NeuroRehabilitation最新文献_第4页

Disorders of consciousness: A field in flux 意识障碍：不断变化的领域

IF 2 4区医学

NeuroRehabilitation Pub Date : 2024-01-09 DOI: 10.3233/nre-246000

C. Schnakers, N. Zasler

引用次数: 0

Medical comorbidities in patients with prolonged disorder of consciousness: A narrative review 长期意识障碍患者的并发症：叙述性综述

IF 2 4区医学

NeuroRehabilitation Pub Date : 2024-01-09 DOI: 10.3233/nre-230130

Anna Estraneo, Marie-Michele Briand, Enrique Noé

{"title":"Medical comorbidities in patients with prolonged disorder of consciousness: A narrative review","authors":"Anna Estraneo, Marie-Michele Briand, Enrique Noé","doi":"10.3233/nre-230130","DOIUrl":"https://doi.org/10.3233/nre-230130","url":null,"abstract":"BACKGROUND:\u0000A few studies specifically addressed medical comorbidities (MCs) in patients with severe acquired traumatic or non-traumatic brain injury and prolonged disorders of consciousness (pDoC; i.e., patients in vegetative state/unresponsive wakefulness syndrome, VS/UWS, or in minimally conscious state, MCS). OBJECTIVE:\u0000To provide an overview on incidence of MCs in patients with pDoC. METHODS:\u0000Narrative review on most impacting MCs in patients with pDoC, both those directly related to brain damage (epilepsy, neurosurgical complications, spasticity, paroxysmal sympathetic hyperactivity, PSH), and those related to severe disability and prolonged immobility (respiratory comorbidities, endocrine disorders and metabolic abnormalities, heterotopic ossifications). RESULTS:\u0000Patients with pDoC are at high risk to develop at least one MC. Moderate or severe respiratory and musculoskeletal comorbidities are the most common MCs. Epilepsy and PSH seem to be more frequent in patients in VS/UWS compared to patients in MCS, likely because of higher severity in the brain damage in VS. Endocrine metabolic, PSH and respiratory complications are less frequent in traumatic etiology, whereas neurogenic heterotopic ossifications are more frequent in traumatic etiology. Spasticity did not significantly differ between VS/UWS and MCS and in the three etiologies. MCs are associated with higher mortality rates, worse clinical improvement and can impact accuracy in the clinical diagnosis. CONCLUSIONS:\u0000The frequent occurrence of several MCs requires a specialized rehabilitative setting with high level of multidisciplinary medical expertise to prevent, appropriately recognize and treat them. Comprehensive rehabilitation could avoid possible progression to more serious complications that can negatively impact clinical outcomes.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"79 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139415359","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}

引用次数: 0

Swallowing dysfunctions in patients with disorders of consciousness: Evidence from neuroimaging data, assessment, and management 意识障碍患者的吞咽功能障碍：来自神经影像学数据、评估和管理的证据

IF 2 4区医学

NeuroRehabilitation Pub Date : 2024-01-08 DOI: 10.3233/nre-230135

Amandine Regnier, Evelyne Mélotte, Charlène Aubinet, Naji Alnagger, David Fischer, Aude Lagier, Aurore Thibaut, Steven Laureys, Jean-François Kaux, Olivia Gosseries

