Brain & NeuroRehabilitation最新文献

{"title":"Factors Associated With Rehabilitation Length of Stay in Patients With Traumatic Brain Injury: A Retrospective Cohort Study.","authors":"Chin-Hen Chang, Thomas Wasser, Somkiat Hemtasilpa","doi":"10.12786/bn.2025.18.e3","DOIUrl":"10.12786/bn.2025.18.e3","url":null,"abstract":"<p><p>This retrospective cohort study aimed to identify predictive factors for patients with traumatic brain injury (TBI) requiring short (≤ 14 days) or long (≥ 15 days) rehabilitation length of stays (LOSs).The study was conducted in an acute rehabilitation hospital associated with a community-based tertiary medical center. Patients who were admitted to the acute inpatient rehabilitation unit with TBI between January 2020 and September 2022 were included (n = 197). The mean rehabilitation LOS of the 197 patients was 16.73 ± 9.4 days. A long rehabilitation LOS was associated with a higher rate of urinary tract infection in the rehabilitation facility (p = 0.002), a higher rate of lung infection in the inpatient rehabilitation facility (p = 0.003), unplanned readmission to acute care (p < 0.001), a longer LOS in acute care before admission to rehabilitation (p < 0.001), and a lower Section GG score on admission to rehabilitation (p < 0.001). The logistic regression model revealed having lower Section GG scores on admission to rehabilitation as the only factor predictive of a long rehabilitation LOS (odds ratio, 0.91; p < 0.001). Our study revealed that the Section GG score at admission to inpatient rehabilitation facilities is a predictor of rehabilitation LOS.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"18 1","pages":"e3"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Virtual Reality Training on Post-Stroke Upper and Lower Limb Function: A Meta-Analysis.","authors":"Woo-Kyoung Yoo, Yongkyun Jung, Gyu Jin Kim, Shahid Bashir, Jihyun Park","doi":"10.12786/bn.2025.18.e2","DOIUrl":"10.12786/bn.2025.18.e2","url":null,"abstract":"<p><p>This meta-analysis presents an updated comparison between virtual reality (VR) training and conventional training (CT) in post-stroke rehabilitation by incorporating recent studies based on prior meta-analyses. We searched 3 international electronic databases (MEDLINE, Embase, and the Cochrane Library) and a Korean database (KoreaMed) to identify relevant studies. Out of 5,218 studies, 30 randomized controlled trials were selected through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. Among these, 21 focused on upper limb training and 14 on lower limb training. A subgroup meta-analysis was conducted based on the VR type. The risk of bias (RoB) was assessed using Cochrane's RoB tool. The certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) method. The outcomes were categorized into upper limb motor function, fine motor function, and activities of daily living (ADLs) for upper limb training, and lower limb motor function, balance, and gait velocity for lower limb training. A random-effects model for the meta-analysis indicated that VR training showed significant superiority over CT in improving upper limb motor function, ADL, and balance. This study provides low- to moderate-certainty evidence supporting the superiority of VR training over CT. Clinicians and therapists should consider individual rehabilitation needs, goals, patient preferences, and available resources when selecting VR for post-stroke functional recovery.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"18 1","pages":"e2"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serial Assessment of Gait Changes After Interventions Using Smart Insole in a Patient With iNPH: A Proof-of-Concept Case Report.","authors":"Wonhee Lee, Seung-Ick Choi, Seok Jong Chung, Jun Kyu Hwang, Na Young Kim","doi":"10.12786/bn.2025.18.e1","DOIUrl":"10.12786/bn.2025.18.e1","url":null,"abstract":"<p><p>Improvement in gait after a cerebrospinal fluid (CSF) tap test is a key indicator for shunt surgery in idiopathic normal pressure hydrocephalus (iNPH) patients. However, quantitative analysis of gait requires sophisticated equipment and specialists that limit practical use. Development of Bluetooth-connected sensors offers affordable way to assess gait. We present a case of iNPH patient in whom gait changes were serially assessed using a smart insole before and after intervention, which helped in clinical decision making. A 68-year-old female who showed the triad of iNPH symptoms (gait disturbance, cognitive decline, and urinary frequency) were evaluated. Before and after the CSF tap test, gait was analyzed and compared using the smart insole with four pressure sensors and accelerometer, along with conventional spatiotemporal parameters. While no significant changes were observed between pre- and post-tap test in conventional parameters of gait, several changes were found in the data collected from the smart insole, including improved heel strike, step regularity and symmetry. Advanced surgical intervention was performed based on subjective and objective improvement in gait. The improved gait was maintained at 3 and 6 months after surgery. Our case showed that easy-to-use smart insoles could assist clinical decisions by providing additional information.