Posts Tagged education

[Abstract] Immediate Effects of Mirror Therapy in Patients With Shoulder Pain and Decreased Range of Motion 

Abstract

Objective

To determine the effects of a brief single component of the graded motor imagery (GMI) sequence (mirror therapy) on active range of motion (AROM), pain, fear avoidance, and pain catastrophization in patients with shoulder pain.

Design

Single-blind case series.

Setting

Three outpatient physical therapy clinics.

Participants

Patients with shoulder pain and limited AROM (N=69).

Intervention

Patients moved their unaffected shoulder through comfortable AROM in front of a mirror so that it appeared that they were moving their affected shoulder.

Main Outcome Measures

We measured pain, pain catastrophization, fear avoidance, and AROM in 69 consecutive patients with shoulder pain and limited AROM before and immediately after mirror therapy.

Results

There were significant differences in self-reported pain (P=.014), pain catastrophization (P<.001), and the Tampa Scale of Kinesiophobia (P=.012) immediately after mirror therapy; however, the means did not meet or exceed the minimal detectable change (MDC) for each outcome measure. There was a significant increase (mean, 14.5°) in affected shoulder flexion AROM immediately postmirror therapy (P<.001), which exceeded the MDC of 8°.

Conclusions

A brief mirror therapy intervention can result in statistically significant improvements in pain, pain catastrophization, fear avoidance, and shoulder flexion AROM in patients presenting with shoulder pain with limited AROM. The immediate changes may allow a quicker transition to multimodal treatment, including manual therapy and exercise in these patients. Further studies, including randomized controlled trials, are needed to investigate these findings and determine longer-term effects.

Source: Immediate Effects of Mirror Therapy in Patients With Shoulder Pain and Decreased Range of Motion – Archives of Physical Medicine and Rehabilitation

Advertisements

, , , , , , ,

Leave a comment

[WEB SITE] Brain surgery helps remove scar tissue causing seizures in epilepsy patients

By the time epilepsy patient Erika Fleck came to Loyola Medicine for a second opinion, she was having three or four seizures a week and hadn’t been able to drive her two young children for five years.

“It was no way to live,” she said.

Loyola epileptologist Jorge Asconapé, MD, recommended surgery to remove scar tissue in her brain that was triggering the seizures. Neurosurgeon Douglas Anderson, MD, performed the surgery, called an amygdalohippocampectomy. Ms. Fleck hasn’t had a single seizure in the more than three years since her surgery.

“I’ve got my life back,” she said. “I left my seizures at Loyola.”

Surgery can be an option for a minority of patients who do not respond to medications or other treatments and have epileptic scar tissue that can be removed safely. In 60 to 70 percent of surgery patients, seizures are completely eliminated, and the success rate likely will improve as imaging and surgical techniques improve, Dr. Anderson said.

Traditionally, patients would have to try several medications with poor results for years or decades before being considered for surgery, according to the Epilepsy Foundation. “More recently, surgery is being considered sooner,” the foundation said. “Studies have shown that the earlier surgery is performed, the better the outcome.” (Ms. Fleck is a service coordinator for the Epilepsy Foundation North/Central Illinois Iowa and Nebraska.)

Dr. Asconapé said Ms. Fleck was a perfect candidate for surgery because the scar tissue causing her seizures was located in an area of the brain that could be removed without damaging critical structures.

Ms. Fleck experienced complex partial seizures, characterized by a deep stare, unresponsiveness and loss of control for a minute or two. An MRI found the cause: A small area of scar tissue in a structure of the brain called the hippocampus. The subtle lesion had been overlooked at another center.

Epilepsy surgery takes about three hours, and patients typically are in the hospital for two or three days. Like all surgery, epilepsy surgery entails risks, including infection, hemorrhage, injury to other parts of the brain and slight personality changes. But such complications are rare, and they pose less risk to patients than the risk of being injured during seizures, Dr. Asconapé said.

