Exercise training and recreational activities to promote executive functions in chronic stroke: a proof-of-concept study.

Background: Stroke survivors represent a target population in need of intervention strategies to promote cognitive function and prevent dementia. Both exercise and recreational activities are promising strategies. We assessed the effect of a 6-month exercise and recreation program on executive functions in adults with chronic stroke.

Systematic review of multivariable prognostic models for mild traumatic brain injury.

Prognostic models can guide clinical management and increase statistical power in clinical trials. The availability and adequacy of prognostic models for mild traumatic brain injury (MTBI) is uncertain. The present study aimed to (1) identify and evaluate multivariable prognostic models for MTBI, and (2) determine which pre-, peri-, and early post-injury variables have independent prognostic value in the context of multivariable models.

Health promotion and disease prevention strategies in older adults with intellectual and developmental disabilities.

The rapid growth in the number of individuals living with intellectual and developmental disabilities (IDD) along with their increased longevity present challenges to those concerned about health and well-being of this unique population. While much is known about health promotion and disease prevention in the general geriatric population, far less is known about those in older adults with IDD. Effective and efficient health promotion and disease prevention strategies need to be developed and implemented for improving the health and quality of life of older adults living with IDD.

Effect of visual feedback on brain activation during motor tasks: an FMRI study.

This study examined the effect of visual feedback and force level on the neural mechanisms responsible for the performance of a motor task. We used a voxel-wise fMRI approach to determine the effect of visual feedback (with and without) during a grip force task at 35% and 70% of maximum voluntary contraction. Two areas (contralateral rostral premotor cortex and putamen) displayed an interaction between force and feedback conditions.

Cognitive-behavioral prevention of postconcussion syndrome in at-risk patients: a pilot randomized controlled trial.

Objective: To examine the tolerability and estimate the treatment effect of cognitive-behavioral therapy (CBT) delivered soon after mild traumatic brain injury to patients at risk for chronic postconcussion syndrome (PCS).

Setting: Tertiary rehabilitation center.

Participants: Twenty-eight patients with uncomplicated mild traumatic brain injury, determined to be at risk for chronic PCS based on a published algorithm that incorporates subacute postconcussion symptoms and maladaptive illness beliefs (recovery expectations and perceived consequences).

Post-concussion symptom reporting after multiple mild traumatic brain injuries.

The relationship between previous mild traumatic brain injury/injuries (MTBI) and recovery from a subsequent MTBI may be complex. The present study investigated three factors hypothesized to influence this relation: (1) the number of prior MTBIs, (2) the interval between MTBIs, and (3) the certainty level of previous MTBIs. The study design was retrospective cross-sectional.

Is rest after concussion "the best medicine?": recommendations for activity resumption following concussion in athletes, civilians, and military service members.

Practice guidelines universally recommend an initial period of rest for people who sustain a sports-related concussion or mild traumatic brain injury (MTBI) in daily life or military service. This practice is difficult to reconcile with the compelling evidence that other health conditions can be worsened by inactivity and improved by early mobilization and exercise. We review the scientific basis for the recommendation to rest after MTBI, the challenges and potential unintended negative consequences of implementing it, and how patient management could be improved by refining it.

Botulinum toxin injection for management of thoracic outlet syndrome: a double-blind, randomized, controlled trial.

We studied the effect of botulinum toxin type A (BTX-A) injections to the scalene muscles on pain in subjects with thoracic outlet syndrome (TOS) in this double-blind, randomized, parallel group trial with follow-up at 6 weeks, 3 months, and 6 months. Thirty-eight patients referred to physiatrists for management of TOS with BTX-A injection were included. One subject was lost to follow-up and all other subjects completed the trial.

The effect of functional electrical stimulation on balance function and balance confidence in community-dwelling individuals with stroke.

Purpose: The purpose of this study was to evaluate the change in balance function and balance confidence in adults with chronic stroke who are starting a gait re-education program with functional electrical stimulation (FES).

Methods: The study used a before-after study design. Fifteen community-dwelling adults with chronic stroke completed four weekly sessions (2 hours each) of balance and ambulation training with FES applied to the ankle dorsiflexors during the swing phase.

Daily physical activity and its contribution to the health-related quality of life of ambulatory individuals with chronic stroke.

Background: Participation in daily physical activity (PA) post-stroke has not previously been investigated as a possible explanatory variable of health-related quality of life (HRQL). The aims were 1) to determine the contribution of daily PA to the HRQL of individuals with chronic stroke and 2) to assess the relationship between the functional ability of these individuals to the amount of daily PA.

Methods: The amount of daily PA of forty adults with chronic stroke (mean age 66.

Feasibility of a 6-month exercise and recreation program to improve executive functioning and memory in individuals with chronic stroke.

Background: Physical activity is beneficial for improving cognitive function in healthy older adults. However, research results on the benefits of physical activity on cognitive performance after stroke are limited.

Objective: To determine if a combined exercise and recreation program can improve the executive functioning and memory of individuals with chronic stroke.

Muscle torque preservation and physical activity in individuals with stroke.

Background: A greater percent loss of concentric versus eccentric muscle torque (i.e., relative eccentric muscle torque preservation) has been reported in the paretic limb of individuals with stroke and has been attributed to hypertonia and/or cocontractions.

Physical activity is related to lower levels of pain, fatigue and depression in individuals with spinal-cord injury: a correlational study.

Study Design: This was a prospective cross-sectional study for people with chronic spinal cord injury (SCI).

Objectives: To (1) evaluate the intensity level and nature of physical activity in community-dwelling individuals living with SCI, and (2) explore the relation between descriptive individual variables (for example, lesion level), secondary complications and participation in physical activity.

Setting: Urban community setting.

