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Effects of motor imagery training of Parkinson's disease: a protocol for a randomized clinical trial
Get PDFBackground
Gait disorders in individuals with Parkinson’s disease (PD) may be associated with alterations in the motor control system and aggravated by psychoemotional and cognitive issues. Therapeutic strategies aimed at self-perception and motor regulation seem to be promising. Motor imagery (MI) has been shown to be one of these strategies, but there is still no clear evidence of its applicability in this population. The aim of this trial is to determine the effects of motor-imagery training on the gait and electroencephalographic activity of individuals with PD.
Methods/design
The sample will consist of 40 individuals, aged between 45 and 75 years, in the mild and moderate phase of the disease, with the ability to generate voluntary mental images. They will be assessed for cognitive level, degree of physical disability, mental-image clarity, kinematic gait variables, electroencephalographic activity and mobility. Next, subjects will be randomly assigned to an experimental group (EG) and a control group (CG). The EG will perform motor imagery and gait, while the CG will only engage in gait exercises. Twelve training sessions will be conducted lasting up to 90 min each, three times a week, for 4 weeks. The subjects will be reassessed on the kinematic variables of gait, electroencephalographic activity and mobility at 1, 7 and 30 days after the final training session.
Discussion
The results may provide an important advance in neurological rehabilitation where an easy-access and low-cost intervention may help to improve gait, electroencephalographic activity and mobility in individuals with PD
Physical activity in individuals with a spinal cord injury: Towards observational-based recommendations
Get PDFRehabilitation following spinal cord injury: how animal models can help our understanding of exercise-induced neuroplasticity
Get PDFSpinal cord injury is a devastating condition that is followed by long and often unsuccessful recovery after trauma. The state of the art approach to manage paralysis and concomitant impairments is rehabilitation, which is the only strategy that has proven to be effective and beneficial for the patients over the last decades. How rehabilitation influences the remodeling of spinal axonal connections in patients is important to understand, in order to better target these changes and define the optimal timing and onset of training. While clinically the answers to these questions remain difficult to obtain, rodent models of rehabilitation like bicycling, treadmill training, swimming, enriched environments or wheel running that mimic clinical rehabilitation can be helpful to reveal the axonal changes underlying motor recovery. This review will focus on the different animal models of spinal cord injury rehabilitation and the underlying changes in neuronal networks that are improved by exercise and rehabilitation
Essensiell tremor
Get PDFEssensiell tremor rammer nesten 1 % av befolkningen og kan være svært hemmende. Fortsatt er mye uklart rundt patofysiologi, miljøfaktorer og genetiske årsaker. Sannsynligvis rommer diagnosen flere forskjellige tilstander. Vi gir her en oppdatert oversikt over essensiell tremor, medikamentell og nevrokirurgisk behandling samt gjennomgang av forslag til nye definisjoner for tremor generelt og essensiell tremor spesielt.
Essensiell tremor er en av de vanligste nevrologiske sykdommene, med en anslått prevalens på nesten 1 % og økende med alder (1). Tradisjonelt ble essensiell tremor oppfattet som en monosymptomatisk sykdom med aksjonstremor, men uten andre nevrologiske symptomer. Vi vet nå at tilstanden kan være mer kompleks, med flere motoriske og ikke-motoriske symptomer (2). En oversikt over essensiell tremor ble publisert i Tidsskriftet i 2008 (3). Siden den gang er det blitt introdusert en ny sykdomsklassifikasjon, og vi har fått flere og bedre alternativer til nevrokirurgisk behandling. Vi gir her en oppdatert klinisk oversikt over tilstanden. Artikkelen bygger dels på forfatternes egne erfaringer, dels på litteratursøk i PubMed, der et skjønnsmessig utvalg av relevante artikler om diagnostikk, etiologi, patofysiologi, definisjon og behandling etter 2007 er inkludert.måsjekke
Likemannstjeneste i Stavanger. Samarbeid om oppfølging etter institusjonsbehandling for rusavhengighet
Get PDFProsjektet «Likemannstjeneste i Stavanger» har vært et forsøk med en ny samarbeidsmodell hvor tidligere rusavhengige har fungert som lønnet støtteperson (likemann/mentor) for andre rusavhengige som er i rehabilitering fra rusavhengighet. Modellen er bygget rundt bruk av erfaringskompetanse i rusfeltet, hvor likemann/mentor i kraft av sine erfaringer fra å selv bli rusfri, kan fungere som en likeverdig rollemodell for deltagerne i likemannstjenesten. Områder hvor deltagerne har hatt størst behov for støtte fra en likemann, har vært ved inkludering av deltager på rusfrie aktiviteter og i rusfrie nettverk, samt ved likemannens funksjon som støttespiller i møte med det offentlige tjenesteapparatet. Likemann fremstår dermed i denne modellen som en personlig og lavterskel «døråpner», en rollemodell og en støttespiller for deltagerne
