国际神经康复杂志

Currently no exercise protocol exists to inform healthcare practitioners how to advise individuals with myasthenia gravis how to begin exercise after stabilization of symptoms, which exercises are most beneficial for improving functioning, or detailing how to progress difficulty of the exercises as improvements in physiological functioning are made. However, with improved strength and endurance, individuals with myasthenia gravis will have a more meaningful life and the ability to engage in activities that are important to them. This literature review demonstrates that with skilled supervision by a rehabilitation professional, exercise is safe for those with mild myasthenia gravis and that strength gains and improvements in physiological functioning are possible. This research supports that exercise may decrease fatigue, increase strength, and improve functional mobility in individuals with myasthenia gravis. Additional rehabilitation research needs to be conducted on the physiological effects of exercise on individuals with myasthenia gravis and which exercises have the most significant impact on function and levels of fatigue.

Background: Traumatic Spinal Cord Injury (SCI) among athletes frequently associated with temporary or permanent sensory and/or motor function loss below the level of lesion. This carries high morbidity which may limit the day to day activities. Awareness of proper techniques in early management of a spinal cord injured patients may limit complications. The main objective of this study is to evaluate the awareness about proper handling and transferring techniques of patient with a SCI among school athletes.

Methods: Self-administered questionnaires with questions related to handling and transferring techniques of patient with a SCI were randomly distributed among school athletes (12-20 years) in Kandy (Sri Lanka) educational zone. Single total score representing the level of awareness, was scored after evaluating the answers. These marks were then compared using Mann Whitney and Kruskal-Wallis to explore the awareness.

Results: Among 243 of school athletes (Male, 50.2%; Female, 49.2%), Age: median=15, IQR=1) interviewed, overall mean awareness level score was 50.8% (17.9 ± SD).

Conclusion: The awareness of proper handling of SCI patient did not differ in relation to gender, age, level of engagement in sports. Although overall awareness level of the questions based on handling and transferring techniques was moderate, there was an inadequate level of awareness regarding the handling of some important emergency situations.

Estimates indicate that 15 million individuals experience strokes worldwide. The short and long term impact of stroke can be devastating to stroke survivors, their families and their communities. A range of approaches to stroke care currently exist with all attempting to achieve the best outcomes. It has become clear that comprehensive evidence based models of care should be consistently utilized to reduce the functional disability often associated with stroke. In this article we briefly highlight a “roadmap of stroke care” that offers considerations to the complexities of stroke care and strategies necessary to achieve optimal outcomes.

In order to study the effect of group therapy on decrease in addiction relapse, two groups, experimental and control group were used. The study population included all drug addicts referred to Addiction Quitting Center of Karaj. Twenty four of them who referred to center and received methadone were chosen as a convenient sample. Among them, a 12 person group participated in group therapy in addition to receiving methadone. Subjects were randomly divided into experimental and control groups. In order to collect data, questionnaires were used that provided demographic information including age, education, the age when drug abuse began, marital status, occupation, the type of drugs being abused and the abusing method, and also a morphine test in order to measure relapse times during therapy period. In order to carry out a descriptive analysis for subjects based on demographic variables and test variable frequency distribution table, mean, standard deviation and standard error of mean estimation and in order to carry out deductive analysis and hypothesis tests in dependent t-tests two-way variance analysis and Schaffer post hoc test were used. The findings of present study showed that there was a significant difference between the 2 groups in relation to addiction relapse and interaction of therapy methods with age and education exerted different effects on decrease in addiction relapse, but therapy methods together with marital status and occupation had no different effects on decrease in addiction relapse. Thus, the overall conclusion of present research is that the rate of decrease in relapse is greater in addicts under both drug therapy and group therapy than those who were only under drug therapy. Thus, it can be said that employing psychological therapies, especially Cognitive-Behavioral Group Therapy, is necessary for addicts under medical therapies and these types of therapies yield efficiency in both money and time respects.

Background: The objective of this review was to evaluate the clinical and electrophysiological findings of eight obese patients following a weight loss of more than 25 kg through diet, bariatric surgery or anorexia nervosa, coming out with peripheral nerves compression signs and symptoms.

