NeuroRehabilitation最新文献

{"title":"A Systems Neuroscience Approach to Diagnosis and Rehabilitation of Post COVID Neurological Syndrome Based on the Systems Neuroscience Test Battery (SNTB) Study Protocol.","authors":"Tissa Wijeratne, Sheila G Crewther","doi":"10.1177/10538135241296773","DOIUrl":"10.1177/10538135241296773","url":null,"abstract":"<p><p>The proposed study reports the design and development of a rapid screening tool, the Systems Neuroscience Test Battery (SNTB), for diagnosing and evaluating the neurological manifestations of Post-COVID-19 Neurological Syndrome (PCNS) within the broader context of Post-Acute Sequelae to COVID-19 (PASC). The SNTB is designed to incorporate a behaviorally relevant Telehealth component that enhances consumer confidence in symptom discrimination, management of PCNS, and guides rehabilitation programs while allowing for continuous evaluation of intervention effectiveness.The study employs a longitudinal design, with telehealth and routine blood assessments conducted at three-month intervals, including at least two follow-ups post-recruitment. These assessments will involve Consumer-Reported Symptoms, Clinical History, Neuropsychological Data, and Timed Psychophysics, aimed at rapid screening of PCNS-related symptoms including 'brain fog\" and its affect on visually driven attention, cognition and visually driven motor behaviors. These assessments are intended to validate the characteristics of 'brain fog' and identify predictive behavioral biomarkers for the development of PCNS.The target population includes adults aged 18-65 who have experienced persistent neurological symptoms for at least three months following a confirmed COVID-19 infection. Exclusion criteria include individuals unable to undergo radiological examinations, such as pregnant women or those with contraindications to MRI, ensuring the robustness of the sample and reducing potential selection bias.The SNTB tool will facilitate the online identification of predictive biomarkers for PCNS and aid in the discovery of effective molecular biomarker combinations for medical intervention and rehabilitation. Complementary to the Telehealth Assessment, hospital facilities will be utilized for radiological and blood-based molecular assessments, ensuring concurrent profiling of structural and functional changes during 'brain fog' and recovery from PCNS symptoms.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"56 1","pages":"37-47"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telerehabilitation - Historical Perspectives and Conceptual Framework in Reference to Neurological Disorders: A Narrative Review.","authors":"Paul Olowoyo, Rajinder K Dhamija, Mayowa O Owolabi","doi":"10.3233/NRE-240079","DOIUrl":"10.3233/NRE-240079","url":null,"abstract":"<p><p>BackgroundTelerehabilitation as a new subdiscipline of telehealth is the application of information technology to support and deliver rehabilitation services via two-way or multipoint interactive online telecommunication technology. This enables the therapist to optimize the timing, intensity, and duration of therapy which is often not possible within the constraints of face-to-face treatment protocols in current health systems.ObjectiveTo review the historical perspective and conceptual framework of telerehabilitation in neurological disorders.MethodsA narrative review of the literature was performed for the historical perspective and a systematic review of the conceptual framework was performed using the PRISMA guidelines on chronic neurological disorders; multiple sclerosis, spinal cord injury, stroke, Parkinson's disease, cognitive impairment, and headaches. The search included articles from the past 20 years (2004 to 2024).ResultsTelerehabilitation dates back to the 1960s and early 1970s. Documented effective interventions were mostly on therapies for speech disorders. The conceptual framework consisted of three major components of telerehabilitation programmes including development, implementation, and evaluation. The COVID-19 pandemic suddenly made telerehabilitation come to the limelight because physical distancing became necessary. Out of the 110,000 articles downloaded, 43 met the inclusion criteria for review on the conceptual framework of telerehabilitation in relation to neurological disorders. The articles discussed multiple sclerosis (2), spinal cord disorders (1), stroke (17), Parkinson's disease (15), headaches (3), and cognitive disorders (5). All articles reviewed assessed the effectiveness of telemedicine except for the articles on multiple sclerosis and spinal cord disorders which examined the interphase between the technology and the end users.ConclusionThe future of telerehabilitation looks promising with the subsequent integration of innovative tools and applications. This will require the adaption of technology, continuous capacity building, education, and training of healthcare professionals to ensure that they are adequately equipped with the necessary skills to provide quality virtual reality rehabilitation care.