Questions related to Neurorehabilitation
Parkinson Disease (PD) is a degenerative disease that affects motor function and sequential.
At which level of H&Y stages will this improve?
Short term or long term effect?
Any evidence to help patient and client?
According to your clinical experience, which approach you prefer in clinic and do you think that it is better than other one approach? (For Stroke patients only)
A top-down approach such as using task-specific interventions.
A bottom-up approach, using weight bearing, PNF, and NDT techniques
Patient with neurological problems have different problems. This will impaired their physical, cognitive and even social interaction and so forth.
So, which approach and why that approach is used?
Look into more discussion and information.
I was wondering if there was an optimal time for performing the follow up assessment when evaluating the long term effect of a rehabilitation technology (such as VR, robot assisted therapy,...) in a stroke population. Especially for upper limb function, activity and participation. Is there any paper supporting the fact that stroke patients’ long term retention should be assessed a certain time after the intervention ?
This study will be relatively small-scale, and will form part of my doctoral thesis. I am hoping to bilaterally stimulate the DLPFC in a group of cannabis users for a short duration, in order to assess whether craving can be temporarily modulated.
I work in a neurorehabilitation center and I am interested in incorporating tDCS for patients with disorders of consciousness, cerebral palsy, spinal cord injuries, neurodegenerative diseases...
I would like to know what is the maximum recommended number of sessions (number of days/weeks/months) and if there is any colleague who has a protocolized number of sessions.
I have seen many articles but they are very heterogeneous so I would like to know the opinion of experts. In fact I even read a case report of a patient with disorders of consciousness treated for 6 months.
I would also like to know if once stimulation has been applied how long the «rest period» would a patient have before resuming electrostimulation.
Thanks in advance.
When treating patients with abnormal tone, I often find recurrent inhibition using a range of sensory modalities from cooling to electrical stimulation at low levels is very effective in some patients. Others respond best to reciprocal activity. Clearly, spasticity results from an inbalance of inhibitory and excitatory activity, but can we deduct or identify which? If so, does that have a direct influence on central or peripheral management of tone? While Botox and other end organ interventions work, I am looking for ways to alter the central activity related to the abnormal tone.
There are some evidences about the positive effects of Kinesio taping among patients post stroke.
I want to know, if it could be useful to decrease the level of spasticity or if it was just as a supporter for their limbs.
Overall, stroke is one of the devastating condition that cause individual lost their ability and so forth.
Even economic burden because leads to more medical treatments, modification of certain activity daily work and so on.
How far the hospital and clinical staff know about it in terms of their knowledge, attitude, perception or even more practice pattern or treatment options in certain country.
There are many Clinical Practical Guideline from different country.
Apart from FAST campaign to increase awareness, what are alternative that being applied across the country in this world? What are other factors that contribute to increase awareness?
Looking for more depth discussion about this issue.
Is it possible to show the recovery of motor function of upper limbs or elbows of individuals with stroke by observing simple elbow flexion and changes in the EMG pattern of the extension muscles?
In addition to simply increasing the potential, please tell me the detail relationship between the phase pattern change of the flexor muscle and extensor muscle, the degree of synchronization with the joint motion or smoothness of the joint movement.
Are there papers showing evidence?
The feasibility study results can be found in clinical rehabilitation and the protocol in Fromtiers in human neuroscience: just search 'home-based neurological music therapy for arm rehabilitation......'
Biofeedback is a method that uses the mind to control a body function that the body normally regulates automatically, such as muscle tension, heart rate, pain perception or stability... The biofeedback therapist will then teach physical and mental exercises that can help patient control the function. Can these exercises also be effective for involuntary actions such as stress? If yes, By which method?
For people with central nervous system disorders, how much joint assistance or individual's effort is required for joint movement to restore motor function or better motor learning? What factor that defines The optimum assistance for reorganization of CNS is? Please tell me the papers or information on these.
Doining a sistimatic review on the eficicy of AAT compared to traditional therapy on adult patients with motor deficit and came across this article which is important and would like to read it but don't know how it's from Bottger S Early neurological rehabilitation of function and emotion using animal supported therapy..
Exercises on unstable surface are very useful on the rehabilitation of prorpioceptive impairments, but i want to know if we can concentrate the work on a specific part of the lower limb
I'm looking for studies that have investigated the impacts of transcranial direct stimulation and repeated magnetic transcranial stimulation on reading processes. Can they help dyslexic people?
