Purpose: To examine the feasibility and possible effect of an 8-week exercise program on sleep quality, insomnia and psychological distress in individuals with multiple sclerosis (MS).
Methods: Twenty-four individuals with MS were recruited into a controlled pre-post feasibility study and divided into 2 groups: exercise (n = 13; Expanded Disability Status Scale (EDSS): 1.0-7.5) and a related control group with no exercise (n = 11; EDSS: 1.0-7.0). The exercise group performed combined upper limb, lower limb and breathing exercises in a controlled group (2d/week, 60 min/session) for 8 weeks. Participants were administered measures to evaluate sleep quality (Pittsburgh Sleep Quality Index, PSQI), insomnia severity (Insomnia Severity Index, ISI), psychological distress (Clinical Outcomes in Routine Evaluation-Outcome Measure, CORE-OM) and additionally impact of fatigue (Modified Fatigue Impact Scale, MFIS) after 8-weeks.
Results: Insomnia severity measured with ISI (F(1;22)=5.95, p = 0.023, ηp2 = 0.213, 90% CI = 0.02-0.42) and psychological distress measured with the CORE-OM (F(1;22)=4.82, p = 0.039, ηp2 = 0.179, 90% CI = 0.01-0.40) showed statistically significant group-by-time interaction. Sleep quality measured with the PSQI showed statistically significant group-by-time interaction only in an aspect of daytime sleep dysfunction (F(1;22)=5.33, p = 0.031, ηp2 = 0.195, 90% CI = 0.01-0.40). The fatigue impact measured with the MFIS showed statistically significant group-by-time interaction in physical (F(1;22)=6.80, p = 0.016, ηp2 = 0.236, 90% CI = 0.02-0.44) and cognitive aspects (F(1;22)=9.12, p = 0.006, ηp2 = 0.293, 90% CI = 0.05-0.49), and total score (F(1;22)=11.29, p = 0.003, ηp2 = 0.339, 90% CI = 0.08-0.52).
Conclusions: Our 8-week program reduced insomnia severity, psychological distress and some aspects of fatigue (physical; cognitive; total), and improved sleep quality in an aspect of daytime sleep dysfunction in a small group of individuals with MS. Good feasibility and significant positive changes from baseline warrant further exploratory work.
目的:研究为期8周的锻炼计划对多发性硬化症(MS)患者的睡眠质量、失眠和心理困扰的可行性和可能影响:方法:24 名多发性硬化症患者被招募参加一项前后对照可行性研究,并被分为两组:运动组(n = 13;残疾状况扩展量表(EDSS):1.0-7.5)和失眠组(n = 10;残疾状况扩展量表(EDSS):1.0-7.5):1.0-7.5)和不做运动的相关对照组(n = 11;EDSS:1.0-7.0)。锻炼组在对照组中进行上肢、下肢和呼吸综合锻炼(每周 2 次,每次 60 分钟),为期 8 周。8 周后,对参与者进行睡眠质量(匹兹堡睡眠质量指数,PSQI)、失眠严重程度(失眠严重程度指数,ISI)、心理困扰(常规评估中的临床结果-结果测量,CORE-OM)和疲劳影响(改良疲劳影响量表,MFIS)的评估:用 ISI 测量的失眠严重程度(F(1;22)=5.95, p = 0.023, η p 2 = 0.213, 90% CI = 0.02-0.42)和用 CORE-OM 测量的心理压力(F(1;22)=4.82, p = 0.039, η p 2 = 0.179, 90% CI = 0.01-0.40)显示出显著的组间时间交互作用。用 PSQI 测量的睡眠质量仅在日间睡眠功能障碍方面显示出具有统计学意义的组间交互作用(F(1;22)=5.33, p = 0.031, η p 2 = 0.195, 90% CI = 0.01-0.40)。在身体(F(1;22)=6.80,p = 0.016,η p 2 = 0.236,90% CI = 0.02-0.44)和认知方面(F(1;22)=9.12, p = 0.006, η p 2 = 0.293, 90% CI = 0.05-0.49),以及总分(F(1;22)=11.29, p = 0.003, η p 2 = 0.339, 90% CI = 0.08-0.52):我们为期8周的计划降低了失眠的严重程度、心理压力和疲劳的某些方面(身体、认知、总体),并改善了一小部分多发性硬化症患者白天睡眠功能障碍方面的睡眠质量。良好的可行性和与基线相比的显著积极变化值得进一步探索。
{"title":"Upper-lower limb and breathing exercise program for improving sleep quality and psychological status in multiple sclerosis: a pilot randomized controlled trial.","authors":"Tanja Grubić Kezele, Zrinka Trope, Valentina Ahel, Natali Ružić, Hrvoje Omrčen, Luka Đudarić, Ariana Fužinac-Smojver","doi":"10.1017/BrImp.2021.17","DOIUrl":"10.1017/BrImp.2021.17","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the feasibility and possible effect of an 8-week exercise program on sleep quality, insomnia and psychological distress in individuals with multiple sclerosis (MS).