Pub Date : 2018-01-01DOI: 10.4172/2376-0281.1000329
A. Wong, L. H. Mak, V. Mok
Conclusion: Our study provides preliminary findings suggesting that both Mozart K.448 and a general relaxing music may reduce the spasticity level. This study suggested that more research is required to strengthen the scientific knowledge of the effects of music intervention on spasticity level in individuals with spasticity. The Effect of Listening to Mozart K.448 Music for Individuals with Spasticity – A Randomized Controlled Trial
{"title":"The Effect of Listening to Mozart K.448 Music for Individuals with Spasticity - A Randomized Controlled Trial","authors":"A. Wong, L. H. Mak, V. Mok","doi":"10.4172/2376-0281.1000329","DOIUrl":"https://doi.org/10.4172/2376-0281.1000329","url":null,"abstract":"Conclusion: Our study provides preliminary findings suggesting that both Mozart K.448 and a general relaxing music may reduce the spasticity level. This study suggested that more research is required to strengthen the scientific knowledge of the effects of music intervention on spasticity level in individuals with spasticity. The Effect of Listening to Mozart K.448 Music for Individuals with Spasticity – A Randomized Controlled Trial","PeriodicalId":91292,"journal":{"name":"International journal of neurorehabilitation","volume":"05 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2376-0281.1000329","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70303236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2376-0281.1000323
J. A. Franck, R. Smeets, Karolien Renders, H. Seelen
Background: Focal spasticity management in patients in the sub-acute phase after a stroke is mainly based on expert opinion. Evidence for the optimal type and intensity of multidisciplinary rehabilitation programs is scarce. This study will investigate the added-value of reduction of early signs of spasticity in the sub-acute phase after stroke on arm-hand rehabilitation outcome involving a well-described rehabilitation intervention. Reduction of early signs of spasticity will be done using abobotulinum toxin A.
{"title":"Added-value of Early Post-stroke Spasticity Reduction during Arm-hand Rehabilitation in Improving Functional Arm-hand Skill Performance: A Multiple Baseline Single Case Experimental Design Study","authors":"J. A. Franck, R. Smeets, Karolien Renders, H. Seelen","doi":"10.4172/2376-0281.1000323","DOIUrl":"https://doi.org/10.4172/2376-0281.1000323","url":null,"abstract":"Background: Focal spasticity management in patients in the sub-acute phase after a stroke is mainly based on expert opinion. Evidence for the optimal type and intensity of multidisciplinary rehabilitation programs is scarce. This study will investigate the added-value of reduction of early signs of spasticity in the sub-acute phase after stroke on arm-hand rehabilitation outcome involving a well-described rehabilitation intervention. Reduction of early signs of spasticity will be done using abobotulinum toxin A.","PeriodicalId":91292,"journal":{"name":"International journal of neurorehabilitation","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2376-0281.1000323","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70303514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2376-0281.1000335
D. Zimmerman
While nociception’s role in pain generation is known and understood what is less certain are the processes that drive rapid and profound pain reduction or cessation, particularly when the physical ‘causes’ are reinstated where orthotic use has seen rapid and durable profound pain reduction. There is a balance between nociceptive and antinociceptive systems. This paper looks at unexpectedly rapid and yet durable reduction in pain suffered achieved using non-invasive therapy.
