Medical Health Central

Archive for the ‘The Clinical Science Of Neurologic Rehabilitation’ Category

for depression, 362 functional neuroimaging, 184 Patient Evaluation Conference System , 294 Patient satisfaction questions, for inpatient rehabilitation, 215, 216t Pearson correlation coefficient, 314 Pearson correlations, 273 Pediatric disease. See also Children and adolescents ethical issues, 565 measures of disability and impairment, 291, 298 measures of quality of life, 301 rehabilitation interventions, 565–67 Pediatric Evaluation of Disability Inventory , 298 Pemoline, in multiple sclerosis, 562 Index 591 592 Index Penile prosthesis, after spinal cord injury, 487 Performance feedback, in motor learning, 226 Perindopril, after stroke, 384 Peripheral nervous system, axon regeneration and sprouting, 91–92 Peripheral neuropathy. See Neuropathies Peroneal nerve stimulation, in step training, 196 Peroneal palsy, gait deviations, 258 Persistent vegetative state functional neuroimaging, 167 interventions, 510 after traumatic brain injury, 508–10, 509t, 510t Personality, after traumatic brain injury, 532–34, 532t PET. See Positron emission tomography Phenol, for spasticity, 355–56 Phenothiazines, for spasticity, 354 Phenytoin for pain management, 342t, 343 for spasticity, 353–54 for stroke prophylaxis, 376 after traumatic brain injury, 506 Photonics, 197 Physical modalities for pain management, 231 for spasticity, 350 Physical Performance Test , 286, 287t Physical therapists, responsibilities, 219–20, 219t Physical therapy interventions, 220–31 biofeedback, 229–31 compensatory muscle reeducation and strengthening, mental practice, 229 motor learning approaches, 225–29 neurofacilitation approaches, 220–24 task-oriented training, 224–25 therapeutic modalities, 231

cognitive networks, 62–64 conceptual models, 239 iconic, in aphasia therapy, 242 measures of impairment, 278, 278t pragmatics in, 241–42 specialized cortical sites for, 236, 238 Language therapy, 235–42. See also Aphasia therapy interventions, 238–42 responsibilities, 236, 238 Leeds Quality of Life Scale, 560 Leukemia inhibitory factor, 95, 96t Levodopa in amyotrophic lateral sclerosis, 550 in cerebral palsy, 566 after stroke, 416–17 Lidocaine, for pain management, 342t, 343 Limb apraxia, 410 Lingraphica System, 242 Lithium, for hypomania, 534 Local anesthetics, for pain management, 342t, 343 Local field potential, in functional magnetic resonance imaging, 151–52 Locomotion. See also Ambulation; Walking brain stem pathways, 28–29 fictive, 32, 35 networks functional imaging, 39 illustration, 7–8, 7f primary motor cortex and, 12–13 Lokomat exoskeleton, 205, 205f London Handicap Scale, 302 Long-term potentiation and depression and dendritic spine growth, 48 molecular mechanisms, 47–48 neuromodulators, 49–52, 50t and neurotrophins, 48–49 and synaptic plasticity, 45–47 Lorazepam, functional neuroimaging, 185 Lower extremity orthotics for, 265–68, 266f–267f robotic aids for, 205–6, 205f Lumbar spinal cord, central pattern generator, 32–33, 32f, 33f Lumbar spinal primitives, 6, 37 Lumbar stenosis, spinal cord injury in, 458 Luria-Nebraska test, 513 Magnetic resonance imaging functional data analysis, 153–55, 155f of declarative memory, 57–58 limitations, 155–56, 161 N-back test, 278 stroke outcome and, 398–99 techniques, 150–56 in neuropathies, 554, 554f after spinal cord injury, 456–57 after traumatic brain injury, 502–3 Index 587 588 Index Magnetic resonance spectroscopy stroke outcome and, 398 techniques, 160 Magnetic scalp stimulation. See Transcranial magnetic stimulation Magnetoencephalography, 158 Malignant edema syndrome, 535 Malignant secondary impact syndrome, 537 Malnutrition, after traumatic brain injury, 503, 505 Mann-Whitney U Test, 313 Marijuana, for spasticity, 354 Marital status, after spinal cord injury, 488 Mayo-Portland Adaptability Inventory, 511 Measurement principles, 272–75 Measurement scales, 272–73 Measurement tools behavioral, 288–89, 288t–289t choosing, 274–75, 274t clinical research, 310–11 reliability, 273 responsiveness, 274 validity, 273–74 Measures of cost-effectiveness, 303 Measures of disability, 289–98, 290t activities of daily living, 290–94, 290t–293t disease-specific, 296–98, 296t instrumental activities of daily living, 294, 295t mixed functional scales, 294–96, 296t pediatric, 298 Measures of handicap, 302–3 Measures of health-related quality of life, 298–302, 298t–299t Measures of impairment, 275–88 cognition, 275–78, 276t consciousness, 275, 276t, 277t disease-specific, 296–98, 296t mixed functional scales, 294–96, 296t pediatric, 298 sensorimotor, 276t, 279–88 balance, 287–88 instrumented, 276t, 285–86 motor performance, 282–86, 283t–285t spasticity, 279–82, 279t, 280t strength, 279 timed tasks, 276t, 286, 287t speech and language, 278, 278t Mechanical ventilation, in motor unit disorders, 550 Median nerve stimulation, and sensorimotor plasticity, Medical model, rehabilitation team approach vs., 214 Medical Outcomes Study SF-12 and SF-36 questionnaires, 299–300 Medication . See Drug Melodic intonation therapy , for aphasia, 240–41 Memory declarative, 54–58 definition, 54 functional imaging, 57–58 motor learning from, 225 and neurogenesis, 57 pathways and neuronal mechanisms, 55–57 storage, 56–57 vs. procedural memory, 54 emotional, neuronal pathways mediating, 55 episodic, 5 priming, 54 procedural characteristics, 54 motor learning from, 225 semantic, 5 short-term, functional imaging, 58–59, 58t storage, 56–57 working effects of practice, 183 and executive function network, 58–61, 58t functional imaging, 58–59, 58t, 60–61 pathways and neuronal mechanisms, 55, 59 Memory disorders aids and strategies, 530–31, 531t duration, as predictor of functional outcome after traumatic brain injury, 514 after stroke, 426–28 with confabulation, 427 incidence and prevalence, 426–27 interventions, 427–28 lesion-related impairments, 427 after traumatic brain injury, 528–31 interventions, 529–31, 531t natural history of recovery, 529 Memory tasks, after traumatic brain injury, predictive value, 514–15 Mental exercise, muscle strength and, 39 Mental imagery, and dance, 17 Mental practice, in physical therapy, 229 Methylphenidate after stroke, 416 after traumatic brain injury, 528 Methylprednisolone, after spinal cord injury, 456 Metoclopramide, for bowel dysfunction, 330 Mexiletine, for pain management, 342t, 343 Microelectromechanical systems , 193 Micturition, classification, 326 Micturition center, 326 Milieu community, after traumatic brain injury, 516 Milodrine, for orthostatic hypotension, 324 Mini-Mental State Examination , 277–78 Minneapolis Multiple Sclerosis Achievement Center program, 563–64 Mirror Image Motion Enabler , 204 Mirror movements, in cerebral palsy, functional neuroimaging, 173–74 Mirror system, in motor cortex, 16–18 Mirtazepine, for depression, 362 Misery index, 299 MIT-MANUS, 204, 415–16 Mobility interventions, after spinal cord injury, 477–80 Modified Ashworth Scale, 279–80, 279t Modified barium swallow, and dysphagia risk, 332 Modified Barthel Index, 452 Modified Motor Assessment Scale, 282 Monaminergic agents, functional neuroimaging, 184–85 Mood disorders management, 358, 360–63 after stroke, 434–36 Morphologic plasticity, effects of practice, 101 Motoneuron columns, spinal cord, 30, 30f Motor Assessment Scale, 282 Motor control general theories, 5–8, 7f network models, 6–8, 7f. See also Sensorimotor networks overview, 4–8 systems theory, 219–20 Motor cortex and