</p><p><strong>Methods: </strong>Twenty-four individuals with MS were recruited into a controlled pre-post feasibility study and divided into 2 groups: exercise (<i>n</i> = 13; Expanded Disability Status Scale (EDSS): 1.0-7.5) and a related control group with no exercise (<i>n</i> = 11; EDSS: 1.0-7.0). The exercise group performed combined upper limb, lower limb and breathing exercises in a controlled group (2d/week, 60 min/session) for 8 weeks. Participants were administered measures to evaluate sleep quality (Pittsburgh Sleep Quality Index, PSQI), insomnia severity (Insomnia Severity Index, ISI), psychological distress (Clinical Outcomes in Routine Evaluation-Outcome Measure, CORE-OM) and additionally impact of fatigue (Modified Fatigue Impact Scale, MFIS) after 8-weeks.</p><p><strong>Results: </strong>Insomnia severity measured with ISI (<i>F</i>(1;22)=5.95, <i>p</i> = 0.023, <i>η</i> <sub><i>p</i></sub> <sup>2</sup> = 0.213, 90% CI = 0.02-0.42) and psychological distress measured with the CORE-OM (<i>F</i>(1;22)=4.82, <i>p</i> = 0.039, <i>η</i> <sub><i>p</i></sub> <sup>2</sup> = 0.179, 90% CI = 0.01-0.40) showed statistically significant group-by-time interaction. Sleep quality measured with the PSQI showed statistically significant group-by-time interaction only in an aspect of daytime sleep dysfunction (<i>F</i>(1;22)=5.33, <i>p</i> = 0.031, <i>η</i> <sub><i>p</i></sub> <sup>2</sup> = 0.195, 90% CI = 0.01-0.40). The fatigue impact measured with the MFIS showed statistically significant group-by-time interaction in physical (<i>F</i>(1;22)=6.80, <i>p</i> = 0.016, <i>η</i> <sub><i>p</i></sub> <sup>2</sup> = 0.236, 90% CI = 0.02-0.44) and cognitive aspects (<i>F</i>(1;22)=9.12<i>, p</i> = 0.006, <i>η</i> <sub><i>p</i></sub> <sup>2</sup> = 0.293, 90% CI = 0.05-0.49), and total score (<i>F</i>(1;22)=11.29, <i>p</i> = 0.003, <i>η</i> <sub><i>p</i></sub> <sup>2</sup> = 0.339, 90% CI = 0.08-0.52).</p><p><strong>Conclusions: </strong>Our 8-week program reduced insomnia severity, psychological distress and some aspects of fatigue (physical; cognitive; total), and improved sleep quality in an aspect of daytime sleep dysfunction in a small group of individuals with MS. Good feasibility and significant positive changes from baseline warrant further exploratory work.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86996471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01Epub Date: 2021-12-13DOI: 10.1017/BrImp.2021.30
Karen Sullivan, Anna Keyter, Kelly Jones, Shanthi Ameratunga, Nicola Starkey, Suzanne Barker-Collo, James Webb, Alice Theadom
Objective: Early reporting of atypical symptoms following a mild traumatic brain injury (mTBI) may be an early indicator of poor prognosis. This study aimed to determine the percentage of people reporting atypical symptoms 1-month post-mTBI and explore links to recovery 12 months later in a community-dwelling mTBI sample.
Methods: Adult participants (>16 years) who had experienced a mTBI were identified from a longitudinal incidence study (BIONIC). At 1-month post-injury, 260 participants completed the Rivermead Post-Concussion Symptoms Questionnaire (typical symptoms) plus four atypical symptom items (hemiplegia, difficulty swallowing, digestion problems and difficulties with fine motor tasks). At 12 months post-injury, 73.9% (n = 193) rated their overall recovery on a 100-point scale. An ordinal regression explored the association between atypical symptoms at 1 month and recovery at 12 months post-injury (low = 0-80, moderate = 81-99 and complete recovery = 100), whilst controlling for age, sex, rehabilitation received, ethnicity, mental and physical comorbidities and additional injuries sustained at the time of injury.