Methods: Eight patients were studied; seven of them had walking difficulty, detecting clinical evidence of common fibular nerve injury, and another one shows unilateral ulnar nerve injury. Neurophysiological study was performed: Electromyogram (EMG). Electroneurogram (ENG): Motor and sensory conduction. Late F responses and H reflex.

Results: The common fibular nerve compression (seven patients) and ulnar compression (one patient) was confirmed by appropriate electrophysiological procedures. Widespread pathology is rejected.

Conclusion: In the peripheral nerve compression pathology there are multiple factors to consider and many neurophysiological procedures available to diagnose it. Excessive weight loss is an exceptional cause but it is essential to think about it as diagnostic, and the correct treatment will avoid an unnecessary surgical decompression.

A kinesthetic illusion induces a feeling as if an individual’s own body is moving during sensory input, even though the body is actually in a resting state. In a previous study, we reported that a visually induced kinesthetic illusion (KiNVIS) increases corticospinal tract excitability that is associated with activity of the motor-association regions. The present study explored the acute effect of KiNVIS on motor function in five patients who had experienced stroke, as a preliminary study. Five Japanese patients with stroke, who had been otherwise healthy, participated in the present trial. During KiNVIS, a display was set over the forearm so that the position of the display would give the illusion that the patient’s forearm was actually the same as that depicted in a movie. The movie showed a hand grasping and opening on the uninvolved side, and was repeatedly played for 15 min. Motor function was evaluated with the upper extremity section of the Fugl-Meyer Assessment (FMA-UE) as a primary outcome. Furthermore, we measured a performance of an appropriate motor task for each patient to detect change in motor function as a secondary outcome. In each patient, a positive effect on motor function was detected immediately after KiNVIS, and the appearance of reciprocal muscular control was observed in surface electromyography. There was no difference in the FMA-UE score between before and after the intervention; however, the score was slightly increased in two patients. Furthermore, upon comparison of the individual measurement results, each examination indicated positive changes in motor function. KiNVIS may have an acute positive effect in patients with stroke. The study provides, for the first time, evidence for the therapeutic potential of KiNVIS in stroke rehabilitation.

The aim of this research is to identify the characteristics of interpersonal and social relations that are established within the Spinal Unit of the “San Raffaele, Sulmona”. The methods that have been used are “Sociogram” by Moreno as well as individual interviews, direct and indirect observation. The sample is composed of 15 para- and quadriplegic patients of the Spinal Unit (6 females and 9 males). From the sociogram and the analysis of the leader’s and the refused member’s personality characteristics we were able in the first place to identify the difficulties of the spinal group, and also to structure future interventions to decrease the difficulties and aid compliance to treatment, rehabilitation and quality of the Department life.

The study examined the effects of a short-term web-based mindfulness program. Participants describing themselves as stressed were recruited and a total of 70 participants were randomly assigned to a treatment group (n=35) and a control group (n=35). The mindfulness program included two, 10-minute exercises per day, six days a week, for two weeks. Twenty participants in the treatment group and 34 participants in the control group completed the training. The mean pretest scores indicated that the group was above the cutoff for severe stress on a wellestablished measure (the Perceived Stress Questionnaire). Measures of stress, anxiety and depression symptoms, and a mindfulness questionnaire were administered before, during (after 1 week), and at the end of the treatment (after 2 weeks). The results showed that mindfulness training increased mindfulness skills and reduced levels of perceived stress, anxiety, and depressive symptoms (Cohen’s ds>1). No significant changes from pre- to posttest were observed in the wait-list control group. Additionally, increments from pre- to post-test in mindfulness skills were associated with reductions in symptom scores, indicating treatment-specific effects. Together, the results suggest that the brief webbased mindfulness program may serve as an effective means to treat individuals suffering from stress, and motivate further research involving active control groups, alternative forms of web-based treatments as a control, and long-term follow-up of the effects.

The use of Botulinum toxin type A (BoNT) to address spasticity has been established over the years, and recently considered first line treatment in chronic post stroke patients. With its promising results, BoNT is now being combined with early neurorehabilitation to treat post-stroke spasticity in order to address the various neuromuscular and biomechanical impairments, contracture prevention, dystonia, associated reactions and pain. The beneficial effects of BoNT as an adjunct to early stroke rehabilitation, in contrast to customary physical therapy alone, is the case in point of this review, so as to suggest another complementary treatment avenue in rehabilitation care.