Rehabilitation Research And Practice[JOURNAL]
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200 papers
The Effect of Therapeutic Exercise on Long-Standing Adductor-Related Groin Pain in Athletes: Modified Hölmich Protocol.
Yousefzadeh A, Shadmehr A, Olyaei GR … +2 more , Naseri N, Khazaeipour Z
Rehabil Res Pract · 2018 · PMID 29721339 · Full text
OBJECTIVE: The Hölmich protocol in therapeutic exercise is the most appropriate method for the treatment of long-standing adductor-related groin pain (LSAGP). Herein, we evaluated a modified Hölmich protocol to resolve t...
OBJECTIVE: The Hölmich protocol in therapeutic exercise is the most appropriate method for the treatment of long-standing adductor-related groin pain (LSAGP). Herein, we evaluated a modified Hölmich protocol to resolve the possible limitations intrinsic to the Hölmich protocol in terms of the rate of return to sport and the recovery period for athletes with LSAGP. DESIGN: The study followed a single-blind, before/after study design, where 15 athletes with LSAGP (mean age = 26.13 years; SD = 4.48) performed a 10-week modified Hölmich therapeutic exercise protocol. RESULTS: Outcome scores related to pain, hip adductor and abductor muscle strengths, and the ratio of maximum isometric and eccentric hip adduction to abduction strength increased significantly. Likewise, hip abduction and internal rotation ROM improved significantly compared to that at baseline. Furthermore, functional records (-test, Edgren Side Step Test, and Triple Hop Test) showed significant improvement after treatment. Finally, 13 athletes (86.6% of the participants) successfully returned to sports activity in a mean time of 12.06 weeks (SD = 3.41). CONCLUSION: The findings of this study objectively show that the modified Hölmich protocol may be safer and more effective than the Hölmich protocol in athletes with LSAGP in promoting their return to sports activity. IRCT2016080829269N1.
Patients' and Health Professionals' Experiences of Using Virtual Reality Technology for Upper Limb Training after Stroke: A Qualitative Substudy.
Pallesen H, Andersen MB, Hansen GM … +2 more , Lundquist CB, Brunner I
Rehabil Res Pract · 2018 · PMID 29593910 · Full text
BACKGROUND: In recent years, virtual reality (VR) therapy systems for upper limb training after stroke have been increasingly used in clinical practice. Therapy systems employing VR technology can enhance the intensity o...
BACKGROUND: In recent years, virtual reality (VR) therapy systems for upper limb training after stroke have been increasingly used in clinical practice. Therapy systems employing VR technology can enhance the intensity of training and can also boost patients' motivation by adding a playful element to therapy. However, reports on user experiences are still scarce. METHODS: A qualitative investigation of patients' and therapists' perspectives on VR upper limb training. Semistructured face-to-face interviews were conducted with six patients in the final week of the VR intervention. Therapists participated in two focus group interviews after the completion of the intervention. The interviews were analyzed from a phenomenological perspective emphasizing the participants' perceptions and interpretations. RESULTS: Five key themes were identified from the patients' perspectives: (i) motivational factors, (ii) engagement, (iii) perceived improvements, (iv) individualization, and (v) device malfunction. The health professionals described the same themes as the patients but less positively, emphasizing negative technical challenges. CONCLUSION: Patients and therapists mainly valued the intensive and motivational character of VR training. The playful nature of the training appeared to have a significant influence on the patients' moods and engagement and seemed to promote a "gung-ho" spirit, so they felt that they could perform more repetitions.
Partial Body Weight-Supported Treadmill Training in Spinocerebellar Ataxia.
de Oliveira LAS, Martins CP, Horsczaruk CHR … +5 more , da Silva DCL, Vasconcellos LF, Lopes AJ, Meira Mainenti MR, Rodrigues EC
Rehabil Res Pract · 2018 · PMID 29535874 · Full text
BACKGROUND AND PURPOSE: The motor impairments related to gait and balance have a huge impact on the life of individuals with spinocerebellar ataxia (SCA). Here, the aim was to assess the possibility of retraining gait, i...