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"5-18"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability of Telerehabilitation Among Stroke Survivors in Nigeria.","authors":"Olubukola A Olaleye, Adesola Oyinkansola Abiodun, Ayomide Daniel Adepoju","doi":"10.1177/10538135241296742","DOIUrl":"10.1177/10538135241296742","url":null,"abstract":"<p><p>BackgroundThe Covid-19 pandemic has accelerated the adoption of telerehabilitation as a tool to overcome geographical barriers, scarcity of care providers, and improve access to rehabilitation services. However, limited studies exist on its acceptability among care recipients particularly in low-and-middle-income countries.ObjectiveThis mixed-methods study explored the perception and acceptability of telerehabilitation among stroke survivors in Ibadan, Nigeria.MethodsA convenient sample of 44 stroke survivors was surveyed, and six participated in a focus group discussion (FGD). Quantitative data was analyzed using inferential statistics at p < 0.05. Qualitative data was thematically analysed.ResultsParticipants (61.4% males) were aged 60.93 ± 13.10 years. 19(43.3%) of them were favorably disposed to receiving treatment via telerehabilitation. Acceptability differed significantly across marital status, level of education, and socioeconomic status (p < 0.05). Qualitative findings indicated positive perceptions, although participants preferred telerehabilitation as an adjunct to face-to-face physiotherapy. Barriers included unstable internet connectivity, high costs of data, and lack of personal contact with physiotherapists. Facilitators included using telerehabilitation for additional or missed sessions, and the provision of necessary equipment and data by the government.ConclusionOur findings revealed limited acceptability of telerehabilitation among stroke survivors in Ibadan, Nigeria. This underscores the need to address the identified concerns and barriers, to enhance acceptability. A contextualized and multifaceted approach can help create awareness about the effectiveness of telerehabilitation and improve its acceptability.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"56 1","pages":"19-29"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Cost Telerehabilitation in Low- and Middle-Income Countries (LMICs): Overcoming Barriers to Access and Improving Healthcare Delivery.","authors":"Nirmal Surya, Hitav Pankaj Someshwar","doi":"10.1177/10538135241303349","DOIUrl":"10.1177/10538135241303349","url":null,"abstract":"<p><p>BackgroundTelerehabilitation (TR) holds promise for addressing healthcare disparities in low- and middle-income countries (LMICs), where access to rehabilitation services is often limited due to economic, geographical, and infrastructure barriers. Despite its potential, TR faces unique challenges in LMICs, including inadequate digital infrastructure, limited access to affordable devices, and variable internet connectivity.ObjectiveThis study investigates the feasibility, barriers, and outcomes of implementing low-cost TR interventions in LMICs.MethodA narrative review was conducted where studies were analyzed for outcomes including cost-effectiveness, patient adherence, and clinical efficacy.ResultsFindings indicate that low-cost TR can significantly improve accessibility to rehabilitation in LMICs, with positive clinical outcomes for patients with stroke, musculoskeletal disorders, and chronic pain. TR led to a 40-60% reduction in travel-related costs for patients, with adherence rates comparable to in-person sessions. However, limited access to reliable internet and devices were major barriers, particularly in rural areas, highlighting a digital divide within LMIC populations. Innovative solutions, such as asynchronous video-based therapy, were found effective in overcoming connectivity challenges.ConclusionLow-cost TR is a viable approach to enhancing rehabilitation accessibility in LMICs, offering substantial reductions in cost and travel barriers. Addressing infrastructure challenges through scalable, offline-enabled platforms could enhance TR's reach and efficacy. Further research is necessary to develop sustainable TR models tailored to the specific needs of LMICs.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"56 1","pages":"30-36"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research, education and practice of tele-neurorehabilitation in low and middle-income countries: A Scoping Review.","authors":"Dorcas Bc Gandhi, Sureshkumar Kamalakannan, Jennifer V Dsouza, Vinicius Montanaro, Nistara S Chawla, Amreen Mahmood, Etienne Ngeh, Sania Zarreen, Pranay J Vijayanand, John M Solomon","doi":"10.3233/NRE-240053","DOIUrl":"10.3233/NRE-240053","url":null,"abstract":"<p><p>BackgroundTele-neurorehabilitation (TNR) allows for remote delivery of rehabilitation services for those with neurological disabilities. Despite growing global interest and uptake, its adoption remains challenging in Low-and-Middle-Income-Countries (LMICs).ObjectiveTo explore available literature on the nature of training and education, research and practice of TNR in LMICs.MethodsFollowing PRISMA-ScR guidelines and predefined selection criteria, four databases were screened. Quality assessment was performed using the