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Neurorehabilitation of Neurodegenerative Diseases and Brain Damage

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A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Neurology".

Deadline for manuscript submissions: closed (30 June 2021) | Viewed by 14991

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Special Issue Editors

Prof. Dr. Juan Pablo Romero

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Guest Editor

1. Faculty of Experimental Sciences, Brain Injury and Movement Disorders Neurorehabilitation Research Group, Francisco de Vitoria University, 28223 Madrid, Spain
2. Brain Damage Unit, Beata María Ana Hospital, 28007 Madrid, Spain
Interests: neurorehabilitation of the motor and non-motor symptoms of Parkinson's disease; neurorehabilitation of motor and cognitive sequelae of acquired brain injury
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Marcos Rios Lago

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Co-Guest Editor

National Distance Education University, Brain Damage Unit, Beata María Ana Hospital, Madrid, Spain
Interests: neuropsychology; human processing speed; traumatic brain injury; magnetic resonance; neurorehabilitation

Special Issue Information

Dear Colleagues,

Neurorehabilitation is a key multidisciplinary effort to recover functions in order to regain independence and increase the quality of life of affected subjects. Traumatic brain injury, stroke, and neurodegenerative diseases affect our patients in different stages of life, but all of them can cause different degrees of motor and cognitive disability. Residual deficits from these diseases determine a need for continuous healthcare and social assistance which causes a great social and economic burden in every society.

Thanks to recent advances in our knowledge of the nervous system from neurophysiological, clinical, and neuroimaging studies, neurorehabilitation has greatly evolved leading to new rehabilitation approaches, but some crucial aspects remain unsolved.

In recent years, technological advances have allowed us to reinforce and improve the results of neurorehabilitation through robotics, non-invasive neuromodulation, virtual reality, and gamification of rehabilitation.

Given the importance of the neurorehabilitation of neurodegenerative diseases and brain damage in the field of medicine and research, the journal Medicina is launching this Special Issue.

We encourage you and your co-workers to submit your articles reporting on this topic. Reviews, project protocols, or original articles dealing with new strategies for cognitive, motor, or sensorial rehabilitation are welcome, as well as articles providing an up-to-date overview of the use of clinical, neurophysiological, or neuroimaging tools for prognostic marker identification or disease characterization. In addition, we warmly invite you to submit articles reporting on evidence and expectations from non-invasive neuromodulation therapies applied to neurorehabilitation, with a special focus on individualized approaches. Especially welcome are articles related to traumatic brain injury, stroke, Parkinson´s Disease, and Alzheimer´s Disease.

Dr. Juan Pablo Romero
Prof. Dr. Marcos Rios Lago
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Traumatic brain injury
Stroke
Parkinson´s Disease
Alzheimer´s Disease
Non-invasive neuromodulation
tDCS
TMS
Neuropsychology
Rehabilitation

Published Papers (4 papers)

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Research

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13 pages, 1148 KiB

Open AccessArticle

Robot-Assisted Gait Training in Patients with Multiple Sclerosis: A Randomized Controlled Crossover Trial

by Cristiano Sconza, Francesco Negrini, Berardo Di Matteo, Alberto Borboni, Gennaro Boccia, Ignas Petrikonis, Edgaras Stankevičius and Roberto Casale

Medicina 2021, 57(7), 713; https://doi.org/10.3390/medicina57070713 - 14 Jul 2021

Cited by 19 | Viewed by 4660

Abstract

Background and Objectives: Gait disorders represent one of the most disabling aspects in multiple sclerosis (MS) that strongly influence patient quality of life. The improvement of walking ability is a primary goal for rehabilitation treatment. The aim of this study is to evaluate the effectiveness of robot-assisted gait training (RAGT) in association with physiotherapy treatment in patients affected by MS in comparison with ground conventional gait training. Study design: Randomized controlled crossover trial. Materials and Methods: Twenty-seven participants affected by MS with EDSS scores between 3.5 and 7 were enrolled, of whom seventeen completed the study. They received five training sessions per week over five weeks of conventional gait training with (experimental group) or without (control group) the inclusion of RAGT. The patients were prospectively evaluated before and after the first treatment session and, after the crossover phase, before and after the second treatment session. The evaluation was based on the 25-foot walk test (25FW, main outcome), 6 min walk test (6MWT), Tinetti Test, Modified Ashworth Scale, and modified Motricity Index for lower limbs. We also measured disability parameters using Functional Independence Measure and Quality of Life Index, and instrumental kinematic and gait parameters: knee extensor strength, double-time support, step length ratio; 17 patients reached the final evaluation. Results: Both groups significantly improved on gait parameters, motor abilities, and autonomy recovery in daily living activities with generally better results of RAGT over control treatment. In particular, the RAGT group improved more than control group in the 25FW (p = 0.004) and the 6MWT (p = 0.022). Conclusions: RAGT is a valid treatment option that in association with physiotherapy could induce positive effects in MS-correlated gait disorders. Our results showed greater effectiveness in recovering gait speed and resistance than conventional gait training. Full article

(This article belongs to the Special Issue Neurorehabilitation of Neurodegenerative Diseases and Brain Damage)

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8 pages, 389 KiB

Open AccessArticle

The Berg Balance Scale at Admission Can Predict Community Ambulation at Discharge in Patients with Stroke

by Wen-Ling Liao, Chiung-Wen Chang, Pi-Yu Sung, Wei-Nung Hsu, Ming-Wei Lai and Sen-Wei Tsai

Medicina 2021, 57(6), 556; https://doi.org/10.3390/medicina57060556 - 31 May 2021

