticity. Since clinical observations that spasticity in the elderly population is lower after stroke, and disagreement about risk factors between different authors, an analysis is performed on the variables that influence the development of spasticity. The objective of the study is to determine the how many factors influence spasticity outcome, and the prevalence of spasticity in patients who have suffered a stroke and require intensive rehabilitation treatment. METHOD: A retrospective assessment was carried out on a total of 554 patients from two neurorehabilitation centres. A record was made of sociodemographic data, aetiology, type and location of stroke, motor and sensory deficits, language and swallowing impairment, incontinence, cognitive and mood state. Spasticity levels at admission and at the third month were studied in 462 patients using the Ashworth scale. Multivariate regression analyses were used to assess the risk factors for spasticity present at the third month after stroke. RESULTS: The mean age of the patients was 67.3 years, of which 67.1% were men, and with ischemic aetiology in 76.5%. On admission 31.4% of patients had spasticity, and this increased to 54.8% at the 3rd month. The absolute risk factor for spasticity was motor index (OR 1.04; 95% CI 1.03-1.05). When this factor was omitted, the variables with predictive ability were: age less than 75 years (OR 0.52; 95% CI 0.30-0.90), sensory impairment (OR 0.66; 95% CI 0.37-1.20), and lower Barthel index score (OR 1.02; 95% CI 1.01-1.03). There was no significant relationship for gender, physiopathological mechanism (ischaemic/haemorrhagic), stroke location, aphasia, or cognitive impairment. CONCLUSION: The prevalence of spasticity in stroke at third month of follow-up was 54.8%. Motor index is the independent predictor of spasticity. Patients younger than 75 years old, with sensory impairment and low Barthel index score are more likely to develop spasticity


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Acidente Vascular Cerebral/complicações , Espasticidade Muscular/epidemiologia , Reabilitação do Acidente Vascular Cerebral/estatística & dados numéricos , Efeito Idade , Estudos Retrospectivos , Centros de Reabilitação/estatística & dados numéricos , Reabilitação Neurológica/métodos , Previsões , Fatores de Risco
9.
PLoS One ; 15(8): e0237152, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32745118

RESUMO

The population of older adults that have Dual Sensory Loss (DSL) is increasing, yet most research to date has focused on single sensory impairment and is inconclusive as to whether DSL is associated with worse impact on health and well-being over single sensory loss. The primary aim of this study was to characterize the health and functioning of community-dwelling older adults with DSL who were receiving sensory rehabilitation, using an understudied assessment: the interRAI Community Health Assessment (CHA). The secondary aim was to investigate whether older adults with DSL had worse health-related outcomes than their peers with only vision loss (VL) or only hearing loss (HL). We report and compare the interRAI CHA results in a sample of 200 older adults (61+ years of age) who had DSL, VL or HL. Overall, all sensory impairment groups showed high functioning in the areas of cognition, communication, activities of daily living, depression, and psycho-social well-being. DSL was not always associated with worse outcomes compared to a single sensory loss. Rather, the results varied depending on the tasks assessed, as well as which groups were compared. Our findings highlight that despite the negative impact of sensory losses, community-dwelling older adults receiving sensory rehabilitation services tend to have overall good health and a high level of independence. These results also show that DSL is not always associated with worse outcomes compared to a single sensory loss. Further research is needed to better characterize older adults with DSL who have more severe sensory and cognitive difficulties than those in our sample, and among those who are not receiving rehabilitation services.


Assuntos
Atividades Cotidianas , Cegueira/reabilitação , Perda Auditiva/reabilitação , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Cegueira/complicações , Cegueira/fisiopatologia , Cognição , Comunicação , Feminino , Perda Auditiva/complicações , Perda Auditiva/fisiopatologia , Humanos , Vida Independente , Masculino , Pessoa de Meia-Idade , Reabilitação Neurológica/métodos
10.
Rev. neurol. (Ed. impr.) ; 71(3): 85-92, 1 ago., 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-195453