Loyola has been designated a Level Four Epilepsy Center by the National Association of Epilepsy Centers. Level Four is the highest level of specialized epilepsy care available. Level Four centers have the professional expertise and facilities to provide the highest level of medical and surgical evaluation and treatment for patients with complex epilepsy.

Loyola’s comprehensive, multidisciplinary Epilepsy Center offers a comprehensive multidisciplinary approach to epilepsy and seizure disorders for adults and children as young as two years old. Pediatric and adult epileptologist consultation and state-of-the-art neuroimaging and electrodiagnostic technology are used to identify and assess complex seizure disorders by short- and long-term monitoring.

Source: Loyola University Health System

Source: Brain surgery helps remove scar tissue causing seizures in epilepsy patients

, , , , , , , , , ,

Leave a comment

[BLOG POST] Anti-epilepsy medicine use during pregnancy does not harm overall health of children, study finds

.

Children whose mothers have taken anti-epilepsy medicine during pregnancy, do not visit the doctor more often than children who have not been exposed to this medicine in utero. This is the result of a new study from Aarhus.

Previous studies have shown that anti-epilepsy medicine may lead to congenital malformations in the foetus and that the use of anti-epilepsy medicine during pregnancy affects the development of the brain among the children. There is still a lack of knowledge in the area about the general health of children who are exposed to anti-epilepsy medicine in foetallife. But this new study is generally reassuring for women who need to take anti-epilepsy medicine during their pregnancy.

Being born to a mother who has taken anti-epilepsy medicine during pregnancy appears not to harm the child’s health. These are the findings of the first Danish study of the correlation between anti-epilepsy medicine and the general health of the child which has been carried out by the Research Unit for General Practice, Aarhus University and Aarhus University Hospital.

The results have just been published in the international scientific journal BMJ Open.

The researchers have looked into whether children who have been exposed to the mother’s anti-epilepsy medicine have contact with their general practitioner (GP) more often than other children – and there are no significant differences.

No reason til worry

“Our results are generally reassuring for women who need to take anti-epilepsy medicine during their pregnancy, including women with epilepsy,” says Anne Mette Lund Würtz, who is one of the researchers behind the project.

The difference in the number of contacts to the general practitioner between exposed and non-exposed children is only three per cent.

“The small difference we found in the number of contacts is primarily due to a difference in the number of telephone contacts and not to actual visits to the GP. At the same time, we cannot rule out that the difference in the number of contacts is caused by a small group of children who have more frequent contact with their GP because of illness,” explains Anne Mette Lund Würtz.

Of the 963,010 children born between 1997 and 2012, who were included in the survey, anti-epilepsy medicine was used in 4,478 of the pregnancies that were studied.

Anti-epilepsy medicine is also used for the treatment of other diseases such as migraine and bipolar disorder. The study shows that there were no differences relating to whether the women who used anti-epilepsy medicine during pregnancy were diagnosed with epilepsy or not.

Background for the results

Type of study: The population study was carried out using the Danish registers for the period 1997-2013.

The analyses takes into account differences in the child’s gender and date of birth, as well as the mother’s age, family situation, income, level of education, as well as any mental illness, use of psychiatric medicine and insulin, and substance abuse.

Source: Anti-epilepsy medicine use during pregnancy does not harm overall health of children, study finds

, , , , , , , , , , , , ,

Leave a comment

[WEB SITE] Brain plasticity after injury: an interview with Dr Swathi Kiran

What is brain plasticity and why is it important following a brain injury?

Brain plasticity is the phenomenon by which the brain can rewire and reorganize itself in response to changing stimulus input. Brain plasticity is at play when one is learning new information (at school) or learning a new language and occurs throughout one’s life.

Brain plasticity is particularly important after a brain injury, as the neurons in the brain are damaged after a brain injury, and depending on the type of brain injury, plasticity may either include repair of damaged brain regions or reorganization/rewiring of different parts of the brain.

