Rehab Centers: The Effect of High and Low Frequency Repetitive Transcranial Magnetic Stimulation on Visuospatial Neglect in Acute Stroke Patients: A Double-Blind, Sham-Controlled Trial.

The Effect of High and Low Frequency Repetitive Transcranial Magnetic Stimulation on Visuospatial Neglect in Acute Stroke Patients: A Double-Blind, Sham-Controlled Trial.

Filed under: Rehab Centers

Arch Phys Med Rehabil. 2013 Jan 5;
Kim BR, Chun MH, Kim DY, Lee SJ

OBJECTIVE: To compare the therapeutic effect of low- and high-frequency repetitive transcranial magnetic stimulation (rTMS) of the posterior parietal cortex (PPC) in acute stroke patients with visuospatial neglect. DESIGN: This study was a prospective, double-blind, sham-controlled trial. Data are presented from 27 patients (15 male, 12 female; mean age 67.0 years) randomly assigned to receive 10 sessions of low-frequency (1 Hz) rTMS over the non-lesioned PPC, high-frequency (10 Hz) rTMS over the lesioned PPC, or sham stimulation. SETTING: National University Hospital PARTICIPANTS: Twenty-seven patients diagnosed with visuospatial neglect following stroke. INTERVENTION: Ten sessions of rTMS over a two week period MAIN OUTCOME MEASURES: The severity of visuospatial neglect was assessed pre- and post-treatment using the Motor-Free Visual Perception Test (MVPT), line bisection test, star cancellation test, and Catherine Bergego Scale (CBS). RESULTS: When comparing the differences of the MVPT, line bisection test, star cancellation test, CBS, and Korean-Modified Barthel Index (K-MBI) scores before and after treatment according to group, the changes in the line bisection test and K-MBI scores were significantly different between two groups. In the post-hoc analysis, the improvement in the line bisection test in the high-frequency rTMS group was statistically significant compared with that in the sham stimulation group (high vs. sham p=0.03, low vs. sham p=0.09, high vs. low p=0.58), and the improvements in the K-MBI scores of the two rTMS groups were statistically significant compared with those in the sham stimulation group (high vs. sham p<0.01, low vs. sham p=0.02, high vs. low p=0.75). CONCLUSIONS: These results indicate that high-frequency rTMS is effective in the treatment of visuospatial neglect in acute stroke patients. HubMed – rehab

Neurologic Grading in Traumatic Spinal Cord Injury.

Filed under: Rehab Centers

World Neurosurg. 2013 Jan 5;
Kalsi-Ryan S, Wilson J, Yang JM, Fehlings M

Quantifying the clinical neurological impairment of individuals with traumatic spinal cord injury (SCI) is of great importance in managing the population. The current gold standard is the International Standards for Neurological Classification (ISNCSCI) of SCI. Administered in isolation, this measure is not sensitive or specific enough to quantify impairment for the whole SCI population with the detail required for clinical trials and interventional studies. This review outlines a broader range of outcome measures which have the potential to assess neurological impairment and function in the traumatic SCI population. We describe recent developments in new, more sensitive outcomes traditionally used in the laboratory; and the efforts being made to validate and encourage their clinical use. However, the use of impairment measures alone will not provide clinicians with enough information regarding the individual’s abilities. Thus, the use of functional outcomes such as the Spinal Cord Independence Measure, Functional Independence Measure and other functional tests alongside the neurological impairment measures, such as the ISNCSCI and the electrophysiological measures are required for adequate characterization of the deficits and abilities in the traumatic SCI population.
HubMed – rehab

Acoustic and perceptual effects of changes in body layer stiffness in symmetric and asymmetric vocal fold models.

Filed under: Rehab Centers

J Acoust Soc Am. 2013 Jan; 133(1): 453-62
Zhang Z, Kreiman J, Gerratt BR, Garellek M

At present, it is not well understood how changes in vocal fold biomechanics correspond to changes in voice quality. Understanding such cross-domain links from physiology to acoustics to perception in the “speech chain” is of both theoretical and clinical importance. This study investigates links between changes in body layer stiffness, which is regulated primarily by the thyroarytenoid muscle, and the consequent changes in acoustics and voice quality under left-right symmetric and asymmetric stiffness conditions. Voice samples were generated using three series of two-layer physical vocal fold models, which differed only in body stiffness. Differences in perceived voice quality in each series were then measured in a “sort and rate” listening experiment. The results showed that increasing body stiffness better maintained vocal fold adductory position, thereby exciting more high-order harmonics, differences that listeners readily perceived. Changes to the degree of left-right stiffness mismatch and the resulting left-right vibratory asymmetry did not produce perceptually significant differences in quality unless the stiffness mismatch was large enough to cause a change in vibratory mode. This suggests that a vibration pattern with left-right asymmetry does not necessarily result in a salient deviation in voice quality, and thus may not always be of clinical significance.
HubMed – rehab

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