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Umeonwuka CI, Roos R, Ntsiea V. Clinical and demographic predictors of unilateral spatial neglect recovery after prism therapy among stroke survivors in the sub-acute phase of recovery. Neuropsychol Rehabil 2023; 33:1624-1649. [PMID: 36242544 DOI: 10.1080/09602011.2022.2131582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 09/28/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND AIMS: Unilateral Spatial Neglect (USN) affects the rehabilitation process and leads to poor outcomes after stroke. Factors that influence USN recovery following prism adaptation therapy have not been investigated. This study investigated predictors of USN recovery after prism therapy at the sub-acute phase of recovery. METHODS: This study was a randomized controlled trial. USN was assessed with the Behavioural Inattention Test and Catherine Bergego scale. Seventy-four patients with USN were divided into control and intervention group (prism). The prism group used 20 dioptre prism lenses for repeated aiming for 12 sessions while the control group used neutral lenses for aiming training. Regression analysis was conducted to establish clinical and sociodemographic factors that influence USN recovery. RESULTS: Gender, age, years of education, race, employment status, handedness, type of stroke, time since stroke and site of stroke (p > 0.005) showed no significant influence on USN recovery following PA treatment. Higher Cognitive function (OR = 1.52, CI = 1.08-2.14, p = 0.016) and group allocationng (being in the prism group) (OR = 63.10, CI = 9.70-410.59, P < 0.001) were found to significantly influence USN recovery following PA treatment session. CONCLUSIONS: A significant modulating effect on general cognitive ability was found in this study. This suggests that prism adaptation therapy's effect on neural activity and spatial neglect depends on the cognitive function of stroke survivors.Trial registration: Pan African Clinical Trial Registry identifier: PACTR201903732473573.
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Affiliation(s)
- Chuka Ifeanyi Umeonwuka
- Department of Physiotherapy, Faculty of Health Science, University of Witwatersrand, Johannesburg, South Africa
| | - Ronel Roos
- Department of Physiotherapy, Faculty of Health Science, University of Witwatersrand, Johannesburg, South Africa
| | - Veronica Ntsiea
- Department of Physiotherapy, Faculty of Health Science, University of Witwatersrand, Johannesburg, South Africa
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Umeonwuka CI, Roos R, Ntsiea V. Current knowledge and practice of post-stroke unilateral spatial neglect rehabilitation: A cross-sectional survey of South African neurorehabilitation physiotherapists. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2022; 78:1624. [PMID: 35402745 PMCID: PMC8991368 DOI: 10.4102/sajp.v78i1.1624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 01/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background Unilateral spatial neglect (USN) affects the rehabilitation process leading to poor functional outcomes after stroke. South African physiotherapists’ level of uptake of available evidence in USN rehabilitation and the barriers they encounter are not known. Objectives To evaluate knowledge, current practice enablers and barriers to USN management in stroke survivors amongst physiotherapists in South Africa. Methods Our cross-sectional survey used a total sampling technique. Questionnaires were sent to neurorehabilitation physiotherapists in South Africa. Descriptive and inferential statistics analysed the data. Results The overall knowledge score of USN was 14.11 ± 5.23 of a total of 25. The knowledge was good for definitions of USN; moderate for incidences, causes, screening, diagnosis and prognosis of USN and poor for pharmacological approaches to the management of USN. A significant low positive correlation between respondents’ age (r = 0.46; p = 0.016) and years of practice as a physiotherapist (r = 0.43; p = 0.026) and knowledge of USN was found. The most frequently utilised intervention was constraint-induced movement therapy; the commonly utilised assessment tool was the comb and razor test. ‘Inadequate therapy time’ (55.56%) and ‘lack of relevant equipment for rehabilitation of USN’ (38.89%) were identified as major barriers to USN rehabilitation. Major enablers to USN rehabilitation were the ‘presence of multidisciplinary stroke team in clinical practice’ (83.35%) and ‘availability of adequate staff’ (76.47%). Conclusion Physiotherapists demonstrated a fair knowledge of USN although knowledge about pharmacological management of USN was modest. Current practice in post-stroke USN by South African neuro-physiotherapists follows current evidence and practice guidelines. Clinical implication Our study shows the level of knowledge and current practice of post-stroke USN rehabilitation. The demonstrated fair knowledge of USN may be improved through training, curriculum modifications or continuing professional development. Identified barriers to the rehabilitation of post-stroke USN can assist health policy, managers and clinicians to improve stroke-specific care.
