Abstract:
BACKGROUND:In clinical trials, behavioral outcomes and physiological measures of activity-dependent plasticity that evolve with task-oriented therapies may fail to reach statistical significance. When significant, clinical effectiveness may not be robust enough to alter professional practices. OBJECTIVE:Provide the conceptual basis for a research design to optimize the effect of an experimental treatment. METHODS:Literature review. RESULTS:Research designs usually do not take into consideration the dynamic state of each subject's potential responsiveness to an intervention. Providing a rational, rather than convenient, intensity and duration of therapy may remedy this potential confounder for clinical trials. To determine whether a most effective dose of a therapy exists, investigators could assess subjects before the intervention, administer interim measures at planned intervals, and continue the intervention until the primary behavioral outcomes or functional imaging parameters or both reach a plateau for at least 15 h of additional treatment. CONCLUSION:Promising interventions ought to be continued in phase II/III trials until subjects reach an asymptote in the primary outcome for behavioral gains. For neuroimaging studies that aim to correlate brain-behavior measures during rehabilitation, the specific intervention should also continue until behavioral gains and cerebral adaptations have attained a persistent plateau. Future trials can investigate whether functional neuroimaging performed in parallel with repeated behavioral assessments can better inform researchers about the optimal duration of an experimental therapy and a subject's maximal capacity for intervention-induced cerebral reorganization.
journal_name
Neurorehabil Neural Repairjournal_title
Neurorehabilitation and neural repairauthors
Dobkin BHdoi
10.1177/1545968305281892keywords:
subject
Has Abstractpub_date
2005-12-01 00:00:00pages
276-82issue
4eissn
1545-9683issn
1552-6844pii
19/4/276journal_volume
19pub_type
杂志文章abstract:PURPOSE:Sarcopenia and increased fat infiltration in muscle may play a role in the functional impairment and high risk for diabetes in stroke. Our purpose was to compare muscle volume and muscle attenuation across 6 muscles of the paretic and nonparetic thigh and examine the relationships between intramuscular fat and ...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968311408920
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Somatosensory deficits are prevalent after stroke, but effective interventions are limited. Brain stimulation of the contralesional primary somatosensory cortex (S1) is a promising adjunct to peripherally administered rehabilitation therapies. OBJECTIVE:To assess short-term effects of repetitive transcrania...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968321989338
更新日期:2021-01-29 00:00:00
abstract:BACKGROUND:Our ability to sense movement is essential for motor control; however, the impact of kinesthesia deficits on functional recovery is not well monitored in the spinal cord injury (SCI) population. One problem is the lack of accurate and reliable tools to measure kinesthesia. OBJECTIVE:The purpose of this stud...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968315591703
更新日期:2016-03-01 00:00:00
abstract::Background The reliable stratification of homogeneous subgroups and the prediction of future clinical outcomes within heterogeneous neurological disorders is a particularly challenging task. Nonetheless, it is essential for the implementation of targeted care and effective therapeutic interventions. Objective This stu...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,多中心研究
doi:10.1177/1545968313520413
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Functional electrical stimulation therapy (FET) has a potential to improve voluntary grasping among individuals with tetraplegia secondary to traumatic spinal cord injury (SCI). OBJECTIVE:This single-site, randomized controlled trial examined the efficacy of 40 hours of FET with conventional occupational th...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,随机对照试验
doi:10.1177/1545968310392924
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Dysphagia diagnosis is limited by our inability to evaluate the underlying neuromuscular pathology of swallowing. A novel approach using pharyngeal surface electromyography (PsEMG) has been reported in the literature. OBJECTIVE:Three exploratory projects were undertaken to provide data toward the validation...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968306293448
更新日期:2007-05-01 00:00:00
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journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968314565464
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Peripheral axon regeneration is improved when the nerve lesion under consideration has recently been preceded by another nerve injury. This is known as the conditioning lesion effect (CLE). While the CLE is one of the most robust and well characterized means to enhance motor axon regeneration in experimental...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968318790020
更新日期:2018-08-01 00:00:00
abstract::The goal of the present study was to examine factors affecting motor impairment and recovery in a primate model of cortical infarction. Microelectrode stimulation techniques were used to delineate the hand representation in the primary motor cortex (M1). Microinfarcts affecting approximately 30% of the hand representa...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/154596830001400406
更新日期:2000-01-01 00:00:00
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journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968310381250
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:A randomized clinical has shown the effectiveness of intramuscular electrical stimulation for the treatment of poststroke shoulder pain. OBJECTIVE:Identify predictors of treatment success and assess the impact of the strongest predictor on outcomes. METHOD:This is a secondary analysis of a multisite random...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1177/1545968306298412
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Fatigue is a debilitating symptom in multiple sclerosis (MS). Previous studies showed no association between fatigue as perceived by the patient and physiological measures of fatigability. OBJECTIVE:The authors investigated associations between perceived fatigue and measures of fatigability after correction...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968311416991
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:This study investigated the course and relationship between investigator-determined and patient-reported level of independence within the first year after spinal cord injury (SCI). The authors examined variables that contributed to these scores. METHODS:In this observational cohort study, 73 patients with tr...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968311407518
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Dual tasking can interfere with activity after stroke. OBJECTIVE:The authors examined the interactions between 3 different cognitive tasks and the swing and double-limb support (DLS) components of the gait cycle in community-dwelling individuals poststroke. METHODS:Acquisition of cognitive and gait data we...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968309357926
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:The neural correlates of training-induced improvements of cognitive functions after brain damage remain still scarcely understood. In the specific case of aphasia, although several investigations have addressed the issue of the neural substrates of functional recovery, only a few studies have attempted to as...
