International Journal of Neurorehabilitation

Parkinson’s disease and focal limb dystonia are neurological movement disorders that may occur co-morbidly, often leading to more severe gait impairment and pain. Treatment options for foot dystonia in Parkinson’s disease are limited and have variable outcomes. Osteopathic manual treatment techniques were previously found to improve gait in Parkinson’s disease. Here, we present three cases in which osteopathic manual treatment was used to treat foot dystonia in patients with Parkinson’s disease. The most prominent features of the foot dystonia were cramping and pain in the foot and ankle radiating up to the ipsilateral torso and involuntary foot inversion. The common musculoskeletal dysfunctions found were spasm of ipsilateral hip adductor muscles, psoas, gastrocnemius, and one or more intrinsic ankle and foot muscles as well as calcaneal inversion and restrictions to motion of the tarsal bones. All patients reported improvement in pain and mobility following treatment that lasted five to seven days. Future research is necessary to define and test the effectiveness of a specific treatment protocol in the long term management.

Background: Constraint-induced movement therapy (CIMT) is a treatment strategy that has been shown to improve the function of an upper limb affected by stroke. Although an extensive corpus of literature supports the positive impact of CIMT on neuroplasticity and the recovery of function, has evaluated CIMT conducted individually. Evidence is limited for the application of a CIMT in a collective modality and investigation is needed. Objective: To determine the effectiveness of a modified version of CIMT as a part of combined or collective treatment, as compared to individual CIMT, in increasing the use and functionality of movement of a paretic upper limb. Methods and subjects: The study was a single-blind, randomized parallel trial. Thirty-six patients who had had a stroke for up to 6 months were randomly divided into two intervention groups. The independent variable was the implementation of collective or individual therapy for 3 h for 10 consecutive days and the dependent variables were amount of use and dexterity of the affected upper extremity in activities of daily life. Dependent variables were evaluated by the Motor Activity Log (MAL) and Action Research Arm test (ARAT), at baseline (pre-intervention evaluation), end (post-intervention evaluation) and six months after intervention (follow-up). Results: By controlling the pre-intervention evaluations, analyses of covariance indicated that both dependent variables presented significant differences and the results were in favor of the group therapy at both the postintervention evaluation and follow-up evaluations. Conclusion: Both types of intervention generated increases in the function and use of the upper extremity, with these increases being higher in the collective modality. The effects of the collective modality were maintained 6 months after the intervention ended.

Purpose: This study aimed to examine the effect on spinal nerve function that differences in the motor image method. Methods: We recorded the F-wave during three different methods of MI from previous research as follows. Vision imagery is the method that subjects image the digital digits to display pinch force. Muscle imagery is the method that subjects image the muscle contraction during pinching. Sensory imagery is the method that subjects image the feeling you hold down the pinch sensor. Results: Both persistence and F/M amplitude ratios motor imagery under vision-image, muscle-image and sensory-image significantly higher than that observed at rest. No significant were noted in relative data for amplitude ratio of F/M and persistence between motor imagery that three image way. Conclusion: Motor imagery under three different methods as vision-image or muscle-image and sensory-image was no significant difference in the excitability of spinal neural function between the three MI methods condition. However excitability of spinal neural function during imaging under all conditions tended to be higher during motor imager than at rest.

Diabetes is well known to affect peripheral nervous system. We have summarized the multiple different presentations of peripheral nervous system involvement in this disease along with the medical and rehabilitation management. The clinical presentation depends on the localization of the damage which can involve nerve roots, plexus, focal nerves, diffuse involvement of multiple nerves and autonomic system. The process can be acute or insidious based on the pathology which can be variable.

