Zeitschriftenartikel: „Early neurorehabilitation“

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Badogina, L. P., O. Yu Obolonskaya, V. A. Kondratiev und M. V. Shirikina. „Justification of early neurorehabilitation in neonates“. CHILD`S HEALTH 12, Nr. 7 (19.12.2017): 827–31. http://dx.doi.org/10.22141/2224-0551.12.7.2017.116189.

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Koleva, Y., und R. Yoshinov. „Early cerebroprotection accelerates neurorehabilitation in patients with post stroke hemiparesis“. Annals of Physical and Rehabilitation Medicine 54 (Oktober 2011): e144-e145. http://dx.doi.org/10.1016/j.rehab.2011.07.602.

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Muratova, T., D. Khramtsov, O. Stoyanov, E. Andryushchenko und S. Kotov. „Early Incremental Mobilization in the Practice of Neurorehabilitation of Ischemic Stroke“. Ukraïnsʹkij žurnal medicini, bìologìï ta sportu 5, Nr. 1 (17.01.2020): 149–55. http://dx.doi.org/10.26693/jmbs05.01.149.

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Khramtsov, Denys N., Olexandr N. Stoyanov, Tetiana N. Muratova und Olexandr R. Pulyk. „Neurorehabilitation in the Early Recovery Period of Ischemic Stroke. Pharmacology Support“. Acta Balneologica 63, Nr. 1 (2021): 22–25. http://dx.doi.org/10.36740/abal202101103.

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Aim: The aim of the study was to evaluate the clinical outcome in the use of neuroprotective agents in the acute period of ischemic stroke. Material and Methods: The study was performed on the basis of the stroke of the Center for Reconstructive and Rehabilitation Medicine (University Clinic) of the Odessa National Medical University. A retrospective analysis of clinical outcomes of 115 patients with acute stroke was conducted. Results: An average NIHSS score at discharge was 4.1±0.1 points when treated with no refinery, then it reached 3.6±0.1 points when using peptidergic drugs, and 3.4±0.1 when using D-fdf. 3.1±0.1 points. When using D-FDF, the MMSE score was 3.5±0.1 points, whereas when using cholinergic agents, this index did not exceed 26.9±1.5 points, and when using peptidergic agents - 26.8±1.4 points. Conclusion: The use of neuroprotective agents positively affects the effectiveness of neuro-rehabilitation in patients with acute stroke. The best results in three months after the hospitalization were obtained for peptidergic agents and D-fructose-1,6-diphosphate.

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Tsay, Jonathan S., und Carolee J. Winstein. „Five Features to Look for in Early-Phase Clinical Intervention Studies“. Neurorehabilitation and Neural Repair 35, Nr. 1 (26.11.2020): 3–9. http://dx.doi.org/10.1177/1545968320975439.

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Neurorehabilitation relies on core principles of neuroplasticity to activate and engage latent neural connections, promote detour circuits, and reverse impairments. Clinical interventions incorporating these principles have been shown to promote recovery and demote compensation. However, many clinicians struggle to find interventions centered on these principles in our nascent, rapidly growing body of literature. Not to mention the immense pressure from regulatory bodies and organizational balance sheets that further discourage time-intensive recovery-promoting interventions, incentivizing clinicians to prioritize practical constraints over sound clinical decision making. Modern neurorehabilitation practices that result from these pressures favor strategies that encourage compensation over those that promote recovery. To narrow the gap between the busy clinician and the cutting-edge motor recovery literature, we distilled 5 features found in early-phase clinical intervention studies—ones that value the more enduring biological recovery processes over the more immediate compensatory remedies. Filtering emerging literature through this lens and routinely integrating promising research into daily practice can break down practical barriers for effective clinical translation and ultimately promote durable long-term outcomes. This perspective is meant to serve a new generation of mechanistically minded and caring clinicians, students, activists, and research trainees, who are poised to not only advance rehabilitation science, but also erect evidence-based policy changes to accelerate recovery-based stroke care.

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Siepen, Bernhard M., Stephan Grubwinkler, Andrea Wagner, Christine Gruber, Alexander Dickopf, Ralf A. Linker, Felix Schlachetzki und Dobri Baldaranov. „Neuromonitoring Using Neurosonography and Pupillometry in A Weaning and Early Neurorehabilitation Unit“. Journal of Neuroimaging 30, Nr. 5 (27.06.2020): 631–39. http://dx.doi.org/10.1111/jon.12742.

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Luther, Marianne S., Carmen Krewer, Friedemann Müller und Eberhard Koenig. „Orthostatic circulatory disorders in early neurorehabilitation: A case report and management overview“. Brain Injury 21, Nr. 7 (Januar 2007): 763–67. http://dx.doi.org/10.1080/02699050701481639.

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Kesselring, Jürg. „Neurorehabilitation in Multiple Sclerosis – Resilience in Practice“. European Neurological Review 12, Nr. 01 (2017): 31. http://dx.doi.org/10.17925/enr.2017.12.01.31.

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In recent years, enormous strides have been made in increasing the range and efficacy of disease-modifying drugs available for the treatment of multiple sclerosis (MS) in its early and remitting stages, and more continue to emerge. Another equally important concept of successful treatment of MS is neurorehabilitation, which must be pursued alongside these medications. Key factors that contribute to the impact of neurorehabilitation include resilience and neuroplasticity. In the former, components such as nutrition, self-belief and physical activity provide a stronger response to the disease and improved responses to treatment. Neuroplasticity is the capacity of the brain to establish new neuronal networks after lesion damage has occurred and distant brain regions assume control of lost functions. In MS, it is vital that each patient is treated by a coordinated multidisciplinary team. This enables all aspects of the disease including problems with mobility, gait, bladder/bowel disturbances, fatigue and depression to be effectively treated. It is also important that the treating team adopts current best practice and provides internationally agreed standards of care. A further vital aspect of MS management is patient engagement, in which individuals are fully involved and are encouraged to strive and put effort into meeting treatment goals. In this approach, healthcare providers become motivators and patients need less intervention and consume fewer resources. Numerous interventions that promote neurorehabilitation are available, though evidence to support their use is limited by a lack of data from large randomised controlled trials. Combining interventions that promote neurorehabilitation with newer, more effective treatments creates a promising potential to substantially improve the outlook for patients at all stages of MS.

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Skirtach, Irina, und Evgenia Pokul. „The problem of recovery of the patients with cerebrovascular accident (CVA): the capabilities of psychological techniques in the improvement of cognitive functions“. E3S Web of Conferences 210 (2020): 17003. http://dx.doi.org/10.1051/e3sconf/202021017003.

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If the appropriate combined measures are not taken to treat the manifestations of cognitive disorders, they have a tendency to progress towards worsening over time in the patients with CVA. The most common cognitive dysfunctions are as follows: disorders of attention, thinking, memory and executive functions. More and more studies are focused on the application of the various methods and techniques for neurorehabilitation of these disorders. Evaluation of the effect of adding the neurorehabilitation techniques in the treatment program in the early recovery period was a part of the objectives of this study. The sample consisted of 70 people with CVA. The study was carried out in the hospital environment. During 10 days, the standard scheme of the drug treatment was supplemented with the neurorehabilitation method using the "Brain jogging" technique and group work techniques in the experimental group. A battery of the psychodiagnostic tests was used, which included the "MMSE Scale" test, Pieron-Ruser test, Ebbinghaus test, and "10-word memorization" technique (according to A.R. Luria). Based on the study results, the features of the dynamics of recovery in the patients with CVA of indicators of cognitive functions are described due to the inclusion of psycho-gymnastic techniques in the rehabilitation program.

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Rauen, Katrin, Judith Schaffrath, Cauchy Pradhan, Roman Schniepp und Klaus Jahn. „Accelerometric Trunk Sensors to Detect Changes of Body Positions in Immobile Patients“. Sensors 18, Nr. 10 (28.09.2018): 3272. http://dx.doi.org/10.3390/s18103272.