BACKGROUND AND PURPOSE: The motor impairments related to gait and balance have a huge impact on the life of individuals with spinocerebellar ataxia (SCA). Here, the aim was to assess the possibility of retraining gait, improving cardiopulmonary capacity, and challenging balance during gait in SCA using a partial body weight support (BWS) and a treadmill. Also, the effects of this training over functionality and quality of life were investigated. METHODS: Eight SCA patients were engaged in the first stage of the study that focused on gait training and cardiovascular conditioning. From those, five took part in a second stage of the study centered on dynamic balance training during gait. The first and second stages lasted 8 and 10 weeks, respectively, both comprising sessions of 50 min (2 times per week). RESULTS: The results showed that gait training using partial BWS significantly increased gait performance, treadmill inclination, duration of exercise, and cardiopulmonary capacity in individuals with SCA. After the second stage, balance improvements were also found. CONCLUSION: Combining gait training and challenging tasks to the postural control system in SCA individuals is viable, well tolerated by patients with SCA, and resulted in changes in capacity for walking and balance.
Pre- and Postintervention Factor Structure of Functional Independence Measure in Patients with Spinal Cord Injury.
Saltychev M, Lähdesmäki J, Jokinen P … +1 more , Laimi K
Rehabil Res Pract · 2017 · PMID 29430307 · Full text
OBJECTIVE: To evaluate the factor structure of Functional Independence Measure (FIM®) scale amongst people with spinal cord injury (SCI). METHODS: This was a retrospective, register-based cohort study on 155 rehabilitant...
OBJECTIVE: To evaluate the factor structure of Functional Independence Measure (FIM®) scale amongst people with spinal cord injury (SCI). METHODS: This was a retrospective, register-based cohort study on 155 rehabilitants with SCI. FIM was assessed at the beginning and at the end of multidisciplinary inpatient rehabilitation. The internal consistency of the FIM was assessed with Cronbach's alpha and exploratory factor analysis was employed to approximate the construct structure of FIM. RESULTS: The internal consistency demonstrated high Cronbach's alpha of 0.95 to 0.96. For both pre- and postintervention assessments, the exploratory factor analysis resulted in 3-factor structures. Except for two items ("walking or using a wheelchair" and "expression"), the structures of the identified three factors remained the same from the beginning to the end of rehabilitation. The loadings of all items were sufficient, exceeding 0.3. Both pre- and postintervention chi-square tests showed significant values < 0.0001. The "motor" domain was divided into two factors with this 2-factor structure enduring through the intervention period. CONCLUSIONS: Amongst rehabilitants with SCI, FIM failed to demonstrate unidimensionality. Instead, it showed a 3-factor structure that fluctuated only little depending on the timing of measurement. Additionally, when measured separately, also motor score was 2-dimensional, not 1-dimensional. Using a total or subscale FIM, scores seem to be unjustified in the studied population.
Effect of Insoles with a Toe-Grip Bar on Toe Function and Standing Balance in Healthy Young Women: A Randomized Controlled Trial.
Nakano H, Murata S, Abiko T … +5 more , Sakamoto M, Matsuo D, Kawaguchi M, Sugo Y, Matsui H
Rehabil Res Pract · 2017 · PMID 29348939 · Full text
OBJECTIVE: The aim of this randomized controlled study was to investigate the effects of insoles with a toe-grip bar on toe function and standing balance in healthy young women. METHODS: Thirty female subjects were rando...
OBJECTIVE: The aim of this randomized controlled study was to investigate the effects of insoles with a toe-grip bar on toe function and standing balance in healthy young women. METHODS: Thirty female subjects were randomly assigned to an intervention group or a control group. The intervention group wore shoes with insoles with a toe-grip bar. The control group wore shoes with general insoles. Both groups wore the shoes for 4 weeks, 5 times per week, 9 hours per day. Toe-grip strength, toe flexibility, static balance (total trajectory length and envelope area of the center of pressure), and dynamic balance (functional reach test) were measured before and after the intervention. RESULTS: Significant interactions were observed for toe-grip strength and toe flexibility ( = 12.53, < 0.01; = 5.84, < 0.05, resp.), with significant improvement in the intervention group compared with that in the control group. Post hoc comparisons revealed that both groups showed significant improvement in toe-grip strength ( < 0.01 and < 0.05, resp.), with higher benefits observed for the intervention group ( < 0.01). Conversely, no significant interaction was observed in the total trajectory length, envelope area, and functional reach test. CONCLUSIONS: This study suggests that insoles with a toe-grip bar contribute to improvements in toe-grip strength and toe flexibility in healthy young women.
