Neurorehabilitation and neural repair
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Neurorehabil Neural Repair · Dec 2002
Rehabilitation Practice through Science and Research. Abstracts of the 79th annual meeting of the American Congress of Rehabilitation Medicine and the 9th annual meeting of the American Society of Neurorehabilitation. October 3-6, 2002. Philadelphia, Pennsylvania, USA.
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Neurorehabil Neural Repair · Jan 2001
Comparative StudyHigher cortical function deficits after stroke: an analysis of 1,000 patients from a dedicated cognitive stroke registry.
Despite spectacular success of animal model neuroprotective therapy in stroke, these agents have been uniformly unsuccessful in humans. One possible explanation is the crudity of cerebral measurement by insensitive of stroke scales comprising scant or absent higher cortical-function parameters and the heterogeneity of stroke syndromes and etiology. We sought to determine the frequency and extent of cognitive disorders after stroke and their relation to stroke risk factors, syndromes, lesion site, and etiology. ⋯ 1. Cognitive impairment is present in the majority of all types of stroke. 2. Cognitive impairment may be the sole presentation of stroke, unaccompanied by long-tract signs. 3. Stroke etiologic subtype differed significantly among the subgroups, but in comparison of young versus older patients, no significant differences in HCFD frequency were recorded. 4. Risk factors for developing cognitive impairment in the indigenous stroke population included increasing age, black race, overweight body habitus, and recent infection.
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Neurorehabil Neural Repair · Jan 2000
Recovery rates after stroke and their impact on outcome prediction.
Current assessments do not provide reliable factors predictive of outcome from stroke for stroke survivors of intermediate age and severity of deficit. We sought to investigate whether early rate of functional improvement can facilitate prediction of functional outcome, length of stay, and disposition beyond that afforded by age and initial severity of deficit. Prospective study of consecutive admissions to acute rehabilitation (N = 244) with diagnosis of ischemic or hemorrhagic stroke. ⋯ ROFC has an independent influence on outcome but was sufficiently powerful in our sample to identify reliably only a very small subset of patients with otherwise indeterminate prognosis. LOS seems inordinately prolonged in patients with poor outcomes. Both of these results can guide efficient rehabilitation management.
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Neurorehabil Neural Repair · Jan 2000
ReviewNeurotrophic factors and gene therapy in spinal cord injury.
Although it was once thought that the central nervous system (CNS) of mammals was incapable of substantial recovery from injury, it is now clear that the adult CNS remains responsive to various substances that can promote cell survival and stimulate axonal growth. Among these substances are growth factors, including the neurotrophins and cytokines, and growth-supportive cells such as Schwann cells, olfactory ensheathing glia, and stem cells. We review the effects of these substances on promoting axonal growth after spinal cord injury, placing particular emphasis on the genetic delivery of nervous system growth factors to specific sites of injury as a means of promoting axonal growth and, in limited instances, functional recovery.
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Neurorehabil Neural Repair · Jan 2000
Effects of aerobic treadmill training on gait velocity, cadence, and gait symmetry in chronic hemiparetic stroke: a preliminary report.
It is widely assumed that only limited improvement in functional mobility is possible beyond the subacute period following ischemic stroke. Contrary to this notion, we studied "neurologically plateaued" stroke patients with chronic hemiparesis to assess whether a "task-oriented" treadmill-training regimen would improve walking speed, cadence, and gait cycle symmetry on a modified "Get-Up and Go" task. Five male patients with a mean age of 60.4 +/- 2.7 years (mean +/- S. ⋯ Interlimb stance symmetry was unchanged. The more impaired subjects experienced the greatest gains in gait velocity and temporal measures. Collectively, these findings indicate that treadmill exercise improves functional overground mobility in individuals with chronic, stable hemiparesis.