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Noé E, Gómez A, Bernabeu M, Quemada I, Rodríguez R, Pérez T, López C, Laxe S, Colomer C, Ríos M, Juárez-Belaúnde A, González C, Pelayo R, Ferri J. Guidelines: basic principles of neurorehabilitation for patients with acquired brain injury. Recommendations of the Spanish Society of Neurorehabilitation. Neurologia 2024; 39:261-281. [PMID: 37116696 DOI: 10.1016/j.nrleng.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/27/2021] [Indexed: 04/30/2023] Open
Abstract
INTRODUCTION We present the Spanish Society of Neurorehabilitation's guidelines for adult acquired brain injury (ABI) rehabilitation. These recommendations are based on a review of international clinical practice guidelines published between 2013 and 2020. DEVELOPMENT We establish recommendations based on the levels of evidence of the studies reviewed and expert consensus on population characteristics and the specific aspects of the intervention or procedure under research. CONCLUSIONS All patients with ABI should receive neurorehabilitation therapy once they present a minimal level of clinical stability. Neurorehabilitation should offer as much treatment as possible in terms of frequency, duration, and intensity (at least 45-60minutes of each specific form of therapy that is needed). Neurorehabilitation requires a coordinated, multidisciplinary team with the knowledge, experience, and skills needed to work in collaboration both with patients and with their families. Inpatient rehabilitation interventions are recommended for patients with more severe deficits and those in the acute phase, with outpatient treatment to be offered as soon as the patient's clinical situation allows it, as long as intensity criteria can be maintained. The duration of treatment should be based on treatment response and the possibilities for further improvement, according to the best available evidence. At discharge, patients should be offered health promotion, physical activity, support, and follow-up services to ensure that the benefits achieved are maintained, to detect possible complications, and to assess possible changes in functional status that may lead the patient to need other treatment programmes.
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Affiliation(s)
- E Noé
- NEURORHB Servicio de Neurorrehabilitación de Hospitales Vithas, Fundación Hospitales Vithas, Valencia, Spain.
| | - A Gómez
- Centro Estatal de Atención al Daño Cerebral-CEADAC, Madrid, Spain
| | | | - I Quemada
- Red Menni de Daño Cerebral, Bilbao, Spain
| | | | - T Pérez
- Clínica San Vicente, Madrid, Spain
| | - C López
- Centro Lescer, Madrid, Spain
| | - S Laxe
- Hospital Clínic, Barcelona, Spain
| | - C Colomer
- NEURORHB Servicio de Neurorrehabilitación de Hospitales Vithas, Fundación Hospitales Vithas, Valencia, Spain
| | - M Ríos
- Unidad de Daño Cerebral, Hospital Beata María Ana, Madrid, Spain
| | | | - C González
- Centro Estatal de Atención al Daño Cerebral-CEADAC, Madrid, Spain
| | - R Pelayo
- Institut Guttmann, Barcelona, Spain
| | - J Ferri
- NEURORHB Servicio de Neurorrehabilitación de Hospitales Vithas, Fundación Hospitales Vithas, Valencia, Spain
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Juárez-Belaúnde A, Orcajo E, Lejarreta S, Davila-Pérez P, León N, Oliviero A. Fatigue in patients with acquired brain damage. Neurologia 2024; 39:178-189. [PMID: 38278413 DOI: 10.1016/j.nrleng.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/22/2021] [Indexed: 01/28/2024] Open
Abstract
Fatigue is a complex, multidimensional syndrome that is prevalent in patients with acquired brain damage and has a negative impact on the neurorehabilitation process. It presents from early stages after the injury, and may persist over time, regardless of whether sequelae have resolved. Fatigue is conditioned by upper neuronal circuits, and is defined as an abnormal perception of overexertion. Its prevalence ranges from 29% to 77% after stroke, from 18% to 75% after traumatic brain injury, and from 47% to 97% after brain tumours. Fatigue is associated with factors including female sex, advanced age, dysfunctional families, history of specific health conditions, functional status (eg, fatigue prior to injury), comorbidities, mood, secondary disability, and the use of certain drugs. Assessment of fatigue is fundamentally based on such scales as the Fatigue Severity Scale (FSS). Advances have recently been made in imaging techniques for its diagnosis, such as in functional MRI. Regarding treatment, no specific pharmacological treatment currently exists; however, positive results have been reported for some conventional neurorehabilitation therapies, such as bright light therapy, neurofeedback, electrical stimulation, and transcranial magnetic stimulation. This review aims to assist neurorehabilitation professionals to recognise modifiable factors associated with fatigue and to describe the treatments available to reduce its negative effect on patients.
