NeuroRehabilitation最新文献

{"title":"Tolerating Uncertainty as a Transdiagnostic Construct and Treatment Target in Functional Motor Disorder.","authors":"Beth K Rush, Katie J Traver, Elizabeth N Geissler, Mariah K Travis, Barbara Lubrano di Ciccone, Margaret A Moutvic-Wasz, Mohit Chauhan","doi":"10.1177/10538135251325460","DOIUrl":"10.1177/10538135251325460","url":null,"abstract":"<p><p>BackgroundIntolerance of Uncertainty (IU) has never been explored in functional motor disorder (FMD) or any functional neurological disorder but perceptions of control are theoretically relevant.ObjectiveTo evaluate if IU changes in people with FMD completing intensive 1-week motor retraining treatment, and if IU change associates with outcome.MethodsA consecutive cohort of 45 FMD patients completed a 1-week intensive outpatient motor retraining treatment. At program beginning and end, patients self-rated IU using the Intolerance of Uncertainty Scale-12 (IUS-12) and four functional impairment measures. Paired t-tests analyzed program changes in IU and functional outcomes. Linear regressions analyzed association strength between IU change and outcome.ResultsIU improved with FMD treatment (p < 0.001). Pre- to post-treatment IU was improved in 32/45 (71%), stable in 5/45 (11%), and worsened in 8/45 (18%). Age, symptom duration, and FMD phenotype did not predict IU improvement. Self-rated function improved across measures with treatment (p < 0.001). Program change in IU positively predicted outcome on 3 of 4 measures.ConclusionsIU improves with FMD rehabilitation, even without explicit psychological focus of treatment, regardless of age or FMD phenotype. Improving IU associates with positive FMD treatment outcomes suggesting an important treatment target in FMD.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"56 4","pages":"501-510"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333693","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":"Optimal Parameter Analysis of Repetitive Transcranial Magnetic Stimulation on Motor Function in Patients with Incomplete Spinal Cord Injury: A Meta-Analysis.","authors":"Yu Liang, Liyun Xue, Saoying Yang, Chen Wang, Xifang Liu","doi":"10.1177/10538135251325435","DOIUrl":"10.1177/10538135251325435","url":null,"abstract":"<p><p>BackgroundRepetitive transcranial magnetic stimulation (rTMS) has shown potential in rehabilitating patients with incomplete spinal cord injury (iSCI). However, the evidence is mainly based on small-scale studies with varying protocols.ObjectiveTo summarize the impact of rTMS on motor function deficits in individuals with iSCI and identify optimal stimulation parameters through a meta-analysis.MethodsA systematic literature search was conducted in multiple databases from inception to July 31, 2024. Randomized controlled trials investigating rTMS effects on motor function in iSCI were included. Study quality was assessed using the RoB 2 and PEDro scale. RESULTS: Eleven studies with 345 participants were included. rTMS applied at 100-110% of resting motor threshold (SMD = 0.81, <i>P</i> = 0.0005), with over 15 stimulation sessions (SMD = 0.66, <i>P</i> = 0.04) and a cumulative pulse count of 1800 (SMD = 0.50, <i>P</i> = 0.04), significantly enhanced motor function recovery in iSCI patients. Four studies reported mild, transient adverse effects in 11 patients.ConclusionrTMS may enhance motor function in iSCI patients with certain parameters. However, given study limitations, conclusions should be viewed as exploratory.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"56 4","pages":"423-437"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333687","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":"Rehabilitation of Vertical Gaze Palsy and Impaired Eye Proprioception Following Bilateral Thalamic Infarcts: A Case Report.","authors":"Charlotte Bellear, Khalil Ali, Nicola Hawko","doi":"10.1177/10538135251325747","DOIUrl":"10.1177/10538135251325747","url":null,"abstract":"<p><p>IntroductionThalamic infarctions, which account for .6% of all ischemic strokes, are characterized by altered mental status, vertical gaze palsy, and memory impairment. There is only one other case report on the rehabilitation of a vertical gaze palsy due to thalamic lesions. Although rehabilitation strategies for vertical gaze palsy have been documented, the role of eye proprioception in this condition was not discussed.Case ReportA man in his late 50 s presented to outpatient occupational therapy following bilateral thalamic infarcts with bilateral vertical gaze palsy, preserved vestibular ocular reflex (VOR), and cognitive impairments. These impairments impeded his performance of functional activities including feeding, dressing, driving, and navigating obstacles during functional ambulation. During rehabilitation, it was revealed that he was unable to identify his line of sight creating the potential for impaired eye proprioception. Interventions included oculomotor exercises, VOR cancellation strategies, and functional adaptations.DiscussionThis case discusses the potential impact of eye proprioception in the rehabilitation of vertical gaze palsy following thalamic infarcts. Two theories for impaired proprioception are explored: damage to thalamic structures and impaired proprioceptive input from the extraocular muscles. Interventions to address eye proprioception led to improved vertical eye movements and functional abilities.