NeuroRehabilitation最新文献

{"title":"Effects of 3 Cycles of Increasing Botulinum Toxin Doses on Functional Parameters of Post-stroke Spastic Gait: A Prospective Cohort Study.","authors":"Clara Selves, Stéphanie Dehem, Thierry Lejeune, Thierry Deltombe, Gaëtan Stoquart","doi":"10.1177/10538135241303343","DOIUrl":"10.1177/10538135241303343","url":null,"abstract":"<p><p>BackgroundSingle botulinum toxin type A (BT-A) injections reduce spasticity, but the effects of repeated injections on walking activities remain unclear.ObjectivesTo demonstrate cumulative effectiveness of progressively higher doses of BT-A on walking activities (primary outcome) and spasticity reduction.Methods32 individuals with lower-limb spasticity impairing gait post-stroke were included in this prospective cohort study. Participants received 3 injections of increasing doses of Inco BT-A (400-600-800 U) in both upper and lower limbs and were followed for 7 months. Activity evaluations included the 10 MWT, 6MWT, TUG, and a timed stairs test (TST). Spasticity was assessed using the Modified Ashworth (MAS) and Modified Tardieu (MTS) scales.ResultsActivities remained stable after the 1st injection but improved after the 2nd and 3rd cycles on the 6MWT (+0.07 and +0.12 m/s, respectively, p < 0.05) and TST (-13.7 s and -14.8 s, respectively, p < 0.05). Spasticity significantly reduced after each injection cycle, with greater reductions after the 2nd and 3rd cycles.ConclusionsRepeated, progressively higher doses of Inco BT-A in lower-limb spasticity post-stroke improved walking activities and reduced spasticity, more so after successive cycles and higher doses. This could suggest cumulative effects, better effects due to higher doses, or both. This supports the use of progressively higher doses to thoroughly treat spasticity patterns.clinicaltrials.gov : NCT04544280.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"175-185"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710733","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":"Determining Predictors of Self-reported Adherence to Rehabilitation Home Programs for Persons with Acquired Brain Injury: A Prospective Observational Study.","authors":"Elena V Donoso Brown, Sarah E Wallace, Seth E Tichenor, Rebecca Blemler, Brooke Foundas","doi":"10.1177/10538135241296736","DOIUrl":"https://doi.org/10.1177/10538135241296736","url":null,"abstract":"<p><p>BackgroundPersons with acquired brain injury are often prescribed home programs to extend rehabilitation services and support recovery, however adherence to these recommendations is often low.ObjectiveThe purpose of this study was to determine factors that predict differing levels of self-reported adherence.MethodsThis was a prospective observational study that was completed from June 2022 to December 2023. We recruited persons with acquired brain injury who met specific inclusion and exclusion criteria. Before leaving the inpatient rehabilitation hospital, they completed a medical history form, home program description interview, and a modified version of the Self-Efficacy for Exercise Scale. Then, participants completed a weekly survey regarding self-reported home program adherence. At the end of six months, the participants did a closing interview.ResultsSeventy-seven participants completed the intake procedures and at least one weekly survey. Several models were developed to determine predictive factors. Higher self-efficacy, fewer reported barriers, and the perception of social support were all predictors of self-reported home program adherence.ConclusionThe predictors identified here can be leveraged by therapists to determine the need for additional support or intervention around home program adherence.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"56 2","pages":"132-142"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986038","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":"How Game Features and Treatment-Related Factors Facilitate Generalization in Technology-Based Aphasia Rehabilitation: A Systematic Review.","authors":"Georgii Gorshkov, Olga Buivolova, Elena Gavrilova, Olga Dragoy","doi":"10.1177/10538135241296737","DOIUrl":"10.1177/10538135241296737","url":null,"abstract":"<p><p>BackgroundNowadays, developers offer mobile applications for aphasia treatment. Although their overall effectiveness and acceptance by the target audience was proved, it has not been established what aspects of technology-based aphasia rehabilitation facilitate these improvements and translate into generalization.ObjectiveThe objectives were to analyze what technology- and treatment-related factors, including treatment dose, intensity and duration, affect treatment efficacy and facilitate generalization.MethodsThe PubMed and ScienceDirect databases were searched in February 2024. The review included experimental articles testing mobile- or computer-based applications for aphasia rehabilitation. Studies were excluded if they described AAC techniques or assistive tools, or focused solely on quality of life. ROB-2 was used to assess risk of bias in the included randomized controlled trials.ResultsEighteen articles meeting the inclusion criteria were analyzed. The key factors increasing the therapy effect and leading to generalization were automatic feedback, diversity of the tasks employed in the training, longer periods of treatment, and interaction between the user and the clinician.ConclusionsTechnology-based aphasia treatment is an effective therapy tool. Contact with the clinician, simultaneous practice targeted at various language domains and executive functions, as well as feedback, positively influence outcomes. The review, however, has limitations, as it lacks statistical analysis and synthesizes heterogeneous data.