Neurorehabilitation Literature

Below you can find some of the most recent, up-to-date evidence-based practice literature in the field of neurorehabilitation!

Articles with free, full-text access:

Ahn, J.Y., Kim, H., & Park, C. B. (2019). Effects of whole-body vibration on upper extremity function and grip strength in patients with subacute stroke: A randomised single-blind controlled trial. Occupational Therapy International, 1-5. doi: 10.1155/2019/5820952

• The results of this study indicated that the use of whole-body vibration training combined with task-related training has more benefits on the improvement of arm function, spasticity, and maximal grip strength than conventional upper limb training alone or with whole-body vibration in people with poststroke hemiplegia.

Schuster-Amft, C., Eng, K., Suica, Z., Thaler, I., Signer, S., Lehmann, I., & Kiper, D. (2018). Effect of a four-week virtual reality-based training versus conventional therapy on upper limb motor function after stroke: A multicenter parallel group randomized trial. Public Library of Science, 13(10), 1-19. doi: 10.1371/journal.pone.0204455

• This study found that patients in the experimental and control group showed similar effects, with most improvements occurring in the first two weeks and persisting until the end of the two-month follow-up period. The study population had moderate to severely impaired motor function at entry (Box and Block Test mean 21.5±SD 16). Patients, who were less impaired (Box and Block Test range 18 to 72) showed higher improvements in favor of the experimental group. This result could suggest that virtual reality-based training might be more applicable for such patients than for more severely impaired patients.

Ploughman, M., Eskes, G. A., Kelly, L. P., Kirkland, M. C., Devasahayam, A. J., Wallack, E. M., . . . Mackay-Lyons, M. (2019). Synergistic benefits of combined aerobic and cognitive training on fluid intelligence and the role of IGF-1 in chronic stroke. Neurorehabilitation and Neural Repair, 33(3), 199–212. doi:10.1177/1545968319832605

• This study found that aerobic exercise combined with cognitive training improved fluid intelligence by almost 50% in patients >6 months poststroke who were presumed to have reached their recovery plateau. Participants in the Aerobic + COG group also experienced gains in aerobic fitness and walking, suggesting that combined interventions have the potential to address several recovery domains.

Lee, S., Kim, Y., & Lee, B. (2016). Effect of virtual reality-based bilateral upper extremity training on upper extremity function after stroke: A randomized controlled clinical trial. Occupational Therapy Intervention, 23, 357-368. doi: 10.1002/oti.1437

• Study designed to test the effectiveness of virtual reality-based bilateral upper extremity training (VRBT) on paretic upper limb function and muscle strength in patients who experienced a stroke. Results showed significant improvements in UE function and muscle strength in the VRBT group compared to the BT group after a 6 week training program.  These results suggest that VRBT is a feasible and beneficial means of improving upper extremity function and muscle strength in individuals following stroke.

Kang, B.R., Her, J.G., Lee, J.S., Ko, T.S., & You, Y. Y, (2019). Effects of the computer desk level on the musculoskeletal discomfort of neck and upper extremities and EMG activities in patients with spinal cord injuries. Occupational Therapy International, 2, 1-10. doi: 10.1155/2019/3026150.

• This study is aimed at identifying the effect of computer desk heights on musculoskeletal discomforts of the neck and upper extremities and EMG activities in patients with spinal cord (C6) and upper thoracic spinal cord injuries. The two groups showed differences in terms of RPE corresponding to each level of the computer desk (p < .05). Postanalysis revealed the C6 group had decreased RPE as the level of computer desk increased, whereas the subjects in the T2-T6 group had decreased RPE values in accordance with the decreasing level of computer desk (p < .05). In EMG, both groups had no significant differences (p > .05). However, in terms of the interaction between the muscles and the level of computer desk in both groups, the differences in the interactions of the upper trapezius and wrist extensor with each level of the desk were found (p < .05). 

Pazzaglia, M. & Galli, G. (2019). Action observation for neurorehabilitation in apraxia. Frontiers in Neurology, 10. doi: 10.3389/fneur.2019.00309

• Neurorehabilitation and brain stimulation studies of post-stroke patients suggest that action-observation effects can lead to rapid improvements in the recovery of motor functions and long-term motor cortical reorganization. This perspective also outlines impacts on neurorehabilitation and brain repair following the reinforcement of the perceptual-motor coupling. To date, interventions based primarily on action observation in apraxia have not been undertaken.

