The aims of this narrative review are to provide scientific support to characterize the postural instability commonly observed in Parkinson’s disease (PD), and to emphasize how bottom-up rehabilitation programs stimulating the sole of the foot can improve postural stability in PD. Postural instability is a typical characteristic of individuals with PD, which increases the frequency of falls and may worsen their consequences. It thus seems relevant to diagnose these alterations as early as possible, in order to develop specific rehabilitative treatment. The association between sensitivity of the sole of the foot and postural instability in individuals with PD is linked to the key role of peripheral alterations of the sensorimotor system in balance and motor symptoms. By enhancing sensory feedback coming from the feet, bottom-up stimulation allows patients to improve their sensorimotor control. In clinical practice, health practitioners can use sensory stimulation to improve postural control. By improving postural stability, a decrease in fall risk can be achieved and the secondary impairments associated with falls prevented. 相似文献
BackgroundOur world is unfortunately facing a huge number of stroke. Attention, response control and activities of daily living (ADL) are important cognitive functions affected by stroke. In line with this explanation, we aimed to investigate the effect of RehaCom rehabilitation software on ADL, attention and response control in chronic stroke patients with damage to middle and anterior cerebral arteries.MethodFor selecting participants, among chronic stroke patients who referred to our special rehabilitation clinic for patients with stroke, fifty patients selected. Participants were assigned to control (n = 25) and experimental (n = 25) groups. The experimental group was compared with the control group before and after using RehaCom (ten 45-min sessions in five weeks).ResultsThere is a significant enhancement in ADL, attention and response control scores in the experimental group compared with the control group. In fact, treatment with RehaCom significantly improved the score of all studied variables in chronic stroke patients.ConclusionsIn conclusion, RehaCom cognitive rehabilitation software has improvement effect on ADL, attention and response control in patients with chronic stroke. Our study reveals a new information about the efficacy of computerized training in the rehabilitation of stroke patients. 相似文献
The pathophysiology of dropped head syndrome (DHS) remains unknown, and its treatment algorithm and indication are not standardized. Here, we established a novel rehabilitation program, short and intensive rehabilitation program for DHS (SHAiR program), consisting of cervical paraspinal muscles exercise, range of motion exercise, cervical and thoracic mobilization, deep cervical flexor muscle exercise, hip lift exercise, anterior pelvic tilt exercise, and walking exercise. The aim of this study was to evaluate the clinical effectiveness of this program. We reviewed clinical outcomes for five consecutive patients with DHS who underwent the SHAiR program (SHAiR group). The outcomes were compared with those of other five patients with DHS who received exercise instruction (control group). Demographic data, the duration from onset of DHS, the apex of sagittal kyphosis on the lateral radiographs, and clinical outcomes including the ability to maintain normal horizontal gaze, chin brow vertical angle, and numerical rating scale (NRS) were evaluated at the initial visit and final follow-up at 7.5 months. There was no significant difference between the two groups in terms of demographic and radiographic data. The ability of horizontal gaze and NRS of cervical pain improved rapidly for all five patients in the SHAiR group as compared to no improvement for all patients in the control group. Rehabilitation for DHS was considered effective not only for localized rehabilitation such as exercise for training cervical extensor muscle function but also exercises for thoracolumbar posture improvement and the psoas muscle. 相似文献
Maksoud Boghos Cololian was born December 12, 1869 in Ortakeuy. It was a suburb of Constantinople. The young Maksoud Boghos was sent to the Armenian school of Berberian when he is expected to learn to read and write in. It was here he developed a taste for litterature and the knowledge of the French language thanks to a thorough instruction. When he completed his secondary schooling, he left Armenia for France. In September 1889, he registered at the faculty of medicine of Paris. Extern in 1891 then intern from the asylums of the Seine (1894), he was appointed doctor of medicine in 1898. Cololian acquired a deep knowledge of psychiatry under the direction of great specialists (Taguet, Briand, Magnan, Garnier). Member of the Société Médico-Psychologique in 1902, his happy memories of his non-residential internship in the department