The rehabilitation of paretic stroke patients uses a wide range of intervention programs to improve the function of impaired upper limb. A new rehabilitative approach, called action observation ...therapy (AOT) is based on the discovery of mirror neurons and has been used to improve the motor functions of adult stroke patients and children with cerebral palsy. Recently, virtual reality (VR) has provided the potential to increase the frequency and effectiveness of rehabilitation treatment by offering challenging and motivating tasks. METHODS: The purpose of the present project is to design a randomized controlled six-month follow-up trial (RCT) to evaluate whether action observation (AO) added to standard VR (AO + VR) is effective in improving upper limb function in patients with stroke, compared with a control treatment consisting of observation of naturalistic scenes (CO) without any action content, followed by VR training (CO + VR).
AO + VR treatment may provide an addition to the rehabilitative interventions currently available for recovery after stroke and could be utilized within standard sensorimotor training or in individualized tele-rehabilitation.
The trial has been prospectively registered on ClinicalTrials.gov. NCT05163210 . 17 December 2021.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Previous analyses demonstrated a lack of unidimensionality, item redundancy, and substantial administrative burden for the Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs).
To ...use Rasch Analysis to calibrate five short-forms of the BIRT-PQs, satisfying the Rasch model requirements.
BIRT-PQs data from 154 patients with severe Acquired Brain Injury (s-ABI) and their caregivers (total sample = 308) underwent Rasch analysis to examine their internal construct validity and reliability according to the Rasch model.
The base Rasch analyses did not show sufficient internal construct validity according to the Rasch model for all five BIRT-PQs. After rescoring 18 items, and deleting 75 of 150 items, adequate internal construct validity was achieved for all five BIRT-PQs short forms (model chi-square p-values ranging from 0.0053 to 0.6675), with reliability values compatible with individual measurements.
After extensive modifications, including a 48% reduction of the item load, we obtained five short forms of the BIRT-PQs satisfying the strict measurement requirements of the Rasch model. The ordinal-to-interval measurement conversion tables allow measuring on the same metric the perception of the neurobehavioral disability for both patients with s-ABI and their caregivers.
Objective: To assess the internal construct validity (ICV) of the five Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQ) with Classical Test Theory methods.
Methods: Multicenter ...cross-sectional study involving 11 Italian rehabilitation centers. BIRT-PQs were administered to patients with severe Acquired Brain Injury and their respective caregivers. ICV was assessed by the mean of an internal consistency analysis (ICA) and a Confirmatory Factor Analysis (CFA).
Results: Data from 154 patients and their respective caregivers were pooled, giving a total sample of 308 subjects. Despite good overall values (alphas ranging from 0.811 to 0.937), the ICA revealed that several items within each scale did not contribute as expected to the total score. This result was confirmed by the CFA, which showed the misfit of the data to a unidimensional model (RMSEA ranging from 0.077 to 0.097). However, after accounting for local dependency found within the data, fitness to a unidimensional model improved significantly (RMSEA ranging from 0.050 to 0.062).
Conclusion: Despite some limitations, our analyses demonstrated the lack of ICV for the BIRT-PQ total scores. It is envisaged that a more comprehensive ICV analysis will be performed with Rasch analysis, aiming to improve both the measurement properties and the administrative burden of each BIRT-PQ.
Aphasic patients occasionally manifest a dissociated naming ability between objects and actions: this phenomenon has been interpreted as evidence of a separate organization for nouns and verbs in the ...mental lexicon. Nevertheless Bird et al. Bird, H., Howard, D., Franklin, S. (2000). Why is a verb like an inanimate object? Grammatical category and semantic category deficits.
Brain
and
Language,
72, 246–309, suggested that the damage underlying noun–verb dissociation affects the corresponding
semantic concepts and not the
lexical representation of words; moreover, they claimed that many dissociations reported in literature are caused merely by a strong imageability effect. In fact, most authors used a picture-naming task to assess patients’ naming ability, and due to the fact that this test involves the use of pictures to represent actions and objects, nouns were frequently more imageable than verbs Luzzatti, C., & Chierchia, G. (2002). On the nature of selective deficit involving nouns and verbs.
Rivista
di
Linguistica,
14, 43–71. In order to overcome this drawback, we devised a new task – nouns and verbs retrieval in a sentence context (NVR-SC) – in which nouns and verbs have the same imageability rate. Patients’ performance on this task is compared with that obtained by the same patients on a standard picture-naming task. Of the 16 aphasic patients with a selective verb deficit, as revealed by the picture-naming task, two continued to show dissociation in the NVR-SC task, while 14 did not. The data indicate that at least some patients have an imageability-independent lexical deficit for verbs. The functional locus/i of the damage is also considered, with particular reference to the
lemma/
lexeme dichotomy suggested by Levelt et al. Levelt, W. J. M., Roelofs, A., & Meyer, A. S. (1999). A theory of lexical access in speech production.
Behavioral
and
Brain
Sciences,
22, 1–75.
