[WEB SITE] UAB – Traumatic Brain Injury Information Network

The University of Alabama at Birmingham Traumatic Brain Injury Model System (UAB-TBIMS)maintains this Information Network as a resource to promote knowledge in research, health, and quality of life for people with traumatic brain injuries, their families, and TBI-related professionals. Here, you will find educational materials and information on research activities of the UAB-TBIMS along with links to outside (Internet) information. Although there are many informative commercial (.com) websites, this website only links to information materials originating from educational, organizational, and government entities.

The UAB-TBIMS Information Network is devoted to making it easier for you to find useful, up-to-date information from reliable sources. We will continue to add and remove links as needed, so you can get updates via twitter, facebook and email. We also want to hear from you! Suggest a link be addedand Ask a question or submit a comment.

Source: UAB – Traumatic Brain Injury Information Network – Home

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[WEB SITE] Tried and True Solutions For Stroke Pain Management – Saebo

After stroke, loss of mobility isn’t the only long-term problem that prevents survivors from resuming normal activities. Post-stroke pain affects more than half of all stroke survivors. In some cases, this pain is chronic, leaving survivors with constant discomfort and hypersensitivity. Let’s walk through the common types of pain that stroke survivors experience, and introduce the tools and therapeutic techniques that were designed to reduce it and restore mobility.

Understanding the Effects of Stroke

Researchers and health care providers are tapping into new technology and learning more about the connections between brain damage and pain. Today, we know which types of brain damage and muscle loss cause certain types of post-stroke pain, making it easier to address the problem at its root. But after stroke, it’s important for patients and their caregivers to understand the distinctions between their symptoms too.

Limb Spasticity

More than one-third of all stroke survivors experience stiff or tight muscles after stroke. This is actually caused by increased muscle tone, also known as spasticity, that develops due to brain or spinal cord damage. While bodybuilders and other athletes strive for increased muscle tone, stroke survivors experience a heightened amount of muscle tension, which can damage tissues and cause painful cramps. If the muscles contract too much, patients may not be able to move their affected joints and muscles at all.

Local Pain

Spasticity also causes localized pain in certain parts of the body. If you suffer from chronic or recurring joint pain after stroke, this is most likely an example of local pain. Local post-stroke pain may affect both sides of the body, because it’s caused by awkward muscle movements and abnormal positions after stroke. While it’s a secondary side effect of the brain damage that happens during stroke, it affects everyday tasks and makes it more difficult for patients to reprogram healthy brain cells.

Central Pain

One of the most debilitating side effects of stroke is central pain. This is caused by brain damage that disrupts the brain’s ability to interpret sensory responses. After stroke, a patient with central pain will experience some of these symptoms:

  • Interpreting light, normal touches as uncomfortable or painful
  • Numbness to heat or cold
  • Heightened sensitivity to heat or cold
  • “Pins and needles” sensation without identifiable triggers
  • Constant aching on the side of the body affected by stroke

Even when central pain is moderate (rather than severe), its constant presence can have serious psychological consequences that impede both their motivation and their ability to recover. Chronic central pain can lead to drug misuse, depression, and refusal to continue physical therapy programs. That’s why it’s so important to minimize this pain as the patient begins their journey to recovery.

Reducing Discomfort with Dynamic Splints

When stroke survivors have weakened or paralyzed limbs, their discomfort is often exaggerated by muscle stiffness and gravitational forces. Splints provide extra support for the affected arm or leg, reducing the burden on the patient’s muscles. Traditional splints are static in nature causing increased pressure on the finger joints. This can lead to increased pain and joint damage. Dynamic splints are adjustable and bendable which helps reduce pain.

 

 

The SaeboStretch is a dynamic splint that offers an adaptable alternative for stroke survivors. Because it reduces or eliminates some of the triggers of pain – such as pressure on the joints or stiffness of the limbs – it can actually improve patient morale and increase home program compliance.

Restoring Range of Motion with Devices

Of course, splints can only do so much to assist stroke survivors and reduce the effects of gravity and muscle stiffness. If you don’t move your muscles regularly, fluid buildup can cause additional swelling and discomfort, especially if your weakened muscles are trying to support their own weight. Swollen hands are a common side effect of this buildup.