{"title":"Using Motor Reflex Challenge to Identify and Appropriately Treat Nociceptive Sources Offers More Tailored Treatment with Prompt and Durable Outcomes","authors":"D. Zimmerman","doi":"10.4172/2376-0281.1000335","DOIUrl":"https://doi.org/10.4172/2376-0281.1000335","url":null,"abstract":"While nociception’s role in pain generation is known and understood what is less certain are the processes that drive rapid and profound pain reduction or cessation, particularly when the physical ‘causes’ are reinstated where orthotic use has seen rapid and durable profound pain reduction. There is a balance between nociceptive and antinociceptive systems. This paper looks at unexpectedly rapid and yet durable reduction in pain suffered achieved using non-invasive therapy.","PeriodicalId":91292,"journal":{"name":"International journal of neurorehabilitation","volume":"05 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2376-0281.1000335","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70303903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2376-0281.1000308
F. L. Belozo, C. Katashima, André V Cordeiro, Luciene Lenhare, Jean F. Alves, V. R. Silva
We previously reported evidence about the positive effects of continuous aerobic training (CAT) in hypertensive obese people. We showed that 90 min/week of aerobic exercise on a treadmill (70%-80% of the Maximal Heart Rate [MHR]) was able to improve the systemic blood metabolism of obese subjects. Therefore, we believe that reducing the recommended amount of aerobic exercise (150 min/week) by American College of Sports Medicine (ACSM) is a valuable strategy to for sedentary individuals with pathological conditions, since the suggested protocol is easyto- perform, fast and enjoyable for the subjects. In this comment, we tempt to summarize the literature evidences regarding physical aerobic exercise on cardiac metabolism in hypertensive obese individuals. These findings may influence the consenting information over the prescription of physical activity for individuals with cardiac-associated pathologies.
{"title":"A Commentary on Effects of Ninety Minutes per Week of Continuous Aerobic Exercise on Blood Pressure in Hypertensive Obese Humans","authors":"F. L. Belozo, C. Katashima, André V Cordeiro, Luciene Lenhare, Jean F. Alves, V. R. Silva","doi":"10.4172/2376-0281.1000308","DOIUrl":"https://doi.org/10.4172/2376-0281.1000308","url":null,"abstract":"We previously reported evidence about the positive effects of continuous aerobic training (CAT) in hypertensive obese people. We showed that 90 min/week of aerobic exercise on a treadmill (70%-80% of the Maximal Heart Rate [MHR]) was able to improve the systemic blood metabolism of obese subjects. Therefore, we believe that reducing the recommended amount of aerobic exercise (150 min/week) by American College of Sports Medicine (ACSM) is a valuable strategy to for sedentary individuals with pathological conditions, since the suggested protocol is easyto- perform, fast and enjoyable for the subjects. In this comment, we tempt to summarize the literature evidences regarding physical aerobic exercise on cardiac metabolism in hypertensive obese individuals. These findings may influence the consenting information over the prescription of physical activity for individuals with cardiac-associated pathologies.","PeriodicalId":91292,"journal":{"name":"International journal of neurorehabilitation","volume":"5 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2376-0281.1000308","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70303119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2376-0281.1000326
Masaru Oga
Higher brain dysfunction after traumatic brain injury in school-aged children potentially have serious impact on their lives than adults, because children are on their developmental way to be mature adults under the environment they should learn various knowledge and skills. Neuropsychological, psychosocial, and academic conditions/outcomes are evaluated by appropriate tools and methods for them. Medical care and support are planned on the basis of their conditions and modified with time in response to their outcomes. Cognitive rehabilitation has been developing to contribute the recovery from their impairment and return to school through four major tactics; improvement of higher brain dysfunction itself, acquirement of compensatory maneuvers/adjustment of environment, support for re-entry to school or finding employment, and acceleration for understanding or acceptance of impairment to people concerned including parents. The number of highly qualified study such as randomized clinical trial or meta-analytic clinical research is still few especially in Japan while developing basic research with a focus on neuroimaging is contributing to the clinical attempt. The issues related to concussion or post-concussion syndrome would be more and more attention in the future.
