1
|
Lorentz L, Müller K, Suchan B. Virtual reality-based attention training in patients with neurological damage: A pilot study. Neuropsychol Rehabil 2024; 34:701-720. [PMID: 37466958 DOI: 10.1080/09602011.2023.2236349] [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: 02/23/2023] [Accepted: 07/05/2023] [Indexed: 07/20/2023]
Abstract
Virtual Reality has been shown to be a valid tool to assess cognitive functions in an ecologically valid way. However, evidence regarding its effectiveness as a treatment option for cognitive rehabilitation has been limited. Furthermore, its potential to facilitate the transfer of training effects to patients' everyday life is still poorly studied. This study aimed to evaluate the efficacy of a VR-based attention training and its transfer to attentional functioning in everyday life. Nineteen inpatients with neurological disorders and attentional deficits underwent daily 30-min VR training sessions over a two-week period. Attentional functions were assessed before and after the training period using several computerized tests, two self-constructed behavioral tasks, and a questionnaire assessing patients' subjective attentional functioning. Pre-Post-analyses show significant decreases in reaction times in the computerized alertness and selective attention tests. Transfer to the behavioral tasks and self-report data could not be observed. Despite the specificity of the changes, confounding effects cannot entirely be ruled out due to the lack of a control group. Results suggest that training was effective in improving attentional functioning along neuropsychological measures, but did not elicit transfer to an ecologically valid or subjective level. Implications for the future development of VR interventions are discussed.
Collapse
Affiliation(s)
- Lukas Lorentz
- St. Mauritius Therapieklinik, Meerbusch, Germany
- Institute of Cognitive Neuroscience, Clinical Neuropsychology, Neuropsychological Therapy Centre, Ruhr University Bochum, Bochum, Germany
| | | | - Boris Suchan
- Institute of Cognitive Neuroscience, Clinical Neuropsychology, Neuropsychological Therapy Centre, Ruhr University Bochum, Bochum, Germany
| |
Collapse
|
2
|
Fernández-Pérez JJ, Serrano-Muñoz D, Beltran-Alacreu H, Avendaño-Coy J, Gómez-Soriano J. Trans-Spinal Direct Current Stimulation in Neurological Disorders: A systematic review. J Neurol Phys Ther 2024; 48:66-74. [PMID: 38015051 DOI: 10.1097/npt.0000000000000463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
BACKGROUND AND PURPOSE Trans-spinal direct current stimulation (tsDCS) is a noninvasive stimulation technique that applies direct current stimulation over spinal levels. However, the effectiveness and feasibility of this stimulation are still unclear. This systematic review summarizes the effectiveness of tsDCS in clinical and neurophysiological outcomes in neurological patients, as well as its feasibility and safety. METHODS The search was conducted using the following databases: PEDro, Scopus, Web of Science, CINAHL, SPORTDiscus, and PubMed. The inclusion criteria were: Participants : people with central nervous system diseases; Interventions : tsDCS alone or in combination with locomotion training; Comparators : sham tsDCS, transcranial direct current stimulation, or locomotion training; Outcomes : clinical and neurophysiological measures; and Studies : randomized clinical trials. RESULTS Eight studies with a total of 143 subjects were included. Anodal tsDCS led to a reduction in hypertonia, neuropathic pain intensity, and balance deficits in people with hereditary spastic paraplegia, multiple sclerosis, and primary orthostatic tremor, respectively. In contrast, cathodal tsDCS only had positive effects on balance and tremor in people with primary orthostatic tremor. No severe adverse effects were reported during and after anodal or cathodal tsDCS. DISCUSSION AND CONCLUSIONS Although certain studies have found an effect of anodal tsDCS on specific clinical outcomes in people with central nervous system diseases, its effectiveness cannot be established since these findings have not been replicated and the results were heterogeneous. This stimulation was feasible and safe to apply. Further studies are needed to replicate the obtained results of tsDCS when applied in populations with neurological diseases.