I was wondering how why in the Materials and Methods : primary motor cortex stroke was exclusion criteria ?
about Science translational medicine in march 2016 "Ipsilesional anodal tDCS enhances the functional benefits of rehabilitation in patients after stroke"
I am writing a case study as part of my degree. the case study looks at a patient with a left sided CVA with right sided hemiplegia. I have to try and include in the case study why injuries on one side of the brain affects the opposite side, but I am struggling to find much solid information.
I am a physical therapist preparing an "evidence-based" mind-body workshop called "The ABCs of Prevention and Fitness," Alignment, Breathing and Centering. I am looking for research establishing the benefits of good posture (Alignment) on physical function; "conscious" and "prolonged exhalation" breathing for reduced stress and improved pulmonary function. I also welcome research related to "mindfulness" especially as it relates to physical function.
C. Vicki Gold, PT, MA
Pres. Thera-Fitness, Inc.
The current Alzheimer disease treatments are using electrical shock or brain pacemaker. There is a potential risk for the patient and the cost is high. However, if applied Chinese medicine theory and use a magnet or magnet to treat, can cut down the cost, eliminate the injury.
If anyone has the grant application experience and would like to collaborate with me to do the research, will be highly appreciated. Please, contact me. Thanks.
The pt has full range of motion in wrist extension. When placing the electrodes on the flexors (Carmick approach) the wrist flexors kick in as expected.
Achieving optimal adjustment is a sensitive and difficult process which hopefully leads to significant cure. At this stage it is important to consolidate a clear plan
1) to avoid the dangerous over drainage,
2) to avoid brain degenerations,
What is your opinion, is it better to use small or large stem cells for therapeutic use, in theory and practice?
Previous findings indicate that i.v. application of MSCs with a diameter ˃25 um resulted in microinfarctions. Does anyone think that the application of large cells is better, for example, for local application, and small cells for systematic application?
Hi, we work in a acute neurorehabilitation clinic admitting SCIs in the first 8 weeks of the injury onset and we have difficulties with the tetraplegic patients during upright positioning trials. Nonpharmachologic(ie: corset,pneumotic compression, fluid intake, meal, urinary and GI tract precautions) and pharmachologic (ie: midodrine up to 30mg) management strategies usually do not work in the first months. For example many patients do not tolerate upright positioning although they can be positioned 60 degree on the tilt table for 15-20 minutes or ortostatic hypotension problems do not resolve in complete tetraplegics up to 4-6 months. Can anyone have experience about ideal timing for upright positioning of tetraplegics and ideal pharmachologic (forexample fluidrocortisone?) treament strategies for ortostatic hypotension during the acute phase rehabilitation process?
Has anyone implemented mirror therapy (MT) based on the unilateral approach (ie, practice by the un affected upper limb)? If there is pertinent literature on this unilateral approach to mirror therapy that you know, please kindly let me know.
We are working with primary care physiotherapy teams to evaluate exercise in thecommunity programmes that are in conjunciton with local gyms. We are looking for an ICF Participation level measure that is validated for use with stroke, PD and MS and that considers either impact of the condition or quality of life, or participation in everyday activities/interaction with family and community. Would be grateful for any suggestions of suitable measures.
One aspect we lag behind in management is the timely rehabilitation in patients with TBI. Can anyone advise on the rational approach for the same in the resource restrained setup ?????
Transcranial Magnetic Stimulation has brought a lot of hope in the field of non-invasive treatment of Neurological disorders.
As it has picked my interest in the case of Parkinson's Disease, I can't help but wonder how we hope such a specific effect of TMS on PD's motor symptoms. Indeed the basal ganglia circuits is a very complex one and each structure will affect several others in an activating or inhibiting way. So how can we really hope for a specific effect, when we are merely activating a superficial region (that will of course, in turn, activate others, but still, how specific can such an intervention be) ?
There has been some effect I have seen, but, as of now (and I know it is still a young field of investigation), results are mitigated (see Benninger and Hallet review in NeuroRehabilitation, 2015 for a recent comparison of results)
Or maybe will it be more useful in combination with medication ?
Any thoughts ?
I have a girl who is already 6 years old, going to attend Kindergarten 2 next year, together with once a week speech therapy support. She started with us when she was about 5 years old, and have attended Kindergarten 1, with twice a week speech therapy and once a week occupational therapy support in the past year. She is not diagnosed and did not attend any therapy previously.