MRI brain injury

How much is known about the level of injury the brain can recover from? Over what time period does the brain adapt to an injury?

A lot is known about brain plasticity immediately after an injury. Like any other injury to the body, after an initial negative reaction to the injury, the brain goes through a massive healing process, where the brain tries to repair itself after the injury. Research tells us exactly what kinds of repair processes occur hours, days and weeks after the injury.

What is not well understood is how recovery continues to occur in the long term. So, there is a lot research showing that the brain is plastic, and undergoes recovery even months after the brain damage, but what promotes such recovery and what hinders such recovery is not well understood.

It is well understood that some rehabilitative training promotes brain injury and most of the current research is focused on this topic.

What techniques are used to study brain plasticity?

Human brain plasticity has mostly been studied using non-invasive imaging methods, because these techniques allow us to measure the gray matter (neurons), white matter (axons) at a somewhat coarse level. MRI and fMRI techniques provide snapshots and video of the brain in function, and that allows us to capture changes in the brain that are interpreted as plasticity.

Also, more recently, there are invasive stimulation methods such as transcranial direct current stimulation or transcranial magnetic stimulation which allow providing electric current or magnetic current to different parts of the brain and such stimulation causes certain changes in the brain.

How has our understanding advanced over recent years?

One of the biggest shifts in our understanding of brain plasticity is that it is a lifelong phenomenon. We used to previously think that the brain is plastic only during childhood and once you reach adulthood, the brain is hardwired, and no new changes can be made to it.

However, we now know that even the adult brain can be modified and reorganized depending on what new information it is learning. This understanding has a profound impact on recovery from brain injury because it means that with repeated training/instruction, even the damaged brain is plastic and can recover.

What role do you see personalized medicine playing in brain therapy in the future?

One reason why rehabilitation after brain injury is so complex is because no two individuals are alike. Each individual’s education and life experiences have shaped their brain (due to plasticity!) in unique ways, so after a brain injury, we cannot expect that recovery in two individuals will be occur the same way.

Personalized medicine allows the ability to tailor treatment for each individual taking into account their strengths and weaknesses and providing exactly the right kind of therapy for that person. Therefore, one size treatment does not fit all, and individualized treatments prescribed to the exact amount of dosage will become a reality.

Senior couple tablet

What is ‘automedicine’ and do you think this could become a reality?

I am not sure we understand what automedicine can and cannot do just yet, so it’s a little early to comment on the reality. Using data to improve our algorithms to precisely deliver the right amount of rehabilitation/therapy will likely be a reality very soon, but it is not clear that it will eliminate the need for doctors or rehabilitation professionals.

What do you think the future holds for people recovering from strokes and brain injuries and what’s Constant Therapy’s vision?

The future for people recovering from strokes and brain injuries is more optimistic than it has ever been for three important reasons. First, as I pointed above, there is tremendous amount of research showing that the brain is plastic throughout life, and this plasticity can be harnessed after brain injury also.

Second, recent advances in technology allow patients to receive therapy at their homes at their convenience, empowering them to take control of their therapy instead of being passive consumers.

Finally, the data that is collected from individuals who continuously receive therapy provides a rich trove of information about how patients can improve after rehabilitation, what works and what does not work.

Constant Therapy’s vision incorporates all these points and its goal to provide effective, efficient and reasonable rehabilitation to patients recovering from strokes and brain injury.

Where can readers find more information?

About Dr Swathi Kiran

DR SWATHI KIRANSwathi Kiran is Professor in the Department of Speech and Hearing Sciences at Boston University and Assistant in Neurology/Neuroscience at Massachusetts General Hospital. Prior to Boston University, she was at University of Texas at Austin. She received her Ph.D from Northwestern University.

Her research interests focus around lexical semantic treatment for individuals with aphasia, bilingual aphasia and neuroimaging of brain plasticity following a stroke.

She has over 70 publications and her work has appeared in high impact journals across a variety of disciplines including cognitive neuroscience, neuroimaging, rehabilitation, speech language pathology and bilingualism.