hand function, 10–12 and hand shaping, 18 and locomotion, 12–13 long-term potentiation and depression in, 46 nonprimary, 13–16, 14t and observation/imitation, 16–18 and precision grip, 18–19 primary, 8–13 cortical motor areas interacting with, 13–16, 14t corticostriatal pyramidal neurons in, 25 cytoarchitectural map, 9f organization, 8–10 special features, 16–19 Motor cortical networks, 8–19 Motor evoked potentials spinal cord injury outcome and, 468–69 stroke outcome and, 397–98 Motor impairment scales, 282–86, 283t–285t disease-specific, 284–85 instrumented, 285–86 manual tests, 282, 284 Motor learning, 225–29 blocked and random practice, 226 after brain injury, 226–27 computerized, using virtual reality technology, 230–31 feedback, 226 and goals, 6 limitations, 228 steps, 39–40, 40t task-oriented approach, 224–25 training techniques, 227–29 Motor map plasticity, 40–42, 41f Motor neuron diseases, 550–52 Motor performance, measures of impairment, 282–86, 283t–285t Motor unit disorders, 548–57. See also specific disorders muscle strengthening exercise for, 548–49 respiratory management, 549–50 Motricity Index, 282 Movement disorders bionic approaches, 194t after traumatic brain injury, 508 Movement therapy constraint-induced, 228 after stroke, 408–9 pregait, 262 MRI. See Magnetic resonance imaging MS. See Multiple sclerosis Mu rhythm, in brain-machine interface, 199–200 Multidisciplinary team model, 213 Multimodal skills training, for cognitive impairment after traumatic brain injury, 525 Multiple Errands and the Six Elements Tests, 513 Multiple input phoneme therapy , for aphasia, 241 Multiple sclerosis, 559–65 clinical trials, 563–65 day care programs, 563–65 depression in, 561 epidemiology of disability, 559–60, 559t functional neuroimaging, 175–76 measures of disability and impairment, 275, 297 measures of quality of life, 300–301 muscle fatigability in, 561–63 pathophysiology, 560 rehabilitative interventions, 560–63 spasticity in, 560–61 spinal cord injury in, 457–58 symptoms, 559–60, 560t Multiple Sclerosis Functional Composite Measure, 560 Multiple Sclerosis Impact Scale, 560 Multiple Sclerosis Quality of Life-54, 300–301, 560 Multiple Sclerosis Quality of Life Inventory, 301 Multiple Sclerosis Walking Scale, 560 Muscle atrophy, 114–17 from disuse, 116–17 in elderly persons, 114–15 neural influences, 116 prevention, 117 trophic influences, 115–16 Muscle fatigability in multiple sclerosis, 561–63 in Parkinson’s disease, 558 in postpolio syndrome, 552 Muscle plasticity, interventions, 113–18 atrophy-related, 114–17 combined approaches, 117–18 exercise, 114 regeneration, 117 Muscle reeducation, compensatory, 220 Muscle regeneration, 117 Muscle strength measures of impairment, 279 and mental exercise, 39 Muscle strengthening exercise in cerebral palsy, 566 compensatory, 220 mental, 39 for motor unit disorders, 548–49 muscle mass and, 114 in postpolio syndrome, 552 after spinal cord injury, 477, 480–82 after stroke, 405 Muscular dystrophy, rehabilitation, 555 Myasthenia gravis, rehabilitation, 555, 556f, 557 Myelin, as substrate for regeneration, 102 Myelin-associated glycoprotein, axonal regeneration inhibition by, 102 Myelin-associated inhibitors of neurite growth, 102 antibodies to, as spinal repair strategy, 120–21 Myelomeningocele, rehabilitation, 566–67 Myelopathies, 451–89. See also Spinal cord injury Myelotomy, for spasticity, 357 Myoblasts, for muscle regeneration, 117 Myofascial pain, 346–48 Myopathies, rehabilitation, 555–57 Nasogastric tube feedings, for dysphagia, 334 National Acute Spinal Cord Injury Study, 452 National Institute of Health Stroke Scale, 285 Near-infrared spectroscopy, techniques, 159 Neck pain, 346–48 Neglect. See Visuospatial and attentional disorders Nerve cuffs, 197–98 Nerve growth factor, 94–95 gene therapy with, 103 injury-induced reappearance, 95 localization, 96t Neural progenitor cells, 95, 97 transplantation, 107–8. See also Cell implants Index 589 590 Index Neural repair interventions, 78t–79t, 99–113 activity-dependent changes at synapses, 99–101 animal models, relevance, 129–34, 129t axonal regeneration stimulation, 101–3, 102t cell replacement therapy, 105–12, 107t neurotrophin delivery, 103–5, 105t pharmacologic potentiation, 112–13 3Rs of, 99 for spinal cord injury, 118–29, 119f. See also Spinal repair strategies Neuralgia, postherpetic, pain management, 341 Neuroaugmentation, 198–99 Neurobehavioral Cognitive Status Examination , 278, 396 Neurobehavioral disorders, after traumatic brain injury, 532–34, 532t behavioral modification for, 533 clinical symptoms, 532–33 pathology, 532 pharmacological interventions, 533–34, 533t Neurobehavioral Rating Scale, 289, 289t, 512–13 NeuroControl FreeHand system, 195–96, 483–84 Neurofacilitation approaches, 220–24 assumptions, 223 Bobath, 222 Brunnstrom, 222 efficacy, 223–24 Johnstone, 222 neurodevelopmental techniques, 221 proprioceptive neuromuscular facilitation, 221–22. See also Proprioceptive neuromuscular facilitation Rood, 222–23 after stroke, 405–6 Neurogenesis adult, 98–99 embryonic, 95, 97–98 and hippocampal-dependent memory, 57 injury-induced alterations, 95, 97–99 stimuli, 106 Neuroimaging functional, 147–86. See also specific techniques activation studies, 167–76 cerebral palsy, 173–74 components, 151t–152t multiple sclerosis, 175–76 pain, 338 peripheral nervous system lesions, 176 spinal cord injury, 174 stroke, 168–73, 170f traumatic brain injury, 174–75 age differences, 161 of aphasia therapy, 180–83 benefits, 149t of cognition, 183 combined methods, 160 of cross-modal plasticity, 183–84 of declarative memory, 57–58 of hand and foot activations, 38–39 limitations, 160–63 of locomotor networks, 39 of neuropharmacologic modulation, 184–85 resting studies, 163–67 aphasia, 166 persistent vegetative state, 167 stroke, 163–66 traumatic brain injury, 166–67 of sensorimotor networks, 37–38 of sensorimotor reorganization after central nervous system lesions, 168–76 after peripheral nervous system lesions, 176 training-induced, 176–84 of sensorimotor training, 177–80 sensory stimulation, 180 upper extremity, 177–78, 179 walking, 178, 180 stroke outcome and, 398–99 subtraction studies, limitations, 162 techniques, 148–60, 148t timing, 162–63 in traumatic brain injury, 503 after stroke, 397 after traumatic brain injury, 502–3 Neurolinguistic assessment, 239 Neurologic impairment, measurement, 275–88. See also Measures of impairment Neuromuscular electrical stimulation. See Functional electrical stimulation ; Functional neuromuscular stimulation Neuromuscular facilitation, proprioceptive. See Proprioceptive neuromuscular facilitation Neuronal ensembles, and synaptic plasticity, 44 Neuronal spike potentials, in brain-machine interface, 201–3, 202f Neuropathic pain. See Pain, neuropathic Neuropathies functional neuroimaging, 176 gait cycle in, 258 magnetic resonance imaging, 554, 554f pain management, 341 rehabilitation, 552–55 Neuropharmacologic modulation, functional neuroimaging of, 184–85 Neuroprostheses and neurostimulators, 193–207 bionic approaches for movement, 194t for central nervous system, 198–203 for neurogenic bladder, 328–29 for neuropathic pain, 345 for peripheral nervous system, 194–98 robotic, 203–6 for spinal cord injury, 483–85 teletherapeutic, 206 Neuroprotection, as spinal repair strategy, 118–20 Neuropsychiatric disorders, after traumatic brain injury, 534–35 Neuropsychiatric Inventory , 289 Neuropsychologic tests, for traumatic brain injury, 513, 514–15 