Results: At 1-month post-injury <1% of participants reported hemiplegia, 5.4% difficulty swallowing, 10% digestion problems and 15.4% difficulties with fine motor tasks. The ordinal regression model revealed atypical symptoms were not significant predictors of self-rated recovery at 12 months. Older age at injury and higher typical symptoms at 1 month were independently associated with poorer recovery at 12 months, p < 0.01.
Conclusion: Atypical symptoms on initial presentation were not linked to global self-reported recovery at 12 months. Age at injury and typical symptoms are stronger early indicators of longer-term prognosis. Further research is needed to determine if atypical symptoms predict other outcomes following mTBI.
{"title":"Atypical symptom reporting after mild traumatic brain injury.","authors":"Karen Sullivan, Anna Keyter, Kelly Jones, Shanthi Ameratunga, Nicola Starkey, Suzanne Barker-Collo, James Webb, Alice Theadom","doi":"10.1017/BrImp.2021.30","DOIUrl":"10.1017/BrImp.2021.30","url":null,"abstract":"<p><strong>Objective: </strong>Early reporting of atypical symptoms following a mild traumatic brain injury (mTBI) may be an early indicator of poor prognosis. This study aimed to determine the percentage of people reporting atypical symptoms 1-month post-mTBI and explore links to recovery 12 months later in a community-dwelling mTBI sample.</p><p><strong>Methods: </strong>Adult participants (>16 years) who had experienced a mTBI were identified from a longitudinal incidence study (BIONIC). At 1-month post-injury, 260 participants completed the Rivermead Post-Concussion Symptoms Questionnaire (typical symptoms) plus four atypical symptom items (hemiplegia, difficulty swallowing, digestion problems and difficulties with fine motor tasks). At 12 months post-injury, 73.9% (<i>n</i> = 193) rated their overall recovery on a 100-point scale. An ordinal regression explored the association between atypical symptoms at 1 month and recovery at 12 months post-injury (low = 0-80, moderate = 81-99 and complete recovery = 100), whilst controlling for age, sex, rehabilitation received, ethnicity, mental and physical comorbidities and additional injuries sustained at the time of injury.</p><p><strong>Results: </strong>At 1-month post-injury <1% of participants reported hemiplegia, 5.4% difficulty swallowing, 10% digestion problems and 15.4% difficulties with fine motor tasks. The ordinal regression model revealed atypical symptoms were not significant predictors of self-rated recovery at 12 months. Older age at injury and higher typical symptoms at 1 month were independently associated with poorer recovery at 12 months, <i>p</i> < 0.01.</p><p><strong>Conclusion: </strong>Atypical symptoms on initial presentation were not linked to global self-reported recovery at 12 months. Age at injury and typical symptoms are stronger early indicators of longer-term prognosis. Further research is needed to determine if atypical symptoms predict other outcomes following mTBI.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76446403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01Epub Date: 2021-11-04DOI: 10.1017/BrImp.2021.18
Maria Jeannette Hennessy, Karen A Sullivan
Objective: This qualitative study aimed to identify the service and support needs of people with a recent history of traumatic brain injury (TBI) living in the community.
Methods: A postal survey was sent to 662 people 6-18 months after hospital admission for a mild-to-severe TBI. The survey included an open-ended item ('wish-basket') for collecting ideas about important unmet needs.
Results: Responses from 53 individuals were coded and processed using thematic analysis. Five themes (n = 39) were identified, three of which were related to personal needs. These personal wishes were about being symptom-free, independent and emotionally supported by, and connected to, loved ones. The remaining themes were about the wished-for changes to the health system and society, such as wishing for health care continuity (as opposed to being abandoned), and for greater understanding and support by society.
Conclusions: There is scope to improve the services and support for people living with TBI in the community. This includes reconsidering the way that discharge occurs, addressing the personal needs that remain when living in the community and promoting greater social awareness of TBI to counteract disadvantage.
