European journal of physical and rehabilitation medicine
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Eur J Phys Rehabil Med · Oct 2014
A new scale for the assessment of performance and capacity of hand function in children with hemiplegic cerebral palsy: reliability and validity studies.
In hemiplegic children, the recognition of the activity limitation pattern and the possibility of grading its severity are relevant for clinicians while planning interventions, monitoring results, predicting outcomes. ⋯ Besta scale scoring system is a valid and reliable tool, utilizable in a clinical setting to monitor evolution of unimanual and bimanual manipulation and to distinguish hand's capacity from performance.
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Eur J Phys Rehabil Med · Oct 2014
Multicenter Study Clinical TrialIs CIMT a rehabilitative practice for everyone? Predictive factors and feasibility.
Constraint Induced Movement Therapy (CIMT) in hemiplegic patient is an efficacious method for upper limb rehabilitation. ⋯ CIMT requires high costs and resources; therefore it is valuable to know the predictive factors which help select the eligible patients. It is then useful to recognize the risk factors of developing Learned Non Use after stroke.
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Eur J Phys Rehabil Med · Oct 2014
Controlled Clinical TrialIsokinetic assessment of the effects of botulinum toxin injection on spasticity and voluntary strength in patients with spastic hemiparesis.
Peak knee flexion during swing phase is frequently reduced following stroke. The main treatment is botulinum toxin injection (BoNT-A) of the Rectus Femoris (RF) muscle. BoNT-A injections have been shown to decrease spasticity (assessed using the modified Ashworth scale) and to improve peak knee flexion during swing phase. Although the effect of BoNT-A has been clearly demonstrated on kinematic parameters during gait, the direct effects on spasticity and strength have been little studied using objective and sensitive outcome measures. ⋯ Peak knee extensor torque was significantly decreased and peak knee flexor torque was significantly increased during maximal voluntary concentric and isometric contractions following BoNT-A injection of the RF. Stretch reflex-related torque evaluated during passive stretching movements was reduced and the angle of occurrence of the peak was greater. Functional outcomes did not change. CONCLUSIONS AND CLINICAL REHABILITATION IMPACT: The results of this study indicate that BoNT-A injection reduced RF spasticity but also reduced quadriceps strength. In contrast, knee flexor strength increased. These changes did not, however, lead to functional gait changes.
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Eur J Phys Rehabil Med · Oct 2014
Management of stroke patients submitted to botulinum toxin type A therapy: a Delphi survey of an Italian expert panel of specialist injectors.
Spasticity is a common disabling symptom of several neurological conditions including stroke. Botulinum toxin type A (BTX-A) injection represents the gold standard therapy for focal spasticity. Post-stroke management of patients receiving BTX-A therapy has been variously investigated, but general agreement on how and when to implement rehabilitation is lacking. ⋯ This expert panel survey can provide guidance for clinicians in the assessment of patients treated with BTX-A therapy.