Collapse
Affiliation(s)
- Juan José Fernández-Pérez
- Toledo Physiotherapy Research Group (GIFTO), Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain
| | | | | | | | | |
Collapse
|
3
|
Ielo A, Quartarone A, Calabrò RS, De Cola MC. A hub and spoke model to supply the Sicilian neurorehabilitation demand: effects on hospitalization rates and patient mobility. Front Public Health 2024; 12:1349211. [PMID: 38572007 PMCID: PMC10987749 DOI: 10.3389/fpubh.2024.1349211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/04/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction Cerebrovascular diseases in Sicily have led to high mortality and healthcare challenges, with a notable gap between healthcare demand and supply. The mobility of patients seeking care, both within and outside Sicily, has economic and organizational impacts on the healthcare system. The Hub and Spoke model implemented by the IRCCS Centro Neurolesi "Bonino-Pulejo" of Messina aims to distribute advanced neurorehabilitation services throughout Sicily, potentially reducing health mobility and improving service accessibility. Methods The evaluation was based on calculating hospitalization rates, examining patient mobility across Sicilian provinces, and assessing the financial implications of neurorehabilitation admissions. Data from 2016 to 2018, covering the period before and after the implementation of the Hub and Spoke network, were analyzed to understand the changes brought about by this model. Results The analysis revealed a significant increase in hospitalization rates for neurorehabilitation in the Sicilian provinces where spokes were established. This increase coincided with a marked decrease in interregional health mobility, indicating that patients were able to receive high-quality care closer to their residences. Furthermore, there was a decrease in both intra-regional and inter-regional escape rates in provinces within the Hub and Spoke network, demonstrating the network's efficacy in improving accessibility and quality of healthcare services. Discussion The implementation of the Hub and Spoke network substantially improved neurorehabilitation healthcare in Sicily, enhancing both accessibility and quality of care for patients. The network's establishment led to a more efficient utilization of healthcare resources and balanced distribution of services. These advancements are vital steps toward equitable and effective healthcare delivery in Sicily.
Collapse
|
4
|
Assylbek MI, Kocyigit BF, Yessirkepov M, Zimba O. Post-stroke rehabilitation in the peri-pandemic COVID-19 era. Rheumatol Int 2024; 44:399-411. [PMID: 38253904 DOI: 10.1007/s00296-023-05520-1] [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: 10/31/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024]
Abstract
The coronavirus disease 2019 (COVID-19), which arose in late 2019, caused extensive destruction, impacting a substantial proportion of the worldwide population and leading to millions of deaths. Although COVID-19 is mainly linked to respiratory and pulmonary complications, it has the potential to affect neurologic structures as well. Neurological involvement may manifest as minimal and reversible; however, a notable proportion of cases have exhibited pronounced neurological consequences, such as strokes. Endothelial inflammation, hypercoagulation, renin-angiotensin-aldosterone system alterations, and cardiogenic embolism are the pathophysiological mechanisms of stroke under COVID-19 circumstances. Physical activity and exercise have improved several aspects of post-stroke recovery, including cardiovascular health, walking capacity, and upper limb strength. They are commonly used to assist stroke survivors in overcoming their motor restrictions. Furthermore, stroke rehabilitation can incorporate a range of specific techniques, including body-weight-supported treadmill applications, constraint-induced movement therapy, robotic rehabilitation interventions, transcranial direct current stimulation, transcranial magnetic stimulation, and prism adaptation training. Under pandemic conditions, there were several barriers to neurological rehabilitation. The most significant of these were individual's fear of infection, which caused them to postpone their rehabilitation applications and rehabilitation areas being converted into COVID-19 units. The primary emphasis had turned to COVID-19 treatment. Several valuable data and views were gained in reorganizing rehabilitation during the pandemic, contributing to establishing future views in this regard.
Collapse
Affiliation(s)
- Meirgul I Assylbek
- Department of Neurology, Psychiatry, Neurosurgery and Rehabilitation, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
- Department of Social Health Insurance and Public Health, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
- Medical Center ''Mediker'', Shymkent, Kazakhstan
| | - Burhan Fatih Kocyigit
- Department of Physical Medicine and Rehabilitation, Adana Health Practice and Research Center, University of Health Sciences, Adana, Turkey.
