Posts Tagged functional recovery

[ARTICLE] The effect of the Bobath therapy programme on upper limb and hand function in chronic stroke individuals with moderate to severe deficits – Full Text

Abstract

Background/Aims

The Bobath concept has long been used to improve postural control and limb function post-stroke, yet its effect in patients with deficits have not been clearly demonstrated. This study aimed to investigate the effect of the latest Bobath therapy programme on upper limb functions, muscle tone and sensation in chronic stroke individuals with moderate to severe deficits.

Methods

A pre–post test design was implemented. The participants were chronic stroke individuals (n=26). Home-based intervention based on the Bobath concept was administered 3 days per week for 6 weeks (20 repetitions × 3 sets per task each session). Outcome measures consisted of the Wolf Motor Function Test, Fugl-Meyer Assessment for the upper extremity, Modified Ashworth Scale, and the Revised Nottingham Sensory Assessment. Data were analysed using the Wilcoxon Signed rank test.

Results

Almost all items of the Wolf Motor Function Test and the Fugl-Meyer Assessment for the upper extremity demonstrated statistically significant differences post-intervention. Finger flexor muscle tone and stereognosis were also significantly improved.

Conclusions

The 6-week Bobath therapy programme could improve upper limb function and impairments in chronic stroke individuals with moderate to severe deficits. Its effects were also demonstrated in improving muscle tone and cortical sensation.

INTRODUCTION

Stroke is a global public health problem that leads to significant disabilities (World Health Organization, 2014). After discharge from a hospital, patients who have experienced stroke return to the community and many do not have access to physical therapy. Around 65% of patients who had experienced a stroke were unable to use their hemiparetic upper limb (Bruce and Dobkin, 2005). Those with moderate to severe arm deficits have difficulty in reaching to grasp, delay in time to maximal grip aperture, prolonged movement time, and a lack of accuracy (Michaelsen et al, 2009). A number of interventions have been proven to be effective in improving upper limb function post-stroke. However, there is little evidence of the effectiveness of these interventions for those with severe deficits.

The therapy programme based on the Bobath concept has been shown to improve upper limb function in individuals who have experienced chronic stroke (Huseyinsinoglu et al, 2012Carvalho et al, 2018). The Bobath concept has been in evolution and the present clinical framework incorporates the integration of postural control and quality of task performance, selective movement, and the role of sensory information to promote normal movement pattern. Therapeutic activities involved movement facilitation together with patient’s active participation in practice to improve motor learning; nevertheless, implementation time varied across studies (Vaughan-Graham et al, 2009Vaughan-Graham and Cott, 2016).

Among the few studies of patients with chronic stroke, none focused on the rehabilitation of patients with different degrees of deficit severity in the community. Moreover, previous studies using the Bobath concept were all conducted in clinical settings (Platz et al, 2005Huseyinsinoglu et al, 2012).[…]

 

Continue —->  The effect of the Bobath therapy programme on upper limb and hand function in chronic stroke individuals with moderate to severe deficits | International Journal of Therapy and Rehabilitation

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[ARTICLE] The Effects of Virtual Reality Training on Function in Chronic Stroke Patients: A Systematic Review and Meta-Analysis – Full Text

Abstract

Objective. The aim of this study was to perform a meta-analysis to examine whether virtual reality (VR) training is effective for lower limb function as well as upper limb and overall function in chronic stroke patients. Methods. Three databases, OVID, PubMed, and EMBASE, were used to collect articles. The search terms used were “cerebrovascular accident (CVA),” “stroke”, and “virtual reality”. Consequently, twenty-one studies were selected in the second screening of meta-analyses. The PEDro scale was used to assess the quality of the selected studies. Results. The total effect size for VR rehabilitation programs was 0.440. The effect size for upper limb function was 0.431, for lower limb function it was 0.424, and for overall function it was 0.545. The effects of VR programs on specific outcomes were most effective for improving muscle tension, followed by muscle strength, activities of daily living (ADL), joint range of motion, gait, balance, and kinematics.Conclusion. The VR training was effective in improving the function in chronic stroke patients, corresponding to a moderate effect size. Moreover, VR training showed a similar effect for improving lower limb function as it did for upper limb function.

1. Introduction

Stroke is a major cause of death in the modern world; it also causes sensory, motor, cognitive, and visual impairments and restricts performance of activities of daily living (ADL) [1]. Motor impairments are observed in 80% of stroke patients, and these can include loss of balance and gait [2]. These problems are important targets of rehabilitation, because they reduce the ability of individuals to perform ADL and this result in impaired community activities [34].