Neuropsychologists, on rehabilitation team, 242–43 Neurostimulators. See Neuroprostheses and neurostimulators Neurotransmitters, synaptic actions mediated by, 49–52, 50t Neurotrophin-3, 94–95 localization, 96t Neurotrophin-4/5, 94–95 localization, 96t Neurotrophins delivery systems, 104–5, 105t gene therapy with, 103–5, 105t injury-induced alterations, 94–95 localization, 96t–97t in long-term potentiation and depression, 48–49 muscle-secreted, 115–16 neuronal properties affected by, 95t for pain management, 344–45 for prevention of cell death, as spinal repair strategy, 119–20 Nicotine, for neural repair enhancement, 112, 113 Nifedipine, for dysphagia, 334 9-Hole Peg Test, 284 NMDA receptor activation, in long-term potentiation and depression, 45–46, 47–48 Nociceptive pain, 337, 337t. See also Pain Nogo-A antibodies to, as spinal repair strategy, 120–21 axonal regeneration inhibition by, 102 Nominal scale, 272 Nonsteroidal antiinflammatory drugs , for pain, Noradrenergic agents, after stroke, 416, 425 Norepinephrine precursors, after stroke, 416 synaptic actions mediated by, 51 Nottingham Health Profile, 299 Null hypothesis, 313 Nurses, on rehabilitation team, 218–19 Nutrition and neurogenic dysphagia, 330–34 after traumatic brain injury, 503, 505 Observation, motor cortex and, 16–18 Occupational therapists, responsibilities, 219t, 231 Occupational therapy interventions, 231–35 adaptive aids, 233–34, 233t orthotics, 232–33 sensory retraining, 232 wheelchairs, 234–35, 234t Office Population Census Survey, 294–95 Olfactory ensheathing cells, transplantation, 108, 121 Operant conditioning, in motor learning, 225 Opioid for pain, 337 for spasticity, 354 Optical imaging signals, intrinsic, high resolution, 159 Orbitofrontal syndrome, 61–62 after traumatic brain injury, 532 Ordinal scale, 272–73 Orofacial apraxia, 410 Orpington Prognostic Scale, 285, 285t, 396 Orthostatic hypotension prevention and management, 324 after spinal cord injury, 465 Orthotics lower extremity, for gait training, 265–68, 266f–267f upper extremity, 232–33 after spinal cord injury, 482 Ossification, heterotopic management, 348 after spinal cord injury, 464 Osteoporosis disuse, after spinal cord injury, 465–66 management, 348 Outcome measures choosing, 274–75, 274t goal, 271–72 relevance, 129t, 132–34 Outpatient rehabilitation after stroke, 389–92 locus of treatment studies, 389–91 pulse therapy, 391 after traumatic brain injury efficacy, 518–19 locus of treatment studies, 515–16 Oxygen, hyperbaric, for aphasia, 242 Paced Auditory Serial Addition Test , 278 Pain, 336–48 back, 346–48 classification, 337t definition, 336 measurement, 341 myofascial, 346–48 neck, 346–48 neuropathic, 337–48, 337t clinical features, 338 in diabetes mellitus, 554 management cognitive-behavioral therapy, 345–46 neurostimulation, 345 overview, 340–41 pharmacological, 341–45, 342t–343t surgical, 345 therapeutic modalities, 231 mechanisms, 338–40 prevalence, 340t after spinal cord injury, 466 nociceptive, 337, 337t in reflex sympathetic dystrophy, 340, 340t shoulder, weakness-associated, 346 thalamic, 339, 340t transmission, 338–40 after traumatic brain injury, 506 Paralysis, hysterical, 570–71 Paraparesis, gait cycle with, 257–58 Paraplegia, sensorimotor changes after, 469–70 Parastep System, 196, 484 Parietal cortex mirror neurons in, 16 right inferior, and hemineglect, 428 sensory, 20–21 Parkinson’s disease, 557–59 cell implants in, 108–9 deep brain stimulation for, 198, 559 interventions, 557–59 measures of disability and impairment, 297

in multiple sclerosis, 561–63 in Parkinson’s disease, 558 in postpolio syndrome, 552 Feedback. See also Biofeedback performance, in motor learning, 226 Fenozolone, functional neuroimaging, 184 FES. See Functional electrical stimulation Fibroblast growth factor, 95, 96t Fictive locomotion, 32, 35 Field potentials, in brain-machine interfaces, 199–201 FIM. See Functional Independence Measure Finasteride, for benign prostatic hypertrophy, 327 Fisher’s Exact test, 313 Fludrocortisone, for orthostatic hypotension, 324 Fluoxetine functional neuroimaging, 184 after stroke, 417 FNS. See Functional neuromuscular stimulation Fondaparinaux, for deep vein thrombosis prophylaxis, 324 Foot activations, functional imaging, 38–39 Footswitch techniques, in gait analysis, 259 Forelimb amputation, representational plasticity after, 89, 93 Frailty, in elderly persons, 567–69 Frankel grade, in spinal cord injury, 467–68, 467t FreeHand system, 195–96, 483–84 Frenchay Activities Index , 294, 295t Frenchay stroke study, 393 Fugl-Meyer Assessment of Physical Performance, 282, 283t–284t Functional Assessment Measure, 293, 293t, 511 Functional Capacity Index, 295 Functional electrical stimulation , 197 definition, 194 electromyogram-triggered for motor learning, 230 after stroke, 418 for shoulder pain, 346 for spasticity, 356 after spinal cord injury, 481–82 for stroke, 418 Functional Independence Measure ambulation definitions, 292t for children , 291, 298 levels of function, 292t scores payment based on, 294 after spinal cord injury, 473, 473t, 474t, 475t and stroke outcome, 399, 400t, 404 Functional Limitations Profile, 299 Functional magnetic resonance imaging. See Magnetic resonance imaging , functional Functional neuroimaging. See Neuroimaging, functional Functional neuromuscular stimulation , 194–97 body weight–supported treadmill training with, 480 for bowel and bladder, 196 contraindications, 194 definition, 194 general design features, 194–95 for standing and walking, 196–97, 484 for upper extremity, 195–96, 483–84 Functional Status Questionnaire , 300, 302 Gabapentin for pain management, 342t, 343 for spasticity, 354 Gains postinjury, terminology, 79–81, 79t spontaneous, 81–84, 81f and diaschisis, 82–83 and gene expression, 83–84 and ischemic penumbra, 82 Gait analysis electromyography, 253f, 259, 261 energy expenditure, 261–62 kinematics, 253f, 259, 260f kinetics, 253f, 261 in patients with spasticity, 261, 281–82 techniques, 253f, 258–62, 258t, 260f temporal measures, 259 Gait cycle with hemiparesis, 252, 254–57, 255t–256t normal, 250–52, 251f, 252t with paraparesis, 257–58 with peripheral neuropathy, 258 with poliomyelitis, 258 with spasticity, 261, 349 Index 585 586 Index Gait trainer, 205–6 Gait training. See also Step training; Treadmill training assistive devices, 264–68, 266f–267f conventional, 262–64, 263f electromyographic biofeedback, 419 improvisation in, 262, 263f movement training prior to, 262 task-oriented, 264, 265t Galveston Orientation and Amnesia Test, 275, 277t, 511 Gastrostomy in amyotrophic lateral sclerosis, 551 percutaneous endoscopic, for dysphagia, 334 Gene expression, reparative, 83–84 Gene therapy, with neurotrophins, 103–5, 105t Generalizability, clinical research, 311–13 Geriatric Depression Scale, 297 Geriatric patients. See Elderly persons Glasgow Coma Scale , 275, 277t, 511 Extended , 511 and length of coma, 514 and outcome after persistent vegetative state, 509t, 510t predictive value, 513–14, 515, 515t Glasgow head injury outcome prediction program, 513 Glasgow Outcome Scale , 296, 296t and neuroimaging findings, 502 Glial scar bridges across, 122–23 limitation, as spinal repair strategy, 120 Global clinical impression, 299 Global subject impression, 299 Glycine, for spasticity, 354 Goal Attainment Scaling, 288 Goals, motor learning and, 6 Grip precision, motor cortex and, 18–19 strength measurement, 279 and risk for falls in elderly persons, 568 Ground reaction