RESUMO

INTRODUCCIÓN: El entrenamiento de la marcha sobre pasarela rodante con soporte parcial del peso corporal es una estrategia terapéutica frecuente en la rehabilitación de personas con lesión medular. OBJETIVO: Analizar los efectos de esta intervención en la marcha, el equilibrio y la fuerza muscular en personas con lesión medular incompleta en comparación con un tratamiento de fisioterapia convencional o con un entrenamiento de la marcha sobre suelo. PACIENTES Y MÉTODOS: Se realizó una recopilación de ensayos clínicos desde 2007 hasta 2019. Se incluyeron trabajos que evaluasen el entrenamiento de la marcha con soporte parcial del peso corporal en cinta rodante en pacientes con lesión medular incompleta y que analizasen la marcha, el equilibrio y la fuerza muscular. RESULTADOS: Se analizaron seis artículos. Según los resultados de los estudios incluidos, la cadencia, la velocidad y la resistencia de marcha mejoraron en los participantes que recibieron entrenamiento sobre pasarela rodante con soporte parcial del peso corporal respecto al grupo de control.Las variables de funcionalidad, equilibrio y fuerza mejoraron en la mayoría de estudios, pero no hubo diferencias entre ambos grupos. CONCLUSIONES: El entrenamiento de la marcha con soporte parcial del peso corporal sobre cinta rodante mejora los parámetros espaciotemporales de la marcha y la resistencia de los pacientes con lesión medular incompleta, pero, en la mayoría de las variables analizadas, los cambios no son superiores a los observados tras un entrenamiento convencional


INTRODUCTION: The partial body weight supported treadmill training is a common therapeutic strategy in rehabilitation of people with spinal cord injuries. AIM: To analyze its effects on gait, balance and muscle strength in people with incomplete spinal cord injury compared to conventional treatment or overground gait training. PATIENTS AND METHODS: A compilation of clinical trials from 2007 to 2019 was carried out. We included articles that evaluate the effects of body weight supported treadmill training on gait, balance and muscle strength in subjects with incomplete spinal cord injury. RESULTS: A total of six articles were analyzed. The walking cadence, speed and resistance improved in the participants that received the intervention compared to those that were treated with conventional training. The functionality, balance and strength improved in most studies, but there were not differences between them. CONCLUSIONS: Body weight supported treadmill training improves the spatiotemporal parameters of walking and resistance in subjects with incomplete spinal cord injury, but in most variables analyzed (balance, functionality and strength) the changes are not superior to those observed after conventional training


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Peso Corporal/fisiologia , Terapia por Exercício/métodos , Reabilitação Neurológica/métodos , Traumatismos da Medula Espinal/reabilitação , Marcha , Força Muscular , Modalidades de Fisioterapia , Terapia por Exercício/instrumentação , Reabilitação Neurológica/instrumentação , Traumatismos da Medula Espinal/fisiopatologia , Aparelhos Ortopédicos , Ensaios Clínicos como Assunto
11.
PLoS One ; 15(7): e0235510, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645046

RESUMO

INTRODUCTION: Acquired brain injury (ABI) leads to cognitive deficits in a great variety of cognitive functions. Interventions aimed at reducing such deficits include the use of computer-based cognitive interventions. The present work synthetizes and quantitively analyses the effect of computer-based cognitive interventions in ABI. METHODS: PubMed, Scopus, Web of Science, ProQuest and Ovid databases were searched for randomized controlled trials (RCT) addressing this issue. A total number of 8 randomized-controlled trials were included for systematic review and meta-analysis. Univariate meta-analyses were conducted for every cognitive function, producing aggregates when a study contributed more than one effect size per cognitive domain. RESULTS: Random-effects meta-analyses showed an improvement of Visual and Verbal working memory, while other domains like Attention, Processing speed, Executive functions and Memory were not benefited by the interventions. CONCLUSIONS: Computer-based cognitive interventions might be a beneficial intervention for ABI population to improve Visual and Verbal working memory, although no effect was found in other cognitive domains. Implications and possible future directions of the research are discussed.


Assuntos
Lesões Encefálicas Traumáticas/terapia , Reabilitação Neurológica/métodos , Terapia Assistida por Computador/métodos , Atenção , Lesões Encefálicas Traumáticas/reabilitação , Função Executiva , Humanos , Memória de Curto Prazo , Ensaios Clínicos Controlados Aleatórios como Assunto , Jogos de Vídeo
12.
Medicine (Baltimore) ; 99(28): e21218, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664173

RESUMO

RATIONALE: Corpus callosum syndrome is a rare consequence of traumatic brain injuries. We provide a case of a patient with typical corpus callosum syndrome following a traumatic brain injury, and demonstrate neural reorganization and significant neural regeneration after comprehensive rehabilitation, using diffusion tensor imaging fiber bundle tracking. PATIENT CONCERNS: We found typical clinical manifestations of damage to the corpus callosum. DIAGNOSES, INTERVENTIONS, AND OUTCOMES: We diagnosed a Traumatic Brain Injury (diffuse axonal injury and rupture of corpus callosum). The patient underwent a comprehensive multifaceted rehabilitation program including drug therapy, integrated physical therapy, occupational therapy, acupuncture, music therapy, computer-aided cognitive rehabilitation training, transcranial magnetic stimulation, and hyperbaric oxygen therapy. This rehabilitation program resulted in greatly improved physical and communication ability. LESSONS: Comprehensive rehabilitation can significantly improve the function of patients with corpus callosum syndrome and may cause neural remodeling, as seen on diffusion tensor imaging.