{"title":"Swallowing dysfunctions in patients with disorders of consciousness: Evidence from neuroimaging data, assessment, and management","authors":"Amandine Regnier, Evelyne Mélotte, Charlène Aubinet, Naji Alnagger, David Fischer, Aude Lagier, Aurore Thibaut, Steven Laureys, Jean-François Kaux, Olivia Gosseries","doi":"10.3233/nre-230135","DOIUrl":"https://doi.org/10.3233/nre-230135","url":null,"abstract":"Following severe brain injuries, a subset of patients may remain in an altered state of consciousness; most of these patients require artificial feeding. Currently, a functional oral phase and the presence of exclusive oral feeding may constitute signs of consciousness. Additionally, the presence of pharyngo-laryngeal secretions, saliva aspiration, cough reflex and tracheostomy are related to the level of consciousness. However, the link between swallowing and consciousness is yet to be fully understood. The primary aim of this review is to establish a comprehensive overview of the relationship between an individual’s conscious behaviour and swallowing (reflexive and voluntary). Previous studies of brain activation during volitional and non-volitional swallowing tasks in healthy subjects are also reviewed. We demonstrate that the areas activated by voluntary swallowing tasks (primary sensorimotor, cingulate, insula, premotor, supplementary motor, cerebellum, and operculum) are not specific to deglutitive function but are shared with other motor tasks and brain networks involved in consciousness. This review also outlines suitable assessment and treatment methods for dysphagic patients with disorders of consciousness. Finally, we propose that markers of swallowing could contribute to the development of novel diagnostic guidelines for patients with disorders of consciousness.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"53 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139409745","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}

引用次数: 0

Medicolegal issues and disorders of consciousness 医疗法律问题和意识障碍

IF 2 4区医学

NeuroRehabilitation Pub Date : 2024-01-08 DOI: 10.3233/nre-230242

Nathan D. Zasler

{"title":"Medicolegal issues and disorders of consciousness","authors":"Nathan D. Zasler","doi":"10.3233/nre-230242","DOIUrl":"https://doi.org/10.3233/nre-230242","url":null,"abstract":"BACKGROUND:\u0000The tasks and responsibilities that come with clinician involvement in medicolegal proceedings can be daunting and particularly so in challenging areas such as provision of medicolegal opinions in cases involving disorders of consciousness (DoC). OBJECTIVE:\u0000The aim of this narrative review was to provide education and advice to healthcare practitioners who by choice or circumstance are asked and/or required to provide medicolegal opinions in cases involving patients with DoC. METHODS:\u0000A literature search was conducted using PubMed Central and MedlinePlus for articles dealing with clinician involvement in medicolegal cases involving persons with DoC. The information provided also integrates the authors nearly 40 years of clinical experience and brain injury medicine practice and “trials and tribulations” associated with medicolegal involvement in such cases. RESULTS:\u0000The literature was found to be replete with articles on brain death and withdrawal/withholding of care (which are not the focus of this review). The extant medical literature in brain injury medicine on the other hand is currently lacking in practical information for clinicians working “in the trenches” regarding the challenges and caveats of medicoegal involvement in such cases. CONCLUSION:\u0000This review provides the reader with a big picture overview of the most pertinent medicolegal topics inherent in clinical work with patients with DOC including pertinent nomenclature, caveats regarding forensic consultation including independent medical examinations, testimony tips, discussion of life expectancy/median survival concepts, prognostication in a medicolegal context, documentation and record keeping as well as some of the specific challenges pertinent to these types of brain injury cases that are not per se relevant in less severe injuries.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"209 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139409747","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}

引用次数: 0

Dry needling combined with exercise therapy: Effects on wrist flexors spasticity in post-stroke patients - A randomized controlled trial. 干针疗法与运动疗法相结合：对中风后患者腕屈肌痉挛的影响--随机对照试验。

IF 2 4区医学

NeuroRehabilitation Pub Date : 2024-01-01 DOI: 10.3233/NRE-230081

Seyedeh Saeideh Babazadeh-Zavieh, Noureddin Nakhostin Ansari, Nastaran Ghotbi, Soofia Naghdi, Seyed Mohammad Jafar Haeri

