NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics最新文献

ASENT Conflict of Interest statement 利益冲突声明

NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics Pub Date : 2011-01-01 DOI: 10.1007/BF03206561

A. Siderowf, R. Holloway, S. Hersch, R. Ferrante, B. Ravina, H. Widner, Marc Pechanski

引用次数: 0

Issues in Selecting Outcome Measures to Assess Functional Recovery After Stroke 选择评估脑卒中后功能恢复的结果指标的问题

NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics Pub Date : 2006-10-01 DOI: 10.1016/j.nurx.2006.07.009

Sharon Barak , Pamela W. Duncan

{"title":"Issues in Selecting Outcome Measures to Assess Functional Recovery After Stroke","authors":"Sharon Barak , Pamela W. Duncan","doi":"10.1016/j.nurx.2006.07.009","DOIUrl":"10.1016/j.nurx.2006.07.009","url":null,"abstract":"<div><p>Most patients who survive a stroke experience some degree of physical recovery. Selecting the appropriate outcome measure to assess physical recovery is a difficult task, given the heterogeneity of stroke etiology, symptoms, severity, and even recovery itself. Despite these complexities, a number of strategies can facilitate the selection of functional outcome measures in stroke clinical trial research and practice. Clinical relevance in stroke outcome measures can be optimized by incorporating a framework of health and disability, such as the International Classification of Functioning, Disability, and Health (ICF). The ICF provides the conceptual basis for measurement and policy formulations for disability and health assessment. All outcome measures selected should also have sound psychometric properties. The essential psychometric properties are reliability, validity, responsiveness, sensibility, and established minimal clinically important difference. It is also important to establish the purpose of the measurement (discriminative, predictive, or evaluative) and to determine whether the purpose of the study is to evaluate the efficacy or effectiveness of an intervention. In addition, when selecting outcome measures and time of assessment, the natural history of stroke and stroke severity must be regarded. Finally, methods for acquiring data must also be considered. We present a comprehensive overview of the issues in selecting stroke outcome measures and characterize existing measures relative to these issues.</p></div>","PeriodicalId":87195,"journal":{"name":"NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics","volume":"3 4","pages":"Pages 505-524"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nurx.2006.07.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26284323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 139

Noninvasive Brain Stimulation in Stroke Rehabilitation 脑卒中康复中的无创脑刺激

NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics Pub Date : 2006-10-01 DOI: 10.1016/j.nurx.2006.07.008

Brian R. Webster, Pablo A. Celnik, Leonardo G. Cohen

{"title":"Noninvasive Brain Stimulation in Stroke Rehabilitation","authors":"Brian R. Webster, Pablo A. Celnik, Leonardo G. Cohen","doi":"10.1016/j.nurx.2006.07.008","DOIUrl":"10.1016/j.nurx.2006.07.008","url":null,"abstract":"<div><p>Stroke is a common disorder that produces a major burden to society, largely through long-lasting motor disability in survivors. Recent studies have broadened our understanding of the processes underlying recovery of motor function after stroke. Bilateral motor regions of the brain experience substantial reorganization after stroke, including changes in the strength of interhemispheric inhibitory interactions. Our understanding of the extent to which different forms of reorganization contribute to behavioral gains in the rehabilitative process, although still limited, has led to the formulation of novel interventional strategies to regain motor function. Transcranial magnetic (TMS) and DC (tDCS) electrical stimulation are noninvasive brain stimulation techniques that modulate cortical excitability in both healthy individuals and stroke patients. These techniques can enhance the effect of training on performance of various motor tasks, including those that mimic activities of daily living. This review looks at the effects of TMS and tDCS on motor cortical function and motor performance in healthy volunteers and in patients with stroke. Both techniques can either enhance or suppress cortical excitability, and may move to the clinical arena as strategies to enhance the beneficial effects of customarily used neurorehabilitative treatments after stroke.</p></div>","PeriodicalId":87195,"journal":{"name":"NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics","volume":"3 4","pages":"Pages 474-481"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nurx.2006.07.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26284406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 153