Modulation of H-Reflex Depression with Paired-Pulse Stimulation in Healthy Active Humans.
Oza PD, Dudley-Javoroski S, Shields RK
Rehabil Res Pract · 2017 · PMID 29225972 · Full text
Depression of the Hoffman reflex (H-reflex) is used to examine spinal control mechanisms during exercise, fatigue, and vibration and in response to training. H-reflex depression protocols frequently use trains of stimuli...
Depression of the Hoffman reflex (H-reflex) is used to examine spinal control mechanisms during exercise, fatigue, and vibration and in response to training. H-reflex depression protocols frequently use trains of stimuli; this is time-consuming and prevents instantaneous assessment of motor neuronal excitability. The purpose of this study was to determine if paired-pulse H-reflex depression is reproducible and whether paired-pulse stimulation adequately estimates the depression induced by the more traditional ten-pulse train. H-reflexes were elicited via ten-pulse trains at 0.1, 0.2, 1, 2, and 5 Hz in ten neurologically intact individuals on two separate days. We measured the depression elicited by the second pulse (H2) and the mean depression elicited by pulses 2-10 (Hmean). H2 was consistent at all frequencies on both days ( = 0.97, < 0.05, and ICC = 0.81). H2 did not differ from Hmean ( > 0.05). The results indicate that paired-pulse H-reflex depression has high between-day reliability and yields depression estimates that are comparable to those obtained via ten-pulse trains. Paired-pulse H-reflex depression may be especially useful for studies that require rapid assessment of motor neuronal excitability, such as during exercise, fatigue, and vibration, or to establish recovery curves following inhibition.
Proposing Development and Utility of a Mobility Composite Measure in Patients with a Neurologic Disorder.
Swank C, Almutairi S, Medley A
Rehabil Res Pract · 2017 · PMID 29209539 · Full text
BACKGROUND: Outcome measures typically assess single domains making holistic assessment difficult. Our purpose was to develop a mobility composite measure (MCM) based on four commonly used outcome measures and compare th...
BACKGROUND: Outcome measures typically assess single domains making holistic assessment difficult. Our purpose was to develop a mobility composite measure (MCM) based on four commonly used outcome measures and compare this composite score to the individual measures in patients with neurologic disorders. METHODS: We retrospectively reviewed 148 medical records for inclusion of primary neurologic diagnosis and scoring for 5 times sit-to-stand test (5TSST), 10-meter walk test (10MWT), 2-minute walk test (2MWT), and activities-specific balance confidence (ABC) scale. RESULTS: After establishing that a single concept was being assessed with interitem correlations, raw scores were converted to percentage of normal and combined into the MCM for analysis from admission to discharge. Scores on each measure significantly improved after intervention (5TSST, < .001; 10MWT, < .001; 2MWT, < .001; ABC, = .02). Mean MCM ( = 93) admission scores were 67.55 ± 31.88% and discharge scores were 74.81 ± 34.39% ( = .002). On average, patients improved 7.26% on the MCM exceeding the threshold of expected error (MDC = 3.59%). CONCLUSIONS: MCM detected change in patient outcomes statistically and clinically and appears to capture a holistic picture of functional status. We recommend a prospective study to further investigate a "composite measure" incorporating measures from several functional domains.
Exergame Grading Scheme: Concept Development and Preliminary Psychometric Evaluations in Cancer Survivors.