{"title":"Dry needling combined with exercise therapy: Effects on wrist flexors spasticity in post-stroke patients - A randomized controlled trial.","authors":"Seyedeh Saeideh Babazadeh-Zavieh, Noureddin Nakhostin Ansari, Nastaran Ghotbi, Soofia Naghdi, Seyed Mohammad Jafar Haeri","doi":"10.3233/NRE-230081","DOIUrl":"10.3233/NRE-230081","url":null,"abstract":"Background: The positive contribution of dry needling (DN) in conjunction with exercise therapy for patients with stroke and spasticity remains uncertain.Objective: To examine the effects of DN combined with exercise therapy on wrist flexor spasticity and motor function in patients with stroke.Methods: Twenty-four participants with stroke were randomly assigned to either the DN and exercise therapy group or the DN alone group. Assessments were conducted at baseline, after the 4th treatment session, and 3 weeks post-treatment.Results: A significant Group×Time interaction was observed for wrist active range of motion (ROM) (P = 0.046), favoring the DN with exercise therapy group (∼10° at baseline, ∼15° immediately after the 4th session, and 15.4° at follow-up). The improvements in spasticity, passive ROM, and H-reflex latency were sustained during follow-up. However, there were no significant between-group differences in any outcome at any measurement time point.Conclusion: The combined DN and exercise therapy did not exhibit superiority over DN alone concerning spasticity severity and motor function. However, it demonstrated additional advantages, particularly in improving motor neuron excitability and wrist passive extension.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"399-409"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139940437","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}

引用次数: 0

Assessing consciousness and cognition in disorders of consciousness. 评估意识障碍中的意识和认知。

IF 2 4区医学

NeuroRehabilitation Pub Date : 2024-01-01 DOI: 10.3233/NRE-230140

Caroline Schnakers

引用次数: 0

Pediatric disorders of consciousness: Considerations, controversies, and caveats. 小儿意识障碍：考虑因素、争议和注意事项。

IF 2 4区医学

NeuroRehabilitation Pub Date : 2024-01-01 DOI: 10.3233/NRE-230131

Beth Slomine, Erika Molteni

引用次数: 0

Changes in self-perceived performance and satisfaction with performance of daily activities following interdisciplinary rehabilitation in people with late effects of polio. 小儿麻痹症晚期患者在接受跨学科康复治疗后，对日常活动表现的自我感觉和满意度的变化。

IF 2 4区医学

NeuroRehabilitation Pub Date : 2024-01-01 DOI: 10.3233/NRE-230219

Katja Appelin, Lena-Karin Erlandsson, Jan Lexell, Eva Månsson Lexell

{"title":"Changes in self-perceived performance and satisfaction with performance of daily activities following interdisciplinary rehabilitation in people with late effects of polio.","authors":"Katja Appelin, Lena-Karin Erlandsson, Jan Lexell, Eva Månsson Lexell","doi":"10.3233/NRE-230219","DOIUrl":"10.3233/NRE-230219","url":null,"abstract":"Background: People with late effects of polio (LEoP) may need rehabilitation to manage everyday life but knowledge of the benefits of interdisciplinary rehabilitation is limited.Objective: To evaluate changes in performance and satisfaction with performance of activities among people with LEoP following interdisciplinary rehabilitation.Methods: A pre-post retrospective study based on data on 102 participants with LEoP from a rehabilitation clinic. Changes in performance and satisfaction with performance of daily activities before and after interdisciplinary rehabilitation were assessed with the Canadian Occupational Performance Measure (COPM).Results: There were statistically significant increases in the mean performance and mean satisfaction with performance COPM scores from admission to discharge. Twenty-three percent and 19% of the participants, respectively, had improved their performance and satisfaction with performance, 25% and 26% of the participants had no changes, and 19% and 22% of the participants, respectively, rated their performance and satisfaction lower at discharge compared to admission.Conclusion: Interdisciplinary rehabilitation can enhance self-rated performance and satisfaction with performance of daily activities among people with LEoP. Future studies of rehabilitation for people with LEoP should use a prospective design and capture the participants' process of change related to their rehabilitation period.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"331-342"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139672338","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}

引用次数: 0

Effect of acupuncture combined with lower limb gait rehabilitation robot on improving walking function in stroke patients with hemiplegia. 针灸结合下肢步态康复机器人对改善中风偏瘫患者行走功能的影响

IF 2 4区医学

NeuroRehabilitation Pub Date : 2024-01-01 DOI: 10.3233/NRE-230258

Chuan Hu, Xin Wang, Tongliang Pan

{"title":"Effect of acupuncture combined with lower limb gait rehabilitation robot on improving walking function in stroke patients with hemiplegia.","authors":"Chuan Hu, Xin Wang, Tongliang Pan","doi":"10.3233/NRE-230258","DOIUrl":"10.3233/NRE-230258","url":null,"abstract":"Background: No study has yet demonstrated the effect of lower limb gait rehabilitation robot treatment combined with acupuncture on stroke patients.Objective: To explore the effect of acupuncture combined with lower limb gait rehabilitation robot on walking function in patients with hemiplegia after stroke.Methods: Fifty-six patients with hemiplegia after stroke were enrolled and randomly divided into two groups. The control group received regular rehabilitation training and acupuncture therapy; the intervention group was additionally trained by AiWalker-I lower limb gait robot. Both groups received 5 sessions a week for 4 weeks. Walking function parameters were assessed before and after the 4-week treatment.Results: There was no significant difference in all parameters between the two groups in baseline (P > 0.05). After 4 weeks of treatment, all parameters including the effectiveness of functional ambulation category (FAC), time up and go test (TUGT) time, Wisconsin gait scale (WGS) score, walking spatiotemporal parameters were all significantly improved in both groups with a significant better effect in the intervention group (P < 0.05).Conclusion: Acupuncture combined with lower limb gait rehabilitation robot training has a positive effect on correction of abnormal gait and improvement of walking ability of hemiplegic patients after stroke.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"309-317"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139672339","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}

引用次数: 0

Effectiveness of repeated injections of botulinum toxin A on gait and fatigue in adults with spastic paraparesis secondary to multiple sclerosis. 反复注射 A 型肉毒毒素对继发于多发性硬化症的痉挛性截瘫成人患者的步态和疲劳的疗效。

IF 1.7 4区医学

NeuroRehabilitation Pub Date : 2024-01-01 DOI: 10.3233/NRE-240038

Aránzazu Vázquez-Doce, Laura García Delgado, María José Arriaza Gómez, María Pía Spottorno Rubio, Virginia Meca Lallana, Beatriz Del Rio Muñoz, María Asunción Bosch-Martín, Otón Vázquez Doce, Paula Ortega García, Noemí Tapiador Juan

{"title":"Effectiveness of repeated injections of botulinum toxin A on gait and fatigue in adults with spastic paraparesis secondary to multiple sclerosis.","authors":"Aránzazu Vázquez-Doce, Laura García Delgado, María José Arriaza Gómez, María Pía Spottorno Rubio, Virginia Meca Lallana, Beatriz Del Rio Muñoz, María Asunción Bosch-Martín, Otón Vázquez Doce, Paula Ortega García, Noemí Tapiador Juan","doi":"10.3233/NRE-240038","DOIUrl":"10.3233/NRE-240038","url":null,"abstract":"Background: Multiple sclerosis (MS) is the most common neurologic disease in young adults. Spasticity is one of its most disabling symptoms, with botulinum toxin A type A (BoNT-A) being one of the treatments of choice for this symptom.Objective: We assessed the response to abobotulinumtoxinA in improving walking ability and fatigue in patients with spastic paraparesis caused by MS.Methods: We performed a real-world, multicenter, prospective, open-label low-intervention trial in 84 patients with MS and spastic paraparesis of the lower limbs infiltrated with abobotulinumtoxinA (LINITOX study). The response of spasticity, walking ability and fatigue is analyzed in 4 cycles of ultrasound-guided injection in the lower limbs.Results: The patients improved their walking ability by an average of 11.34% meters measured with 6-Minute Walk Test (6MWT), and decreased the percentage of fatigue by 6.86% (4.66 percentage points less), in the 12-Item Multiple Sclerosis Walking Scale (MSWS-12) 4 weeks after abobotulinumtoxinA injection, both values are statistically significant. This improvement seems to persist over time, throughout the cycles.Conclusion: We found improved walking ability and less fatigue in patients with MS-related spastic paresis of the lower limbs after injection of abobotulinumtoxinA.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"663-675"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141321263","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}

引用次数: 0