Multidisciplinary Care for Stroke Patients Living in the Community: A Systematic Review.

Multidisciplinary care for stroke patients living in the community: A systematic review.

J Rehabil Med. 2013 Mar 28; 45(4): 321-30
Fens M, Vluggen T, van Haastregt JC, Verbunt JA, Beusmans GH, van Heugten CM

Objective: A systematic review of randomized controlled trials was performed to evaluate the effectiveness of multidisciplinary care for stroke patients living in the community. Data sources: Databases PubMed, EMBASE, CINAHL and the Cochrane Library from January 1980 until July 2012. Study selection: Randomized controlled trials focused on multidisciplinary interventions for stroke patients living at home after hospitalization or inpatient rehabilitation were selected. The outcome domains were activities of daily living, social participation and quality of life. A total of 14 studies were included. Data extraction: Two authors independently extracted the data and independently assessed the quality of reporting of the included studies using the Consolidated Standards of Reporting Trials (CONSORT) statement 2010. Data synthesis: None of the studies showed favourable effects of the intervention on activities of daily living and none assessed social participation. Furthermore, two studies reported favourable effects of the intervention in terms of quality of life. These concerned an intervention combining assessment with follow-up care and a rehabilitation intervention. Conclusion: There is little evidence for the effectiveness of multidisciplinary care for stroke patients being discharged home. Additional research should provide more insight into potentially effective multidisciplinary care for community-living stroke patients. HubMed – rehab

Successful treatment of heart failure in an adult patient with prader-willi syndrome.

Intern Med. 2013; 52(7): 771-6
Kawano H, Ikeda T, Shimazaki K, Arakawa S, Matsumoto Y, Hayano M, Maemura K

Prader-Willi Syndrome (PWS) is a rare genetic disorder characterized by physical, psychological and physiological abnormalities. Obesity and related cardiovascular diseases are a common problem in adult patients with PWS. This report describes a case of adult PWS with heart failure associated with marked obesity and sleep-disordered breathing that was successfully treated with oxygen therapy, adaptive servoventilation, medications, diet therapy and rehabilitation. HubMed – rehab

Management options of chronic low back pain. A randomized blinded clinical trial.

Neurosciences (Riyadh). 2013 Apr; 18(2): 152-9
Nazzal ME, Saadah MA, Saadah LM, Al-Omari MA, Al-Oudat ZA, Nazzal MS, El-Beshari MY, Al-Zaabi AA, Alnuaimi YI

To compare efficacies of 2 active programs in the management of chronic low back pain (CLBP).This prospective, stratified, randomized single-blinded controlled study was conducted in the Department of Rehabilitation Medicine, King Abdullah University Hospital, Irbid, Jordan, between February and December 2010. A total of 100 patients were randomized to either 6-weeks of multidisciplinary rehabilitation (group A) or therapist-assisted exercise (group B). At baseline and 6 weeks, the visual analogue scale (VAS) pain score was estimated, as a primary outcome measure. McGill pain score, Oswestry Disability Index (ODI), trunk forward flexion and extension, left and right lateral bending, were applied before and after treatment and were employed as secondary outcome measures.All outcome measures significantly improved in group A after treatment, compared with group B. The VAS, McGill, ODI scores, left and right lateral bending decreased significantly, whereas forward and backward bending increased. A significant number of patients returned to work in group A at the end of 6 weeks, compared with group B. These effects were maintained over 12 and 24 weeks of follow-up.Multidisciplinary rehabilitation improved functional indices and pain scale scores in group A compared with B. This would be an effective strategy in CLBP management. HubMed – rehab

PKC activation during training restores mushroom spine synapses and memory in the aged rat.

Neurobiol Dis. 2013 Mar 29;
Hongpaisan J, Xu C, Sen A, Nelson TJ, Alkon DL

Protein kinase C (PKC) ? and ? activation has been implicated in synaptogenesis. We used aged rats to test whether the PKC?/? activator bryostatin and PKC?-specific activator DCP-LA combined with spatial memory training could restore mushroom dendritic spinogenesis and synaptogenesis. Compared with young rats, aged, learning-impaired rats had lower memory retention; lower densities of mushroom spines and synapses in the apical dendrites of CA1 pyramidal neurons; fewer PKC?-containing presynaptic axonal boutons; and lower activation and expression of two PKC?/? substrates, the mRNA-stabilizing protein HuD and brain-derived neurotrophic factor (BDNF). PKC activator treatment combined with spatial memory training restored mushroom spines and mushroom spine synapses; rescued PKC?/? expression and PKC/HuD/BDNF signaling; and normalized memory to the levels seen in young rats. These effects were produced by treatment with either bryostatin or the PKC?-specific activator, DCP-LA. Bryostatin also reversed alterations in GABAergic inhibitory postsynaptic currents (IPSPs) in aged, learning-impaired rats. Thus, our results support the therapeutic potential of PKC activators when added to cognitive rehabilitation for inducing mushroom spine synaptogenesis and reversing memory decline associated with aging. HubMed – rehab