Assuntos
Lesões Encefálicas Traumáticas/reabilitação , Corpo Caloso/lesões , Reabilitação Neurológica/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome
13.
Artigo em Inglês | MEDLINE | ID: mdl-32698430

RESUMO

Cerebrovascular diseases, including stroke, are historically considered diseases of old adults so only in a few studies has "return to work" (RTW) been considered as an index of rehabilitative outcome. At the moment, data on RTW in patients with stroke are highly variable: four different reviews reported the following ranges: 11-85%, 19-73%, 22-53%, and 40-45%. The absence of re-integration to work after a stroke is shown to be associated with an increase of cardiac disorders and depression, with a higher level of mortality, with social isolation and with insufficient adaptive skills. The aim of this study was to verify the effectiveness of technological treatment, performed with optic (SonicHand) and wearable (Riablo™) systems providing auditory and visual biofeedback, on RTW in patients with stroke. RTW was found to be associated with a higher independence in the activities of daily living (assessed by the Modified Barthel Index). No significant differences were found between technological versus conventional rehabilitation in terms of RTW, despite the former showing a higher odds ratio than the latter (OR = 9 vs. 6). Assistive devices were mainly used in patients who had not returned to work. Finally, quality of life was found higher in those patients who returned to work with the same conditions (work duties and time) as before stroke.


Assuntos
Reabilitação Neurológica/métodos , Qualidade de Vida/psicologia , Retorno ao Trabalho , Reabilitação do Acidente Vascular Cerebral , Atividades Cotidianas , Adulto , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Reabilitação Neurológica/normas , Acidente Vascular Cerebral
14.
NeuroRehabilitation ; 46(4): 455-466, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32508337

RESUMO

BACKGROUND: Balance deficits are common impairments in individuals with post-traumatic brain injury (TBI). Balance deficits can restrict the activities of daily living and productive participation in social life. To date, no systematic reviews have examined the impact of physical therapy intervention on balance post-TBI. OBJECTIVE: To examine the effects of physical therapy interventions on balance impairments in individuals with TBI. METHODS: We systematically searched in PubMed, EMBASE, Scopus, PEDro, MEDLINE, REHABDATA, and Web of Science for randomized controlled trials (RCTs), clinical control trials, and pilot studies that examined the effects of physical therapy interventions on balance deficits in individuals post-TBI. The methodological quality was estimated using the Physiotherapy Evidence Database (PEDro) scale. RESULTS: Eight studies published from 2003 to 2019 were included in this study. A total of 259 TBI participants post-TBI were included in this review, 71 (27.41%) of which were females. The methodological quality of the selected studies ranged from low to high. There were no significant differences between experimental interventions, virtual reality (VR), vestibular rehabilitation therapy (VRT), control group interventions, and other traditional physical therapy interventions. CONCLUSIONS: The evidence about the effects of the physical therapy interventions in improving the balance ability post-TBI was limited. Further randomized controlled trials are strongly warranted to understand the role of physical therapy in patients with TBI who complain about balance deficits.


Assuntos
Lesões Encefálicas Traumáticas/reabilitação , Reabilitação Neurológica/métodos , Modalidades de Fisioterapia , Equilíbrio Postural , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
15.
NeuroRehabilitation ; 46(4): 467-482, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32508340

RESUMO

BACKGROUND: One of the most interesting emerging medical devices is the medical avatar - a digital representation of the patient that can be used toward myriad ends, the full potential of which remains to be explored. Medical avatars have been instantiated as telemedical tools used to establish a representation of the patient in tele-space, upon which data about the patient's health can be represented and goals and progress can be visually tracked. Manipulation of the medical avatar has also been explored as a means of increasing motivation and inducing neural plasticity. OBJECTIVE: The article reviews the literature on body representation, simulation, and action-observation and explores how these components of neurorehabilitation are engaged by an avatar-based self-representation. METHODS: Through a review of the literature on body representation, simulation, and action-observation and a review of how these components of neurorehabilitation can be engaged and manipulated with an avatar, the neuroplastic potential of the medical avatar is explored. Literature on the use of the medical avatar for neurorehabilitation is also reviewed. RESULTS: This review demonstrates that the medical avatar has vast potentialities in neurorehabilitation and that further research on its use and effect is needed.