The teachers are all worried about her because she is really SLOW. Prior to her intervention program with us, she was observed to be unaware of lip closure and she used to drool because of this. Now after 1 year of ST + OT support, she no longer drools. She is also quite talkative (but her speech lacks variety and details), and has all the foundation learning skills (e.g., writing, phonics, etc.). However, she always looks absent-minded, and does not do anything if not pushed or reminded by the teacher. Since she does not speak up in the class at all, the teacher does not know if she understands certain concepts.
She is also naturally anxious, according to our ST, even if she knows something, she has to get absolute assurance that she is correct, she refuses to say it out loud if no assurance is given.
She is able to write well, but her major concern is the speed of doing things. She usually takes more than 1 hour to complete one meal, be it individually or in a group (individual performance is slightly better). We tried to condition her but it did not work, she does not initiate any reaction even if she is hungry and deprived (and of course parents would not allow that to happen). She starts to cry badly if she is scolded or forced, and only babbles one thing when crying "I want mama". She is not yet off diaper, because she cannot control the bowl and bladder movement well, and still does not spontaneously indicate the needs to toilet. Even after a long-winded toilet training, she still passes urine in class occasionally. She is able to mingle with friends but refuses most gross motor activities or games by keeping telling us that she "cannot do".
I think she is within the average intellectually, but we are all worried that she can no longer keep up with the pace of the class if the academic learning gets heavier. Given her anxious nature, we are also worried that she might "shut down" even more in the future, when she notice the difference between herself and the peers.
Any experts or experienced professional could please give some advice on what exactly is her problem, and how to better help her? Thank you for your help.
I would like to hear everyone's opinion on the use of Elastic Therapeutic (Kinesio / Kinesiology) Tape OR NMES on tattoos. I wonder, as both activate the superficial circulation, if we are doing harm when applying tape or electrodes on top of tattoos. Could the chemicals and inkt be 'enticed' to enter the body further?
Do you have any knowledge about researches about using remote methods of rehabilitation in stroke?
Do you know any technologies that can be used to control excercises performed by patient himself?
I'm involved in a short term research project comparing outcomes of individual vs. group dysphagia exercise programs in medical settings. Also wondering if anyone has examined using SLPAs in hospitals to carry out prescribed dysphagia exercises. Any information would be much appreciated!
I want to write a paper and have looked through endless journals which i feel are not that appropriate. Hoping someone has read something that will help me. Thank you
Changes in sexual behavior, loss of libido or in some cases hypersexuality has been noted in patients with mild head injury. However this changes are not seen all mTBI patients, a selected few. What could be the possible explanation to it besides hormonal or morphological changes?
I'm agree with their opinion towards vascular factor disorders in the MS lesions. Why do explore only venous vascular net? As for my experience, majority of MS-patients have a multivascular reasons in patogenesis of MS-focuses. I believe, that adequate vascular correction of the cerebral arterio-venous balance leads to the decreasing of neurological deficits. In our practice we have some no-walking MS- patients, which began realized their self serving program slowly step-by-step due to our long-term combine courses with vascular therapy and individual neurorehabilitation approach. There are nearly 5-6 etipatogenetical hemodynamical patterns of MS-arterio-venous disorders at extra- and intracranial levels.
My collaborators and I have published several articles with preliminary results of the research concerning role of toys in neurorehabilitation of children (including both traditional toys, therapeutic toys, therapeutic robots, etc.) - mainly in the clinical practice of physiotherapist (including NDT-Bobath method). Research concerns infants and younger children, where video games and Virtual Reality may be not applicable. Please let me know about similar studies.
I am trying to understand the concept of FES. Since I'm not an expert in rehab research, is there any good link or maybe good review paper that I can read that clarifies the research direction of this FES? For those who are experts, is there any issue or gap that can be filled if I'm interested in getting involved in this area of research? Thanks.
1. Spasticity in UMN lesions is seen predominantly in "ANTI-GRAVITY" muscles (Susan B O'Sullivan, Physical rehabilitation). What is the rationale behind this?
2. Why are shoulder adductors and ankle plantar flexors spastic in the same case as their action is not evidently against gravity? How can this be explained?