Most studies on balance and gait rehabilitation have shown positive effects. However, training-based methods often become tiresome are resource-intensive and require specialized facilities or equipment. Therefore, there is a demand for economical and safe methods of rehabilitation [2].

Virtual reality (VR) is defined by “the use of interactive simulations created with computer hardware and software to present users with opportunities to engage in environments that appear and feel similar to real world objects and events.” Participants interact with projected images, maneuver virtual objects and perform activities programmed into the task, giving the user a sense of immersion in the simulated environment. Various forms of feedback are provided through the environment, the most common being visual and auditory, to enhance enjoyment and motor learning through real-time feedback and immediate results [5]. VR training using these features has recently been widely used in the field of stroke rehabilitation [3]. VR training aims to improve neural plasticity by providing a safe and enriched environment to perform functional task-specific activities with increased repetitions, intensity of practice, and motivation to comply with the intervention [1].

In the field of stroke rehabilitation, VR training is reported to be mostly effective at increasing upper limb joint range of motion, improving sensation, muscle strengthening, reducing pain, and improving functional processesRecently, various VR programs have been developed and implemented for the lower limbs as well as the upper limbs, and their effects are being tested. VR training for stroke patients has been shown to be safe and cost-effective at improving lower limb function, specifically improving balance, stair climbing speed, ankle muscle strength, range of motion, and gait speed [1]. Compared with existing treatment methods, it may be more effective at improving dynamic balance control and preventing falls in subacute and chronic stroke patients [6].

Treatment methods using VR provide a virtual environment for ADLs that are difficult to perform in a hospital, and therefore, it could be very effective at improving both upper limb and lower limb function. However, because the lower limbs have to support the weight of the body, various elements are required, including muscle strength and balance to control body weight, joint movements, and cognitive ability to integrate these other elements. Although studies related to VR training have been increasing in recent years, VR intervention has been used more extensively to improve upper limb function, which is relatively easier to apply than lower limb function.

Furthermore, doubts could be raised as to whether VR treatment methods for the lower limbs can improve these elements; these doubts related to lack of VR equipment or programs, as well as safety issues or dizziness during treatment. For this reason, we aimed to perform a meta-analysis as a scientific method to test the effects of uncertain treatment methods using statistical methods, in order to examine whether VR training is effective for lower limb function as well as upper limb function. […]

Continue —>  The Effects of Virtual Reality Training on Function in Chronic Stroke Patients: A Systematic Review and Meta-Analysis

 

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[Abstract] High-Intensity Interval Training After Stroke: An Opportunity to Promote Functional Recovery, Cardiovascular Health, and Neuroplasticity.

Abstract

INTRODUCTION:

Stroke is the leading cause of adult disability. Individuals poststroke possess less than half of the cardiorespiratory fitness (CRF) as their nonstroke counterparts, leading to inactivity, deconditioning, and an increased risk of cardiovascular events. Preserving cardiovascular health is critical to lower stroke risk; however, stroke rehabilitation typically provides limited opportunity for cardiovascular exercise. Optimal cardiovascular training parameters to maximize recovery in stroke survivors also remains unknown. While stroke rehabilitation recommendations suggest the use of moderate-intensity continuous exercise (MICE) to improve CRF, neither is it routinely implemented in clinical practice, nor is the intensity always sufficient to elicit a training effect. High-intensity interval training (HIIT) has emerged as a potentially effective alternative that encompasses brief high-intensity bursts of exercise interspersed with bouts of recovery, aiming to maximize cardiovascular exercise intensity in a time-efficient manner. HIIT may provide an alternative exercise intervention and invoke more pronounced benefits poststroke.

OBJECTIVES:

To provide an updated review of HIIT poststroke through ( a) synthesizing current evidence; ( b) proposing preliminary considerations of HIIT parameters to optimize benefit; ( c) discussing potential mechanisms underlying changes in function, cardiovascular health, and neuroplasticity following HIIT; and ( d) discussing clinical implications and directions for future research.

RESULTS:

Preliminary evidence from 10 studies report HIIT-associated improvements in functional, cardiovascular, and neuroplastic outcomes poststroke; however, optimal HIIT parameters remain unknown.

CONCLUSION:

Larger randomized controlled trials are necessary to establish ( a) effectiveness, safety, and optimal training parameters within more heterogeneous poststroke populations; (b) potential mechanisms of HIIT-associated improvements; and ( c) adherence and psychosocial outcomes.