{"title":"A 'Network of Understanding and Compassion': A Qualitative Study of Survivor Perspectives on Unmet Needs After Traumatic Brain Injury (TBI) in Regional Communities.","authors":"Maria Jeannette Hennessy, Karen A Sullivan","doi":"10.1017/BrImp.2021.18","DOIUrl":"10.1017/BrImp.2021.18","url":null,"abstract":"<p><strong>Objective: </strong>This qualitative study aimed to identify the service and support needs of people with a recent history of traumatic brain injury (TBI) living in the community.</p><p><strong>Methods: </strong>A postal survey was sent to 662 people 6-18 months after hospital admission for a mild-to-severe TBI. The survey included an open-ended item ('wish-basket') for collecting ideas about important unmet needs.</p><p><strong>Results: </strong>Responses from 53 individuals were coded and processed using thematic analysis. Five themes (<i>n</i> = 39) were identified, three of which were related to personal needs. These personal wishes were about being symptom-free, independent and emotionally supported by, and connected to, loved ones. The remaining themes were about the wished-for changes to the health system and society, such as wishing for health care continuity (as opposed to being abandoned), and for greater understanding and support by society.</p><p><strong>Conclusions: </strong>There is scope to improve the services and support for people living with TBI in the community. This includes reconsidering the way that discharge occurs, addressing the personal needs that remain when living in the community and promoting greater social awareness of TBI to counteract disadvantage.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77563318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Armstrong, J. Dahm, B. Dimech-Betancourt, Katherine A R Frencham, Diane, Parcell, Sue Sloan, K. Trezise, C. Ziino, Dana K. Wong, D. Lawson, R. Stolwyk, D. Cadilhac, Nicolette Kamberis, R. Nair
S THURSDAY 5TH MAY Workshop: Adult ADHD: Assessment, Diagnosis and Intervention Caroline Fisher1, Nicci Grace1, Mary Castellani1 and Eddie Tsang1 1Neuropsychology Service, The Melbourne Clinic, Melbourne, Australia This workshop is targeted at clinicians who are interested in developing clinical knowledge and skills in the assessment and diagnosis of adults with ADHD, as well as ways to support with neurocognitive intervention. Increasingly, adults of all ages are being referred to neuropsychology for diagnostic clarification of possible ADHD. This is likely due to increased community awareness and greater understanding of this condition. Adults with ADHD typically also present with longstanding challenges with mental health and emotional dysregulation, and this can be a complicating factor when providing diagnostic clarification. The workshop will be interactive and include case studies. It will cover three main areas: 1) Clinical features of ADHD in adults, what to look for and ask about in history taking. How undiagnosed ADHD may have impacted on functioning, as well as common mental health and neurodevelopmental comorbidities. 2) Recommendations for conducting a neuropsychology diagnostic assessment including; clinical and cognitive features of ADHD in adults and how to identify these alongside other Abstract 347
{"title":"ASSBI / NZRA AWARDS - Kevin Walsh Award for Most Outstanding Masters Student 2012","authors":"A. Armstrong, J. Dahm, B. Dimech-Betancourt, Katherine A R Frencham, Diane, Parcell, Sue Sloan, K. Trezise, C. Ziino, Dana K. Wong, D. Lawson, R. Stolwyk, D. Cadilhac, Nicolette Kamberis, R. Nair","doi":"10.1017/BrImp.2022.29","DOIUrl":"https://doi.org/10.1017/BrImp.2022.29","url":null,"abstract":"S THURSDAY 5TH MAY Workshop: Adult ADHD: Assessment, Diagnosis and Intervention Caroline Fisher1, Nicci Grace1, Mary Castellani1 and Eddie Tsang1 1Neuropsychology Service, The Melbourne Clinic, Melbourne, Australia This workshop is targeted at clinicians who are interested in developing clinical knowledge and skills in the assessment and diagnosis of adults with ADHD, as well as ways to support with neurocognitive intervention. Increasingly, adults of all ages are being referred to neuropsychology for diagnostic clarification of possible ADHD. This is likely due to increased community awareness and greater understanding of this condition. Adults with ADHD typically also present with longstanding challenges with mental health and emotional dysregulation, and this can be a complicating factor when providing diagnostic clarification. The workshop will be interactive and include case studies. It will cover three main areas: 1) Clinical features of ADHD in adults, what to look for and ask about in history taking. How undiagnosed ADHD may have impacted on functioning, as well as common mental health and neurodevelopmental comorbidities. 2) Recommendations for conducting a neuropsychology diagnostic assessment including; clinical and cognitive features of ADHD in adults and how to identify these alongside other Abstract 347","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84300663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-01Epub Date: 2021-10-28DOI: 10.1017/BrImp.2021.20
Lindsey J Byom, Meaghan Whalen, Lyn S Turkstra
This preliminary study investigated the interaction between working memory and social cognition in adolescents and young adults with traumatic brain injury (TBI). It was hypothesized that participants with or without TBI would better recognize social information when working memory or social cognitive load was low, and that adolescents and young adults with TBI would be more affected by increased cognitive demand than their uninjured peers. Eight adolescents and young adults with complicated mild-severe TBI (aged 14-22 years) and eight age- and sex-matched typically developing (TD) adolescents completed computer-based n-back tasks requiring recognition of either face identity or facial affect, with 0-back, 1-, and 2-back conditions. The TBI group had lower scores overall than the TD group, and scores for both groups were lower for affect recognition than identity recognition. Scores for both groups were lower in conditions with a higher working memory load. There was a significant group-by-working memory interaction, with larger group differences in high-working memory conditions. Study results and their potential implications for social outcomes are discussed.