In recent years an increase of interest concerning the altered states of consciousness was observed. In particular literature provided a wide amount of contribution about the scales for measurement ...of level of responsivity. Our aim is to describe the principale scales used in diagnosis of Disorder of Consciousness (DOC) trying to illustrate administation procedures, specifically assessed aspects, modality of stimulation, reliability, and validity. We divided them in four main different groups: the first one in which descriptive scales are included, that is those scales basically used after a clinical observation; the second group which concerns scales requiring defined stimulation sets; in the third group we considered the scale which refer to diagnostic criteria stated by the Aspen Work Group (Giacino et al., 2002); whilst in the fourth group we describe a battery aimed to assess patients with severe cognitive deficits which are not yet evaluable with neuropsychological tests.
Aim of this work is to provide an overview on the main clinical issues concerning disorder of consciousness (DOC). After a briefly description of the debate on clinical differences in states of ...altered consciousness, we report the description of clinical features of the three different levels of DOC: coma, vegetative state, and minimally conscious state, according to the Multi Society Task Force for Persistent Vegetative State (1994) and the Aspen Work Group (Giacino et al., 2002). We will then describe an observation procedure, stated by Whyte and coworkers in 1999, based upon a single-case methodology aimed to assess responsiveness and its variations. At least, we will give a description of the evidences on stimulation treatment efficacy, as we collected in occasion of the last Consensus Conference in Neuropsychological Rehabilitation held in Siena (Italy) in 2010. Our conclusions confirm the lack of evidences concerning the efficacy of treatment for recovery of consciousness in agreement with other authors and we will finally provide suggestions for future research.
Safe resumption of driving after a severe acquired brain injury (sABI) is a strongly felt need because driving is related to recovery of independence and social-occupational re-integration. The aim ...of this prospective observational cohort study was to determine whether epilepsy secondary to sABI is a significant factor for being declared fit to drive by the relevant government authorities in Italy. In the period 2006-2015 we recruited 187 patients with sABI, 30 of whom (16.4%) developed secondary epilepsy. The interval between the acute event and the first seizure varied widely (6-96 months), confirming the need for prolonged follow-up. With regard to the aetiology, traumatic brain injury (TBI) was associated with the highest risk of epilepsy: 66.7% of the 30 patients with epilepsy had TBI, as opposed to cerebrovascular disease or anoxic brain damage (33.3%). The percentage of patients who resumed driving was about the same in the epilepsy (80%) and non-epilepsy (81%) groups.
We report results of a writing task given to 53 mildly to moderately aphasic Italian subjects. The task was designed to test the writing performance along the subword-level routine for the spelling ...of regular words and non-words, and along the lexical routine for the spelling of irregular words. The aim of the study was to identify the incidence of different dysgraphic subtypes in Italian, a language that is considered to have shallow orthography. Its spelling, however, is not completely free of ambiguity. A five-part writing task was used: (i) words with regular one-sound-to-one-grapheme conversion; (ii) words with regular syllabic conversion; (iii) words with ambiguous transcription; (iv) loan-words; and (v) non-words. For regular words, the effects of word length and word frequency, and of the variables determining the complexity of the acoustic-to-phonological conversion (continuant versus plosive phones; consonant-vowel sequence versus doubled consonants or consonant clusters) were also considered. Patients' performances were classified according to the presence of a dissociation between (i) regular words and non-words, (ii) regular words and words with unpredictable spellings, and (iii) one-to-one and syllabic conversions. The 53 aphasic patients span the whole spectrum of dysgraphic taxonomy. Thirty-nine patients, in particular, manifested a dissociated pattern of performance. Eighteen patients showed a prevalent surface dysgraphic pattern and seven a phonological one, while 11 patients showed a mixed pattern (i.e. a better performance for regular words than for ambiguous words or regular non-words). Three patients showed a specific deficit for regular syllabic conversion rules only. A high rate of 'mixed dysgraphia' suggests either a mutual interaction of the two impaired routines when regular words are written, or two separate functional lesions: one at the level of the auditory-to-phonological conversion procedure, the other at the level of the orthographic output lexicon.
Three groups of patients (right brain-damaged patients with or without left neglect, and left brain-damaged patients) and a group of healthy subjects, matched for age and educational level to the ...three groups of patients, were asked to report which of the two frontal surfaces of Necker cubes oriented in four different ways looked, at first sight, nearer to the viewer. The extent to which, and the way in which, disambiguation of the apparent perspective of Necker cubes occurred was found to vary across the four orientations and to be different in left-neglect patients compared with subjects of the other three groups. With normal subjects, the disambiguating factor is suggested to be a disposition to perceive the upper surface, which is nearly orthogonal to the frontal plane, as external to the cube. This would result from a navigation of the observer's spatial attention towards its target along a particular path that is altered in patients suffering from left neglect. It is suggested that comparison of the paths followed by the attentional vectors of normal subjects and left-neglect patients is potentially fruitful for a better understanding of the brain's normal mechanisms of spatial attention and of unresolved issues concerning the perception of the Necker cube.
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