Brain & NeuroRehabilitation最新文献

Traumatic brain injury (TBI) is an acquired injury to the brain caused by external mechanical forces, which can cause temporary or permanent disability. TBI and its potential long-term consequences are serious public health concerns. This review seeks to provide updated information on the current methods of management of patients with TBI to improve patient care.

Motor impairment due to stroke limits patients' mobility, activities of daily living, and negatively affects their return to the workplace. It also reduces patients' quality of life and increases the socioeconomic burden of stroke. Therefore, optimizing the recovery of motor impairment after stroke is a very important goal for both individuals and society as a whole. The emergence and improvement of various technologies in the Fourth Industrial Revolution have exerted a major influence on the development of new rehabilitation methods and efficiency enhancements for existing methods. This review categorizes rehabilitation methods that promote the recovery of motor function into upper limb function and lower limb function and summarizes recent advances in stroke rehabilitation. Although debate continues regarding the effects of some rehabilitation therapies, it is hoped that the evidence will be improved through ongoing research so that clinicians can treat patients with a higher level of evidence.

Restoration of ambulation is important for stroke patients. Valid and reliable methods are required for the assessment of lower limb functional status. We reviewed the psychometric properties of methods employed to assess lower extremity motor function, ambulation, and balance, with a focus on stroke patients. We define "motor function" as the ability to produce bodily movements when the brain, motor neurons, and muscles interact. "Ambulation" is defined as the ability to walk with or without a personal assistive device, and "balance" as the ability to maintain stability (without falling) during various physical activities. The Motricity Index and Fugl-Meyer Assessment of Lower Extremities assess the motor function of the lower limbs. The Functional Ambulation Category, 10-m Walk Test, and 6-minute Walk Test assess ambulation. The Berg Balance Scale, Timed Up and Go Test, Functional Reach Test, and Trunk Impairment Scale explore balance. All these tests exhibit high-level validity and have good inter-rater and test-retest reliabilities. However, only 3 methods have been formally translated into Korean. The methods discussed here can be used for standardized assessment, personalized goal setting, rehabilitation planning, and estimation of therapeutic efficacy.

The need for a comprehensive nursing care service ward (CNCW) is emerging, but few studies have investigated its medical validity. This study aimed to assess the effect of hospitalization on functional recovery and fall incidence in poststroke patients. This retrospective study enrolled 354 patients with subacute stroke between July 2017 and April 2020. CNCW provided full caregiving and nursing to the patient. Baseline demographic and hospital data, including fall occurrence, were collected. Functional outcomes, including the Medical Research Council (MRC), Korean version of the Modified Barthel Index (K-MBI), and Korean version of the Mini-Mental State Examination (K-MMSE), were evaluated upon admission and discharge. One hundred seventy-two patients were hospitalized in CNCW among the 354 stroke patients. Initial and final K-MMSE and K-MBI were significantly higher in the CNCW group. The K-MMSE score gain was significantly lower in the CNCW group (p < 0.05). The fall occurrence was significantly higher in the CNCW group (p < 0.01). Hospitalization in CNCW adversely affected cognitive function after stroke. Falls were detected more frequently and reported in CNCW.

Aphasia is one of the most serious cognitive impairments in stroke patients. An accurate diagnosis of aphasia is important for early interventions that optimize patients' functional status. Therefore, we present a review of the aphasia assessment tools currently available in Korea. Aphasia is usually evaluated using a standardized comprehensive assessment battery to establish the diagnosis of aphasia, its severity, and the treatment plan. Before a comprehensive language test, a brief screening test for aphasia can be useful to identify whether any further assessment is necessary. Several standardized evaluation tools are readily available in Korea. The Paradise-Korean version of the Western Aphasia Battery (PK-WAB) is a commonly used comprehensive aphasia test for determining the presence, type, and severity of aphasia. The Korean version of the Boston Naming Test (K-BNT) is an in-depth test to evaluate naming ability. Several screening tests, such as the Korean version of the Frenchay Aphasia Screening Test (K-FAST), the Screening Test for Aphasia and Neurologic Communication Disorders (STAND), and Semantic Verbal Fluency (SVF), can be applied to identify patients at risk in terms of language performance. Depending on the outcome of these tests, patients can be referred for further evaluation.

Bioelectrical impedance analysis (BIA) has been used to investigate the body compositions and predict functional outcomes in patients with stroke, while the role of BIA to predict motor function or recovery in stroke has not been clarified. This study aimed to investigate relationship between body composition measured by BIA and upper limb motor function and recovery. Body compositions (soft tissue lean mass, phase angle, body fat mass and body water) of fifty patients who are admitted to the stroke rehabilitation unit were segmentally analyzed via BIA. The motor recovery of upper extremity (UE) was evaluated via Fugl-Meyer Assessment (UE-FMA) at the time of transfer and discharge. Correlations between body composition and UE-FMA at discharge were analyzed using Spearman correlation coefficient. Multiple regression analysis was used to determine the regression between body composition and motor function and recovery. The Δ Phase angle, the difference of both sides was significantly linearly inversely correlated with UE-FMA at discharge. However, in multiple regression analysis, body compositions including phase angle did not significantly predict motor function at discharge or motor recovery. The Δ Phase angle is related to the severity of upper limb motor function at discharge in subacute stroke patients, and further studies are needed to determine its value as a predictor for motor recovery.

Various interventions exist to treat non-motor impairments caused by stroke. Adjuvant treatments such as non-invasive brain stimulation, virtual reality, computer-assisted training, neurostimulation, and biofeedback are being investigated and applied in the areas of cognitive dysfunction, language problems, visual disorders, dysphagia, mood disorders, and post-stroke pain. Most of these treatments have shown efficacy and symptom improvement, but further investigation is required to fully clarify their effects.

Although there are many assessment tools for upper extremity (UE) function, it is still difficult to select an appropriate outcome measurement for the rehabilitation process of individuals with stroke. This review aims to classify each tool within the International Classification of Functioning, Disability and Health (ICF) framework and provide an overview of UE assessments. Through a comprehensive understanding of assessments based on ICF, health care professionals will be able to choose suitable measurement tools for individuals, facilitating their rehabilitation.

Parkinson's disease (PD) is the second most common neurodegenerative disorder. Although dopaminergic drugs are the mainstay for improving PD symptoms, there are still few effective disease-modifying therapies. With the increasing prevalence of PD and the rapid transition to an aging society, more emphasis needs to be placed on rehabilitation that could slow the disease progression combined with pharmacological therapy. In this review, we present an update on evidence related to rehabilitation programs for motor function, swallowing difficulty, and speech disorders in PD. Aerobic exercise, music therapy, dance, virtual reality, and non-invasive brain stimulation have been shown to improve motor function, and telerehabilitation could also be feasibly applied in PD. Recent studies have shown the effectiveness of expiratory muscle strengthening exercises and Lee Silverman Voice Treatment for swallowing difficulty and speech disorders, respectively. Although many rehabilitation programs have been tried, the evidence is still limited. Well-designed future randomized controlled trials with large numbers of participants are needed to establish evidence for rehabilitation in PD.

[This corrects the article e4 in vol. 9.].