Stroke and sensory rehabilitation research


JRRD tipsheet

Auditory brainstem responses detect early ototoxicity, pg 373

This study compares two test methods of auditory brainstem responses (ABRs) for the early detection of ototoxic hearing loss. In the first method, ABRs elicited by single-tone bursts (STB) stimuli were compared with those elicited by conventional and high frequency (HF) clicks. HF clicks produced a larger, more robust response and were more time-efficient than STBs. In the second method, single as well as trains of tone bursts elicited ABRs. The trains of stimuli allow more efficient data collection. The current study can potentially minimize or prevent debilitating hearing loss through early detection of hearing deficits before speech perception is impaired.

Obstacle avoidance training improves walking in individuals with poststroke hemiplegia, pg 283

This study evaluates two training interventions to improve gait velocity and stepping distance in individuals with poststroke hemiplegia whose walking ability has been compromised. Twenty volunteers with poststroke hemiplegia completed six sessions where they were asked to step over either virtual objects while walking on a motorized treadmill or real foam objects on a 10-meter walkway. The volunteers showed clinically meaningful changes in gait velocity, stride length, walking endurance, and obstacle clearance capacity as a result of either training method. Data suggest improved walking performance enhances the ability of persons with poststroke hemiplegia to negotiate steps, obstacles, and uneven surfaces and walk independently.

Blind rehabilitation improves mobility function in older veterans, pg 337

Orientation and mobility training for persons with visual impairment is evaluated in this article. One hundred twenty-eight veterans who are legally blind rated how difficult they found each of 34 mobility situations at the beginning and two months after completing a blind rehabilitation program. They also rated their confidence in different travel situations and provided information about falls and fear of falling before and after rehabilitation. Veterans reported significantly less difficulty performing 26 of 34 mobility tasks following rehabilitation. They also reported higher levels of confidence in their mobility and fewer falls following rehabilitation.

Automated constraint-induced therapy delivers same health benefits as traditional CI therapy, pg 249

Article discusses the development of Automated Constraint-Induced Therapy Extension (AutoCITE), a workstation delivering the task practice component of upper-limb constraint-induced movement therapy (CI therapy). Nine patients with chronic stroke with mild to moderate motor deficits practiced with AutoCITE for three hours per day for two weeks. Patients who received rehabilitation therapy with AutoCITE received the same health benefits as a matched group of 12 patients who received standard CI therapy. AutoCITE eliminates the need for one-on-one supervision from a therapist, substantially reducing the cost of CI therapy by allowing patients to perform the exercises at home or by having a therapist treat multiple patients simultaneously in the clinic.

Resistance training improves strength in persons with post-stroke hemiplegia, pg 293

This review of literature discusses the relationship between weakness and motor dysfunction and the effects of strengthening persons with hemiplegia following stroke. Nine studies published between 1973 and the present report results of strengthening for hemiparetic persons. Data indicate that strengthening in adults with post stroke hemiparesis does not produce harmful effects. Hemiparetic persons can produce significant strength gains in response to resistance training. Strength gains appear to transfer to functional movements including sit-to-stand, gait, and reaching. This review paper reports the current state of our understanding and proposes several lines of potential investigation to advance this area of rehabilitation practice.

The experience of time in the transition from hospital to home following stroke, pg 259

This preliminary study describes the transition from hospital to home during the first month after discharge following acute stroke. Findings indicate that changes in the temporal order of life are related to functional impairments and disruption in the taken-for-granted body. At one month post-discharge, survivors are struggling with establishing routines and coping with an increased amount of idle time. Three implications for rehabilitation therapists charged with the responsibility for preparing patients for discharge can be defined from the study: helping patients establish routines, understanding patients are testing physical capabilities while their self concept is changing, and assisting patients to find meaningful activities.

Functional status and quality of life among persons with stroke, pg 279

This study explores the relationship between functional status and self-reported quality of life among patients with stroke. Patients at eight VA medical centers were interviewed at 1, 6, and 12 months poststroke. There was a weak relationship between functional status and quality of life. The improvement in quality of life over time after stroke is modest at best. Patients with similar levels of disability reported quite different quality of life. Quality of life after major stroke may not necessarily be as low as previously reported. Individual response to stroke differs markedly, and quality of life depends on more than just level of physical function.

Peripheral vision may hold promise to compensate for central vision loss, pg 359

This study measures the visual abilities of the peripheral retina. Four normally sighted, healthy adults looked at the center of a computer monitor while patterns of different sizes, contrasts, and durations were presented at many places on the screen. Although the peripheral retina was never as good as the central retina in seeing patterns, there were some areas where vision was relatively better than others. Data yielded from this study could be used to measure the effectiveness of rehabilitation programs that train patients with central vision loss to use other areas of the retina to read.

Application of adaptive filters to visual testing and treatment in acquired pendular nystagmus, pg 313

In this study, investigators implement an adaptive filter algorithm on a desktop computing platform and test the ability of this filter, when coupled to either a shutter mechanism or a simulated image-shifting mechanism, to restore acuity in normal subjects in whom the visual effects of acquired pendular nystagmus (APN) were simulated by oscillating visual targets. The adaptive filter algorithm, when coupled to image stabilization optics, is a promising new strategy for alleviating visual disability in patients with APN. While the immediate goal of this research is to develop a visual aid for patients with APN, the basic strategy of computer controlled image-shifting optics may ultimately be applicable to other eye movement disorders.

Image-shifting optics for a nystagmus treatment device, pg 325

This study describes research aimed at developing a visual aid for patients with acquired pendular nystagmus (APN), a particularly disabling form of ocular oscillation. A prototype image-shifting mechanism was built from elements salvaged from a commercial image-stabilizing lens and integrated with nystagmus-tracking software. The prototype image-shifting optics exhibited characteristics suitable for use in a future APN treatment device, requiring low current, generating minimal waste heat, and exhibiting low degrees of distortion over the frequency range relevant to APN. In combination with software designed to track nystagmus, the optical mechanism proved capable of improving acuity in normal subjects experiencing simulated two-dimensional nystagmus.

Why ethnic designation matters for stroke rehabilitation, pg 269

This study examines agreement in ethnic designation between VA administrative and medical rehabilitation data. Ethnic designations from an FY 2001 stroke cohort drawn from medical rehabilitation records were compared for reliability with ethnic identifiers in the main VA administrative records. Subject analyses examining differences among black, Hispanic, and white veterans in rehabilitation assessments and outcomes were then compared. Agreement for ethnic identification between medical rehabilitation records and administrative data was good, with reliability for individual ethnic groups ranging from moderate to very good. However, statistical significance of results comparing admission severity and length of stay differed notably among ethnic groups.

Driving performance of people with diabetic retinopathy, pg 347

This study identifies clinical vision measures associated with the driving performance of patients with diabetic retinopathy. Twenty-five licensed drivers with diabetic retinopathy completed clinical tests and structural examinations. Driving performance was assessed with an interactive driving simulator and a driving history questionnaire. Increased retinal thickness was significantly correlated with a higher frequency of simulator accidents and near accidents. Laser scar grades significantly correlated with steeper brake-response, increased brake-pressure, and longer response times. Patients with focal laser scars had significantly higher average brake-pedal pressure and brake-pressure than patients without focal laser scars. Retinal thickness and laser scarring correlated with driving simulator performance in subjects with diabetic retinopathy.

Source: Eurekalert & others

Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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