Post-Stroke Functional Changes: In-Depth Analysis of Clinical Tests and Motor-Cognitive Dual-Tasking Using Wearable Sensors.

Clinical tests like Timed Up and Go (TUG) facilitate the assessment of post-stroke mobility, but they lack detailed measures. In this study, 21 stroke survivors and 20 control participants underwent TUG, sit-to-stand (STS), and the 10 Meter Walk Test (10MWT). Tests incorporated single tasks (STs) and motor-cognitive dual-task (DTs) involving reverse counting from 200 in decrements of 10.

Fall Risk Assessment in Stroke Survivors: A Machine Learning Model Using Detailed Motion Data from Common Clinical Tests and Motor-Cognitive Dual-Tasking.

Background: Falls are common and dangerous for stroke survivors. Current fall risk assessment methods rely on subjective scales. Objective sensor-based methods could improve prediction accuracy.

A Systematic Review of Fall Risk Factors in Stroke Survivors: Towards Improved Assessment Platforms and Protocols.

To prevent falling, a common incident with debilitating health consequences among stroke survivors, it is important to identify significant fall risk factors (FRFs) towards developing and implementing predictive and preventive strategies and guidelines. This review provides a systematic approach for identifying the relevant FRFs and shedding light on future directions of research. A systematic search was conducted in 5 popular research databases.

A causal test of the motor theory of speech perception: a case of impaired speech production and spared speech perception.

The debate about the causal role of the motor system in speech perception has been reignited by demonstrations that motor processes are engaged during the processing of speech sounds. Here, we evaluate which aspects of auditory speech processing are affected, and which are not, in a stroke patient with dysfunction of the speech motor system. We found that the patient showed a normal phonemic categorical boundary when discriminating two non-words that differ by a minimal pair (e.

When concepts lose their color: a case of object-color knowledge impairment.

Color is important in our daily interactions with objects, and plays a role in both low- and high-level visual processing. Previous neuropsychological studies have shown that color perception and object-color knowledge can doubly dissociate, and that both can dissociate from processing of object form. We present a case study of an individual who displayed an impairment for knowledge of the typical colors of objects, with preserved color perception and color naming.

Preserved tool knowledge in the context of impaired action knowledge: implications for models of semantic memory.

A number of studies have observed that the motor system is activated when processing the semantics of manipulable objects. Such phenomena have been taken as evidence that simulation over motor representations is a necessary and intermediary step in the process of conceptual understanding. Cognitive neuropsychological evaluations of patients with impairments for action knowledge permit a direct test of the necessity of motor simulation in conceptual processing.

Patient management problem-preferred responses.

Following are the preferred responses for the Patient Management Problem in this CONTINUUM issue. The case, questions, and answer options are repeated, and the preferred response appears in bold print, followed by an explanation and a reference with which you may seek more specific information. You are encouraged to review the responses and explanations carefully to evaluate your general understanding of the material.

Neurorehabilitation for other neurologic disorders.

Rehabilitation treatment and the interdisciplinary approach to care may improve the function of those with progressive neurologic disorders such as multiple sclerosis, Parkinson disease, ALS, muscular dystrophy, and neuropathy. Appropriate goals and therapies are specific to the stage of the disease as well as the needs and values of the individual patient. Preliminary evidence exists to support moderate aerobic and strengthening regimens in these patients.

Traumatic brain injury.

Traumatic brain injury (TBI) is a leading cause of death and disability in both children and adults. TBI is complex, as it involves injury to multiple brain areas caused by both the initial injury and secondary events. The most persistent sequelae of TBI are cognitive and behavioral, reflecting the fact that the preponderance of damage is to the frontal lobes.

Emerging therapies in neurorehabilitation.

Just as advancing technology has furthered our understanding of how the nervous system recovers, technology also enables the development of novel approaches to treatment. Because nervous system disease and injury often lead to severely impaired function, patients and families are willing to try anything, so therapies are often adopted with little evidence that they actually work. Evidence shows that comprehensive rehabilitation programs produce better outcomes, but it is still not understood what components of these multifaceted programs are critical to their success.

Introduction: the evolving field of neurorehabilitation.

Over the past 15 years, our understanding of how the nervous system responds to brain injury, spinal cord injury, and stroke has expanded exponentially. Research demonstrates that the CNS, once thought to be unable to regenerate, maintains a degree of plasticity that responds to activity and pharmacologic therapy, producing both neurophysiologic changes and clinical recovery. Removing barriers to optimize axonal regrowth appears to further enhance this plasticity.

Maximizing recovery from stroke: new advances in rehabilitation.

Stroke is the leading cause of disability in the United States. The magnitude of its economic impact is growing due to improved survival and the aging of the population. Acute interventions for stroke have had little effect on cost.

Understanding stroke recovery and rehabilitation: current and emerging approaches.