{"title":"Higher Brain Dysfunction after Traumatic Brain Injury in School-aged Children: Review of the Literature","authors":"Masaru Oga","doi":"10.4172/2376-0281.1000326","DOIUrl":"https://doi.org/10.4172/2376-0281.1000326","url":null,"abstract":"Higher brain dysfunction after traumatic brain injury in school-aged children potentially have serious impact on their lives than adults, because children are on their developmental way to be mature adults under the environment they should learn various knowledge and skills. Neuropsychological, psychosocial, and academic conditions/outcomes are evaluated by appropriate tools and methods for them. Medical care and support are planned on the basis of their conditions and modified with time in response to their outcomes. Cognitive rehabilitation has been developing to contribute the recovery from their impairment and return to school through four major tactics; improvement of higher brain dysfunction itself, acquirement of compensatory maneuvers/adjustment of environment, support for re-entry to school or finding employment, and acceleration for understanding or acceptance of impairment to people concerned including parents. The number of highly qualified study such as randomized clinical trial or meta-analytic clinical research is still few especially in Japan while developing basic research with a focus on neuroimaging is contributing to the clinical attempt. The issues related to concussion or post-concussion syndrome would be more and more attention in the future.","PeriodicalId":91292,"journal":{"name":"International journal of neurorehabilitation","volume":"5 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2376-0281.1000326","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70303153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2376-0281.1000327
M. Hirose, Y. Furukawa, M. Tsuboi
Volume 5 • Issue 4 • 1000327 Int J Neurorehabilitation, an open access journal ISSN: 2376-0281 *Corresponding author: Masamichi Hirose, MD, PhD, Division of Molecular and Cellular Pharmacology, Department of Pathophysiology and Pharmacology, Iwate Medical University School of Pharmaceutical Science, 2-1-1 Nishitokuta, Yahaba, Iwate 028-3694, Japan, Tel: 81-19-651-5110; Email: mhirose@iwate-med.ac.jp
{"title":"Cardiac Autonomic Disorders and Botulinum Toxin Treatment","authors":"M. Hirose, Y. Furukawa, M. Tsuboi","doi":"10.4172/2376-0281.1000327","DOIUrl":"https://doi.org/10.4172/2376-0281.1000327","url":null,"abstract":"Volume 5 • Issue 4 • 1000327 Int J Neurorehabilitation, an open access journal ISSN: 2376-0281 *Corresponding author: Masamichi Hirose, MD, PhD, Division of Molecular and Cellular Pharmacology, Department of Pathophysiology and Pharmacology, Iwate Medical University School of Pharmaceutical Science, 2-1-1 Nishitokuta, Yahaba, Iwate 028-3694, Japan, Tel: 81-19-651-5110; Email: mhirose@iwate-med.ac.jp","PeriodicalId":91292,"journal":{"name":"International journal of neurorehabilitation","volume":"05 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2376-0281.1000327","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70303164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2376-0281.1000315
P. Csecsei, L. Nagy, S. Kéki, L. Szapáry, Z. Illés, N. Farkas, T. Molnár
Background: Increased levels of asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) are associated with endothelial dysfunction. Here, we analyzed the relationship between L-arginine pathway metabolites and functional outcome of ischemic stroke at discharge and 6 months follow-up. Methods: Plasma concentration of L-arginine, ADMA, SDMA were investigated in 46 patients at post-stroke 24 h. Outcome measures were assessed by modified Rankin scale (mRS) at hospital discharge and 6 months follow-up. According to change in mRS score during the 6 months period, patients were divided into subgroups of improved, unchanged and worsened function. Predictive role of L-arginine pathway metabolites were explored in these outcome groups. Results: Significant inverse correlations were found between initial NIHSS and the L-arginine/ADMA, the L-arginine/SDMA ratios and L-arginine plasma concentration (all p<0.05, respectively). Patients with worsened mRS by 6 months had significantly higher L-arginine plasma concentrations at 24 post-stroke hours compared to patients with improved mRS (p<0.001) and unchanged mRS (p<0.005). The L-arginine/ADMA (p<0.004) and the L-arginin/ SDMA (p<0.002) ratios at 24 h were significantly higher among patients with worsened compared to improved mRS. Besides, clinical factors, such as BMI showed negative correlation with L-arginine/ADMA; creatinine showed positive correlation with L-arginine and L-arginine/ADMA; LDL showed positive correlation with L-arginine/SDMA ratio. Plasma concentration of ADMA was significantly higher among smokers compared to non-smokers. The L-arginine/ADMA, the L-arginine/SDMA ratios and L-arginine plasma concentration negatively correlated with change of mRS between hospital discharge and at 6 months. Conclusion: Our data indicate that lower L-arginine/SDMA ratio is associated with worse outcome on the shortterm, but these patients improve on the long-term resulting in association of lower ratios with improving mRS. In contrast, patients with high L-arginine and low mRS improve fast, but will not improve or may even worsen by 6 months indicating a time-dependent biological effect.