forces, in gait analysis, 253f, 261 Growth factors. See Neurotrophins Guillain-Barré syndrome, 553 Guy’s Neurological Disability Scale , 297 H-reflex. See Hoffman’s reflex Halstead-Reitan test, 513 Hamilton Rating Scale, 298 Hand activations, functional imaging, 38–39 alien, after stroke, 402 function brain stem pathways, 28 measurement, 284 motor cortex and, 10–12 after spinal cord injury, 452 after stroke, 178, 179 Hand grasping, functional neuromuscular stimulation for, 195–96, 483–84 Hand grip strength measurement, 279 and risk for falls in elderly persons, 568 Hand shaping, motor cortex and, 18 Hand splints, 232–33 for joint contractures, 357, 358t Handicap definition, 80 measures, 302–3 Handmaster, 196 Head injury closed vs. penetrating, 498, 500 mild, 536–37 traumatic. See Traumatic brain injury Headache, after traumatic brain injury, 506 Health-related quality of life, 298–302, 298t–299t. See also Quality of life Hebbian plasticity, 44–45 heterosynaptic, 45 homosynaptic, 44 Helm-elicited language program for syntax stimulation , 241 Hematoma, subdural, after traumatic brain injury, 536 Hemicuff, 233 Hemineglect. See Visuospatial and attentional disorders Hemiparesis, gait cycle with, 252, 254–57, 255t–256t Hemiparetic stroke. See Stroke, hemiparetic Hemispherectomy, dendritic sprouting after, 89, 91 Heparin, for deep vein thrombosis prophylaxis, 324 Heterosynaptic plasticity, 45 Heterotopic ossification management, 348 after spinal cord injury, 464 Hippocampus in declarative memory, 55, 56 neurogenesis in, 57, 98 HIV infection, 571 Hoffman’s reflex compared to motor response , 280 modulation, spinal cord injury outcome and, 469 plasticity, 31 Holistic approach, for cognitive impairment after traumatic brain injury, 525–26 Homeostatic plasticity, 44 Homocysteine, stroke risk and, 381, 383 Homosynaptic plasticity, 44 Hormones, for muscle atrophy prevention, 117 HSQuale, 301 Human immunodeficiency virus infection, 571 Huntington’s disease, cell implants in, 109–10 Hydrocephalus in myelomeningocele, 566–67 after traumatic brain injury, 507–8 Hyperbaric oxygen, for aphasia, 242 Hypercalcemia, after spinal cord injury, 465 Hyperreflexia bladder, ventral sacral root stimulation for, 197 detrusor, 326 spinal mechanisms, 87, 87t Hypersensitivity, denervation, as biologic adaptation after injury, 91 Hypertension, after stroke, 384–85 Hypertonicity. See also Spasticity overall approach, 350 value, 349 Hypomania, after traumatic brain injury, 534 Hyponatremia, after traumatic brain injury, 505 Hypotension, orthostatic prevention and management, 324 after spinal cord injury, 465 Hypothalamic-pituitary dysfunction, after traumatic brain injury, 505 Hypothesis, null, 313 Hypoxic-ischemic injury, after traumatic brain injury, 501 Hysterical paralysis, 570–71 IBOT wheelchair, 235 Iconic language, in aphasia therapy, 242 Ideational apraxia, 410 Ideomotor apraxia, 410 Imaginability, test for, 408 Imitation, motor cortex and, 16–18 Immunoglobulin, for Guillain-Barré syndrome, 553 Immunophilins, 95, 97t Impairment definition, 80–81 measurement, 275–88. See also Measures of impairment Implicit memory. See Procedural memory Impulsive behavior, after traumatic brain injury, 533 Incontinence bowel, 329–30 emotional, after stroke, 434–35 reflex neurogenic, 329 urinary, after stroke, 325–29, 403 Inpatient rehabilitation patient satisfaction questions, 215, 216t after stroke, 385–89 discharge, 389 eligibility, 385–88, 386t, 387f, 388t guidelines, 385, 386t, 387f locus of treatment studies, 388–89, 388t after traumatic brain injury efficacy, 517–18 locus of treatment studies, 515, 515t sequence of approaches, 517t Insomnia, 363–64 Instrumental activities of daily living, 294, 295t Insulin-like growth factors, 95, 96t Interdisciplinary team model, 213–14 Internal models, cerebellum and, 25 Internal validity, clinical research, 309–11 Interrater reliability, 273 Interval scale, 272 Intraclass correlation coefficient, 273 Intracranial pressure, after traumatic brain injury, 501 Irritability, after traumatic brain injury, 534 Ischemic-hypoxic injury, after traumatic brain injury, 501 Ischemic penumbra, and spontaneous gains, 82 Isokinetic dynamometry, 279 Java Therapy, 206 Jebsen-Taylor Test of Hand Function, 284 Johnstone’s neurofacilitation approach, 222 Joint contractures management, 357–58, 358t, 359t after traumatic brain injury, 521 Kappa correlations, 273 Karnofsky Performance Status Scale, 296 Katz Adjustment Scale–Relatives Form, 512 Katz ADLs Index, 294 Katz Social Adjustment Scale, 301 Kendall rank correlation coefficient, 313–14 Kinematics in gait analysis, 253f, 259, 260f in spasticity measurement, 281–82 Kinetics, in gait analysis, 253f, 261 Klein-Bell scale, 294 Kluver-Bucy syndrome, after traumatic brain injury, 534 Knee-ankle-foot-orthoses , 267 Kurtzke Expanded Disability Status Scale for multiple sclerosis, 285, 559

interventions, 236, 238 syndromes, 236 Dysautonomia, after spinal cord injury, 465, 465t Dysphagia in amyotrophic lateral sclerosis, 551 neurogenic, 330–34 assessment, 331–32 definition, 330 diagnosis, 330 pathophysiology, 331, 331t treatment, 332–34, 333t tube feedings for, 334 after traumatic brain injury, 503 Dystonia, after traumatic brain injury, 508 Dystrophy, muscular, rehabilitation, 555 Edema syndrome, malignant, 535 Effect size, in clinical research, 311–12, 312f Elderly persons frailty and falls in, 567–69 causes, 567, 567t interventions, 568–69 medications associated with, 568t physical tests for, 567–68 functional neuroimaging, 161 muscle atrophy in, 114–15 spinal cord injury in, 486 traumatic brain injury in, 536 walking speed, 252, 254t Electrical stimulation neuromuscular. See Functional electrical stimulation ; Functional neuromuscular stimulation sensory. See Sensory stimulation transcutaneous. See Transcutaneous electrical nerve stimulation Electroencephalography, high resolution, techniques, 158–59 Electromyogram-triggered stimulation, 230, 418 Electromyographic biofeedback, 229–30 after spinal cord injury, 482–83 after stroke, 418–19 Electromyography in gait analysis, 253f, 259, 261 in spasticity, 281–82 Electrophysiology, in spasticity, 280 Embryonic stem cell transplantation, 107, 108, 125. See also Cell implants Embryonic tissue transplantation, as spinal repair strategy, 124–25 Emotional incontinence, after stroke, 434–35 Emotional memory, neuronal pathways mediating, 55 Emotional regulatory network, 61–62 Employment after spinal cord injury, 487–88 after traumatic brain injury predictors, 521–22, 521t supported, 516, 522 Endocrine disorders after spinal cord injury, 465–66 after traumatic brain injury, 505 Energy expenditure, in gait analysis, 261–62 Engineered bridges, as spinal repair strategy, 122–23 Enoxaparin, for deep vein thrombosis prophylaxis, 324 Epidermal growth factors, 95, 96t Epidural stimulation, for pain management, 345 Epilepsy rehabilitation, 570 after stroke, 376 after traumatic brain injury, 506–7 Episodic dyscontrol, after traumatic brain injury, 534 Erectile dysfunction after spinal cord injury, 487 treatment, 362 Ergometry, bicycle, in multiple sclerosis, 563 Estradiol, effects, on functional neuroimaging, 161 Ethical issues clinical research, 304 pediatric disease, 565 traumatic brain injury, 537–38 Ethicist, on rehabilitation team, 244 EuroQOL, 300 Evoked potentials in brain-machine interface, 199 spinal cord injury outcome and, 468–69 stroke outcome and, 397–98 Executive function, pathways and neuronal mechanisms, 59–60 Exercise aerobic in multiple sclerosis, 563 after traumatic brain injury, 521 mental, muscle strength and, 39 muscle plasticity and, 114 and neurogenesis, 106 in Parkinson’s disease, 558 resistance in cerebral palsy, 566 for motor unit disorders, 548–49 in postpolio syndrome, 552 after stroke, 405 after spinal cord injury, 481 stretching, for joint contractures, 358, 358t Explicit memory. See Declarative memory Extended Disability Status Scale , 285, 297, 559 Eye patch, for visuospatial and attentional disorders, 432–33 Face validity, 273–74 Falls, in elderly persons, 567–69 causes, 567, 567t interventions, 568–69 medications associated with, 568t physical tests for, 567–68