Behavioral Tests for Preclinical Intervention Assessment 临床前干预评估的行为测试

NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics Pub Date : 2006-10-01 DOI: 10.1016/j.nurx.2006.08.001

Timothy Schallert

{"title":"Behavioral Tests for Preclinical Intervention Assessment","authors":"Timothy Schallert","doi":"10.1016/j.nurx.2006.08.001","DOIUrl":"10.1016/j.nurx.2006.08.001","url":null,"abstract":"<div><p>Select functional outcome tests commonly used for evaluating sensorimotor and cognitive capacity in rodents with focal intracerebral ischemic or hemorrhagic injury are described, along with upgrades and issues of concern for translational research. An emphasis is placed on careful quantitative and qualitative assessment of acute and long-term behavioral deficits, and on avoidance of frequent pitfalls. Methods for detecting different degrees of injury and treatment-related improvements are included. Determining the true potential of an intervention requires a set of behavioral analyses that can monitor compensatory learning. In a number of preclinical outcome tests, animals can develop remarkably effective “tricks” that are difficult to detect but frequently lead to dramatic improvements in performance, particularly with repeated practice. However, some interventions may facilitate learning without promoting brain repair, but these may not translate into a meaningful level of benefit in the clinic. Additionally, it is important to determine whether there are any preinjury functional asymmetries in order to accurately assess damage-related changes in behavior. This is illustrated by the fact that some animals have chronic endogenous asymmetries and that others, albeit infrequently, can sustain a spontaneous cerebral stroke, without any experimental induction, that can lead to chronic deficits as reflected by behavioral, imaging, and histological analyses. Finally, a useful new modification of the water maze that involves moving the platform from trial to trial within the target quadrant is reviewed, and its advantages over the standard version are discussed.</p></div>","PeriodicalId":87195,"journal":{"name":"NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics","volume":"3 4","pages":"Pages 497-504"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nurx.2006.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26284409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 231

Neurotransmitters and Motor Activity: Effects on Functional Recovery after Brain Injury 神经递质和运动活动:对脑损伤后功能恢复的影响。

NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics Pub Date : 2006-10-01 DOI: 10.1016/j.nurx.2006.07.010

Larry B. Goldstein

引用次数: 23

Growth Factors and Stroke 生长因子与中风

NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics Pub Date : 2006-10-01 DOI: 10.1016/j.nurx.2006.08.003

David A. Greenberg, Kunlin Jin

引用次数: 35

Community Neurorehabilitation: A Synthesis of Current Evidence and Future Research Directions 社区神经康复:当前证据和未来研究方向的综合

NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics Pub Date : 2006-10-01 DOI: 10.1016/j.nurx.2006.07.002

Sarah E. Chard

{"title":"Community Neurorehabilitation: A Synthesis of Current Evidence and Future Research Directions","authors":"Sarah E. Chard","doi":"10.1016/j.nurx.2006.07.002","DOIUrl":"10.1016/j.nurx.2006.07.002","url":null,"abstract":"<div><p>Over the past decade, community neurorehabilitation has emerged as a promising extension of neurological rehabilitation. The goal of community neurorehabilitation is to maximize functional ability and quality of life through multidimensional rehabilitation that occurs while the individual is living in a home <em>versus</em> acute or transitory care setting. Because of its multidisciplinary focus, many variations of community neurorehabilitation teams have been implemented. Critical gaps exist, however, in understanding of the influence of structural and procedural differences among programs, as well as patient level variables such as social support, on recovery. This paper examines the current evidence of the effectiveness of community neurorehabilitation through a review of the findings of systematic reviews and meta-analyses of four neurological conditions: stroke, multiple sclerosis, traumatic brain injury, and Parkinson’s disease. It focuses in particular on the data regarding physical therapy and occupational therapy, which are two of the primary components of community neurorehabilitation programs.</p></div>","PeriodicalId":87195,"journal":{"name":"NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics","volume":"3 4","pages":"Pages 525-534"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nurx.2006.07.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26284325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 22

