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न्यूरोरिहेबिलिटेशन के अंतर्राष्ट्रीय जर्नल

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आयतन 3, मुद्दा 1 (2016)

शोध आलेख

Internal Memory Rehabilitation Strategies in the Context of Post-acute Brain Injury: A Pilot Study

Robert Perna* and Hana Perkey

Memory impairments are one of the most common consequences of acquired brain injury. Poor memory can have a severe impact on a person’s daily functioning and his/her quality of life. While research provides some support for using external, compensatory strategies (e.g. diaries, lists, visual or electronic reminders), empirical evidence in favor of internal, restorative strategies (i.e. learning and training strategies that utilize less impaired or healthy cognitive resources to restore function) is much sparser. This study investigates the effects of a rehabilitation treatment comprised of internal strategies on the memory functioning of 11 participants with acquired brain injury associated memory impairments. The interventions utilized in this study included practicing visualization, first letter mnemonics, semantic clustering, elaborative encoding, and completing worksheets from Workbook of Activities for Language and Cognition (WALC 10 Memory). The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used for the pre- and post- treatment assessment of memory functioning. Treatment gains as measured by pre-post therapy RBANS differences suggested large memory improvements of a magnitude to suggest clinically meaningful gains. This study was limited by its sample size, absence of a control group, and use of only one outcome measure.

शोध आलेख

Reflex Profile of Children with Down Syndrome Improvement of Neurosensorimotor Development Using the MNRI® Reflex Integration Program

Svetlana Masgutova*, Nelli Akhmatova and Sadowska Ludwika

A reflex profile of children with Down Syndrome (n=48) has been created based on an Assessment of their reflex patterns. This profile and its analysis demonstrate that dysfunctional patterns intrude upon the neurodevelopment of children in this group significantly, and cause more delays in their neurosensorimotor integration, motor coordination, and other areas. The MNRI® (Masgutova Neurosensorimotor Reflex Integration) therapy modality which comprises of techniques and exercises of repatterning, was used for children participating in this research. It has proved its optimizing effect on sensory (tactile, visual-auditory) perception, motor programming and control, and proprioceptive awareness. The MNRI® concept of reflex integration differs from other traditional theories of reflex inhibition/extinction of retained reflexes. The MNRI® approach with immature or dysfunctional reflex circuits is based on activating the sensory-motor patterns encoded in a human nervous system on the genetic level. Non-invasive exercises and techniques in the MNRI® Program are aimed at the development of proper connectivity between sensory and motor neurons in neurophysiological circuits, and at strengthening and coordinating the links between different reflex patterns. The MNRI® process proposes exercises that remind the body-brain system of reflex patterns in a delicate and safe way, sometimes through the use of games and play. These techniques can be easily used by parents, caregivers, and specialists working with Down syndrome children. Statistic analysis of five paramers of a reflex pattern: sensory-motor coordination, direction of a response, intensity (muscle tone regulation), latency/dynamics, and symmetry before and after the MNRI® therapy process (based on synthesized Z function; A. Krefft algorythm) allowed for an objective scientific approach of the effectiveness of the MNRI® processes. The therapy program and evaluations were conducted during 11 day therapy-rehabilitation camps with 48 children from different countries (Poland, USA, Canada, and Russia). The feedback reports by parents and specialists on the motor and cognitive function changes in children with Down syndrome after the MNRI® program show certain improvements.

शोध आलेख

Functional Correlates of the Aging Brain: Beta Frequency Band Responses to Age-related Cortical Changes

Mario Christov and Juliana Dushanova*

Background: Cognitive decline and symptoms of attention deficits, executive dysfunction, and memory impairments describe dementia in the elderly. Particular frequency oscillations that occur within the affected brain regions could be used to classify some idiopathic dementias as specific diseases. The approach, applied in this study, can be useful for early discrimination between normal and pathological brain aging, and could contribute additional information to the clinical data in evaluating dementia that is of benefit for treatment of cognitive alterations and dementia.
Methods: In this study, the age effect on the brain electrical activity was examined auditory discrimination task (low–frequency and high–frequency tone) at particular cortical locations in beta–frequency bands (β1: 12.5–20; β2: 20.5–30 Hz) during sensory (post–stimulus interval, 0-250 ms) and cognitive processing (250–600 ms).
Results: The beta1 activity is less affected by age during sensory processing. The reduced beta1 was more widespread during cognitive processing. This difference increased in fronto–parietal direction more expressed after high-frequency tone stimulation. Beta2 activity was more pronounced with a progressive age during sensory processing and diminished with age on cognitive processes. Reducing regional-process specificity with progressing age characterized age-related and tone-dependent beta2 changes during sensory processing.
Conclusions: The age influence was higher on the cognitive processes than on the perceptual ones.