functional neuroimaging, 165–66 and spontaneous gains, 82–83 3,4-Diminopyridine, in multiple sclerosis, 562–63 Dipyridamole, after stroke, 385 Disability definition, 80–81 measurement, 289–98, 290t. See also Measures of disability Disability Rating Scale , 296, 511 Disuse atrophy, 116–17 Disuse osteoporosis, after spinal cord injury, 465–66 Dizziness, 569–70 Donepezil, for cognitive impairment, 527 Dopamine functional neuroimaging, 184–85 synaptic actions mediated by, 50–51 Dopaminergic agents for aphasia, 242, 425 for cognitive impairment, 528 for spasticity, 353 after stroke, 416–17, 425 Doppler ultrasonography, transcranial, 160 Dorsal column stimulation for pain management, 345 for spasticity, 356 Dorsal horn neurons, regeneration, as spinal repair strategy, 127 Dorsal rhizotomy in cerebral palsy, 566 for pain after spinal cord injury, 466 for spasticity, 357 Double blinding, in clinical research, 306 Doxazosin, for benign prostatic hypertrophy, 327 Drug effects, functional neuroimaging of, 185 falls in elderly persons associated with, 568t and functional neuroimaging, 161–62 for muscle atrophy prevention, 117 as neural repair manipulation, 112–13 after stroke, negative effects, 380–81 Duchenne’s muscular dystrophy rehabilitation, 555 respiratory management, 549–50 Dynamometry handheld, 279 isokinetic, 279 in spasticity, 281

cell implants for, 110 neuroprotection against, as spinal repair strategy, 118–20 Apraxia forms, 410 after stroke, interventions, 410–11 Arm Ability Training , after stroke, 406–7 Arm crank training, after spinal cord injury, 481 Arm function, after stroke concentrated practice, 407–11 constraint-induced movement therapy, 408–9 disabilities, 401–2 focused retraining, 409–10 sensory retraining, 411 task-oriented training, 406–7 Arnold Chiari Type II malformation, in myelomeningocele, 567 Ashworth Scale, Modified, 279–80, 279t Aspiration pneumonia, 332 Aspirin, after stroke, 385 Assimilation, compensation through, 80 Assisted Rehabilitation and Measurement , 204–5 Assistive devices for gait training, 264–68, 266f–267f after spinal cord injury, 478 after stroke, 415–16 Atelectasis, after spinal cord injury, 462, 463 Atrophy, muscle. See Muscle atrophy Attentional disorders. See Visuospatial and attentional disorders Auditory prostheses, 203 Augmentation cystoplasty, for neurogenic bladder, 328 Autoambulator, 205 Autonomic dysreflexia, after spinal cord injury, 465, 465t Axon conduction, injury-induced alterations, 94 Axon growth cones attractants, 94 barriers, 93 promotion, as spinal repair strategy, 121–22 repulsants, 94 antibodies to, 102, 120–21 production of, blockage, 102 Axonal injury diffuse, after traumatic brain injury, 500–501, 501f in multiple sclerosis, 560 Axonal regeneration as biologic adaptation after injury, 91–94 stimulation bridges for, 122–23 as neural repair manipulation, 101–3, 102t as spinal repair strategy, 120–23 Axonal sprouting, as biologic adaptation after injury, 91–94 Back pain, 346–48 Baclofen in cerebral palsy, 566 for pain management, 343t, 344 side effects, 352 for spasticity, 351–52, 351t after stroke, 417 Apnea, sleep, 363–64 Bakas Caregiving Outcomes Scale, 301 Balance disorders, 567–70 measures of impairment, 287–88 Barium swallow, modified, and dysphagia risk, 332 Barrow Neurological Institute Screen for Higher Cerebral Functions , 513 Barthel Index, 290–91, 290t modified, 452 Basal ganglia, in sensorimotor networks, 24–25 Bayesian approach, 313 Beck Depression Inventory , 298 Behavioral disorders. See Neurobehavioral disorders Behavioral modification measurement, 288–89, 288t for pain management, 345–46 after traumatic brain injury, 533 Behavioral substitution, compensation through, 79–80 Behavioral training for cognitive impairment after traumatic brain injury, 524 for visuospatial and attentional disorders, 430–31, 431f Benign positional vertigo, 569–70 Benzodiazepines side effects, 352–53 for spasticity, 352–53 Berg Balance Scale, 288 Beta blockers, for irritability after traumatic brain injury, Beta rhythm, in brain-machine interface, 199–200 Betz cells, and locomotion, 13 Bias, in clinical research, 306 Bicycle ergometry, in multiple sclerosis, 563 Biofeedback, 229–31 electromyogram-triggered stimulation, 230, 418 electromyographic, 229–30, 419 after spinal cord injury, 482–83 after stroke, 418–19 virtual reality, 230–31 Biologic adaptations after injury, 76–135 activity in spared pathways, 84–85, 86f axon conduction, 94 axon regeneration and sprouting, 91–94 denervation hypersensitivity, 91 extrinsic, 78t–79t, 99–113. See also Neural repair interventions growth factors, 94–95, 95t, 96t–97t intrinsic, 77t, 81–99 neurogenesis, 95, 97–99 sensorimotor representational plasticity, 85–86 spasticity, 86–89, 87t spontaneous gains, 81–84, 81f synaptogenesis, 89–90, 91, 92f, 93 terminology, 79–81, 79t upper motor neuron syndrome, 86–89, 87t Bisacodyl, for bowel dysfunction, 330 Bladder catheterization in multiple sclerosis, 561 for neurogenic bladder, 327 after spinal cord injury, 463 functional neuromuscular stimulation, 196, 484–85 hyperreflexia, ventral sacral root stimulation for, 197 neurogenic, 325–29 management, 327–29 invasive procedures, 327–29 pharmacological, 327 pathophysiology, 326–27 after spinal cord injury, 463–64 Bladder outlet obstruction, after spinal cord injury, 463–64 Blinding, in clinical research, 306 Blindness, cross-modal plasticity associated with, 183 Blisssymbol lexicon, 242 Blood oxygenation level dependent signal, in functional magnetic resonance imaging, 150 Bobath sling, 233 Bobath’s neurofacilitation approach, 222 Body weight–supported treadmill training , 36–37, 36f, 264, 265t benefits, 479 in cerebral palsy, 565–66 contraindications, 478 with functional neuromuscular stimulation, 480 in Parkinson’s disease, 558 after spinal cord injury, 478–80, 479f Bone loss, after spinal cord injury, 465–66 metabolism disorders, 348 Boston Diagnostic Aphasia Examination , 278, 421 Botulinum toxin for neurogenic bladder, 329 for spasticity, 354–55 after stroke, 417–18 Bowel functional neuromuscular stimulation, 196, 484–85 neurogenic, 329–30 management, 330 pathophysiology, 329 after spinal cord injury, 463–64 Box and Block Test, 284 Bracy’s Process Approach, 525 Bradykinesia, in Parkinson’s disease, 557 Brain deep stimulation, 198, 559 electrical activity, measurement, 158–59 rodent vs. human, 131–32, 132f traumatic injury. See Traumatic brain injury Brain-derived neurotrophic factor , 94–95 localization, 96t in long-term potentiation and depression, 48–49 Brain-machine interfaces, 199–203 field potentials in, 199–201 neuronal spike potentials in, 201–3, 202f sensory prostheses in, 203 Brain stem pathways, 28–29 hand functions, 28 locomotor functions, 28–29 Bridges, as spinal repair strategy, 122–23 