Wang HL, Liu CJ, Kilpatrick M … +8 more , Jim H, McMillan S, Vijayakumar N, McDonald S, Padhya T, Russell J, Vondruska K, Visovsky C
Rehabil Res Pract · 2017 · PMID 29098087 · Full text
The challenge of using exergames to promote physical activity among cancer survivors lies in the selection of the exergames that match their fitness level. There is a need for a standardized grading scheme by which to ju...
The challenge of using exergames to promote physical activity among cancer survivors lies in the selection of the exergames that match their fitness level. There is a need for a standardized grading scheme by which to judge an exergame's capacity to address specific physical fitness attributes with different levels of physical engagement. The study aimed to develop an Exergame Grading Scheme and preliminarily evaluate its psychometric properties. Fourteen (14) items were created from the human movement and exergame literature. The content validity index (CVI) was rated by content experts with two consecutive rounds ( = 5 and = 3 independently). The interrater reliability (IRR) was determined by two raters who used the Exergame Grading Scheme to determine the grading score of the five exergames performed by two cancer survivors ( = 10). Each item had a score of 1 for item-level CVI and 1 for . For IRR, 9 items had rho values of 1, 1 item had 0.93, and 4 items had between 0.80 and 0.89. This valid and reliable Exergame Grading Scheme makes it possible to develop a personalized physical activity program using any type of exergame or fitness mobile application in rehabilitation practice to meet the needs of cancer survivors.
Effect of Modified Shaker Exercise on the Amplitude and Duration of Swallowing Sounds: Evidence from Cervical Auscultation.
Babu S, Balasubramaniam RK, Varghese A
Rehabil Res Pract · 2017 · PMID 29082044 · Full text
OBJECTIVE: Anecdotal evidence shows that the Shaker exercise and its modifications improve pharyngeal muscle contraction. However, there is no experimental evidence for the same. Thus, the present study examined the effe...
OBJECTIVE: Anecdotal evidence shows that the Shaker exercise and its modifications improve pharyngeal muscle contraction. However, there is no experimental evidence for the same. Thus, the present study examined the effect of modified Shaker exercise on the amplitude and duration of pharyngeal muscle contraction using cervical auscultation. DESIGN: The study follows a cross-sectional study design, where 50 healthy individuals (23 males and 27 females) performed modified Shaker exercise and noneffortful swallow during 10 ml water swallowing. Swallow sound characteristics were analyzed with and without modified Shaker exercise using cervical auscultation. RESULTS: The results of mixed ANOVA revealed significant differences for the amplitude of swallow sound with modified Shaker exercise (mean = 47.24, SD = 20.64) when compared to noneffortful swallow (mean = 28.19, SD = 10.26) at < 0.05. However, no significant difference was obtained for the swallow sound duration with (mean = 0.19, SD = 0.07) and without (mean = 0.18, SD = 0.07) modified Shaker exercise at > 0.05. No significant difference across the genders was also noted at > 0.05. CONCLUSION: The outcomes of the study suggest that modified Shaker exercise improves the amplitude of pharyngeal muscle contraction. Further studies are needed to confirm this finding using gold standard tools like videofluoroscopy.
Understanding the Connection between Cognitive Impairment and Mobility: What Can Be Gained from Neuropsychological Assessment?
Pavol MA, Stein J, Kabir FM … +4 more , Yip J, Sorkin LY, Marshall RS, Lazar RM
Rehabil Res Pract · 2017 · PMID 28536658 · Full text
The ability of neuropsychological tests to predict rehabilitation outcome is unclear, particularly when other ratings of cognition are available. Neuropsychological test scores and functional ratings of cognition (Functi...