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Affiliation(s)
- Chuka I Umeonwuka
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ronel Roos
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Veronica Ntsiea
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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3
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Seitz RJ. Beliefs: A challenge in neuropsychological disorders. J Neuropsychol 2021; 16:21-37. [PMID: 33969626 DOI: 10.1111/jnp.12249] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 03/11/2021] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Beliefs have recently been defined as the neural product of perception of objects and events in the external world and of an affirmative internal affective state reflecting personal meaning. It is, however, undetermined in which way diseases of the brain affect these integrative processes. METHODS Here, the formation and updating of abnormal beliefs in cerebral disorders are described. RESULTS It will be shown that well-defined neuropsychological syndromes resulting from brain lesions also interfere with the neural processes that enable the formation, up-dating and communication of beliefs. Similarly, in neuropsychiatric disorders abnormal and delusional beliefs appear to be caused by altered perception and/or misattribution of aversive meaning. CONCLUSION Given the importance of beliefs for ordinary social behaviour, abnormal beliefs are a challenge in neuropsychological disorders.
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Affiliation(s)
- Rüdiger J Seitz
- Department of Neurology, Centre of Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany.,Florey Neuroscience Institutes, Melbourne, Victoria, Australia
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Pinto JO, Dores AR, Peixoto B, Geraldo A, Barbosa F. Systematic Review of Sensory Stimulation Programs in the Rehabilitation of Acquired Brain Injury. EUROPEAN PSYCHOLOGIST 2020. [DOI: 10.1027/1016-9040/a000421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Acquired Brain Injury (ABI) can lead to sensory deficits and compromise functionality. However, most studies have been focused on motor stimulation in stroke and traumatic brain injury (TBI). Sensory stimulation in stroke and mild/moderate TBI has received reduced interest. The main objective of this review is to know the methodological characteristics and effects of sensory programs in ABI. Studies with the purpose of testing the efficacy of those programs were identified through a literature search, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Cochrane Collaboration Guidelines. Twenty-three studies were included in this review. The results show that in most studies sensory stimulation started within 12 months after injury and there is no consensus regarding frequency, duration and number of sessions, duration of intervention, and instruments used to assess outcomes. Most programs involved unisensory stimulation, and vision was the predominant target. The most used methods were compensation and somatosensory discrimination training. Most studies used a pre- and post-intervention assessment, with few studies comprising follow-up assessment. Regarding the studies revised, the interventions with positive outcomes in ABI are: compensation, cognitive training, vestibular intervention, somatosensory discrimination training, proprioceptive stimulation with muscle vibration, and sustained attention training with olfactory stimulation. Available findings suggest that sensory stimulation has positive results with immediate and long-term improvements in sensory functioning. This review provides useful information to improve rehabilitation and to design future investigation.