British Medical Council Scale, 279 Broca’s aphasia, 236, 421 Broca’s area in aphasia therapy, 181 in language, 62, 63 Brodman’s area, 8, 9f. See also Motor cortex Bromocriptine for aphasia, 425 for cognitive impairment, 528 for coma or persistent vegetative state, 510 Brunnstrom’s neurofacilitation approach, 222 Buccofacial apraxia, 410 BWSTT. See Body weight–supported treadmill training Index 581 582 Index Caffeine, effects, on functional neuroimaging, 162 Calcium, in long-term potentiation and depression, 47 Calf compression, for deep vein thrombosis prophylaxis, Canadian Neurological Scale, 285, 397 Canes, for gait training, 268 Canonical neurons, in ventral premotor area, 18 Capsaicin for neurogenic bladder, 329 for pain management, 344 Carbamazepine for pain management, 342t, 343 for spasticity, 353–54 Carbidopa in amyotrophic lateral sclerosis, 550 in cerebral palsy, 566 Caregiver Burden Scale, 301 Caregiver scales, 301 Catheter, condon, after spinal cord injury, 464 Catheterization, bladder in multiple sclerosis, 561 for neurogenic bladder, 327 after spinal cord injury, 463 Cauda equina syndrome, in spinal stenosis, 458 Cell implants, 105–12, 107t in apoptosis model, 110 in demyelinating diseases, 112 in Huntington’s disease, 109–10 in Parkinson’s disease, 108–9 as spinal repair strategy, 121–22, 123–28 in stroke, 110–12 Center for Epidemiologic Studies of Depression Scale, 297 Central motor programs, stored, in theory of motor control, 5–6 Central nervous system axonal regeneration postinjury, 92–94 stimulation, 101–3, 102t grafting, considerations for, 105t Central pattern generators, spinal, 32–37, 32f, 33f distribution, 33 experimental case study, 35 in humans, evidence for, 34–37, 36f Cerebellum, 25–27 and internal models, 25 long-term potentiation and depression in, 46 motor functions, 26–27 structure, 25–26 Cerebral palsy functional neuroimaging, 173–74 rehabilitation interventions, 565–66 sensorimotor reorganization in, 173–74 spasticity in, 566 Cervical myelopathy, in spinal stenosis, 458 Chemical blocks, for spasticity, 354–56 Children and adolescents. See also Pediatric disease epilepsy in, 570 functional independence measure, 291, 298 functional neuroimaging, 161 traumatic brain injury in, 535–36 walking speed, 252, 254t Children’s Orientation and Amnesia Test , 535 Cholinergic agents for aphasia, 425 for cognitive impairment, 527 Chronic fatigue syndrome , 571 Cingulate cortex anterior, 15–16 syndrome, 62, 532 in working memory, 59 functional roles, 14t, 15–16 posterior, in working memory, 59 rostral, 15 Classical conditioning, in motor learning, 225 Clinical research, 303–14 categories, 303 confounding issues, 309–13 ethical considerations, 304 federal guidelines, 303–4 generalizability, 311–13 integrity of intervention, 310 internal validity, 309–11 measurement tools, 310–11 monitoring, 304 quasi-experimental designs, 308–9 randomization, 309–10 randomized trials, 305–6, 307t–308t sample size and power, 311–13, 312f single-subject trials, 306, 308 statistical analyses, 308f, 313–14 study designs, 304–9, 305t Clonidine for pain management, 342t, 344 for spasticity, 351t, 353 Clopidogrel, after stroke, 385 Cochlear implant, 203 Cochrane Database of Systematic Reviews, 303 Cognition cerebellum in, 27 functional neuroimaging, 183 measures of impairment, 275–78, 276t overview of organization, 52–54 Cognitive-behavioral therapy, for neuropathic pain, 345–46 Cognitive disorders after spinal cord injury, 462 after stroke, 425–36 after traumatic brain injury, 522–31, 522t approaches for amnestic disorders, 528–31, 531t behavioral training, 524 cognitive remediation, 524–25, 531 compensatory approach, 523–24 comprehensive or holistic approach, 525–26 efficacy of interventions, 531 multimodal skills training, 525 overview of interventions, 523 pharmacological facilitation, 526–31, 527t psychotherapy, 526 after whiplash injury, 537 Cognitive networks, 52–64 affected by CNS lesions, characteristics, 54 for emotional regulation, 61–62 for explicit vs. implicit memory, 54–58 for language, 62–64 for spatial awareness, 62 for working memory and executive functions, 58–61, 58t Cognitive remediation comprehensive approach, 525–26 computer-based, 525 efficacy, 531 after traumatic brain injury, 524–25, 531 Cognitive stimulation, after traumatic brain injury, 524 Coma duration of, as predictor of functional outcome after traumatic brain injury, 514 interventions, 510 persistent vegetative state after, 508–9 scales, 275, 277t. See also Glasgow Coma Scale Coma stimulation, 510 Commotio cerebri, 536–37 Community Integration Questionnaire, 303 Community Outcome Scale, 511–12 Community reintegration after stroke, 392 after traumatic brain injury, 516, 521 Compensation definition, 79, 79t domains, 79–80, 79t Compensatory approach, for cognitive impairment after traumatic brain injury, 523–24 Complex regional pain syndrome. See Reflex sympathetic dystrophy Comprehensive approach, for cognitive impairment after traumatic brain injury, 525–26 Comprehensive Psychopathological Rating Scale–Depression, 298 Computed tomography , after traumatic brain injury, 502–3 Computer technology. See also Brain-machine interfaces for cognitive rehabilitation after traumatic brain injury, 525 for communication, 233–34 for motor learning, 230–31 Computerized visual iconic communication systems , 242 Concurrent validity, 274 Concussion, 536–37 repeated, 537 Confabulation, after stroke, 427 Confounding issues, clinical research, 309–13 Consciousness level of, as predictor of functional outcome after traumatic brain injury, 513–14 measures of impairment, 275, 276t, 277t Constraint-induced movement therapy, 228 after stroke, 408–9 Construct validity, 274 Content validity, 273 Contextual interference, in motor learning, 226 Continuous positive airway pressure , for sleep apnea, 363–64 Contract-relax agonist-contract , in proprioceptive neuromuscular facilitation, 221 Contractures management, 357–58, 358t, 359t after traumatic brain injury, 521 Conversion disorders, with neurologic symptoms, 570–71 Copenhagen Stroke Study, 393, 401, 402, 404 Cornell Scale, 298 Corpus callostomy, dendritic sprouting after, 89, 92f Correlation coefficient intraclass, 273 Kendall rank, 313–14 Pearson, 314 Cortical ensemble activity and neurostimulation, 198–99 and synaptic plasticity, 44 Cortical stimulation, for visuospatial and attentional disorders, 433 Corticospinal projections, in sensorimotor networks, 21–24, 21t, 22f Corticospinal tract, activity in spared pathways, 84–85, 86f Corticosteroids, after spinal cord injury, 456 Corticostriatal pyramidal neurons, in primary motor cortex, 25 Cost-effectiveness measures, 303 Craig Handicap Assessment and Reporting Technique , 302 Criterion validity, 274 Critical illness polyneuropathy, 554–55 Cronbach’s reliability coefficient, 273 Cryotherapy, for spasticity, 350 CyberGlove, 206, 230 Cyproheptadine, for spasticity, 353 Cystometrography, in neurogenic bladder, 326 Cystoplasty, augmentation, for neurogenic bladder, 328 Dalteparin, for deep vein thrombosis prophylaxis, 324 Dance, mirror mapping, mental imagery and, 17 Dantrolene for spasticity, 351, 351t after stroke, 417 Data Safety Monitoring Committee, 304 Deafness, cross-modal plasticity associated with, 183 Declarative memory, 54–58 definition, 54 functional imaging, 57–58 motor learning from, 225 and neurogenesis, 57 pathways and neuronal mechanisms, 55–57 storage, 56–57 vs. procedural memory, 54 Deep brain