{"title":"Working Memory for Emotions in Adolescents and Young Adults with Traumatic Brain Injury.","authors":"Lindsey J Byom, Meaghan Whalen, Lyn S Turkstra","doi":"10.1017/BrImp.2021.20","DOIUrl":"10.1017/BrImp.2021.20","url":null,"abstract":"<p><p>This preliminary study investigated the interaction between working memory and social cognition in adolescents and young adults with traumatic brain injury (TBI). It was hypothesized that participants with or without TBI would better recognize social information when working memory or social cognitive load was low, and that adolescents and young adults with TBI would be more affected by increased cognitive demand than their uninjured peers. Eight adolescents and young adults with complicated mild-severe TBI (aged 14-22 years) and eight age- and sex-matched typically developing (TD) adolescents completed computer-based n-back tasks requiring recognition of either face identity or facial affect, with 0-back, 1-, and 2-back conditions. The TBI group had lower scores overall than the TD group, and scores for both groups were lower for affect recognition than identity recognition. Scores for both groups were lower in conditions with a higher working memory load. There was a significant group-by-working memory interaction, with larger group differences in high-working memory conditions. Study results and their potential implications for social outcomes are discussed.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9873224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10638652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Primary progressive aphasias are rare younger-onset dementias. As the label denotes, these dementias are characterised clinically by marked changes in language skills. Evidence over the years has shown that individuals with primary progressive aphasia experience widespread cognitive and behavioural changes that extend beyond language. This evidence, however, seems to be largely ignored or downplayed. This article proposes that linguistic relativity which induces a cognitive bias may be responsible for this omission; it also indicates that a revision of the current diagnostic criteria may need to be revised.
{"title":"2022 ASSBI PRESIDENTIAL ADDRESS. Reflections on language and primary progressive aphasias","authors":"O. Piguet","doi":"10.1017/BrImp.2022.25","DOIUrl":"https://doi.org/10.1017/BrImp.2022.25","url":null,"abstract":"Abstract Primary progressive aphasias are rare younger-onset dementias. As the label denotes, these dementias are characterised clinically by marked changes in language skills. Evidence over the years has shown that individuals with primary progressive aphasia experience widespread cognitive and behavioural changes that extend beyond language. This evidence, however, seems to be largely ignored or downplayed. This article proposes that linguistic relativity which induces a cognitive bias may be responsible for this omission; it also indicates that a revision of the current diagnostic criteria may need to be revised.","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76220888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lauren Ziaks, Jenna Tucker, T. Koc, Alexa Schaefer, Kristin R. Hanson
To identify trends of provoked dysautonomia signs and symptoms during the Buffalo Concussion Treadmill Test (BCTT). This is a retrospective cohort study of 101 patient charts post-concussion who were screened for suspected dysautonomia. Patients with suspected dysautonomia were assessed for exercise intolerance using a BCTT. Symptoms and rate of perceived exertion were recorded on a standardized form. Digital pulse oximetry was used to collect heart rate (HR) and oxygen saturation. Descriptive analyses were conducted on BCTT results. Of 101 patient charts, 57 were excluded from analysis, including four patients who completed the BCTT by asymptomatically reaching the target HR zone for their estimated HR max. The remaining 44 patients demonstrated: 35 (79.5%) poor HR stabilization defined as a drop or plateau in HR during exercise, 28 (63.8%) exacerbated concussion symptoms, 13 (29.5%) autonomic nervous system response such as hot flushed sensation, 12 (27.3%) rebound symptoms during recovery phases, and 8 (18.2%) desaturation of 90% or below. The mean delta (80% expected HR max – 80% achieved HR max) on the initial test was 80.66 (± 23.08) beats per minute. This study is the first to identify trends of signs and symptoms during the BCTT in an expanded population with suspected dysautonomia after concussion. Future studies are indicated to validate these findings and contribute to development of modified termination criteria for the BCTT in individuals with suspected dysautonomia associated with protracted concussion recovery.
