Neurorehabilitation and neural repair
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Neurorehabil Neural Repair · Mar 2010
Clinical TrialBotulinum toxin to treat upper-limb spasticity in hemiparetic patients: analysis of function and kinematics of reaching movements.
Poor control of reaching in spastic hemiparetic patients could be because of a combination of poor individuation of joints, weakness, spasticity, and/or sensory loss. ⋯ Kinematic parameters improved following BTI, without significant changes in clinical outcomes such as ARAT and BBT. The decrease in spasticity alone does not seem to explain the results, which may be a result of adaptation to the decrease in hypertonicity leading to increased use of the arm and possibly an increase in antagonist muscle strength.
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Neurorehabil Neural Repair · Feb 2010
ReviewContribution of transcranial magnetic stimulation to the understanding of functional recovery mechanisms after stroke.
Motor impairments are a major cause of morbidity and disability after stroke. This article reviews evidence obtained using transcranial magnetic stimulation (TMS) that provides new insight into mechanisms of impaired motor control and disability. They briefly discuss the use of TMS in the diagnosis, prognosis, and therapy of poststroke motor disability. Particular emphasis is placed on TMS as a tool to explore mechanisms of neuroplasticity during spontaneous and treatment-induced recovery of motor function to develop more rational and clinically useful interventions for stroke rehabilitation.
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Neurorehabil Neural Repair · Feb 2010
Long-term therapeutic and orthotic effects of a foot drop stimulator on walking performance in progressive and nonprogressive neurological disorders.
Stimulators applying functional electrical stimulation (FES) to the common peroneal nerve improve walking with a foot drop, which occurs in several disorders. ⋯ Subjects with progressive and nonprogressive disorders had an orthotic benefit from FES up to 11 months. The therapeutic effect increased for 11 months in nonprogressive disorders but only for 3 months in progressive disorders. The combined effect remained significant and clinically relevant.
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Neurorehabil Neural Repair · Jan 2010
Randomized Controlled TrialCombined botulinum toxin type A with modified constraint-induced movement therapy for chronic stroke patients with upper extremity spasticity: a randomized controlled study.
Botulinum toxin type A (BtxA) injection and modified constraint-induced movement therapy (mCIMT) are both promising approaches to enhance recovery after stroke. The combined application of these 2 promising modalities has rarely been studied. The aim was to investigate whether combined BtxA and mCIMT would improve spasticity and upper extremity motor function more than BtxA plus conventional rehabilitation in chronic stroke patients with upper extremity spasticity. ⋯ Combining BtxA and mCIMT is an effective and safe intervention for improving spasticity and motor function in chronic stroke patients. The results are promising enough to justify further studies. We recommend future research to address the likely need for including rehabilitation with BtxA to improve function in patients with poststroke spasticity.
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Neurorehabil Neural Repair · Jan 2010
Olfactory mucosal autografts and rehabilitation for chronic traumatic spinal cord injury.
Basic science advances in spinal cord injury (SCI) are leading to novel clinical approaches. The authors report a prospective, uncontrolled pilot study of the safety and outcomes of implanting olfactory mucosal autografts (OMA) in 20 patients with chronic, sensorimotor complete or motor complete SCI. ⋯ OMA is feasible, relatively safe, and possibly beneficial in people with chronic SCI when combined with postoperative rehabilitation. Future controlled trials may need to include a lengthy and intensive rehabilitation arm as a control.