Mental health literacy (MHL) has been defined as the knowledge, beliefs and abilities that enable the recognition, management or prevention of mental health problems. From history of demonic procession concept to modern neuroscientific explanation is the outcome of advancement in mental health literacy. It’s now evidence that, neural connections that form networks and circuits in the brain are essential to the existence of the mind. The health infrastructure doesn’t included mental health concept yet in service delivery system in developing part of glove. Medical education in under graduation level is still dominantly focused on physical health. Computer assisted telephone interview (CATI) is a modern method of phone survey and globally many survey done to explore the mental health literacy in population. Prior conventional broad based study; it was a snapshot of current scenario of knowledge among physicians. It was a cross sectional phone survey among physicians in three hospitals at Dhaka city in Bangladesh. Though almost 60% of physicians said that they know the seat of mind in the body, 11% of them said “Heart” is the anatomical location. The prevalence of mental disorders is 18% in child adolescents and 16% among adults in Bangladesh. To combat the situation, sound knowledge of mind, mental health and mental illness is mandatory in physician community. In future, further exploration of mental health literacy MHL could be helpful to detect the gap and to formulate an effective mental health service system.

Objective: To compare the efficacy of Motor Relearning Programme and Bobath technique with Motor Relearning Programme in improving functional activities among hemiplegic patients. Design: Two group experimental studies designed with pre-test and post-test.

Background: The primary goal of strokeil rehabitation is functional enhancement by maximizing the independence, life style and dignity of the patient. A new development for stroke treatment in specialized and well organized manner generated by different neurological treatment approaches includes Bobath technique and Motor Relearning Programme. There has been less research explaining about the importance of Bobath technique for improvement in functional activities. Bobath technique with MRP still remains to be optimized and lacks the much needed standardization. In this study comparison of the efficacy of MRP and Bobath technique with MRP in improving functional activities among hemiplegic patients was done.

Method: Thirty subjects aged 40 to 55 years with stroke under Brunnstorm recovery stage II were selected under purposive sampling technique and assigned into two groups with 15 subjects each, one group received Motor Relearning Programme and the other group received Bobath technique with Motor Relearning Programme for a period of 4 weeks.

Outcome measure: The Functional Independence Measure scale was used to evaluate functional activities (ADL). Intervention values for self-care and transfer activities were measured before and after treatment.

Results: Statistical analysis done by using student ‘t’ test and independent ‘t’ test showed that there was significant improvement in subjects who received Bobath technique with Motor Relearning Programme.

Conclusion: Bobath technique with Motor Relearning Programme shows significant improvement in functional activities than Motor Relearning Programme.

The impact of dementia on the UKs Black, Asian and minority ethnic communities has been identified at the highest levels of dementia policy making in the UK but this has yet to translate in to changes in how services are developed in local areas. The African-Caribbean population in the UK is demographically the oldest of the ‘Black’ categories in the UK census. This population has known higher risk of developing vascular dementia and early onset dementia. The raised incidence of Type II in this population also suggests it could have higher risk for Alzheimer’s disease. Community organisations will need to be proactive in insisting on more attention being paid to the specific service needs of this and other minority ethnic communities. Culture Dementia UK is a community organisation showing how community groups can provide benefits in disseminating information and developing appropriate services that cannot be achieved by mainstream services alone. Building on these initiatives is an important next step that needs supporting by mainstream research.

Objective: To compare the efficacy of functional strength training in improving gross motor function among the children with spastic diplegic cerebral palsy. Design: Experimental study design with pre-test and post-test. Background: The primary goal of rehabilitation for spastic dipelgic cerebral palsy is functional enhancement by maximizing the independence, life style, and dignity of the patient. A new development for treatment in specialized and well organized manner generated by different neurological treatment approach includes functional strength training. There has been less research explaining about the importance of functional strength training for improvement in functional activities. Method: Fifteen subjects spastic diplegic cerebral palsy were selected under purposive sampling technique and received functional strength training for a period of 10 weeks. Outcome measure: Gross motor function measure-the gross motor function measure is a standardized observational instrument designed to measure changes in gross motor function over time in children with CP. Results: Statistical analysis done by using student’s t-test and showed that there was significant improvement in subjects who received functional strength training. Conclusion: The statistical results show that there is an improvement in gross motor function after 10 weeks of functional strength training program