Assuntos
Imagem Corporal , Reabilitação Neurológica/métodos , Plasticidade Neuronal , Terapia de Exposição à Realidade Virtual/métodos , Humanos , Interface Usuário-Computador
17.
Brain Stimul ; 13(3): 800-803, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32289710

RESUMO

BACKGROUND: Studies have found that pairing vagus nerve stimulation (VNS) with motor activity accelerates cortical reorganization. This synchronous pairing may enhance motor recovery. OBJECTIVE: To develop and validate a motor-activated auricular vagus nerve stimulation (MAAVNS) system as a potential neurorehabilitation tool. METHODS: We created MAAVNS and validated its function as part of an ongoing clinical trial investigating whether taVNS-paired rehabilitation enhances oromotor learning. We compared 3 different MAAVNS EMG electrode configurations in 3 neonates. The active lead was placed over the buccinator muscle. Reference lead placements were orbital, temporal or frontal. RESULTS: The frontal reference lead produced the highest sensitivity (0.87 ± 0.07 (n = 8)) and specificity (0.64 ± 0.13 (n = 8)). Oral sucking reliably triggers MAAVNS stimulation with high confidence. CONCLUSION: EMG electrodes placed on target orofacial muscles can effectively trigger taVNS stimuli in infants in a closed loop fashion.


Assuntos
Atividade Motora/fisiologia , Reabilitação Neurológica/métodos , Reabilitação Neurológica/normas , Estimulação do Nervo Vago/métodos , Estimulação do Nervo Vago/normas , Eletromiografia/métodos , Eletromiografia/normas , Feminino , Humanos , Recém-Nascido , Reprodutibilidade dos Testes , Reabilitação do Acidente Vascular Cerebral/métodos , Reabilitação do Acidente Vascular Cerebral/normas , Nervo Vago/fisiologia
18.
NeuroRehabilitation ; 46(3): 311-320, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32250326

RESUMO

BACKGROUND: People with Parkinson disease (PD) have difficulty initiating internally generated movements. We have shown that computer-based cognitive training can improve movement initiation. However, little is known about the optimal duration of training. OBJECTIVES: To determine the optimal training duration for computer-based neurorehabilitation of internally represented movement initiation in people with PD. METHODS: Nineteen PD and twenty-one age-matched control participants, ages 50-85 years, were included in analysis of pre- and post-training evaluation and 30 training sessions. Computer training consisted of cued and un-cued movement trials. The presentation of a cue (a combination of numbers on either the right, left or both sides of the screen) indicated that participants should respond by typing the numbers. Successful cued trials were followed by un-cued trials consisting of a green filled circle. Participants re-enter the cued sequence, thus producing an internally represented (IR) movement. The training was adaptive. Outcome measures were reaction time and error rate, and cumulative sum (CUSUM) analysis was used to identify peak training improvement. RESULTS: Participants with PD were divided into impaired (IPD) and unimpaired (UPD) groups, based on mean control group pre-training performance. All three groups showed improved RT and error rates for IR trials; however, the IPD group demonstrated significantly greater improvement in reaction time. Training was most effective in participants with greater disease severity and duration. Peak day of training improvement for the IPD group was 8 days. CONCLUSION: Optimal training duration was relatively short and the IPD group demonstrated the most gain, indicating that cognitive training should be tailored to individual needs.


Assuntos
Reabilitação Neurológica/métodos , Doença de Parkinson/reabilitação , Idoso , Idoso de 80 Anos ou mais , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento
19.
J Neuroeng Rehabil ; 17(1): 38, 2020 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-32131857