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"56 2","pages":"113-131"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004806","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":"Qualitative Analysis of Symptoms from the Central Thalamic Deep Brain Stimulation Trial for Traumatic Brain Injury.","authors":"Linda M Gerber, Kaiulani S Shulman, Megan S Wright, Nicholas D Schiff, Joseph J Fins","doi":"10.1177/10538135241296732","DOIUrl":"https://doi.org/10.1177/10538135241296732","url":null,"abstract":"<p><p>BackgroundStudies of moderate-to-severe traumatic brain injury (TBI) report persistent clinical impairment post-injury. In the CENTURY-S study of deep brain stimulation (DBS) in chronic TBI, Schiff et al.'s paper, \"Thalamic deep brain stimulation in traumatic brain injury: a phase 1, randomized feasibility study\" demonstrated improvements in executive control. A companion narrative analysis by Fins et al., \"Subject and Family Perspectives from the Central Thalamic Deep Brain Stimulation Trial for Traumatic Brain Injury\" Parts I and II described improvements in cognitive, behavioral, and emotional capabilities.ObjectiveThe present study provides an aggregate symptom assessment utilizing pre- and post-DBS narratives from subjects and their family members.MethodsDrawing upon participants from the CENTURY-S study, Fins et al. conducted semi-structured interviews with five subjects with moderate-to-severe TBI and their family members. Transcripts were subsequently coded deductively and inductively in Dedoose by two independent investigators.ResultsSubjects and families frequently volunteered memory and cognitive symptoms as well as difficulties with self-regulation, frustration, and irritability pre-DBS. Following stimulation, four subjects and four families noted improvement in memory and attention and focus, while three subjects and five families volunteered improvements in self-regulation. Fatigue improved in three subjects who previously reported this symptom and in one who did not.ConclusionsSecondary qualitative analysis of narrative data of DBS trial participants supports the incorporation of qualitative data as additional outcome measures in studies of DBS in TBI.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"56 2","pages":"143-151"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004865","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":"Based on fNIRS Technology: The Effects of Scalp Acupuncture Combined with iTBS on Cognitive Function After Stroke.","authors":"Lida Zhong, Jinning Luo, Xiancong Ma, Jiayan Yan, Qiong Tang, Xiao Bao, Shouhuang Lan","doi":"10.1177/10538135241303348","DOIUrl":"https://doi.org/10.1177/10538135241303348","url":null,"abstract":"<p><p>BackgroundStroke is recognized as the second primary cause of mortality and disability worldwide. Cognitive dysfunction often remains a residual issue post-stroke.ObjectiveTo explore the impact of integrating scalp acupuncture with iTBS therapy on cognitive impairments post-stroke.MethodsThis study was a randomized, controlled, single-blind trial. Fifty-four patients completed the study and were allocated into the SA group, iTBS group, and combined group using a random number table method. The SA group received scalp acupuncture treatment for 4 weeks, the iTBS group underwent intermittent theta burst stimulation for 4 weeks, and the combined group received both scalp acupuncture and iTBS treatments for 4 weeks. All enrolled patients also received standard pharmacological and conventional rehabilitation treatments, six days a week, for four weeks in total. Cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) before treatment (baseline) and after treatment (4 weeks). Additionally, changes in cerebral hemodynamics during the experiment were measured using functional near-infrared spectroscopy (fNIRS).ResultsScalp acupuncture therapy, iTBS therapy, and the combination of scalp acupuncture with iTBS therapy all significantly activated the cortical regions of the frontal and temporal lobes in patients with Post-Stroke Cognitive Impairment No Dementia (PSCIND) (<i>P </i>< 0.05). Compared to scalp acupuncture or iTBS therapy alone, the combined therapy activated more channels, with more significant activation in the right Superior Temporal Cortex (r-STC), right Ventrolateral Prefrontal Cortex (r-VLPFC), Medial Prefrontal Cortex (mPFC), left Ventrolateral Prefrontal Cortex (l-VLPFC), right Superior Frontal Cortex (r-SFC), and left Dorsolateral Prefrontal Cortex (l-DLPFC) (<i>P </i>< 0.05). The combined therapy enhances cognitive functions in PSCIND patients, exhibiting superior clinical effectiveness compared to either scalp acupuncture or iTBS therapy when used individually (<i>P </i>< 0.05).ConclusionThe combination of scalp acupuncture with iTBS therapy represents a novel and promising neurorehabilitation treatment technique for post-stroke cognitive impairment. Future clinical research is needed to explore its therapeutic mechanisms and further refine this technique.