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Mobilization, verticalization and position change are mandatory for severely affected neurological patients in early neurorehabilitation in order to improve neurological status and prevent complications. However, with the exception of hospitals and rehabilitation facilities, this activity is not usually monitored and so far the automated monitoring of position changes in immobile patients has not been investigated. Therefore, we investigated whether accelerometers on the upper trunk could reliably detect body position changes in immobile patients. Thirty immobile patients in early neurorehabilitation (Barthel Index ≤ 30) were enrolled. Two tri-axial accelerometers were placed on the upper trunk and on the thigh. Information on the position and position changes of the subject were derived from accelerometer data and compared to standard written documentation in the hospital over 24 h. Frequency and duration of different body positions (supine, sidelying, sitting) were measured. Data are presented as mean ± SEM. Groups were compared using one-way ANOVA or Kruskal-Wallis-test. Differences were considered significant if p < 0.05. Trunk sensors detected 100% and thigh sensors 66% of position changes (p = 0.0004) compared to standard care documentation. Furthermore, trunk recording also detected additional spontaneous body position changes that were not documented in standard care (81.8 ± 4.4% of all position changes were documented in standard care documentation) (p < 0.0001). We found that accelerometric trunk sensors are suitable for recording position changes and mobilization of severely affected patients. Our findings suggest that using accelerometers for care documentation is useful for monitoring position changes and mobilization frequencies in and outside of hospital for severely affected neurological patients. Accelerometric sensors may be valuable in monitoring continuation of care plans after intensive neurorehabilitation.

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Alves-Pinto, Ana, Varvara Turova, Tobias Blumenstein und Renée Lampe. „The Case for Musical Instrument Training in Cerebral Palsy for Neurorehabilitation“. Neural Plasticity 2016 (2016): 1–9. http://dx.doi.org/10.1155/2016/1072301.

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Recent imaging studies in cerebral palsy (CP) have described several brain structural changes, functional alterations, and neuroplastic processes that take place after brain injury during early development. These changes affect motor pathways as well as sensorimotor networks. Several of these changes correlate with behavioral measures of motor and sensory disability. It is now widely acknowledged that management of sensory deficits is relevant for rehabilitation in CP. Playing a musical instrument demands the coordination of hand movements with integrated auditory, visual, and tactile feedback, in a process that recruits multiple brain regions. These multiple demands during instrument playing, together with the entertaining character of music, have led to the development and investigation of music-supported therapies, especially for rehabilitation with motor disorders resulting from brain damage. We review scientific evidence that supports the use of musical instrument playing for rehabilitation in CP. We propose that active musical instrument playing may be an efficient means for triggering neuroplastic processes necessary for the development of sensorimotor skills in patients with early brain damage. We encourage experimental research on neuroplasticity and on its impact on the physical and personal development of individuals with CP.

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Patel, Ferzeen Khushroo, Wilson J. Chang, Candice Johnson und Micah Price. „Early Neurorehabilitation Psychology Intervention Results in Reduction of Length of Stay after Acute TBI“. Archives of Physical Medicine and Rehabilitation 96, Nr. 10 (Oktober 2015): e23-e24. http://dx.doi.org/10.1016/j.apmr.2015.08.073.

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Pyatin, V., N. Romanchuk, P. Romanchuk und A. Volobuev. „Brain, Eyes, Light: Biological Electrical Magnetism of Light and Neurorehabilitation of Cognitive Impairment“. Bulletin of Science and Practice 5, Nr. 12 (15.12.2019): 129–55. http://dx.doi.org/10.33619/2414-2948/49/14.

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Biological electrical magnetism of light and neural networks of the brain is the adaptation and optimization of external and internal lighting conditions (type, nature, duration) to improve the cognitive brain. Homo sapiens brain operates in a 24-hour biological electrical magnetic environment. Light is the strongest synchronizing signal for the circadian system, and therefore keeps most biological and psychological rhythms internally synchronized, which is important for the optimal functioning of H. sapiens brain. Circadian Sleep–Wake disorders and chronic circadian misalignment, often seen in psychiatric and neurodegenerative diseases, may be effective in neurorehabilitation of cognitive impairment. Beneficial effects on circadian synchronization, sleep quality, mood and cognitive performance-depend on the time, intensity and spectral composition of light exposure. Multidisciplinary and multimodal interaction in the triad “brain–eyes–vessels” allows to identify early biomarkers of both General accelerated and pathological aging, and timely diagnose neurodegeneration, and conduct effective neurorehabilitation of cognitive disorders. Control and treatment of vascular risk factors and endocrine disorders can reduce the prevalence of long-term disability among the elderly population. Combined and hybrid methods of neuroimaging in conjunction with artificial intelligence technologies, allow to understand and diagnose neurological disorders and find new methods of neurorehabilitation and medical and social support that will lead to improved mental health. To restore circadian neuroplasticity of the brain, a multimodal scheme is proposed: circadian glasses, functional nutrition and physical activity. A combined and hybrid cluster in the diagnosis, treatment, prevention and rehabilitation of cognitive disorders and cognitive disorders has been developed and implemented.

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Braun, Robynne G., und George F. Wittenberg. „Motor Recovery: How Rehabilitation Techniques and Technologies Can Enhance Recovery and Neuroplasticity“. Seminars in Neurology 41, Nr. 02 (04.03.2021): 167–76. http://dx.doi.org/10.1055/s-0041-1725138.

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AbstractThere are now a large number of technological and methodological approaches to the rehabilitation of motor function after stroke. It is important to employ these approaches in a manner that is tailored to specific patient impairments and desired functional outcomes, while avoiding the hype of overly broad or unsubstantiated claims for efficacy. Here we review the evidence for poststroke plasticity, including therapy-related plasticity and functional imaging data. Early demonstrations of remapping in somatomotor and somatosensory representations have been succeeded by findings of white matter plasticity and a focus on activity-dependent changes in neuronal properties and connections. The methods employed in neurorehabilitation have their roots in early understanding of neuronal circuitry and plasticity, and therapies involving large numbers of repetitions, such as robotic therapy and constraint-induced movement therapy (CIMT), change measurable nervous systems properties. Other methods that involve stimulation of brain and peripheral excitable structures have the potential to harness neuroplastic mechanisms, but remain experimental. Gaps in our understanding of the neural substrates targeted by neurorehabilitation technology and techniques remain, preventing their prescriptive application in individual patients as well as their general refinement. However, with ongoing research—facilitated in part by technologies that can capture quantitative information about motor performance—this gap is narrowing. These research approaches can improve efforts to attain the shared goal of better functional recovery after stroke.

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Yan, Hua, und Canjun Yang. „Design and validation of a lower limb exoskeleton employing the recumbent cycling modality for post-stroke rehabilitation“. Proceedings of the Institution of Mechanical Engineers, Part C: Journal of Mechanical Engineering Science 228, Nr. 18 (20.03.2014): 3517–25. http://dx.doi.org/10.1177/0954406214527578.

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This paper presents the design and validation of a lower limb exoskeleton robot for post-stroke patients at the early stage of neurorehabilitation. Instead of the usual walking gait, the popular exercise, recumbent cycling, is adopted to provide a safe and comfortable movement training to the patients who lost active motor abilities due to a very low muscle power. The exoskeleton robot mounted on a commercial wheelchair possesses two pairs of hip and knee joints on the right and left legs, respectively, and each joint has one degree of freedom actuated by a custom-made linear actuator in the sagittal plane. Additionally, two passive ankle joints are added to provide a limited range of motion for human comfort. The hip and knee joint motion profiles were calculated based on a simplified kinematic model of the recumbent cycling modality, and implemented through the motor position–velocity–time trajectory. Clinical trials were conducted on six stable post-stroke patients with a low muscle power under the supervision of a skilled therapist. The preliminary results validated the functionality and feasibility of the new exoskeleton robot and showed a promising application of the recumbent cycling modality in robot-assisted neurorehabilitation.