{"title":"L-Arginine Pathway Metabolites Predict 6 Months Outcome after Acute Ischemic Stroke","authors":"P. Csecsei, L. Nagy, S. Kéki, L. Szapáry, Z. Illés, N. Farkas, T. Molnár","doi":"10.4172/2376-0281.1000315","DOIUrl":"https://doi.org/10.4172/2376-0281.1000315","url":null,"abstract":"Background: Increased levels of asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) are associated with endothelial dysfunction. Here, we analyzed the relationship between L-arginine pathway metabolites and functional outcome of ischemic stroke at discharge and 6 months follow-up. Methods: Plasma concentration of L-arginine, ADMA, SDMA were investigated in 46 patients at post-stroke 24 h. Outcome measures were assessed by modified Rankin scale (mRS) at hospital discharge and 6 months follow-up. According to change in mRS score during the 6 months period, patients were divided into subgroups of improved, unchanged and worsened function. Predictive role of L-arginine pathway metabolites were explored in these outcome groups. Results: Significant inverse correlations were found between initial NIHSS and the L-arginine/ADMA, the L-arginine/SDMA ratios and L-arginine plasma concentration (all p<0.05, respectively). Patients with worsened mRS by 6 months had significantly higher L-arginine plasma concentrations at 24 post-stroke hours compared to patients with improved mRS (p<0.001) and unchanged mRS (p<0.005). The L-arginine/ADMA (p<0.004) and the L-arginin/ SDMA (p<0.002) ratios at 24 h were significantly higher among patients with worsened compared to improved mRS. Besides, clinical factors, such as BMI showed negative correlation with L-arginine/ADMA; creatinine showed positive correlation with L-arginine and L-arginine/ADMA; LDL showed positive correlation with L-arginine/SDMA ratio. Plasma concentration of ADMA was significantly higher among smokers compared to non-smokers. The L-arginine/ADMA, the L-arginine/SDMA ratios and L-arginine plasma concentration negatively correlated with change of mRS between hospital discharge and at 6 months. Conclusion: Our data indicate that lower L-arginine/SDMA ratio is associated with worse outcome on the shortterm, but these patients improve on the long-term resulting in association of lower ratios with improving mRS. In contrast, patients with high L-arginine and low mRS improve fast, but will not improve or may even worsen by 6 months indicating a time-dependent biological effect.","PeriodicalId":91292,"journal":{"name":"International journal of neurorehabilitation","volume":"5 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2376-0281.1000315","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70303339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2376-0281.1000333
M. Rabadi, P. Munden
A 60-year-old edentulous man with past medical history of hyperlipidemia, current smoker, and depression presented to the eye department with a 4-week history of progressive blurred vision. As per patient he saw a “white sheet” in front of his eyes worse in the right eye constantly. After his eye evaluation he was referred to the neurology clinic as he complained of having difficulty finding words to express him-self. He did report of having lost 10 lbs (4.5 kg) in weight during this period but no other complains such as fever, fatigue, sweating, chest pain, shortness of breath or any other neurological complains. There was no history of substance abuse including history of intravenous drug use.