| | - Marlen Yessirkepov
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | - Olena Zimba
- Department of Clinical Rheumatology and Immunology, University Hospital in Krakow, Krakow, Poland
- National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
- Department of Internal Medicine N2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| |
Collapse
|
5
|
Shao Z, Dou W, Ma D, Zhai X, Xu Q, Pan Y. A Novel Neurorehabilitation Prognosis Prediction Modeling on Separated Left-Right Hemiplegia Based on Brain-Computer Interfaces Assisted Rehabilitation. IEEE Trans Neural Syst Rehabil Eng 2023; 31:3375-3383. [PMID: 37581962 DOI: 10.1109/tnsre.2023.3305474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
It is essential for neuroscience and clinic to estimate the influence of neuro-intervention after brain damage. Most related studies have used Mirrored Contralesional-Ipsilesional hemispheres (MCI) methods flipping the axial neuroimaging on the x-axis in prognosis prediction. But left-right hemispheric asymmetry in the brain has become a consensus. MCI confounds the intrinsic brain asymmetry with the asymmetry caused by unilateral damage, leading to questions about the reliability of the results and difficulties in physiological explanations. We proposed the Separated Left-Right hemiplegia (SLR) method to model left and right hemiplegia separately. Two pipelines have been designed in contradistinction to demonstrate the validity of the SLR method, including MCI and removing intrinsic asymmetry (RIA) pipelines. A patient dataset with 18 left-hemiplegic and 22 right-hemiplegic stroke patients and a healthy dataset with 40 subjects, age- and sex-matched with the patients, were selected in the experiment. Blood-Oxygen Level-Dependent MRI and Diffusion Tensor Imaging were used to build brain networks whose nodes were defined by the Automated Anatomical Labeling atlas. We applied the same statistical and machine learning framework for all pipelines, logistic regression, artificial neural network, and support vector machine for classifying the patients who are significant or non-significant responders to brain-computer interfaces assisted training and optimal subset regression, support vector regression for predicting post-intervention outcomes. The SLR pipeline showed 5-15% improvement in accuracy and at least 0.1 upgrades in [Formula: see text], revealing common and unique recovery mechanisms after left and right strokes and helping clinicians make rehabilitation plans.
Collapse
|
6
|
Mitsopoulos K, Fiska V, Tagaras K, Papias A, Antoniou P, Nizamis K, Kasimis K, Sarra PD, Mylopoulou D, Savvidis T, Praftsiotis A, Arvanitidis A, Lyssas G, Chasapis K, Moraitopoulos A, Astaras A, Bamidis PD, Athanasiou A. NeuroSuitUp: System Architecture and Validation of a Motor Rehabilitation Wearable Robotics and Serious Game Platform. SENSORS (BASEL, SWITZERLAND) 2023; 23:3281. [PMID: 36991992 PMCID: PMC10053382 DOI: 10.3390/s23063281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/04/2023] [Accepted: 03/14/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND This article presents the system architecture and validation of the NeuroSuitUp body-machine interface (BMI). The platform consists of wearable robotics jacket and gloves in combination with a serious game application for self-paced neurorehabilitation in spinal cord injury and chronic stroke. METHODS The wearable robotics implement a sensor layer, to approximate kinematic chain segment orientation, and an actuation layer. Sensors consist of commercial magnetic, angular rate and gravity (MARG), surface electromyography (sEMG), and flex sensors, while actuation is achieved through electrical muscle stimulation (EMS) and pneumatic actuators. On-board electronics connect to a Robot Operating System environment-based parser/controller and to a Unity-based live avatar representation game. BMI subsystems validation was performed using exercises through a Stereoscopic camera Computer Vision approach for the jacket and through multiple grip activities for the glove. Ten healthy subjects participated in system validation trials, performing three arm and three hand exercises (each 10 motor task trials) and completing user experience questionnaires. RESULTS Acceptable correlation was observed in 23/30 arm exercises performed with the jacket. No significant differences in glove sensor data during actuation state were observed. No difficulty to use, discomfort, or negative robotics perception were reported. CONCLUSIONS Subsequent design improvements will implement additional absolute orientation sensors, MARG/EMG based biofeedback to the game, improved immersion through Augmented Reality and improvements towards system robustness.
