Impact of Motor Therapy with Dynamic Body-Weight Support on Functional Independence Measures in Traumatic Brain Injury: An Exploratory Study

BACKGROUND: Contemporary goals of rehabilitation after traumatic brain injury (TBI) aim to improve cognitive and motor function by applying concepts of neuroplasticity. This can be challenging to carry out in TBI patients with motor, balance, and cognitive impairments. OBJECTIVE: To determine whether use of dynamic body-weight support (DBWS) would allow safe administration of intensive motor therapy during inpatient rehabilitation and whether its use would yield greater improvement in functional recovery than standard-of-care (SOC) therapy in adults with TBI. METHODS: Data in this retrospective cohort study was collected from patients with TBI who receive inpatient rehabilitation incorporating DBWS (n = 6) and who received inpatient rehabilitation without DBWS (SOC, n = 6). The primary outcome measure was the change in Functional Independence Measures (FIM) scores from admission to discharge. RESULTS: There was significant improvement in total FIM scores at discharge compared to admission for both the DBWS (p = 0.001) and SOC (p = 0.005) groups. Overall, the DBWS group had greater improvement in total FIM score and FIM subscales compared to the SOC group. CONCLUSIONS: Our results suggest DBWS has the potential to allow a greater intensity of therapy during inpatient rehabilitation and yield better outcomes compared to SOC in patients with TBI

Cerebropulmonary dysgenetic syndrome

Author Posting. © The Author(s), 2008. This is the author's version of the work. It is posted here by permission of Elsevier B.V. for personal use, not for redistribution. The definitive version was published in Experimental and Molecular Pathology 85 (2008): 112-116, doi:10.1016/j.yexmp.2008.04.006.Ventilatory treatment of neonatal respiratory distress often results in bronchopulmonary dysplasia from congenital surfactant deficiency due to mutants of transporter protein ABCA3. Association of this condition with other severe disorders in premature newborns has not heretofore been reported. A neonatal autopsy included an in vivo whole blood sample for genetic tcsting. Autopsy revealed severe interstitial pulmonary fibrosis at age 8 days with heterozygotic mutation p.E292V of ABCA3 and severe dystrophic retardation of cerebral cortcx and cerebellum. Subsequently, 1300 archival neonatal autopsies, 1983-2006, were reviewed for comparable concurrent findings and bronchopulmonary dysplasia or retarded cerebral dystrophy lacking the other principal feature of this syndrome. Archival review revealed four similar cases and eight less so, without gene analysis. Further review for bronchopulmonary dysplasia revealed 59 cases, 1983-2006. Several other examples of similar retarded migration of germinal matrix and underdevelopment of cortical mantle, without pulmonary lesions of this type, were identified. The determination of an ABCA3 mutation in one case of severe pulmonary fibrosis with significant dystrophy of the brain and the identification of four highly similar archival cases and eight others with partial pathological findings supports the designation of an independent disorder, here referred to as the cerebroprrlmonary dysgenetic syndrome

Effects of shifts in food deprivation on consummatory successive negative contrast

a b s t r a c t Rats exposed to a downshift from a large reward (32% sucrose) to a small reward (4% sucrose) show less consummatory behavior than unshifted rats always exposed to the small reward-an effect called consummatory successive negative contrast (cSNC). Four experiments studied the effects of shifts in deprivation level between preshift and postshift sessions on the size of the cSNC effect. This manipulation is designed to test the general proposition that the cSNC effect depends not only on external factors (e.g., reward disparity), but also on the internal state of the organism either at the time it first experiences the rewards (incentive learning), at the time of reward downshift (reward need), or as a function of the transition of states from pre-to postshift sessions (state dependency). Experiments 1-2 adjusted deprivation level during a 10-day interval between the last preshift and first postshift sessions. During this interval, food deprivation was either maintained or changed (increased or reduced) relative to preshift sessions. Experiments 3-4 maintained all animals at 81-85% of their ad lib weight during the entire experiment, but they were either fed before each session (nondeprivation condition) or fed after the session (deprivation condition). This procedure avoided the 10-day interval used in previous experiments. In three of the four experiments, the size of the cSNC effect increased when animals were deprived while exposed to the large reward (32% sucrose) during preshift sessions, independently of postshift deprivation conditions. The remaining experiment yielded inconclusive results. Of the three tested hypothesis, the incentive learning view received the strongest support. According to this view, the incentive value of the large reward is partly determined by the deprivation state of the organism at the time of learning. © 2015 Elsevier Inc. All rights reserved. Animals exposed to reward devaluation show an abrupt reduction or disruption in instrumenta

Improving Hand Recovery in Tetraplegia Through the use of Meaningful Occupations: A Qualitative Case Series

Purpose: This qualitative descriptive study explored participants’, with chronic spinal cord injury (SCI), experiences with meaningful intensive task specific training (ITST). Methods: Three participants completed 24-ITST upper extremity motor therapy intervention sessions. Qualitative interviews were completed at three time points for a case series: baseline, within 7 days of the completion of the final ITST intervention session, and within one month of the final ITST intervention session for a total of 9 interviews. Results: Three themes were identified including: Quality of Movement Enhances Normal Use of Hands, Empowering Through Education and Motivation to Participate and Enhance Quality of Life. Through the use of motor learning concepts, positive reinforcement, and education positive outcomes were reported and promoted self-efficacy in all participants. Conclusions: A collaborative and client-centered approach to rehabilitation with a focus on performance-based goals was found to increase self-efficacy leading to greater independence and self-determination for participants. Interventions focusing on meaningful client-centered occupations are recommended. Individuals with chronic SCI typically do not have access to rehabilitation services and more research is needed on interventions to further explore the benefits of additional rehabilitation services and an increased focus on practitioner education on optimal interventions for chronic injury populations

Complex effects of reward upshift on consummatory behavior

Exposing rats to an upshift from a small reward to a larger reward sometimes yields evidence of consummatory successive positive contrast (cSPC), an effect that could be a suitable animal model of positive emotion. However, cSPC is an unreliable effect. Ten experiments explored the effects of an upshift in sucrose or saccharin concentration on consummatory behavior under several conditions. There was occasional evidence of cSPC, but mostly a combination of increased consummatory behavior relative to preshift reward concentrations and a reducedbehavioral level relative to unshifted controls. Such a pattern is consistent with processes causing opposite changes on behavior. Reward upshift may induce processes that suppress behavior, such as taste neophobia (induced by an intense sucrose taste) and generalization decrement (induced by novelty in reward conditions after the upshift). An experiment tested the role of such novelty-related effects by preexposing animals to either the upshift concentration(12% sucrose) or water during three days before the start of the experiment. Sucrosepreexposed animals drank significantly more than water-preexposed animals during the upshift, but just as much as unshifted controls (i.e., no evidence of cSPC). These results suggest that cSPC may be difficult to obtain reliably because reward upshift induces opposing processes.However, they also seriously question the ontological status of cSPC.Fil: Annicchiarico, Ivan. Texas Christian University; Estados UnidosFil: Glueck, Amanda C.. Texas Christian University; Estados UnidosFil: Cuenya, Lucas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Kawasaki, Katsuyoshi. Hoshi University; JapónFil: Conrad, Shannon E.. Texas Christian University; Estados UnidosFil: Papini, Mauricio Roberto. Texas Christian University; Estados Unido