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Affiliation(s)
- Joana O. Pinto
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Portugal
| | | | - Bruno Peixoto
- CESPU, University Institute of Health Sciences, Gandra, Portugal
- NeuroGen – Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
| | - Andreia Geraldo
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Portugal
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Toglia J, Chen P. Spatial exploration strategy training for spatial neglect: A pilot study. Neuropsychol Rehabil 2020; 32:792-813. [PMID: 32684100 DOI: 10.1080/09602011.2020.1790394] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Spatial neglect is a syndrome due to impaired neural networks critical for spatial attention and related cognitive and motor functions. Affected individuals also have impaired self-awareness of their own neglect symptoms. The present randomized controlled study was the first proof-of-concept pilot examining the multi-context treatment approach using a protocol of spatial exploration strategy training in one brief session (20-30 minutes). The therapist provided supportive feedback and semi-structured guidance to promote strategy learning and self-discovery of omission errors. 40 patients with left-sided neglect after right brain stroke were included. The results showed that the treatment reduced lateralized bias toward the ipsilesional side of space but did not improve overall detection performance. Impaired general self-awareness of daily-life spatial difficulties was found independent of treatment outcome. This implies that judgment regarding responsiveness to treatment should not be made based on an awareness interview or the severity of neglect symptoms. Lastly, the treatment showed the potential of improving online contextual self-awareness of spatial abilities. A collaborative and interactive approach that focuses on helping the patient self-discover, monitor and self-manage their errors, appears to have a potential for decreasing neglect symptoms. Future studies are required to examine additional aspects of the multi-context treatment approach.
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Affiliation(s)
- Joan Toglia
- School of Health and Natural Sciences, Mercy College, Dobbs Ferry, NY, USA.,Rehabilitation Medicine Department, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA
| | - Peii Chen
- Kessler Foundation, West Orange, NJ, USA.,Department of Physical Medicine and Rehabilitation, Rutgers University, Newark, NJ, USA
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Daniel A, Barker L, Martini M. Pain modulation by illusory body rotation: A new way to disclose the interaction between the vestibular system and pain processing. Eur J Pain 2020; 24:1119-1129. [DOI: 10.1002/ejp.1556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Aster Daniel
- School of Psychology University of East London London UK
| | - Leon Barker
- School of Arts and Digital Industries University of East London London UK
| | - Matteo Martini
- School of Psychology University of East London London UK
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Hreha K, Rich T, Wong J. A One-Year Follow-Up Study on Community Dwelling Multiple Stroke Survivors with Spatial Neglect. Occup Ther Health Care 2020; 34:48-61. [PMID: 32153228 DOI: 10.1080/07380577.2020.1737894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study assessed nine participants, who sustained multiple strokes and had spatial neglect, one year after participation in a prior trial on whether Prism Adaptation Treatment (PAT) was a feasible and effective treatment for spatial neglect remediation compared to standard care. The objectives were to: (1) describe the sample, (2) measure the degree of spatial neglect symptoms if present, and (3) determine group differences in motor and spatial performance. Three (60%) participants from the PAT group and two (50%) from the comparison group still displayed spatial neglect. A series of two-way mixed ANOVAs exploring group (PAT vs. comparison of standard care) and time effects (pretest vs. posttest vs. follow-up) found a main effect of time for all participants on the Kessler Foundation Neglect Assessment (F(1,2) = 30.28, p<.001), Functional Independence Measure (F(1,2) = 16.998, p<.001), and star cancelation (F(1,2) = 11.077, p<.001). An interaction effect of time*prism was observed when assessing the line bisection test (F(1,2) = 6.986, p = .008), suggesting that the PAT group performed significantly better on this test. Additional research should be completed with a larger sample in order to better understand the PAT long term effects as well as develop clinical recommendations for occupational therapy practitioners.
