1,720,973 research outputs found
Functional status and quality of life of stroke survivors undergoing rehabilitation programmes in a hospital setting
No full textBACKGROUND: While the positive effects of rehabilitation on physical functioning are well documented in stroke literature, more controversial results arise from the evaluation of the impact on quality of life.OBJECTIVE: The aim of the present study is to examine the associations among functional status and different measures of quality of life in a sample of inpatients undergoing rehabilitation programmes, and to consider the role of psychological distress, coping strategies and social support.METHODS: Twenty-nine stroke survivors were evaluated at the admission to a hospital-based Rehabilitation Unit and just before discharge. Questionnaires for the evaluation of functional status, health-related QoL, individualised QoL, psychological distress, coping strategies and social support were administered to them.RESULTS: While functional status improves significantly after treatment, individualised evaluations of QoL seem to be less affected. Adaptive coping strategies and social support showed significant correlations with positive outcomes on specific QoL domains, whereas psychological distress was associated with negative outcomes.CONCLUSIONS: The data from the present study support the evidence that different measures of QoL and functional status are not strongly associated one another, and that psychological distress, coping strategies and social support can be significantly related to specific outcome measures
The role of psychological well-being in multiple sclerosis rehabilitation
No full textBACKGROUND: In patients affected by multiple sclerosis (MS) the disabilities increase during the progression of the disease, with a negative impact on quality of life. Rehabilitation improves motor performances, but remains unclear the role of psychological variables on motor recovery. AIM: The aim of this study was to investigate the role of the psychological well-being during a rehabilitation care in MS patients with moderate to severe disability. DESIGN: Longitudinal study. SETTING: Outpatients in a Neurorehabilitation Unit of Pisa and Ferrara University Hospital. POPULATION: 93 subjects affected by MS with moderate to severe degree of impairment were recruited (43 male, 50 female; mean age 53±11.19 years). In relation to the Expanded Disability Status Scale (EDSS) score the sample was divided in two group: Group 1 with moderate impairment (EDSS 4-5.5) and Group 2 with severe impairment (EDSS 6-7). METHODS: Psychological and functional status was assessed before and after a motor rehabilitative treatment, appropriate to their clinical needs. Parameters collected were: Short Form 36, Patient Health Questionnaire, Fatigue Severity Scale, 6-minute walking test and 10-meter walking test. RESULTS: Mood disorders, low quality of life (QoL) and high perceived fatigue are characteristic symptoms in our sample. Results do not show a direct correlation with motor impairment. Mood improves in both groups, while walking endurance and speed ability recovers only in Group 1, on the contrary QoL improves only in Group 2. Regression analysis show that in Group 1 a better QoL predicts a higher motor recovery, whereas in Group 2 the improvement of walking endurance influences the subjective well-being at the discharge. CONCLUSIONS: Subjective well-being is related with the perception of the new condition of life. In less impaired patients psychological status can influence the liability toward rehabilitation treatment, while in more impaired patients motor recovery affect well-being. Therefore, the psychological counselling should be provided during the rehabilitation treatment in order to achieve a successful patients' care. CLINICAL REHABILITATION IMPACT: Our approach contributes to bring out the role of subjective factors on motor rehabilitation outcome and the functional recovery effect on the psychological well-being. The knowledge of subjective needs related to disability degree should be used to customize an appropriate care in MS patients
Long-latency components of somatosensory evoked potentials during passive tactile perception of gratings
No full textPerception of tactile stimuli elicits Somatosensory Evoked Potentials (SEPs) that can be recorded via non-invasive electroencephalography (EEG). However, it is not yet clear how SEPs localization, shape and latency are modulated by different stimuli during mechanical tactile stimulation of fingertips. The aim of this work is thus to characterize SEPs generated by the tactile perception of gratings during dynamic passive stimulation of the dominant fingertip by means of a mechatronic platform. Results show that a random sequence of stimuli elicited SEPs with two long-latency components: (i) a negative deflection around 140 ms located in the frontal-central-parietal side in the contralateral hemisphere; (ii) a positive deflection around 250 ms located in the frontal-central midline. Time-frequency analysis revealed significant continuous bilateral desynchronization in the alpha band throughout the passive stimulation. These results are a fundamental step towards building a model of brain responses during perception of tactile stimuli for future benchmarking studies
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
A survey on virtual environment applications to fear of public speaking
No full textSocial Anxiety Disorder (SAD) is one of the most prevalent anxiety disorders in Europe and comprises the fear of public speaking as its typical sub-type. Cognitive-Behavioural Therapy (CBT) is the intervention of choice for SAD, and it includes exposure to anxiety-provoking stimuli to induce systematic desensitization and reduce anxiety. Similarly, exposure therapy per se has been used and found effective, although it is not as specific as CBT for the treatment of SAD. Interestingly, exposure to anxiety-provoking situations can be achieved in Virtual Environments (VEs) through the simulation of social situations allowing individuals with public speaking anxiety to live and develop real exposure-like reactions. The Virtual Reality Exposure Therapy (VRET) is the treatment of anxiety disorders based on such VEs.
AIM: This article aims to provide an overview of the scientific literature related to the applications of Virtual reality to the treatment of fear of public speaking.
MATERIALS AND METHODS: We conducted the literature review on PubMed and Google Scholar for studies including the fear-of-publicspeaking VEs.
