ニューロリハビリテーションの国際ジャーナル

For many years, invasive neuromodulation has been used in neurorehabilitation, mainly in treatment of movement disorders and various psychiatric conditions. Use of deep brain stimulation and other implanted electrical stimulators is being explored in other conditions, such as stroke, traumatic brain injury and spinal cord injury. This paper provides a review of the possible role of Neuromodulation in neurorehabilitation and highlights some of its applications for patients with various neurological conditions. Since most of the existing findings are based on animal studies, preliminary data, case reports and poor-controlled studies, further investigations including research and clinical trials are necessary to increase the applications of neurostimulation in the field of neurorehabilitation.

Background: Upper extremity paresis post stroke is an important contributor to disability and task oriented rehabilitation aims at compensating loss of function in the affected upper extremity. Bilateral arm training focuses on coupling both the extremities during treatment to gain symmetrical and synchronous movement in both the limbs.

Objective: To analyze the efficacy of bilateral arm training over unilateral training in improving upper limb functional tasks of subjects with hemiplegia.

Methods: 30 hemiplegic subjects were randomly assigned into experimental and control groups where the former performed three sets of exercises using both the upper extremities while those in the latter group performed same exercises using only the affected extremity. Motor Activity Log (MAL) was used to quantify the treatment outcome.

Results: Pre-post comparison within groups showed significant improvement in AOU (amount of usage) and QOM (quality of movement ) components of MAL (p<0.001) in both experimental and control groups, whereas only AOU showed significant difference between the groups (p<0.05 ).

Conclusion: Bilateral arm training improved functional tasks better than unilateral arm training in subjects with hemiplegia.

Background: Evaluation and treatment of perceptual dysfunction have traditionally been emphasized by occupational therapists working with adults with brain injury. Visual perceptual problems have been well documented as they have an impact on activities such as driving and reading. Limited information is available on the effectiveness of treatment.

Objective: To study the effect of visual perceptual training combined with left hand somatosensory stimulation on reading skills in individuals with acquired right brain damage

Methods: 10 subjects with acquired right brain damage were included in the study based on selection criteria. They underwent a comprehensive occupational therapy program of visual perceptual training emphasizing on reading- related tasks and left hand somatosensory stimulation for 6 weeks. Baseline, post intervention and followup assessments were done using Test of Visual Perceptual Skills-3 (TVPS-3), Letter Cancellation Test, and Reading Ability Screening Test (RAST).

Results: The program had a significant effect on reading skills with retention on follow-up as shown by RAST (p<0.05). However, there was no significant improvement on TVPS-3 post intervention indicating a lack of generalization to skills other than reading.

Conclusion: Visual perceptual training and left hand somatosensory stimulation may be effective in remediation of reading related perceptual deficits in individuals with acquired right brain damage.

Aim: The aim of this experimental study was to examine the effect of erythropoietin on rat model and particularly in an ischemia-reperfusion (IR) protocol. The beneficial effect or non-effectiveness of that molecule was studied biochemically using blood mean total protein levels.

Materials and Methods: 40 rats of mean weight 247.7 g were used in the study. Total protein levels were measured at 60 min (groups A and C) and 120 min (groups B and D) of reperfusion. Erythropoietin was administered in groups C and D.

Results: Epo administration non-significantly decreased the predicted TP levels by 1.27% ± 1.51% (p=0.3721). Reperfusion time non-significantly increased the predicted TP levels by 1.27% +1.51% (p=0.3549). However, erythropoietin administration and reperfusion time together produced a non-significant combined effect in decreasing the predicted TP levels by 0.68% ± 2.48% (p=0.4430).

Conclusions: Erythropoietin administration interacted or not with reperfusion time has non-significant short – term decreasing effects on blood total protein levels.