Mechanical devices like the SaeboGlove actually incorporate extra features that support specific joints and muscles, decreasing the impact of gravity and making it easier to move stiff or sore joints. Spasticity is less likely when patients rely on these artificial tension systems, which can be adjusted as they regain more strength and mobility. Tension systems within the SaeboGlove actually step in to extend and release crucial joints in the fingers, thumb, and wrist.

Restoring Circulation with Tight-Fitting Gloves

Do you or your patient suffer from swollen hands? This is a common side effect of stroke, because muscles need to move constantly in order to keep the blood flowing through them. If a stroke survivor cannot move their hand or forearm, fluids may build up in the tissue, requiring external stimulation to recirculate it.

Tight-fitting gloves, or edema gloves, are one effective way to recirculate these fluids and prevent painful and uncomfortable swelling. After health care providers rule out blood clots and cardiac problems, they may recommend a tight-fitting glove to push fluids back out of the arm and hand. It’s very important to recirculate this fluid until the arms can be used appropriately again.

Stretching the Muscles to Reduce Contractures

Muscle contracture is the complete loss of voluntary movement due to stiff joints and muscles. This painful and debilitating symptom usually affects muscles that haven’t been moved properly after stroke. If you already suffer from spasticity after stroke, physiotherapy is a great way to maintain healthy movements until you can regain more muscle control.

Physiotherapists help stroke survivors prevent contractures by gently manipulating their affected limbs into a variety of different positions. Although voluntary movement may still be impossible, these stretching exercises prevent the muscles from atrophying completely or becoming too tight or stiff to move.

Reduce Spasticity with Botox

Botox isn’t just a cosmetic way to reverse the effects of aging. This injectable prescription substance actually originated as a way to relax the muscles and reduce pain associated with muscle tension and contracture. Because more than one-third of all stroke survivors experience spasticity, some turn to Botox treatments to reduce their muscle tone and make it possible to straighten their limbs again.

Botox works by preventing the transmission of signals between the body and brain. Specifically, it blocks the chemical that tells your muscles to start contracting. Doctors now inject very tiny portions of Botox directly into stroke survivor’s arms and legs, effectively reducing their risk of spasms or spasticity. By preventing stiffness and complete paralysis of the limbs, Botox may help thousands of stroke survivors regain function.

(Photo Source: New York Times)

Combat Pain And Recover Faster

Because pain makes it more difficult for patients to retrain their brains and bodies, it’s very important to minimize post-stroke pain as much as possible and allow patients to focus on their rehabilitation. We hope that these tools and techniques were helpful to you as you learn how to combat the most common side effects of stroke and help reprogram the neural connections that make everyday tasks possible.

Source: Tried and True Solutions For Stroke Pain Management | Saebo

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[VIDEO] PABLO System Hand-Arm-Rehabilitation (English) – YouTube

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[ARTICLE] Multi-User Virtual Reality Therapy for Post-Stroke Hand Rehabilitation at Home. – Full Text PDF

Abstract

Our paper describes the development of a novel multi-user virtual reality (VR) system for post-stroke rehabilitation that can be used independently in the home to improve upper extremity motor function. This is the pre-clinical phase of an ongoing collaborative, interdisciplinary research project at the Rehabilitation Institute of Chicago involving a team of engineers, researchers, occupational therapists and artists. This system was designed for creative collaboration within a virtual environment to increase patients’ motivation, further engagement and to alleviate the impact of social isolation following stroke. This is a low-cost system adapted to everyday environments and designed to run on a personal computer that combines three VR environments with audio integration, wireless Kinect tracking and hand motion tracking sensors. Three different game exercises for this system were developed to encourage repetitive task practice, collaboration and competitive interaction. The system is currently being tested with 15 subjects in three settings: a multi-user VR, a single-user VR and at a tabletop with standard exercises to examine the level of engagement and to compare resulting functional performance across methods. We hypothesize that stroke survivors will become more engaged in therapy when training with a multi-user VR system and this will translate into greater gains.