of Nicolas Augustin Gilbert (1858–1927) led him to practice general medicine. That is the speciality he dedicated to as a liberal, in Paris rue de Ponthieu, without forgetting his training in psychiatry. In the Rosenwald Book, his speciality was neuropsychiatry. Considering he was a former Ottoman subject and volunteer since the beginning of hostilities in 1914, Cololian became immediately naturalized French with the title of assistant major physician medical. He was appointed head physician of the physiotherapy centers of Versailles (VR 69 and 74), Grignon and the Officers’ Hospital at Versailles. Also, he named himself Paul. He took care of war-wounded and became a precursor in the field of mechano-therapeutic on one hand, and for the measurement of impotence and infirmities one the other hand. In 1918, Cololian was decorated with the Legion of Honor by Raymond Poincaré (1860–1934) himself. Several times laureate of the Academy of Medicine and the Institute, Cololian wrote articles or memories on semiology and psychiatric treatment. He was with P. Garnier the author of a treatise on therapeutics of mental and nervous diseases (1901). Author of chronic hunting in the newspaper “Le Figaro”, medical and scientific popularization in the review “Guérir” and “La Femme et l’Enfant” and too informal written in “Les Annales politiques et littéraires”, Cololian published various articles or analyzes on studies based on morbid psychological constitutions from characters in literature, plays, movies or politics (Emma Bovary, Marie Lafarge, Hitler…). In his psychiatric and psychoanalytic reading of Flaubert's Madame Bovary, Cololian asserted that the creator of Freudianism was Flaubert. Regarding psychoanalysis, he felt Freud's theory had been taken too far by the founder and mostly by his students. 相似文献
Background: Little is known of stroke outcomes in low- and middle-income countries with limited formal stroke rehabilitation services and of homebased-stroke services delivered within the primary health care (PHC) context by community health workers (CHWs).
Objectives: To describe and analyze the outcomes of patients with stroke from a rural PHC setting in the Western Cape, South Africa.
Methods: In a longitudinal survey, 93 stroke patients, referred to home and community-based care services (HCBC) between June 2015 and December 2017, were assessed at baseline, one month and three months. Changes in function (Barthel Index (BI)), caregiver strain (Caregiver Strain Index (CSI)), impact of environmental factors and satisfaction with stroke care were measured.
Results: HCBC was delayed, fragmented and brief (median session duration 20 minutes (IQR 15.0–30.0)). Although function improved significantly, dependence remained high: median BI score changed from 40.0 (IQR 15.0–70.0) to 62.5 (IQR 30.0–81.25) (p = .019). A third (33.0% (30/91)) of caregivers initially experienced strain and the median CSI score remained 3.0 (IQR 0.0–7.0) (p = .672). Overall, patient and caregiver satisfaction with HCBC was low with only 46.9% (31/66) of caregivers and 17.4% (12/69) of patients satisfied with all aspects of care. Only 47.6% of assistive product needs were met. Environmental factors negatively impacted on patient function and caregiving.
Conclusions: Clinical practice pathways and referral guidelines should be developed for the HCBC platform. Specific training of CHWs, focusing on how to educate, support and train family caregivers, provide assistive devices and refer to health services is needed. 相似文献
Objective: Multiple sclerosis (MS) is associated with prospective memory (PM) deficits, which may increase the risk of poor functional/health outcomes such as medication non-adherence. This study examined the potential benefits of selective reminding to enhance PM functioning in persons with MS.
Method: Twenty-one participants with MS and 22 healthy adults (HA) underwent a neuropsychological battery including a Selective Reminding PM (SRPM) experimental procedure. Participants were randomly assigned to either: (1) a selective reminding condition in which participants learn (to criterion) eight prospective memory tasks in a Selective Reminding format; or (2) a single trial encoding condition (1T).
Results: A significant interaction was demonstrated, with MS participants receiving greater benefit than HAs from the SR procedure in terms of PM performance. Across diagnostic groups, participants in the SR conditions (vs. 1T conditions) demonstrated significantly better PM performance. Individuals with MS were impaired relative to HAs in the 1T condition, but performance was statistically comparable in the SR condition.
Conclusions: This preliminary study suggests that selective reminding can be used to enhance PM cue detection and retrieval in MS. The extent to which selective reminding of PM is effective in naturalistic settings and for health-related behaviours in MS remains to be determined. 相似文献