RESUMO

BACKGROUND: Many studies showed that robot-assisted gait training might improve walking of patients after stroke. The question remains whether patients with other neurological diagnoses can improve their ability to walk by training in a gait center. Aim of the present study was therefore to investigate the effects of a gait center training in inpatient neurological rehabilitation on walking ability. METHODS: We implemented a gait center training in addition to individual inpatient rehabilitation. Our primary outcome was walking ability based on the Functional Ambulation Categories (FAC). Our secondary outcomes were vital capacity and blood pressure. We predefined subgroups of patients with ischemic and hemorrhagic stroke and critical illness myopathy (CIM) and polyneuropathy (CIP). RESULTS: We included 780 patients from our inpatient rehabilitation center in our cohort study. We analyzed 329 patients with ischemic, 131 patients with hemorrhagic stroke and 74 patients with CIP/ CIM. A large number of patients were able to improve their ability to walk. At the end of rehabilitation, patients with ischemic stroke and FAC 3 = increased theirFAC scores by 5%, FAC 4 = 4% and FAC 5 = 7%. Patients with hemorrhagic stroke and FAC 3 = increased by 5%, FAC 4 = 11% and FAC 5 = 9% and patients with CIP/CIM increased by FAC 3 = 3%, FAC 4 = 22% and FAC 5 = 26%. The largest improvement in walking ability during rehabilitation had patients with a FAC = 1 at baseline who improved by a median of 1.4 FAC points (p < 0.001). After adjusting for the number of gait training sessions, the largest improvement in walking ability during rehabilitation had patients with a FAC = 0 at baseline who improved by 1.8 FAC points (p < 0.001). CONCLUSIONS: Implementation of an additional gait center training may significantly improve walking ability in neurological rehabilitation.


Assuntos
Transtornos Neurológicos da Marcha/reabilitação , Reabilitação Neurológica/métodos , Idoso , Estudos de Coortes , Estado Terminal , Terapia por Exercício/instrumentação , Terapia por Exercício/métodos , Exoesqueleto Energizado , Feminino , Transtornos Neurológicos da Marcha/etiologia , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Doenças Musculares/complicações , Doenças Musculares/reabilitação , Reabilitação Neurológica/instrumentação , Polineuropatias/complicações , Polineuropatias/reabilitação , Acidente Vascular Cerebral/complicações , Caminhada
20.
NeuroRehabilitation ; 46(2): 167-180, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32083597

RESUMO

BACKGROUND: Persistent Sport-Related Post-Concussion Syndrome is often diagnosed with any type of prolonged PCS symptoms. However, there are not specific diagnostic criteria for PPCS such that misdiagnosis often occurs. Further, the signs and symptoms of PCS overlap with other common illnesses such as depression, anxiety, migraines, ADHD and others. Misdiagnosis may lead to less than efficacious treatment, resulting in prolonged symptoms. OBJECTIVE: This article will review relevant evidence-based literature on PCS, pointing out the lack of a systemic diagnostic framework. It will also provide evidence that highlights the multiple conflicting findings in the literature. This article will posit the BioPsychoSocial framework as the best diagnostic framework for understanding the impact of concussions on the person and to generate individualized and personal interventions. METHODS: A narrative review of sport concussion-related articles was conducted, after extensive searches of relevant and non-relevant literature by each author, as well as articles recommended by colleagues. Articles varied from American Academy of Neurology Class I to IV for evaluation and critique. Class IV articles were reviewed, as there is much public misconception regarding sport and other concussion treatment that needed identification and discussion. RESULTS: Articles reviewed varied by quality of research design and methodology. Multiple symptoms, recovery patterns and rehabilitation treatment approaches are purported in the sport-related concussion literature. Current consensus data as well as the mixed and contradictory findings were explored. CONCLUSIONS: Persistent Sport-Related Post-Concussion Syndrome is a topic of great interest to both professionals and the general public. There is much misunderstanding about the etiology, causation, diagnostic formulations, symptom presentation, prolonging factors and treatment involved in this syndrome. This article posits an individualized multi-system diagnostic formulation, examining all relevant factors, as generating the best interventions for neurorehabilitation of Persistent Sport-Related Post-Concussion Syndrome.


Assuntos
Traumatismos em Atletas/psicologia , Traumatismos em Atletas/reabilitação , Reabilitação Neurológica/métodos , Reabilitação Neurológica/psicologia , Síndrome Pós-Concussão/psicologia , Síndrome Pós-Concussão/reabilitação , Ansiedade/etiologia , Ansiedade/psicologia , Ansiedade/reabilitação , Traumatismos em Atletas/complicações , Biorretroalimentação Psicológica/métodos , Concussão Encefálica/diagnóstico , Terapia Cognitivo-Comportamental/métodos , Humanos , Transtornos de Enxaqueca/etiologia , Transtornos de Enxaqueca/psicologia , Transtornos de Enxaqueca/reabilitação , Educação de Pacientes como Assunto/métodos , Síndrome Pós-Concussão/etiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...