 

  1. INTRODUCTION

Stroke is the leading cause of major, long-term disability in adults in the United States [1]. Every 40 seconds someone in
the U.S. has a stroke [2] and more than 700,000 people suffer a new or recurrent stroke each year. The majority of stroke survivors endure chronic impairment [1], which dramatically impacts their lives physically, psychologically and socially. Stroke incidence is even greater in low to middle income countries. Around 50% of all stroke survivors will have residual hemiparesis involving the upper extremity [4, 5], which can have a profound, adverse impact on self-care, employment, and overall quality of life. A number of studies [6, 7, 8, 9] have shown that upper extremity motor control can still be improved, even in stroke survivors with chronic hemiparesis subsequent to stroke. Many patients continue to be highly motivated to achieve further gains after standard rehabilitation has been completed, seeking out new methods, technologies and practices that can improve upper extremity motor control.

Repetitive movement practice proved to be crucial for maximizing therapeutic benefits [15]. The necessary repetition of rehabilitation exercises can be tedious, however [10, 11, 12] and many patients, including stroke survivors, discontinue treatment long before optimal results have been achieved. Lack of motivation, disengagement, and boredom contribute to impeded progress in rehabilitation [13]. Additionally, opportunities for task practice in the clinic are becoming increasingly limited due to shortened hospital stays [14] and a reduced number of allotted outpatient therapy sessions (Figure 1). Furthermore, lack of transportation can prevent outpatient stroke survivors from taking full advantage of the available therapy sessions.

Tele-rehabilitation seems a possible solution, but current telerehabilitation systems [7, 16] largely consist of teleconferencing between the therapist and the client. Therapist-client interaction is limited and quantitative measurement of performance is lacking. Instead, we propose a multi-user virtual reality environment (VRE) in which the therapist and client can interact with each other and with objects in the VRE.

An inexpensive motion capture system allows control of avatars, as well as collection of movement kinematics. Our system is innovative, because it brings the therapist and client together in the virtual space to work together in real-time. Alternatively, or additionally, the client can participate with a training partner, potentially another patient, providing additional motivation and encouragement. One study showed that impaired subjects prefer competitive/cooperative multi-user rehabilitation games compare to single-user rehabilitation games [17]. This system can mitigate issues related to transportation and limited clinical access by providing home-based training environment developed specifically for upper extremity rehabilitation.

Full Text PDF

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[WEB SITE] Finger Motion – tyromotion

Finger-Motion-AppFINGER MOTION

Exercises which bring feeling to your finger tips!

The new Finger Motion application was specifically developed for exercises  using individual fingers and the hand on the iPad. A variety of games, which can be played with individual or multiple fingers, are available. Furthermore, in the extended version the user can carry out exercises instructed by a deviation profile to improve motion control. The user also receives individual feedback on accuracy and execution after each exercise. Follow-up evaluations give insight into the number and intensity of games passed.

 Favorit at the Fast Forward Award 2015 for most innovative therapy app!

One App, many Benefits

The Fingermotion App allows clinics to be closer to their patients than ever, even after completion of the patients’ therapy programme. Simply create your own page and connect with your patients. The additional offer makes your clinic unique, attracts new target groups and increases revenue!

  • Free ad for your clinic on the front page – whatever you want, completely individual
  • Additional offers and services for patients
  • Motivating exercises for higher patient satisfaction

Fingermotion-Appstore

 

 

Image advertising for practices and clinics with Finger Motion

1. App StoreInvest in the start package and load app. You’ll receive a new iPad, your individual cover page and vouchers.

Finger-Motion-Laden

2. AdvertiseHand out vouchers for cheaper downloads to your patients and advertise your clinic directly on your patients’ iPad!

Finger-Motion-Werben

3. ProfitierenPosition yourself as an innovative clinic and provide your patients with more opportunities and more motivation.