She is a fellow of the American Speech Language and Hearing Association and serves on various journal editorial boards and grant review panels including at National Institutes of Health.

Her work has been continually funded by the National Institutes of Health/NIDCD and American Speech Language Hearing Foundation awards including the New Investigator grant, the New Century Scholar’s Grant and the Clinical Research grant. She is the co-founder and scientific advisor for Constant Therapy, a software platform for rehabilitation tools after brain injury.

Source: Brain plasticity after injury: an interview with Dr Swathi Kiran

, , , , , , , , , ,

Leave a comment

[Education] FINR Brain Atlas – 3D Brain Model of Anatomy & Injuries

Photo

Traumatic Brain Injury Rehabilitation Educational Resources > FINR Educational Materials > FINR Brain Atlas – 3D Brain Model

3D Brain Model – Explore our interactive 3-dimensional brain atlas to discover where structures are located within the brain, their purpose, and explore brain injury models. All structures and models are accompanied by easy-to-understand detailed explanations.

It is our hope that this model assists to further the understanding of brain injury by those affected.

Find the FINR 3D Brain model application for the iPhone, iPod Touch, and the iPad in the iTunes App Store.

Source: FINR Brain Atlas – 3D Brain Model of Anatomy & Injuries

, , , ,

Leave a comment

[Poster] Cognitive Rehabilitation Information for the Families of Individuals with Traumatic Brain Injury: A Review of Online Resources

To identify and critically appraise the content, readability, accessibility and usability of websites providing information on cognitive rehabilitation for the families of adults with traumatic brain injury (TBI).

Source: Cognitive Rehabilitation Information for the Families of Individuals with Traumatic Brain Injury: A Review of Online Resources – Archives of Physical Medicine and Rehabilitation

, , , ,

Leave a comment

[WEB SITE] Research could pave way for more effective and safer anti-epilepsy drugs

Columbia University Medical Center (CUMC) researchers have discovered how a new epilepsy drug works, which may lead the way to even more effective and safer medications.

The findings were published today in Neuron.

The most commonly used anti-epilepsy drugs are ineffective for about 30 percent of people with seizure disorders.

A new direction in the treatment of epilepsy is aimed at inhibiting AMPA receptors, which help transmit electrical signals in the brain and play a key role in propagating seizures. Currently, perampanel is the only FDA-approved drug that targets AMPA receptors. But because perampanel is associated with significant side effects, its clinical use has been limited.

“The problem is that AMPA receptors are heavily involved in the central nervous system, so if you inhibit their function, you cause an array of unwanted effects,” said study leader Alexander I. Sobolevsky, PhD, professor of biochemistry and molecular biophysics at CUMC. “If we hope to design better drugs for epilepsy, we need to learn more about the structure and function of these receptors.”

In this study, Dr. Sobolevsky employed a technique called crystallography to determine how perampanel and two other inhibitors interact with the AMPA receptors to stop transmission of electrical signals. The study was conducted using rat AMPA receptors, which are almost identical to human receptors.

In the new study, the researchers were able to pinpoint exactly where the drugs bind to AMPA receptors.

“Our data suggest that the inhibitors wedge themselves into the AMPA receptor, which prevents the opening of a channel within the receptor,” said Dr. Sobolevsky. When that channel is closed, ions cannot pass into the cell to trigger an electrical signal.

According to the researchers, these findings may allow drug makers to develop medications that are highly selective for the AMPA receptors, which could be safer and more effective than currently available anti-epilepsy drugs.

Source: Research could pave way for more effective and safer anti-epilepsy drugs

, , , , , , , , , , , ,

Leave a comment

[WEB SITE] 3 ways Virtual Reality can change healthcare

Healthcare has a long history of benefiting from new technologies, and it started using virtual reality surprisingly early. Education, rehabilitation and early detection are the three main areas where VR can contribute the most.