A Rhythm-Based Serious Game for Fine Motor Rehabilitation Using Leap Motion
Get PDFThis paper presents a system to deliver automated and noninvasive fine motor rehabilitation through a rhythm-based game using a Leap Motion Controller. The platform is a rhythm game wherein hand gestures are used as input and must match the rhythm and gestures shown on screen, thus allowing a physical therapist to represent an exercise session as a series of patterns involving the user's hand and finger joints. Fine motor rehabilitation plays an important role in the recovery and improvement of the effects of diseases and conditions such as stroke, Parkinson's disease, multiple sclerosis, among many others. Individuals with these conditions possess a wide range of impairments such as fine motor movement. The proposed serious game is adaptive to the player to enable access to patients across a wide range of ability. In two pilot studies in collaboration with the South West Advanced Neurological Rehabilitation (SWAN Rehab) in Phoenix, Arizona, we compared the performance of individuals with fine motor impairment to individuals without impairment to determine the accessibility of the proposed serious game, i.e., to assess whether the platform is adaptive to a user's range of motion to allow an individual with fine motor impairment to perform at a similar level as a non-impaired user. We also separately evaluated the adaptive calibration algorithm to understand its impact on an individual's performance.måsjekke
Context matters in implementation science: a scoping review of determinant frameworks that describe contextual determinants for implementation outcomes
Get PDFBackground
The relevance of context in implementation science is reflected in the numerous theories, frameworks, models and taxonomies that have been proposed to analyse determinants of implementation (in this paper referred to as determinant frameworks). This scoping review aimed to investigate and map how determinant frameworks used in implementation science were developed, what terms are used for contextual determinants for implementation, how the context is conceptualized, and which context dimensions that can be discerned.
Methods
A scoping review was conducted. MEDLINE and EMBASE were searched from inception to October 2017, and supplemented with implementation science text books and known published overviews. Publications in English that described a determinant framework (theory, model, taxonomy or checklist), of which context was one determinant, were eligible. Screening and inclusion were done in duplicate. Extracted data were analysed to address the study aims. A qualitative content analysis with an inductive approach was carried out concerning the development and core context dimensions of the frameworks. The review is reported according to the PRISMA guidelines.
Results
The database searches yielded a total of 1113 publications, of which 67 were considered potentially relevant based on the predetermined eligibility criteria, and retrieved in full text. Seventeen unique determinant frameworks were identified and included. Most were developed based on the literature and/or the developers’ implementation experiences. Six of the frameworks explicitly referred to “context”, but only four frameworks provided a specific definition of the concept. Instead, context was defined indirectly by description of various categories and sub-categories that together made up the context. Twelve context dimensions were identified, pertaining to different aggregation levels. The most widely addressed context dimensions were organizational support, financial resources, social relations and support, and leadership.
Conclusions
The findings suggest variation with regard to how the frameworks were developed and considerable inconsistency in terms used for contextual determinants, how context is conceptualized, and which contextual determinants are accounted for in frameworks used in implementation science. Common context dimensions were identified, which can facilitate research that incorporates a theory of context, i.e. assumptions about how different dimensions may influence each other and affect implementation outcomes. A thoughtful application of the concept and a more consistent terminology would enhance transparency, simplify communication among researchers, and facilitate comparison across studies
Et samfunn for alle – Likestilling, demokrati og menneskerettigheter. Regjeringens handlingsplan for likestilling av personer med funksjonsnedsettelse 2020–2025
Get PDFRegjeringens mål er et samfunn for alle. Et samfunn der alle borgere har samme muligheter til å ta utdanning, delta i arbeidslivet på like vilkår, få gode helsetjenester og selv velge hva de vil gjøre på fritida. Det handler om å være medborger i et demokrati