Finger-Motion-Profit

 

The App – an Overview

Health and Fitness
Version: 2.0
15.5 MB
 German, English
Tyromotion GmbH
Requires iOS 7.0 oder newer.
Test version: € 0,-
Full version: € 2,99

iPad-App

 

 

 

 

 

 

 

 

 

Download test version for free

Source: Finger Motion

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[WEB SITE] A New Assistive Glove Can Help People Regain Hand Function After a Stroke – NARIC

About 800,000 Americans have a stroke each year, according to the Centers for Disease Control and Prevention. A stroke occurs when a blood vessel in the brain becomes blocked or bursts, causing brain damage. Sometimes, stroke can lead to long-lasting difficulties with moving one hand or arm due to both muscle weakness and spasms. Therapies are available to help people regain hand mobility after a stroke, but these therapies may not work for people with severely limited hand movement. Research shows that, even with therapy, some people can stall in their recovery (plateau) around three months after experiencing a stroke. A recent NIDILRR-funded study tested a new portable assistive glove to see if it could help people move beyond that plateau and regain hand strength and mobility after a stroke.

Researchers from the Rehabilitation Research and Training Center on Enhancing the Functional and Employment Outcomes of Individuals Who Experience a Stroke tested a new therapy device called the X-Glove. The X-Glove is a modified sports glove with cables running through the back of the glove along the fingers. The cables apply an external source to aid or resist finger movements through a battery-powered system. The glove can be set to one of two modes: passive stretching mode and active training mode. In the passive stretching mode, the glove bends and straightens the user’s finger joints in a repeating cycle. This passive movement provides finger stretching that helps loosen the muscles and reduce spasms. In the active training mode, the glove provides individualized constant tension that maintains the finger joints toward a straight position. The user then bends his or her finger against the tension to build finger strength.

The researchers tested the glove with 13 stroke survivors who were receiving rehabilitation services in a day program, including physical, speech, and occupational therapy. The participants were at least 40 years old and had a stroke in the past 2-6 months. Most had severe limitations in their hand function. The participants completed an additional 15 occupational therapy sessions, 3 per week for 5 weeks, using the X-Glove.

An occupational therapist assists a patient with therapy exercises using the X-glove. The patient is wearing the glove on his right hand and grasping a telephone handset.

Photo: A therapy session with the X-glove.

At the beginning of each session, the participants completed 30 minutes of passive finger stretching with the glove set in the passive stretching mode to help loosen the muscles and reduce spasms. Then they practiced using their hand to complete meaningful tasks for 60 minutes with the glove set in the active training mode to help build strength and skills, while the glove provided resistance. For example, participants practiced grasping, holding, and lifting small objects in their affected hand while pushing against the tension applied by the glove. To find out if the task practice with the X-Glove improved hand function, the researchers first measured participants’ hand mobility and strength three times, once per week over 3 weeks, before the participants started working with the glove. The researchers then took measurements after the participants’ ninth occupational therapy session with the glove, at the end of the fifteenth session, and again one month after the sessions ended.

Although the participants showed little or no improvement in hand strength or function over the course of 3 weeks before working with the glove, they did improve significantly with the help of the X-Glove. For example, the researchers found that participants’ grip was strengthened by about 35% and maintained the strength one month after the treatment ended. The participants also did better on functional tests, such as moving blocks or pouring water from glass to glass. According to the authors, participants showed improvement within the first half of the treatment, and continued to improve throughout the treatment sessions. They suggested that participants could have improved more with more time using the X-Glove.

According to the authors, these findings indicated that with devices like the X-glove, improvements in hand function are possible even for people with severe hand impairment after a stroke. Incorporating both passive stretching of and active practice with the hand during occupational therapy using a device like the X-Glove may help push past the therapy plateau if implemented soon after a stroke. For future research, the authors recommended randomized controlled trials to test the X-Glove with stroke patients in inpatient and outpatient rehabilitation settings, as well as studies with longer treatment and follow-up periods.

To Learn More

The prototype X-Glove and other hand rehabilitation technology are under development at the Rehabilitation Institute of Chicago’s Hand Rehabilitation Laboratory:http://smpp.northwestern.edu/research/hand/research.html

To see the X-Glove and other hand rehabilitation technology in action, check out this Prezi from the Hand Rehabilitation Laboratory https://prezi.com/8jmdkbz3gm2h/new-developments-in-the-hand-rehabilitation-lab-at-ric/

Flint Rehabilitation developed the Music Glove, another hand rehabilitation device that was tested under a NIDILRR grant and shown to improve hand function post-stroke:https://www.flintrehab.com/musicglove/