{"title":"Identifying Trends of Dysautonomia Signs and Symptoms Associated with Protracted Concussion Recovery during the Buffalo Concussion Treadmill Test: A Retrospective Study","authors":"Lauren Ziaks, Jenna Tucker, T. Koc, Alexa Schaefer, Kristin R. Hanson","doi":"10.1017/brimp.2022.5","DOIUrl":"https://doi.org/10.1017/brimp.2022.5","url":null,"abstract":"\u0000 \u0000 \u0000 To identify trends of provoked dysautonomia signs and symptoms during the Buffalo Concussion Treadmill Test (BCTT).\u0000 \u0000 \u0000 \u0000 This is a retrospective cohort study of 101 patient charts post-concussion who were screened for suspected dysautonomia.\u0000 \u0000 \u0000 \u0000 Patients with suspected dysautonomia were assessed for exercise intolerance using a BCTT. Symptoms and rate of perceived exertion were recorded on a standardized form. Digital pulse oximetry was used to collect heart rate (HR) and oxygen saturation. Descriptive analyses were conducted on BCTT results.\u0000 \u0000 \u0000 \u0000 Of 101 patient charts, 57 were excluded from analysis, including four patients who completed the BCTT by asymptomatically reaching the target HR zone for their estimated HR max. The remaining 44 patients demonstrated: 35 (79.5%) poor HR stabilization defined as a drop or plateau in HR during exercise, 28 (63.8%) exacerbated concussion symptoms, 13 (29.5%) autonomic nervous system response such as hot flushed sensation, 12 (27.3%) rebound symptoms during recovery phases, and 8 (18.2%) desaturation of 90% or below. The mean delta (80% expected HR max – 80% achieved HR max) on the initial test was 80.66 (± 23.08) beats per minute.\u0000 \u0000 \u0000 \u0000 This study is the first to identify trends of signs and symptoms during the BCTT in an expanded population with suspected dysautonomia after concussion. Future studies are indicated to validate these findings and contribute to development of modified termination criteria for the BCTT in individuals with suspected dysautonomia associated with protracted concussion recovery.\u0000","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79763996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Genevieve Tolé, Gavin Williams, A. Holland, R. Clark
To determine if the intention to perform an exercise at speed leads to beneficial alterations in kinematic and kinetic components of the movement in people with post-stroke hemiplegia. Comparative study. Subacute metropolitan rehabilitation hospital. Convenience sample of patients admitted as an inpatient or outpatient with a diagnosis of stroke with lower limb weakness, functional ambulation category score ≥3, and ability to walk ≥14metres. Participants performed a single leg squat exercise on their paretic and nonparetic legs on a leg sled under three conditions: 1) self-selected speed (SS), 2) fast speed (FS), 3) jump squat (JS). Measures of displacement, flight time, peak concentric velocity, and muscle excitation (via electromyography) were compared between legs and conditions. Eleven participants (age: 56 ± 17 years; median time since stroke onset: 3.3 [IQR 3,41] months) were tested. All participants achieved a jump during the JS, as measured by displacement and flight time respectively, on both their paretic (0.25 ± 0.16 m and 0.42 ± 0.18 s) and nonparetic (0.49 ± 0.36 m and 0.73 ± 0.28 s) legs; however it was significantly lower on the non-paretic leg (p < 0.05). Peak concentric velocity increased concordantly with intended movement speed (JS-FS paretic: 0.96 m/s, non-paretic: 0.54 m/s; FS-SS paretic 0.69 m/s, nonparetic 0.38 m/s; JS-SS paretic 1.66 m/s, non-paretic 0.92 m/s). Similarly, muscle excitation increased significantly (p < 0.05) with faster speed for the paretic and nonparetic vastus lateralis. For gastrocnemius, the only significant difference was an increase during nonparetic JS vs. SS and FS. Speed affects the kinematic and kinetic components of the movement. Performing exercises ballistically may improve training outcomes for people post-stroke.