stimulation, 198, 559 Deep vein thrombosis prevention and management, 323–24 after spinal cord injury, 324 Dementia after stroke, 426–28. See also Memory disorders vascular, functional neuroimaging, 164 Dementia pugislistica, 537 Demyelinating diseases, cell implants in, 112 Dendritic spine growth, in long-term potentiation and depression, 48 Dendritic sprouting experimental case studies, 89, 90, 91, 93 reactive, 89–90, 91, 92f, 93 Denervation hypersensitivity, as biologic adaptation after injury, 91 Depression, 361–63 dexamethasone suppression test for, 362 diagnosis, 361, 361t measures of disability and impairment, 297–98 in multiple sclerosis, 561 after spinal cord injury, 488 after stroke, 434–36 anatomic correlations, 435 incidence, 434–35 treatment, 435–36 synaptic. See Long-term potentiation and depression after traumatic brain injury, 534 treatment, 362–63 Index 583 584 Index Desipramine, for pain management, 341, 342t, 343 Desmopressin, for incontinence, 327 Detrusor hyperreflexia, 326 Detrusor-sphincter dyssynergia, 326 Dexamethasone suppression test, for depression, 362 Dextromethorphan, functional neuroimaging, 185 Diabetic neuropathy, 554

Classification , 297 American Spinal Injury Association classification system, 452, 452f impairment scale, 452, 454t Motor Score, 279 4-Aminopyridine in multiple sclerosis, 562–63 for neural repair enhancement, 112 Amitriptyline, for pain management, 341, 342t Amnesia. See Memory disorders AMPA receptors, in long-term potentiation, 47 Amphetamine for aphasia, 242, 425 functional neuroimaging, 184, 185 for neural repair enhancement, 112, 113 after stroke, 416, 425 after traumatic brain injury, 528 Amygdala, in declarative memory, 55–56 Amyotrophic lateral sclerosis rehabilitation, 550–51 respiratory management, 550 Analysis of variance , 313 Angiotensin-converting enzyme inhibitors for muscle atrophy prevention, 117 after stroke, 384 580 Index Animal models pitfalls, 130–34 of spinal repair, relevance, 129–34, 129t Ankle-foot-orthoses , 265–68, 266f–267f articulated, 267, 267f indications, 265 thermoplastic, 266f–267f, 267 Anterior cingulate syndrome, 62, 532 Antibodies, to axon growth cone repulsants, 102, 120–21 Anticoagulants, after stroke, 385 Anticonvulsants for episodic dyscontrol, 534 for pain management, 342t, 343 for seizure prophylaxis, 506–7 for stroke prophylaxis, 376 Antidepressants for pain management, 341, 342t, 343 side effects, 363 after stroke, 435–36 after traumatic brain injury, 534 tricyclic, 362 Antiplatelet agents, after stroke, 385 Antispasticity agents in amyotrophic lateral sclerosis, 550 in cerebral palsy, 566 in multiple sclerosis, 560–61 after spinal cord injury, 485 after stroke, 417–18 Antithrombotics, after stroke, 385 Anxiety after spinal cord injury, 488 after stroke, 434 Apathy, after stroke, 435 Aphasia classification, 236, 237t depression and, 420 diagnostic tests, 278, 278t functional neuroimaging resting studies, 166 training studies, 180–83 incidence, 235 lesions associated with, 238 neurolinguistic assessment, 239 after stroke, 420–25 functional neuroimaging, predictive value, 422 pharmacotherapy, 424–25 prognosticators, 421–22 functional neuroimaging, 422 lesion location, 421–22 rate of gains, 420–21 Aphasia therapy, 238–42 functional neuroimaging, 180–83 general strategies, 238–40, 239t iconic language, 242 pharmacological, 242 practice parameters, 240 priming techniques, 240 responsibilities of therapist, 236–37 for specific syndromes, 237t, 240–42 stimulation-facilitation approach, 239–40 after stroke, 422–24, 423t intensity and specificity, 424 lesion location and, 422 pharmacological, 424–25

in multiple sclerosis, 562 in postpolio syndrome, 552 after traumatic brain injury, 527 Ambulation. See also Gait entries; Locomotion; Walking definitions, in Functional Independence Measure, 292t after spinal cord injury, 475–77, 477t classification, 452 FIM subscores and, 473, 473t, 474t functional neuroimaging, 180 interventions, 477–80, 484 natural history of recovery, 475–76 rehabilitation outcomes, 476–77 strength and recovery, 476, 477t after stroke body weight–supported treadmill training, 412–15, 414f concentrated practice, 412–15, 414f disabilities, 402–3 functional neuroimaging, 178, 180 pulse therapy, 391 recovery of, impairment group and, 395–96, 396t task-oriented training, 407 treadmill training, 412 Ambulatory Motor Index , 476 American Congress of Rehabilitation Medicine, Brain

The myriad neurologic complications of infection by the human immunodeficiency virus require ongoing assessment and management. Rehabilitative efforts can optimize strength, mobility, fitness, ADLs, and cognition for the neurobehavioral problems, dementia, myelopathy, mononeuritis or polyneuropathy, and myopathy that can compromise patients. Fortunately, medical treatment over the past 5 years has greatly reduced the neurologic complications of the disease.198 SUMMARY Rehabilitationists can find opportunities to diminish disabilities associated with every neurologic disease and any neurologic complication of a medical illness. The physician with skills in rehabilitation can serve patients well by acting as the general practitioner or “quarterback” for the person’s long-term care as it relates to the disease. With a chronic or progressive central or peripheral neurologic disease, proactive interventions can sometimes delay or prevent deterioration in the quality Other Central and Peripheral Disorders 571 572 Rehabilitation of Specific Neurologic Disorders of a patient’s life. New treatments for these diseases may be more effective in reducing disability if accompanied by a rehabilitation program that emphasizes strengthening, conditioning, and task-oriented practice of motor and cognitive skills, along with psychosocial supports and assistive devices. REFERENCES 1. Berger A, Schaumburg H. Rehabilitation of focal nerve injuries. J Neurol Rehabil 1988; 2:65–91. 2. Ringel S, Neville H. The rehabilitation of muscular disorders. J Neurol Rehabil 1990; 4:203–215. 3. Cohn R, Campbell K. Molecular basis of muscular with neuromuscular disorders. Arch Phys Med Re habil 1988; 69:14–19. 17. Miller R. The effects of aging upon nerve and mus cle function and their importance for neurorehabil itation. J Neurol Rehabil 1995; 9:175–181. 18. Cooper R, Quatrano L, Axelson P. Research on physical activity and health among people with disabilities: a consensus statement. J Rehabil Res Dev 1999; 36:142–154. 19. Fiatarone M, O’Neill E, Ryan N, Clements KM, So lares G, Nelson M, Roberts S, Kehayias J, Lipsitz L, Evans W. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 1994; 330:1769–1775. 20. Annoni J-M, Chevrolet J, Kesselring J. Respiratory problems in chronic neurological disorders. Crit Rev Phys Rehabil Med 1993; 5:155–192. 21. Heckmatt J, Dubowitz V. Night-time nasal ventilation in neuromuscular disease. Lancet 1990; 1:579– dystrophies. Muscle Nerve 2000; 23:1456–1471. 581. 4. Fletcher S, Wilton S, Howell J. Gene therapy and molecular approaches to the treatment of hereditary muscular disorders. Curr Opin Neurol 2000; 13:553– 560. 5. Chakravarthy M, Davis B, Booth F. IGF-I restores satellite cell proliferative potential in immobilized old skeletal muscle. Appl Physiol 2000; 89:1365–1379. 6. Singleton J, Feldman E. Insulin-like growth factor1 in muscle metabolism and myotherapies. Neurobiol Dis 2001; 8:541–554. 7. Grounds M. Muscle regeneration: molecular aspects and therapeutic implications. Curr Opin Neurol 1999; 12:535–543. 