The American Stroke Association and the National Stroke Association both offer resources for stroke recovery:

http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/
RegainingIndependence/PhysicalChallenges/Post-Stroke-Rehabilitation_UCM_310447_Article.jsp#.V5IeuvmANBc

http://www.stroke.org/we-can-help/survivors/stroke-recovery

To Learn More About This Study

Fischer, H.C., Triandafilou, K.M., Thielbar, K.O., Ochoa, J.M., Lazzaro, E.D.C., Pacholski, K.A., & Kamper, D.G. (2016) Use of a portable assistive glove to facilitate rehabilitation in stroke survivors with severe hand impairment. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 24(3), 344-351. This article is available from the NARIC collection under Accession Number J73926

Date published:

2016-08-17

Source: National Rehabilitation Information Center | Information for Independence

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[ARTICLE] Motor priming in virtual reality can augment motor-imagery training efficacy in restorative brain-computer interaction: a within-subject analysis – Full Text

Abstract

Background

The use of Brain–Computer Interface (BCI) technology in neurorehabilitation provides new strategies to overcome stroke-related motor limitations. Recent studies demonstrated the brain’s capacity for functional and structural plasticity through BCI. However, it is not fully clear how we can take full advantage of the neurobiological mechanisms underlying recovery and how to maximize restoration through BCI. In this study we investigate the role of multimodal virtual reality (VR) simulations and motor priming (MP) in an upper limb motor-imagery BCI task in order to maximize the engagement of sensory-motor networks in a broad range of patients who can benefit from virtual rehabilitation training.

Methods

In order to investigate how different BCI paradigms impact brain activation, we designed 3 experimental conditions in a within-subject design, including an immersive Multimodal Virtual Reality with Motor Priming (VRMP) condition where users had to perform motor-execution before BCI training, an immersive Multimodal VR condition, and a control condition with standard 2D feedback. Further, these were also compared to overt motor-execution. Finally, a set of questionnaires were used to gather subjective data on Workload, Kinesthetic Imagery and Presence.

Results

Our findings show increased capacity to modulate and enhance brain activity patterns in all extracted EEG rhythms matching more closely those present during motor-execution and also a strong relationship between electrophysiological data and subjective experience.

Conclusions

Our data suggest that both VR and particularly MP can enhance the activation of brain patterns present during overt motor-execution. Further, we show changes in the interhemispheric EEG balance, which might play an important role in the promotion of neural activation and neuroplastic changes in stroke patients in a motor-imagery neurofeedback paradigm. In addition, electrophysiological correlates of psychophysiological responses provide us with valuable information about the motor and affective state of the user that has the potential to be used to predict MI-BCI training outcome based on user’s profile. Finally, we propose a BCI paradigm in VR, which gives the possibility of motor priming for patients with low level of motor control.

Continue —> Motor priming in virtual reality can augment motor-imagery training efficacy in restorative brain-computer interaction: a within-subject analysis | Journal of NeuroEngineering and Rehabilitation | Full Text

Fig. 2 MI-BCI training conditions. (a) VRMP: the user has to perform motor priming by mapping his/her hand movements into the virtual environment. (b) VR: the user has to perform training through simultaneous motor action observation and MI, before moving to the MI task were he/she has to control the virtual hands through MI. (c) Control: MI training with standard feedback through arrows-and-bars

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[Editorial] Advances in Rehabilitation and Assistive Robots for Restoring Limb Function in Persons with Movement Disorders. 

Editorial

Advances in Rehabilitation and Assistive Robots for Restoring Limb Function in Persons with Movement Disorders

1Department of Health Care Sciences, UT Southwestern Medical Center at Dallas, Dallas, TX 75390, USA
2Research Center for Neural Engineering, The Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Shenzhen 518055, China
3School of Energy Systems, Lappeenranta University of Technology, 53851 Lappeenranta, Finland
4The Robotics Research Group, College of Engineering, Peking University, Beijing 100871, China
5The Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL 60611, USA
6Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia

Received 3 July 2016; Accepted 3 July 2016

Copyright © 2016 Fan Gao et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


People with movement disorders are plagued with debilitating conditions, which significantly degrade their quality of life. Traditional rehabilitation typically involves intensive interaction between patients and therapists. While effective, traditional rehabilitation cannot keep abreast of the increasing patient population primarily attributed to a higher surviving rate after diseases and/or injuries. Furthermore, patients living in the rural areas have fairly limited access to rehabilitation services. In the past two decades, tremendous efforts have been put into developing rehabilitation and assistive robots to facilitate the rehabilitation training while relieving the physical involvement of therapists and/or lowering the related cost. Most notably, the rehabilitation and assistive robots have been significantly advanced with developments in actuators, sensors, microprocessors, and mobile software platforms. However, unlike traditional robotics, the intimate interaction between robot and human in rehabilitation robots indicates that the success is also closely related to a thorough understanding of the human neuromuscular aspects and human-machine interaction.

This special issue primarily aims to gather the latest achievements in rehabilitation robots, exoskeletons, and prostheses including the following topics:

(a) development of rehabilitation robots, exoskeleton, and upper/lower limb prostheses driven by bionics;
(b) functional evaluation of rehabilitation robots, exoskeleton, and upper/lower limb prostheses with an emphasis on human movement biomechanics;
(c) musculoskeletal modeling and simulation of human movements while wearing exoskeleton or prostheses;
(d) noninvasive human-machine interface based on electromyography and/or electroencephalogram;
(e) sensors for monitoring kinematics/kinetics, as well as biological signals in real time;
(f) innovative actuators and control algorithms applied to rehabilitation robots, exoskeletons, and prostheses.

In this special issue, collective studies address the aforementioned key elements via both technical and biomechanical approaches. A reconfigurable robotic hand exoskeleton was proposed to meet the fast growing need in hand rehabilitation. A novel control algorithm integrating sliding model control with cerebellar model articulation controller neural network was implemented in lower limb exoskeleton to enhance the coordination between patient and exoskeleton. An upper limb exoskeleton was enhanced with integrated optical cameras to offer more accurate estimation of joint posture than traditional motion capture system. A hybrid upper limb rehabilitation system consisting of a shoulder-elbow-forearm exoskeleton and a robotic manipulator was validated and tested in the clinic. The characteristics of muscle-tendon stimulation such as perception threshold and vibration frequency significantly influenced the muscle forces as well as the reaction time. Patellar retention was found to be superior to patellar replacement in knee arthroplasty via a comprehensive computer simulation. These collective studies, as part of the latest representative work, offered some new insights into the development and implementation of rehabilitation and assistive robots.

Fan Gao
Guanglin Li
Huapeng Wu
Qining Wang
Jie Liu
Justin Keogh

Source: Advances in Rehabilitation and Assistive Robots for Restoring Limb Function in Persons with Movement Disorders

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[Abstract] Systematic review of traumatic brain injury and the impact of antioxidant therapy on clinical outcomes. – CNS

Systematic review of traumatic brain injury and the impact of antioxidant therapy on clinical outcomes.

Worldviews Evid Based Nurs. 2016 May 31. doi: 10.1111/wvn.12167. [Epub ahead of print]. Shen Q(1), Hiebert JB(2), Hartwell J(3), Thimmesch AR(4), Pierce JD(5).

BACKGROUND: Traumatic brain injury (TBI) is an acquired brain injury that occurs when there is sudden trauma that leads to brain damage. This acute complex event can happen when the head is violently or suddenly struck or an object pierces the skull or brain. The current principal treatment of TBI includes various pharmaceutical agents, hyperbaric oxygen, and hypothermia. There is evidence that secondary injury from a TBI is specifically related to oxidative stress. However,
the clinical management of TBI often does not include antioxidants to reduce oxidative stress and prevent secondary injury.

AIMS: The purpose of this article is to examine current literature regarding the use of antioxidant therapies in treating TBI. This review evaluates the evidence of antioxidant therapy as an adjunctive treatment used to reduce the underlying mechanisms involved in secondary TBI injury.

METHODS: A systematic review of the literature published between January 2005 and September 2015 was conducted. Five databases were searched including CINAHL, PubMed, the Cochrane Library, PsycINFO, and Web of Science.

