NeuroRehabilitation最新文献

{"title":"Overview of randomized controlled trials of moderate to severe traumatic brain injury: A systematic review","authors":"Robert Teasell, Cecilia Flores-Sandoval, Emma A. Bateman, Heather M. MacKenzie, Keith Sequeira, Mark Bayley, Shannon Janzen","doi":"10.3233/nre-240019","DOIUrl":"https://doi.org/10.3233/nre-240019","url":null,"abstract":"BACKGROUND:\u0000Given the complexity of post-TBI medical, surgical, and rehabilitative care, research is critical to optimize interventions across the continuum of care and improve outcomes for persons with moderate to severe TBI. OBJECTIVE:\u0000To characterize randomized controlled trials (RCTs) of moderate to severe traumatic brain injury (TBI) in the literature. METHOD:\u0000Systematic searches of MEDLINE, PubMed, Scopus, CINAHL, EMBASE and PsycINFO for RCTs up to December 2022 inclusive were conducted in accordance with PRISMA guidelines. RESULTS:\u0000662 RCTs of 91,946 participants published from 1978 to 2022 met inclusion criteria. The number of RCTs published annually has increased steadily. The most reported indicator of TBI severity was the Glasgow Coma Scale (545 RCTs, 82.3%). 432 (65.3%) RCTs focused on medical/surgical interventions while 230 (34.7%) addressed rehabilitation. Medical/surgical RCTs had larger sample sizes compared to rehabilitation RCTs. Rehabilitation RCTs accounted for only one third of moderate to severe TBI RCTs and were primarily conducted in the chronic phase post-injury relying on smaller sample sizes. CONCLUSION:\u0000Further research in the subacute and chronic phases as well as increasing rehabilitation focused TBI RCTs will be important to optimizing the long-term outcomes and quality of life for persons living with TBI.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"28 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140799131","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":"Therapeutic effects of deep pharyngeal electrical stimulation combined with modified masako maneuver on aspiration in patients with stroke","authors":"Bo-Ye Ni, Hua-Ping Jin, Wei Wu","doi":"10.3233/nre-240005","DOIUrl":"https://doi.org/10.3233/nre-240005","url":null,"abstract":"BACKGROUND:Stroke patients often experience difficulty swallowing. OBJECTIVE:To assist in the improvement of dysphagia symptoms by introducing a novel approach to the treatment of patients with post-stroke aspiration. METHODS:A total of 60 patients with post-stroke aspiration were enrolled and divided into an experimental group (n = 30) and a control group (n = 30). The control group received standard treatment, sham intraoral stimulation, and the Masako maneuver, while the experimental group was administered standard treatment, deep pharyngeal electrical stimulation (DPES), and a modified Masako maneuver. Changes in their Functional Oral Intake Scale (FOIS) and Rosenbek scale scores were observed. RESULTS:The FOIS scores of both groups increased significantly after treatment (p < 0.01, respectively). The Rosenbek scale scores of both groups decreased significantly after treatment, with the experimental group scoring significantly lower than the control group (1.01±0.09 vs. 2.30±0.82) (p < 0.05). After treatment, the overall response rate in the experimental group (93.33%) was significantly higher than that in the control group (83.33%) (p < 0.001). CONCLUSION:In terms of effectively improving dysphagia in aspiration patients after stroke, DPES combined with modified Masako maneuver is clinically recommended.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"15 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140592930","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":"Computational methodology to support functional vision assessment in premature infants: A viability study","authors":"Ricardo Pires Maciel, Bruna Samantha Marchi, Henrique da Silva da Silveira, Giovana Pascoali Rodovanski, Aicha Al-Rob, Rodrigo Souza, Marcelo Fernandes Costa, Cristiane Aparecida Moran, Antonio Carlos Sobieranski","doi":"10.3233/nre-230193","DOIUrl":"https://doi.org/10.3233/nre-230193","url":null,"abstract":"BACKGROUND:Premature newborns have a higher risk of abnormal visual development and visual impairment. OBJECTIVE:To develop a computational methodology to help assess functional vision in premature infants by tracking iris distances. METHODS:This experimental study was carried out with children upto two years old. A pattern of image capture with the visual stimulus was proposed to evaluate visual functions of vertical and horizontal visual tracking, visual field, vestibulo-ocular reflex, and fixation. The participants’ visual responses were filmed to compose a dataset and develop a detection algorithm using the OpenCV library allied with FaceMesh for the detection and selection of the face, detection of specific facial points and tracking of the iris positions is done. A feasibility study was also conducted from the videos processed by the software. RESULTS:Forty-one children of different ages and diagnoses participated in the experimental study, forming a robust dataset. The software resulted in the tracking of iris positions during visual function evaluation stimuli. Furthermore, in the feasibility study, 8 children participated, divided into Pre-term and Term groups. There was no statistical difference in any visual variable analyzed in the comparison between groups. CONCLUSION:The computational methodology developed was able to track the distances traveled by the iris, and thus can be used to help assess visual function in children.