A Case of Apoplexy Attack-Like Neuropathy due to Hereditary Neuropathy with Liability to Pressure Palsies in a Patient Diagnosed with Chronic Cerebral Infarction

Hereditary neuropathy with liability to pressure palsies is an inherited disease associated with the loss of a copy of the PMP22 gene. The condition leads to mononeuropathy due to compression and easy strangulation during daily life activities, resulting in sudden muscle weakness and sensory disturbance, and displaying symptoms similar to cerebrovascular diseases. We report the case of an 80-year-old man with left paralysis due to chronic cerebral infarction. His medical history indicated remarkable recovery from about 4 months after the onset of left hemiplegia with predominant involvement of the fingers. Despite subsequent recurrent monoplegia of the upper or lower limbs, brain magnetic resonance imaging consistently revealed only previous cerebral infarction in the right corona radiata without new lesions. Medical examination showed reduced deep tendon reflexes in his extremities on both the healthy and hemiplegic sides. Nerve conduction studies showed delayed conduction at the bilateral carpal and cubital tunnels and near the right caput fibulae. Genetic analysis revealed loss of a copy of the PMP22 gene. Thus, he was diagnosed with a cerebral infarction complicated by hereditary neuropathy with liability to pressure palsies. Stroke patients develop sudden muscle weakness and sensory disturbance. However, if such patients have no hyperactive deep tendon reflexes and show atypical recovery of paralysis that does not correspond to findings of imaging modalities, nerve conduction studies and genetic analysis may be necessary, considering the complication of hereditary neuropathy with liability to pressure palsies

Development of Practical Wrist Rehabilitation Robot by Mirror Effect

The authors have developed wrist rehabilitation robot for hemiplegic patients. The robot is much effective for repetitive rehabilitation, and useful for patients. Mirror effect control system is developed based on the experience that a patient can easily move a limb while moving a limb on the other side. The effectiveness is successfully confirmed by the practical test in the hospital.3rd International Conference on Advanced Materials Design and Mechanics, ICAMDM 2014; ; 23 May 2014 through 24 May 201

Assessment of the Efficacy of ReoGo-J Robotic Training Against Other Rehabilitation Therapies for Upper-Limb Hemiplegia After Stroke: Protocol for a Randomized Controlled Trial

Background: Stroke patients experience chronic hemiparesis in their upper extremities leaving negative effects on quality of life. Robotic therapy is one method to recover arm function, but its research is still in its infancy. Research questions of this study is to investigate how to maximize the benefit of robotic therapy using ReoGo-J for arm hemiplegia in chronic stroke patients.Methods: Design of this study is a multi-center parallel group trial following the prospective, randomized, open-label, blinded endpoint (PROBE) study model. Participants and setting will be 120 chronic stroke patients (over 6 months post-stroke) will be randomly allocated to three different rehabilitation protocols. In this study, the control group will receive 20 min of standard rehabilitation (conventional occupational therapy) and 40 min of self-training (i.e., sanding, placing and stretching). The robotic therapy group will receive 20 min of standard rehabilitation and 40 min of robotic therapy using ReoGo®-J device. The combined therapy group will receive 40 min of robotic therapy and 20 min of constraint-induced movement therapy (protocol to improve upper-limb use in ADL suggests). This study employs the Fugl-Meyer Assessment upper-limb score (primary outcome), other arm function measures and the Stroke Impact Scale score will be measured at baseline, 5 and 10 weeks of the treatment phase. In analysis of this study, we use the mixed effects model for repeated measures to compare changes in outcomes between groups at 5 and 10 Weeks. The registration number of this study is UMIN000022509.Conclusions: This study is a feasible, multi-site randomized controlled trial to examine our hypothesis that combined training protocol could maximize the benefit of robotic therapy and best effective therapeutic strategy for patients with upper-limb hemiparesis

Development of a rehabilitative training robot for both wrists

The authors developed a rehabilitative training robot which detects and analyzes the intention when a person tries to move a wrist with a biological signal, such as muscle action potential, and makes a wrist movement as one\u27s intention. It consists of a grip for wrists, an actuator, a biological signal primary means, biological signal processing part, and a training controller. Due to its small, compact size, training can be performed in a small space at a hospital or home. The new system which can conduct both wrists training is successfully developed for practical uses.2013 7th ICME International Conference on Complex Medical Engineering, CME 2013; Beijing; China; 25 May 2013 through 28 May 201

Return to work among elderly patients with acquired brain injuries

Objectives: Generally, it is difficult for elderly patients with acquired brain injuries (ABI) to return to work (RTW). To assess whether elderly patients with ABI can return to their workplace, like working-age patients, we investigated medical and support records and compared the rates of RTW between the working-age and elderly groups. Methods: A prospective cohort study on RTW among inpatients with ABI was conducted. We collected the clinical data of inpatients who were admitted to the Department of Neurosurgery for acute treatment and participation in a health and employment support program; follow-ups were conducted after discharge. Participants with almost independent activities of daily living (ADL) were enrolled. A χ2 test was used to examine factors influencing RTW and successful RTW by groups stratified by white-collar and blue-collar occupations and hemiplegia. The Kaplan-Meier method was used to calculate the RTW proportion curves. Results: The RTW rates were 74% for the working-age group and 89% for the elderly group (χ2 test, p=0.149); age was not a significant factor. Occupation type was the only significant factor for RTW (χ2 test, p=0.014). The RTW proportion curves of both the working age and elderly groups showed early RTW, and the elderly group had a significantly higher RTW profile than the working-age group (log-rank test, p<0.039). Almost all elderly participants were engaged in white-collar or less physical jobs, to which it is easy to return. Conclusions: In participants with almost independent ADL, the elderly group had a higher RTW rate than the working-age group

Rate of return to work in patients with stroke under the health and employment support program of Rosai hospitals in Japan

Abstract To facilitate return to work (RTW) in patients with stroke, a health and employment support (HES) program was started at Rosai hospitals in Japan. This study aimed to determine the rate of RTW in patients with stroke under this support program. We collected demographic and clinical data of patients with stroke from the implementation reports of the HES program. The program provided coordinated dual support, such as acute medical treatments, and stroke and vocational rehabilitation on the medical side, and management and support on the workplace side. The primary endpoint was RTW. Successful and unsuccessful RTW were examined using the χ2 test. The RTW rate curves were analyzed using the Kaplan–Meier method. We enrolled 483 patients; 355 (73%) and 128 (27%) patients had successful and unsuccessful RTW, respectively. Stroke types, neurological findings, and activities of daily living were significant factors for RTW. The Kaplan–Meier method revealed that left hemiplegia, right hemiplegia, and neuropsychological deficits, except for combined disability (hemiplegia with neuropsychological deficits), had similar RTW curves with an RTW rate of > 70%