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Affiliation(s)
- Kimberly Hreha
- Rehabilitation Medicine, University of Washington Medical Center, Seattle, WA
| | - Timothy Rich
- Rehabilitation Medicine, University of Washington Medical Center, Seattle, WA
| | - Jennifer Wong
- Rehabilitation Medicine, University of Washington Medical Center, Seattle, WA
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Sukumaran S, Sivadasan S, Sakunthala PT, Tandon V, Sarma SP. "Sequential multimodality stimulation" for post-stroke-hemineglect: Feasibility and outcome in a pilot randomized controlled trial. J Clin Neurosci 2019; 71:108-112. [PMID: 31495658 DOI: 10.1016/j.jocn.2019.08.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 08/25/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To test the feasibility and efficacy of multimodality stimulation combined with motor tasking as a corrective strategy for hemineglect following right hemispheric ischemic strokes. MATERIAL AND METHODS A prospective randomized controlled single blinded clinical trial was conducted over eighteen months from January 2017. All patients with right hemispheric ischemic strokes were screened for hemineglect and those fulfilling criteria were recruited and randomized. Patients under the therapy group (TG) received the intervention based on a structured protocol in addition to standard physiotherapy. The control group (CG) received standard physiotherapy alone. NIHSS, mRS and Neuropsychological test scores were recorded at different time points. The primary outcome measures (neuropsychological test scores) were compared between the two groups (Student's t-test to find out the difference in outcome measures) at one and three months post-stroke. RESULTS Of the 14 patients recruited, data from 12 were available for analysis, 5 patients in TG and 7 in CG. There was a trend for better hemineglect and functional outcomes in TG. CONCLUSION Multimodality stimulation, in addition to standard physiotherapy, is feasible and potentially results in better neurocognitive and functional recovery following right hemispheric ischemic strokes. However, larger studies are warranted to prove these preliminary observations beyond doubt.
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Affiliation(s)
- Sajith Sukumaran
- Comprehensive Stroke Care Centre, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
| | - Sesh Sivadasan
- Comprehensive Stroke Care Centre, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Parthan T Sakunthala
- Comprehensive Stroke Care Centre, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Vaibhav Tandon
- Comprehensive Stroke Care Centre, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Sankara P Sarma
- Department of Biostatistics, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
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9
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Abstract
The wars in Afghanistan and Iraq have been notable for the high rates of traumatic brain injury (TBI) that have been incurred by the troops. Visual impairments often occur following TBI and present new challenges for rehabilitation. We describe a neurological vision rehabilitation therapy that addresses the unique needs of patients with vision loss that is due to TBI.
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10
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Donoso Brown EV, Powell JM. Assessment of unilateral neglect in stroke: Simplification and structuring of test items. Br J Occup Ther 2017; 80:448-452. [PMID: 34413568 DOI: 10.1177/0308022616685582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Statement of context Unilateral neglect is a complex impairment that is common after stroke and limits occupational performance. Sensitive assessment of unilateral neglect is critical for planning treatment and ensuring safe community discharge. Critical reflection on practice This reflection describes unexpected findings in the assessment of neglect with two individuals in the acute phase of recovery post stroke. When trialing a new activity based test battery, we observed few neglect behaviors during test tasks despite observation of multiple neglect behaviors outside of the testing situation. Upon reflection, we better understood how simplification and structuring of test items and environments could impact the observation and assessment of neglect behaviors. Implications for practice This practice analysis further supports the use of multiple assessments when evaluating unilateral neglect and specifically encourages the inclusion of assessment methods that maintain the complexity of everyday tasks and environments.
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Affiliation(s)
- Elena V Donoso Brown
- Duquesne University, Rangos School of Health Sciences, Department of Occupational Therapy
| | - Janet M Powell
- University of Washington, School of Medicine, Department of Rehabilitation Medicine, Division of Occupational Therapy
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11
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Trejo-Gabriel-Galan JM, Rogel-Melgosa V, Gonzalez S, Sedano J, Villar JR, Arenaza-Basterrechea N. Rehabilitation of hemineglect of the left arm using movement detection bracelets activating a visual and acoustic alarm. J Neuroeng Rehabil 2016; 13:79. [PMID: 27590188 PMCID: PMC5009713 DOI: 10.1186/s12984-016-0191-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 08/30/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hemineglect is frequent after right hemisphere stroke and prevents functional independence, but effective rehabilitation interventions are lacking. Our objective was to determine if a visual-acoustic alarm in the hemineglect arm activated by a certain discrepancy in movement of both hands can enhance neglect arm use in five tasks of daily living. METHODS In this pre-post intervention study 9 stroke patients with residual hemineglect of the arm were trained for 7 days in five bimanual tasks of daily living: carrying a tray, button fastening, cutting food with knife and fork, washing the face with both hands and arm sway while walking. This was done through motion sensors mounted in bracelets on both wrists that compared movement between them. When the neglect-hand movement was less than a limit established by two fuzzy logic based classifiers, a visual-acoustic alarm in the neglect-hand bracelet was activated to encourage its use in the task. RESULTS Both motion and function of the neglect hand improved during the seven days of training when visual-acoustic alarms were active but a worsening to baseline values occurred on day 8 and day 30 when alarms where switched off. Improvement was limited to vision-dependent tasks. CONCLUSIONS Neglect-hand improvement with this approach is limited to bimanual activities in which an object is manipulated under vision control, but no short or long term learning happens.
