International Journal of Neurorehabilitation

Background and Purpose: Spasticity is a common impairment in hemiplegia arising in about 90% of the patients, which leads to various direct or indirect secondary impairments. Various studies have shown the association between depression, spasticity and quality of life in hemiplegic patients. Music therapy yet not very popular in physical therapy practice but evidences suggest its influence on different determinants of health viz. depression, anxiety, blood pressure and heart rate. Hence this study was conducted in attempt to study the effects of music therapy on spasticity, functional independence and quality of life in hemiplegic subjects.
Methods: 20 subjects with hemiplegia were enrolled in a 3 days randomized controlled trial. They were randomly allocated into (1) Experimental group, receiving music therapy and conventional treatment or (2) Control group, receiving only conventional treatment. Both the groups received treatment for 3 days (a session per day). Outcome measures were primarily spasticity and secondarily functional independence and quality of life.
Results: Participants in both the groups showed significant (P<0.05) reduction in the level of spasticity in all the group of muscles. There was significant (P<0.05) improvement in Functional Independence Measure and Stroke Specific Quality Of Life scores in both the groups. None of the variables yielded significant (P<0.05) difference when compared between the groups.
Discussion and Conclusions: Taken together, the statistical and clinical impressions point to the mild complementary effects of music therapy on spasticity and subsequently on functional independence and quality of life.

Objective: To evaluate Katona’s neurorehabilitation therapy in preterm and term infants with risk factors for brain damage followed up to 24 months of age. Methods: 262 infants from 25 to 40 weeks of gestational age (GA) were treated with neurohabilitation beginning before 2 months of corrected age. Treatment was intensive, sustained for at least 12 months and required family participation. Neuropediatric examinations, MRI and Bayley-II scales were performed. Results: Abnormal MRI findings were observed in 80% of infants (increase in lateral ventricle volumes, decrease in corpus callosum volume, diffuse and cystic periventricular leukomalacia, diffuse white matter abnormalities, haemorrhages, infarcts). Outcome: Bayley-II scales showed that 20% of infants with a GA of less than 29 weeks and less than 15% of infants with a 30-40 week GA had significantly delayed MDI and PDI scores. Conclusion: Diagnosis and treatment using neurohabilitation in new-borns at risk of brain damage is recommended.

Background: Because the rehabilitation of proper of eating and swallowing is important, the motor function of tongue has been highly studied due to its role in these processes. In addition, the previous studies have reported that the plasticity in the primary motor cortex and the primary somatosensory cortex are induced by tongue-task training.
Objective: This pilot study aimed to verify the possibility of neuroplasticity in the prefrontal cortex (PFC) by the visually guided direction-selective tongue-protrusion task (VD task).
Method: Cortical activities were measured by functional near-infrared spectroscopy, while the subjects performed the VD task and other tasks.
Results: The direction-selective activation of the PFC was found in all subjects performed the VD task. Conclusion: This study suggests that the VD task may contribute to develop a novel rehabilitation method for improving higher brain functions, because the activation have been considered to promote neuroplasticity in the brain.

Neuroplasticity is an important factor for upper-extremity stroke rehabilitation, yet the amount of neuromodulation achieved with an acute session of motor practice is not fully characterized. The objective of this study was to determine how engaging in isometric motor practice acutely influences motor control, dexterity, and neuromodulation. Thirteen healthy controls and 5 stroke survivors participated in 2 separate experiments. Assessments [Box and Block Test (BBT), force steadiness, Transcranial Magnetic Stimulation (TMS)] were completed immediately before and following motor practice. Two force steadiness trials were completed at 10 and 20% of the maximum voluntary contraction (MVC). The TMS outcome included an average of 12 suprathreshold stimulations with motor evoked potentials (MEP) amplitudes recorded. Data were analyzed using paired t-tests for each experiment. Both participant groups were able to move significantly more blocks with the hand that practiced, but not with the non-practicing side. Force steadiness and muscle activity significantly improved for both groups, yet the MEP amplitudes did not. These results suggest that a short intervention of isometric wrist extension can influence motor control and dexterity, but may have a slight impact on neuromodulation. This demonstrates the importance of better understanding how possible rehabilitation interventions influence neuroplasticity through neuromodulation.

This article describes how African American prostate cancer survivors negotiate medical systems create guideposts for survival, and strategies for rehabilitation. The intent is to explore the availability and significance of formal and informal psychosocial support systems that are utilized by African American prostate cancer survivors and to better understand the coping and adaptation of survivors and their families. The article will address the role of social support systems, prostate cancer support groups, and self-help groups. Prostate cancer survivorship will be viewed within the larger context of cancer survivorship initiatives in the United States. According to the SEER statistics, 5 year survival by race is 99.6% for White men and 95.9% for African American men. The lower survival rate and higher mortality rate among African American men have resulted in diminished outcomes and poorer quality of life experiences.

Sleep disruptions are prevalent following head injury, but are presently poorly understood. The current paper examines literature that pertains to assessment of sleep function during acute, intermediate and chronic periods following Traumatic Brain Injury (TBI). Review of the literature indicates that initial assessment was focused on primarily self-report measures, which may have psychometric limitations. Many of the findings from previous studies are not directly comparable, as there is significant heterogeneity between sample populations. However, more recent focus on objective measures such as overnight Polysomnography (PSG), Multiple Sleep Latency Test (MSLT) and ambulatory measurements such as actigraphy during multiple time periods post-injury has the potential for further identification and classification of patients with significant sleep disruption following TBI and holds promise in assisting with the treatment of identifiable sleep disorders. The development of state of the art assessment techniques should ultimately assist with evolution of the identification and management of sleep disorders that are related to TBI.

Background: Respiratory muscle impairment is common in patients with moderate Myasthenia Gravis. Whether respiratory muscle training (RMT) improve lung function tests and/or respiratory muscle strength is still debatable.

Methods: A systematic review and a meta-analysis including the relevant randomized controlled trials (RCTs) and prospective studies published from June 1996 and June 2016 and assessing the effect of the (RMT) on the respiratory muscle tests and the respiratory muscle strength.

Results: One RCT and 2 prospective cohort studies were included. Respiratory muscle training was found to improve the Maximal voluntary ventilation (MD=-10.3 L/min; CI95% [-17.95, -2.31]; p=0.01; I2=0%; n=24). However, it improved neither FEV1 (MD=-0.10 L; CI95% [-0.28, 0.08]; p=0.27; I2=0%; n=24) nor the Vital Capacity (MD=-0.06; CI95% [-0.24, 0.13]; p=0.57; I2=0%; n=24). Respiratory muscle training did not significantly improve the Maximal inspiratory pressure (PImax) (MD=-15.35; CI95% [-38.5, 7.8]; I2=97%; n=34). However, it significantly improved the maximal expiratory pressure (PEmax) (MD=- 14.7; CI95% [-18.3, -11.12]; p˂0.001; I2=51%; n=24).

Conclusion: The respiratory muscle training significantly improves the maximal voluntary ventilation and the maximal expiratory pressure. Further studies with larger sample size are required to confirm these findings.

Cerebral palsy (CP) is the most common lifelong disability affecting motor development in children. Hemiplegic CP is the most common syndrome in children born at term. Numerous rehabilitation approaches have been reported in children with CP. Recent studies have shown that robot-assisted training can complement conventional therapies in children with cerebral palsy. In this study we present a case of an 18 year old girl with spastic hemiparesis as a form of cerebral palsy, who showed significant recovery after intensive technology-enhanced physical rehabilitation using Armeo spring system.