Joanna Briggs Institute tools. Relevant data was extracted to using a data extraction form in Microsoft Excel and were narratively synthesised under Education/training, Research and Clinical Practice of TNR.ResultsWe identified no formal structured training courses/programs for TNR users/providers. Sessions were mainly delivered as part of a research project. The included studies highlighted the need to engage stakeholders in TNR research and improve digital-literacy among healthcare providers/users. Development and use of clinical decision-making-tools, models of TNR suitable for varied populations and prior area-mapping were a few suggestions for clinical/research practice.ConclusionThere is an immense need to develop academic/structured programs for TNR to build capacity among providers/users in LMICs. Practice must adhere to principles of safety, effectiveness, and based on high quality clinical-guidelines suitable to the context to ensure optimal uptake and practice of TNR in LMICs.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"48-60"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increase in EEG alpha-to-theta ratio after transcranial direct current stimulation (tDCS) in patients with disorders of consciousness: A pilot study.","authors":"Vincenza Tarantino, Maria Lorena Fontana, Angela Buttà, Simona Ficile, Massimiliano Oliveri, Giorgio Mandalà, Daniela Smirni","doi":"10.1177/10538135241296371","DOIUrl":"https://doi.org/10.1177/10538135241296371","url":null,"abstract":"<p><p>BackgroundTranscranial direct current stimulation (tDCS) has emerged as a potentially effective intervention for improving consciousness levels in patients with disorders of consciousness (DoC). Most studies demonstrating benefits have targeted the left dorsolateral prefrontal cortex (DLPFC). However, inconsistent results have been reported across studies, and the brain effects of the stimulation remain unclear.ObjectiveThis work aimed to investigate the effects of a tDCS treatment on brain reactivity at rest in patients with DoC.MethodsA 10-session tDCS treatment was administered over the left DLPFC in a group of patients with DoC. The effect of this stimulation was tested by combining the conventional behavioral assessment, conducted with the Coma Recovery Scale-Revised (CRS-R), with a quantitative analysis of the resting-state electrical brain activity, measured by electroencephalography (EEG).ResultsFollowing treatment, there was a slight improvement in CRS-R scores. More importantly, an increase in the ratio between alpha and theta power over posterior scalp regions was observed, even in patients who did not show changes in CRS-R scores.ConclusionsThese findings suggest that adding a simple quantitative EEG analysis alongside conventional clinical assessment post-tDCS could enhance the detection of changes in brain reactivity.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"55 4","pages":"440-447"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gait analysis in patients with cerebral infarction and intracerebral hemorrhage walking with a body weight-supported walker.","authors":"Hiroo Koshisaki, Shigeo Tanabe, Shota Nagai, Kenji Kawakami, Hiroaki Sakurai","doi":"10.1177/10538135241296738","DOIUrl":"https://doi.org/10.1177/10538135241296738","url":null,"abstract":"<p><p>BackgroundThere is increasing recognition of the effectiveness of body weight-supported (BWS) walkers for stroke patients with hemiplegia. However, it is unclear whether the effectiveness of BWS walkers is because of the walker alone or the combined effect of the walker and body weight support.ObjectiveWe aimed to determine whether there are differences between normal, walker, and BWS walker gaits in patients after cerebral infarction (CI) and intracerebral hemorrhage (ICH).MethodsTwenty-one stroke patients with hemiplegia underwent trials under three gait conditions: normal, walker, and BWS walker gait. Spatiotemporal parameters and joint kinematics during walking were calculated using a three-dimensional motion analyzer. We further examined differences in effects depending on CI and ICH.ResultsSpeed and cadence improved in the walker gait and BWS gait groups compared with the normal gait group. In addition, the percentage of the stance and swing phases was improved in BWS walker gait compared to normal gait. Both patients with CI and those with ICH showed similar trends in gait parameters by BWS Walker.ConclusionsThese results suggest that using a BWS walker improves walking in stroke patients with hemiplegia in terms of gait parameter, and is a useful tool for gait training.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"55 4","pages":"468-474"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of chest expansion resistance exercise and respiratory muscle stretching on respiratory function and gait endurance in patients with stroke.","authors":"Jiyeon Lee, Jinseop Kim","doi":"10.3233/NRE-240132","DOIUrl":"https://doi.org/10.3233/NRE-240132","url":null,"abstract":"<p><strong>Background: </strong>Limited chest expansion and asymmetry in the respiratory muscles after a stroke lead to poor ventilation and reduced physical performance.