Collapse
Affiliation(s)
- Konstantinos Mitsopoulos
- Medical Physics & Digital Innovation Laboratory, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Vasiliki Fiska
- Medical Physics & Digital Innovation Laboratory, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Konstantinos Tagaras
- Medical Physics & Digital Innovation Laboratory, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Athanasios Papias
- Medical Physics & Digital Innovation Laboratory, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Panagiotis Antoniou
- Medical Physics & Digital Innovation Laboratory, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Konstantinos Nizamis
- Department of Design, Production and Management, University of Twente, 7522 NB Enschede, The Netherlands
| | - Konstantinos Kasimis
- Department of Physiotherapy, International Hellenic University, 57400 Thessaloniki, Greece
| | - Paschalina-Danai Sarra
- Medical Physics & Digital Innovation Laboratory, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Diamanto Mylopoulou
- Medical Physics & Digital Innovation Laboratory, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Theodore Savvidis
- Medical Physics & Digital Innovation Laboratory, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Apostolos Praftsiotis
- Medical Physics & Digital Innovation Laboratory, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Athanasios Arvanitidis
- Medical Physics & Digital Innovation Laboratory, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - George Lyssas
- Medical Physics & Digital Innovation Laboratory, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Konstantinos Chasapis
- Medical Physics & Digital Innovation Laboratory, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Alexandros Moraitopoulos
- Medical Physics & Digital Innovation Laboratory, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Alexander Astaras
- Department of Computer Science, American College of Thessaloniki, 55535 Thessaloniki, Greece
| | - Panagiotis D. Bamidis
- Medical Physics & Digital Innovation Laboratory, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Alkinoos Athanasiou
- Medical Physics & Digital Innovation Laboratory, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| |
Collapse
|
7
|
Gouveia D, Cardoso A, Carvalho C, Almeida A, Gamboa Ó, Ferreira A, Martins Â. Approach to Small Animal Neurorehabilitation by Locomotor Training: An Update. Animals (Basel) 2022; 12:ani12243582. [PMID: 36552502 PMCID: PMC9774773 DOI: 10.3390/ani12243582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/05/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Neurorehabilitation has a wide range of therapies to achieve neural regeneration, reorganization, and repair (e.g., axon regeneration, remyelination, and restoration of spinal circuits and networks) to achieve ambulation for dogs and cats, especially for grade 1 (modified Frankel scale) with signs of spinal shock or grade 0 (deep pain negative), similar to humans classified with ASIA A lesions. This review aims to explain what locomotor training is, its importance, its feasibility within a clinical setting, and some possible protocols for motor recovery, achieving ambulation with coordinated and modulated movements. In addition, it cites some of the primary key points that must be present in the daily lives of veterinarians or rehabilitation nurses. These can be the guidelines to improve this exciting exercise necessary to achieve ambulation with quality of life. However, more research is essential in the future years.
Collapse
Affiliation(s)
- Débora Gouveia
- Arrábida Veterinary Hospital—Arrábida Animal Rehabilitation Center, 2925-538 Setubal, Portugal
- Superior School of Health, Protection and Animal Welfare, Polytechnic Institute of Lusophony, Campo Grande, 1950-396 Lisboa, Portugal
- Faculty of Veterinary Medicine, Lusófona University, Campo Grande, 1749-024 Lisboa, Portugal
- Correspondence:
| | - Ana Cardoso
- Arrábida Veterinary Hospital—Arrábida Animal Rehabilitation Center, 2925-538 Setubal, Portugal
| | - Carla Carvalho
- Arrábida Veterinary Hospital—Arrábida Animal Rehabilitation Center, 2925-538 Setubal, Portugal
| | - António Almeida
- Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisboa, Portugal
| | - Óscar Gamboa
- Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisboa, Portugal
| | - António Ferreira
- Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisboa, Portugal
- CIISA—Centro Interdisciplinar-Investigaçāo em Saúde Animal, Faculdade de Medicina Veterinária, Av. Universi dade Técnica de Lisboa, 1300-477 Lisboa, Portugal
| | - Ângela Martins
- Arrábida Veterinary Hospital—Arrábida Animal Rehabilitation Center, 2925-538 Setubal, Portugal
- Superior School of Health, Protection and Animal Welfare, Polytechnic Institute of Lusophony, Campo Grande, 1950-396 Lisboa, Portugal
- Faculty of Veterinary Medicine, Lusófona University, Campo Grande, 1749-024 Lisboa, Portugal
- Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisboa, Portugal
| |
Collapse
|
8
|
EEG in Neurorehabilitation: A Bibliometric Analysis and Content Review. Neurol Int 2022; 14:1046-1061. [PMID: 36548189 PMCID: PMC9782188 DOI: 10.3390/neurolint14040084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND There is increasing interest in the role of EEG in neurorehabilitation. We primarily aimed to identify the knowledge base through highly influential studies. Our secondary aims were to imprint the relevant thematic hotspots, research trends, and social networks within the scientific community. METHODS We performed an electronic search in Scopus, looking for studies reporting on rehabilitation in patients with neurological disabilities. We used the most influential papers to outline the knowledge base and carried out a word co-occurrence analysis to identify the research hotspots. We also used depicted collaboration networks between universities, authors, and countries after analyzing the cocitations. The results were presented in summary tables, plots, and maps. Finally, a content review based on the top-20 most cited articles completed our study. RESULTS Our current bibliometric study was based on 874 records from 420 sources. There was vivid research interest in EEG use for neurorehabilitation, with an annual growth rate as high as 14.3%. The most influential paper was the study titled "Brain-computer interfaces, a review" by L.F. Nicolas-Alfonso and J. Gomez-Gill, with 997 citations, followed by "Brain-computer interfaces in neurological rehabilitation" by J. Daly and J.R. Wolpaw (708 citations). The US, Italy, and Germany were among the most productive countries. The research hotspots shifted with time from the use of functional magnetic imaging to EEG-based brain-machine interface, motor imagery, and deep learning. CONCLUSIONS EEG constitutes the most significant input in brain-computer interfaces (BCIs) and can be successfully used in the neurorehabilitation of patients with stroke symptoms, amyotrophic lateral sclerosis, and traumatic brain and spinal injuries. EEG-based BCI facilitates the training, communication, and control of wheelchair and exoskeletons. However, research is limited to specific scientific groups from developed countries. Evidence is expected to change with the broader availability of BCI and improvement in EEG-filtering algorithms.