The ability of neuropsychological tests to predict rehabilitation outcome is unclear, particularly when other ratings of cognition are available. Neuropsychological test scores and functional ratings of cognition (Functional Independence Measure (FIM) Cognition score) were used to predict improvement in patient mobility and self-care skill, as measured by the FIM Motor score. Regression models used both raw neuropsychology test scores and age-adjusted scores. Retrospective chart review was performed for patients on an inpatient rehabilitation unit and referred for neuropsychological assessment. The group included 126 subjects (average age 64.2 ± 17.1 years) and a variety of medical diagnoses. Neuropsychological tests included the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). After forcing the Admission FIM Cognition score into the model, RBANS scores and duration of rehabilitation predicted FIM Motor improvements ( = 11.42, < 0.0001). Raw neuropsychological test scores performed better than the model with age-adjusted test scores. FIM Cognition alone did not predict FIM Motor improvements. Neuropsychological tests, combined with duration of rehabilitation, predicted mobility gains for patients undergoing inpatient rehabilitation beyond what was predicted by another, readily available, assessment of cognition. Neuropsychology raw scores performed better than age-adjusted scores, raising questions about the standard use of demographic adjustments for predicting real-world function.
Unilateral Discomfort Increases the Use of Contralateral Side during Sit-to-Stand Transfer.
Oludare SO, Ma CC, Aruin AS
Rehabil Res Pract · 2017 · PMID 28529804 · Full text
Individuals with unilateral impairment perform symmetrical movements asymmetrically. Restoring symmetry of movements is an important goal of rehabilitation. The aim of the study was to evaluate the effect of using discom...
Individuals with unilateral impairment perform symmetrical movements asymmetrically. Restoring symmetry of movements is an important goal of rehabilitation. The aim of the study was to evaluate the effect of using discomfort-inducing devices on movement symmetry. Fifteen healthy individuals performed the sit-to-stand (STS) maneuver using devices inducing unilateral discomfort under the left sole and left thigh or right sole and right thigh and without them. 3D body kinematics, ground reaction forces, electrical activity of muscles, and the level of perceived discomfort were recorded. The center of mass (COM), center of pressure (COP), and trunk displacements as well as the magnitude and latency of muscle activity of lower limb muscles were calculated during STS and compared to quantify the movement asymmetry. Discomfort on the left and right side of the body (thigh and feet) induced statistically significant displacement of the trunk towards the opposite side. There was statistically significant asymmetry in the activity of the left and right Tibialis Anterior, Medial Gastrocnemius, and Biceps Femoris muscles when discomfort was induced underneath the left side of the body (thigh and feet). The technique was effective in causing asymmetry and promoted the use of the contralateral side. The outcome provides a foundation for future investigations of the role of discomfort-inducing devices in improving symmetry of the STS in individuals with unilateral impairment.
The Effect of Diabetic Peripheral Neuropathy on Ground Reaction Forces during Straight Walking in Stroke Survivors.
Mustapa A, Justine M, Mustafah NM … +1 more , Manaf H
Rehabil Res Pract · 2017 · PMID 28491477 · Full text
. The aim of this present study was to investigate the ground reaction forces (GRFs) alterations in stroke survivors with diabetic peripheral neuropathy (DPN). . Ten stroke survivors with DPN, 10 stroke survivors without...
. The aim of this present study was to investigate the ground reaction forces (GRFs) alterations in stroke survivors with diabetic peripheral neuropathy (DPN). . Ten stroke survivors with DPN, 10 stroke survivors without DPN, and 10 healthy controls with matched body weight between groups participated in this case-control cross-sectional study. Three-dimensional GRFs (anterior-posterior, medial-lateral, and vertical) were collected at a comfortable walking speed using the Nexus Vicon motion analysis system and force plate. The Kruskal-Wallis test was used to analyze GRFs parameters. . We found significant alterations of medial-lateral forces of the nonparetic side and vertical forces of the paretic side in stroke survivors with DPN compared to stroke survivors without DPN and healthy controls. In addition, there were smaller braking and lower propulsion peak in anterior-posterior forces, smaller magnitude of medial-lateral forces, and lower first and second peak of vertical forces in stroke survivors with DPN compared to stroke survivors without DPN and healthy controls. . The study findings identified that GRFs were affected in stroke survivors with DPN on both the paretic and the nonparetic sides. Further investigations are warranted to explore the impact of DPN on the kinematics and muscle activity related to the gait performance in stroke survivors with DPN.
An Examination of Women's Self-Presentation, Social Physique Anxiety, and Setting Preferences during Injury Rehabilitation.