 

via High-Intensity Interval Training After Stroke: An Opportunity to Promote Functional Recovery, Cardiovascular Health, and Neuroplasticity. – PubMed – NCBI

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[WEB SITE] Neural works

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STROKE IS THE leading cause of disability in adults, and can affect many parts of the brain, causing multiple deficits including the ones in cognitive, behavioural, visual, speech, sensation, movement, muscle tone and sphincter functions. There are two types of recovery after stroke—spontaneous neurological recovery, which happens in the first three to six months owing to resolution of local injury and can be modified by newer interventions, and functional recovery, for which the time period is unlimited and that involves intensive training that triggers newer electrical circuits in the brain.

Similarly, there are two different approaches of neurological rehabilitation—compensation and remediation. In the compensatory approach, for example, if someone has difficulty in walking because of lack of movements in the leg, then we give him a stick to walk. In remediation, on the other hand, we try to minimise the impairment or improve power in the leg muscles and reduce the chances of using a stick. This ability of the brain to restore the function by minimising the impairment depends upon the formation of new or alternative circuits in the brain. This inherent but not widely known ability of the brain to change in response to a triggered stimulus is called neuroplasticity.

Neuroplasticity is the capacity of neurons and neural networks in the brain to change their connections and behaviour in response to new information, sensory stimulation, development, damage or dysfunction. In fact, for many years, it was believed that certain functions were hard-wired in specific, localised regions of the brain and that any incidents of brain change or recovery were mere exceptions to the rule—’brain cannot change’. However, since the 1970s and 1980s, neuroplasticity has gained wide acceptance in the scientific community as a complex, multifaceted, fundamental property of the brain. Remodelling of neural circuits through plasticity can occur spontaneously or can be triggered by intensive training (experience-dependent plasticity) and biological treatments (pharmacological agents and transcranial magnetic stimulation).

Dr Abhishek Srivastava

Dr Abhishek Srivastava

There are four different types of neuroplasticity: map expansion, homologous area adaptation, compensatory masquerade and cross-modal reassignment.

Map expansion entails flexibility of local brain regions that are dedicated to performing one type of function or storing a particular form of information. The arrangement of these local regions in the cerebral cortex is referred to as a ‘map’. When one function is carried out frequently enough through repeated behaviour or stimulus, the region of the cortical map dedicated to this function grows and shrinks as an individual exercises this function. This phenomenon usually takes place during the learning and practising of a skill such as playing a musical instrument or in task-specific trainings in stroke patients to improve specific functions like arm or leg movements, speech, language, cognitive or swallow function. This is the most commonly used approach in neurorehab.

Homologous area adaptation occurs during the early critical period of development. If a particular brain module becomes damaged in early life, its normal operations have the ability to shift to brain areas that do not include the affected module. The function is often shifted to a module in the matching or homologous area of the opposite brain hemisphere. This concept can help improve speech and language function after stroke with involvement of the dominant lobe.

Compensatory masquerade can simply be described as the brain figuring out an alternative strategy for carrying out a task when the initial strategy cannot be followed due to impairment. One example is when a person attempts to navigate from one location to another. Most people have an intuitive sense of direction and distance that they employ for navigation. However, a person who suffers some form of brain injury or stroke and impaired spatial sense will resort to another strategy for spatial navigation, such as memorising landmarks. The only change that occurs in the brain is a reorganisation of preexisting neuronal networks. This is a simple and novel way by which stroke survivors who were not able to do a complex everyday task can be trained to do it themselves.

Cross-modal reassignment entails the introduction of new inputs into a brain area deprived of its main inputs. A classic example of this is the ability of an adult who has been blind since birth to have touch or somatosensory input redirected to the visual cortex in the occipital lobe of the brain—specifically, in an area known as V1. Sighted people, however, do not display any V1 activity when presented with similar touch-oriented experiments. This occurs because neurons communicate with one another in the same abstract language of electrochemical impulses regardless of sensory modality. This strategy is useful to improve visual or auditory functions after stroke.

Most of the recent rehabilitation approaches to improve sensory-motor recovery, including rehab robotics, virtual reality, mirror training, constraint induced therapy, task-specific training and intensive locomotor training, work on the principles of neuroplasticity. These help in improving most of the functions after stroke including cognitive, visual, behavioural, speech, language, swallow, movements, tone or sphincter functions. I have seen many stroke patients, thought to be in a vegetative state for life, now living independently, thanks to neurological rehabilitation.