शोध आलेख

Effect of Cage Therapy using Advanced Spider Suit Compared to Traditional Physical Therapy on Gross Motor Function in Children with Cerebral Palsy An Indian Experience

Kanu Kaushik and Kishore Kumar*

Objectives: Cerebral Palsy (CP) is a condition where non progressive disorders of posture caused by abnormal development of, or damage to, motor control centers of brain resulting in abnormal movements. Improving gross motor function in children with cerebral palsy has been a major aim of physical therapist. The purpose of this study is to find out the Effect of Cage Therapy using Advanced Spider Suit Compared to Traditional Physical Therapy on Gross Motor Function in Children with Cerebral Palsy.
Materials and Methods: A comparative study was conducted to find out the effect of Cage Therapy using Advanced Spider Suit Compared to Traditional Physical Therapy on Gross Motor Function in Children with Cerebral Palsy. 10 children with cerebral palsy were selected for this intervention. Age group between 4-8 years With GMFCS level III-IV were selected for this study. In 10 children we have 2 Hypotonic, 2 hemiplegic and 6 Spastic diplegic kids. These subjects were equally distributed in each group.
Intervention: Therapy lasted for 8 weeks (5 days a week and 2hrs/day). Group A - 5 subjects were subjected to Cage therapy using advanced spider suit. Group B – 5 subjects were subjected to traditional physical therapy. Gross Motor Function Measure was used to assess gross motor abilities of the subjects before and after intervention.
Results: The result showed significant improvement with Cage therapy using advanced spider suit therapy than traditional physical therapy on Gross Motor Function Measure.
Conclusions: The Cage Therapy using Advanced Spider Suit is more effective and beneficial therapy than Traditional Physical Therapy in improving Gross Motor Function in Children with Cerebral Palsy.

समीक्षा लेख

Human Behavior in Cancer Quackery: Historical Review

Wilson Onuigbo IB*

Human behavior has enduring facets which are of considerable concern especially in terms of cancer quackery. This historical review concerns the behavior of both the quacks and their patients. Both aspects demand documentation which should be available in our own age in the context of neurohabilitation.

शोध आलेख

Impact of Yoga on Postural Stability in Stroke

Peter Altenburger A*, Arlene Schmid A, Marieke Van Puymbroeck and Kristine Miller K

Deficits in motor capacity following stroke poses a potential threat to postural stability. The purpose of the study was to assess the impact of yoga training on postural alignment, anticipatory postural adjustments, and compensatory postural adjustments in individuals with chronic stroke deficits. This study is a subset analysis from a prospective, randomized control trial using therapeutic yoga. Twenty one individuals with chronic motor deficits from stroke participated in an hour-long group yoga sessions twice a week for 8 weeks focusing on progressively challenging postures, breathing, and meditation in sitting, standing, and supine positions. Postural symmetry, compensatory postural adjustment, and anticipatory postural adjustment from the NeuroCom SMART Balance Master® were used to evaluate changes in postural stability. The Berg Balance Scale was used to evaluate correlations to changes in dynamic balance control. Prior to participation in yoga, significant weight distribution asymmetry was observed during full upright standing. After 8 weeks of yoga training, there were no significant differences in weight distribution between right and left legs at 0 degrees. Subjects demonstrated greater than 50% improvement in symmetry alignment for different standing positions. No significant changes in compensatory or anticipatory postural adjustments were seen following yoga training. Changes in functional BBS scores were significantly correlated to changes in upright standing symmetry. Yoga training may improve postural symmetry enhancing postural control decreasing the risk for falls in individuals with deficits from chronic stroke.

समीक्षा लेख

Interventions for Fetal Alcohol Spectrum Disorder: Meeting Needs Across the Lifespan

Jacqueline Pei*, Katherine Flannigan, Lori Walls and Carmen Rasmussen

Background: Fetal Alcohol Spectrum Disorder (FASD) is a complicated disability resulting in a diverse, highneeds population for whom intervention is critical to optimize functional competence and reduce the emergence of adverse outcomes. Researchers have been evaluating intervention efforts for FASD to inform practice and policy decision-making.
Objective: The current review provides a synopsis of the current state of evidence for intervention research in FASD, with consideration of how our growing understanding of the unique needs of individuals with FASD might inform future intervention initiatives.
Method: A comprehensive literature review was conducted across a number of databases using multiple search terms linking FASD and intervention.
Results: Existing evidence-based interventions are limited and focus predominantly on the school-aged population, thereby neglecting adolescents and adults. Future research efforts are needed to support individuals with FASD across the entire lifespan, particularly during transitions and for individuals involved in the legal system.
Conclusion: As the field of FASD continues to grow, so must the quality and quantity of intervention research. It is through cross-discipline intervention research efforts that the evidence supporting best practices will be established, and policies can be implemented to reflect best uses of available funds to support this population.

शोध आलेख

Creating a Proactive Behavior towards Exercising after a Transient Ischemic Attack

Gabriela Adriana Marinescu* and Erwah AL Nablsi

Nowadays society is facing a constant increase in the level of stress, diversity and complexity of daily activities. The cardiovascular and cerebrovascular diseases have increased alarmingly, putting individuals’ lives at risk. People face insecurity and unfortunately become sick at young ages. Moreover, the vast majority of the world’s population has a sedentary lifestyle which raises the risk of severe health problems. Stroke has become a major public health problem, with almost 16 million new cases around the world annually. It is also being considered a burden for the national economies and a real life tragedy for the patients and their families; therefore, preventing its occurrence is of great importance. Changing a person’s behavior relating to a healthy lifestyle may decrease the risk of stroke and its impairments. The aim of this research is to prove that constant and systematized physical activity has a significant role in the diminishment of the modifiable stroke risk factors for the patients who have a history of transient ischemic attack. This may change their behavior towards exercising to a proactive one. The study was performed in Bucharest, on a small group of 10 subjects and lasted for 6 months. The results were positive and encourage us to extend the research on larger groups of subjects.

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