Driediger MV, McKay CD, Hall CR
Rehabil Res Pract · 2017 · PMID 28386484 · Full text
. This study investigated whether women experience self-presentational concerns related to rehabilitation settings and explored preferences for characteristics of the social and physical treatment environment in relation...
. This study investigated whether women experience self-presentational concerns related to rehabilitation settings and explored preferences for characteristics of the social and physical treatment environment in relation to women's Social Physique Anxiety (SPA). . Two cross-sectional studies were conducted. In Study 1, female undergraduate students ( = 134) completed four questionnaires (Social Physique Anxiety Scale; three bespoke questionnaires assessing self-presentation in rehabilitation and social and physical environment preferences) with respect to hypothetical rehabilitation scenarios. Study 2 recruited injured women who were referred for physiotherapy ( = 62) to complete the same questionnaires regarding genuine rehabilitation scenarios. . Women with high SPA showed less preference for physique salient clothing than women with low SPA in both hypothetical ( = 0.001) and genuine settings ( = 0.01). In Study 2, women with high SPA also preferred that others in the clinic were female ( = 0.01) and reported significantly greater preference for private treatment spaces ( = 0.05). . Self-presentational concerns exist in rehabilitation as in exercise settings. Results indicated inverse relationships between women's SPA and preference for the presence of men, physique-enhancing clothing, and open-concept treatment settings. Future studies to determine the effect of self-presentational concerns on treatment adherence are needed.
Self-Reported Ability to Walk, Run, and Lift Objects among Older Canadians.
Kopec JA, Russell L, Sayre EC … +1 more , Rahman MM
Rehabil Res Pract · 2017 · PMID 28367332 · Full text
The purpose of the study was to develop new self-report instruments to measure the ability to walk, run, and lift objects and describe the distribution of these abilities among older Canadians. Questions were developed...
The purpose of the study was to develop new self-report instruments to measure the ability to walk, run, and lift objects and describe the distribution of these abilities among older Canadians. Questions were developed following a focus group. We carried out an online survey among members of the Canadian Association of Retired Persons. The distribution of each ability was described and presented graphically according to age, sex, and number of health conditions. We calculated summary scores for each ability and assessed their reliability and relationships with health status and use of health services. 22% of the subjects reported difficulty walking 100 m, 15% were unable to run 10 m, and 50% had difficulty lifting 10 kg. Men reported higher abilities than women but differences according to age were small. Test-retest reliability ranged from 0.89 for walking to 0.88 for running and 0.81 for lifting. Scores for the three measures correlated with other measures of health status as expected. . The study provided new data on self-reported walking, running, and lifting abilities among older Canadians. The new measures are valid, reliable, and easy to interpret. We expect these measures to be useful in clinical and research settings.
Effect on Gait Speed, Balance, Motor Symptom Rating, and Quality of Life in Those with Stage I Parkinson's Disease Utilizing LSVT BIG®.
Millage B, Vesey E, Finkelstein M … +1 more , Anheluk M
Rehabil Res Pract · 2017 · PMID 28331638 · Full text
Individuals with Parkinson's Disease (PD) are often not referred to Physical Therapy (PT) until there are issues with mobility in later Hoehn and Yahr Stages. There have been no studies outlining the benefits of PT inter...
Individuals with Parkinson's Disease (PD) are often not referred to Physical Therapy (PT) until there are issues with mobility in later Hoehn and Yahr Stages. There have been no studies outlining the benefits of PT intervention in Stage I only. For persons with PD, deficits in motor function increase over time due to destruction of dopamine-producing cells. LSVT BIG, an exercise program for PD, has been shown to be effective in improving mobility. The purpose of this study was to assess participants functional improvement at a level of minimal clinically important difference (MCID) in one of four outcome measures: Gait Speed, Berg Balance Assessment, Functional Gait Assessment, and Unified Parkinson's Disease Rating Scale Motor Section. Nine participants with Stage I PD received LSVT BIG 4x/week for 4 weeks followed by bimonthly participation in a community class. Outcome measurement occurred at baseline, after LSVT BIG, and three months after LSVT BIG. Eight of nine participants (88.9%) achieved MCID in at least one of the four measures at both after and 3 months after LSVT BIG training indicating improvement based on our criteria. Participants in Stage I of PD in this study completed LSVT BIG and demonstrated improved function.