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"18 1","pages":"e1"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysphagia due to Lyme Disease: A Case Report.","authors":"Pureum Kim, Seong Hoon Lim, Jong In Lee, Ho-Geon Namgung, Donghwan Kim, Eun Ji Lee","doi":"10.12786/bn.2024.17.e25","DOIUrl":"10.12786/bn.2024.17.e25","url":null,"abstract":"<p><p>Lyme disease is a multisystem infection that can affect the joints, heart, and nervous system when untreated. While it can present with cranial nerve palsy, dysphagia is rarely reported. This case highlights a rare instance of dysphagia in Lyme disease, typically known for neurological symptoms like facial nerve palsy. Despite the absence of erythema migrans or a documented tick bite, the patient's facial palsy, hearing loss, vocal cord paralysis, and dysphagia were attributed to Lyme disease. With the rising prevalence of Lyme disease, similar cases may increase, particularly in endemic regions of North America, Europe, and parts of Asia, emphasizing the need for early diagnosis and treatment in patients with unexplained dysphagia.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"17 3","pages":"e25"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Literature Review on Optimal Stimulation Parameters of Transcranial Direct Current Stimulation for Motor Recovery After Stroke.","authors":"Soo Ho Lee, Yeun Jie Yoo","doi":"10.12786/bn.2024.17.e24","DOIUrl":"10.12786/bn.2024.17.e24","url":null,"abstract":"<p><p>Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulatory technique with potential in stroke rehabilitation by modulating cortical excitability. However, the optimal parameters, including electrode placement, current intensity, stimulation duration, and electrode size, remain poorly understood, and the interactions among these factors contribute to mixed results in motor recovery post-stroke. This review explores the various stimulation parameters and their impact on enhancing corticospinal excitability (CSE) and motor function recovery. Different electrode placement (montages), such as anodal, cathodal, and bi-hemispheric stimulation, have demonstrated varying effectiveness in restoring motor function. Bihemispheric stimulation demonstrated a larger effect size compared to other unihemispheric (anodal or cathodal) stimulation; however, its relative superiority remains inconclusive. Inter-individual anatomical variations, such as skull thickness, lesion location, and cortical atrophy, can affect tDCS outcomes, highlighting the need for personalized electrode placement guided by computational modeling based on brain imaging. Furthermore, stimulation intensity, typically 1-2 mA, exhibited nonlinear effects on CSE, contrasting with the dose-response relationships observed in earlier studies. Stimulation duration is also critical, with evidence suggesting that prolonged stimulation may reverse excitability-enhancing effects beyond a certain threshold. While smaller electrodes enhance focality, an appropriately sized electrode is necessary to effectively modulate electrical activity in the target region, with evidence suggesting a dose-response relationship between electrode size and motor recovery. Overall, the interplay among these parameters underscores the need for personalized and optimized tDCS protocols to achieve consistent motor recovery in stroke patients. Future research should focus on refining these parameters to maximize the therapeutic benefits of tDCS.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"17 3","pages":"e24"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stroke-Related Sarcopenia: Pathophysiology and Diagnostic Tools.","authors":"Jinmann Chon, Yunsoo Soh, Ga Yang Shim","doi":"10.12786/bn.2024.17.e23","DOIUrl":"10.12786/bn.2024.17.e23","url":null,"abstract":"<p><p>Sarcopenia is characterized by the progressive loss of muscle mass and strength and can be categorized as either primary or secondary. Patients who have experienced a stroke may develop sarcopenia, which can adversely impact their functional recovery. The pathophysiology of sarcopenia related to stroke involves nutritional deficiency, disuse atrophy, denervation, and metabolic disturbance. Various evaluation tools are available to diagnose this condition, assessing skeletal muscle mass, muscle strength, and physical function. However, due to the limitations of traditional sarcopenia diagnostic criteria in the context of stroke, there is pressing need to establish diagnostic standards that accurately reflect the disabilities experienced by patients with stroke.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"17 3","pages":"e23"},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Recovery in Acute and Subacute Stroke Patients With or Without Post-stroke Fatigue.","authors":"Juwon Lee, Gowun Kim","doi":"10.12786/bn.2024.17.e22","DOIUrl":"10.12786/bn.2024.17.e22","url":null,"abstract":"<p><p>This study analyzed the impact of post-stroke fatigue (PSF) on functional recovery in acute and subacute stroke patients during inpatient rehabilitation. Medical records of 177 patients were retrospectively reviewed. PSF was assessed using the Fatigue Severity Scale (FSS)-9. Patients were classified into two groups: a PSF group (mean FSS ≥ 4) and a non-PSF group (mean FSS < 4). Stroke severity was measured with the National Institutes of Health Stroke Scale, and functional outcomes were evaluated using Functional Ambulation Category (FAC), Berg Balance Test, Korean version of the Modified Barthel Index (K-MBI), and Mini-Mental State Examination-Korean version (MMSE-K). Statistical significance was set at p < 0.05. The prevalence of PSF was 52.5%. The repeated measures of analysis of variance showed significant \"time\" effects on FAC (F = 29.726, p < 0.001) and K-MBI (F = 15.348, p < 0.001). A significant \"group\" effect was observed on MMSE-K (F = 4.571, p = 0.035), and a \"time × group\" interaction on only K-MBI (F = 4.284, p = 0.041). Multivariable logistic regression analysis showed that improvements in K-MBI scores were independent of initial severity, depression, and age (p = 0.043). PSF affects the recovery of activities of daily living (ADL) in stroke patients, suggesting that regulating early fatigue after stroke positively affects functional recovery.