Yadav, R. K., Sharma, R., Borah, D., & Kothari, S. Y. (2016). Efficacy of modified constraint induced movement therapy in the treatment of hemiparetic upper limb in stroke patients: A randomized controlled trial. Journal of Clinical and Diagnostic Research : JCDR, 10(11), YC01–YC05. doi:10.7860/JCDR/2016/23468.8899

• This study provides experimental data addressing the improvement in hand function of stroke patients following mCIMT in terms of motor recovery and functional outcome. In this study all measured outcomes were improved significantly with a mCIMT protocol of treatment time 3 hours per day for 3 days per week and constraint time of 5 hours per day for 5 days per week over a total duration of 4 weeks. Researchers concluded that their mCIMT protocol is a convenient and acceptable design to both patients and caregiver.

Stoykov, M. E. & Madhavan, S. (2015). Motor priming in neurorehabilitation. Journal of Neurologic Physical Therapy, 39(1), 33-42. doi: 10.1097/NPT.0000000000000065

• Priming is a type of implicit learning wherein a stimulus prompts a change in behavior. Priming has been long studied in the field of psychology. More recently, rehabilitation researchers have studied motor priming as a possible way to facilitate motor learning. In this Special Interest article we discuss those priming paradigms that are supported by the greatest amount of evidence including: (i) stimulation-based priming, (ii) motor imagery and action observation, (iii) sensory priming, (iv) movement-based priming, and (v) pharmacological priming.

Articles that require membership or payment:

Yacoby, A., Zeilig, G., Weingarden, H., Weiss, R., & Rand, D. (2019). Feasibility of, adherence to, and satisfaction with video game versus traditional self-training of the upper extremity in people with chronic stroke: A pilot randomized controlled trial. American Journal of Occupational Therapy, 73(1), 7301205080p1-7301205080p14. doi: 10.5014/ajot.2019.026799

• This study found that using commercial video game consoles for daily training of upper extremity and body movements is feasible and enjoyable and has potential to maintain long-term activity. Participants with chronic stroke demonstrated high adherence to and satisfaction with both self-training programs to train their weaker upper extremity; therefore, occupational therapy practitioners should offer participants a self-training program to continue practicing upper extremity movements at the chronic stage poststroke.

Estilow, T., Glanzman, A. M., Powers, K., Moll, A., Flickinger, J., Medne, L., . . . Yum, S. W. (2018). Use of the wilmington robotic exoskeleton to improve upper extremity function in patients with duchenne muscular dystrophy. American Journal of Occupational Therapy, 72(2), 7301205080p1-7301205080p14. doi: 10.5014/ajot.2019.026799.

• This study evaluated the ability of the Wilmington Robotic Exoskeleton (WREX) to improve AROM and independence with ADLs. Patients demonstrated increased shoulder flexion and abduction (25°–100°, median = 55°) and elbow flexion (10°–110°, median = 60°). Increased independence with self-feeding, item retrieval, use of phones and tablets, and facial grooming were noted. The WREX allowed for gravity-reduced movement via elastic bands to unweight the upper extremity, enabling increased upper extremity active movement that supported increased independence with ADLs.

Green, E., Huynh, A., Broussard, L., Zunker, B., Matthews, J., Hilton, C. L., & Aranha, K. (2019). Systematic review of yoga and balance: Effect on adults with neuromuscular impairment. American Journal of Occupational Therapy, 73, 7301205150p1-7301205150p11. doi: 10.5014/ajot.2019.028944

• This systematic review examined the efficacy of yoga as a neuromuscular intervention with community-dwelling populations at risk for falls. The purpose was to understand the salutary benefits of yoga with clients who are at risk for falls because of neuromuscular issues to determine its utility for use in occupational therapy intervention. Benefits of yoga included improved posture control, improved flexibility of mind and body, relaxation, and decreased anxiety and stress. The review found moderate evidence to support the use of yoga to decrease the risk of falls among community-dwelling older adults and people with CVA, dementia and AD-type dementia, and MS.

