NeuroRehabilitation
-
NeuroRehabilitation · Jan 2013
ReviewNeuropsychological and neuroanatomical sequelae of chronic non-malignant pain and opioid analgesia.
The pervasive disease of chronic pain is a common challenge for the clinical rehabilitation professional. Concurrent with physical and emotional symptoms, pain-related cognitive impairment has been reported. Although opioid analgesics are frequently prescribed, concern exists that opioids possess adverse cognitive effects of their own. ⋯ To date, evidence from opioid studies suggests only mild deficits in specific cognitive domains (e.g., memory, attention/concentration) and only under specific conditions (e.g., dose escalations). Additionally, neuroimaging and neuropsychological evidence suggests that pain itself results in cognitive sequelae. Methodological improvements in future research will allow for better delineation of the contributing effects of pain and opioids, with an overall goal of improving evidence-based clinical treatment recommendations.
-
NeuroRehabilitation · Jan 2013
Selective use of low frequency stimulation in Parkinson's disease based on absence of tremor.
High frequency stimulation (HFS) of the subthalamic nucleus is one of the most effective treatments for advanced Parkinson's disease (PD). HFS has provided beneficial improvements in the cardinal features of PD, but has not been proven as effective for addressing the axial predominant levodopa resistant symptoms, such as speech disturbances, gait disturbances, and postural instability. Recent studies have suggested that changes in stimulation parameters may influence differing PD symptoms. ⋯ These results may suggest that HFS is better than LFS for reducing tremor in tremor dominant patients. However, patients with mild or no tremor show no acute differences in benefit from LFS as compared to HFS.
-
NeuroRehabilitation · Jan 2013
Quality of patient education materials for rehabilitation after neurological surgery.
To evaluate the quality of online patient education materials for rehabilitation following neurological surgery. ⋯ Evaluations of several websites from the NINDS, NLM, AOTA, and AAOS demonstrated that their reading levels were higher than that of the average American. Improved readability might be beneficial for patient education. Ultimately, increased patient comprehension may correlate to positive clinical outcomes.
-
NeuroRehabilitation · Jan 2013
Study of accent-based music speech protocol development for improving voice problems in stroke patients with mixed dysarthria.
Based on the anatomical and functional commonality between singing and speech, various types of musical elements have been employed in music therapy research for speech rehabilitation. This study was to develop an accent-based music speech protocol to address voice problems of stroke patients with mixed dysarthria. Subjects were 6 stroke patients with mixed dysarthria and they received individual music therapy sessions. ⋯ Also, there were statistically significant differences in the measures of shimmer, and alternating motion rates (AMR) of the syllable /K$\inve$/ between pre- and post-test. The results indicated that the accent-based music speech protocol may improve speech motor coordination including respiration, phonation, articulation, resonance, and prosody of patients with dysarthria. This suggests the possibility of utilizing the music speech protocol to maximize immediate treatment effects in the course of a long-term treatment for patients with dysarthria.
-
NeuroRehabilitation · Jan 2013
Improved motor performance in chronic spinal cord injury following upper-limb robotic training.
Recovering upper-limb motor function has important implications for improving independence of patients with tetraplegia after traumatic spinal cord injury (SCI). ⋯ Robotic-assisted training of the upper limb over six weeks is a feasible and safe intervention that can enhance movement kinematics without negatively affecting pain or spasticity in chronic SCI. In addition, robot-assisted devices are an excellent tool to quantify motor performance (kinematics) and can be used to sensitively measure changes after a given rehabilitative intervention.