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Publications (5)5.69 Total impact

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    ABSTRACT: Objective The objective of this study is to assess the autonomic nerve heart rate regulation system at rest and its immediate response to paced breathing among patients with complex regional pain syndrome (CRPS) as compared with age-matched healthy controls.DesignQuasiexperimental.SettingOutpatient clinic.SubjectsTen patients with CRPS and 10 age- and sex-matched controls.Methods Participants underwent Holter ECG (NorthEast Monitoring, Inc., Maynard, MA, USA) recording during rest and biofeedback-paced breathing session. Heart rate variability (HRV), time, and frequency measures were assessed.ResultsHRV and time domain values were significantly lower at rest among patients with CRPS as compared with controls. A significant association was noted between pain rank and HRV frequency measures at rest and during paced breathing; although both groups reduced breathing rate significantly during paced breathing, HRV time domain parameters increased only among the control group.Conclusions The increased heart rate and decreased HRV at rest in patients with CRPS suggest a general autonomic imbalance. The inability of the patients to increase HRV time domain values during paced breathing may suggest that these patients have sustained stress response with minimal changeability in response to slow-paced breathing stimuli.
    Pain Medicine 08/2014; · 2.46 Impact Factor
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    ABSTRACT: This study assessed the potential therapeutic benefi t of using HandTutor™ in combination with traditional rehabilitation in a post-stroke sub-acute population. The study compares an experimental group receiving traditional therapy combined with HandTutorTM treatment, against a control group receiving only traditional therapy. An assessor-blinded, randomized controlled pilot trial, was conducted in the Reuth rehabilitation unit in Israel. Thirty-one stroke patients in the sub-acute phase, were randomly assigned to one of the two groups (experimental or control) in sets of three. The experimental group (n = 16) underwent a hand rehabilitation programme using the HandTutorTM combined with traditional therapy. The control group (n = 15) received only traditional therapy. The treatment schedules for both groups were of similar duration and frequency. Improvements were evaluated using three indicators: 1) The Brunnström-Fugl-Meyer (FM) test, 2) the Box and Blocks (B&B) test and 3) improvement parameters as determined by the HandTutorTM software. Following 15 consecutive treatment sessions, a signifi cant improvement was observed within the experimental group (95% confi dence intervals) compared with the control group: B&B p = 0.015; FM p = 0.041, HandTutor™ performance accuracy on x axis and performance accuracy on y axis p < 0.0003. The results from this pilot study support further investigation of the use of the HandTutorTM in combination with traditional occupational therapy and physiotherapy during post stroke hand function rehabilitation.
    Physiotherapy Research International 12/2011; 16(4):191-200.
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    ABSTRACT: To examine test-retest reliability of time and frequency domain heart rate variability (HRV) in patients 1 month after stroke during rest, paced breathing and light-to-moderate physical activity. Fifteen patients up to 1 month after stroke underwent two measurements of HRV, with the measurements 4 days apart. Measurements took place under three conditions while sitting: (1) at rest with self-select breathing frequency, (2) paced breathing and (3) cycling while sitting. Reliability was assessed statistically by calculating intraclass correlation coefficients (ICC), standard error of measurement and coefficient of variance (CV). The relative reliability was found to be good-to-excellent for SDNN (ICC: 0.86-0.91), RMSSD (ICC: 0.81-0.87) and HF (ICC: 0.91-0.94) in all three conditions and poor for LF at rest and paced breathing (ICC: 0.43-0.47). The absolute reliability for all measures was found to be poor (CV >15%). HRV can be reliably assessed at rest, paced breathing and light-to-moderate physical activity for identifying differences between patients, while individual changes in autonomic functioning exhibited large random variations between test-retest measurements.
    European Neurology 08/2011; 66(2):117-22. · 1.50 Impact Factor
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    ABSTRACT: the Rehabilitation program needs to improve motor, sensory and cognitive performance so that the patient can do everyday functional tasks efficiently. The HandTutor™ rehabilitation program focuses on improving fine motor skills, sensory and cognitive impairments together with augmented feedback. Our research, on stroke patients, proves that combining HandTutor™ therapy with traditional hand therapy is more effective than traditional hand treatment alone.
    01/2009;
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    ABSTRACT: This study aimed to investigate whether any physiological changes might have a clinically significant effect on function in sedentary, institutionalized, older adults treated by a passive training program. A total of 18 subjects (mean age 60.7 +/- 3.4) with intellectual disability (ID) participated. We measured SpO2 (arterial oxygen saturation) before, during, and after passive training, and used Barthel Index to measure daily living activities. The general trend indicated that inactive people with ID evidenced a continual increase in SpO2% levels and some functional gains during passive treatment, with superiority to manual passive treatment compared to mechanical active passive training. For current clinical practice, most sedentary patients who experience clinically significant deconditioning and desaturation can benefit from passive treatment.
    The Scientific World Journal 02/2006; 6:1075-80. · 1.73 Impact Factor