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"56 4","pages":"571-576"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333690","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":"Association Between Psychotropic Medication and Falls Among Older Rehabilitation Inpatients with Varied Activity Levels.","authors":"Xiaoping Li, Jie Yan, Qingfang Zhang, Jianjun Long, Linlin Shan, Jia Cao, Chengting Wang, Yulong Wang","doi":"10.1177/10538135251327115","DOIUrl":"10.1177/10538135251327115","url":null,"abstract":"<p><p>BackgroundFalls are a common risk in older rehabilitation inpatients, with psychotropic medications potentially increasing fall risk. This study aims to assess the correlation between falls and the use of psychotropic medications in older inpatients at different activity levels in rehabilitation departments.MethodsA multi-center cross-sectional study analyzed patient characteristics, medications, fall incidents, and physical levels using the Longshi Scale. Chi-square tests, ANOVA, and binary logistic regression were applied.ResultsThis study enrolled a total of 6,425 patients, among them 711 cases (11.07%) experienced falls, and 333 cases (5.18%) had a history of psychotropic medication use. Psychotropic use was an independent fall risk factor <i>P </i>< 0.05), with significant correlation in bedridden (OR = 1.77, 95% CI: 1.18-2.64) and domestic (OR = 1.99, 95% CI: 1.12-3.53) groups, but not in the community group (<i>P </i>> 0.05).ConclusionBedridden and domestic group individuals, as per Longshi Scale classification, are vulnerable to psychotropic-induced falls. Targeted prevention and monitoring are necessary for these groups.Trial RegistrationThe study is approved by the Regional ethical committee and registered at Chinese Clinical Trial Registry (https://www.chictr.org.cn), ChiCTR-2000034067.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"56 4","pages":"560-570"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333684","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":"What Is the Evidence on Immunomodulators and Immunosuppressants for Progressive Multiple Sclerosis? - A Cochrane Review Summary with Commentary.","authors":"Antimo Moretti","doi":"10.1177/10538135251346351","DOIUrl":"10.1177/10538135251346351","url":null,"abstract":"<p><p>BackgroundMultiple sclerosis (MS) is a chronic inflammatory demyelinating disease affecting the central nervous system and is a major cause of disability in adults, particularly in those affected by progressive MS. A variety of drugs with different effects, some carrying significant risks, are currently available, making evidence-based approach essential for clinicians treating MS patients.ObjectiveTo compare the efficacy and safety of immunomodulators and immunosuppressants for progressive multiple sclerosis (PMS).MethodsA systematic search was performed in CENTRAL, MEDLINE, Embase, and trials registers on 8 august 2022, including RCTs comparing immunomodulators and immunosuppressants versus placebo or another drug.ResultsThe network meta-analysis (NMA) included 23 RCTs (with 10,167 participants). Moderate certainty of evidence suggests that rituximab probably not reduce the risk of relapse at 2 years, while interferon beta-1b probably reduces the risk of relapses at 3 years (-18%) compared to placebo in PMS people. Regarding SAE, low-to-very-low certainty of evidence for no increased risk with disease-modifying therapies (DMTs) versus placebo is available, except for immunoglobulins that seem to have a 7-fold increased risk of serious adverse events (SAEs). Only low-to-very low certainty of evidence is available about disability progression and SAEs in PMS people treated with DMTs versus placebo. On the other side, the risk for treatment discontinuation due to AEs is increased with interferon beta-1a by 2.93-fold, and probably increased with interferon-beta-1b, glatiramer acetate, and fingolimod by 2.98-fold, 3.98-fold, and 2.29-fold, respectively. Also, rituximab, natalizumab, siponimod, and ocrelizumab probably do not increase the risk for treatment discontinuation due to AEs, while laquinimod may not increase the risk treatment discontinuation due to AEs.ConclusionsCompared with placebo, two-, and three-year treatment with rituximab or interferon beta-1b, respectively, probably slightly reduce relapses in PMS people. A slight increase of treatment discontinuation due to AEs has been reported for rituximab, interferon beta-1b, interferon beta-1a, immunoglobulins, glatiramer acetate, natalizumab, fingolimod, siponimod, and ocrelizumab. No reliable evidence is available for disability progression and SAEs with available DMTs compared to placebo.