{"title":"Progressive Visual Loss from Roth Spots in a Patient with Infective Endocarditis","authors":"M. Rabadi, P. Munden","doi":"10.4172/2376-0281.1000333","DOIUrl":"https://doi.org/10.4172/2376-0281.1000333","url":null,"abstract":"A 60-year-old edentulous man with past medical history of hyperlipidemia, current smoker, and depression presented to the eye department with a 4-week history of progressive blurred vision. As per patient he saw a “white sheet” in front of his eyes worse in the right eye constantly. After his eye evaluation he was referred to the neurology clinic as he complained of having difficulty finding words to express him-self. He did report of having lost 10 lbs (4.5 kg) in weight during this period but no other complains such as fever, fatigue, sweating, chest pain, shortness of breath or any other neurological complains. There was no history of substance abuse including history of intravenous drug use.","PeriodicalId":91292,"journal":{"name":"International journal of neurorehabilitation","volume":"05 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2376-0281.1000333","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70303823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2376-0281.1000306
E. Yılmaz, C. Fisahn, A. Mayadev, Kim Kobota, Ziádee Cambier, Cameron K Schmidt, D. Norvell, J. Chapman
Introduction: The Hybrid Assistive Limb (HAL, Cyberdyne, Japan) facilitates voluntary, user-driven ambulation through a neurologically-controlled system based on bioelectrical signals derived from the user. This allows for the repeated execution of physiologically faithful gait patterns, crucial to recovery in cases of neurologic motor deficit. In this series, we present the first three patients in the United States to undergo HAL neurorehabilitation training. Patient and methods: A case series of three patients participating in a single-center prospective, interventional pilot study, suffering neurologic motor deficits secondary to spinal cord infarct following a pulmonary embolism (patient 1), multiple sclerosis (patient 2) and the surgical resection of a petroclival meningioma (patient 3). The patients underwent 60 sessions of body weight-supported treadmill training in the HAL over the course of 12 weeks. Measures of functional ambulation (10 Minute Walk Test, 10MWT) were performed out of the HAL before and after each session and at the 12 week and 6 month follow-up. Timed Up & Go (TUG) test was performed each week. Treadmill data (time, distance) while in HAL was recorded at each session. Measures of endurance (6 Minute Walk Test, 6MWT), risk of fall (TUG), balance impairment (Berg Balance Scale) and improvements in walking performance (Walking Index for Spinal Cord Injury II, WISCI II) were measured at baseline, after 12 weeks and at 6 months follow-up. Results: Patients 2 and 3 completed 60 visits, patient 1 completed 56 visits. All patients achieved markedly increased treadmill paces, improved functional scores, increased distance in the 6MWT and decreased TUG times at 6-month follow-up. In the 10MWT, all patients achieved a clinically significant decrease in time and steps and showed improvements in the required assistance level to perform the test. Patients 1 and 3 showed improvement on the Berg Balance Scale. Patient 2 had no change between baseline and 6-month follow-up. Only minor adverse effects were reported, including skin abrasions and irritation secondary to chaffing of the HAL unit and EMG electrodes. Conclusion: These data show that HAL training is both feasible and effective in the neurorehabilitation of patients suffering neurologic motor deficits secondary to trauma and/or pathological/neurodegenerative processes after they have undergone normal rehab. A greater number of patients are required to meaningfully assess the differences in improvement from baseline, based upon underlying pathologies.