FINDINGS: Critical evaluation of the six studies that met inclusion criteria
suggests that antioxidant therapies such as amino acids, vitamins C and E, progesterone, N-acetylcysteine, and enzogenol may be safe and effective adjunctive therapies in adult patients with TBI. Although certain limitations were found, the overall trend of using antioxidant therapies to improve the clinical outcomes of TBI was positive.

LINKING EVIDENCE TO ACTION: By incorporating antioxidant therapies into practice, clinicians can help attenuate the oxidative posttraumatic brain damage and optimize patients’ recovery.

Source: Traumatic Brain Injury Resource Guide – Research Reports – Systematic review of traumatic brain injury and the impact of antioxidant therapy on clinical outcomes

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[WEB SITE] Inosine treatment helps recovery of motor functions after brain injury.

First study in primates shows promise reports restorative neurology and neuroscience

Date:
August 3, 2016
Source:
IOS Press
Summary:
Brain tissue can die as the result of stroke, traumatic brain injury, or neurodegenerative disease. When the affected area includes the motor cortex, impairment of the fine motor control of the hand can result. Researchers found that inosine, a naturally occurring purine nucleoside that is released by cells in response to metabolic stress, can help to restore motor control after brain injury.

Brain tissue can die as the result of stroke, traumatic brain injury, or neurodegenerative disease. When the affected area includes the motor cortex, impairment of the fine motor control of the hand can result. In a new study published inRestorative Neurology and Neuroscience, researchers found that inosine, a naturally occurring purine nucleoside that is released by cells in response to metabolic stress, can help to restore motor control after brain injury.

Based on evidence from rodent studies, researchers used eight rhesus monkeys ranging in age from 5 to 10 years (approximately equivalent to humans from 15 to 30 years of age). All received medical examinations and motor skills were tested, including video recording of fine motor functions used to retrieve small food rewards. All monkeys were given initial MRI scans to ensure there were no hidden brain abnormalities.

Brain injuries were created in the area controlling each monkey’s favored hand. Four monkeys received inosine treatment, while four received a placebo. Research staff were not informed regarding which monkeys were included in the treatment vs placebo groups. Recovery of motor function was then measured for a period of 14 weeks after surgery.

While both the treated and placebo groups recovered significant function, three out of four of the treated monkeys were able to return to their pre-operative grasping methods. The placebo group developed a compensatory grasping method for retrieving food rewards unlike the original thumb-and-finger method.

«In the clinical context, the enhanced recovery of grasp pattern suggests that inosine facilitates greater recovery from this type of cortical injury and motor impairment,» explained lead investigator Tara L. Moore, PhD, of the Department of Anatomy & Neurobiology and the Department of Neurology, Boston University School of Medicine, Boston, MA, USA. «To our knowledge, this is the first study to demonstrate the positive effects of inosine for promoting recovery of function following cortical injury in a non-human primate.»

Inosine has also been administered in human clinical trials for multiple sclerosis and Parkinson’s disease and has been proven to be safe in doses up 3000 mg/day. Athletes have used inosine as a nutritional supplement for decades, and inosine supplements are widely available commercially. «Given the effectiveness of inosine in promoting cortical plasticity, axonal sprouting, and dendritic branching, the present evidence of efficacy after cortical injury in a non-human primate, combined with a long history of safe use, indicates a need for clinical trials with inosine after cortical injury and spinal cord injury,» noted Dr. Moore.

The study points to neural plasticity, whereby the brain essentially «re-wires» connections between neurons to reestablish control pathways, as a therapeutic target for the recovery of fine motor control and grasping ability. Further study of cortical tissue from these monkeys is currently being completed and may provide further insights into the mechanisms underlying recovery.


Story Source:

The above post is reprinted from materials provided by IOS Press. Note: Content may be edited for style and length.


Journal Reference:

  1. Tara L. Moore, Monica A. Pessina, Seth P. Finklestein, Ronald J. Killiany, Bethany Bowley, Larry Benowitz, Douglas L. Rosene. Inosine enhances recovery of grasp following cortical injury to the primary motor cortex of the rhesus monkey. Restorative Neurology and Neuroscience, 2016; 1 DOI: 10.3233/RNN-160661

Source: Inosine treatment helps recovery of motor functions after brain injury: First study in primates shows promise reports restorative neurology and neuroscience — ScienceDaily

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