Factors Contributing to Limited or Non-Use in the Cochlear Implant Systems in Children: 11 Years Experience.
Factors contributing to limited or non-use in the cochlear implant systems in children: 11 years experience.
Filed under: Rehab Centers
Int J Pediatr Otorhinolaryngol. 2012 Dec 29;
Ozdemir S, Tuncer U, Tarkan O, K?ro?lu M, Cetik F, Akar F
OBJECTIVES: The aim of this study was to analyze the incidence and etiologic factors of non-use and limited use of cochlear implants. The patients’ age, gender, duration of implantation and additional disabilities were investigated. PATIENTS AND METHODS: Of the 413 (200 males, 213 females) pediatric patients (age under 16) implanted in our clinic between January 2000 and December 2011, 12 limited user/non-user cochlear implanted patients were selected who had a follow-up of at least 24 months. Preoperative and postoperative listening progress profile (LiP) and meaningful auditory integration scale (MAIS) tests were performed to analyze the auditory performances of the patients. RESULTS: In total of 12 recipients (2.90%) (7 male and 5 female patients; age range, 5-13 years), 4 (0.96%) patients were non-users and 8 (1.93%) patients were limited users. The patients had some additional disabilities as autism, cerebral palsy, moderate mental retardation, attention deficit/hyperactivity disorder, ossified cochlea due to meningitis and learning disability-lack of family interest. None had experienced device failure. In the postoperative 24th month, listening progress profile and meaningful auditory integration scale test scores were better in the limited users as expected. CONCLUSIONS: It should always be considered in patients with additional factors like autism, mental-motor retardation, learning disabilities that they will show limited development from cochlear implantation. These patients are potential limited/non-users. These patients require unique rehabilitation and provide high family and educational interest.
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A case of atypical benign partial epilepsy with action myoclonus.
Filed under: Rehab Centers
Seizure. 2012 Dec 29;
Kobayashi S, Inui T, Wakusawa K, Tanaka S, Nakayama T, Uematsu M, Takayanagi M, Yamamoto T, Haginoya K
We describe a boy, 3 years and 6 months old, who experienced a rolandic seizure accompanied by a cluster of atypical absence seizures, the EEGs for which corresponded to those of atypical benign partial epilepsy (ABPE). Of note, this patient suffered from developmental delay beginning in infancy and exhibited giant middle-latency somatosensory evoked potentials with action myoclonus. With the exceptions of ethosuximide, acetazolamide, and adrenocorticotropic hormone, which have been reported to be effective in ABPE, the atypical absence seizures were intractable despite extensive treatment with various anticonvulsants. The drugs that were effective led to a remarkable reduction in seizure frequency and EEG improvement, but the efficacy was temporary. The patient demonstrated moderate mental retardation without regression and could not walk with support or speak any meaningful words at the age of 3 years and 6 months. Based on thorough differential diagnosis, although further studies will be necessary, we propose that this boy may present a new phenotype of ABPE: ABPE with action myoclonus.
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The home stroke rehabilitation and monitoring system trial: a randomized controlled trial.
Filed under: Rehab Centers
Int J Stroke. 2013 Jan; 8(1): 46-53
Linder SM, Rosenfeldt AB, Reiss A, Buchanan S, Sahu K, Bay CR, Wolf SL, Alberts JL
Because many individuals poststroke lack access to the quality and intensity of rehabilitation to improve upper extremity motor function, a home-based robotic-assisted upper extremity rehabilitation device is being paired with an individualized home exercise program.The primary aim of this project is to determine the effectiveness of robotic-assisted home therapy compared with a home exercise program on upper extremity motor recovery and health-related quality of life for stroke survivors in rural and underserved locations. The secondary aim is to explore whether initial degree of motor function of the upper limb may be a factor in predicting the extent to which patients with stroke may be responsive to a home therapy approach. We hypothesize that the home exercise program intervention, when enhanced with robotic-assisted therapy, will result in significantly better outcomes in motor function and quality of life.A total of 96 participants within six-months of a single, unilateral ischemic, or hemorrhagic stroke will be recruited in this prospective, single-blind, multisite randomized clinical trial.The primary outcome is the change in upper extremity function using the Action Research Arm Test. Secondary outcomes include changes in: upper extremity function (Wolf Motor Function Test), upper extremity impairment (upper extremity portion of the Fugl-Meyer Test), self-reported quality of life (Stroke Impact Scale), and affect (Centers for Epidemiologic Studies Depression Scale).Similar or greater improvements in upper extremity function using the combined robotic home exercise program intervention compared with home exercise program alone will be interpreted as evidence that supports the introduction of in-home technology to augment the recovery of function poststroke.
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Stroke, cognitive deficits, and rehabilitation: still an incomplete picture.
Filed under: Rehab Centers
Int J Stroke. 2013 Jan; 8(1): 38-45
Cumming TB, Marshall RS, Lazar RM
Cognitive impairment after stroke is common and can cause disability with major impacts on quality of life and independence. There are also indirect effects of cognitive impairment on functional recovery after stroke through reduced participation in rehabilitation and poor adherence to treatment guidelines. In this article, we attempt to establish the following: ? whether there is a distinct profile of cognitive impairment after stroke; ? whether the type of cognitive deficit can be associated with the features of stroke-related damage; and ? whether interventions can improve poststroke cognitive performance. There is not a consistent profile of cognitive deficits in stroke, though slowed information processing and executive dysfunction tend to predominate. Our understanding of structure-function relationships has been advanced using imaging techniques such as lesion mapping and will be further enhanced through better characterization of damage to functional networks and identification of subtle white matter abnormalities. Effective cognitive rehabilitation approaches have been reported for focal cortical deficits such as neglect and aphasia, but treatments for more diffusely represented cognitive impairment remain elusive. In the future, the hope is that different techniques that have been shown to promote neural plasticity (e.g., exercise, brain stimulation, and pharmacological agents) can be applied to improve the cognitive function of stroke survivors.
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