Handelzalts, S., Kenner-Furman, M., Gray, G., Soroker, N., Shani, G., & Melzer, I. (2019). Effects of perturbation-based balance training in subacute persons with stroke: A randomized controlled trial. Neurorehabilitation and Neural Repair, 33(3), 213–224. doi: 10.1177/1545968319829453

• This randomized controlled trial explored the effect of a short-term perturbation-based balance training (PBBT) on reactive balance responses, performance-based measures of balance and gait and balance confidence compared to weight shifting and gait training (WS&GT). Compared with the WS&GT group, immediately postintervention participants in the PBBT group showed higher multiple-step thresholds in response to forward and backward surface translations (effect size [ES] = 1.07 and ES = 1.10, respectively) and moderate ES in the ABC scale (ES = 0.74). No significant differences were found in fall-threshold, BBS, 6MWT, and 10MWT between the groups. 

Mooney, R. A., Ackerley, S. J., Rajeswaran, D. K., Cirillo, J., Barber, P. A., Stinear, C. M., & Byblow, W. D. (2019). The influence of primary motor cortex inhibition on upper limb impairment and function in chronic stroke: A multimodal study. Neurorehabilitation and Neural Repair, 33(2), 130–140. doi: 10.1177/1545968319826052

• This purpose of this study was to quantify GABA neurotransmission and concentration within ipsilesional and contralesional M1 and determine if they relate to upper limb impairment and function at the chronic stage of stroke. Short-interval intracortical inhibition was similar between patients and controls (P = .10). Long-interval intracortical inhibition was greater in ipsilesional M1 compared with controls (P < .001). Patients who did not exhibit late cortical disinhibition in ipsilesional M1 were those with greater upper limb impairment and worse function (P = .002 and P = .017). GABA concentration was lower within ipsilesional (P = .009) and contralesional (P = .021) M1 compared with controls, resulting in an elevated excitation-inhibition ratio for patients.

Johnson, B. P., Shipper, A. G., & Westlake, K. P. (2019). Systematic review investigating the effects of nonpharmacological interventions during sleep to enhance physical rehabilitation outcomes in people with neurological diagnoses. Neurorehabilitation and Neural Repair. doi: 10.1177/1545968319840288

• This systematic review addressed nonpharmacological interventions applied during sleep to enhance physical rehabilitation outcomes of individuals with a neurological diagnosis. The only nonpharmacological intervention to be administered during sleep in a neurological population to improve physical rehabilitation outcomes was found to be CPAP. This review was complicated by the variety of outcome measures used, lack of physical rehabilitation description, and CPAP compliance.

Reliable Databases

Below you can find some of the most reliable, pertinent databases that can be used when searching for evidence-based practice literature in the field of neurorehabilitation.

PubMed

• “PubMed comprises more than 29 million citations for biomedical literature from MEDLINE, life science journals, and online books.”

CINAHL Complete

• “Provides broad content coverage including 50 nursing specialties, speech and language pathology, nutrition, general health and medicine and more.”

Biomed Central

• “An evolving portfolio of high quality peer-reviewed journals.”

Academic Search Elite

• “Provides access to acclaimed full-text scholarly journals and magazines.”

MEDLINE Complete

• “Full-text database of biomedical and health journals.”

 Research Tips & Tricks

Below you can find some tips and tricks that you can utilize while researching for evidence-based practice literature in the field of neurorehabilitation.

• When wanting to combine keywords or phrases use “AND”
• Ex. Motor impairment AND stroke

• Use “*” at the end of a word in order to bring up other words that start with that word
• Ex. Child* can bring up children, childhood, etc.

• If the database allows, use a subject search when researching
• When searching, narrow down your search by selecting the box that ensures that all articles are “peer-reviewed”
• When performing a search, limit the time frame to the last 5 years in order to pull up the most recent evidence

Key Terms to Search

Below you can find some key terms related to neurorehabilitation and potential interventions that can be utilized while performing a search for evidence-based practice literature in the field of neurorehabilitation.

Neurologic rehabilitation
Neurologic impairment
Computational neuroscience
Neuromodulation
Ischemic stroke
Cerebrovascular accident (CVA)
Traumatic brain injury (TBI)
Acquired brain injury (ABI)
Spinal cord injury (SCI)
Neurodevelopmental treatment (NDT)
Modified constraint-induced movement therapy (mCIMT)
Virtual reality (VR)
Modalities
Occupational therapy (OT)
Occupational intervention