</p><p><strong>Objectives: </strong>To determine the effect of chest expansion resistance exercise and respiratory muscle stretching on respiratory function and gait endurance in patients with stroke.</p><p><strong>Methods: </strong>Thirty stroke patients were randomly assigned to a chest expansion resistance group (CERG), a respiratory muscle stretching group (RMSG), and a control group (CG). CERG and RMSG received chest expansion resistance and respiratory muscle stretching, respectively, 3 times a week for 8 weeks. Respiratory function, respiratory muscle strength, and gait endurance were measured before and after the intervention period.</p><p><strong>Results: </strong>The experimental groups, CERG and RMSG, showed significant improvements in respiratory function variables (p < .05). For respiratory muscle strength variables, maximal inspiratory pressure (MIP) in the CERG and maximal expiratory pressure (MEP) in the RMSG showed significant changes compared to the CG (p < .05). Both CERG and RMSG also showed significant improvements in the 6MWT compared to the CG (p < .05).</p><p><strong>Conclusion: </strong>Chest expansion resistance exercise would be a more effective method, while both chest expansion resistance exercise and respiratory muscle stretching are helpful in improving respiratory function and gait endurance.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous eye blinking as a diagnostic and prognostic marker in disorders of consciousness: Protocol of an international multicentre longitudinal study.","authors":"Alfonso Magliacano, Giovanni Scarano, Cinzia Fasano, Andrea Mannini, Piergiuseppe Liuzzi, Alice Finocchi, Anna Estraneo","doi":"10.3233/NRE-240127","DOIUrl":"https://doi.org/10.3233/NRE-240127","url":null,"abstract":"<p><strong>Background: </strong>Diagnostic and prognostic decision-making in patients with Disorders of Consciousness (DoC) is challenging. It has been suggested that spontaneous eye blink rate is an index of patients' level of consciousness easy to detect in clinical practice. Further blinking features (i.e., amplitude, duration, variability in intervals between blinks) may change as a function of cognitive load, but have not been investigated in patients with DoC.</p><p><strong>Objective: </strong>This multicentre, longitudinal study aims at exploring the diagnostic and prognostic value of spontaneous eye blinking features in DoC.</p><p><strong>Methods: </strong>Eight European medical institutions will enrol consecutively admitted adult patients with DoC. Within two weeks from study entry demographic, anamnestic and clinical data will be collected. Moreover, patients will undergo two 20-minute EEG-EOG recordings at rest, to collect blinking features and EEG activity. A clinical follow-up will be performed after 6 months. A group of healthy individuals will be enrolled for reference.</p><p><strong>Results: </strong>Possible differences in blink features between patients and the reference group, differences across diagnostic sub-groups, and correlations between blinking features and clinical outcome will be investigated.</p><p><strong>Conclusion: </strong>The results of this study might help clinicians to reduce misdiagnosis rate in DoC and provide useful information for prognostication and care pathway plan.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of YouTube videos as a source of information on facial paralysis exercises.","authors":"Onur Engin, Ayşe Sezgi Kızılırmak Karataş, Betül Taşpınar, Ferruh Taşpınar","doi":"10.3233/NRE-240027","DOIUrl":"https://doi.org/10.3233/NRE-240027","url":null,"abstract":"<p><strong>Background: </strong>YouTube has emerged as an important source for obtaining information regarding health issues.</p><p><strong>Objective: </strong>The study aimed to assess the reliability and quality of facial paralysis exercise videos that are accessible on the YouTube platform.</p><p><strong>Methods: </strong>The investigation was carried out on Youtube, utilizing the keyword \"facial paralysis exercises\". We listed the first 100 videos based on relevancy. The quality and reliability of the videos were assessed using DISCERN, the Journal of the American Medical Association (JAMA) Benchmark Criteria, the Global Quality Scale (GQS), and the Video Power Index (VPI).</p><p><strong>Results: </strong>Out of 100 studies, we excluded 52 and included the remaining 48. The scores we obtained for the videos were as follows: DISCERN Quality (2.92±0.91), DISCERN Total (39.16±6.75), JAMA (2.09±0.55), and GQS (3.00±0.89). Our study also revealed that videos uploaded by healthcare professionals had significantly higher DISCERN total, JAMA and VPI scores compared to those uploaded by non-healthcare professionals (p = 0.018, 0.001 and 0.023, respectively). Additionally, we observed a positive and statistically significant correlation between the DISCERN quality score, total score, JAMA, and video features.</p><p><strong>Conclusion: </strong>The facial paralysis exercise videos were determined to be of medium to low quality. Higher-quality videos need to be produced.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}