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Neurorehabilitation and Neural Repair

Nina Lefeber, Emma De Keersmaecker, Stieven Henderix, Marc Michielsen, Eric Kerckhofs, Eva Swinnen
INTRODUCTION: Physiological responses are rarely considered during walking after stroke and if considered, only during a short period (3-6 minutes). The aims of this study were to examine physiological responses during 30-minute robot-assisted and body weight-supported treadmill and overground walking and compare intensities with exercise guidelines. METHODS: A total of 14 ambulatory stroke survivors (age: 61 ± 9 years; time after stroke: 2.8 ± 2.8 months) participated in 3 separate randomized walking trials...
November 12, 2018: Neurorehabilitation and Neural Repair
Serene S Paul, Sydney Y Schaefer, Genevieve N Olivier, Christopher S Walter, Keith R Lohse, Leland E Dibble
INTRODUCTION: Treatment of Parkinson's disease (PD) with exogenous dopamine (ie, levodopa) may positively affect motor symptoms, but may negatively affect other functions such as the learning of motor skills necessary for rehabilitation. This study aimed to determine whether levodopa medication affects general and sequence-specific learning of a stepping task and the transfer of movement skill to untrained balance tasks in people with PD. METHODS: Participants with PD were randomized to practice "on" (n = 14) or "off" (n = 13) levodopa medication...
November 9, 2018: Neurorehabilitation and Neural Repair
Carolina C Alcântara, Charalambos C Charalambous, Susanne M Morton, Thiago L Russo, Darcy S Reisman
BACKGROUND: Studies in neurologically intact subjects suggest that the gradual presentation of small perturbations (errors) during learning results in better transfer of a newly learned walking pattern to overground walking. Whether the same result would be true after stroke is not known. OBJECTIVE: To determine whether introducing gradual perturbations, during locomotor learning using a split-belt treadmill influences learning the novel walking pattern or transfer to overground walking poststroke...
November 9, 2018: Neurorehabilitation and Neural Repair
Peter R A Malik, Ryan T Muir, Sandra E Black, Fuqiang Gao, Richard H Swartz, Brian J Murray, Mark I Boulos
OBJECTIVE: Impaired attentional processes have been linked with poor outcomes after stroke, but their radiographical correlates have been infrequently studied. Our objective was to assess the relationship between stroke location and vigilant attention. METHODS: A total of 39 patients presenting within 2 weeks of a minor stroke were prospectively recruited. Vigilant attention was assessed using the psychomotor vigilance task (PVT), and neuroimaging was used to assess stroke location, white matter hyperintensity (WMH) burden, and ischemic stroke involvement within lateral cholinergic projections...
October 24, 2018: Neurorehabilitation and Neural Repair
Julia Boonzaier, Geralda A F van Tilborg, Sebastiaan F W Neggers, Rick M Dijkhuizen
BACKGROUND: Stroke is the leading cause of adult disability, but treatment options remain limited, leaving most patients with incomplete recovery. Patient and animal studies have shown potential of noninvasive brain stimulation (NIBS) strategies to improve function after stroke. However, mechanisms underlying therapeutic effects of NIBS are unclear and there is no consensus on which NIBS protocols are most effective. OBJECTIVE: Provide a review of articles that assessed effects and mechanisms of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) in animal stroke models...
October 24, 2018: Neurorehabilitation and Neural Repair
Nergiz Turgut, Lisa Möller, Kerstin Dengler, Katrin Steinberg, Andreas Sprenger, Paul Eling, Andreas Kastrup, Helmut Hildebrandt
BACKGROUND: Visuospatial neglect is a disabling syndrome with serious consequences for activities in daily life. This study investigated the effect of adaptive cueing during a reading task as a possible treatment for neglect by including (1) a task relevant for the patient's daily life, (2) a fading out procedure to stimulate independent orientation to the left by self-cueing, and (3) a clear definition of neglect severity for the adaptive treatment protocol. METHODS: A randomized controlled crossover design was used, including 26 patients from an early rehabilitation unit with left-sided visuospatial neglect after stroke or hemorrhage...
October 17, 2018: Neurorehabilitation and Neural Repair
Hsing-Ching Kuo, Ephrem Zewdie, Patrick Ciechanski, Omar Damji, Adam Kirton
BACKGROUND: Clinical trials are suggesting efficacy of intensive therapy combined with brain stimulation to improve hand function in hemiparetic children with perinatal stroke. However, individual variability exists and the underlying neuroplasticity mechanisms are unknown. Exploring primary motor cortex (M1) neurophysiology, and how it changes with such interventions, may provide valuable biomarkers for advancing personalized neurorehabilitation. METHODS: Forty-five children (age 6-19 years) with hemiparesis participated in PLASTIC CHAMPS, a blinded, sham-controlled, factorial clinical trial...