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Affiliation(s)
| | - V Rogel-Melgosa
- Hospital Universitario de Burgos, Ave. Islas Baleares 3, 09006, Burgos, Spain
| | - S Gonzalez
- Instituto Tecnológico de Castilla y León, Burgos, Spain
| | - J Sedano
- Instituto Tecnológico de Castilla y León, Burgos, Spain
| | - J R Villar
- Computer Science Department, Universidad de Oviedo, Oviedo, Spain
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12
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Barman A, Chatterjee A, Bhide R. Cognitive Impairment and Rehabilitation Strategies After Traumatic Brain Injury. Indian J Psychol Med 2016; 38:172-81. [PMID: 27335510 PMCID: PMC4904751 DOI: 10.4103/0253-7176.183086] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Traumatic brain injury (TBI) is among the significant causes of morbidity and mortality in the present world. Around 1.6 million persons sustain TBI, whereas 200,000 die annually in India, thus highlighting the rising need for appropriate cognitive rehabilitation strategies. This literature review assesses the current knowledge of various cognitive rehabilitation training strategies. The entire spectrum of TBI severity; mild to severe, is associated with cognitive deficits of varying degree. Cognitive insufficiency is more prevalent and longer lasting in TBI persons than in the general population. A multidisciplinary approach with neuropsychiatric evaluation is warranted. Attention process training and tasks for attention deficits, compensatory strategies and errorless learning training for memory deficits, pragmatic language skills and social behavior guidance for cognitive-communication disorder, meta-cognitive strategy, and problem-solving training for executive disorder are the mainstay of therapy for cognitive deficits in persons with TBI. Cognitive impairments following TBI are common and vary widely. Different cognitive rehabilitation techniques and combinations in addition to pharmacotherapy are helpful in addressing various cognitive deficits.
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Affiliation(s)
- Apurba Barman
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Ahana Chatterjee
- Formerly Clinical Fellow, Division of Physiatry, Department of Medicine, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Rohit Bhide
- Princess Royal Spinal Injuries Unit, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, South Yorkshire, UK
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Seo HG, Beom J, Oh BM, Han TR. Effects of Robot-assisted Upper Limb Training on Hemiplegic Patients. BRAIN & NEUROREHABILITATION 2014. [DOI: 10.12786/bn.2014.7.1.39] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Han Gil Seo
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Korea
| | - Jaewon Beom
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Korea
| | - Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Korea
| | - Tai Ryoon Han
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Korea
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Simons LE, Elman I, Borsook D. Psychological processing in chronic pain: a neural systems approach. Neurosci Biobehav Rev 2013; 39:61-78. [PMID: 24374383 DOI: 10.1016/j.neubiorev.2013.12.006] [Citation(s) in RCA: 246] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Revised: 12/17/2013] [Accepted: 12/19/2013] [Indexed: 12/22/2022]
Abstract
Our understanding of chronic pain involves complex brain circuits that include sensory, emotional, cognitive and interoceptive processing. The feed-forward interactions between physical (e.g., trauma) and emotional pain and the consequences of altered psychological status on the expression of pain have made the evaluation and treatment of chronic pain a challenge in the clinic. By understanding the neural circuits involved in psychological processes, a mechanistic approach to the implementation of psychology-based treatments may be better understood. In this review we evaluate some of the principle processes that may be altered as a consequence of chronic pain in the context of localized and integrated neural networks. These changes are ongoing, vary in their magnitude, and their hierarchical manifestations, and may be temporally and sequentially altered by treatments, and all contribute to an overall pain phenotype. Furthermore, we link altered psychological processes to specific evidence-based treatments to put forth a model of pain neuroscience psychology.
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Affiliation(s)
- Laura E Simons
- Center for Pain and the Brain, P.A.I.N. Group, Boston Children's Hospital, United States; Department of Psychiatry, United States; Harvard Medical School, United States.
| | | | - David Borsook
- Center for Pain and the Brain, P.A.I.N. Group, Boston Children's Hospital, United States; Harvard Medical School, United States
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15
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Müri RM, Cazzoli D, Nef T, Mosimann UP, Hopfner S, Nyffeler T. Non-invasive brain stimulation in neglect rehabilitation: an update. Front Hum Neurosci 2013; 7:248. [PMID: 23772209 PMCID: PMC3677145 DOI: 10.3389/fnhum.2013.00248] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 05/19/2013] [Indexed: 11/13/2022] Open
Abstract
Here, we review the effects of non-invasive brain stimulation such as transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) in the rehabilitation of neglect. We found 12 studies including 172 patients (10 TMS studies and 2 tDCS studies) fulfilling our search criteria. Activity of daily living measures such as the Barthel Index or, more specifically for neglect, the Catherine Bergego Scale were the outcome measure in three studies. Five studies were randomized controlled trials with a follow-up time after intervention of up to 6 weeks. One TMS study fulfilled criteria for Class I and one for Class III evidence. The studies are heterogeneous concerning their methodology, outcome measures, and stimulation parameters making firm comparisons and conclusions difficult. Overall, there are however promising results for theta-burst stimulation, suggesting that TMS is a powerful add-on therapy in the rehabilitation of neglect patients.
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Affiliation(s)
- René Martin Müri
- Division of Cognitive and Restorative Neurology, Departments of Neurology and Clinical Research, Inselspital, Bern University Hospital, and University of Bern , Bern , Switzerland ; Gerontechnology and Rehabilitation Research Group, ARTORG Center for Biomedical Engineering Research, University of Bern , Bern , Switzerland
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Reynolds S, Lane SJ, Richards L. Using animal models of enriched environments to inform research on sensory integration intervention for the rehabilitation of neurodevelopmental disorders. J Neurodev Disord 2010; 2:120-32. [PMID: 22127899 PMCID: PMC3164047 DOI: 10.1007/s11689-010-9053-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Accepted: 05/28/2010] [Indexed: 01/09/2023] Open
Abstract
The field of behavioral neuroscience has been successful in using an animal model of enriched environments for over five decades to measure the rehabilitative and preventative effects of sensory, cognitive and motor stimulation in animal models. Several key principles of enriched environments match those used in sensory integration therapy, a treatment used for children with neurodevelopmental disorders. This paper reviews the paradigm of environmental enrichment, compares animal models of enriched environments to principles of sensory integration treatment, and discusses applications for the rehabilitation of neurodevelopmental disorders. Based on this review, the essential features in the enriched environment paradigm which should be included in sensory integration treatment are multiple sensory experiences, novelty in the environment, and active engagement in challenging cognitive, sensory, and motor tasks. Use of sensory integration treatment may be most applicable for children with anxiety, hypersensitivity, repetitive behaviors or heightened levels of stress. Additionally, individuals with deficits in social behavior, social participation, or impairments in learning and memory may show gains with this type of treatment.
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Affiliation(s)
- Stacey Reynolds
- Department of Occupational Therapy, School of Allied Health Professions, Virginia Commonwealth University, Box 980008, Richmond, VA, 23298, USA,
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