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Lebedev, Mikhail A., und Miguel A. L. Nicolelis. „Brain-Machine Interfaces: From Basic Science to Neuroprostheses and Neurorehabilitation“. Physiological Reviews 97, Nr. 2 (April 2017): 767–837. http://dx.doi.org/10.1152/physrev.00027.2016.

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Brain-machine interfaces (BMIs) combine methods, approaches, and concepts derived from neurophysiology, computer science, and engineering in an effort to establish real-time bidirectional links between living brains and artificial actuators. Although theoretical propositions and some proof of concept experiments on directly linking the brains with machines date back to the early 1960s, BMI research only took off in earnest at the end of the 1990s, when this approach became intimately linked to new neurophysiological methods for sampling large-scale brain activity. The classic goals of BMIs are 1) to unveil and utilize principles of operation and plastic properties of the distributed and dynamic circuits of the brain and 2) to create new therapies to restore mobility and sensations to severely disabled patients. Over the past decade, a wide range of BMI applications have emerged, which considerably expanded these original goals. BMI studies have shown neural control over the movements of robotic and virtual actuators that enact both upper and lower limb functions. Furthermore, BMIs have also incorporated ways to deliver sensory feedback, generated from external actuators, back to the brain. BMI research has been at the forefront of many neurophysiological discoveries, including the demonstration that, through continuous use, artificial tools can be assimilated by the primate brain's body schema. Work on BMIs has also led to the introduction of novel neurorehabilitation strategies. As a result of these efforts, long-term continuous BMI use has been recently implicated with the induction of partial neurological recovery in spinal cord injury patients.

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Pignat, Jean-Michel, Jane Jöhr und Karin Diserens. „From disorders of consciousness to early neurorehabilitation using assistive technologies in patients with severe brain damage“. Current Opinion in Neurology 28, Nr. 6 (Dezember 2015): 587–94. http://dx.doi.org/10.1097/wco.0000000000000264.

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Bennett. „Increasing collaboration within a multidisciplinary neurorehabilitation team: the early stages of a small action research project“. Journal of Clinical Nursing 7, Nr. 3 (Mai 1998): 227–31. http://dx.doi.org/10.1046/j.1365-2702.1998.00160.x.

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Yatsugi, Aya, Takashi Morishita, Hiroyuki Fukuda, Naoya Kotani, Kenji Yagi, Hiroshi Abe, Etsuji Shiota und Tooru Inoue. „Feasibility of Neurorehabilitation Using a Hybrid Assistive Limb for Patients Who Underwent Spine Surgery“. Applied Bionics and Biomechanics 2018 (10.07.2018): 1–11. http://dx.doi.org/10.1155/2018/7435746.

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Recent studies of robotic rehabilitation have demonstrated its efficacy for neurological disorders. However, few studies have used the Hybrid Assistive Limb (HAL) during the early postoperative stage of spine disorders. We aimed to evaluate the safety and efficacy of HAL treatment during the early postoperative period for spine disorder patients. We retrospectively identified patients who underwent spine surgery and who could complete HAL treatment. We evaluated the 10-m walking test (10MWT), the modified Gait Abnormality Rating Scale (GARS-M), Barthel Index (BI), and the walking index for spinal cord injury II (WISCI II) score results before and after robotic rehabilitation. Clinical outcomes were compared after treatment. We included nine patients with various spine problems. After HAL treatment, the speed during the 10MWT significantly improved from 64.1 ± 16.0 to 74.8 ± 10.8 m/min, and the walking cadence decreased from 102.7 ± 17.6 to 92.7 ± 10.9 steps/min. The BI score also improved from 83.3 ± 16.0 to 95.6 ± 5.8, and the WISCI II score improved from 19.7 ± 0.5 to 20.0 ± 0.0. Furthermore, the total GARS-M score improved from 6.0 ± 5.7 to 2.3 ± 3.3. The maximum angles of the trunk swing were improved from 2.2 ± 1.9 to 1.2 ± 0.9 degrees. Neurorehabilitation therapy using HAL for spinal surgery patients was considered feasible following spine surgery.

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Lin, Yingnan, Qingming Qu, Yifang Lin, Jieying He, Qi Zhang, Chuankai Wang, Zewu Jiang, Fengxian Guo und Jie Jia. „Customizing Robot-Assisted Passive Neurorehabilitation Exercise Based on Teaching Training Mechanism“. BioMed Research International 2021 (31.05.2021): 1–10. http://dx.doi.org/10.1155/2021/9972560.

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Passive movement is an important mean of rehabilitation for stroke survivors in the early stage or with greater paralysis. The upper extremity robot is required to assist therapists with passive movement during clinical rehabilitation, while customizing is one of the crucial issues for robot-assisted upper extremity training, which fits the patient-centeredness. Robot-assisted teaching training could address the need well. However, the existing control strategies of teaching training are usually commanded by position merely, having trouble to achieve the efficacy of treatment by therapists. And deficiency of flexibility and compliance comes to the training trajectory. This research presents a novel motion control strategy for customized robot-assisted passive neurorehabilitation. The teaching training mechanism is developed to coordinate the movement of the shoulder and elbow, ensuring the training trajectory correspondence with human kinematics. Furthermore, the motion trajectory is adjusted by arm strength to realize dexterity and flexibility. Meanwhile, the torque sensor employed in the human-robot interactive system identifies movement intention of human. The goal-directed games and feedbacks promote the motor positivity of stroke survivors. In addition, functional experiments and clinical experiments are investigated with a healthy adult and five recruited stroke survivors, respectively. The experimental results present that the suggested control strategy not only serves with safety training but also presents rehabilitation efficacy.

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Hansen, Anders, Mette Boll, Lisbeth Minet, Karen Søgaard und Hanne Kristensen. „Novel occupational therapy intervention in the early rehabilitation of patients with brain tumours“. British Journal of Occupational Therapy 80, Nr. 10 (07.08.2017): 603–7. http://dx.doi.org/10.1177/0308022617714165.

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Statement of context The Danish Health Authority recommends that patients with brain tumours should have their rehabilitation needs evaluated prior to hospital discharge. Critical reflection on practice To our knowledge, no specific recommendations for specialised occupational therapy intervention in patients with glioma have been published. We rationalise how occupational therapy practices founded on shared decision-making and common goal-setting are implicated to patients with brain tumours and elaborate on how an occupation-centred approach with occupation-focused and based intervention has the potential to impact a patient’s performance ability and satisfaction in performing occupations established by the Canadian Occupational Performance Measure. This practice was embedded in a randomised controlled trial investigating the effectiveness of intensive rehabilitation efforts and involving occupational therapy compared with standard care in patients with glioma (ClinicalTrials.gov Identifier NCT02221986). Implications for practice Occupational therapy makes an important contribution in neurorehabilitation, which may also apply to patients with brain tumours.

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Joy, Mary Teena, und S. Thomas Carmichael. „Learning and Stroke Recovery: Parallelism of Biological Substrates“. Seminars in Neurology 41, Nr. 02 (09.03.2021): 147–56. http://dx.doi.org/10.1055/s-0041-1725136.

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AbstractStroke is a debilitating disease. Current effective therapies for stroke recovery are limited to neurorehabilitation. Most stroke recovery occurs in a limited and early time window. Many of the mechanisms of spontaneous recovery after stroke parallel mechanisms of normal learning and memory. While various efforts are in place to identify potential drug targets, an emerging approach is to understand biological correlates between learning and stroke recovery. This review assesses parallels between biological changes at the molecular, structural, and functional levels during learning and recovery after stroke, with a focus on drug and cellular targets for therapeutics.

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Dolce, Giuliano, Francesco Arcuri, Simone Carozzo, Maria Daniela Cortese, Pierpaolo Greco, Lucia Francesca Lucca, Loris Pignolo, Maria Elena Pugliese und Francesco Riganello. „Care and Neurorehabilitation in the Disorder of Consciousness: A Model in Progress“. Scientific World Journal 2015 (2015): 1–10. http://dx.doi.org/10.1155/2015/463829.

