Prism Adaptation Improves Ego-Centered but Not Allocentric Neglect in Early Rehabilitation Patients.

Prism Adaptation Improves Ego-Centered but Not Allocentric Neglect in Early Rehabilitation Patients.

Neurorehabil Neural Repair. 2013 Mar 7;
Gossmann A, Kastrup A, Kerkhoff G, Herrero CL, Hildebrandt H

BACKGROUND: and OBJECTIVE: . Unilateral neglect due to parieto-temporo-frontal lesions has a negative impact on the success of rehabilitation, and prism adaptation (PA) enhances recovery from neglect. However, it is unclear if this effect holds also in severely impaired patients and/or in the postacute phase of rehabilitation. Moreover, it is not known whether PA affects all aspects of neglect recovery or ego-centered spatial orientation only. METHODS: . Sixteen patients in a postacute stage (on average 36 days after a large right cerebrovascular stroke) were entered into a series of single case design studies with 4 measurements: 2 before and 2 after 1 week of PA treatment. All patients had severe neglect (showing trunk, head, and eye deviation; canceling less than 20% of targets in a visual cancellation test). Lesions were transferred to a standard brain to analyze size and location. RESULTS: . Patients improved in cued body orientation and in the cancellation task, that is, in ego-centered neglect. However, none of the measures used to evaluate neglect of left side of objects irrespective of their position on the right or left side of the patient (allocentric neglect) showed an improvement. Treatment effects were not influenced by total lesion size, but lesions including the postcentral cortex were related to smaller recovery gains. CONCLUSION: . PA is helpful in treating severely impaired patients in the postacute phase, but the effect is restricted to ego-centered neglect. Lesions in the postcentral cortex (middle occipito-temporal, middle temporal, and posterior parietal areas) seem to limit the effect of PA. HubMed – rehab


Effects of deception for intensity on surface electromyogram (SEMG) activity and blood lactate concentration during intermittent cycling followed by exhaustive cycling.

Acta Physiol Hung. 2013 Mar; 100(1): 54-63
Matsuura R, Arimitsu T, Yunoki T, Kimura T, Yamanaka R, Yano T

The purpose of the present study was to determine the effects of deception for exercise intensity on surface electromyogram (SEMG) activity and blood lactate concentration during intermittent cycling exercise (ICE) tests. Sixteen healthy male were randomly assigned to two groups who completed two ICE [three 4-min cycling at 80% peak power output (PPO) with 3-min passive recovery periods followed by exhaustive cycling] tests (ICE-1 and ICE-2). The experimental group (ICED) was deceived of the actual cycling intensity, while the control group (ICEC) was informed of the actual protocol in ICE-2. In ICE-1, both groups were informed of the actual protocol. In ICE-2, root mean square (RMS) calculated from SEMG during submaximal cycling was significantly higher in the ICEC than in the ICED and blood lactate concentration ([La-]) was significantly higher in the ICEC than in the ICED. In particular, the difference in RMS between the groups was also observed during the first 4-min cycling, in which there was no difference in [La-] between the groups. These results suggest that the CNS modulates skeletal muscle recruitment due to the prior deception for exercise intensity. HubMed – rehab


Survival times of patients with a first hip fracture with and without subsequent major long-bone fractures.

J Nippon Med Sch. 2013; 80(1): 42-9
Angthong C, Angthong W, Harnroongroj T, Naito M, Harnroongroj T

Objectives: Survival rates are poorer after a second hip fracture than after a first hip fracture. Previous survival studies have included in-hospital mortality. Excluding in-hospital deaths from the analysis allows survival times to be evaluated in community-based patients. There is still a lack of data regarding the effects of subsequent fractures on survival times after hospital discharge following an initial hip fracture. This study compared the survival times of community-dwelling patients with hip fracture who had or did not have a subsequent major long-bone fracture. Hazard ratios and risk factors for subsequent fractures and mortality rates with and without subsequent fractures were calculated. Materials and Methods: Of 844 patients with hip fracture from 2000 through 2008, 71 had a subsequent major long-bone fracture and 773 did not. Patients who died of other causes, such as perioperative complications, during hospitalization were excluded. Such exclusion allowed us to determine the effect of subsequent fracture on the survival of community-dwelling individuals after hospital discharge or after the time of the fracture if they did not need hospitalization. Demographic data, causes of death, and mortality rates were recorded. Differences in mortality rates between the patient groups and hazard ratios were calculated. Results: Mortality rates during the first year and from 1 to 5 years after the most recent fracture were 5.6% and 1.4%, respectively, in patients with subsequent fractures, and 4.7% and 1.4%, respectively, in patients without subsequent fractures. These rates did not differ significantly between the groups. Cox regression analysis and calculation of hazard ratios did not show significant differences between patients with subsequent fractures and those without. On univariate and multivariate analyses, age <75 years and male sex were risk factors for subsequent fracture. Conclusions: This study found that survival times did not differ significantly between patients with and without subsequent major long-bone fractures after hip fracture. Therefore, all patients with hip fracture, with or without subsequent fractures, need the same robust holistic care. The risks of subsequent fractures should be addressed in patients with hip fracture and should be reduced where possible by education regarding fracture prevention and regular rehabilitation programs. Efforts should be made to decrease the rates of major long-bone fractures and their burdens, even though such fractures have only a minor effect on survival in community-dwelling individuals. HubMed – rehab


Genetic and environmental influences on blood pressure variability: a study in twins.

J Hypertens. 2013 Apr; 31(4): 690-697
Xu X, Ding X, Zhang X, Su S, Treiber FA, Vlietinck R, Fagard R, Derom C, Gielen M, Loos RJ, Snieder H, Wang X

OBJECTIVES:: Blood pressure variability (BPV) and its reduction in response to antihypertensive treatment are predictors of clinical outcomes; however, little is known about its heritability. In this study, we examined the relative influence of genetic and environmental sources of variance of BPV and the extent to which it may depend on race or sex in young twins. METHODS:: Twins were enrolled from two studies. One study included 703 white twins (308 pairs and 87 singletons) aged 18-34 years, whereas another study included 242 white twins (108 pairs and 26 singletons) and 188 black twins (79 pairs and 30 singletons) aged 12-30 years. BPV was calculated from 24-h ambulatory blood pressure recording. RESULTS:: Twin modeling showed similar results in the separate analysis in both twin studies and in the meta-analysis. Familial aggregation was identified for SBP variability (SBPV) and DBP variability (DBPV) with genetic factors and common environmental factors together accounting for 18-40% and 23-31% of the total variance of SBPV and DBPV, respectively. Unique environmental factors were the largest contributor explaining up to 82-77% of the total variance of SBPV and DBPV. No sex or race difference in BPV variance components was observed. The results remained the same after adjustment for 24-h blood pressure levels. CONCLUSIONS:: The variance in BPV is predominantly determined by unique environment in youth and young adults, although familial aggregation due to additive genetic and/or common environment influences was also identified explaining about 25% of the variance in BPV. HubMed – rehab



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