国际神经康复杂志

Objective: The National Agency for Automotive Safety and Victims’ Aid score original (NASVA score-O) is an evaluative assessment for patients in an unresponsive wakefulness state (UWS). The objective was to examine the difficulty of each sub-item of the NASVA score-O and its suitability for the assessment of patients in a UWS. Methods: The participants were 134 patients in a UWS (96 men, 38 women; age range at admission, 9-83 years). The scaled NASVA score-O, an outfit mean square (MNSQ), and an infit MNSQ for each sub-item using Rasch modeling were calculated. The 48 sub-items were arranged in order of the score of the item measures, and a difficulty map was created. The suitability of the 48 sub-items was analyzed using the outfit and the infit MNSQs. Results: Ten sub-items were classified as misfits, and the item measure of five sub-items was -5.1 points. Conclusions: Medical staff and family members may be able to set suitable short-term goals and adapt caregiving methods to the recovery process using the difficulty map. It is necessary to remove 10 misfit sub-items, modify the questions, or create an interpretation manual and to reanalyze it without the five sub-items with negative points.

International Journal of Neurorehabilitation is an Open Access, rapid peerreviewed journal that aims to publish the most complete and reliable source of information on discoveries and current developments which encourages innovative research, covering all aspects of Neurology and Neurorehabilitation.

Background: VR has proven successful in simulating activities and settings that prove inaccessible or unsafe to rehabilitate patients in. Current VR rehabilitation studies largely focus on assessing cognitive skills, not on training cognitive deficits. The current study focused on repeated exposure with a VR-based cognitive intervention to improve deficits known to impact the ability to resume complex activities. Associations between the VR Stroop and neuropsychological, speech therapy, and global rehabilitation measures were examined. We included a brain injured control group to address this frequently cited methodological concern. Design: This was a mixed design study with quasi-experimental Intervention group (N = 12) and retrospective Control group (N = 12). Both groups comprised individuals with brain injury admitted to an outpatient day neurorehabilitation program. Results: Patients with higher level of education and shorter acute medical course deliberated longer before responding on specific Virtual Stroop indices. The brain injury group receiving Virtual Stroop intervention demonstrated a significant increase in level of independence in the home and in community participation by discharge from day neurorehabilitation, compared with the Control group. Increased independence of the virtual reality group was associated with improved attention and self-monitoring, and less disinhibition on the Virtual Stroop. Conclusion: Patients with brain injury demonstrated improvements in various executive functioning and attention indices on the Virtual Stroop, compared with patients who received standard neurorehabilitation. Neurocognitive training within an immersive real-world setting was associated with improved global and specific neurorehabilitation outcomes. Performance on the Virtual Stroop also demonstrated a relationship with cognitive flexibility on traditional neuropsychological testing.

Attention deficits as well as aphasia are being frequently observed among post-stroke patients. However, studies analysing attentional deficits of aphasic patients in the acute phase after stroke are rare. Therefore, the aim of the study was to investigate attentional deficits in stroke patients with aphasia, the relationship between attentional and linguistic deficits as well as changes in these domains from acute to post-acute phase. Twelve patients with first insult in the left hemisphere, aged between 45 to 88 years were included. Each patient completed a linguistic and a neuropsychological assessment Bielefeld Aphasie Screening (BiAS); attention test of the Aphasie-Check-Liste (ACL); Reduced Symbol-Digit-Test (R-SDT) in the acute as well as in the post-acute phase after stroke. In the acute phase, 91.67% (n=11/12) of the aphasic patients showed attentional deficits. While the percentage of errors in the ACL attention test of the ACL negatively correlated with the necessary number of repetitions of the instructions in the BiAS (p<.01) in the acute phase; the number of necessary repetitions in the BiAS was associated with the processing time of the R-SDT (p<.05) in the post-acute phase. In this study, a significantly positive relationship between language functions and attentional performance was observed in both, the acute and post-acute phase after stroke.