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The operational model and strategies developed at the Institute S. Anna-RAN to be applied in the care and neurorehabilitation of subjects with disorders of consciousness (DOC) are described. The institute units are sequentially organized to guarantee appropriate care and provide rehabilitation programs adapted to the patients’ clinical condition and individual’s needs at each phase of evolution during treatment in a fast turnover rate. Patients eligible of home care are monitored remotely. Transferring advanced technology to a stage of regular operation is the main mission. Responsiveness and the time windows characterized by better residual responsiveness are identified and the spontaneous/induced changes in the autonomic system functional state and biological parameters are monitored both in dedicated sessions and by means of anambient intelligenceplatform acquiring large databases from traditional and innovative sensors and interfaced withknowledge management and knowledge discoverysystems. Diagnosis ofvegetative state/unresponsive wakefulness syndromeorminimal conscious stateand early prognosis are in accordance with the current criteria. Over one thousand patients with DOC have been admitted and treated in the years 1998–2013. The model application has progressively shortened the time of hospitalization and reduced costs at unchanged quality of services.

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Sava, Mihai, Maria-Gabriela Catană und Corina Roman-Filip. „The importance of early neurorehabilitation in the recovery of post-vaccination Guillain-Barre syndrome – a case report“. Balneo Research Journal 10, Nr. 10.2 (20.05.2019): 98–102. http://dx.doi.org/10.12680/balneo.2019.246.

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Abstract Guillain-Barre syndrome (GBS) is the most common cause of acute flaccid paralysis worldwide, having an incidence of about 1/100,000 across several studies in a number of countries. We present the case of a 60-year-old female patient, with known hypertension, admitted to our department for paresthesia and muscle weakness predominantly in the distal upper and lower limbs. Symptomatology had an acute onset after 14 days from influenza vaccine administration. Lumbar puncture revealed CSF glucose (91 mg/dl), CSF protein (0.508 g/l) and no pleocytosis. Electromyography supported the presumptive diagnosis of polyradiculoneuritis. The patient underwent three sessions of double filtration and the final diagnosis was Guillain-Barre polyradiculoneuritis secondary to influenza vaccination. Approximately 80% of patients with polyradiculoneuritis recover completely within a few months to one year; however, 5-10% of these patients experience one or more recurrences. It should be emphasized that acute-phase rehabilitation must start immediately and include an individualized program of gentle strengthening, and manual resistive and progressive resistive exercises. Key words: polyradiculoneuropathy, influenza vaccine, neurorehabilitation,

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Iosa, M., G. Morone, A. Fusco, M. Bragoni, P. Coiro, M. Multari, V. Venturiero, D. De Angelis, L. Pratesi und S. Paolucci. „Seven Capital Devices for the Future of Stroke Rehabilitation“. Stroke Research and Treatment 2012 (2012): 1–9. http://dx.doi.org/10.1155/2012/187965.

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Stroke is the leading cause of long-term disability for adults in industrialized societies. Rehabilitation’s efforts are tended to avoid long-term impairments, but, actually, the rehabilitative outcomes are still poor. Novel tools based on new technologies have been developed to improve the motor recovery. In this paper, we have taken into account seven promising technologies that can improve rehabilitation of patients with stroke in the early future: (1) robotic devices for lower and upper limb recovery, (2) brain computer interfaces, (3) noninvasive brain stimulators, (4) neuroprostheses, (5) wearable devices for quantitative human movement analysis, (6) virtual reality, and (7) tablet-pc used for neurorehabilitation.

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Kotov, S. V., E. V. Isakova und Yu V. Egorova. „Post-stroke depression and the abilities of antidepressants to enhance the effectiveness of neurorehabilitation“. Neurology, Neuropsychiatry, Psychosomatics 12, Nr. 6 (12.12.2020): 110–16. http://dx.doi.org/10.14412/2074-2711-0-0-.

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Stroke is the leading cause of disability in adults. Depression after a stroke is detected in one third of patients, complicating physical rehabilitation, worsening functional outcome, increasing mortality rates. The question of the use of antidepressants in the treatment of post-stroke depression is currently not completely resolved, there is no consensus on the most optimal drug. The drugs of choice are selective serotonin reuptake inhibitors, the use of tricyclic antidepressants is possible. A number of clinical studies indicate the effectiveness of selective serotonin reuptake inhibitors in the treatment of post-stroke depression, including through mechanisms including increased neuroplasticity and stimulation of neurogenesis, while others disprove their effectiveness. The article presents a clinical case of the use of vortiroxetin in the patient’s neurorehabilitation in the early recovery period of a stroke, its safety and positive effect are shown.

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Frank, U., K. Frank und H. Zimmermann. „Effects of Respiratory Therapy (bagging) on Respiratory Function, Swallowing Frequency and Vigilance in Tracheotomized Patients in Early Neurorehabilitation“. Pneumologie 69, Nr. 07 (30.06.2015): 394–99. http://dx.doi.org/10.1055/s-0034-1392359.

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Rubega, Maria, Emanuela Formaggio, Franco Molteni, Eleonora Guanziroli, Roberto Di Marco, Claudio Baracchini, Mario Ermani, Nick S. Ward, Stefano Masiero und Alessandra Del Felice. „EEG Fractal Analysis Reflects Brain Impairment after Stroke“. Entropy 23, Nr. 5 (11.05.2021): 592. http://dx.doi.org/10.3390/e23050592.

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Stroke is the commonest cause of disability. Novel treatments require an improved understanding of the underlying mechanisms of recovery. Fractal approaches have demonstrated that a single metric can describe the complexity of seemingly random fluctuations of physiological signals. We hypothesize that fractal algorithms applied to electroencephalographic (EEG) signals may track brain impairment after stroke. Sixteen stroke survivors were studied in the hyperacute (<48 h) and in the acute phase (∼1 week after stroke), and 35 stroke survivors during the early subacute phase (from 8 days to 32 days and after ∼2 months after stroke): We compared resting-state EEG fractal changes using fractal measures (i.e., Higuchi Index, Tortuosity) with 11 healthy controls. Both Higuchi index and Tortuosity values were significantly lower after a stroke throughout the acute and early subacute stage compared to healthy subjects, reflecting a brain activity which is significantly less complex. These indices may be promising metrics to track behavioral changes in the very early stage after stroke. Our findings might contribute to the neurorehabilitation quest in identifying reliable biomarkers for a better tailoring of rehabilitation pathways.

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Ward, Nick S., Fran Brander und Kate Kelly. „Intensive upper limb neurorehabilitation in chronic stroke: outcomes from the Queen Square programme“. Journal of Neurology, Neurosurgery & Psychiatry 90, Nr. 5 (15.02.2019): 498–506. http://dx.doi.org/10.1136/jnnp-2018-319954.

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ObjectivePersistent difficulty in using the upper limb remains a major contributor to physical disability post-stroke. There is a nihilistic view about what clinically relevant changes are possible after the early post-stroke phase. The Queen Square Upper Limb Neurorehabilitation programme delivers high-quality, high-dose, high-intensity upper limb neurorehabilitation during a 3-week (90 hours) programme. Here, we report clinical changes made by the chronic stroke patients treated on the programme, factors that might predict responsiveness to therapy and the relationship between changes in impairment and activity.MethodsUpper limb impairment and activity were assessed on admission, discharge, 6 weeks and 6 months after treatment, with modified upper limb Fugl-Meyer (FM-UL, max-54), Action Research Arm Test (ARAT, max-57) and Chedoke Arm and Hand Activity Inventory (CAHAI, max-91). Patient-reported outcome measures were recorded with the Arm Activity Measure (ArmA) parts A (0–32) and B (0–52), where lower scores are better.Results224 patients (median time post-stroke 18 months) completed the 6-month programme. Median scores on admission were as follows: FM-UL = 26 (IQR 16–37), ARAT=18 (IQR 7–33), CAHAI=40 (28-55), ArmA-A=8 (IQR 4.5–12) and ArmA-B=38 (IQR 24–46). The median scores 6 months after the programme were as follows: FM-UL=37 (IQR 24–48), ARAT=27 (IQR 12–45), CAHAI=52 (IQR 35–77), ArmA-A=3 (IQR 1–6.5) and ArmA-B=19 (IQR 8.5–32). We found no predictors of treatment response beyond admission scores.ConclusionWith intensive upper limb rehabilitation, chronic stroke patients can change by clinically important differences in measures of impairment and activity. Crucially, clinical gains continued during the 6-month follow-up period.

