Rehabilitation

OBJECTIVE: To explore the multiple specific biomarkers and cognitive compensatory mechanisms of mild traumatic brain injury (mTBI) patients at recovery stage. METHODS: The experiment was performed in two sections. In Section I, using event-related potential, event-related oscillation and spatial phase-synchronization, we explored neural dynamics in 24 volunteered healthy controls (HC) and 38 patients at least 6 months post-mTBI (19 with epidural hematoma, EDH; 19 with subdural hematoma, SDH) during a Go/NoGo task...

Aggressive nutrition therapy is essential to improve nutrition and function in patients with malnutrition and sarcopenia. Malnutrition and sarcopenia negatively affect functional recovery and activities of daily living. Nutrition improvement is associated with better functional recovery. Target energy intake in aggressive nutrition therapy is defined as total energy expenditure (TEE) plus the amount of energy accumulated. The amount of energy accumulation per 1 kg of body weight is generally 7500 kcal. If the goal is to gain 1 kg of weight over 30 d, TEE + 250 kcal is the target daily energy intake...

Many surgical options have been proposed for the treatment of first carpometacarpal (CMC1) osteoarthritis. Conventional techniques are invasive, so we wanted to develop an arthroscopic technique. Partial trapeziectomy combined with various interpositions and ligament reconstruction is a long-standing intervention. As in total trapeziectomy, the combination with ligament reconstruction remains controversial. The aim of this study was to demonstrate the benefits of adding an abductor pollicis longus (APL) ligament reconstruction to partial trapeziectomy performed under arthroscopy...

Cavernous malformations are angiographically-occult vascular hamartomas without intervening neural tissue that represent an estimated 10% of central nervous system vascular pathologies1 . Management is often dictated by lesion location, intranidal versus extranidal hemorrhage, presenting symptoms, acuity of onset, and surgical accessibility. Deep-seated cavernous malformations are often adjacent to eloquent structures, including functional white matter tracts that must be accounted for during surgical planning and respected during resection of the cavernoma...

BACKGROUND: Previous studies have reported that chemotherapy results in substantial long-term risk of heart failure. Exercise ameliorates exercise responses and exercise tolerance in patients receiving chemotherapy. The cardioprotective effect of real-time exercise in breast cancer is still unclear. OBJECTIVES: The aim of the present study was to determine the effect of real-time moderate-to-high-intensity exercise training in women with breast cancer undergoing chemotherapy and to follow up on parameters of cardiac function and exercise capacity at different times...

PURPOSE: The purpose of this study was to establish an international expert consensus using the modified Delphi technique on the evaluation and management of glenohumeral instability with associated bone loss METHODS: A working group of five individuals generated a list of statements related to history and physical examination, imaging and specialized diagnostic tests, bone loss quantification and classification, treatment outcomes and complications, and rehabilitation for the management of glenohumeral instability associated with bone loss to form the basis of an initial survey for rating by a group of experts...

Intermittent hypoxia induces respiratory neuroplasticity to enhance respiratory motor outputs and is a potential rehabilitative strategy to improve respiratory function following cervical spinal injury. The present study was designed to evaluate the functional role of intermittent and sustained carbon dioxide (CO2 ) on intermittent hypoxia-induced ventilatory responses in rats with mid-cervical spinal contusion. The breathing pattern of unanesthetized rats at the subchronic and chronic injured stages was measured in response to one of the following treatments: (1) Intermittent hypercapnic-hypoxia (10 × 5 min 10%O2  + 4%CO2 with 5 min normoxia interval); (2) Intermittent hypoxia with sustained hypercapnia (10 × 5 min 10%O2  + 4%CO2 with 5 min 21%O2  + 4%CO2 interval); (3) Intermittent hypoxia (10 × 5 min 10%O2 with 5 min normoxia interval); (4) Intermittent hypercapnia (10 × 5 min 21%O2  + 4%CO2 with 5 min normoxia interval); (5) Sustained hypercapnia (100 min, 21% O2  + 4% CO2 ); (6) Sustained normoxia (100 min, 21% O2 )...

This paper is an interdisciplinary narrative review of efficacious non-invasive therapies that are becoming increasingly used to restore function in people with chronic spinal cord injuries (SCI). First presented are the secondary injury cascade set in motion by the primary lesion and highlights in therapeutic developments for mitigating the acute pathophysiologic process. Then summarized are the pharmacological strategies for modulation of the noradrenergic, serotonergic, and dopaminergic neurotransmissions to enhance recovery in bench and clinical studies of subacute and chronic SCI...

After spinal cord injury (SCI), the majority of individuals develop spasticity, a debilitating condition involving involuntary movements, co-contraction of antagonistic muscles, and hyperreflexia. By acting on GABAergic and Ca2+ -dependent signaling, current anti-spastic medications lead to serious side effects, including a drastic decrease in motoneuronal excitability which impairs motor function and rehabilitation efforts. Exercise, in contrast, decreases spastic symptoms without decreasing motoneuron excitability...