Collapse
|
9
|
Maffoni M, Sommovigo V, Giardini A, Velutti L, Setti I. Well-Being and Professional Efficacy Among Health Care Professionals: The Role of Resilience Through the Mediation of Ethical Vision of Patient Care and the Moderation of Managerial Support. Eval Health Prof 2022; 45:381-396. [PMID: 34530627 DOI: 10.1177/01632787211042660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Drawing on the Conservation of Resources theory, this study analyzes whether resilience could be related to healthcare providers' wellbeing and professional self-efficacy, both directly and indirectly, as mediated by ethical vision of patient care and moderated by managerial support in dealing with ethical issues. Overall, 315 Italian healthcare professionals employed in neuro-rehabilitation medicine or palliative care specialties participated in this multi-centered cross-sectional study. The following variables were investigated: resilience (Connor-Davidson Resilience Scale), wellbeing (Maugeri Stress Index-Reduced), professional self-efficacy (Maslach Burnout Inventory-General Survey), ethical vision of patient care and managerial support in dealing with ethical issues (Italian version of the Hospital Ethical Climate Survey). Overall, resilience was positively associated with healthcare providers' wellbeing and professional self-efficacy, directly and indirectly, as mediated by ethical vision of patient care. Highly resilient healthcare professionals who perceived the presence of a positive ethical vision of patient care in their workplace were more likely to experience greater wellbeing when managerial support in dealing with ethical issues was high (vs. low). Thus, these findings provide suggestions for tailored interventions sustaining healthcare professionals along their daily activity characterized by high-demanding and challenging situations.
Collapse
Affiliation(s)
- Marina Maffoni
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute (Pavia), Italy
| | - Valentina Sommovigo
- Department of Brain and Behavioural Sciences, Unit of Applied Psychology, University of Pavia, Italy
| | - Anna Giardini
- IT Department, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Laura Velutti
- Medical Oncology and Hematology Unit, Humanitas Clinical and Research Center-IRCCS, Humanitas Cancer Center, Rozzano, Milan, Italy
| | - Ilaria Setti
- Department of Brain and Behavioural Sciences, Unit of Applied Psychology, University of Pavia, Italy
| |
Collapse
|
10
|
Virtual/Augmented Reality for Rehabilitation Applications Using Electromyography as Control/Biofeedback: Systematic Literature Review. ELECTRONICS 2022. [DOI: 10.3390/electronics11142271] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Virtual reality (VR) and augmented reality (AR) are engaging interfaces that can be of benefit for rehabilitation therapy. However, they are still not widely used, and the use of surface electromyography (sEMG) signals is not established for them. Our goal is to explore whether there is a standardized protocol towards therapeutic applications since there are not many methodological reviews that focus on sEMG control/feedback. A systematic literature review using the PRISMA (preferred reporting items for systematic reviews and meta-analyses) methodology is conducted. A Boolean search in databases was performed applying inclusion/exclusion criteria; articles older than 5 years and repeated were excluded. A total of 393 articles were selected for screening, of which 66.15% were excluded, 131 records were eligible, 69.46% use neither VR/AR interfaces nor sEMG control; 40 articles remained. Categories are, application: neurological motor rehabilitation (70%), prosthesis training (30%); processing algorithm: artificial intelligence (40%), direct control (20%); hardware: Myo Armband (22.5%), Delsys (10%), proprietary (17.5%); VR/AR interface: training scene model (25%), videogame (47.5%), first-person (20%). Finally, applications are focused on motor neurorehabilitation after stroke/amputation; however, there is no consensus regarding signal processing or classification criteria. Future work should deal with proposing guidelines to standardize these technologies for their adoption in clinical practice.