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Hernando Rosado, Alicia, und Ana Isabel Useros. „Intervención fisioterápica en el proceso rehabilitador de pacientes con daño cerebral adquirido“. Acción Psicológica 4, Nr. 3 (07.07.2012): 35. http://dx.doi.org/10.5944/ap.4.3.472.

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There are different points of view on physical therapy treatament in neurorehabilitation. During the last years physical therapy intervention has been defined as the group of actions that allow the relearning of motor processes in pathological circumstances. Treatament has an holistic focus and the patient is treated as a functional unit with a global organic response. Patient rehabilitation after brain injuy is divided in two periods: acute and subacute. In the beginning of rehabilitation, physical therapy assess the patient´s functional status. Later it uses different holistic methods of treatment and monitor effectiveness of rehabilitation. Physical therapy consists of prevention of complications, improvement of muscle force and range of motion, balance, movement coordination, endurance and cognitive function. Early an proper rehabilitation can help to regain lost functions and to come back to society.

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Brosnan, Méadhbh B., Mahnaz Arvaneh, Siobhán Harty, Tara Maguire, Redmond O'Connell, Ian H. Robertson und Paul M. Dockree. „Prefrontal Modulation of Visual Processing and Sustained Attention in Aging, a tDCS–EEG Coregistration Approach“. Journal of Cognitive Neuroscience 30, Nr. 11 (November 2018): 1630–45. http://dx.doi.org/10.1162/jocn_a_01307.

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The ability to sustain attention is integral to healthy cognition in aging. The right PFC (rPFC) is critical for maintaining high levels of attentional focus. Whether plasticity of this region can be harnessed to support sustained attention in older adults is unknown. We used transcranial direct current stimulation to increase cortical excitability of the rPFC, while monitoring behavioral and electrophysiological markers of sustained attention in older adults with suboptimal sustained attention capacity. During rPFC transcranial direct current stimulation, fewer lapses of attention occurred and electroencephalography signals of frontal engagement and early visual attention were enhanced. To further verify these results, we repeated the experiment in an independent cohort of cognitively typical older adults using a different sustained attention paradigm. Again, prefrontal stimulation was associated with fewer attentional lapses. These experiments suggest the rPFC can be manipulated in later years to increase top–down modulation over early sensory processing and improve sustained attention performance. This holds valuable information for the development of neurorehabilitation protocols to ameliorate age-related deficits in this capacity.

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Markovic, G., M. Schult, A. Bartfai und M. Elg. „Statistical process control: A feasibility study of the application of time-series measurement in early neurorehabilitation after acquired brain injury“. Journal of Rehabilitation Medicine 49, Nr. 2 (2017): 128–35. http://dx.doi.org/10.2340/16501977-2172.

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Khasanova, D. P., T. V. Danilova, T. V. Demin, K. S. Knni und L. V. Gaifutdinova. „The effect of cellex on the recovery of motor and speech functions during early neurorehabilitation of patients with ischemic stroke“. Medical Council, Nr. 9 (29.05.2018): 14–19. http://dx.doi.org/10.21518/2079-701x-2018-9-14-19.

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Baker, Felicity, Nikki Rickard, Jeanette Tamplin und Chantal Roddy. „Mechanisms of change in self-concept and well-being following songwriting interventions for people in the early phase of neurorehabilitation“. Nordic Journal of Music Therapy 25, sup1 (30.05.2016): 10–11. http://dx.doi.org/10.1080/08098131.2016.1179881.

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Delmondes, Erikson De Luna, Lucas Tavares Cruz de Albuquerque und Lilianny Medeiros Pereira. „NEUROREHABILITATION WITH PADOVAN METHOD IN A NEWBORN WITH TREACHER COLLINS SYNDROME: A CASE REPORT“. Amadeus International Multidisciplinary Journal 3, Nr. 5 (05.11.2018): 1–7. http://dx.doi.org/10.14295/aimj.v3i5.41.

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Treacher Collins Syndrome (TCS) is an autosomal dominant disorder that leads to congenital craniofacial malformation, and may then be assisted by the Padovan Method® for neurological rehabilitation. That being said, the aim of this article is to report the functional improvements obtained by a patient with TCS who underwent the Padovan Method®. The child was born on november 26th of 2014, cesarean delivery, 37 weeks, Apgar 9/10, weighted 3625g, PC = 35cm, C = 49CM, presenting mild respiratory discomfort, absence of suction and the presence of syndromic facies, which is characteristic of TCS with retrognathism, oblique palpebral cleft downward divergent strabismus on left, pointed ears with cleft lobes, narrow auditory canal, malar hypoplasia and narrow palate. Padovan therapy was initiated at the 6th day of life, from orofacial, vestibular, ocular and motor exercises that seek to recapitulate the neuroevolutionary phases of human development with the purpose of propitiating a motor and neurological maturation of the central nervous system (CNS) and the correction of its possible failures. The child presented suction on the second day of therapy and on the fifth day was discharged from the hospital with good suction to the breast. The patient was followed up on an outpatient office and was given physiotherapy and speech therapy. The patient no longer received the Padovan Method® because at that time it was not available outside the hospital. Upon returning to childcare at age of 3, a good motor coordination performance was noticed, also speaking few loose words, but with good interaction and understanding. Therefore, due to the lack of standard behavior in neonatal neurological rehabilitation, considering the concepts of neuroplasticity andknowing the importance of early intervention, the Padovan Method® is shown as an alternative in the CNS reorganization in patients with TCS.

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Buch, Ethan R., Sook-Lei Liew und Leonardo G. Cohen. „Plasticity of Sensorimotor Networks“. Neuroscientist 23, Nr. 2 (08.07.2016): 185–96. http://dx.doi.org/10.1177/1073858416638641.

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Redundancy is an important feature of the motor system, as abundant degrees of freedom are prominent at every level of organization across the central and peripheral nervous systems, and musculoskeletal system. This basic feature results in a system that is both flexible and robust, and which can be sustainably adapted through plasticity mechanisms in response to intrinsic organismal changes and dynamic environments. While much early work of motor system organization has focused on synaptic-based plasticity processes that are driven via experience, recent investigations of neuron–glia interactions, epigenetic mechanisms and large-scale network dynamics have revealed a plethora of plasticity mechanisms that support motor system organization across multiple, overlapping spatial and temporal scales. Furthermore, an important role of these mechanisms is the regulation of intrinsic variability. Here, we review several of these mechanisms and discuss their potential role in neurorehabilitation.

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Döbrössy, Máté D., und Stephen B. Dunnett. „Environmental Housing and Duration of Exposure Affect Striatal Graft Morphology in a Rodent Model of Huntington's Disease“. Cell Transplantation 17, Nr. 10-11 (Oktober 2008): 1125–34. http://dx.doi.org/10.3727/096368908787236558.