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"28 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139668412","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":"Music, occupational, physical, and speech therapy interventions for patients in disorders of consciousness: An umbrella review","authors":"Brooke Murtaugh, Ann-Marie Morrissey, Susan Fager, Heather E. Knight, Jess Rushing, Jennifer Weaver","doi":"10.3233/nre-230149","DOIUrl":"https://doi.org/10.3233/nre-230149","url":null,"abstract":"BACKGROUND:\u0000Current clinical guidelines recommend that a multidisciplinary team inclusive of allied healthcare practitioners deliver assessment and intervention for disorders of consciousness. Allied health professionals include music, occupational, physical, and speech therapists. These allied health clinicians are challenged to select interventions due to a lack of evidence-based recommendations regarding rehabilitation interventions that support recovery of consciousness. This umbrella review synthesizes available systematic reviews (SRs) that describe occupational, speech and language, physical and/or musical therapeutic interventions for people with disorders of consciousness. OBJECTIVES:\u0000Identify and summarize evidence from systematic reviews (SRs) that examine allied healthcare interventions for patients with disorders of consciousness. Additionally, this umbrella review aims to evaluate the impact of allied health interventions on recovery of consciousness, methodological quality and risk of bias for the included systematic reviews. METHODS:\u0000An umbrella review was completed. The review was reported according to the Preferred Reporting Items for Overview of Reviews (PRIOR) guidance. Five academic databases (PubMed, CINAHL, PsycInfo, Web of Science, and the Cochrane Library) were searched for SRs and/or meta-analyses of allied health (i.e., music, occupational, physical, and speech therapy) interventions for disorders of consciousness. For included studies, data were extracted and quality of the SRs appraised using the A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2 checklist. Data extracted from each SR identified the authors and years of primary studies, interventions, comparators, and outcomes related to recovery of consciousness (i.e., neurobehavioral/cognitive), functional status, physiological response pain, and adverse events. Rehabilitation interventions were categorized and described. RESULTS: Fifteen SRs were included and three of these reviews conducted meta-analyses. Identified rehabilitation interventions included: 1) sensory stimulation, 2) median nerve stimulation, 3) communication/environmental control through assistive technology, 4) mobilization, and 5) music-based therapy. SRs were published between 2002 and 2022 and included 2286 participants. Using the AMSTAR 2, the quality of reviews was critically low (k = 6), low (k = 3), moderate (k = 4), and high (k = 2). SRs within this umbrella review demonstrated significant heterogeneity in research methods and use of outcome measures to evaluate the recovery of consciousness within the primary studies. These factors influenced the ability to conduct meta-analyses. CONCLUSIONS:Sensory stimulation, median nerve stimulation, music therapy and mobilization are all interventions that demonstrate some level of benefit, but current SRs fail to prove benefit through high-level quality evidence. There is an indisputable need for continued rehabilitation research to expand op","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"148 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139562025","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":"Utility of in-session assessments during cognitive behavioral therapy for depression after traumatic brain injury: Results from a randomized controlled trial","authors":"Jennifer M. Erickson, Ryan Williams, Charles H. Bombardier, Jesse R. Fann","doi":"10.3233/nre-230218","DOIUrl":"https://doi.org/10.3233/nre-230218","url":null,"abstract":"BACKGROUND:The development of depression after moderate to severe traumatic brain injury (TBI) is common. Cognitive-behavioral therapy (CBT) can be used to treat post-TBI depression, but the symptoms response is poorly described. OBJECTIVE:This secondary analysis assessed: (1) the trajectory of depression symptoms up to 12 sessions of CBT, (2) which depressive symptom