Collapse
|
11
|
Ilut S, Vadan I, Muresanu D. The impact of cognitive reserve in the recovery of chronic encephalopathy associated with traumatic brain injury. J Med Life 2022; 15:723-726. [PMID: 35928373 PMCID: PMC9321498 DOI: 10.25122/jml-2022-1007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/08/2022] [Indexed: 11/21/2022] Open
Affiliation(s)
- Silvina Ilut
- Department of Neuroscience, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania,RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Iulia Vadan
- Department of Neuroscience, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania,RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Dafin Muresanu
- Department of Neuroscience, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania,RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| |
Collapse
|
12
|
Paek AY, Brantley JA, Evans BJ, Contreras-Vidal JL. Concerns in the Blurred Divisions between Medical and Consumer Neurotechnology. IEEE SYSTEMS JOURNAL 2021; 15:3069-3080. [PMID: 35126800 PMCID: PMC8813044 DOI: 10.1109/jsyst.2020.3032609] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Neurotechnology has traditionally been central to the diagnosis and treatment of neurological disorders. While these devices have initially been utilized in clinical and research settings, recent advancements in neurotechnology have yielded devices that are more portable, user-friendly, and less expensive. These improvements allow laypeople to monitor their brain waves and interface their brains with external devices. Such improvements have led to the rise of wearable neurotechnology that is marketed to the consumer. While many of the consumer devices are marketed for innocuous applications, such as use in video games, there is potential for them to be repurposed for medical use. How do we manage neurotechnologies that skirt the line between medical and consumer applications and what can be done to ensure consumer safety? Here, we characterize neurotechnology based on medical and consumer applications and summarize currently marketed uses of consumer-grade wearable headsets. We lay out concerns that may arise due to the similar claims associated with both medical and consumer devices, the possibility of consumer devices being repurposed for medical uses, and the potential for medical uses of neurotechnology to influence commercial markets related to employment and self-enhancement.
Collapse
Affiliation(s)
- Andrew Y Paek
- Department of Electrical & Computer Engineering and the IUCRC BRAIN Center at the University of Houston, Houston, TX, USA
| | - Justin A Brantley
- Department of Electrical & Computer Engineering and the IUCRC BRAIN Center at the University of Houston. He is now with the Department of Bioengineering at the University of Pennsylvania, Philadelphia, PA, USA
| | - Barbara J Evans
- Law Center and IUCRC BRAIN Center at the University of Houston. University of Houston, Houston, TX. She is now with the Wertheim College of Engineering and Levin College of Law at the University of Florida, Gainesville, FL, USA
| | - Jose L Contreras-Vidal
- Department of Electrical & Computer Engineering and the IUCRC BRAIN Center at the University of Houston, Houston, TX, USA
| |
Collapse
|
13
|
Gandhi DB, Kamalakannan S, Chockalingam M, Sebastian IA, Urimubenshi G, Alim M, Khatter H, Chakraborty S, Solomon JM. Expert consensus for in-hospital neurorehabilitation during the COVID-19 pandemic in low- and middle-income countries. Wellcome Open Res 2021; 6:130. [PMID: 35118197 PMCID: PMC8787554 DOI: 10.12688/wellcomeopenres.16715.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2021] [Indexed: 11/20/2022] Open
Abstract
Background: People with neurological dysfunction have been significantly affected by the ongoing coronavirus disease 2019 (COVID-19) crisis in receiving adequate and quality rehabilitation services. There are no clear guidelines or recommendations for rehabilitation providers in dealing with patients with neurological dysfunction during a pandemic situation especially in low- and middle-income countries. The objective of this paper was to develop consensus-based expert recommendations for in-hospital based neurorehabilitation during the COVID-19 pandemic for low- and middle-income countries based on available evidence. Methods: A group of experts in neurorehabilitation consisting of neurologists, physiotherapists and occupational therapists were identified for the consensus groups. A scoping review was conducted to identify existing evidence and recommendations for neurorehabilitation during COVID-19. Specific statements with level 2b evidence from studies identified were developed. These statements were circulated to 13 experts for consensus. The statements that received ≥80% agreement were grouped in different themes and the recommendations were developed. Results: 75 statements for expert consensus were generated. 72 statements received consensus from 13 experts. These statements were thematically grouped as recommendations for neurorehabilitation service providers, patients, formal and informal caregivers of affected individuals, rehabilitation service organizations, and administrators. Conclusions: The development of this consensus statement is of fundamental significance to neurological rehabilitation service providers and people living with neurological disabilities. It is crucial that governments, health systems, clinicians and stakeholders involved in upholding the standard of neurorehabilitation practice in low- and middle-income countries consider conversion of the consensus statement to minimum standard requirements within the context of the pandemic as well as for the future.
Collapse
Affiliation(s)
- Dorcas B.C. Gandhi
- College of Physiotherapy and Department of Neurology, Christian Medical College, Ludhiana, Punjab, 141008, India
| | | | - Manigandan Chockalingam
- Occupational Therapy, School of Health Sciences, National University of Ireland, Galway, Galway, H91 TK33, Ireland
| | - Ivy A. Sebastian
- Department of Neurology, St. Stephen’s Hospital, New Delhi, New Delhi, 110054, India
| | - Gerard Urimubenshi
- Department of Physiotherapy, School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Mohammed Alim
- Stroke Clinical Trials Group, Cumming School of Medicine, Calgary, Alberta, T2N 1N4, Canada
| | - Himani Khatter
- Department of Neurology, Christian Medical College and Hospital, Ludhiana, Punjab, 141008, India
| | - Stuti Chakraborty
- Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, Vellore, Tamil Nadu, 632002, India
| | - John M. Solomon
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
- Centre for Comprehensive Stroke Rehabilitation and Research, Manipal Academy of Higher Education, Manipal, Karnataka, 567104, India
| |
Collapse
|
14
|
Gama GL, Ramos de Amorim MM, Alves da Silva Júnior R, Cristina de Sousa Santos A, Assunção PL, de Sales Tavares J, de Sales Regis T, de Sales Tavares J, Melo A. Effect of Intensive Physiotherapy Training for Children With Congenital Zika Syndrome: A Retrospective Cohort Study. Arch Phys Med Rehabil 2020; 102:413-422. [PMID: 33007306 DOI: 10.1016/j.apmr.2020.08.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 08/03/2020] [Accepted: 08/07/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate the effect of intensive physiotherapy training on the motor function of children with congenital Zika syndrome (CZS). DESIGN A retrospective cohort study. SETTING A support center for children with microcephaly. PARTICIPANTS Children (N=7) aged 14 to 18 months old who were diagnosed with CZS and previously monitored more than 1 year. INTERVENTIONS A 2-stage protocol repeated uninterruptedly for 1 year. In the first stage, the children were submitted to 1 hour of conventional physiotherapy and 1 hour of suit therapy 5 times a week for 4 weeks. The second stage consisted of 1 hour of suit therapy 3 times a week for 2 weeks. MAIN OUTCOME MEASURES Gross motor function measure (GMFM) and body weight. RESULTS Six evaluations were conducted approximately 3 months apart. An increase in the overall GMFM score was observed between the first and second (P=.046), first and third (P=.018), first and fourth (P=.018), first and fifth (P=.043), and first and sixth evaluations (P=.018). Differences in the scores of the individual GMFM dimensions were found only for dimension A (lying and rolling) between the first and fourth evaluations (P=.027) and for dimension B (sitting) between the first and third (P=.018), first and fourth (P=.046), and first and sixth evaluations (P=.027). No difference was found in body weight between the first and sixth evaluations (P=.009). During follow-up, only 1 child required hospitalization, and another had increased irritability. CONCLUSIONS Children with CZS were able to perform 2 hours of motor physiotherapy daily with no serious complications, resulting in an increase or stabilization in GMFM scores.
Collapse
Affiliation(s)
- Gabriela Lopes Gama
- Professor Joaquim Amorim Neto Research Institute (IPESQ), Campina Grande, Paraíba, Brazil; UNIFACISA University Center, Campina Grande, Paraíba, Brazil
| | | | | | | | - Paula Lisiane Assunção
- Professor Joaquim Amorim Neto Research Institute (IPESQ), Campina Grande, Paraíba, Brazil
| | | | | | | | - Adriana Melo
- Professor Joaquim Amorim Neto Research Institute (IPESQ), Campina Grande, Paraíba, Brazil; UNIFACISA University Center, Campina Grande, Paraíba, Brazil.