OBJECTIVE: To evaluate the psychometric properties of the Spinal Cord Injury Functional Index (SCI-FI) instruments in a community-dwelling sample. DESIGN: Cross-sectional study. SETTING: Community setting. PARTICIPANTS: 269 individuals recruited from six SCI Model Systems sites. INTERVENTIONS: n/a MAIN OUTCOME MEASURES: Participants completed computer adaptive test (CAT) and short form versions of four SCI-FI/Capacity banks (SCI-FI/C; Ambulation, Basic Mobility, Fine Motor, Self-Care) and one SCI-FI/Assistive Technology (AT) bank (Wheelchair Mobility) at baseline and after two weeks...

OBJECTIVE: To compare two different protocols (ESWT, oral medications, and an exercise program with the control group ) for the treatment of CLBP, we designed this study. DESIGN: All the patients were randomly allocated to two intervention and control groups. Simple complete randomization was used for the allocation of the patients using the table of random numbers. SETTING: In this study, 32 patients with CLBP were referred to Isfahan University Hospitals randomly divided into intervention and control groups...

OBJECTIVE: World Health Organization's (WHO) Rehabilitation 2030 initiative is developing a set of evidence-based interventions selected from clinical practice guidelines for Universal Health Coverage. As an initial step, WHO Rehabilitation Programme and Cochrane Rehabilitation convened global content experts to conduct systematic reviews of clinical practice guidelines for 20 chronic health conditions, including cerebral palsy. DATA SOURCES: Six scientific databases (Pubmed, EMBASE, Scopus, Web of Science, PEDro, CINAHL), Google Scholar, guideline databases and professional society websites were searched...

OBJECTIVE: To determine the impact of aerobic exercise on maximal and submaximal cardiopulmonary responses and predictors of change in individuals with Parkinson's disease (PD). DESIGN: Single-center, parallel-group, rater-blind study. SETTING: Research laboratory PARTICIPANTS: Individual's with mild to moderate PD (N=100) INTERVENTION: Participants were enrolled in a trial evaluating the impact of cycling on PD and randomized to either voluntary exercise (VE), forced exercise (FE), or a no exercise, control group...

AIM: To summarize the current knowledge on brain involvement in spinal muscular atrophy (SMA) type 1, focusing on brain pathology, cognition, and speech/language development. METHOD: A scoping review was performed using the methodology of the Joanna Briggs Institute. Five databases and references from relevant articles were searched up to December 2019. Articles were screened on the basis of titles and abstracts. Full-text papers published in peer-reviewed journals in English were selected...

BACKGROUND: Populations at risk during humanitarian crises can suffer traumatic injuries or have medical conditions that result in the need for limb amputation (LA). The objectives of this study were to describe the indications for and associations with LA during and after humanitarian crises in surgical projects supported by Médecins Sans Frontières (MSF). METHODS: MSF-Operational Center Brussels data from January 1, 2008, to December 31, 2017, were analyzed...

In motor learning, the slow development of implicit learning is traditionally taken for granted. While much is known about training performance during adaptation to a perturbation in reaches, saccades and locomotion, little is known about the time course of the underlying implicit processes during normal motor adaptation. Implicit learning is characterized by both changes in internal models and state estimates of limb position. Here, we measure both as reach aftereffects and shifts in hand localization in our participants, after every training trial...

Antimuscarinics are first-line medication for management of overactive bladder with solifenacin being commonly prescribed. Angioedema is the swelling of mucosa and submucosal tissue. There are no published case reports of drug-induced angioedema involving solifenacin. We report a case of a 41-year-old man with spinal cord injury who presented with oedema of face, lips, tongue and associated pruritic urticaria after taking 5 mg of solifenacin. All other possible causes including food allergy, insect bite, hereditary angioedema, use of NSAIDs, ACE inhibitors and antibiotics were ruled out...

OBJECTIVE: To establish recommendations for optimisation of the management of patients undergoing pulmonary lobectomy, particularly Enhanced Recovery After Surgery (ERAS). DESIGN: A consensus committee of 13 experts from the French Society of Anaesthesia and Intensive Care Medicine (Société française d'anesthésie et de réanimation, SFAR) and the French Society of Thoracic and Cardiovascular Surgery (Société française de chirurgie thoracique et cardiovasculaire, SFCTCV) was convened...

PURPOSE: We hypothesized that magnetic resonance imaging (MRI) would more accurately diagnose small gaps (<6 mm) after flexor tendon repair than static ultrasound (US) and that suture artifact would negatively impair accuracy. METHODS: A laceration of the flexor digitorum profundus was created in 160 fresh-frozen cadaveric digits and randomized to either an intact repair (0-mm gap) or repairs using a locked 4-strand suture repair with either 4-0 Prolene, Ethibond, or and gaps of 2, 4,or 6 mm; or no suture in which 2-, 4-, or 6-mm gaps were created without a suture crossing the repair site...

OBJECTIVES: This prospective randomized study aimed to investigate whether patients with dysphagia after treatment for head and neck cancer improve their vocal function from doing head lift exercises (Shaker's exercise). METHODS: Patients were randomized into an intervention group (n = 24) or a control group (n = 26). Patients in the intervention group performed the head lift exercise three times a day for 8 weeks. At baseline and at follow-up after 8 weeks, participants' voices were evaluated perceptually with the Grade-Roughness-Breathiness-Asthenia-Strain (GRBAS) scale...