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Affiliation(s)
- A Juárez-Belaúnde
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España.
| | - E Orcajo
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España; Unidad avanzada de neurorehabilitación, Hospital Los Madroños, Madrid, España
| | - S Lejarreta
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España; Consorci Sanitari Alt Penedès-Garraf, Departmento de Neurología, Cataluña, España
| | - P Davila-Pérez
- Unidad avanzada de neurorehabilitación, Hospital Los Madroños, Madrid, España; Hospital Universitario Rey Juan Carlos (HURJC), Departmento de Neurofisiología Clínica, Madrid, España; Health Research Institute - Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, España
| | - N León
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España; Unidad avanzada de neurorehabilitación, Hospital Los Madroños, Madrid, España
| | - A Oliviero
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España; Unidad avanzada de neurorehabilitación, Hospital Los Madroños, Madrid, España; Hospital Nacional para Paraplégicos (SESCAM), Grupo FENNSI, Toledo, España
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Juárez-Belaúnde A, Serrano Afonso AA. Neuropathic pain and COVID-19: A silent relationship. Rev Esp Anestesiol Reanim (Engl Ed) 2022; 69:708-709. [PMID: 36344402 PMCID: PMC9622383 DOI: 10.1016/j.redare.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/19/2021] [Indexed: 11/06/2022]
Affiliation(s)
- A Juárez-Belaúnde
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Brunete, Madrid, Spain; Coordinación del Grupo de Estudio de Dolor Neuropático de la Sociedad Española de Neurología.
| | - A A Serrano Afonso
- Servicio de Anestesiología y Reanimación, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Coordinación del Grupo de Trabajo de Dolor Neuropático de la Sociedad Española del Dolor
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Noé E, Gómez A, Bernabeu M, Quemada I, Rodríguez R, Pérez T, López C, Laxe S, Colomer C, Ríos M, Juárez-Belaúnde A, González C, Pelayo R, Ferri J. Guía: Principios básicos de la neurorrehabilitación del paciente con daño cerebral adquirido. Recomendaciones de la Sociedad Española de Neurorrehabilitación. Neurologia 2021. [DOI: 10.1016/j.nrl.2021.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Juárez-Belaúnde A, Orcajo E, Lejarreta S, Davila-Pérez P, León N, Oliviero A. Fatigue in patients with acquired brain damage. Neurologia 2021:S0213-4853(21)00111-0. [PMID: 34538507 DOI: 10.1016/j.nrl.2021.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/22/2021] [Indexed: 01/05/2023] Open
Abstract
Fatigue is a complex, multidimensional syndrome that is prevalent in patients with acquired brain damage and has a negative impact on the neurorehabilitation process. It presents from early stages after the injury, and may persist over time, regardless of whether sequelae have resolved. Fatigue is conditioned by upper neuronal circuits, and is defined as an abnormal perception of overexertion. Its prevalence ranges from 29% to 77% after stroke, from 18% to 75% after traumatic brain injury, and from 47% to 97% after brain tumours. Fatigue is associated with factors including female sex, advanced age, dysfunctional families, history of specific health conditions, functional status (eg, fatigue prior to injury), comorbidities, mood, secondary disability, and the use of certain drugs. Assessment of fatigue is fundamentally based on such scales as the Fatigue Severity Scale (FSS). Advances have recently been made in imaging techniques for its diagnosis, such as in functional MRI. Regarding treatment, no specific pharmacological treatment currently exists; however, positive results have been reported for some conventional neurorehabilitation therapies, such as bright light therapy, neurofeedback, electrical stimulation, and transcranial magnetic stimulation. This review aims to assist neurorehabilitation professionals to recognise modifiable factors associated with fatigue and to describe the treatments available to reduce its negative effect on patients.
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Affiliation(s)
- A Juárez-Belaúnde
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España.
| | - E Orcajo
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España
| | - S Lejarreta
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España
| | - P Davila-Pérez
- Servicio de Neurofisiología, Hospital Los Madroños, Madrid, España
| | - N León
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España
| | - A Oliviero
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España; Servicio de Neurofisiología, Hospital Los Madroños, Madrid, España; Grupo FENNSI, Hospital Nacional de Parapléjicos, SESCAM, Toledo, España
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Juárez-Belaúnde A, Colomer Font C, Laxe S, Ríos-Lago M, Ferri Campos J. Futuro de la neurorrehabilitación tras la pandemia por el SARS-CoV-2. Neurologia 2020; 35:410-411. [PMID: 32563565 PMCID: PMC7280127 DOI: 10.1016/j.nrl.2020.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 06/01/2020] [Indexed: 11/30/2022] Open
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