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"577-580"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249052","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":"From Concept to Practice: Integrating Contextual Factors into Neurorehabilitation Among Physical Therapists.","authors":"Maha Almarwani, Emtenan Alsadhan","doi":"10.1177/10538135251344927","DOIUrl":"https://doi.org/10.1177/10538135251344927","url":null,"abstract":"<p><p>BackgroundNeurological disorders are the leading cause of global disability. To enhance neurorehabilitation effectiveness, it is essential to consider contextual factors that influence patient outcomes and the overall experience.ObjectiveThis study aimed to examine the integration of contextual factors into neurorehabilitation practice among physical therapists, focusing on their frequency of use, associated beliefs, ethical considerations, and communication strategies.MethodsA cross-sectional web-based survey was disseminated to a convenience sample of physical therapy professionals via various online platforms. The survey collected demographic data and information regarding the integration of contextual factors into neurorehabilitation practice.ResultsA total of 369 physical therapists completed the survey. Respondents reported moderate use of contextual factors (43%), with verbal communication (85%), positive attitude (82%), and physical contact (75%) the most frequently employed factors. The strongest beliefs about the influence of contextual factors on therapeutic outcomes were linked to verbal communication and optimistic behavior. No significant correlations were found between respondents' characteristics and the use of contextual factors.ConclusionPhysical therapists recognize the importance of contextual factors such as verbal communication, positive attitudes, and a professional approach in neurorehabilitation. Enhanced training is recommended to further integrate these factors into neurorehabilitation practice and optimize patient outcomes.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"10538135251344927"},"PeriodicalIF":1.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144160800","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":"Spasticity Management with Botulinum Toxin in Post-stroke and Multiple Sclerosis Patients: A Retrospective, 'Real-world', Multicenter Study.","authors":"Calogera Butera, Marcello Esposito, Trinchillo Assunta, Morena Giovannelli, Anna Rivaroli, Mario Pata, Mathieu Beneteau, Massimo Filippi, Patrizia M Caglioni, Ubaldo Del Carro","doi":"10.1177/10538135251329322","DOIUrl":"https://doi.org/10.1177/10538135251329322","url":null,"abstract":"<p><p>BackgroundWhile there is strong evidence for botulinum toxin-A (BoNT-A) in post-stroke spasticity, there is a paucity of data in multiple sclerosis and other conditions in real-world settings.ObjectiveDocument the use of BoNT-A in the management of spasticity, with focus on the treatment of spasticity due to stroke and multiple sclerosis.MethodsThis noninterventional, retrospective study included all adults treated for upper and/or lower limb spasticity (any etiology) at three centers in Italy who received ≥3 BoNT-A injection cycles between 2008 and 2018.ResultsInjection data from 149 patients were analyzed (n = 67 post-stroke, n = 47 MS, n = 35 other etiologies). The median treatment duration was 54.9 months in the post-stroke population and 41.9 months in the MS population. Total doses for the commercially available BoNT-A formulations were typically lower than approved for use in spasticity; we also observed clinically relevant differences in the muscle patterns treated between the MS and post-stroke indications. Regardless of etiology, most patients were satisfied with treatment.ConclusionsThis retrospective study provides a snapshot of spasticity management for patients referred for BoNT-A treatment. Most patients were satisfied with their treatment over several cycles and the data support the effectiveness of BoNT-A for focal spasticity regardless of etiology.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"10538135251329322"},"PeriodicalIF":1.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144160831","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":"Developing an mHealth App-based Telerehabilitation Programme for Stroke Survivors: A Feasibility and Usability Study.","authors":"Mathilde Van Durme, Thierry Lejeune, Gaetan Stoquart, Stephanie Dehem","doi":"10.1177/10538135251344925","DOIUrl":"https://doi.org/10.1177/10538135251344925","url":null,"abstract":"<p><p>Telerehabilitation, especially through mobile health applications, offers a promising approach to prolong and intensify stroke rehabilitation at a distance. This feasibility study aims to evaluate the usability, adherence and satisfaction of a telerehabilitation application called TeleRe-app for post-stroke individuals. The TeleRe-app uses the REApad platform. It includes self-rehabilitation exercises presented via video and serious games, and therapeutic education. Subjects were asked to use TeleRe-app for 4 weeks, 5 times/week, 30 min/session. Weekly remote monitoring was organised through the TeleRe-app teleconferencing module. Usability and satisfaction were measured using Likert scales and the System Usability Scale (SUS), while adherence was tracked by frequency and duration of use of TeleRe-app. 28 post-stroke individuals participated in the study. The usability of TeleRe-app was excellent (SUS 85%). Satisfaction was high (averaged 8/10). These results were better for outpatients than for inpatients. On average, participants performed telerehabilitation 4 times/week for 16 min/session. Adherence was thus lower than expected, but participants engaged in additional exercise by an average of 70 min/week. TeleRe-app is a valuable adjunct to conventional rehabilitation and warrants further evaluation in clinical trials.ClinicalTrials Registration : NCT06016374.