Srivastava is a neurorehab specialist and director, centre for rehabilitation, Kokilaben Dhirubhai Ambani Hospital, Mumbai.

 

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[Abstract+References] Brain Plasticity and Modern Neurorehabilitation Technologies

Abstract

In recent decades, interest in studies on basic and applied aspects of how the nervous system functions has been growing rapidly around the world. The recovery of lost functions rests on processes of neuroplasticity, which is determined by the ability of the brain to transform its structures in response to injury. The effects of both routine and state-of-the-art neurorehabilitation technologies are ensured by synaptic plasticity— long-term potentiation and long-term depression, which influence learning and the preservation of new knowledge and skills obtained during rehabilitation. The introduction of new methods of neuroimaging, neurophysiology, and mathematical statistics have powerfully stimulated the development of the neuroplasticity doctrine. It has become clear that the main role in the recovery of injured functions is played by the reorganization of cortical nets and not by tissue reparation as such. The Research Center of Neurology has accumulated significant experience in the use of innovative treatment methods based on modern neurorehabilitation principles. Some of them are used for acute stroke; among other things, their effectiveness and safety have been shown with regard to patients in intensive care units (cyclic robotic mechanotherapy) and patients with severe motor deficit and an associated somatic pathology (stimulation of plantar support zones). Opportunities to assess neuroplasticity under various rehabilitation methods using fMRI and navigated transcranial magnetic stimulation (TMS) are revealed. The center also studies the fundamentals of consciousness using original neuroimaging and neurophysiological protocols for the sake of its recovery. The center is actively introducing its data into the practice of domestic clinics specializing in recovery medicine and neurorehabilitation.

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[Abstract] Pilot Study Combining Electrical Stimulation and a Dynamic Hand Orthosis for Functional Recovery in Chronic Stroke

Abstract

OBJECTIVE. We investigated the effect of a combined neuromuscular electrical stimulation (ES) and dynamic hand orthosis (DHO) regimen with a group of people with chronic stroke to improve performance on specific daily tasks.

METHOD. Four people with chronic stroke participated in an ES–DHO regimen using the affected upper extremity 5×/wk for 6 wk. Outcome measures included grip strength, range of motion (ROM), and analysis of muscle activation–deactivation during release of grasp through electromyography. Ability to perform specific daily living tasks was assessed using the Assessment of Motor and Process Skills (AMPS).

RESULTS. Results suggested that improvements in strength, ROM, and grasp deactivation are possible with the combined ES–DHO regimen. All participants’ AMPS motor scores improved.

CONCLUSIONS. An ES–DHO regimen may improve motor skills needed for functional task performance in people with chronic stroke. Results should be interpreted cautiously because of the pilot nature of the study and the small sample size.

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[Abstract] Improving Cognitive Function in Patients with Stroke: Can Computerized Training Be the Future?

Background

Cognitive impairment after stroke is common and can cause disability with a high impact on quality of life and independence. Cognitive rehabilitation is a therapeutic approach designed to improve cognitive functioning after central nervous system’s injuries. Computerized cognitive rehabilitation (CCR) uses multimedia and informatics resources to optimize cognitive compromised performances. The aim of this study is to evaluate the effects of pc cognitive training with Erica software in patients with stroke.

Methods

We studied 35 subjects (randomly divided into 2 groups), affected by either ischemic or hemorrhagic stroke, having attended from January 2013 to May 2015 the Laboratory of Robotic and Cognitive Rehabilitation of Istituto di Ricerca e Cura a Carattere Scientifico Neurolesi in Messina. Cognitive dysfunctions were investigated through a complete neuropsychological battery, administered before (T0) and after (T1) each different training.

Results

At T0, all the patients showed language and cognitive deficits, especially in attention process and memory abilities, with mood alterations. After the rehabilitation program (T1), we noted a global cognitive improvement in both groups, but a more significant increase in the scores of the different clinical scales we administered was found after CCR.

Conclusions

Our data suggest that cognitive pc training by using the Erica software may be a useful methodology to increase the post-stroke cognitive recovery.

 

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[Abstract] Improving Cognitive Function in Patients with Stroke: Can Computerized Training Be the Future?

Background

Cognitive impairment after stroke is common and can cause disability with a high impact on quality of life and independence. Cognitive rehabilitation is a therapeutic approach designed to improve cognitive functioning after central nervous system’s injuries. Computerized cognitive rehabilitation (CCR) uses multimedia and informatics resources to optimize cognitive compromised performances. The aim of this study is to evaluate the effects of pc cognitive training with Erica software in patients with stroke.

