Cognitive Neurorehabilitation of HIV-Associated Neurocognitive Disorders: A Qualitative Review and Call to Action.
Cognitive Neurorehabilitation of HIV-associated Neurocognitive Disorders: A Qualitative Review and Call to Action.
Filed under: Rehab Centers
Neuropsychol Rev. 2013 Feb 16;
Weber E, Blackstone K, Woods SP
Despite significant advances in the virologic management of HIV infection over the last two decades, effective treatments for HIV-associated neurocognitive disorders (HAND) remain elusive. While pharmacological interventions have yielded some success in improving neurocognitive outcomes in HIV, there is a dearth of rigorous studies examining the efficacy of cognitive rehabilitation for remediating HIV-associated neurocognitive impairment. This qualitative review summarizes and critiques the emerging literature on cognitive and behavioral treatments for HAND, which provides many reasons for optimism, but also has major limitations that underscore the scope of the work that lies ahead. Considering the notable real-world consequences of HAND, the development, validation, and clinical deployment of cognitive neurorehabilitation interventions tailored to the needs of persons living with HIV infection is a priority for clinical neuroAIDS investigators. In describing potential future directions for this endeavor, particular attention was paid to the application of cognitive neuropsychological principles in developing theory-driven approaches to managing HAND, improving everyday functioning, and enhancing HIV health outcomes.
HubMed – rehab
Unilateral Superior Laryngeal Nerve Lesion in an Animal Model of Dysphagia and Its Effect on Sucking and Swallowing.
Filed under: Rehab Centers
Dysphagia. 2013 Feb 16;
Ding P, Campbell-Malone R, Holman SD, Lukasik SL, Fukuhara T, Gierbolini-Norat EM, Thexton AJ, German RZ
We tested two hypotheses relating to the sensory deficit that follows a unilateral superior laryngeal nerve (SLN) lesion in an infant animal model. We hypothesized that it would result in (1) a higher incidence of aspiration and (2) temporal changes in sucking and swallowing. We ligated the right-side SLN in six 2-3-week-old female pigs. Using videofluoroscopy, we recorded swallows in the same pre- and post-lesion infant pigs. We analyzed the incidence of aspiration and the duration and latency of suck and swallow cycles. After unilateral SLN lesioning, the incidence of silent aspiration during swallowing increased from 0.7 to 41.5 %. The durations of the suck containing the swallow, the suck immediately following the swallow, and the swallow itself were significantly longer in the post-lesion swallows, although the suck prior to the swallow was not different. The interval between the start of the suck containing a swallow and the subsequent epiglottal movement was longer in the post-lesion swallows. The number of sucks between swallows was significantly greater in post-lesion swallows compared to pre-lesion swallows. Unilateral SLN lesion increased the incidence of aspiration and changed the temporal relationships between sucking and swallowing. The longer transit time and the temporal coordinative dysfunction between suck and swallow cycles may contribute to aspiration. These results suggest that swallow dysfunction and silent aspiration are common and potentially overlooked sequelae of unilateral SLN injury. This validated animal model of aspiration has the potential for further dysphagia studies.
HubMed – rehab
Effect of a Cane on Sit-to-Stand Transfer in Subjects with Hemiparesis.
Filed under: Rehab Centers
Am J Phys Med Rehabil. 2013 Mar; 92(3): 191-202
Hu PT, Lin KH, Lu TW, Tang PF, Hu MH, Lai JS
OBJECTIVE: The aim of this study was to determine the effect of using a cane on movement time, joint moment, weight symmetry, and muscle activation patterns during sit-to-stand (STS) transfer in healthy subjects and subjects who have had a stroke. DESIGN: Nine subjects with hemiparesis (mean [SD] age, 61.11 [12.83] yrs) and nine healthy adults (mean [SD] age, 63.11 [10.54] yrs) were included. The subjects with hemiparesis performed STS transfer in two randomly assigned conditions: (1) without a cane and (2) with a cane. The healthy subjects performed only STS transfer without a cane. A three-dimensional motion system, force plates, and eletromyography were used to examine STS transfer. The symmetry index between the two limbs was calculated. RESULTS: The movement time of the subjects with hemiparesis in both conditions without a cane and with a cane was longer than that of the healthy subjects without a cane (P < 0.025). However, STS transfer with a cane in the subjects with hemiparesis resulted in shorter movement time, greater knee extensor moment of the paretic limb, and more symmetry of weight bearing than in those without a cane (P < 0.05). The sequence of muscle onset tended to improve with a cane in the subjects with hemiparesis. CONCLUSIONS: Cane use may promote more symmetrical STS transfers rather than compensation by the unaffected limb. HubMed – rehab
The nobel prize, stem cells, and rehabilitation.
Filed under: Rehab Centers
Am J Phys Med Rehabil. 2013 Mar; 92(3): 189-90
Frontera WR
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