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"10538135251344925"},"PeriodicalIF":1.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144160751","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":"Emotional Training after Facial Nerve Palsy: Let's Smile Again!","authors":"Fabrizio Gervasoni, Antonella LoMauro, Vincenzo Ricci, Arnaldo Andreoli, Silvia Cupello, Andrea Bernetti, Massimiliano Mangone, Teresa Paolucci, Francesco Agostini, Rossella Pagani, Antonino Michele Previtera","doi":"10.1177/10538135251335123","DOIUrl":"https://doi.org/10.1177/10538135251335123","url":null,"abstract":"<p><p>BackgroundWe aimed to propose <i>Emotional training</i> (<i>ET</i>) as a neurocognitive approach, based on motor imagery by stimulating the patient's perception through different stimuli on the face to treat peripheral paralysis of the facial nerve.MethodsRetrospective, observational, double-centres cohort study of 50 patients diagnosed with peripheral facial nerve palsy. Facial function was assessed through the House-Brackmann scale (HBS, the primary outcome), the Sunnybrook Facial Grading System (FGS, secondary outcome) and the Italian validated version of the Facial Disability Index (It-FDI, secondary outcome) at the beginning and the end of the rehabilitation protocol. An author blinded to the protocols did the data analysis.ResultsAll patients showed improvement at the end of <i>ET</i> (HBS: 2 (p < 0.001); FGS: 57 (p < 0.001); It-FDI: 80 (p = 0.002)), by achieving a slight dysfunction or even normal function compared to baseline (HBS: 4; FGS: 21; It-FDI: 76). A second group of 8 surgical patients treated with an already published protocol served as control. HSB and FGC did not differ between the two groups at baseline and after 20 rehabilitative sections, with similar improvements.Conclusion<i>ET</i> provided significant improvements in the symmetry of the face at rest and during voluntary movements, in social function and subjectively perceived well-being. <i>ET</i> is an effective therapeutic proposal for patients suffering from idiopathic or iatrogenic facial nerve palsy.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"10538135251335123"},"PeriodicalIF":1.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144160768","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":"Validation of the Arabic Version of Multiple Sclerosis Quality of Life-29 (MSCOL-29-Ar): Cross-cultural Adaptation and Psychometric Analysis.","authors":"Afaf Am Shaheen As, Jude A Alsharafi, Mishel M Aldaihan, Asma S Alrushud, Asma A Aldera, Mai A Alder, Saad Alhammad, Ahmed Farrag, Walaa Elsayed, Muneera Almurdi, Maha Algabbani","doi":"10.1177/10538135251344929","DOIUrl":"https://doi.org/10.1177/10538135251344929","url":null,"abstract":"<p><p>Background and objectivesTo translate and adapt the Multiple Sclerosis Quality of Life-29 into Arabic <b>(</b>MSQOL-29-Ar) and assess its psychometric properties in people with multiple sclerosis (MS).MethodsGenerally, 101 Arabic-speaking adults with MS aged 21 to 60 were recruited. Construct validity was tested by correlating MSQOL-29-Ar with the Arabic Functional Assessment of Multiple Sclerosis (FAMS-AR) and Multiple Sclerosis International Quality of Life (MusiQOL). Known-group validity was assessed by correlating the scale's Physical Health Composite (PHC) and Mental Health Composite (MHC) scores with the demographic and clinical data. Test-retest reliability, internal consistency, standard error of measurement (SEM), minimal detectable change (MDC₉₅), limit of agreement (LOA), responsiveness, and floor/ceiling effects were also investigated.ResultsPHC and MHC scores correlated strongly with FAMS-ARA (r = 0.76 and 0.70, respectively).PHC scores were associated with age, employment, and MS chronicity, while MHC scores correlated with the Expanded Disability Status Scale. Internal consistency was acceptable (PHC α = 0.80; MHC α = 0.90), with excellent test-retest reliability (PHC r = 0.76; MHC r = 0.90). SEM (1.4-1.6) and MDC₉₅ (4.3-3) were low. Responsiveness analysis indicated moderate accuracy (AUC = 0.70-0.75) with on-floor/ceiling effects.ConclusionMSQOL-29-Ar is valid and reliable for assessing HQOL in people with MS, making it suitable for clinical and rehabilitation settings.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"10538135251344929"},"PeriodicalIF":1.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151374","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}