Methods

We studied 35 subjects (randomly divided into 2 groups), affected by either ischemic or hemorrhagic stroke, having attended from January 2013 to May 2015 the Laboratory of Robotic and Cognitive Rehabilitation of Istituto di Ricerca e Cura a Carattere Scientifico Neurolesi in Messina. Cognitive dysfunctions were investigated through a complete neuropsychological battery, administered before (T0) and after (T1) each different training.

Results

At T0, all the patients showed language and cognitive deficits, especially in attention process and memory abilities, with mood alterations. After the rehabilitation program (T1), we noted a global cognitive improvement in both groups, but a more significant increase in the scores of the different clinical scales we administered was found after CCR.

Conclusions

Our data suggest that cognitive pc training by using the Erica software may be a useful methodology to increase the post-stroke cognitive recovery.

 

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[Abstract] Effects of Transcranial direct current stimulation with sensory modulation on stroke motor rehabilitation: A randomized controlled trial  

 

Abstract

Objective

To test whether a multi-strategy intervention enhanced recovery immediately and longitudinally in patients with severe to moderate upper extremity (UE) paresis.

Design

Double-blind randomized controlled trial with placebo control.

Setting

An outpatient department of a local medical center.

Participants

People (n = 25) with chronic stroke were randomly assigned to 2 groups. Participants in the transcranial direct current stimulation with sensory modulation (tDCS-SM) and in the control group were 55.3±11.5 (n=14) and 56.9±13.5 (n=11) years old, respectively.

Interventions

8-week intervention. The tDCS-SM group received bilateral tDCS, bilateral cutaneous anesthesia, and high repetitions of passive movements on the paretic hand. The control group received the same passive movements but with sham tDCS and sham anesthesia. During the experiment, all participants continued their regular rehabilitation.

Main outcome measures

Voluntary UE movement, spasticity, UE function, and basic activities of daily living. Outcomes were assessed at baseline, at post-intervention, and at 3- and 6-month follow-ups.

Results

No significant differences were found between groups. However, there was a trend that the voluntary UE movement improved more in the tDCS-SM group than in the control group, with a moderate immediate effect (partial η2, ηp2 = 0.14, p = 0.07) and moderate long-term effects (ηp2 =0.17, p = 0.05 and ηp2 = 0.12, p = 0.10). Compared with the control group, the tDCS-SM group had a trend of a small immediate effect (ηp2 = 0.02 – 0.04) on reducing spasticity but no long-term effect. A trend of small immediate and long-term effects in favor of tDCS-SM was found on UE function and daily function recovery (ηp2= 0.02 – 0.09).

Conclusions

Accompanied with traditional rehabilitation, tDCS-SM had a non-significant trend of having immediate and longitudinal effects on voluntary UE movement recovery in patients with severe to moderate UE paresis after stroke, but its effects on spasticity reduction and functional recovery may be limited. (NCT01847157)

Source: Effects of Transcranial direct current stimulation with sensory modulation on stroke motor rehabilitation: A randomized controlled trial – Archives of Physical Medicine and Rehabilitation

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[ARTICLE] Cognitive and functional outcomes following inpatient rehabilitation in patients with acquired brain injury: A prospective follow-up study – Full Text

Abstract

Objectives: To study the effects of cognitive retraining and inpatient rehabilitation to study the effects of cognitive retraining and inpatient rehabilitation in patients with acquired brain injury (ABI).

Design and Setting: This was a prospective follow-up study in a neurological rehabilitation department of quaternary research hospital.

Patients and Methods: Thirty patients with ABI, mean age 36.43 years (standard deviation [SD] 12.6, range 18–60), mean duration of illness 77.87 days (SD 91.78, range 21–300 days) with cognitive, physical, and motor-sensory deficits underwent inpatient rehabilitation for minimum of 14 sessions over a period of 3 weeks. Nineteen patients (63%) reported in the follow-up of minimum 3 months after discharge. Type of ABI, cognitive status (using Montreal Cognitive assessment scale [MoCA] and cognitive Functional Independence Measure [Cog FIM]®), and functional status (motor FIM®) were noted at admission, discharge, and follow-up and scores were compared.