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"56 2","pages":"152-163"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064321","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":"Improving Gait Ability and Cognition Function through Action Observation Training in Elderly with Dementia.","authors":"Cheol Jin Kang, Se-Hee Park, Sung-Min Son","doi":"10.1177/10538135241296772","DOIUrl":"https://doi.org/10.1177/10538135241296772","url":null,"abstract":"<p><p>BackgroundDementia is one of the most prevalent conditions among older adults.ObjectiveThis study aimed to investigate the effect of action observation training (AOT) on gait ability and cognition in older individuals with dementia.MethodsA total of 36 participants were randomly assigned to the experimental (n=18) or control (n=18) group. The 5-week intervention involved 45-min sessions. The participants engaged in general group exercises for 30 min. The experimental group watched a training video for 5 min, while the control group watched a scenic video. Subsequently, both groups underwent functional training for 10 min. All participants were assessed using a gait analyzer (G-walk), Dynamic Gait Index (DGI), timed up and go (TUG) test, and the Korean version of the Montreal Cognitive Assessment (MoCA-K) before and after the intervention.ResultsThe two groups showed significant within-group changes in gait velocity, cadence, stride length, DGI, and MoCA-K scores (p<0.05). However, the TUG test showed a significant differences only in the experimental group (p<0.05). A significant difference was observed between the experimental and control groups regarding the changes in gait velocity, cadence, DGI, TUG test, and MoCA-K score after the intervention (p<0.05).ConclusionsThe study suggest that AOT is effective in improving the gait and cognitive abilities of older individuals with dementia.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"56 2","pages":"234-242"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031344","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 Effect of Intermittent Theta Burst Stimulation for Post-Stroke Lower Limb Motor Recovery: A Systematic Review and Meta-Analysis.","authors":"Xinyi Su, Beisi Zheng, Haiping Huang, Shishi Chen, Manting Cao, Jianer Chen","doi":"10.1177/10538135241304991","DOIUrl":"10.1177/10538135241304991","url":null,"abstract":"<p><p>BackgroundIntermittent theta burst stimulation (iTBS) appears to be a potential intervention for enhancing motor recovery in post-stroke. However, the optimal parameters of iTBS protocol for lower limb dysfunction is ambiguous.ObjectiveTo evaluate the efficacy of iTBS in treating lower limb motor impairment after stroke and to explore the optimal stimulation parameters.MethodsRelevant randomized controlled trials (RCTs) were retrieved from seven databases from their inception to May 2024. We defined primary outcomes as Fugl-Meyer Assessment for Lower Extremity (FMA-LE) and Berg Balance Scale (BBS). Subgroup analyses included stroke stage, stimulation sites, dosages and treatment sessions.ResultsThe study results indicated that compared with the sham iTBS group, the iTBS group showed a significant improvement in lower limb motor recovery, balance, gait and activity of daily living (ADL). No significant effect was found in the Motor Evoked Potential amplitude. Subgroup analysis demonstrated that cerebellar iTBS had a therapeutic effect on subacute stroke patients. Furthermore, administrating 1200 pulses per session for a minimum of 15 sessions of iTBS intervention could significantly improve the balance and ADL performance.ConclusioniTBS could enhance lower limb motor function, improving the quality of life in subacute stroke patients with relatively high safety.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"56 2","pages":"219-233"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019267","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":"Video-Based Directly Observed Therapy (ViDOT) as a Strategic Tool to Improve Medication Adherence in Epilepsy: A Narrative Review.","authors":"Paul Olowoyo, Olabode Oguntiloye, Luqman Ogunjimi, Olaleye Adeniji, Segun Atolani, Olumuyiwa Ariyo, Mayowa Owolabi","doi":"10.3233/NRE-240080","DOIUrl":"10.3233/NRE-240080","url":null,"abstract":"<p><p>BackgroundThe prevalence of epilepsy is highest in the Central Africa subregion most especially in rural settlements. This is further compounded by a high prevalence of treatment gap, from poor drug adherence, and poor road network. One approach to overcoming this burden is to leverage Video-based Directly Observed Therapy (ViDOT) use for stable patients living with epilepsy, harnessing the advancement in mHealth technologies, and widespread adoption of smartphones. ViDOT is a form of telemedicine that is a smartphone-based, treatment approach for monitoring and evaluating remote patients.ObjectiveWe performed a narrative review of the existing literature using electronic databases from PubMed and Google Scholar to identify relevant publications related to ViDOT and chronic diseases, in particular epilepsy.MethodsThe selected articles were assessed for relevance, and key findings were synthesized to provide an overview of the role of ViDOT in addressing the challenges of drug adherence in epilepsy.ResultsThe review shows that poor drug adherence is a major risk for poor outcomes in patients living with epilepsy. ViDOT has the potential to significantly contribute to improved drug adherence in patients living with epilepsy. Other benefits of ViDOT include the elimination of prolonged waiting times, improvement in access to specialized care, eradication of self-induced stigma and discrimination, diminishing neurologists' workload, and cost-effectiveness. Challenges include poor network coverage and unstable internet service.ConclusionGiving a brief psychoeducation about epilepsy, anti-epileptic drug (AED) side effects, and the importance of sticking with the recommended drug use can improve AED adherence and epilepsy outcomes. Information dissemination through ViDOT to people with epilepsy and their caregivers at large is important to promote a healthy life.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":" ","pages":"72-77"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036558","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":"Improving Access to Care of People Living with Neurological Disorders Through Teleneurorehabilitation.","authors":"Paul Olowoyo, Mayowa Owolabi","doi":"10.1177/10538135241303602","DOIUrl":"https://doi.org/10.1177/10538135241303602","url":null,"abstract":"","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"56 1","pages":"3-4"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780607","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":"Which Prognostic Models Best Predict Clinical Disease Progression, Worsening, and Activity in People with Multiple Sclerosis? A Cochrane Review Summary with Commentary.","authors":"Bhasker Amatya, Fary Khan","doi":"10.1177/10538135241303581","DOIUrl":"10.1177/10538135241303581","url":null,"abstract":"<p><p>BackgroundPrognostic models have the potential to support people with Multiple Sclerosis (pwMS) and clinicians in treatment decision-making, enable stratified and precise interpretation of interventional trials, and offer insights into disease mechanisms. Despite many researchers being involved in developing these models to predict clinical outcomes in multiple sclerosis (MS), no widely accepted prognostic model is currently used in clinical practice.ObjectiveCommentary on the review by Reeve et al. (2023) to identify and summarise multivariable prognostic models, and their validation studies for quantifying the risk of clinical disease progression, worsening, and activity in pwMS.MethodsThis review included studies evaluating statistically developed multivariable prognostic models aiming to predict clinical disease progression, worsening, and activity, as measured by disability, relapse, conversion to definite MS, conversion to progressive MS, or a composite of these in adult individuals with MS.ResultsThe review included 57 studies, comprising 75 model developments, 15 external validations, and six author-reported validations. Only two models were validated multiple times externally, and none by independent researchers. The outcomes evaluated included disease progression (41%), relapses (8%), conversion to definite MS (18%), and conversion to progressive MS (28%). All models required specialist skills, 59% needed specialized equipment, and 52% lacked sufficient details for application or independent validation. Reporting quality was poor, and most models had a high risk of bias. The findings suggest increases in the number of participants on treatment, diverse diagnostic criteria, the use of biomarkers, and machine learning over time.ConclusionsDespite the development of many prognostic prediction models in pwMS, current evidence is insufficient to recommend any of these models for clinical use due to the high risk of bias, poor reporting, and lack of independent validation. The review's findings necessitate a cautious approach to integrating existing MS prognostic models into rehabilitation practice.</p>","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"56 1","pages":"78-80"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780609","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}