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Clinical trials of cell replacement therapy in Huntington's disease have shown its safety, feasibility, and potentially long-lasting effects. However, more needs to be known regarding the conditions that stimulate plasticity and compensation achieved by neural grafts to maximize posttransplantation recovery of such neurorehabilitative therapies. The effects of enriched environment (EE), behavioral experience, and transplantation can each separately influence neuronal plasticity and recovery of function after brain damage, and the mechanisms by which these factors interact to modify the survival, integration, or function of grafted tissues are at present unknown. To investigate the effects of variable housing conditions and duration on morphological and cellular changes within embryonic striatal transplants, rats received unilateral excitotoxic lesions of the striatum, followed by E15 whole-ganglionic eminence suspension grafts. The rats were divided into three groups according to housing: full-time EE, 1 h/day exposure to EE, or standard laboratory cages. The experimental design included “early” (7 weeks postgrafting) and “late” (13 weeks postgrafting) survival time points to explore the effects of exposure lengths to the three housing conditions. The morphological and cellular effects on the grafts were analyzed using immunohistochemistry, cell morphology, image analysis, and enzyme-linked immunoassay. Both the duration of the exposure and the housing conditions were seen to influence multiple parameters of grafted cell morphology. The factors acted either independently (e.g., on graft size), complementarily (e.g., on spine density), or had no distinctive effect (e.g., on lesion size) on graft development. Features of embryonic striatal grafts and their trophic milieu were influenced both by the complexity of the environmental conditions and by the length of exposure to them. The data suggest that neurorehabilitation should be a feature of clinical trials of cell transplantation in order to exploit the underlying mechanisms that promote anatomical integration of the grafted cells and maximize transplant-mediated functional recovery.

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Carvalho, Alessandra Lemos de, Paloma Ventura, Tânia Taguchi, Ivar Brandi, Carlos Brites und Rita Lucena. „Cerebral Palsy in Children With Congenital Zika Syndrome: A 2-Year Neurodevelopmental Follow-up“. Journal of Child Neurology 35, Nr. 3 (13.11.2019): 202–7. http://dx.doi.org/10.1177/0883073819885724.

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Objective: To describe the 2-year neurodevelopmental outcome in children with cerebral palsy associated with congenital Zika (CZ) and explore variables associated with a more severe presentation. Methods: Data on 69 children with cerebral palsy associated with CZ, followed in a neurorehabilitation hospital, who consecutively attended the neurodevelopmental assessment at 2 years of age, were collected. Bayley III Scales of Infant and Toddler Development, Hammersmith Infant Neurological Examination, and Gross Motor Function Classification System were used for the outcome evaluation. Descriptive and inferential statistical analysis were performed. Results: The median age at follow-up was of 24.0 (23-32) months. Only 3 (4.3%) children were not microcephalic. The majority presented with bilateral (94.2%), spastic (100.0%), Gross Motor Function Classification System grade IV or V (92.8%) cerebral palsy, epilepsy (73.1%), extremely low performances on cognitive (94.2%), language (95.7%), and motor (95.7%) Bayley-III Scales of Infant and Toddler Development Test scores. The median Hammersmith Infant Neurological Examination score was of 21.0 (range 9-75). There was a correlation between birth head circumference with the cognitive ( r = 0.3, P < .01), language ( r = 0.3, P < .01), and motor ( r = 0.3, P < .01) Bayley-III Scales of Infant and Toddler Development Test scores, as well as with the Hammersmith Infant Neurological Examination score ( r = 0.2, P < .03). An association was observed between an inferior median Hammersmith Infant Neurological Examination score with congenital microcephaly ( P = .04), arthrogryposis ( P = .02), and epilepsy in the first year ( P < .01). Conclusion: Cerebral palsy related to CZ presents with a severe global impairment at a 2-year follow-up. Birth head circumference, arthrogryposis, and early epilepsy are associated with a worse outcome and may be considered as prognostic markers. These findings are important for the neurorehabilitation planning, parents’ guiding, and future prognostic studies.

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Eilander, H. J., V. J. M. Wijnen, J. G. M. Scheirs, P. L. M. de Kort und A. J. H. Prevo. „Children and young adults in a prolonged unconscious state due to severe brain injury: Outcome after an early intensive neurorehabilitation programme“. Brain Injury 19, Nr. 6 (Juni 2005): 425–36. http://dx.doi.org/10.1080/02699050400025299.

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Plotnikov, D. M., O. A. Ivannikova, A. M. Alifirova, L. N. Alekseyeva und Yu V. Petlin. „ACTIVITIES RESULTS AIMED AT IMPROVED MEDICAL ASSISTANCE TO THE VASCULAR PATIENTS IN TOMSK REGION“. Bulletin of Siberian Medicine 12, Nr. 5 (28.10.2013): 87–98. http://dx.doi.org/10.20538/1682-0363-2013-5-87-98.

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Acute disorders of cerebral circulation remain serious medical and social problem associated with high disability and mortality rates. Since 2011 Tomsk oblast is a participating member of the medical campaign aimed at improved medical services to the vascular patients. The preliminary implementation data analysis for 2012 revealed improvement of most of the indices of medical support to patients suffering from acute cerebral circulation; increased number of the in-patient cases (Regional Vascular Center and primary vascular department), decreased lethality rates from strokes, specifically hemorrhagic cases. Strict observance of the Regulations on Medical Assistance for stroke patients and the using of modern methods of therapy allowed to decrease hospital mortality in the Primary Vascular Departments and early mortality in the Regional Vascular Center. The active implementation of neurorehabilitation approaches resulted in the increased number of patients who do not require third parties’ assistance. Analysis of the work of the departments helped to identifying current problems and perspectives of further development of special medical care for stroke patients.

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Chia, Kai Xin, Sonali Polakhare und Stefania Dafne Bruno. „Possible affective cognitive cerebellar syndrome in a young patient with COVID-19 CNS vasculopathy and stroke“. BMJ Case Reports 13, Nr. 10 (Oktober 2020): e237926. http://dx.doi.org/10.1136/bcr-2020-237926.

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Early case series suggest that about one-third of patients with COVID-19 present with neurological manifestations, including cerebrovascular disease, reported in 2%–6% of hospitalised patients. These are generally older patients with severe infection and comorbidities. Here we discuss the case of a previously fit and well 39-year-old man who presented with fever and respiratory symptoms, evolving in pneumonia with hypoxia but only requiring continuous positive airway pressure. After resolution of the respiratory disease, the patient developed focal neurology and was found to have bilateral occipital, thalamic and cerebellar infarcts. A diagnosis of COVID-19 central nervous system vasculopathy was made. He developed a florid neuropsychiatric syndrome, including paranoia, irritability, aggression and disinhibition, requiring treatment with antipsychotics and transfer to neurorehabilitation. Neuropsychometry revealed a wide range of cognitive deficits. The rapid evolution of the illness was matched by fast resolution of the neuropsychiatric picture with mild residual cognitive impairment.

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Iandolo, Riccardo, Giulia Bommarito, Laura Falcitano, Simona Schiavi, Niccolò Piaggio, Giovanni Luigi Mancardi, Maura Casadio und Matilde Inglese. „Position Sense Deficits at the Lower Limbs in Early Multiple Sclerosis: Clinical and Neural Correlates“. Neurorehabilitation and Neural Repair 34, Nr. 3 (07.02.2020): 260–70. http://dx.doi.org/10.1177/1545968320902126.

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Background/Objective. Position sense, defined as the ability to identify joint and limb position in space, is crucial for balance and gait but has received limited attention in patients with multiple sclerosis (MS). We investigated lower limb position sense deficits, their neural correlates, and their effects on standing balance in patients with early MS. Methods. A total of 24 patients with early relapsing-remitting MS and 24 healthy controls performed ipsilateral and contralateral matching tasks with the right foot during functional magnetic resonance imaging. Corpus callosum (CC) integrity was estimated with diffusion tensor imaging. Patients also underwent an assessment of balance during quiet standing. We investigated differences between the 2 groups and the relations among proprioceptive errors, balance performance, and functional/structural correlates. Results. During the contralateral matching task, patients demonstrated a higher matching error than controls, which correlated with the microstructural damage of the CC and with balance ability. In contrast, during the ipsilateral task, the 2 groups showed a similar matching performance, but patients displayed a functional reorganization involving the parietal areas. Neural activity in the frontoparietal regions correlated with the performance during both proprioceptive matching tasks and quiet standing. Conclusion. Patients with early MS had subtle, clinically undetectable, position sense deficits at the lower limbs that, nevertheless, affected standing balance. Functional changes allowed correct proprioception processing during the ipsilateral matching task but not during the more demanding bilateral task, possibly because of damage to the CC. These findings provide new insights into the mechanisms underlying disability in MS and could influence the design of neurorehabilitation protocols.