clusters were responsive to in-person and phone CBT, and (3) whether interim depression thresholds predict 16-week treatment response. METHOD:This secondary analysis of the IRB-approved Life Improvement Following Traumatic Brain Injury trial included 100 adults with major depressive disorder (MDD) within ten years of moderate to severe traumatic brain injury from throughout the US. We used a combination of descriptive, graphical, and diagnostic accuracy methods. RESULTS:Cardinal and cognitive-affective symptom clusters improved most from CBT over 16 weeks. At 8 and 16 weeks, the most responsive individual symptoms were anhedonia, depressed mood, and fatigue; the least responsive were sleep and appetite. PHQ-9 thresholds with a Negative Predictive Value greater than 0.7 for sessions 6, 7, and 8 were, respectively: >15, >10, and >9. CONCLUSION:In-person and phone CBT led to similar symptom responses during treatment. Additionally, using PHQ-9 thresholds for predicting intervention response within eight sessions may help identify the need for treatment adjustments.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"41 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139561977","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":"Prognosis and enhancement of recovery in disorders of consciousness","authors":"Mary E. Russell, Flora M. Hammond, Brooke Murtaugh","doi":"10.3233/nre-230148","DOIUrl":"https://doi.org/10.3233/nre-230148","url":null,"abstract":"<h4><span>Abstract</span></h4><p>Disorders of consciousness after severe brain injury encompass conditions of coma, vegetative state/unresponsive wakefulness syndrome, and minimally conscious state. DoC clinical presentation pose perplexing challenges to medical professionals, researchers, and families alike. The outcome is uncertain in the first weeks to months after a brain injury, with families and medical providers often making important decisions that require certainty. Prognostication for individuals with these conditions has been the subject of intense scientific investigation that continues to strive for valid prognostic indicators and algorithms for predicting recovery of consciousness. This manuscript aims to provide an overview of the current clinical landscape surrounding prognosis and optimizing recovery in DoC and the current and future research that could improve prognostic accuracy after severe brain injury. Improved understanding of these factors will aid healthcare professionals in providing optimal care, fostering hope, and advocating for ethical practices in the management of individuals with DoC.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139562049","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":"Ethical issues of nosology in disorders of consciousness","authors":"Nathaniel M. Robbins MD, James L. Bernat MD","doi":"10.3233/nre-230120","DOIUrl":"https://doi.org/10.3233/nre-230120","url":null,"abstract":"The current classification scheme for severe disorders of consciousness (DoC) has several shortcomings. First, there is no consensus on how to incorporate patients with covert consciousness. Second, there is a mismatch between the definitions of severe DoC, based on consciousness, and the diagnosisof these same DoC, which is based on observable motoric responsiveness. Third, current categories are grouped into large heterogeneous syndromes which share phenotype, but do not incorporate underlying pathophysiology. Here we discuss several ethical issues pertaining to the current nosology of severe DoC. We conclude by proposing a revised nosology which addresses these shortcomings.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"252 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139562048","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":"Efficacy of balance exercises intervention on postural control-related impairment in children with sensorineural hearing loss","authors":"Roshdy M. Kamel, Alaaeldin Khaireldin, Mohamed A. Gad Allah, Ramez Yousry Fawzy Bakhoom, Nadia Mohamed Abdelhakiem, Elsayed S. Mehrem","doi":"10.3233/nre-230284","DOIUrl":"https://doi.org/10.3233/nre-230284","url":null,"abstract":"BACKGROUND:Sensorineural hearing loss is the most common type of permanent hearing impairment and results in postural control and motor deficits in children that may affect or delay all developmental indicators. OBJECTIVE:The purpose of the study was to investigate the efficacy of balance exercisesintervention on postural control-related impairment in children with sensorineural hearing loss. METHODS:Forty students of both genders, ages ranging from 10 to 16 years, diagnosed with severe to profound sensorineural hearing loss, were selected from the Public School for the Deaf and Hard of Hearing in El-Minia district, Minia governorate, Egypt. They divided randomly into two groups, 20 (study group), received balance exercises in addition to their ordinary daily living activities. Meanwhile, the control group of 20 children