Results: Patients received inpatient rehabilitation addressing cognitive and functional impairments. Baseline MoCA, motor FIM, and Cog FIM scores were 15.27 (SD = 7.2, range 3–30), 31.57 (SD = 15.6, range 12–63), and 23.47 (SD = 9.7, range 5–35), respectively. All the parameters improved significantly at the time of discharge (MoCA = 19.6 ± 7.4 range 3–30, motor FIM® = 61.33 ± 18.7 range 12–89, Cog FIM® =27.23 ± 8.10 range 9–35). Patients were discharged with home-based programs. Nineteen patients reported in follow-up and observed to have maintained cognition on MoCA (18.8 ± 6.8 range 6–27), significantly improved (P < 0.01) on Cog FIM® (28.0 ± 7.7 range 14–35) and motor FIM® =72.89 ± 16.2 range 40–96) as compare to discharge scores.

Conclusions: Cognitive and functional outcomes improve significantly with dedicated and specialized inpatient rehabilitation in ABI patients, which is sustainable over a period.

 Introduction

Acquired brain injury (ABI) is defined as “damage to the brain, which occurs after birth and is not related to a congenital or a degenerative disease.” “These impairments may be temporary or permanent and cause physical, functional disability, or psychosocial maladjustment.”[1],[2] By this definition, ABI encompasses a wide variety of disorders of varying etiologies such as vascular, hypoxic, malignant, and traumatic. There are often long-lasting effects on domains of cognition, motor, behavior, and personality in affected individuals.[3] Cognitive impairment is common sequelae and important marker for prediction of rehabilitation outcomes, and cognitive outcome can be modified through targeted interventions.[4]

Studies suggest that traumatic brain injury (TBI) and stroke are the two main causes of ABI and regarded as important public health problem.[5] The incidence of TBI from 23 reports was found to vary greatly among European countries. Most rates were in the range 150–300/100,000 people per year.[6] The prevalence of stroke In western developed world ranges from 500 to 600/100,000. Rates per 100,000 from developing countries are also variable and range from 58 in India and 76 in the United Republic of Tanzania to 620 in China and 690 in Thailand.[7] Between 1.5 and 2 million persons are injured and 1 million die every year in India following TBI.[8] Cardiovascular diseases including stroke caused 19% of deaths in India between 2001 and 2003 and this is estimated to rise to 36% by 2030.[9] According to disease burden in India report September 2005, central nervous system malignancies (included in ABI) comprise 2% of the total cancer burden.[10] Other causes of ABI such as meningoencephalitis and stroke mimics also contribute to this pool of patients.

The majority of ABI survivors continue to live with disabilities without access to comprehensive rehabilitation services and remain a burden on caregivers and society.[11],[12] Physical and cognitive deficits are most commonly observed in these patients but are not adequately addressed due to lack of approachable rehabilitation services and awareness.[13],[14] Many of these patients opt for complementary and alternative medicine, which are popular in India but demonstrate questionable benefits.[15]

It is evident, both clinically and scientifically, that the improvement in motor control after ABI is training dependent, responding best to repetitive task training with continuous modification of the program to keep training tasks challenging to the patients (activity-based recovery and neural plasticity).[16],[17] Single or multiple domains of cognition can be affected in these patients depending on the site (s) and severity of injury. Disturbances in memory, attention, and/or executive functions are commonly involved. Deficits in language and speech, learning, abstract thinking, and orientation occur in severe cases. It is well established that cognitive deficits interfere with rehabilitation efforts and also result in a greater negative impact on quality of life.[18] Cognitive rehabilitation (CR) is a specialized treatment procedure designed to improve the cognition affected by internal or external injury to the brain. There are two types of CR: restorative and compensatory rehabilitation.[19],[20],[21] Restorative rehabilitation enables the patient to develop lost functions through specialized computerized and manual cognitive exercises. Compensatory rehabilitation helps the patient to train and use aids and tools to overcome the impairment. The objective of the present study was to rehabilitate ABI patients in all affected domains including cognitive, physical, sensory-motor, and behavior with customized inpatient programs. Another objective was to observe the effect of inpatient rehabilitation in improving cognition and functionality of the patients (by comparing admission and discharge scores). We also tried to observe whether the benefits of inpatient rehabilitation are sustainable by assessing the patients in follow-up examination a minimum of 3 months after discharge.[…]

Continue —>  Cognitive and functional outcomes following inpatient rehabilitation in patients with acquired brain injury: A prospective follow-up study Patil M, Gupta A, Khanna M, Taly AB, Soni A, Kumar J K, Thennarasu K – J Neurosci Rural Pract

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