| |
Collapse
|
15
|
Grau JW, Baine RE, Bean PA, Davis JA, Fauss GN, Henwood MK, Hudson KE, Johnston DT, Tarbet MM, Strain MM. Learning to promote recovery after spinal cord injury. Exp Neurol 2020; 330:113334. [PMID: 32353465 PMCID: PMC7282951 DOI: 10.1016/j.expneurol.2020.113334] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 04/19/2020] [Accepted: 04/26/2020] [Indexed: 02/06/2023]
Abstract
The present review explores the concept of learning within the context of neurorehabilitation after spinal cord injury (SCI). The aim of physical therapy and neurorehabilitation is to bring about a lasting change in function-to encourage learning. Traditionally, it was assumed that the adult spinal cord is hardwired-immutable and incapable of learning. Research has shown that neurons within the lower (lumbosacral) spinal cord can support learning after communication with the brain has been disrupted by means of a thoracic transection. Noxious stimulation can sensitize nociceptive circuits within the spinal cord, engaging signal pathways analogous to those implicated in brain-dependent learning and memory. After a spinal contusion injury, pain input can fuel hemorrhage, increase the area of tissue loss (secondary injury), and undermine long-term recovery. Neurons within the spinal cord are sensitive to environmental relations. This learning has a metaplastic effect that counters neural over-excitation and promotes adaptive learning through an up-regulation of brain-derived neurotrophic factor (BDNF). Exposure to rhythmic stimulation, treadmill training, and cycling also enhances the expression of BDNF and counters the development of nociceptive sensitization. SCI appears to enable plastic potential within the spinal cord by down-regulating the Cl- co-transporter KCC2, which reduces GABAergic inhibition. This enables learning, but also fuels over-excitation and nociceptive sensitization. Pairing epidural stimulation with activation of motor pathways also promotes recovery after SCI. Stimulating motoneurons in response to activity within the motor cortex, or a targeted muscle, has a similar effect. It is suggested that a neurofunctionalist approach can foster the discovery of processes that impact spinal function and how they may be harnessed to foster recovery after SCI.
Collapse
Affiliation(s)
- James W Grau
- Behavioral and Cellular Neuroscience, Department of Psychology, Texas A&M University, College Station, TX 77843, USA.
| | - Rachel E Baine
- Behavioral and Cellular Neuroscience, Department of Psychology, Texas A&M University, College Station, TX 77843, USA
| | - Paris A Bean
- Behavioral and Cellular Neuroscience, Department of Psychology, Texas A&M University, College Station, TX 77843, USA
| | - Jacob A Davis
- Behavioral and Cellular Neuroscience, Department of Psychology, Texas A&M University, College Station, TX 77843, USA
| | - Gizelle N Fauss
- Behavioral and Cellular Neuroscience, Department of Psychology, Texas A&M University, College Station, TX 77843, USA
| | - Melissa K Henwood
- Behavioral and Cellular Neuroscience, Department of Psychology, Texas A&M University, College Station, TX 77843, USA
| | - Kelsey E Hudson
- Behavioral and Cellular Neuroscience, Department of Psychology, Texas A&M University, College Station, TX 77843, USA
| | - David T Johnston
- Behavioral and Cellular Neuroscience, Department of Psychology, Texas A&M University, College Station, TX 77843, USA
| | - Megan M Tarbet
- Behavioral and Cellular Neuroscience, Department of Psychology, Texas A&M University, College Station, TX 77843, USA
| | - Misty M Strain
- Battlefield Pain Research, U.S. Army Institute of Surgical Research, 3698 Chambers Pass, BHT-1, BSA Fort Sam Houston, TX 78234, USA
| |
Collapse
|
16
|
Bagherpour R, Dykstra DD, Barrett AM, Luft AR, Divani AA. A Comprehensive Neurorehabilitation Program Should be an Integral Part of a Comprehensive Stroke Center. Front Neurol 2014; 5:57. [PMID: 24795694 PMCID: PMC4001043 DOI: 10.3389/fneur.2014.00057] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 04/07/2014] [Indexed: 11/30/2022] Open
Affiliation(s)
- Reza Bagherpour
- Department of Physical Medicine and Rehabilitation, University of Minnesota , Minneapolis, MN , USA ; Department of Neurology, University of Minnesota , Minneapolis, MN , USA
| | - Dennis D Dykstra
- Department of Physical Medicine and Rehabilitation, University of Minnesota , Minneapolis, MN , USA
| | - A M Barrett
- Stroke Rehabilitation Research, Kessler Foundation , West Orange, NJ , USA
| | - Andreas R Luft
- Clinical Neurorehabilitation, Department of Neurology, University of Zurich , Zurich , Switzerland
| | - Afshin A Divani
- Department of Neurology, University of Minnesota , Minneapolis, MN , USA ; Department of Neurosurgery, University of Minnesota , Minneapolis, MN , USA
| |
Collapse
|