{"title":"Lower limb muscle performance during a closed chain single leg squat and a squat jump in people with leg weakness after stroke: A comparative study","authors":"Genevieve Tolé, Gavin Williams, A. Holland, R. Clark","doi":"10.1017/brimp.2022.4","DOIUrl":"https://doi.org/10.1017/brimp.2022.4","url":null,"abstract":"\u0000 \u0000 \u0000 To determine if the intention to perform an exercise at speed leads to beneficial alterations in kinematic and kinetic components of the movement in people with post-stroke hemiplegia.\u0000 \u0000 \u0000 \u0000 Comparative study.\u0000 \u0000 \u0000 \u0000 Subacute metropolitan rehabilitation hospital.\u0000 \u0000 \u0000 \u0000 Convenience sample of patients admitted as an inpatient or outpatient with a diagnosis of stroke with lower limb weakness, functional ambulation category score ≥3, and ability to walk ≥14metres.\u0000 \u0000 \u0000 \u0000 Participants performed a single leg squat exercise on their paretic and nonparetic legs on a leg sled under three conditions: 1) self-selected speed (SS), 2) fast speed (FS), 3) jump squat (JS). Measures of displacement, flight time, peak concentric velocity, and muscle excitation (via electromyography) were compared between legs and conditions.\u0000 \u0000 \u0000 \u0000 Eleven participants (age: 56 ± 17 years; median time since stroke onset: 3.3 [IQR 3,41] months) were tested. All participants achieved a jump during the JS, as measured by displacement and flight time respectively, on both their paretic (0.25 ± 0.16 m and 0.42 ± 0.18 s) and nonparetic (0.49 ± 0.36 m and 0.73 ± 0.28 s) legs; however it was significantly lower on the non-paretic leg (p < 0.05). Peak concentric velocity increased concordantly with intended movement speed (JS-FS paretic: 0.96 m/s, non-paretic: 0.54 m/s; FS-SS paretic 0.69 m/s, nonparetic 0.38 m/s; JS-SS paretic 1.66 m/s, non-paretic 0.92 m/s). Similarly, muscle excitation increased significantly (p < 0.05) with faster speed for the paretic and nonparetic vastus lateralis. For gastrocnemius, the only significant difference was an increase during nonparetic JS vs. SS and FS.\u0000 \u0000 \u0000 \u0000 Speed affects the kinematic and kinetic components of the movement. Performing exercises ballistically may improve training outcomes for people post-stroke.\u0000","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87761445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Genevieve Tolé, Gavin Williams, Anne E Holland, Ross A Clark
Objective: To determine if the intention to perform an exercise at speed leads to beneficial alterations in kinematic and kinetic components of the movement in people with post-stroke hemiplegia.
Participants: Convenience sample of patients admitted as an inpatient or outpatient with a diagnosis of stroke with lower limb weakness, functional ambulation category score ≥3, and ability to walk ≥14metres.
Methods: Participants performed a single leg squat exercise on their paretic and nonparetic legs on a leg sled under three conditions: 1) self-selected speed (SS), 2) fast speed (FS), 3) jump squat (JS). Measures of displacement, flight time, peak concentric velocity, and muscle excitation (via electromyography) were compared between legs and conditions.
Results: Eleven participants (age: 56 ± 17 years; median time since stroke onset: 3.3 [IQR 3,41] months) were tested. All participants achieved a jump during the JS, as measured by displacement and flight time respectively, on both their paretic (0.25 ± 0.16 m and 0.42 ± 0.18 s) and nonparetic (0.49 ± 0.36 m and 0.73 ± 0.28 s) legs; however it was significantly lower on the non-paretic leg (p p Conclusions: Speed affects the kinematic and kinetic components of the movement. Performing exercises ballistically may improve training outcomes for people post-stroke.