October 4, 2018: Neurorehabilitation and Neural Repair
Jolanda M B Roelofs, Kirsten van Heugten, Digna de Kam, Vivian Weerdesteyn, Alexander C H Geurts
BACKGROUND: The relationships between motor impairment of the affected leg, postural control asymmetry, and impaired body sway control after stroke are not well understood. OBJECTIVE: To examine the relationship between motor impairment of the affected leg and reduced contribution of this leg to body sway control (ie, dynamic control asymmetry [DCA]) and to determine the relationships between impaired body sway control, DCA, and weight-bearing asymmetry (WBA). METHODS: We assessed quiet-standing balance with eyes open in 70 persons with a unilateral supratentorial chronic stroke using 2 force plates...
November 2018: Neurorehabilitation and Neural Repair
Rodrigo Vitorio, Samuel Stuart, Lilian T B Gobbi, Lynn Rochester, Lisa Alcock, Annette Pantall
BACKGROUND: Aging is associated with declining mobility, which negatively affects quality of life and incurs substantial economic costs. Techniques to maintain safe mobility in older adults are therefore essential. Rhythmic auditory cueing (RAC) can improve walking patterns in older adults. However, the neural correlates associated with RAC, how they are influenced by repeated exposure and their relationships with gait response, cognitive function, and depressive symptoms are unclear...
November 2018: Neurorehabilitation and Neural Repair
Jessica Battisto, Katharina V Echt, Steven L Wolf, Paul Weiss, Madeleine E Hackney
BACKGROUND: The Body Position Spatial Task (BPST) is a novel measure of whole-body spatial cognition involving multidirectional steps and turns. Individuals with Parkinson disease (PD) are affected by motor and cognitive impairments, particularly in spatial function, which is important for mental imagery and navigation. Performance on the BPST may inform understanding of motor-cognitive and spatial cognitive function of individuals with PD. OBJECTIVES: We conducted this study to determine feasibility and validity of the BPST with standard, validated, and reliable measures of spatial cognition and motor-cognitive integration and to compare BPST performance in adults with and without PD...
November 2018: Neurorehabilitation and Neural Repair
Maria I Pestalozzi, Marie Di Pietro, Chrisovalandou Martins Gaytanidis, Lucas Spierer, Armin Schnider, Leila Chouiter, Françoise Colombo, Jean-Marie Annoni, Lea B Jost
BACKGROUND: A successful interplay between prefrontal and domain-specific language areas is critical for language processing. Previous studies involving people with aphasia have shown that executive control processes might act on lexical-semantic representations during retrieval. Modulating the prefrontal control network by means of noninvasive brain stimulation might, therefore, improve lexical access in people with aphasia. OBJECTIVE: The present study investigates the effects of prefrontal transcranial direct current stimulation (tDCS) on lexical access in chronic poststroke aphasia...
October 2018: Neurorehabilitation and Neural Repair
Meng Ni, Joseph B Hazzard, Joseph F Signorile, Corneliu Luca
This systematic review and meta-analysis is to provide comprehensive evidence-based exercise recommendations targeting walking function for adults with Parkinson's disease. METHODS: Fixed- or random-effect meta-analyses estimated standardized effect sizes (Hedge's g), comparing treatment effects from exercise with nonexercise and another form of exercise (non-EXE control and EXE control). Cuing and exercise duration were used as moderators for subanalyses. RESULTS: The 40 included randomized controlled trials comprised 1656 patients...
October 2018: Neurorehabilitation and Neural Repair
Emma Ghaziani, Christian Couppé, Volkert Siersma, Mette Søndergaard, Hanne Christensen, S Peter Magnusson
BACKGROUND: Arm paresis is present in 48% to 77% of acute stroke patients. Complete functional recovery is reported in only 12% to 34%. Although the arm recovery is most pronounced during the first 4 weeks poststroke, few studies examined the effect of upper extremity interventions during this period. OBJECTIVE: To investigate the effect of electrical somatosensory stimulation (ESS) delivered during early stroke rehabilitation on the recovery of arm functioning...