COP decomposition has been made by some MATLAB codes such as "Cubic spline function" to obtain an estimate of rambling trajectory. Trembling is the deviation of COP from rambling trajectory. I was wondering if the whole process can be completed by this function?
The change or advances in the rehabilitation of stroke is enormous: from Biofeedback, Brunnstrom, Bobath (NDT) approaches to Carr and Shephard MRP, task specific training, strength training (beyond the controversies), CIMT, FES, TMS to robotic therapy and so on. But none proves to be the most effective. Cost effectiveness of the rehab protocol is also another major concern.
Anyone who have validated the 6min walk test for wheelchair shuttle ride? Or does anyone know of a good, clinical tool for measuring cardiorespiratory fitness in wheelchair users? Primarily for young adults with disabilities (CP, TBI, SCI).
In a review on robot assisted neuro-rehabilitation I realised that the group had defined pronation and supination as part of wrist movement, however, to me it seems as if it is rather part of the movements of the forearm. Please see the attached image.
Observationally providing sensory input via cutaneous or sensory nerve stimulation improves task performance in some individuals, yet the sensory contribution is rarely evaluated or measured. Motor components of task performance are much easier to measure and quantify. Therapists frequently focus on strengthening as a primary intervention and outcome measure. Yet we see some very weak individuals with good timing and coordination be very functional while conversely there are very strong patients by traditional muscle testing who are very functionally deficient. How is somatic, schematic awareness and proprioception involved in motor learning and task performance and how might we measure? Has this been done? Any references?
How can we assess VMC when there is spasticity (say MAS more than 1+)? Or would you prefer manual muscle testing when there is spasticity?
I am interested in assessment of social communication of children with autism, but I would like develop alternative assessment methods from questionnaires.
Which is the best way to measure joint range of motion in clinical practice. I´m now using goniometry, but i don't know who is the reference author.
Stroke Research and Treatment
Special Issue on
Stroke in Developing Countries
Call for Papers
Stroke is a major health burden around the world, with general mean yearly rates of 120 per 100’000 inhabitants. It is commonly accepted that stroke is a disease of the elderly in developed countries, with a strong association with risk factors, such as hypertension, diabetes mellitus, cigarette smoking and increased cholesterol. Gender also bears an association, with male predominance, except in the youngest and eldest patients. However, epidemiological data suggest that stroke is also a major issue in emerging and developing countries, including in much younger patients, in association with similar or different risk factors.
We invite authors to submit original research and review articles addressing epidemiological, diagnostic issues, and management in developing countries around the world. This will allow gathering a series of data which will help to understand better this complex problem with critical impact on population health.
Potential topics may include, but without being limited to:
Prevalence and incidence changes
Political medical issues in specific countries
Acute phase therapy
Stroke prevention strategy and implementation
Rehabilitation after stroke
Cultural aspects dealing with mood disorders after stroke
Before submission, authors should carefully read over the journal’s Author Guidelines, which are located at http://www.hindawi.com/journals/srt/guidelines. Prospective authors should submit an electronic copy of their complete manuscript through the journal Manuscript Tracking System at http://mts.hindawi.com/ according to the following timetable:
Manuscript Due November 29, 2013 First Round of Reviews February 21, 2014 Publication Date April 18, 2014
Lead Guest Editor
Julien Bogousslavsky, GSMN Neurocenter, Switzerland; JBOGOUSSLAVSKY@cliniquevalmont.ch
Bartlomjej Piechowski-Jozwiak, Imperial College London, UK; email@example.com
Alexander Tsiskaridze, University of Tbilisi, Georgia; firstname.lastname@example.org
Jacques Joubert, University of Notre Dame Australia, Melbourne, Australia; email@example.com
Abderramane Chahidi, Beni Mellal, Morocco; firstname.lastname@example.org
Jorge Moncayo, University of Quito, Ecuador; email@example.com
although one reason may be TVR and reciprocal inhibition bt that would affect antagonist not agonist.
Anyone who has recommendations for if and how physical activity should be limited after traumatic carotid artery dissection? Or references to evidence-based recommendations?
We now treat a 45 year old female patient with bilateral traumatic carotid dissection after a cycling accident. Furthermore bifrontal brain damage. Some cognitive, but almost no motor impairment. As she is used to a lot of physical activity, she is quite eager to start with high intensity training.
Thanks for any suggestions
- Frank Becker MD PhD
Sunnaas Rehabilitation Hospital, Norway