RESULTS AND CONCLUSIONS: Reviewed studies addressed two main aspects: the design parameters of the VEs for adequate reactions to synthetic social stimuli, and the efficacy of VEs for fear of public speaking treatment. VEs resulted effective for triggering as-if-real reactions in relation to public speaking. VE-based exposures reduced public speaking anxiety measurements, decreased scores and maintained them at 3 month follow-up.
Studies comparing VRET to pharmacological therapy are lacking, and there are few randomized controlled trials that compare VRET to CBT, especially on fear of public speaking treatment
Caregiver burden and family functioning in different neurological diseases
No full textAim of this study is to examine caregiver burden and family
functioning in different neurological conditions. Forty-two primary
caregivers of patients with Amyotrophic Lateral Sclerosis (ALS),
Alzheimer’s Disease and other dementia (AD), Parkinson’s Disease
(PD), Acquired Brain Injuries (ABI) and Multiple Sclerosis (MS) were
administered scales for the evaluation of caregiver burden (CBI)
and family functioning (FACES IV). Caregiver burden was overall
high, with caregivers of patients with ALS and ABI having
exceeded the CBI cut-off score for possible burn-out. The average
scores of caregivers of patients with AD or other dementia and PD
were close to the cut-off score, whereas those of caregivers of
patients with MS were significantly lower than the others. Family
cohesion, family satisfaction and the quality of family communication
were associated with reduced levels of caregiver burden,
whereas disengagement was associated with a higher burden.
The data from the present study confirm that caregiver burden is
a relevant issue in the context of neurological diseases, especially
for those causing higher degrees of impairment. Significant correlations
with family functioning emerged as well, highlighting the
importance of studying and treating caregiver burdenwithin the context of family relations
Predictive value of electroencephalography connectivity measures for motor training outcome in multiple sclerosis: an observational longitudinal study
No full textBACKGROUND: Neurophysiological investigations represent powerful tools to shed light on brain plasticity in multiple sclerosis (MS) patients. AIM: We investigated the relationship between electroencephalography (EEG)-based connectivity, the extent of brain lesions and changes in motor performance after an intensive task-oriented circuit training (TOCT). DESIGN: Observational longitudinal study. SETTING: Outpatients training program. POPULATION: Sixteen MS patients (10F; mean age =51.4 years; range: 27-67; mean disease duration =15.1 years; range: 2-26; mean Expanded Disability Status Scale 4.4; range: 3.5-5.5), were included in our study. METHODS: MS patients with mild gait impairment were evaluated through functional scales and submitted to TOCT. Resting-state EEG was performed before (T0) and after (T1) rehabilitation. Alpha-band weighted Phase Lag Index (wPLI) and broadband weighted Symbolic Mutual Information (wSMI) connectivity analyses were performed. White matter lesion load was measured using MRI prior to the TOCT. Neurophysiological and structural parameters were then related to behavioral changes. RESULTS: Dynamic Gait Index significantly improved after TOCT (F(1,14) =13.10, P=0.003). Moreover, the interaction between TOCT and age was observed for changes in Timed Up and Go (TUG) performance (F(1,14) = 7.75, P=0.015), indicating that older patients only benefited in this measure. Regarding the relationship between EEG connectivity and TOCT outcome, we observed positive correlations between changes in TUG and strength (P=0.017) and efficiency (Pone-tail =0.029) of alpha-band wPLI connectivity at T0. Such correlation was mainly driven by antero-posterior regional interactions (P=0.038), rather than by inter-hemispheric connectivity (P=0.089). Moreover, we observed a positive correlation between performance improvements and wSMI connectivity at T1 (P=0.001) as well as the difference between T0 and T1 (P=0.005). Lesion load percentage was not related to functional improvement after TOCT (Pone-tail=0.137). CONCLUSIONS: Results of the current study demonstrated that baseline alpha-band wPLI connectivity predicts TOCT outcome in MS patients. Moreover, broadband wSMI tracks neural changes that accompany treatment-related variations in motor performance. CLINICAL REHABILITATION IMPACT: Our findings suggest that EEG-based connectivity measures may represent a potential tool for customizing rehabilitative management of the disease
Unidirectional brain to muscle connectivity reveals motor cortex control of leg muscles during stereotyped walking
Full text linkIn lower mammals, locomotion seems to be mainly regulated by subcortical and spinal networks. On the contrary, recent evidence suggests that in humans the motor cortex is also significantly engaged during complex locomotion tasks. However, a detailed understanding of cortical contribution to locomotion is still lacking especially during stereotyped activities. Here, we show that cortical motor areas finely control leg muscle activation during treadmill stereotyped walking. Using a novel technique based on a combination of Reliable Independent Component Analysis, source localization and effective connectivity, and by combining electroencephalographic (EEG) and electromyographic (EMG) recordings in able-bodied adults we were able to examine for the first time cortical activation patterns and cortico-muscular connectivity including information flow direction. Results not only provided evidence of cortical activity associated with locomotion, but demonstrated significant causal unidirectional drive from contralateral motor cortex to muscles in the swing leg. These insights overturn the traditional view that human cortex has a limited role in the control of stereotyped locomotion, and suggest useful hypotheses concerning mechanisms underlying gait under other conditions. One sentence summary Motor cortex proactively drives contralateral swing leg muscles during treadmill walking, counter to the traditional view of stereotyped human locomotion
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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