practiced only the ordinary daily living activities. The outcome was assessed pre-treatment and post-treatment by Humac Balance System and Bruininks-Oseretsky Test (BOT-2) subtest (5) for balance. RESULTS:Regarding the Humac balance system and subtest (5) of BOT-2, there was a statistically significant difference between pre-treatment data and post-treatment data of the study group with a p value equal to 0.036 or less. However, no statistically significant difference was observed in the control group with a p value equal to 0.096 or more. Finally, there was a statistically significant difference between the groups with respect to the post-treatment data, where the p value was 0.014 or less. CONCLUSION:Postural control of children with sensorineural hearing loss has been improved by balance exercises.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"10 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139562139","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":"The Life After Stroke In Northern Sweden Study (LASINS): Methodology, cohort demographics and initial results","authors":"Maria Kähler, Hanna M. Nilsson, Jan Lexell","doi":"10.3233/nre-230278","DOIUrl":"https://doi.org/10.3233/nre-230278","url":null,"abstract":"<h4><span>Abstract</span></h4><h3><span></span>BACKGROUND:</h3><p>To advance rehabilitation we need a comprehensive understanding of functioning and disability of people after stroke.</p><h3><span></span>OBJECTIVE:</h3><p>To present an overview of the methodology of the Life After Stroke In Northern Sweden Study, compare participants and non-participants regarding gender and age, and describe baseline sociodemographics, stroke characteristics and the participants’ self-rated degree of recovery.</p><h3><span></span>METHODS:</h3><p>Data were collected through a study specific questionnaire, from the participants’ medical records and with internationally established self-assessment tools focusing on sleep disturbances, depressive symptoms, fatigue, physical activity, and remaining physical and cognitive impairments, activity limitations, participation restrictions and life satisfaction.</p><h3><span></span>RESULTS:</h3><p>Of 301 potential participants, 160 comprise the final sample (response rate 53% ; 86 men and 74 women, mean age 73 years±26, mean time since stroke onset 35 months±11; 18– 61). Most participants had an ischemic stroke (87%), were retired (84%), cohabitant (63%) and walked independently (71%). The mean self-rated degree of recovery was 75 (SD±24; 0– 100).</p><h3><span></span>CONCLUSIONS:</h3><p>These baseline data together with forthcoming studies will describe stroke-related impairments, activity limitations, participation restrictions and life satisfaction more than one year after stroke, and deepen our understanding of factors of importance for a healthy and successful life after stroke.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"17 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139562019","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":"Comorbid treatment of traumatic brain injury and mental health disorders","authors":"Katie A. Ragsdale, Anastacia A. Nichols, Mansi Mehta, Jessica L. Maples-Keller, Carly W. Yasinski, Courtland S. Hyatt, Laura E. Watkins, Laura A. Loucks, Elizabeth Carbone, Sheila A. M. Rauch, Barbara O. Rothbaum","doi":"10.3233/nre-230235","DOIUrl":"https://doi.org/10.3233/nre-230235","url":null,"abstract":"BACKGROUND:The Emory Healthcare Veterans Program (EHVP) is a multidisciplinary intensive outpatient treatment program for post-9/11 veterans and service members with invisible wounds, including posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), substance use disorders (SUD), and other anxiety- and depression-related disorders. OBJECTIVE:This article reviews the EHVP. METHODS:The different treatment tracks that provide integrated and comprehensive treatment are highlighted along with a review of the standard, adjunctive, and auxiliary services that complement individualized treatment plans. RESULTS:This review particularly emphasizes the adjunctive neurorehabilitation service offered to veterans and service members with a TBI history and the EVHP data that indicate large reductions in PTSD and depression symptoms across treatment tracks that are maintained across 12 months follow up. Finally, there is a discussion of possible suboptimal treatment response and the pilot programs related to different treatment augmentation strategies being deploying to ensure optimal treatment response for all. CONCLUSION:Published data indicate that the two-week intensive outpatient program is an effective treatment program for a variety of complex presentations of PTSD, TBI, SUD, and other anxiety- and depression-related disorders in veterans and active duty service members.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"58 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139562138","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}