Are musculoskeletal problems in Parkinson’s disease neglected

Parkinson’s disease – PD patients do not receive adequate treatment for musculoskeletal problems. This was the conclusion reached by Kim YE et al. from the Department of Neurology and Movement Disorder Center, Parkinson Study Group, Seoul National University Hospital, Seoul, Republic of Korea.

The researches found the prevalence of musculoskeletal problems was significantly higher in the Parkinson disease (PD) group compared to controls. However these musculoskeletal problems in the PD group tended to receive less treatment than that of the control group despite PD patients having a higher prevalence than in the controls.

Post-stroke spasticity Management

An estimated 16 million people worldwide experience first-time strokes each yea. Of these two-thirds of stroke patients are younger than 70 years of age. Stroke is therefore a leading cause of disability in adults with functional movement disability being caused by spasticity, cognitive impairment, paresis, and depression. Disabling spasticity is defined as spasticity that is severe enough to require intervention. This post-stroke spasticity  occurs in 4% of stroke survivors within 1 year of first-time stroke. Post-stroke spasticity – PSS management and rehabilitation  is discussed in Acta Neurologica Scandinavica, 05/07/2013  by Sunnerhagen KS et al. from the Institute of Neuroscience and Physiology – Section for Clinical Neuroscience and Rehabilitation, Gothenburg University, Göteborg, Sweden.

The impact of rehabilitative services in the lives of adults and children with disabilities

What is the impact of rehabilitative services in the lives of adults and children with disabilities and is their a relationship between amount of treatment and functional gains. This question was asked by Dr. Patel from St. Bartholomew’s Hospital , London , UK in Disability & Rehabilitation, 05/06/2013. Occupational therapy and physical therapy were the primary rehabilitation services received by patients across impairment groups. The authors failed to find enough evidence in the literature to answer these questions and concluded that better systematic reporting of type and quantity of rehabilitation therapies along with functional assessments is needed.

New Evidence for Therapies in Stroke Rehabilitation

A report in Current Atherosclerosis Reports, 05/03/2013 looks at the evidence based in medicine for physical therapy interventions to promote Neurologic rehabilitation post stroke.

The report by Dobkin BH et al. from Department of Neurology, Geffen School of Medicine, University of California Los Angeles, CA, USA shows that persons with serious stroke do return to participation in usual self-care and daily activities as independently as is feasible. The physical and occupational therapy detailed includes progressive task-related practice of skills, exercise for strengthening and fitness, neurostimulation, and drug and biological manipulations. The group also discuss how intensive practice can induce adaptations at multiple levels of the nervous system which lead to neuroplasticity and functional improvement.  The group discuss recent clinical trials to manage walking, reach and grasp, aphasia, visual field loss, and hemi-inattention.

Upper limb arm and hand home-based exercise training for people after stroke in the UK

New research in the UK will be conducted on administering Physiotherapy at home after stroke. Neuro physical therapists from Bristol, Birmingham and Newcastle will recruit patients with upper-limb motor impairment including shoulder  and hand movement deficits after discharge from hospital post-stroke. The stroke patients will be up to 12 months post stroke. The primary outcome measures for assessment of arm function will be the Action Research Arm Test (ARAT) and Wolf Motor Function Test (WMFT). The secondary measures will be the Motor Activity Log, Stroke Impact Scale, Carer Strain Index, and health and social care resource use.

Resting-State fMRI pinpoints changes in brain organization after TBI

Evidence from functional MRI findings show the traumatic effect on brain network function of traumatic brain injury (tbi). Writing in Neurology, 04/26/2013 Zhou Y et al. from New York University Langone Medical Center, New York.USA report that RS-fMRI shows a variety of changes in subjects after mild TBI that may be responsible for both physical deficits and behavioral symptoms following traumatic brain injury.

Chronic pain syndromes after ischemic stroke

Chronic pain syndromes after ischemic stroke and are associated with increased functional dependence and cognitive decline.

Writing in Stroke, 05/01/2013 O’Donnell MJ et al from McMaster University Ontario,Canada looks at a large cohort with ischemic stroke. Of these stroke patients ~ 11% reported new chronic post stroke pain, with 3% central post stroke pain and 1.5% with peripheral neuropathic pain and 1.3% with pain from spasticity. The group concluded that Chronic pain syndromes after ischemic stroke and are associated with increased functional dependence and cognitive decline.

 

Telerehabilitation for addressing executive dysfunction after traumatic brain injury

Telerehabilitation allows for the delivery of cognitive training post traumatic brain injury. Writing in Brain Injury, 05/01/2013 Ng EMW et al. from Toronto Rehabilitation Institute, University Health Network , Toronto, ON look at the delivery of the Cognitive Orientation to daily Occupational Performance approach (CO-OP) in a telerehabilitation format. Using the Outcome measures included the Canadian Occupational Performance Measure, the Mayo-Portland Adaptability Inventory-4 Participation Index, and the Dysexecutive Questionnaire the group conclude that Telerehabilitation can be used for addressing executive dysfunction after traumatic brain injury and may help promote community integration of individuals living with TBI.

Patient functioning after traumatic brain injury

Laxe S et al. disucuss International Classification on Functioning in Brain Injury, 05/01/2013.

The group from Brain Injury Unit, Institut Guttmann-Universitat Autónoma de Barcelona Spain report on the use of 23 Brief Core Sets within the International Classification on Functioning, Disability and Health (ICF) as a basic international standard for the multidisciplinary assessment of a TBI patient’s functioning.

 

Neurosteroids as neuroprotectants for the treatment of Parkinsons disease (PD)

Parkinson’s disease (PD) is associated with a massive loss of dopaminergic cells in the substantia nigra leading to dopamine hypofunction and alteration of the basal ganglia circuitry. Writing in Experimental Neurologydi Michele F et al from Fondazione Santa Lucia, Rome, Italy reviews the roles of Neurosteroids – NS acting as neuroprotectants and as GABAA receptor agonists in the physiology and pathophysiology of the basal ganglia. He looks at their impact on dopaminergic cell activity and survival. The review article then considers their potential therapeutic application in PD.