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Beghi, Ettore, Heinrich Binder, Codruta Birle, Natan Bornstein, Karin Diserens, Stanislav Groppa, Volker Homberg et al. „European Academy of Neurology and European Federation of Neurorehabilitation Societies guideline on pharmacological support in early motor rehabilitation after acute ischaemic stroke“. European Journal of Neurology 28, Nr. 9 (21.06.2021): 2831–45. http://dx.doi.org/10.1111/ene.14936.

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Molchanova, E. E., V. V. Polunina, V. P. Plotnikov und B. A. Polyaev. „Comparative efficiency of various accupucture methods in early rehabilitation of patients after ischemic stroke“. Medical Journal of the Russian Federation 26, Nr. 2 (19.08.2020): 78–84. http://dx.doi.org/10.18821/0869-2106-2020-26-2-78-84.

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Three hundred and thirty patients aged 3579 years, who underwent early rehabilitation in the primary vascular department, participated in a randomized controlled trial. In 220 patients (the main group of the study), non-drug rehabilitation (in the form of a combination of physiotherapy and exercise therapy) was optimized using various reflex therapy methods. The effectiveness of including them in rehabilitation schemes was analyzed in seven subgroups. One hundred and ten patients (the comparison group) underwent comprehensive non-drug rehabilitation without the inclusion of reflex therapy. The effectiveness of rehabilitation measures was evaluated by assessing dynamics (on the first day and after two weeks) according to the National Institutes of Health Stroke Scale, Barthel index, Beck questionnaires (level of depression), Spielberger-Hanin (level of reactive anxiety), and the Motivation for Success and Motivation for Fear of Failure (level of motivation) questionnaire tests. The best indicators on almost all scales were obtained in groups where patients underwent combined reflex therapy techniques: dynamic electroneurostimulation (DENS) in combination with classical acupuncture, su jok therapy in combination with classical, auricular acupuncture and craniopuncture, and prolonged craniopuncture in combination with corporal and auricular acupuncture. Indicators were slightly lower in the cases when separate methods were applied: DENS or su jok, and in subgroups where corporal and auricular acupuncture were combined with craniopuncture (according to the methodology of Professor Yu Zhi Shun, China), or craniopuncture according to classical methodology. The lowest indicators were in the group of patients who did not use methods of reflex therapy. This study confirmed the need to integrate acupuncture techniques in the schemes of early neurorehabilitation schemes of post-stroke patients for whom combined technologies are most effective.

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Varžaitytė, Lina, Aleksandras Kriščiūnas und Edita Tamulionienė. „ASMENŲ, SERGANČIŲ GUILLAIN-BARRE SINDROMU, REABILITACIJOS EFEKTYVUMAS BEI JĮ ĮTAKOJANTYS VEIKSNIAI“. Visuomenės sveikata 23, Nr. 2 (03.05.2013): 122–25. http://dx.doi.org/10.5200/sm-hs.2013.057.

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The aim - to assess individuals with Guillain-Barre syndrome (GBS), the effectiveness of rehabilitation and the factors influencing it at an early period of the disease. Retrospectively medical record analysis was performed on persons sick with GBS and rehabilitated at LSMUL KK Neurorehabilitation subdivision 1999-2012 m. The study involved 31 persons. Rehabilitation effectiveness was assessed by Barthel index change during rehabilitation. The factors that may influence the effectiveness of rehabilitation (age, comorbidity, complications, functional status at the beginning of rehabilitation, acute respiratory failure requiring mechanical ventilation, rehabilitation time) were analyzed. Persons’ with GBS, functional status during rehabilitation significantly improved (p = 0.001). Age, functional status at the beginning of rehabilitation, comorbidity, duration of rehabilitation, acute respiratory failure did not have a statistically significant impact on rehabilitation performance for patients with GBS, but the younger people’s functional status at the beginning and end of the rehabilitation was better as compared to older individuals. Complications had a statistically significant negative impact on rehabilitation efficiency (p = 0.036) for individuals with GBS.

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Stepansky, Kasey, Amit Sethi, Pamela Toto und Scott Bleakley. „Caring for Our Caregivers: a feasibility study of caregiver preparedness training within inpatient brain injury rehabilitation“. International Journal of Therapy and Rehabilitation 27, Nr. 10 (02.10.2020): 1–11. http://dx.doi.org/10.12968/ijtr.2019.0106.

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Background/aims Evidence-based inpatient caregiver training may ensure that caregiver needs are met and hospital readmission costs reduced. The aim of this study was to evaluate the feasibility of implementing a caregiver education model, Caring for Our Caregivers, within an inpatient brain injury programme. Methods A total of 32 adults were admitted to inpatient neurorehabilitation during the 7-week feasibility trial. The three-step Caring for Our Caregivers programme included evidence-based recommendations following a caregiver needs assessment, goal setting and hands-on training. Satisfaction levels and caregiver preparedness were assessed via a survey. Results The caregiver needs assessment and goal collaboration was completed within 5 days 66% of the time. Results indicated an even distribution of hands-on (47%) and discussion-based (53%) education. Caregivers and staff identified high levels of satisfaction with the programme. Conclusions Early engagement, collaborative goals and hands-on training of the family caregiver of a client with acquired brain injury during inpatient rehabilitation demonstrated initial feasibility with positive implications for caregiver satisfaction and community discharge.

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Pingue, Valeria, Alberto Priori, Alberto Malovini und Caterina Pistarini. „Dual Transcranial Direct Current Stimulation for Poststroke Dysphagia: A Randomized Controlled Trial“. Neurorehabilitation and Neural Repair 32, Nr. 6-7 (Juni 2018): 635–44. http://dx.doi.org/10.1177/1545968318782743.

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Background. Poststroke dysphagia is associated with considerable morbidity and has high health care cost implications. Objective. To evaluate whether anodal transcranial direct current stimulation (tDCS) over the lesioned hemisphere and cathodal tDCS to the contralateral one during the early stage of rehabilitation can improve poststroke dysphagia. Methods. A total of 40 patients referred to our neurorehabilitation department were randomized to receive anodal tDCS over the damaged hemisphere plus cathodal stimulation over the contralateral one versus sham stimulation during swallowing maneuvers over the course of 10 sessions of treatment. Swallowing function was evaluated before and after stimulation using the Dysphagia Outcome and Severity Scale (DOSS). Results. The percentage of patients who reached various thresholds of improvement was higher in the tDCS group than in the sham group, but the differences were not significant (eg, DOSS score ≥ 20% increase from baseline: 55% in the tDCS group vs 40% in the sham group; P = .53). Among all variables recorded at baseline, only a subgroup of patients without nasogastric tube showed a significantly higher improvement with tDCS treatment versus sham (DOSS score ≥10% and ≥20% from baseline: 64.29% vs 0%, P = .01). Conclusions. In patients with poststroke dysphagia, treatment with dual tDCS in the early phase of rehabilitation does not significantly increase the probability of recovery compared with sham stimulation.

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Errante, Antonino, Donatella Saviola, Fabrizio Fasano, Benedetta Basagni, Serena Alinovi, Sara Bosetti, Margherita Chiari et al. „Application of an Intensive Rehabilitation Program After Very Late Recovery of Consciousness: A Single-Case Neurorehabilitation and Neuroimaging Study“. Journal of Central Nervous System Disease 11 (Januar 2019): 117957351984349. http://dx.doi.org/10.1177/1179573519843492.

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Late recovery of consciousness in vegetative state is considered as an exceptional outcome and has been reported prevalently in patients who suffered a traumatic brain injury. In these patients, the benefits of prolonging the rehabilitation, aimed at the recovery of autonomy in basic everyday activities, has been demonstrated. Here, we describe the application of an intensive multi-professional rehabilitation program carried out on a young female patient, with exceptionally late recovery of consciousness, specifically, after 7 years of vegetative state due to severe brain hemorrhage. Neuropsychological and functional assessment was conducted before and after the end of the rehabilitation program. In addition, functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI)-based probabilistic tractography were performed. Two follow-up neuropsychological and functional assessments were also conducted 6 and 29 months after the conclusion of the program. Functional results showed an improvement, maintained over time, in walking with assistance, cognitive efficiency, visual acuity and visual field, dysarthria, and execution of activities of daily living. Moreover, functional and structural magnetic resonance imaging (MRI) data documented the existence of preserved neural networks involved in sensory, motor, and linguistic tasks, which in all likelihood support the recovery process. This report suggests the possibility of undertaking an intensive rehabilitation program in patients who remain for long periods in altered states of consciousness, in spite of early negative prognosis.

