Neurophysiatry: forgotten but reborn in neurorehabilitation

Ryszard Kinalski

Ryszard Kinalski – Neurophysiatry: forgotten but reborn in neurorehabilitation. Fizjoterapia Polska 2001; 1(1); 80-82

Abstract
Goal. To present the development of the bond that exist between physiotherapy and clinical neurology. Material and method. A meta-analysis of publications and events in Poland and around the world that have affected the development of neurophysiatry, and later neurorehabilitation, before and after the Decade of the Brain. Conclusion. The bond between physiotherapy and clinical neurology is continually strengthened by new discoveries in neurobiology and clinical neurophysiology.

Key words:
neurophysiatry, neurorehabilitation, clinical neurology, Decade of the Brain

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Clinical neurophysiology and early post stroke neurorehabilitation

Ryszard Kinalski, Jan Talar

Ryszard Kinalski, Jan Talar – Clinical neurophysiology and early post stroke neurorehabilitation. Fizjoterapia Polska 2001; 1(1); 47-50

Abstract
The interest of the neurorehabilitation of the stroke survivors have increased in the Brain Decade. The Helsinborg Declaration and the National Program of the Stroke Prevention and Treatment recommends to organize the stroke units and to start with the physiotherapy since the first day of hospitalization. The authors justifies the usefulness of the verification of the early post stroke rehabilitation effects on the basis of the instrumented tests, that image and quantify the neuromechanisms underlying the behaviour of the movement disorders, more accurately than the stroke scales. The heuristic possibility of the repetitive electrostimulation applicability in the early post stroke neurorehabilitation was discussed.

Key words:
clinical neurophysiology, neurorehabilitation, acute stroke

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Therapy for limb apraxia in a patient with the Melas syndrome

Maria Pąchalska, Bogusław Frańczuk, Tadeusz Gałkowski, Bożena Grochmal-Bach, Henryk Knapik, Ewa Gostyk, Bruce MacQueen, Adam Pąchalski, Piotr Pąchalski, Rafał Stabrawa, Irena Jeleńska-Szyguła

Maria Pąchalska, Bogusław Frańczuk, Tadeusz Gałkowski, Bożena Grochmal-Bach, Henryk Knapik, Ewa Gostyk, Bruce MacQueen, Adam Pąchalski, Piotr Pąchalski, Rafał Stabrawa, Irena Jeleńska-Szyguła – Therapy for limb apraxia in a patient with the Melas syndrome. Fizjoterapia Polska 2001; 1(1); 26-38

Abstract
Introduction. The authors report the results of four years of research and therapy of apraxia occurring in a patient with a mitochondrial cytopathy known as the MELAS syndrome, which causes heterogeneous organic changes in the brain. This is an original contribution, since the clinical literature contains no references to apraxia therapy in MELAS. Slowly progressive apraxia of the upper and lower limbs is described, and the rehabilitative potential of a specially developed authorial program entitled “Semantically Controlled Patterns of Motion” (referred to as “SSWR” from the Polish abbreviation) is measured.Material and methods. The patient, K.S., female age 22, diagnosed with MELAS, is under treatment in the Department of Medical Rehabilitation at the Cracow Rehabilitation Center. The extraordinarily complicated clinical picture of her illness (one of the mitochondrial cytopathies) consists of episodic exacerbation overlaid on a patient of slowly progressive symptoms, including dementia, fluctuating aphasia, tactile agnosia, sensorineural deafness, cortical blindness, and slowly progressive ideomotor apraxia. The holistic therapy program involves the indicated pharmacological treatment and comprehensive neurorehabilitation aimed at the polymodal reintegration of higher cortical functions, including voluntary limb movements. The SSWR program is comprised of an authorial set of patterns of limb motion involving both gross and fine movements, along with descriptive humorous names for the individual patterns, in order to support the process of remembering and recalling, since the patient exhibits cognitive disturbances. The effectiveness of the therapy program developed for this patient was assessed by means of standard neuropsychological tests, including the Boston Test of Praxis and the Test of Activities of Daily Life (ADL). Results. It was found that despite the continued development of the illness as measured by the results of MRI examinations, the patient achieved considerable progress in respect to conscious control of limb movements, as indicated by significant improvement in the results from successive administrations of the Boston Test of Praxis. Improvement in general ability to adapt as well as emotional and social functioning, is indicated by the results from standard neuropsychological tests and from the Test of Activities of Daily Life (ADL). Discussion. The authors present the theoretical foundations of the program. Imitating a movement requires that a mental representation of the intended movement be evoked in the brain, after which a motor program (in the seanse of praxis) is formulated and executed. The significance of this discovery for contemporary physiotherapy will be demonstrated.

Key words:
MELAS syndrome, limb apraxia ideomotor apraxia, patterns of motion, neurorehabilitation

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Effects of cognitive exercise therapy on upper extremity function in stroke patients – A case study

Joanna Pawełczyk, Katarzyna Adamczewska, Jacek Lewandowski

J. Pawełczyk, K. Adamczewska, J. Lewandowski – Effects of cognitive exercise therapy on upper extremity function in stroke patients – A case study. FP 2017; 17(4); 70-75

Abstract

Purpose. The purpose of this study was to evaluate the effects of cognitive exercise therapy on upper extremity function in a female stroke patient.
Materials and methods. The study was conducted on a 76-year-old female patient who suffered an ischemic stroke and exhibited severe left-sided hemiparesis. The patient underwent a 6-week therapy regimen based on the cognitive exercise treatment method, with 3 therapy session each week. Therapy progress was evaluated every two weeks using the Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES).
Results. The patient showed motor function improvement on all MESUPES subscales. The overall progress was 31%. The highest rate of improvement (45%) was recorded on the first part of the scale (MESUPES I), which evaluated general movements. In the second part, the patient showed a 25% improvement in joint mobility and a 17% improvement in coordination.
Conclusion. The cognitive exercise therapy proved to be an effective treatment for improving upper extremity function of the patient.

Key words:
neurorehabilitation, stroke, Perfetti method, cognitive exercise therapy

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