NeuroRehabilitation
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NeuroRehabilitation · Jan 2012
Case ReportsRecovery of assisted overground stepping in a patient with chronic motor complete spinal cord injury: a case report.
Clinical studies have shown that after incomplete spinal cord lesions at the thoracic level, patients can develop functional gait patterns through gait training. To date, however, training has been ineffective in producing gait in patients with clinically motor complete spinal cord lesions. ⋯ Even after a motor complete lesion with some preservation of sensory pathways, the spinal cord may be able to retain some of its locomotor function through intensive gait rehabilitation.
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NeuroRehabilitation · Jan 2012
Relationship between the modified Rankin Scale and the Barthel Index in the process of functional recovery after stroke.
The modified Rankin Scale (mRS) and the Barthel Index (BI) are the most common clinimetrical instruments for measuring disability after stroke. This study investigated the relationship between the BI and the mRS at multiple time points after stroke. The BI, which is a widely used instrument for longitudinal follow-up post-stroke, was used as reference to determine the effect of time on the sensitivity of the mRS in differentiating functional recovery. ⋯ Maximum sensitivity of mRS in differentiating functional recovery is reached at six months post-stroke.
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Case report. ⋯ In our department, spinal cord injuries after stab wounds are very rare, and they usually cause incomplete lesions that eventually lead to Brown-Séquard syndrome. In our patient, the spinal cord injury was due to a vasospasm of the vertebral artery, which was accompanied by good functional prognosis. MRI helped to define the physiopathologic mechanism of the injury and guided the appropriate treatment decision.
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NeuroRehabilitation · Jan 2011
Review Historical ArticleDisorders of consciousness: what's in a name?
Following a coma, some patients may "awaken" without voluntary interaction or communication with the environment. More than 40 years ago this condition was coined coma vigil or apallic syndrome and later became worldwide known as "persistent vegetative state". About 10 years ago it became clear that some of these patients who failed to recover verbal or non-verbal communication did show some degree of consciousness--a condition called "minimally conscious state". ⋯ These neuroimaging studies have also demonstrated that a small subset of unresponsive "vegetative" patients may show unambiguous signs of consciousness and command following inaccessible to bedside clinical examination. These findings, together with negative associations intrinsic to the term "vegetative state" as well as the diagnostic errors and their potential effect on the treatment and care for these patients gave rise to the recent proposal for an alternative neutral and more descriptive name: unresponsive wakefulness syndrome. We here give an overview of PET and (functional) MRI studies performed in these challenging patients and stress the need for a separate ICD-9-CM diagnosis code and MEDLINE MeSH entry for "minimally conscious state" as the lack of clear distinction between vegetative state/unresponsive wakefulness syndrome and minimally conscious state may encumber scientific studies in the field of disorders of consciousness.
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NeuroRehabilitation · Jan 2011
ReviewDo racial and ethnic minority patients fare worse after SCI?: a critical review of the literature.
A number of researchers have identified differences in SCI outcomes between racial and ethnic groups, but findings have never been synthesized to give clinicians and researchers a coherent picture of the problem. The goals of the current project were to (1) conduct a critical literature review of studies specifically investigating racial and ethnic disparities in spinal cord injury care, services, and outcomes; (2) explore possible causative factors that may explain these disparities; (3) propose strategies that may reduce disparities and improve access, service, and outcomes for minority patients with SCI; and (4) generate ideas for future research in this area. ⋯ Results indicated that after an SCI, racial and ethnic minority groups have shorter hospital lengths of stay, higher rehospitalizations rates, higher levels of depression, more days in poor health, greater degrees of unemployment, more difficulties with mobility, lower self-reported subjective well-being and quality of life and life satisfaction, and greater risk of marital breakup. A variety of causative factors, intervention strategies, and directions for future research are presented.