The changing field of rehabilitation

McDonald, John W.; Sadowsky, Cristina L.; Stampas, Argyrios

doi:10.1016/b978-0-444-52137-8.00020-6

Cited by 12 publications

(3 citation statements)

References 148 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is surprising considering that baclofen is centrally acting and its administration overlaps with recovery of neurological function [6,7]. Moreover, there are anecdotal reports of deleterious effects of baclofen in both humans and animal models [8,9]. Concerns regarding the neurologic safety of baclofen have even led to precautions against the use of anti-spasticity medications in the Brecovery phase^of stroke and multiple sclerosis [10].…”

Section: Introductionmentioning

confidence: 99%

A Longitudinal Study of the Neurologic Safety of Acute Baclofen Use After Spinal Cord Injury

et al. 2019

View full text Add to dashboard Cite

The objective of our study was to determine whether treatment with baclofen is neurologically safe with respect to exposure during recovery from spinal cord injury. We performed a secondary longitudinal analysis of a cohort of adult patients with traumatic acute spinal cord injury. Cumulative baclofen dose was computed over the first 4 weeks following injury from concomitant medication information from a completed clinical trial. The main outcome measure was neurologic status, which was assessed over 52 weeks with Bmarked recovery^defined as the conversion to higher sensory and motor function. To complete the drug safety profile, drug toxicity was assessed with assays from standard blood work. Multivariable Cox regression was used to compute hazard ratios (HRs) and 95% confidence intervals (CIs). Of the cohort (n = 651), 18% (n = 115) received baclofen within 4 weeks post injury. Baclofen use was associated with higher rates of marked neurologic recovery, even after adjustment for injury severity (HR = 2.1, 95% CI 1.5-3.0 for high dose vs none). Baclofen exposure was not associated with liver or renal side effects. The use of other medications indicated for spasticity was not associated with neurological outcomes. Overall, this longitudinal analysis provides level 3 evidence on the neurologic safety of baclofen and potential beneficial effects on recovery in the early days after acute traumatic spinal cord injury. The usefulness of concomitant medication files from completed clinical trials is highlighted. We also highlight the importance of incorporating logical patient questions and neurological outcomes into research addressing drug safety.

show abstract

Section: Introductionmentioning

confidence: 99%

A Longitudinal Study of the Neurologic Safety of Acute Baclofen Use After Spinal Cord Injury

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The disability-adjusted life years (DALYs) lost due to stroke is projected to rise globally from 38 million in 1990 to 61 million DALYs in 2020 [1]. Utilizing recent advances in brain-machine interface (BMI) and robot-assisted rehabilitation technologies, there is potential to promote functional compensation through sensorimotor adaptation and central nervous system plasticity [2] and help reduce the socio-economic burden of disability [3], [4]. Towards this end, rehabilitation robots and exoskeletons are being developed to improve functional motor recovery after stroke.…”

Section: Introductionmentioning

confidence: 99%

Detecting movement intent from scalp EEG in a novel upper limb robotic rehabilitation system for stroke

Bhagat

French

Venkatakrishnan

et al. 2014

2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society

View full text Add to dashboard Cite

Stroke can be a source of significant upper extremity dysfunction and affect the quality of life (QoL) in survivors. In this context, novel rehabilitation approaches employing robotic rehabilitation devices combined with brain-machine interfaces can greatly help in expediting functional recovery in these individuals by actively engaging the user during therapy. However, optimal training conditions and parameters for these novel therapeutic systems are still unknown. Here, we present preliminary findings demonstrating successful movement intent detection from scalp electroencephalography (EEG) during robotic rehabilitation using the MAHI Exo-II in an individual with hemiparesis following stroke. These findings have strong clinical implications for the development of closed-loop brain-machine interfaces to robotic rehabilitation systems.

show abstract

“…Lack of functional independence to access outpatient facilities, and more importantly, rehabilitation costs and reimbursement caps, can be significant rate-limiters in functional recovery and enhancing independent quality of life. Harnessing recent advances in brain–machine interfaces (BMI) and robotic-assisted rehabilitation technologies has the potential not only to promote functional restitution through sensorimotor adaptation and central nervous system plasticity [3], but also help reduce the socio-economic burden of disability [4, 5]. By adjusting parameters tailored to each individual, his/her state of disability, and goals of intervention, these technologies can provide greater durations of consistent, patient-engaged, repetitive motor practice that consequently allow a physical therapist to work with more patients in the same allotted time.…”

Section: Introductionmentioning

confidence: 99%

Applications of Brain–Machine Interface Systems in Stroke Recovery and Rehabilitation

Venkatakrishnan

Francisco

Contreras-Vidal

2014

Curr Phys Med Rehabil Rep

View full text Add to dashboard Cite

Stroke is a leading cause of disability, significantly impacting the quality of life (QOL) in survivors, and rehabilitation remains the mainstay of treatment in these patients. Recent engineering and technological advances such as brain-machine interfaces (BMI) and robotic rehabilitative devices are promising to enhance stroke neu-rorehabilitation, to accelerate functional recovery and improve QOL. This review discusses the recent applications of BMI and robotic-assisted rehabilitation in stroke patients. We present the framework for integrated BMI and robotic-assisted therapies, and discuss their potential therapeutic, assistive and diagnostic functions in stroke rehabilitation. Finally, we conclude with an outlook on the potential challenges and future directions of these neurotechnologies, and their impact on clinical rehabilitation.

show abstract

The changing field of rehabilitation

Cited by 12 publications

References 148 publications

A Longitudinal Study of the Neurologic Safety of Acute Baclofen Use After Spinal Cord Injury

A Longitudinal Study of the Neurologic Safety of Acute Baclofen Use After Spinal Cord Injury

Detecting movement intent from scalp EEG in a novel upper limb robotic rehabilitation system for stroke

Applications of Brain–Machine Interface Systems in Stroke Recovery and Rehabilitation

Contact Info

Product

Resources

About