Although stroke is the third leading cause of death in the United States, it is the significant disability among survivors that has the greatest impact on healthcare and society. It is currently accepted that comprehensive rehabilitation programs improve outcome following stroke. We are now trying to discern which specific therapeutic approaches work and which do not.

U.S. health care in conflict--Part II. The challenges of balancing cost quality and access.

Faced with the technology explosion, the aging population and the growing uninsured, our health care system confronts an uncertain and troubling future. In this second part of a two-part series, look at some proposed solutions to the problems.

U.S. health care in conflict--Part I. The challenges of balancing cost, quality and access.

Grappling with a technology explosion, an aging population and a growing number of uninsured, our health care system faces an uncertain and troubling future. Examine the critical issues influencing health care policy development and think about ways to address the dilemma of balancing cost, quality and access.

Cognitive and behavioural efficacy of amantadine in acute traumatic brain injury: an initial double-blind placebo-controlled study.

The objective of the current study was to determine the efficacy of amantadine in improving cognitive and behavioural performance in a traumatic brain injury (TBI) rehabilitation sample. The design was a prospective, randomized, double-blind, placebo-controlled, crossover design. Subjects were 10 adult traumatic brain injury patients in an acute brain injury rehabilitation unit.

Epidemiology and predictors of post-concussive syndrome after minor head injury in an emergency population.

Objective: To determine if clinical variables or neurobehavioural test (NBT) scores obtained in the ED within 24 hours of minor head injury (MHI) predict the development of postconcussive syndrome (PCS).

Methods: Prospective, observational study of 71 MHI patients and 60 orthopaedic controls. MHI defined as loss of consciousness < 10 minutes or amnesia, GCS 15, no skull fracture or new neurologic focality on PE, and no brain injury on CT (if done).

Rehabilitation outcomes in encephalitis--a retrospective study 1990-1997.

Background: Encephalitis is an uncommon clinical entity compared to traumatic brain injury, and stroke. Many encephalitis survivors have disabling sequelae. There is scant information in the literature addressing outcome following inpatient rehabilitation for encephalitis.

Recovery and rehabilitation following subarachnoid haemorrhage: Part II. Long-term follow-up.

Background And Purpose: Subarachnoid haemorrhage (SAH) accounts for 5-10% of all strokes, strikes at a mean age of 50 years and results in a pattern of deficits similar to that of traumatic brain injury. This study is an extension of a previous study which described outcome at discharge from inpatient rehabilitation. The purpose of this follow-up study was to describe long-term functional, cognitive and psychosocial outcome in a cohort of SAH survivors who received inpatient rehabilitation.

Recovery and rehabilitation following subarachnoid haemorrhage. Part I: Outcome after inpatient rehabilitation.

Background And Purpose: Although subarachnoid haemorrhage (SAH) is a subtype of stroke, functional outcome following rehabilitation for SAH must be considered distinct from that of cerebral infarction because of the younger age and the difference in pathology and resultant neurologic deficits. The purposes of this study were to: (1) describe the demographic and clinical characteristics of SAH patients receiving rehabilitation; (2) describe functional outcomes following inpatient rehabilitation; and (3) investigate possible relationships between patient characteristics and functional outcomes.

Methods: Retrospective chart review of SAH patients admitted to inpatient rehabilitation.

Recovery and rehabilitation following traumatic brain injury.

Although most patients are discharged following traumatic brain injury (TBI) with "good recovery', recent reports indicate that many have persistent neuropsychological deficits. The purposes of this study were to: (1) determine if functional, neuropsychological and social outcome at 3 and 6 months in patients hospitalized following TBI could be ascertained via telephone follow-up, and (2) assess use of rehabilitation services in this population. Patients were identified through acute hospital admissions.

Recovery from stroke: rehabilitation.

Most of the neurological and functional recovery following stroke occurs during the first 3-6 months, although some patients show prolonged and unexpected levels of recovery. Research shows that the determination of outcome is multifactorial and includes demographics and psychosocial as well as medical factors. New information on how the brain recovers from injury has given us insights into which therapy approaches theoretically might be beneficial.

Clinical use of amantadine in brain injury rehabilitation.

We retrospectively reviewed the charts of 12 subjects with brain injury who were treated with amantadine. Ten of the 12 subjects exhibited some improvement in cognitive and/or physical function while on amantadine. Areas most consistently showing improvement included focused and sustained attention and concentration, orientation, alertness, arousal, processing, time, and psychomotor speed, mobility, vocalization, agitation, anxiety and participation in therapy.

Clinical observations on recovery from stroke.

Recovery from stroke occurs in a similar pattern in most patients, but the final functional status is difficult to predict. This recovery is most rapid in the first few months, but it may continue for years. The factors facilitating prolonged and more complete recovery are unclear and multiple.