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"17 3","pages":"e22"},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Post-Stroke Cognitive Impairment: A Narrative Review.","authors":"Seyoung Shin, Seung Mi Yeo, Byung Chan Lee, Won Hyuk Chang","doi":"10.12786/bn.2024.17.e20","DOIUrl":"10.12786/bn.2024.17.e20","url":null,"abstract":"<p><p>Post-stroke cognitive impairment (PSCI) is a common and significant disorder affecting a considerable proportion of stroke patients. PSCI is a known factor that increases the risk of mortality, dependency, and institutionalization in stroke patients. The early prediction of PSCI and the implementation of cognitive rehabilitation could enhance the quality of life of stroke patients and reduce the burden on their families. It is therefore imperative to identify risk factors for PSCIs in the early stages of stroke and to implement early cognitive rehabilitation with an appropriate prognosis. A number of risk factors for PSCI can be identified in patient characteristics, clinical findings, and imaging findings. It is unfortunate that the majority of factors associated with PSCI are non-modifiable. However, the only modifiable factor that can be controlled is the management of stroke risk factors for secondary prevention. Further research is needed to elucidate the potential benefits of various cognitive rehabilitation programs for the prevention and improvement of PSCI.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"17 3","pages":"e20"},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Constraint-Induced Movement Therapy on Arm Function and Activities of Daily Living in Post-stroke Patients: A Systematic Review and Meta-Analysis.","authors":"Hyoseon Choi, Hyun Jung Kim","doi":"10.12786/bn.2024.17.e19","DOIUrl":"10.12786/bn.2024.17.e19","url":null,"abstract":"<p><p>This meta-analysis aimed to evaluate the effect of constraint-induced movement therapy (CIMT) on arm function and daily living compared with conventional rehabilitation in stroke patients with hemiplegia. We searched three international electronic databases-MEDLINE, Embase, and the Cochrane Library-for relevant studies. The risk of bias was evaluated using Cochrane's Risk of Bias version 1.0, and the certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations method. A total of 34 randomized controlled trials (RCTs) were included herein. Specifically, 21 RCTs regarding arm motor function, 13 on upper limb motor impairment, and 12 on activities of daily living (ADL) performance were analyzed. The results of the meta-analysis demonstrated that CIMT was significantly more effective than conventional therapy in improving arm motor function, reducing upper limb motor impairment, and enhancing ADL performance. CIMT should be implemented and tailored to the strength of the affected upper limb to improve upper limb function and ADL performance in post-stroke patients with hemiplegia.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"17 3","pages":"e19"},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"I Was Diagnosed, but There Was Nothing: A Parkinson's Patient's Perspective on the Reality of Korea.","authors":"Yangtae Han","doi":"10.12786/bn.2024.17.e18","DOIUrl":"https://doi.org/10.12786/bn.2024.17.e18","url":null,"abstract":"<p><p>From the perspective of a Parkinson's patient, this paper aims to elucidate some of the unreasonable and difficult-to-understand realities in Korea, from diagnosis to treatment, with a view to improving the system and policies. Adequate procedures for furnishing information to patients following a diagnosis are lacking. To date, no websites have been established by doctors, public institutions, or the government to provide adequate information. This dearth of information creates a problematic situation that gives rise to patients receiving erroneous or misleading information, thereby wasting their time, financial resources, and ultimately, impacts their health. It is recommended that the government establish an authoritative organization to provide information about Parkinson's disease in order to prevent harm and promote non-motor and motor symptom treatments, such as psychotherapy, as demonstrated in the United States and the United Kingdom. In Korea, the Korea Parkinson Association, a nonprofit private organization, has initiated a campaign for understanding and consideration. With the support of the government and society, an environment can be created where people with Parkinson's disease can live with dignity as members of society.</p>","PeriodicalId":72442,"journal":{"name":"Brain & NeuroRehabilitation","volume":"17 3","pages":"e18"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}