{"title":"Lower limb muscle performance during a closed chain single leg squat and a squat jump in people with leg weakness after stroke: A comparative study.","authors":"Genevieve Tolé, Gavin Williams, Anne E Holland, Ross A Clark","doi":"10.1071/IB22031","DOIUrl":"https://doi.org/10.1071/IB22031","url":null,"abstract":"<p><strong>Objective: </strong>To determine if the intention to perform an exercise at speed leads to beneficial alterations in kinematic and kinetic components of the movement in people with post-stroke hemiplegia.</p><p><strong>Design: </strong>Comparative study.</p><p><strong>Setting: </strong>Subacute metropolitan rehabilitation hospital.</p><p><strong>Participants: </strong>Convenience sample of patients admitted as an inpatient or outpatient with a diagnosis of stroke with lower limb weakness, functional ambulation category score ≥3, and ability to walk ≥14metres.</p><p><strong>Methods: </strong>Participants performed a single leg squat exercise on their paretic and nonparetic legs on a leg sled under three conditions: 1) self-selected speed (SS), 2) fast speed (FS), 3) jump squat (JS). Measures of displacement, flight time, peak concentric velocity, and muscle excitation (via electromyography) were compared between legs and conditions.</p><p><strong>Results: </strong>Eleven participants (age: 56 ± 17 years; median time since stroke onset: 3.3 [IQR 3,41] months) were tested. All participants achieved a jump during the JS, as measured by displacement and flight time respectively, on both their paretic (0.25 ± 0.16 m and 0.42 ± 0.18 s) and nonparetic (0.49 ± 0.36 m and 0.73 ± 0.28 s) legs; however it was significantly lower on the non-paretic leg (p p Conclusions: Speed affects the kinematic and kinetic components of the movement. Performing exercises ballistically may improve training outcomes for people post-stroke.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lauren Ziaks, Jenna Tucker, Thomas Koc, Alexa Schaefer, Kristina Hanson
Objective: To identify trends of provoked dysautonomia signs and symptoms during the Buffalo Concussion Treadmill Test (BCTT).
Subjects: This is a retrospective cohort study of 101 patient charts post-concussion who were screened for suspected dysautonomia.
Methods: Patients with suspected dysautonomia were assessed for exercise intolerance using a BCTT. Symptoms and rate of perceived exertion were recorded on a standardized form. Digital pulse oximetry was used to collect heart rate (HR) and oxygen saturation. Descriptive analyses were conducted on BCTT results.
Results: Of 101 patient charts, 57 were excluded from analysis, including four patients who completed the BCTT by asymptomatically reaching the target HR zone for their estimated HR max. The remaining 44 patients demonstrated: 35 (79.5%) poor HR stabilization defined as a drop or plateau in HR during exercise, 28 (63.8%) exacerbated concussion symptoms, 13 (29.5%) autonomic nervous system response such as hot flushed sensation, 12 (27.3%) rebound symptoms during recovery phases, and 8 (18.2%) desaturation of 90% or below. The mean delta (80% expected HR max â€" 80% achieved HR max) on the initial test was 80.66 (± 23.08) beats per minute.
Conclusions: This study is the first to identify trends of signs and symptoms during the BCTT in an expanded population with suspected dysautonomia after concussion. Future studies are indicated to validate these findings and contribute to development of modified termination criteria for the BCTT in individuals with suspected dysautonomia associated with protracted concussion recovery.
{"title":"Identifying Trends of Dysautonomia Signs and Symptoms Associated with Protracted Concussion Recovery during the Buffalo Concussion Treadmill Test: A Retrospective Study.","authors":"Lauren Ziaks, Jenna Tucker, Thomas Koc, Alexa Schaefer, Kristina Hanson","doi":"10.1071/IB22030","DOIUrl":"https://doi.org/10.1071/IB22030","url":null,"abstract":"<p><strong>Objective: </strong>To identify trends of provoked dysautonomia signs and symptoms during the Buffalo Concussion Treadmill Test (BCTT).</p><p><strong>Subjects: </strong>This is a retrospective cohort study of 101 patient charts post-concussion who were screened for suspected dysautonomia.</p><p><strong>Methods: </strong>Patients with suspected dysautonomia were assessed for exercise intolerance using a BCTT. Symptoms and rate of perceived exertion were recorded on a standardized form. Digital pulse oximetry was used to collect heart rate (HR) and oxygen saturation. Descriptive analyses were conducted on BCTT results.</p><p><strong>Results: </strong>Of 101 patient charts, 57 were excluded from analysis, including four patients who completed the BCTT by asymptomatically reaching the target HR zone for their estimated HR max. The remaining 44 patients demonstrated: 35 (79.5%) poor HR stabilization defined as a drop or plateau in HR during exercise, 28 (63.8%) exacerbated concussion symptoms, 13 (29.5%) autonomic nervous system response such as hot flushed sensation, 12 (27.3%) rebound symptoms during recovery phases, and 8 (18.2%) desaturation of 90% or below. The mean delta (80% expected HR max â€\" 80% achieved HR max) on the initial test was 80.66 (± 23.08) beats per minute.</p><p><strong>Conclusions: </strong>This study is the first to identify trends of signs and symptoms during the BCTT in an expanded population with suspected dysautonomia after concussion. Future studies are indicated to validate these findings and contribute to development of modified termination criteria for the BCTT in individuals with suspected dysautonomia associated with protracted concussion recovery.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}