Cited by 10 | Viewed by 3102

Abstract

Background and Objectives: To regain the ability of community ambulation is a meaningful goal for stroke patients. Recent research recommended that the distance accomplished during the six-minute walk test (≥205 m in 6MWT) is the fittest for defining community ambulation. Until now, there are few studies that have used the updated definition to investigate the related predictors. The aim of this study was to investigate the association between the admission clinical parameters and community ambulation measured by the 6MWT at discharge. The other aim was to find the admission Berg Balance Scale (BBS) cut-off score to discriminate between household or community ambulators. Materials and Methods: This cohort study collected the data of patients who entered the post-acute Care Cerebrovascular Diseases program. Multivariate logistic regression was used to identify significant predictors measured at admission that are associated with community ambulation, and a receiver operating characteristic was adopted to calculate the cut-off value for admission status. There were 120 participants included in this study, and 25% (n = 30) of them regained the ability of community ambulation at discharge. The BBS on admission was identified as the only significant predictor for community ambulation (odds ratio 1.06). Results: The optimal cut-off score for the BBS at admission was 29, and the area under the curve for BBS scores on admission when discriminating between household and community ambulators at discharge was 0.74. Conclusions: The admission BBS scores could be used to predict household and community ambulators at discharge in stroke patients. The results of this study could help clinical physicians set appropriate discharge goals early. Full article

(This article belongs to the Special Issue Neurorehabilitation of Neurodegenerative Diseases and Brain Damage)

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13 pages, 965 KiB

Open AccessStudy Protocol

Clinical Effects of Immersive Multimodal BCI-VR Training after Bilateral Neuromodulation with rTMS on Upper Limb Motor Recovery after Stroke. A Study Protocol for a Randomized Controlled Trial

by Francisco José Sánchez-Cuesta, Aida Arroyo-Ferrer, Yeray González-Zamorano, Athanasios Vourvopoulos, Sergi Bermúdez i Badia, Patricia Figuereido, José Ignacio Serrano and Juan Pablo Romero

Medicina 2021, 57(8), 736; https://doi.org/10.3390/medicina57080736 - 21 Jul 2021

Cited by 7 | Viewed by 3500

Abstract

Background and Objectives: The motor sequelae after a stroke are frequently persistent and cause a high degree of disability. Cortical ischemic or hemorrhagic strokes affecting the cortico-spinal pathways are known to cause a reduction of cortical excitability in the lesioned area not only for the local connectivity impairment but also due to a contralateral hemisphere inhibitory action. Non-invasive brain stimulation using high frequency repetitive magnetic transcranial stimulation (rTMS) over the lesioned hemisphere and contralateral cortical inhibition using low-frequency rTMS have been shown to increase the excitability of the lesioned hemisphere. Mental representation techniques, neurofeedback, and virtual reality have also been shown to increase cortical excitability and complement conventional rehabilitation. Materials and Methods: We aim to carry out a single-blind, randomized, controlled trial aiming to study the efficacy of immersive multimodal Brain–Computer Interfacing-Virtual Reality (BCI-VR) training after bilateral neuromodulation with rTMS on upper limb motor recovery after subacute stroke (>3 months) compared to neuromodulation combined with conventional motor imagery tasks. This study will include 42 subjects in a randomized controlled trial design. The main expected outcomes are changes in the Motricity Index of the Arm (MI), dynamometry of the upper limb, score according to Fugl-Meyer for upper limb (FMA-UE), and changes in the Stroke Impact Scale (SIS). The evaluation will be carried out before the intervention, after each intervention and 15 days after the last session. Conclusions: This trial will show the additive value of VR immersive motor imagery as an adjuvant therapy combined with a known effective neuromodulation approach opening new perspectives for clinical rehabilitation protocols. Full article

(This article belongs to the Special Issue Neurorehabilitation of Neurodegenerative Diseases and Brain Damage)

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9 pages, 1013 KiB

Open AccessStudy Protocol

Validation of Cognitive Rehabilitation as a Balance Rehabilitation Strategy in Patients with Parkinson’s Disease: Study Protocol for a Randomized Controlled Trial

by Aida Arroyo-Ferrer, Francisco José Sánchez-Cuesta, Yeray González-Zamorano, María Dolores del Castillo, Carolina Sastre-Barrios, Marcos Ríos-Lago and Juan Pablo Romero

Medicina 2021, 57(4), 314; https://doi.org/10.3390/medicina57040314 - 26 Mar 2021

Cited by 4 | Viewed by 2622

Abstract

Background: Parkinson’s disease (PD) is the second most common neurodegenerative disorder. This disease is characterized by motor symptoms, such as bradykinesia, tremor, and rigidity. Although balance impairment is characteristic of advanced stages, it can be present with less intensity since the beginning of the disease. Approximately 60% of PD patients fall once a year and 40% recurrently. On the other hand, cognitive symptoms affect up to 20% of patients with PD in early stages and can even precede the onset of motor symptoms. There are cognitive requirements for balance and can be challenged when attention is diverted or reduced, linking a worse balance and a higher probability of falls with a slower cognitive processing speed and attentional problems. Cognitive rehabilitation of attention and processing speed can lead to an improvement in postural stability in patients with Parkinson’s. Methods: We present a parallel and controlled randomized clinical trial (RCT) to assess the impact on balance of a protocol based on cognitive rehabilitation focused on sustained attention through the NeuronUP platform (Neuronup SI, La Rioja, Spain) in patients with PD. For 4 weeks, patients in the experimental group will receive cognitive therapy three days a week while the control group will not receive any therapy. The protocol has been registered at trials.gov NCT04730466. Conclusions: Cognitive therapy efficacy on balance improvement may open the possibility of new rehabilitation strategies for prevention of falls in PD, reducing morbidity, and saving costs to the health care system. Full article

(This article belongs to the Special Issue Neurorehabilitation of Neurodegenerative Diseases and Brain Damage)

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