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Woischneck, D., P. Lindner, A. Pfaffenzeller und T. Kapapa. „Klinischer Verlauf nach spontaner Hirnblutung mit Koma“. Neurologie & Rehabilitation 26, Nr. 4 (2020): 201–6. http://dx.doi.org/10.14624/nr2011001.

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Zusammenfassung Ziel der Studie: Die Zusammenhänge zwischen Akutbehandlung, Rehabilitationsverlauf und Out-come nach spontaner intrakranieller Blutung (»Hirnblutung«) werden anhand der funktionellen Scores am Ende der Frührehabilitation untersucht. Methodik: Die Kohortenstudie schließt die Verläufe nach Hirnblutungen bei 115 Erwachsenen ein. Protokolliert wurden Daten der Akutbehandlung (Komatiefe, Behandlungsdauer, Intubations-dauer) und die Ergebnisse am Ende der neurologischen Frührehabilitation (Koma-Remissions-Skala [KRS], Early Functional Abilities [EFA], der Barthel Index [BI], Functional Independence Measure [FIM] und Glasgow Outcome Scale [GOS]). Eingeschlossen wurden Patienten mit intra-zerebralen Blutungen, ausschließlich extrakranielle Hämatome wurden nicht berücksichtigt. Patienten mit Blutungen bei Gefäßmalformationen wurden ausgeschlossen. Ergebnisse: Das Verbesserungspotential und die letztlich erreichten funktionellen Ergebnisse san-ken mit steigendem Lebensalter. Eine deutliche Schwelle hin zum ungünstigen Outcome wiesen mehrere Scores ab dem 60. Lebensjahr auf. EFA und KRS zeigten zwar eine Altersabhängigkeit, aber keine klare Inzisur wie die anderen Scores. Ähnlich wurden ab 400 Stunden Intubationsdau-er die funktionellen Werte für alle Scores prägnant schlechter. Das Rehabilitationspotential sank bei einer Rehabilitationsdauer über 60 Tage. Patienten mit einem schlechteren Glasgow Coma Score (GCS), ermittelt durch den Notarzt, zeigten allerdings eine bessere Erholung, wenn der Aufenthalt in der Rehabilitationseinrichtung länger war. Patienten mit schlechtem Eingangsbe-fund am Beginn der Frührehabilitation profitieren besonders bei einer Rehabilitationsdauer von länger als 60 Tagen. Die Korrelationen waren für die traumatischen und spontanen Blutungen vergleichbar. Schlussfolgerung: Die Ergebnisse belegen die Prädiktorqualität des Alters, der Dauer der Behand-lung in der Akutklinik und der Intubationsdauer. Dabei profitieren Patienten mit schlechterem initialen GCS von einer verlängerten Rehabilitation. Die gemeinsame Datenanalyse von Akutme-dizin und Neurorehabilitation könnte helfen, die Entscheidungsfindung für oder gegen Intensiv-therapie und Operation zu optimieren. Schlüsselwörter: intrakranielle Blutung, Koma, Prognose, Rehabilitation Clinical course after coma due to spontaneous cerebral hemorrhage D. Woischneck, P. Lindner, A. Pfaffenzeller, T. Kapapa Abstract Purpose: The relationships between acute treatment, rehabilitation course and outcome after intracranial hemorrhage are examined on the basis of functional scores at the end of early rehabilitation. Methods: This cohort study included the course of spontaneous and traumatic intracranial bleeding in 115 adults. Data on acute treatment (coma depth, duration of treatment, duration of intubation) and results at the end of neurological early rehabilitation (coma remission scale [KRS], early functional abilities [EFA,], Barthel index [BI], functional independence measure [FIM[ and Glasgow Outcome Scale [GOS]) were recorded. Results: The potential for improvement and the functional results finally achieved decline with increasing age. A clear threshold for the unfavorable outcome is displayed for several scores at the age of 60 years. Although EFA and KRS were age-dependent, there was no clear incision as seen with the other scores. Similarly, after 400 hours of intubation, the functional aspects for all scores significantly worsened. The rehabilitation potential decreases during a rehabilitation period of more than 60 days. However, patients with a more severe Glasgow Coma Score (GCS), as determined by the emergency physician, had a better recovery if they stayed longer at the rehabilitation facility. Patients with poor initial findings at the initiation of early rehabilitation particularly benefit from a rehabilitation period of more than 60 days. The correlations were comparable for traumatic and spontaneous bleeding. Conclusion: The results confirm the predictor quality of age and the duration of therapy and intubation. Patients with a more severe initial GCS benefit from prolonged rehabilitation. The joint data analysis of neurosurgery and neurorehabilitation might help to optimize decision-making. Keywords: cerebral hemorrhage, coma, prognosis, rehabilitation

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Poologaindran, A., R. Romero-Garcia, M. Hart, I. Young, T. Santarius, S. Price, R. Sinha et al. „OS14.4.A The Neuroplastic Potential of the Human Brain before and After Glioma Surgery: Towards “Interventional Neurorehabilitation“. Neuro-Oncology 23, Supplement_2 (01.09.2021): ii16. http://dx.doi.org/10.1093/neuonc/noab180.052.

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Abstract INTRODUCTION The human brain is a highly neuroplastic ‘complex’ network: it self-organises without a hard blueprint, adapts to evolving circumstances, and can withstand insults. However, similar to other naturally occurring networks, brain networks can only endure a finite amount of damage before cognitive processes are affected. In this study, we first sought to establish the brain networks governing domain-general cognition (DGC) in healthy individuals across the lifespan. We then sought to map, track, and potentially rehabilitate networks governing DGC through connectomics and non-invasive brain stimulation (NIBS) when damaged by low-grade gliomas (LGG) and surgical oncology. METHODS Using MRI and cognitive data from n=629 individuals (aged 18–88, Female= 51%), we assessed the structural, functional, and topological relevance of the spatially-distributed multiple-demand (MD) system for DGC. Next, in n=17 patients undergoing glioma surgery, we longitudinally acquired connectomic and cognitive data at multiple time points: pre-surgery and post-surgery Day 1, Month 3, Month 12. In an independent cohort of n=34 patients, we sought to establish the safety profile for “interventional neurorehabilitation”: connectome-driven NIBS in the acute post-operative period to accelerate cognitive recovery. RESULTS In healthy individuals, the MD system across multiple scales of biological organisation was positively associated with higher-order cognition (Catell’s fluid intelligence). In our patients, pre-operative LGG infiltration into the structural MD system was negatively associated with the number of long-term cognitive deficits, suggesting a functional reorganisation. Mixed-effects modelling demonstrated the resilience of the functional MD system to infiltration and resection, while the early post-operative period was critical for effective neurorehabilitation. Graph analyses revealed increased perioperative modularity can distinguish patients with long-term cognitive improvements at one-year follow-up. Finally, NIBS within two weeks post-craniotomy had a 90% (n=31/34) recruitment rate into the trial. There were no seizures or serious complications due to NIBS in this patient population. Transient headaches and tingling were reported in a minority of patients. CONCLUSION For the first time, we elucidate long-term cognitive and network trajectories following LGG surgery while establishing a positive safety-profile for NIBS in the acute post-operative period. We argue that “mesoscale” brain mapping serves as a robust biomarker for intervention-related plasticity for future clinical trials. While we performed these experiments in the context of neurosurgery, connectomics and NIBS could be adopted across diverse neuro-oncological care pathways (i.e. chemotherapy/radiation).

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