Emergency Medical Service (EMS) is an important option in health care delivery system which can reduce morbidity and mortality. Though emergency medical service (EMS) service available for physical illness, still absent for mental illness in government sector. Bangladesh is one of the developing countries in Asia which just transformed from low income status to lower middle income. The prevalence of psychiatric disorders in adult is 6.5 to 31% but the government expenses 0.06% of the total budget in mental health sector and the mental health act is yet to be approved. This cross sectional study intended to observe the demography and distribution of diagnosis of patients of two private hospitals who were hospitalized involuntarily via EMS. Two psychiatric hospitals were selected purposively and reviewed the EMS request forms and hospital discharge certificates of the respective patients. Among the patients, the common diagnoses were Schizophrenia (34.7%), Substance Related Disorders (18.8%), Bipolar Disorders (15.8%) and Personality Disorders (12.9%). Very few patients were admitted from rural background. There is lack of integrated national EMS system and some private initiatives provided for medical and psychiatric patients. It is an urgent need of further research in this field to identify limits and strength of the emergency medical service system as well as the integration and expansion of the service in government and private hospitals can be an effective option for addressing the mental health emergencies across the areas.

Alzheimer’s disease (AD) is one of the most frequent neurodegenerative disorders. AD is usually associated with non-cognitive neuropsychiatric impairment (NCNI) as apathy, depression, anxiety, emotional labiality, sleep disorders. Methods: 131 patients with AD (mild, moderate degree) were included in the investigation according to the diagnostic criteria of DSM IV and MKB 10. 45 AD patients were on galantamine, 43-memantin and 43-combined therapy. The control group includes 45 patients. In our investigation in the main group of AD patients the duration of the disease was from 6 months to 4.3 years, on average 3.3 years. Standard neuropsychological an investigation was performed in AD and control group which included the following tests- MMSE: Mini Mental State Examination, FAB: Frontal Assessment Battery), clock drawing test, 12 world list immediate and delayed recall (subscore, total). Neuropsychiatric investigation includes neuropsychyatric inventory (NPI-Cummings). Results: Correlation analysis between cognitive and non-cognitive neuropsychiatric impairments in combined group showed Total NPI-MMSE, r=-0.312, p=0.032; Total NPI-FAB, r=-0.41, p=0.03, Total NPI-FAB, r=-0.41 p=0.03, Apathy-12 world delayed recall (total), r=-0.45 p=0.001, Apathy-12 world learning test delayed recall with help r=-0.45 p=0.001, Sleep scale-12 word learning test immediate recall (r=+0.44 р=0.03, Sleep disorders-12 worlds learning test-delayed recall r=+0.55 р=0.001). Correlation between NPI and EEG data showed Total NPI-spectral power in Т3, r=+0.46 p=0.048, Depression-spectral power of delta in С3 r=+0.34 p=0.032, Depression-spectral power of theta band in С4 r=+0.32 p=0.032, Apathy-spectral power in theta band in С3, r=+0.37 р=0.01, Apathy-spectral power in theta band in С4 r=+0.33 p=0.031, Emotional liability-spectral power in delta F1 r=+0.47 р=0.027, Emotional liability-spectral power in F2 r=+0.46 p=0.049, Total NPI-intra hemispheric coherence of theta in Т3-T4 r=-0.45 p=0.048, Depression- Intra hemispheric coherence in С3-C4 r=-0.35 p=0.033, Аpathy-Intra hemispheric coherence in С3-С4 r=-0.45 p=0.048, Аpathy-Intra hemispheric coherence of theta in T3-T4 r=-0.32 p=0.03, Emotional liability-Intra hemispheric coherence in F1-F2 r=-0.46 р=0.026, Emotional liability-Intra hemispheric coherence in T3-T4 r=-0.47 p=0.048. Conclusion: There were found significant correlations between cognitive and non-cognitive neuropsychiatric impairments. So the data gives significant possibility to think that NCNI are the obligatory sign of AD.