Education and visualisation

VR can help education in two distinct ways. First, it can help medical students and medical professionals to practice complex medical treatments, such as surgeries. Some universities, including Stanford, have been using virtual reality for years now in medical training. As a student you can see exactly the same as your professor conducting an operation. Practicing in virtual scenarios is cost effective, and very accessible.

VR can also help people who are not medical professionals, but who are living with a medical condition, or just want to learn more about a specific medical symptom. Since virtual reality can simulate any medical condition it can teach parents how to raise a child with disabilities. It helps to understand blindness, colour blindness, autism, mental issues, or as seen in the video, just a “simple” migraine.

Rehabilitation and assessment

A small circle of healthcare professionals has been experimenting with virtual reality in brain damage recovery and assessment for quite some time now. The scientific paper CyberPsychology & Behavior published a whole study on using VR in brain damage rehabilitation as early as 2005. These techniques are now getting adopted on a much wider scale.

The military, also well-known for utilising the latest technologies, is now using VR for post traumatic stress disorder (PTSD) rehabilitation, helping soldiers who returned from war zones. It’s also being used in psychiatry in exposure therapies, helping patients to overcame their fears. DEEP is using VR as a meditation tool.

The possibilities of using virtual reality in rehabilitation and neurological assessment are endless.

Early detection and the power of virtual reality in changing habits

Virtual reality can be combined with gaming and data visualisation. Vivid Vision is using VR to detect and analyse eye problems like amblyopia and strabismus, through VR vision analysis and simple games. Unello Designs is developing VR tools for stress relief, meditation, relaxation and to help patients overcoming phobias. VR is also used to cure fears like agoraphobia, anxiety or even to help quitting bad habits.  And we haven’t even started talking about wellness and fitness (check VirZOOM for example), a huge market on its own.

Healthcare is an incredibly exciting field, as both virtual reality and biotechnology are developing in a breathtaking pace. The synergies will profoundly change the whole industry in the upcoming decades.

Continue —> 3 ways Virtual Reality can change healthcare — RealityShift

, , , , ,

Leave a comment

[WEB SITE] What is an Occupational Therapist?

Occupational therapy is an allied health profession that plays a key role in the rehabilitation process of many conditions, injuries or illnesses. Occupational therapists possess knowledge about how individuals, the environment and human occupation (activity) stimulate health and well-being.

The Occupational Therapists professional philosophy is to maximise occupational (often referred to as functional) independence.  They use activities that are meaningful to the client to develop treatment plans, taking an holistic and client centred approach.

For occupational therapists, occupation refers to the activities of everyday living that people need to, want to and are expected to do. Therefore an occupational therapist can help a person regain and/or maintain personal purpose and independence in everyday living.

Consider the activities you participate in every day. Getting washed and dressed, cooking, making a drink, getting to work and socialising; or the roles you have, father/mother, son/daughter, colleague, friend and carer.  How would you complete these tasks or perform the expected roles if you were affected by trauma, chronically deteriorating health or relapse of some kind?

The Occupational Therapist provides practical support to enable people to facilitate recovery and overcome any barriers that prevent them from doing the activities that matter to them, covering all developmental & life stages.

Continue —> What is an Occupational Therapist?

, , , , , , ,

Leave a comment

[REVIEW] Community Reintegration | EBRSR – Evidence-Based Review of Stroke Rehabilitation – Full Text PDF

 

Abstract

While the majority of stroke survivors return to live in the community, re-integration may be an enormous challenge. The ability to return to an acceptable lifestyle, participating in both social and domestic activities is important for perceived quality of life. The present review examines issues arising following discharge from hospital care or rehabilitation into the community. These include social support, impact of caregiving on informal carers, family functioning, provision of information and education, leisure activities, driving, sexuality and return to work.

Get Full Text PDF

via Community Reintegration | EBRSR – Evidence-Based Review of Stroke Rehabilitation.

, , , , , , , , , , , ,

Leave a comment

%d bloggers like this: