1
|
Gillespie J, Trammell M, Ochoa C, Driver S, Callender L, Dubiel R, Swank C. Feasibility of overground exoskeleton gait training during inpatient rehabilitation after severe acquired brain injury. Brain Inj 2024; 38:459-466. [PMID: 38369861 DOI: 10.1080/02699052.2024.2317259] [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: 01/18/2023] [Accepted: 02/07/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE To describe the safety, feasibility, and tolerability of overground exoskeleton gait training (OEGT) integrated into clinical practice for patients after severe acquired brain injury (ABI). SETTING Inpatient rehabilitation hospital. PARTICIPANTS Eligible patients with severe ABI met the following criteria: age > 18, medically stable, met exoskeleton frame limitations, and a score of ≤ 3 on the motor function portion of the Coma Recovery Scale - Revised (CRS-R). Presence of consciousness disorder was not exclusionary. DESIGN Prospective observational study. MAIN MEASURES Outcomes examined safety (adverse events), feasibility (session count and barriers to session completion), and tolerability of OEGT (session metrics and heart rate). RESULTS Ten patients with ABI completed 10.4 ± 4.8 OEGT sessions with no adverse events. Barriers to session completion included clinical focus on prioritized interventions. Sessions [median up time = 17 minutes, (IQR: 7); walk time = 13 minutes, (IQR: 9); step count = 243, (IQR: 161); device assist = 74, (IQR: 28.0)] were primarily spent in Very Light to Light heart rate intensities [89%, (IQR: 42%) and 9%, (IQR: 33%), respectively]. CONCLUSION OEGT incorporated into the rehabilitation plan of care during inpatient rehabilitation after severe ABI was observed to be safe, feasible, and tolerable. However, intentional steps must be taken to facilitate patient safety.
Collapse
Affiliation(s)
- Jaime Gillespie
- Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, Texas, USA
| | - Molly Trammell
- Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, Texas, USA
| | - Christa Ochoa
- Physical Medicine and Rehabilitation, Baylor Scott and White Research Institute, Dallas, Texas, USA
| | - Simon Driver
- Physical Medicine and Rehabilitation, Baylor Scott and White Research Institute, Dallas, Texas, USA
| | - Librada Callender
- Physical Medicine and Rehabilitation, Baylor Scott and White Research Institute, Dallas, Texas, USA
| | - Rosemary Dubiel
- Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, Texas, USA
| | - Chad Swank
- Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, Texas, USA
- Physical Medicine and Rehabilitation, Baylor Scott and White Research Institute, Dallas, Texas, USA
| |
Collapse
|
2
|
Cai W, Han X, Tang X, Cao Z, Yu Z, Sun Z, Wu J, Wu Y, Xie H. Uncovering sympathetic nervous system dysfunction in disorders of consciousness via heart rate variability during head-up tilt test. Physiol Rep 2024; 12:e16000. [PMID: 38584117 PMCID: PMC10999365 DOI: 10.14814/phy2.16000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 04/09/2024] Open
Abstract
Few standardized tools are available for evaluation of disorders of consciousness (DOC). The potential of heart rate variability (HRV) during head-up tilt (HUT) test was investigated as a complementary evaluation tool. Twenty-one DOC patients and 21 healthy participants were enrolled in this study comparing clinical characteristics and HRV time- and frequency-domain outcomes and temporal changes during HUT test. During the 1st-5th min of the HUT, DOC group showed a significant increase and decrease in log low frequency (LF) (p = 0.045) and log normalized high frequency (nHF) (p = 0.02), respectively, compared to the supine position and had lower log normalized LF (nLF) (p = 0.004) and log ratio of low-to-high frequency (LF/HF) (p = 0.001) compared to healthy controls. As the HUT continued from the 6th to the 20th min, DOC group exhibited a significant increase in log LF/HF (16th-20th min) (p < 0.05), along with a decrease in log nHF (6th-10th and 16th-20th min) (p < 0.05) and maintained lower log LF, log nLF, and log LF/HF than controls (p < 0.05). 1st-10th min after returning to the supine position, DOC group demonstrated a significant decrease in log nHF (p < 0.01) and increases in log LF/HF (p < 0.01) and had lower log LF (p < 0.01) and log nLF (p < 0.05) compared to controls. In contrast, the control group exhibited a significant decrease in log nHF (p < 0.05) and increase in log LF/HF (p < 0.05) throughout the entire HUT test. Notably, no significant differences were observed when comparing time-domain outcomes reflecting parasympathetic nervous system between the two groups. HRV during HUT test indicated a delayed and attenuated autonomic response, particularly in the sympathetic nervous system, in DOC patients compared with healthy individuals.
Collapse
Affiliation(s)
- Weiqiang Cai
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Xu Han
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Xinwei Tang
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Zuojun Cao
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Zi Yu
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Zuowen Sun
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Junfa Wu
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Yi Wu
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Hongyu Xie
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| |
Collapse
|
3
|
Svingos AM, McLean HB, Slomine BS, Suskauer SJ. Head Control Contributes to Prediction of Emergence From the Minimally Conscious State in Children Admitted to Inpatient Rehabilitation. Arch Phys Med Rehabil 2024; 105:20-26. [PMID: 37348826 PMCID: PMC10730769 DOI: 10.1016/j.apmr.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 04/25/2023] [Accepted: 06/14/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE To examine the utility of head and trunk control, assessed using the Physical Abilities and Mobility Scale, for predicting emergence from a minimally conscious state (eMCS) among children with acquired brain injury admitted to inpatient rehabilitation in a disorder of consciousness (DoC). DESIGN Retrospective study. SETTING Pediatric inpatient rehabilitation hospital. PARTICIPANTS Forty patients (2-21 years-old) directly admitted from acute care to pediatric inpatient brain injury rehabilitation in a DoC (average length of stay=85 days; N=40). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES State of consciousness (eMCS vs not) at discharge from inpatient rehabilitation. RESULTS Forty-five percent of patients emerged from a minimally conscious state during inpatient rehabilitation. Admission state of consciousness and head control (but not trunk control) were significantly associated with eMCS and provided complementary prognostic information. Admission state of consciousness (ie, admitting in a vegetative state/unresponsive wakefulness syndrome) afforded the greatest negative predictive value (93.8%), whereas admission head control ability afforded the greatest positive predictive value (81.8% for any independent head control; 100% for maintaining head-up position for >30 seconds). Fifty percent of patients who emerged during the inpatient stay did not have independent head control at admission, highlighting the importance of exploring head control as a prognostic marker in conjunction with indicators with greater sensitivity (eg, state of consciousness at admission). CONCLUSIONS A brief measure of head control at admission may contribute to identification of a subgroup of patients who are likely to emerge.
Collapse
Affiliation(s)
- Adrian M Svingos
- Brain Injury Clinical Research Center, Kennedy Krieger Institute, Baltimore, MD; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD.
| | - Heather B McLean
- Department of Physical Therapy, Kennedy Krieger Institute, Baltimore, MD
| | - Beth S Slomine
- Brain Injury Clinical Research Center, Kennedy Krieger Institute, Baltimore, MD; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Stacy J Suskauer
- Brain Injury Clinical Research Center, Kennedy Krieger Institute, Baltimore, MD; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
| |
Collapse
|
4
|
Murtaugh B, Morrissey AM, Fager S, Knight HE, Rushing J, Weaver J. Music, occupational, physical, and speech therapy interventions for patients in disorders of consciousness: An umbrella review. NeuroRehabilitation 2024; 54:109-127. [PMID: 38277314 DOI: 10.3233/nre-230149] [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] [Indexed: 01/28/2024]
Abstract
BACKGROUND Current clinical guidelines recommend that a multidisciplinary team inclusive of allied healthcare practitioners deliver assessment and intervention for disorders of consciousness. Allied health professionals include music, occupational, physical, and speech therapists. These allied health clinicians are challenged to select interventions due to a lack of evidence-based recommendations regarding rehabilitation interventions that support recovery of consciousness. This umbrella review synthesizes available systematic reviews (SRs) that describe occupational, speech and language, physical and/or musical therapeutic interventions for people with disorders of consciousness. OBJECTIVES Identify and summarize evidence from systematic reviews (SRs) that examine allied healthcare interventions for patients with disorders of consciousness. Additionally, this umbrella review aims to evaluate the impact of allied health interventions on recovery of consciousness, methodological quality and risk of bias for the included systematic reviews. METHODS An umbrella review was completed. The review was reported according to the Preferred Reporting Items for Overview of Reviews (PRIOR) guidance. Five academic databases (PubMed, CINAHL, PsycInfo, Web of Science, and the Cochrane Library) were searched for SRs and/or meta-analyses of allied health (i.e., music, occupational, physical, and speech therapy) interventions for disorders of consciousness. For included studies, data were extracted and quality of the SRs appraised using the A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2 checklist. Data extracted from each SR identified the authors and years of primary studies, interventions, comparators, and outcomes related to recovery of consciousness (i.e., neurobehavioral/cognitive), functional status, physiological response pain, and adverse events. Rehabilitation interventions were categorized and described. RESULTS Fifteen SRs were included and three of these reviews conducted meta-analyses. Identified rehabilitation interventions included: 1) sensory stimulation, 2) median nerve stimulation, 3) communication/environmental control through assistive technology, 4) mobilization, and 5) music-based therapy. SRs were published between 2002 and 2022 and included 2286 participants. Using the AMSTAR 2, the quality of reviews was critically low (k = 6), low (k = 3), moderate (k = 4), and high (k = 2). SRs within this umbrella review demonstrated significant heterogeneity in research methods and use of outcome measures to evaluate the recovery of consciousness within the primary studies. These factors influenced the ability to conduct meta-analyses. CONCLUSIONS Sensory stimulation, median nerve stimulation, music therapy and mobilization are all interventions that demonstrate some level of benefit, but current SRs fail to prove benefit through high-level quality evidence. There is an indisputable need for continued rehabilitation research to expand options for treatment modalities and to ensure that the interventions being applied to DoC rehabilitation are evidence-based to improve consciousness and recovery.
Collapse
Affiliation(s)
- Brooke Murtaugh
- Department of Rehabilitation Programs, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Ann-Marie Morrissey
- School of Allied Health, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Susan Fager
- Communication Center, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Heather E Knight
- Department of Physical Therapy, School of Pharmacy & Health Professions, Creighton University, Omaha, NE, USA
| | - Jess Rushing
- Colorado State University, Fort Collins, CO, USA
| | - Jennifer Weaver
- Department of Occupational Therapy, College of Health and Human Sciences, Colorado State University, Fort Collins, CO, USA
| |
Collapse
|
5
|
Bender A, Eifert B, Rubi-Fessen I, Jox RJ, Maurer-Karattup P, Müller F. The Neurological Rehabilitation of Adults With Coma and Disorders of Consciousness. DEUTSCHES ARZTEBLATT INTERNATIONAL 2023; 120:605-612. [PMID: 37434290 PMCID: PMC10568738 DOI: 10.3238/arztebl.m2023.0159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/26/2023] [Accepted: 06/26/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Severe quantitative disorders of consciousness (DoC) due to acute brain injury affect up to 47% of patients upon admission to intensive care and early rehabilitation units. Nevertheless, the rehabilitation of this vulnerable group of patients has not yet been addressed in any German-language guidelines and has only been studied in a small number of randomized clinical trials. METHODS In an S3 clinical practice guideline project, a systematic literature search was carried out for interventions that could improve consciousness in patients with coma, unresponsive wakefulness syndrome, or minimally conscious state after acute brain injury, and an evidence-based evaluation of these interventions was performed. Recommendations concerning diagnostic methods and medical ethics were issued by consensus. RESULTS Misdiagnoses are common in patients with DoC, with minimal consciousness often going unrecognized. Patients with DoC should, therefore, be repeatedly assessed with standardized instruments, particularly the Coma Recovery Scale-Revised. The literature search yielded 54 clinical trials, mostly of low quality; there were two randomized controlled clinical trials providing level 1 evidence. The best available evidence for the improvement of impaired consciousness is for the administration of amantadine (4 studies) and for anodal transcranial direct-current stimulation of the left dorsolateral prefrontal cortex in patients in the minimal conscious state (8 studies, 2 systematic reviews). Further important components of rehabilitation include positioning methods and sensory stimulation techniques such as music therapy. CONCLUSION For the first time, evidence-based German-language clinical practice guidelines have now become available for the neurological rehabilitation of patients with DoC.
Collapse
Affiliation(s)
- Andreas Bender
- Therapiezentrum Burgau and Department of Neurology, LMU Klinikum, LMU München, Munich, Germany
| | | | - Ilona Rubi-Fessen
- Rehanova Neurorehabilitation Center, Cologne, Germany and Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Ralf J. Jox
- Institut des humanités en médecine, University Hospital and University of Lausanne, Switzerland
| | | | | |
Collapse
|
6
|
Yang X, Zhang T, Cao L, Ye L, Song W. Early Mobilization for Critically Ill Patients. Respir Care 2023; 68:781-795. [PMID: 37041029 PMCID: PMC10209006 DOI: 10.4187/respcare.10481] [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] [Indexed: 04/13/2023]
Abstract
Advances in the field of critical care medicine have helped improve the survival rate of these ill patients. Several studies have demonstrated the potential benefits of early mobilization as an important component of critical care rehabilitation. However, there have been some inconsistent results. Moreover, the lack of standardized mobilization protocols and the associated safety concerns are a barrier to the implementation of early mobilization in critically ill patients. Therefore, determining the appropriate modalities of implementation of early mobilization is a key imperative to leverage its potential in these patients. In this paper, we review the contemporary literature to summarize the strategies for early mobilization of critically ill patients, assess the implementation and validity based on the International Classification of Functioning, Disability and Health, as well as discuss the safety aspects of early mobilization.
Collapse
Affiliation(s)
- Xiaolong Yang
- Department of Rehabilitation Medicine, Capital Medical University Xuanwu Hospital, Beijing, China
| | - Tiantian Zhang
- Department of Rehabilitation Medicine, Capital Medical University Xuanwu Hospital, Beijing, China
| | - Lei Cao
- Department of Rehabilitation Medicine, Capital Medical University Xuanwu Hospital, Beijing, China
| | - Linlin Ye
- Department of Rehabilitation Medicine, Capital Medical University Xuanwu Hospital, Beijing, China
| | - Weiqun Song
- Department of Rehabilitation Medicine, Capital Medical University Xuanwu Hospital, Beijing, China.
| |
Collapse
|
7
|
Rosenfelder MJ, Helmschrott VC, Willacker L, Einhäupl B, Raiser TM, Bender A. Effect of robotic tilt table verticalization on recovery in patients with disorders of consciousness: a randomized controlled trial. J Neurol 2023; 270:1721-1734. [PMID: 36536249 PMCID: PMC9971146 DOI: 10.1007/s00415-022-11508-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022]
Abstract
Verticalization is a common therapeutic intervention during rehabilitation of patients with disorders of consciousness (DoC). The Erigo®Pro is a robotic tilt-table (RTT) with built-in stepping unit for the lower extremities to prevent orthostatic hypotension during verticalization. In addition, the system also provides functional electrical stimulation (FES) of muscles of the lower extremities. In this randomized controlled clinical trial (RCT), 47 patients with subacute DoC received a 4-week verticalization regime (16 verticalization sessions) and were allocated to one of three experimental groups: (1) verticalization by means of RTT with FES, (2) by means of RTT without FES, or (3) by conventional physiotherapy (CPT). Level of consciousness (LoC), spasticity, functional independence in daily activities, and functional brain connectivity measured by means of high-density quantitative EEG were assessed at baseline, directly after the verticalization program and after 6 months. There was a similar clinical improvement in all three experimental groups. RTT was not associated with an effect on any of the clinical outcomes. Verticalization or mobilization time during the study period was significantly positively correlated with recovery of consciousness (rho = 0.494, p < 0.001) in the short term and showed a statistical trend at the 6 months follow-up (rho = 0.244, p = 0.078). In conclusion, RTT treatment is not more effective in promoting recovery of consciousness than CPT in subacute DoC patients. Yet, our data suggest, that verticalization may be an important and feasible rehabilitation intervention in this group of patients. ClinicalTrials.gov NCT Number NCT02639481, registered on December 24, 2015.
Collapse
Affiliation(s)
- M J Rosenfelder
- Therapiezentrum Burgau, Kapuzinerstraße 34, 89331, Burgau, Germany.
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89069, Ulm, Germany.
| | - V C Helmschrott
- Therapiezentrum Burgau, Kapuzinerstraße 34, 89331, Burgau, Germany
| | - L Willacker
- Department of Neurology, Ludwig-Maximilians-University of Munich, Marchioninistraße 15, 81377, Munich, Germany
| | - B Einhäupl
- Department of Neurology, Ludwig-Maximilians-University of Munich, Marchioninistraße 15, 81377, Munich, Germany
| | - T M Raiser
- Department of Neurology, Ludwig-Maximilians-University of Munich, Marchioninistraße 15, 81377, Munich, Germany
| | - A Bender
- Therapiezentrum Burgau, Kapuzinerstraße 34, 89331, Burgau, Germany
- Department of Neurology, Ludwig-Maximilians-University of Munich, Marchioninistraße 15, 81377, Munich, Germany
| |
Collapse
|
8
|
Zheng RZ, Qi ZX, Wang Z, Xu ZY, Wu XH, Mao Y. Clinical Decision on Disorders of Consciousness After Acquired Brain Injury: Stepping Forward. Neurosci Bull 2023; 39:138-162. [PMID: 35804219 PMCID: PMC9849546 DOI: 10.1007/s12264-022-00909-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/10/2022] [Indexed: 01/22/2023] Open
Abstract
Major advances have been made over the past few decades in identifying and managing disorders of consciousness (DOC) in patients with acquired brain injury (ABI), bringing the transformation from a conceptualized definition to a complex clinical scenario worthy of scientific exploration. Given the continuously-evolving framework of precision medicine that integrates valuable behavioral assessment tools, sophisticated neuroimaging, and electrophysiological techniques, a considerably higher diagnostic accuracy rate of DOC may now be reached. During the treatment of patients with DOC, a variety of intervention methods are available, including amantadine and transcranial direct current stimulation, which have both provided class II evidence, zolpidem, which is also of high quality, and non-invasive stimulation, which appears to be more encouraging than pharmacological therapy. However, heterogeneity is profoundly ingrained in study designs, and only rare schemes have been recommended by authoritative institutions. There is still a lack of an effective clinical protocol for managing patients with DOC following ABI. To advance future clinical studies on DOC, we present a comprehensive review of the progress in clinical identification and management as well as some challenges in the pathophysiology of DOC. We propose a preliminary clinical decision protocol, which could serve as an ideal reference tool for many medical institutions.
Collapse
Affiliation(s)
- Rui-Zhe Zheng
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- National Center for Neurological Disorders, Shanghai, 200040, China
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, 200040, China
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, 200040, China
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, 200032, China
| | - Zeng-Xin Qi
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- National Center for Neurological Disorders, Shanghai, 200040, China
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, 200040, China
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, 200040, China
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, 200032, China
| | - Zhe Wang
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- National Center for Neurological Disorders, Shanghai, 200040, China
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, 200040, China
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, 200040, China
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, 200032, China
| | - Ze-Yu Xu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- National Center for Neurological Disorders, Shanghai, 200040, China
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, 200040, China
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, 200040, China
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, 200032, China
| | - Xue-Hai Wu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
- National Center for Neurological Disorders, Shanghai, 200040, China.
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, 200040, China.
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China.
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, 200040, China.
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, 200032, China.
| | - Ying Mao
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
- National Center for Neurological Disorders, Shanghai, 200040, China.
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, 200040, China.
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China.
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, 200040, China.
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, 200032, China.
| |
Collapse
|
9
|
Min JH, Shin YI. Treatment and Rehabilitation for Traumatic Brain Injury: Current Update. BRAIN & NEUROREHABILITATION 2022; 15:e14. [PMID: 36743200 PMCID: PMC9833473 DOI: 10.12786/bn.2022.15.e14] [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: 06/15/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/08/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Ji Hong Min
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yong-Il Shin
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.,Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, Korea
| |
Collapse
|
10
|
Bohannon RW, Green MD. Neurologic and musculoskeletal effects of tilt-table standing on adults: a systematic review. J Phys Ther Sci 2021; 33:700-706. [PMID: 34539077 PMCID: PMC8436033 DOI: 10.1589/jpts.33.700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/27/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Tilt table use is associated, most often, with the assessment of syncope. However, it also has applications for patients with neurologic and orthopedic problems. These applications do not appear to be widely applied. The purpose of this review, therefore, was to summarize the research literature addressing the use of tilt tables for treating specific musculoskeletal and neurologic impairments in adults. [Methods] Relevant literature was identified by searches of the PubMed, CINAHL, and Scopus databases and hand searches (December 2018 and October 2020). The methodological quality of the identified research articles was assessed using the PEDro scale. [Results] Of 482 unique articles identified, 20 matched the eligibility criteria of the review and were included. The studies varied widely in the populations studied, procedures used, and responses reported. The studies provide limited support for tilt table standing as an intervention. [Conclusion] However, evidence that some patients with neurologic conditions may respond positively to tilt-table standing is available. Among such individuals are those with decreased ankle range of motion, positive neurologic signs in the lower limbs, and decreased levels of consciousness.
Collapse
|