简介:混合辅助肢体(HAL, Cyberdyne, Japan)通过基于来自用户的生物电信号的神经控制系统促进自愿的、用户驱动的行走。这允许重复执行生理上忠实的步态模式，对于神经运动缺陷的恢复至关重要。在这个系列中，我们介绍了美国前三位接受HAL神经康复训练的患者。患者和方法:参与一项单中心前瞻性、介入性先导研究的3例患者，在肺栓塞(患者1)、多发性硬化症(患者2)和岩斜坡脑膜瘤手术切除(患者3)后继发于脊髓梗死的神经运动功能障碍。患者在HAL中接受了60次体重支撑的跑步机训练，为期12周。在每次治疗前后以及随访12周和6个月时，在HAL外进行功能活动测量(10分钟步行测试，10MWT)。每周进行一次定时Up & Go (TUG)测试。在HAL中，记录每个会话的跑步机数据(时间，距离)。在基线、12周和6个月随访后测量耐力(6分钟步行测试，6MWT)、跌倒风险(TUG)、平衡障碍(Berg平衡量表)和步行性能改善(脊髓损伤步行指数II, WISCI II)。结果:患者2、3共就诊60次，患者1共就诊56次。在6个月的随访中，所有患者的跑步机步速明显增加，功能评分改善，6MWT距离增加，TUG次数减少。在10MWT中，所有患者的时间和步数均有临床意义上的显著减少，完成测试所需的辅助水平也有所提高。患者1和3在Berg平衡量表上表现出改善。患者2在基线和6个月随访期间无变化。仅报道了轻微的不良反应，包括HAL单元和肌电图电极摩擦引起的皮肤磨损和刺激。结论:这些数据表明HAL训练对于创伤和/或病理/神经退行性病变继发神经运动障碍患者进行正常康复后的神经康复是可行和有效的。需要更多的患者根据潜在的病理来有意义地评估与基线相比的改善差异。
{"title":"Functional Neurorehabilitation using the Hybrid Assistive Limb (HAL): A First Experience in the United States","authors":"E. Yılmaz, C. Fisahn, A. Mayadev, Kim Kobota, Ziádee Cambier, Cameron K Schmidt, D. Norvell, J. Chapman","doi":"10.4172/2376-0281.1000306","DOIUrl":"https://doi.org/10.4172/2376-0281.1000306","url":null,"abstract":"Introduction: The Hybrid Assistive Limb (HAL, Cyberdyne, Japan) facilitates voluntary, user-driven ambulation through a neurologically-controlled system based on bioelectrical signals derived from the user. This allows for the repeated execution of physiologically faithful gait patterns, crucial to recovery in cases of neurologic motor deficit. In this series, we present the first three patients in the United States to undergo HAL neurorehabilitation training. Patient and methods: A case series of three patients participating in a single-center prospective, interventional pilot study, suffering neurologic motor deficits secondary to spinal cord infarct following a pulmonary embolism (patient 1), multiple sclerosis (patient 2) and the surgical resection of a petroclival meningioma (patient 3). The patients underwent 60 sessions of body weight-supported treadmill training in the HAL over the course of 12 weeks. Measures of functional ambulation (10 Minute Walk Test, 10MWT) were performed out of the HAL before and after each session and at the 12 week and 6 month follow-up. Timed Up & Go (TUG) test was performed each week. Treadmill data (time, distance) while in HAL was recorded at each session. Measures of endurance (6 Minute Walk Test, 6MWT), risk of fall (TUG), balance impairment (Berg Balance Scale) and improvements in walking performance (Walking Index for Spinal Cord Injury II, WISCI II) were measured at baseline, after 12 weeks and at 6 months follow-up. Results: Patients 2 and 3 completed 60 visits, patient 1 completed 56 visits. All patients achieved markedly increased treadmill paces, improved functional scores, increased distance in the 6MWT and decreased TUG times at 6-month follow-up. In the 10MWT, all patients achieved a clinically significant decrease in time and steps and showed improvements in the required assistance level to perform the test. Patients 1 and 3 showed improvement on the Berg Balance Scale. Patient 2 had no change between baseline and 6-month follow-up. Only minor adverse effects were reported, including skin abrasions and irritation secondary to chaffing of the HAL unit and EMG electrodes. Conclusion: These data show that HAL training is both feasible and effective in the neurorehabilitation of patients suffering neurologic motor deficits secondary to trauma and/or pathological/neurodegenerative processes after they have undergone normal rehab. A greater number of patients are required to meaningfully assess the differences in improvement from baseline, based upon underlying pathologies.","PeriodicalId":91292,"journal":{"name":"International journal of neurorehabilitation","volume":"5 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2376-0281.1000306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70303050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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