Long-Term Use and Perceived Benefits of Goal-Oriented Attentional Self-Regulation Training in Chronic Brain Injury.
Loya F, Novakovic-Agopian T, Binder D … +4 more , Rossi A, Rome S, Murphy M, Chen AJ
Rehabil Res Pract · 2017 · PMID 28265472 · Full text
To investigate the long-term use and perceived benefit(s) of strategies included in Goal-Oriented Attentional Self-Regulation (GOALS) training (Novakovic-Agopian et al., 2011) by individuals with acquired brain injury (A...
To investigate the long-term use and perceived benefit(s) of strategies included in Goal-Oriented Attentional Self-Regulation (GOALS) training (Novakovic-Agopian et al., 2011) by individuals with acquired brain injury (ABI) and chronic executive dysfunction. Longitudinal follow-up of training. Sixteen participants with chronic ABI participated in structured telephone interviews 20 months (range 11 to 31 months) following completion of GOALS training. Participants responded to questions regarding the range of strategies they continued to utilize, perceived benefit(s) of strategy use, situations in which strategy use was found helpful, and functional changes attributed to training. Nearly all participants (94%) reported continued use of at least one trained strategy in their daily lives, with 75% of participants also reporting improved functioning resulting from training. However, there was considerable variability with respect to the specific strategies individuals found helpful as well as the perceived impact of training on overall functioning. GOALS training shows promising long-term benefits for individuals in the chronic phase of brain injury. Identifying individual- and injury-level factors that account for variability in continued strategy use and the perceived long-term benefits of training will help with ongoing intervention development.
Constraint-Induced Movement Therapy Combined with Transcranial Direct Current Stimulation over Premotor Cortex Improves Motor Function in Severe Stroke: A Pilot Randomized Controlled Trial.
Andrade SM, Batista LM, Nogueira LL … +6 more , de Oliveira EA, de Carvalho AG, Lima SS, Santana JR, de Lima EC, Fernández-Calvo B
Rehabil Res Pract · 2017 · PMID 28250992 · Full text
We compared the effects of transcranial direct current stimulation at different cortical sites (premotor and motor primary cortex) combined with constraint-induced movement therapy for treatment of stroke patients. Sixt...
We compared the effects of transcranial direct current stimulation at different cortical sites (premotor and motor primary cortex) combined with constraint-induced movement therapy for treatment of stroke patients. Sixty patients were randomly distributed into 3 groups: Group A, anodal stimulation on premotor cortex and constraint-induced movement therapy; Group B, anodal stimulation on primary motor cortex and constraint-induced movement therapy; Group C, sham stimulation and constraint-induced movement therapy. Evaluations involved analysis of functional independence, motor recovery, spasticity, gross motor function, and muscle strength. A significant improvement in primary outcome (functional independence) after treatment in the premotor group followed by primary motor group and sham group was observed. The same pattern of improvement was highlighted among all secondary outcome measures regarding the superior performance of the premotor group over primary motor and sham groups. Premotor cortex can contribute to motor function in patients with severe functional disabilities in early stages of stroke. This study was registered in ClinicalTrials.gov database (NCT 02628561).
A Pulmonary Rehabilitation Decisional Score to Define Priority Access for COPD Patients.
Vitacca M, Comini L, Barbisoni M … +3 more , Francolini G, Paneroni M, Ramponi JP
Rehabil Res Pract · 2017 · PMID 28239495 · Full text
This retrospective study aimed to evaluate, through an ad hoc 17-item tool, the Pulmonary Rehabilitation Decisional Score (PRDS), the priority access to PR prescription by respiratory specialists. The PRDS, scoring funct...