journal_title:Neurorehabilitation and neural repair
pub_type: 临床试验,杂志文章
doi:10.1177/1545968306294735
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to establish the minimal detectable change (MDC) and clinically important differences (CIDs) of the physical domains of the Stroke Impact Scale (SIS) and to assess the proportions of patients' change scores exceeding the MDC and CIDs after stroke rehabilitation. METHODS:Seventy...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,随机对照试验
doi:10.1177/1545968309356295
更新日期:2010-06-01 00:00:00
abstract::Proprioception is a vital aspect of motor control and when degraded or lost can have a profound impact on function in diverse clinical populations. This systematic review aimed to identify clinically related tools to measure proprioceptive acuity, to classify the construct(s) underpinning the tools, and to report on t...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,评审
doi:10.1177/1545968315573055
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Limited data are available about the effectiveness of early rehabilitation after stroke. OBJECTIVE:This is the 1st randomized controlled trial of constraint-induced movement therapy (CIMT) in subacute stroke to investigate neurophysiologic mechanisms and long-term outcome. METHODS:Within 2 weeks after stro...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,随机对照试验
doi:10.1177/1545968306291858
更新日期:2007-01-01 00:00:00
abstract::A major problem in neurorehabilitation is the lack of objective outcomes to measure movement quality. Movement quality features, such as coordination and stability, are essential for everyday motor actions. These features allow reacting to continuously changing environment or to resist external perturbations. Neurolog...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968320969936
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Current available therapies for Parkinson disease (PD) have strong limitations, and patients usually present with refractory symptoms despite all efforts. Deep brain stimulation (DBS), which has been used in PD patients for decades (since 1987), has best indications for symptoms like tremor, motor fluctuatio...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968320956984
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:The use of exercise in amyotrophic lateral sclerosis (ALS) is controversial. Although moderate exercise appears to be beneficial for limb muscles in ALS, the effects of exercise on bulbar muscles such as the tongue have not been studied. OBJECTIVE:To determine the effects of tongue force training on bulbar ...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968316666956
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Hemiparetic gait following stroke requires substantial energy consumption, which would promote deconditioning and disability. Optimal modalities for decreasing this energy cost remain challenging. Excessive energy consumption, however, seems to be mainly due to extra positive muscle work to substantially lif...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968309349927
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:The assessment of rehabilitation efficacy in spinal cord injury (SCI) should be based on a combination of neurological and functional outcome measures. The Spinal Cord Independence Measure II (SCIM II) is an independence scale that was specifically developed for subjects with SCI. However, little is known ab...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,多中心研究
doi:10.1177/1545968307306240
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Cortical networks underlying motor imagery are functionally close to motor performance networks and can be activated by patients with severe motor disabilities. OBJECTIVE:The aim of the study was to examine the longitudinal effect of progressive motoneuron degeneration on cortical representation of motor im...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968307300698
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Stroke patients with a low memory self-efficacy (MSE) report more memory complaints than patients with a high MSE. OBJECTIVE:The aim of this study was to examine the effect of a memory-training program on MSE in the chronic phase after stroke and to identify which patients benefit most from the MSE training...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,随机对照试验
doi:10.1177/1545968312455222
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:This study investigated the relative effects of distributed constraint-induced therapy (CIT) and bilateral arm training (BAT) on motor performance, daily function, functional use of the affected arm, and quality of life in patients with hemiparetic stroke. METHODS:A total of 60 patients were r...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,随机对照试验
doi:10.1177/1545968308328719
更新日期:2009-06-01 00:00:00
abstract::Implementation is the use of strategies to adopt and integrate evidence-based health interventions and to change practice patterns. In their article, "Implementation-the missing link in the research translation pipeline," Lynch et al1 report that only a small fraction of published stroke rehabilitation research in lea...
journal_title:Neurorehabilitation and neural repair
pub_type: 评论,杂志文章
doi:10.1177/1545968318794904
更新日期:2018-09-01 00:00:00
abstract::Background. High-intensity repetitive training is challenging to provide poststroke. Robotic approaches can facilitate such training by unweighting the limb and/or by improving trajectory control, but the extent to which these types of assistance are necessary is not known. Objective. The purpose of this study was to ...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968319887685
更新日期:2020-02-01 00:00:00
abstract::The remarkable scientific and technological advances in the field of cell research have not been translated into viable restorative therapies for brain disorders. In this article, we examine the best available evidence for the clinical efficacy of reconstructive intracerebral transplantation in people with Parkinson's...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968316635277
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:and purpose. Mental practice (MP), which involves cognitive rehearsal of physical movements, is a noninvasive, inexpensive method of enabling repetitive, task-specific practice (RTP). Recent, randomized controlled data suggest that MP, when combined with an RTP therapy program, increases affected arm use and...
journal_title:Neurorehabilitation and neural repair
pub_type: 临床试验,杂志文章
doi:10.1177/1545968308326427
更新日期:2009-05-01 00:00:00