Purpose of Review
We explored themes in recent post-stroke dysphagia literature, focusing on the following questions: (1) What does post-stroke dysphagia look like?; (2) Who gets post-stroke ...dysphagia?; (3) What are the consequences of post-stroke dysphagia?; and (4) How can we improve treatment of post-stroke dysphagia?
Recent Findings
There have been several improvements in quantitative descriptions of swallowing physiology using standard and new evaluation techniques. These descriptions have been correlated with lesion locations, and several factors can predict development of post-stroke dysphagia and its sequelae. Novel treatment paradigms have leveraged post-stroke neuroplastic improvements using neurostimulation and biofeedback techniques. Despite recent findings, the field is limited by lack of standardization and unanswered questions on rehabilitation variables.
Summary
Our improved understanding of post-stroke dysphagia will enhance our ability to prevent, identify, and treat it. Future work should be grounded in swallowing physiology and continue refining treatments, particularly in the acute stage.
Aphasia Recovery: When, How and Who to Treat? Doogan, Catherine; Dignam, Jade; Copland, David ...
Current neurology and neuroscience reports,
12/2018, Letnik:
18, Številka:
12
Journal Article
Recenzirano
Odprti dostop
Purpose of Review
We now know that speech and language therapy (SALT) is effective in the rehabilitation of aphasia; however, there remains much individual variability in the response to ...interventions. So, what works for whom, when and how?
Recent Findings
This review evaluates the current evidence for the efficacy of predominantly impairment-focused aphasia interventions with respect to optimal dose, intensity, timing and distribution or spacing of treatment. We conclude that sufficient dose of treatment is required to enable clinical gains and that e-therapies are a promising and practical way to achieve this goal. In addition, aphasia can be associated with other cognitive deficits and may lead to secondary effects such as low mood and social isolation.
Summary
In order to personalise individual treatments to optimise recovery, we need to develop a greater understanding of the interactions between these factors.
Neuroplasticity is defined as the property of the brain to adapt to environmental pressures, experiences, and challenges including brain damage. It is a lifelong capacity of the brain to change and ...rewire itself in response to the stimulation of learning and experience. Based upon this input, several conclusions were recently appearing on the surface. First, there appears to be tremendous latent plasticity even in the adult brain. Second, the brain should be thought of, not as a hierarchy of organized autonomous modules, each of which delivers its output to the next level, but as a set of complex interacting networks that are in a state of dynamic equilibrium with the brain’s environment. Both principles can be potentially exploited in a clinical context to facilitate recovery of function. Promoting neuroplasticity in an enriched environment will eventually result in dendritic branching, synapses, glial processes, brain weight, and cortical thickness. Currently, it is believed that activity drives reorganization of cerebral networks, which is paralleled by functional improvements in cases of acquired brain injuries that are usually in need of intense rehabilitation programs. Numeral studies have demonstrated reorganization of brain activity pattern in response to intense training of motor and cognitive tasks and imagination of movements. For instance, promising results were shown using feedback techniques, like mirror visual feedback (MVF) improving chronic regional pain syndrome and hemiparesis following stroke. Evidence based therapeutic interventions using neuroplasticity as its base include aerobic exercise, bilateral arm training, constraint induced movement therapy,body weight supported treadmill training, mirror therapy, action observation, motor imagery/mental practice, functional electrical stimulation and music therapy.Promising therapies that may enhance training-induced cognitive and motor learning, such as brain stimulation and neuropharmacological interventions, were also identified, along with arousing questions involving more updated ways to use neuroplasticity in improving quality of life in cases of human disability.
A BSTRACT Introduction: Stroke is one of the leading causes of death and disability in India and rehabilitation therapy is underdeveloped. Neurorehabilitation is a program that caters to people who ...have disabilities to help them attain and maintain optimal performance. The majority of people with disabilities are economically underprivileged and have trouble getting access to basic health care (including rehabilitation). Physiotherapists also face limitations in providing services to stroke survivors and this study is to identify those challenges. Objective: The objective of this study is to identify the limitations faced by physiotherapists during stroke rehabilitation. Material and Method: In November 2022, a focus group discussion was held with a sample size of 12 physiotherapy residents from neurorehabilitation and community rehabilitation working in a tertiary hospital. After consent was taken, audiovideography was recorded, transcripted, and documented. Data were thoroughly transcribed, and thematic analysis and characteristics were established. Results: After extraction of codes and themes, the following results were found. General categories of themes are lack of awareness on stroke and physiotherapy, infrastructure, financial constraints, family dynamic, social health, amotivation and mental health, collaboration limitations, problems in-home services, and the impact of COVID-19 pandemic on rehabilitation. Recommendations given by the participants were creating a stroke community, availability of more insurance companies to support and provide relief for financial stress, early education and awareness on stroke from school level, active participation of caregivers and family members to assist the patient in home-based therapy, and availability of NGOs that cater specifically to physiotherapy. Conclusion: It was concluded that neurorehabilitation in India needs to attend to the given categories. Policymakers must be aware of the financial and social issues that stroke survivors experience and enact legislation that will decrease mental and financial stress.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Purpose of Review
Stroke is the leading cause of permanent motor disability in the United States (US), but there has been little progress in developing novel, effective strategies for treating ...post-stroke motor deficits. The past decade has seen the rapid development of many promising, gamified neurorehabilitation technologies; however, clinical adoption remains limited. The purpose of this review is to evaluate the recent literature surrounding the adoption and use of gamification in neurorehabilitation after stroke.
Recent Findings
Gamification of neurorehabilitation protocols is both feasible and effective. Deployment strategies and scalability need to be addressed with more rigor. Relationship between engaged time on task and rehabilitation outcomes should be explored further as it may create benefits beyond repetitive movement.
Summary
As gamification becomes a more common and feasible way of delivering exercise-based therapies, additional benefits of gamification are emerging. In spite of this, questions still exist about scalability and widespread clinical adoption.
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