This retrospective study aimed to evaluate, through an ad hoc 17-item tool, the Pulmonary Rehabilitation Decisional Score (PRDS), the priority access to PR prescription by respiratory specialists. The PRDS, scoring functional, clinical, disability, frailty, and participation parameters from 0 = low priority to 34 = very high priority for PR access, was retrospectively calculated on 124 specialist reports sent to the GP of subjects (aged 71 ± 11 years, FEV% 51 ± 17) consecutively admitted to our respiratory outpatient clinic. From the specialist's report the final subject's allocation could be low priority (LP) (>60 days), high priority (HP) (30-60 days), or very high priority (VHP) (<30 days) to rehabilitation. The PRDS calculation showed scores significantly higher in VHP versus LP ( < 0.001) and significantly different between HP and VHP ( < 0.001). Comparing the specialist's allocation decision and priority choice based on PRDS cut-offs, PR prescription was significantly more appropriate in VHP than in HP ( = 0.016). Specialists underprescribed PR in 49% of LP cases and overprescribed it in 46% and 30% of the HP and VHP prescriptions, respectively. A multicomprehensive score is feasible being useful for staging the clinical priorities for PR prescription and facilitating sustainability of the health system.
A Mixed Methods Small Pilot Study to Describe the Effects of Upper Limb Training Using a Virtual Reality Gaming System in People with Chronic Stroke.
Stockley RC, O'Connor DA, Smith P … +3 more , Moss S, Allsop L, Edge W
Rehabil Res Pract · 2017 · PMID 28197341 · Full text
. This small pilot study aimed to examine the feasibility of an upper limb rehabilitation system (the YouGrabber) in a community rehabilitation centre, qualitatively explore participant experiences, and describe changes...
. This small pilot study aimed to examine the feasibility of an upper limb rehabilitation system (the YouGrabber) in a community rehabilitation centre, qualitatively explore participant experiences, and describe changes after using it. . Chronic stroke participants attending a community rehabilitation centre in the UK were randomised to either a YouGrabber or a gym group and completed 18 training sessions over 12 weeks. The motor activity log, box and block, and fatigue severity score were administered by a blinded assessor before and after the intervention. Semistructured interviews were used to ascertain participants' views about using the YouGrabber. . Twelve participants (6 females) with chronic stroke were recruited. All adhered to the intervention. There were no adverse events, dropouts, or withdrawal. There were no significant differences between the YouGrabber and gym groups although there were significant within group improvements on the motor activity log (median change: 0.59, range: 0.2-1.25; < 0.05) within the YouGrabber group. Participants reported that the YouGrabber was motivational but they expressed frustration with technical challenges. . The YouGrabber appeared practical and may improve upper limb activities in people several months after stroke. Future work could examine cognition, cost effectiveness, and different training intensities.
The Influence of Speech-Language-Hearing Therapy Duration on the Degree of Improvement in Poststroke Language Impairment.
Hayashi H, Okada E, Shibata Y … +2 more , Nakamura M, Ojima T
Rehabil Res Pract · 2017 · PMID 28168056 · Full text
. The relevance of speech-language-hearing therapy (ST) duration to language impairment remains unclear. To determine the effect of ST duration on improvement in language impairment as a stroke sequela and to compare th...
. The relevance of speech-language-hearing therapy (ST) duration to language impairment remains unclear. To determine the effect of ST duration on improvement in language impairment as a stroke sequela and to compare the findings with those for occupational therapy (OT) and physical therapy (PT). . Data regarding patients with stroke sequelae who were registered in the Japanese Association of Rehabilitation Medicine database were analyzed. Propensity scores for ST, OT, and PT duration were calculated using logistic regression, followed by inverse probability weighting in generalized estimating equations to examine the odds ratio for improvement in the Functional Independence Measures scores for comprehension, expression, and memory. Analyses stratified by age and dementia severity were also conducted. . Compared with short-duration ST, long-duration ST was significantly associated with improved scores for comprehension and expression in the overall study population and in some groups, with higher benefit especially for younger participants (<64 years) and those with more severe dementia. A significant but less pronounced effect was also observed for OT and PT. . Long-duration ST is more effective than long-duration OT or PT for improving language impairment occurring as stroke sequela. However, these effects are limited by age and severity of dementia.
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