Incidence of autonomic dysreflexia and silent autonomic dysreflexia in men with spinal cord injury undergoing sperm retrieval: implications for clinical practice.

Background/objective: To determine the incidence of symptomatic autonomic dysreflexia (AD) and asymptomatic autonomic dysreflexia (silent AD) in men with spinal cord injury (SCI) undergoing sperm retrieval procedures.

Design: Descriptive study.

Methods: Thirteen men underwent cardiovascular monitoring during vibrostimulation (or self-stimulation) to the point of ejaculation.

Prevention and Treatment of Bone Loss after a Spinal Cord Injury: A Systematic Review.

Preserving and maintaining bone mass after a spinal cord injury (SCI) is crucial to decrease the risk of fragility or low trauma fractures- significant health events that occur as a result of minimal trauma such as falling during transfers or from a standing height or less. There is an increased risk for low trauma fractures after a SCI especially in the lower extremity. Therefore, purpose of this systematic review was to appraise the literature to provide clinical guidance for the optimization of bone health after SCI.

Spinal Cord Injury Rehabilitation Evidence: Methods of the SCIRE Systematic Review.

The Spinal Cord Injury Rehabilitation Evidence (SCIRE) is a synthesis of the research evidence underlying rehabilitation interventions to improve the health of people living with SCI. SCIRE covers a comprehensive set of topics and in this issue we present six papers relevant to SCI rehabilitation clinicians (SCI inpatient rehabilitation practices, gait strategies, upper extremity reconstructive surgery, spasticity treatments, cardiovascular health and bone health). The SCIRE used a systematic and well-defined protocol to assess and synthesize the evidence.

Disparity between physical capacity and participation in seniors with chronic disease.

Unlabelled: Consistently low rates of physical activity are reported for older adults, and there is even lower participation if a chronic disease is present.

Purpose: To explore the predictors of physical capacity and participation in older community-dwelling individuals living with multiple chronic diseases.

Methods: This was a descriptive cross-sectional investigation of physical capacity (physiological potential) and physical activity participation (recorded engagement in physical activity).

Reliability and validity of the six-minute arm test for the evaluation of cardiovascular fitness in people with spinal cord injury.

Objectives: To design a submaximal arm ergometry test (six-minute arm test [6-MAT]), for persons with spinal cord injury (SCI) and to determine the test-retest reliability and concurrent validity of this test.

Design: Prospective, exploratory, methodologic study. To determine test-retest reliability, subjects completed the 6-MAT on 2 days, separated by 1 week.

Gait initiation is dependent on the function of the paretic trailing limb in individuals with stroke.

The purposes of this study were to compare the gait initiation task between individuals with chronic stroke and age-matched healthy controls, to determine whether the observed differences between groups could be attributed to the presence of a stroke or to differences in gait initiation speed, and to establish the gait initiation variables that relate with a faster gait initiation speed. All subjects initiated gait at their preferred speed, while control subjects were also asked to initiate gait at a speed that was comparable to the stroke group. It was found that while many temporal and kinetic differences were observed between the two groups, most were simply due to differences in gait initiation speed.

Pain following spinal cord injury: the impact on community reintegration.

Study Design: Prospective, correlational.

Objectives: (1) Describe how pain changes over recovery from admission to spinal cord injury (SCI) rehabilitation, discharge and after 6 months of community living and (2) examine the relationship between pain and community integration at 6 months of community living.

Setting: Tertiary rehabilitation centre, SCI unit, Vancouver, Canada.

Magnitude and pattern of 3D kinematic and kinetic gait profiles in persons with stroke: relationship to walking speed.

The purpose of this study was to identify 3D kinematic and kinetic gait profiles in individuals with chronic stroke and to determine whether the magnitude or pattern (shape and direction of curve) of these profiles relate to gait performance (as measured by self-selected gait speed). More than one type of kinematic and kinetic pattern was identified in all three planes in 20 individuals with stroke (age: 61.2+/-8.

How a woman's sexual adjustment after sustaining a spinal cord injury impacts sexual health interventions.

This qualitative study describes the female experience of sexual adjustment after spinal cord injury (SCI) in relation to the need for sexual health intervention. Ten women with SCI were interviewed using a predetermined, semistructured set of questions. Audiotaping and field notes were utilized to gather data.

Level walking and ambulatory capacity in persons with incomplete spinal cord injury: relationship with muscle strength.

Study Design: Prospective analysis of relationships.

Objectives: (1) To quantify the relationship between individual lower extremity muscle strength and functional walking measures and (2) to determine whether a multiple regression model incorporating lower extremity muscle strength could predict the performance of functional walking measures in persons with incomplete spinal cord injury (ISCI) living in the community.

Setting: Tertiary rehabilitation center, Vancouver, Canada.

Client-centred assessment and the identification of meaningful treatment goals for individuals with a spinal cord injury.

Study Design: Retrospective analysis.

Objectives: (1) Describe the self-care, productivity and leisure problems identified by individuals with a spinal cord injury (SCI) during rehabilitation, (2) describe the perceived level of satisfaction and performance with self-care, productivity and leisure activities following an SCI, (3) quantify the relationship between the Canadian occupational performance measure (COPM), a client-centred, individualized measure of function, and the functional independence measure (FIM).

Setting: Tertiary rehabilitation centre, spinal cord injury unit, GF Strong Rehabilitation Centre, Vancouver, Canada.

The relationship of lower-extremity muscle torque to locomotor performance in people with stroke.

Background And Purpose: Improved walking is a common goal after stroke. The purpose of this study was to examine the relationship between the torque generated by the muscles of both lower extremities and 2 locomotor tasks: gait on level surfaces and stair climbing in people who had strokes.

Subjects: Twenty community-dwelling individuals (mean age=61.