Activity-Based Therapies 作业疗法

NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics Pub Date : 2006-10-01 DOI: 10.1016/j.nurx.2006.07.004

Alexander W. Dromerick , Peter S. Lum , Joseph Hidler

{"title":"Activity-Based Therapies","authors":"Alexander W. Dromerick , Peter S. Lum , Joseph Hidler","doi":"10.1016/j.nurx.2006.07.004","DOIUrl":"10.1016/j.nurx.2006.07.004","url":null,"abstract":"<div><p>Therapeutic activity is a mainstay of clinical neurorehabilitation, but is typically unstructured and directed at compensation rather than restoration of central nervous system function. Newer activity-based therapies (ABTs) are in early stages of development and testing. The ABTs attempt to restore function via standardized therapeutic activity based on principles of experimental psychology, exercise physiology, and neuroscience. Three of the best developed ABTs are constraint-induced therapy, robotic therapy directed at the hemiplegic arm, and treadmill training techniques aimed at improving gait in persons with stroke and spinal cord injury. These treatments appear effective in improving arm function and gait, but they have not yet been clearly demonstrated to be more effective than equal amounts of traditional techniques. Resistance training is clearly demonstrated to improve strength in persons with stroke and brain injury, and most studies show that it does not increase hypertonia. Clinical trials of ABTs face several methodological challenges. These challenges include defining dosage, standardizing treatment parameters across subjects and within treatment sessions, and determining what constitutes clinically significant treatment effects. The long-term goal is to develop prescriptive ABT, where specific activities are proven to treat specific motor system disorders. Activity-based therapies are not a cure, but are likely to play an important role in future treatment cocktails for stroke and spinal cord injury.</p></div>","PeriodicalId":87195,"journal":{"name":"NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics","volume":"3 4","pages":"Pages 428-438"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nurx.2006.07.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26283935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 68

Exercise Rehabilitation After Stroke 中风后的运动康复

NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics Pub Date : 2006-10-01 DOI: 10.1016/j.nurx.2006.07.011

Frederick M. Ivey , Charlene E. Hafer-Macko , Richard F. Macko

{"title":"Exercise Rehabilitation After Stroke","authors":"Frederick M. Ivey , Charlene E. Hafer-Macko , Richard F. Macko","doi":"10.1016/j.nurx.2006.07.011","DOIUrl":"10.1016/j.nurx.2006.07.011","url":null,"abstract":"<div><p>Stroke is a leading cause of disability that results not only in persistent neurological deficits, but also profound physical deconditioning that propagates disability and worsens cardiovascular risk. The potential for exercise-mediated adaptations to improve function, fitness, and cardiovascular health after stroke has been underestimated: it represents an emerging arena in neurotherapeutics. To define the health rationale for cardiovascular (aerobic) exercise, we first outline the impact of debilitating secondary biological changes in muscle and body composition on fitness and metabolic health after stroke. We provide an overview of evidence-based advances in exercise therapeutics, with a focus on task-oriented models that combine a progressive aerobic conditioning stimulus with motor learning to improve multiple physiological domains that determine longitudinal outcomes after stroke. Although progress in development of safe and effective exercise strategies is advancing, fundamental questions regarding dose intensity, prescription to optimize central and peripheral neuromuscular adaptations, and the public health value of exercise in secondary stroke prevention remain unanswered. Key issues steering future research in exercise neurotherapeutics are discussed within the context of initiatives to facilitate translation to community-based studies, requisite for dissemination.</p></div>","PeriodicalId":87195,"journal":{"name":"NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics","volume":"3 4","pages":"Pages 439-450"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nurx.2006.07.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26284402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 121

Imaging Motor Recovery After Stroke 脑卒中后运动恢复成像

NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics Pub Date : 2006-10-01 DOI: 10.1016/j.nurx.2006.07.003

Nuray Yozbatiran , Steven C. Cramer

引用次数: 19