October 2018: Neurorehabilitation and Neural Repair
Brian M Sandroff, Robert W Motl, William R Reed, Aron K Barbey, Ralph H B Benedict, John DeLuca
There is a proliferation of research examining the effects of exercise on mobility and cognition in the general population and those with neurological disorders as well as focal research examining possible neural mechanisms of such effects. However, there is seemingly a lack of focus on what it is about exercise, in particular, that drives adaptive central nervous system neuroplasticity. We propose a novel conceptual framework (ie, PRIMERS) that describes such adaptations as occurring via activity-dependent neuroplasticity based on the integrative processing of multisensory input and associated complex motor output that is required for the regulation of physiological systems during exercise behavior...
October 2018: Neurorehabilitation and Neural Repair
Daniel S Peterson, Keith R Lohse, Martina Mancini
BACKGROUND: Effective protective steps are critical for fall prevention, and anticipatory postural adjustments (APAs) after a perturbation but prior to protective steps affect step performance. Although APAs prior to protective steps are altered in people with Parkinson's disease (PD), whether these changes affect subsequent step performance is poorly understood. OBJECTIVE: Characterize the relationship between mediolateral APA size and protective step outcomes in response to anteroposterior balance perturbations in people with PD...
October 2018: Neurorehabilitation and Neural Repair
Adriana Bastos Conforto, Sarah Monteiro Dos Anjos, Wanderley Marques Bernardo, Arnaldo Alves da Silva, Juliana Conti, André G Machado, Leonardo G Cohen
BACKGROUND: Enhancement of sensory input in the form of repetitive peripheral sensory stimulation (RPSS) can enhance excitability of the motor cortex and upper limb performance. OBJECTIVE: To perform a systematic review and meta-analysis of effects of RPSS compared with control stimulation on improvement of motor outcomes in the upper limb of subjects with stroke. METHODS: We searched studies published between 1948 and December 2017 and selected 5 studies that provided individual data and applied a specific paradigm of stimulation (trains of 1-ms pulses at 10 Hz, delivered at 1 Hz)...
October 2018: Neurorehabilitation and Neural Repair
Yushin Kim, Thomas C Bulea, Diane L Damiano
BACKGROUND: There is mounting evidence that the central nervous system utilizes a modular approach for neuromuscular control of walking by activating groups of muscles in units termed muscle synergies. Examination of muscle synergies in clinical populations may provide insights into alteration of neuromuscular control underlying pathological gait patterns. Previous studies utilizing synergy analysis have reported reduced motor control complexity during walking in those with neurological deficits, revealing the potential clinical utility of this approach...
September 2018: Neurorehabilitation and Neural Repair
Liming Qing, Huanwen Chen, Juyu Tang, Xiaofeng Jia
Peripheral nerve injury is a major clinical problem and often results in a poor functional recovery. Despite obvious clinical need, treatment strategies have been largely suboptimal. In the nervous system, exosomes, which are nanosized extracellular vesicles, play a critical role in mediating intercellular communication. More specifically, microRNA carried by exosomes are involved in various key processes such as nerve and vascular regeneration, and exosomes originating from Schwann cells, macrophages, and mesenchymal stem cells can promote peripheral nerve regeneration...
September 2018: Neurorehabilitation and Neural Repair
Daan P J Verberne, Marcel W M Post, Sebastian Köhler, Leeanne M Carey, Johanna M A Visser-Meily, Caroline M van Heugten
BACKGROUND: Many persons with stroke experience physical, cognitive, and emotional problems that contribute to restrictions in social participation. There is, however, a lack of knowledge on the long-term course of participation over time post-stroke. OBJECTIVE: To describe the time course of participation up to 2 years post-stroke and to identify which demographic and stroke-related factors are associated with this time course. METHODS: This was a multicenter, prospective cohort study following 390 persons with stroke from hospital admission up to 2 years (at 2, 6, 12, and 24 months)...
September 2018: Neurorehabilitation and Neural Repair
Hongchae Baek, Ki Joo Pahk, Min-Ju Kim, Inchan Youn, Hyungmin Kim
BACKGROUND: Stroke affects widespread brain regions through interhemispheric connections by influencing bilateral motor activity. Several noninvasive brain stimulation techniques have proved their capacity to compensate the functional loss by manipulating the neural activity of alternative pathways. Over the past few decades, brain stimulation therapies have been tailored within the theoretical framework of modulation of cortical excitability to enhance adaptive plasticity after stroke...
September 2018: Neurorehabilitation and Neural Repair
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