8. Dobkin B. Exercise fitness and sports for individuals with neurologic disability. In: Gordon S, Gonzalez-Mestre X, Garrett W, eds. Sports and Exercise in Midlife. Rosemont, IL: American Academy of Orthopedic Surgeons, 1993:235–252. 9. Phillips B, Mastaglia F. Exercise therapy in patients with myopathy. Curr Opin Neurol 2000; 13:547–552. 10. Bohannon R. Exercise training variables influencing the enhancement of voluntary muscle strength. Clin Rehabil 1990; 4:325–331. 11. Aitkens S, McCrory M, Kilmer D, Bernauer E. Moderate resistance exercise program: Its effect in slowly progressive neuromuscular disease. Arch Phys Med Rehabil 1993; 74:711–715. 22. Bach J. Pulmonary rehabilitation considerations for Duchenne muscular dystrophy. Crit Rev Phys Rehabil Med 1992; 3:239–269. 23. Bach J. Intubation and tracheostomy paradigm paralysis. Neurology 2000; 55:613–614. 24. Bach J. Amyotrophic lateral sclerosis: Predictors for prolongation of life by noninvasive respiratory aids. Arch Phys Med Rehabil 1995; 76:828–832. 25. Annane D, Chevrolet J, Chevret S, Raphael J. Nocturnal mechanical ventilation for chronic hypoventilation in patients with neuromuscular and chest wall disorders. In: Review C, ed. The Cochrane Library: Oxford: Update Software, 2000. 26. Nomori H, Ishihara T. Pressure-controlled ventilation via a mini-tracheostomy tube for patients with neuromuscular disease. Neurology 2000; 55:698–702. 27. Reynolds J, Mendell J. Another approach to ventilatory failure in neuromuscular disease. Neurology 2000; 55:611–612. 28. Bach J, Barnett V. Ethical considerations in the management of individuals with severe neuromuscular disorders. Am J Phys Med Rehabil 1994; 73:134–140. 29. Moss A, Casey P, Stocking C, Roos R, Brooks B, Siegler M. Home ventilation for ALS patients. Neurology 1993; 43:438–443. 30. Munsat T, Andres P, Finison L, Conlon T, Thibodeau L. The natural history of motoneuron loss in amyotrophic lateral sclerosis. Neurology 1988; 38:409– 12. Kilmer D, McCrory M, Wright N, Aitkens S, Bernauer E. The effect of a high resistance exercise 413. program in slowly progressive neuromuscular dis ease. Arch Phys Med Rehabil 1994; 75:560–563. 13. Kobashigawa J, Leaf D, Lee N, Gleeson M, Liu H, Hamilton M, Moriguchi J, Kawata N, Einhorn K, Herlihy E, Laks H. A controlled trial of exercise rehabilitation after heart transplantation. N Engl J Med 1999; 340:272–277. 14. Brinkmann J, Ringel S. Effectiveness of exercise in progressive neuromuscular disease. J Neurol Reha bil 1991; 5:195–199. 15. Taivassalo T, Shoubridge E, Chen J, Kennaway N, DiMauro S, Arnold D, Haller R. Aerobic conditioning in patients with mitochondrial myopathies: Physiological, biochemical, and genetic effects. Ann Neurol 2001; 50:133–141. 16. Milner-Brown H, Miller R. Muscle strengthening through high-resistance weight training in patients 31. Andres P, Finison L, Conlon T, Munsat T. Use of composite scores to measure deficit in ALS. Neurology 1988; 38:405–408. 32. Slavin M, Jette D, Andres P, Munsat T. Lower extremity muscle force measures and functional ambulation in patients with amyotrophic lateral sclerosis. Arch Phys Med Rehabil 1998; 79:950–954. 33. Maselli R, Wollman R, Leung C, Distad B, Palombi S, Richman D, Salazar-Grueso E, Roos R. Neuromuscular transmission in amyotrophic lateral sclerosis. Muscle Nerve 1993; 16:1193–1203. 34. Kubler A, Neumann N, Kaiser J, Kotchoubey B, Hinterberger T, Birbaumer N. Brain-computer communication: Self-regulation of slow cortical potentials for verbal communication. Arch Phys Med Rehabil 2001; 82:1533–1539. 35. Gregory S, Siderowf A, Golaszewski A, McCluskey L. Gastrostomy insertion in ALS patients with low vital capacity: Respiratory support and survival. Neurology 2002; 58:485–488. 36. Windebank A, Litchy W, Daube J, Kurland L. Late effects of paralytic poliomyelitis in Olmsted County, Minnesota. Neurology 1991; 41:501–507. 37. Sonies B, Dalakas M. Dysphagia in patients with the post-polio syndrome. N Eng J Med 1991; 324:1162– 1167. 38. Goerss J, Atkinson E, Winderbank A, O’Fallon W, Melton LJ 3rd. Fractures in an aging population of poliomyelitis survivors: A community based study in Olmstead County. Mayo Clin Proc 1994; 69:333–339. 39. Windebank A, Litchy W, Daube J, Iverson R. Lack of progression of neurologic deficit in survivors of paralytic polio: A 5-year prospective populationbased study. Neurology 1996; 46:80–84. 40. Ivanyi B, Nollet F, Redekop W. Late onset polio sequelae: disabilities and handicaps in a populationbased cohort of the 1956 poliomyelitis outbreak in the Netherlands. Arch Phys Med Rehabil 1999; 80:687–690. 41. Kemp B, Krause J. Depression and life satisfaction among people ageing with post-polio and spinal cord injury. Disabil Rehabil 1999; 21:241–249. 42. Trojan D, Cashman N. Pathophysiology and diagnosis of post-polio syndrome. NeuroRehabil 1997; 8: 83–92. 43. Sharma K, Kent-Braun J, Miller R, Mynhier M, Weiner M. Excessive muscular fatigue in the postpoliomyelitis syndrome. Neurology 1994; 44:642–646. 44. Sunnerhagen K, Carlsson U, Sandberg A, Stalberg E, Hedberg M, Grimby G. Electrophysiologic evaluation of muscle fatigue development and recovery in late polio. Arch Phys Med Rehabil 2000; 81:770–776. 45. Nollet F, Beelen A, Sargeant A, de Visser M, Lankhorst G, de Jong B. Submaximal exercise capacity and maximal power output in polio subjects. Arch Phys Med Rehabil 2001; 82:1678–1685. 46. Jones D, Speier J, Canine K, Owen R, Stull G. Cardiorespiratory responses to aerobic training by patients with postpoliomyelitis sequelae. JAMA 1989; 261:3255–3258. 47. Einarsson G. Muscle conditioning in late poliomyelitis. Arch Phys Med Rehabil 1991; 72:11–14. 48. Agre J, Rodriquez A, Franke T. Strength, endurance, and work capacity after muscle strengthening exercise in postpolio subjects. Arch Phys Med Rehabil 1997; 78:681–686. 49. Perry J, Mulroy S, Renwick S. The relationship of lower extremity strength and gait parameters in patients with post-polio syndrome. Arch Phys Med Rehabil 1993; 74:165–169. 50. Dalakas M. Why drugs fail in postpolio syndrome: lessons from another clinical trial. Neurology 1999; 53:1166–1167. 51. Trojan D, Collet J, Shapiro S, Tandan R, Granger C, Robinson A, Finch L, Ducruet T, Jubelt B, Miller R, Agre J, Munsat T, Hollander D, Cashman N. A multicenter, randomized, double-blinded trial of pyridostigmine in postpolio syndrome. Neurology 1999; 53:1225–1233. 52. Gupta K, Shetty K, Agre J, Cuisinier M, Rudman I, Rudman D. Human growth hormone effect on serum IGF-I and muscle function in poliomyelitis survivors. Arch Phys Med Rehabil 1994; 75:889–894. 53. Vickrey B, Hays R, Beckstrand M. Development of a health-related quality of life measure for peripheral neuropathy. Neurorehabil Neural Repair 2000; 14: 93–104. 54. Fletcher D, Lawn N, Wolter T, Wijdicks E. Longterm outcome in patients with Guillain-Barre syndrome requiring mechanical ventilation. Neurology 2000; 54:2311–2315. 55. Lennon S, Koblar S, Hughes R. Reasons for persistent disability in Guillain-Barre syndrome. Clin Rehabil 1993; 7:1–8. 56. Bergin P, Miller D, Hirsch N, Murray N. Failure of 3,4-diaminopyridine to reverse conduction block in inflammatory demyelinating neuropathies. Ann Neurol 1993; 34:406–409. 57. Mackinnon S, Dellon A. Surgery of the Peripheral Nerve. New York: Thieme, 1988:521–533. 58. Feldman E, Russell J, Sullivan K, Golovoy D. New insights into the pathogenesis of diabetic neuropathy. Curr Opin Neurol 1999; 12:553–563. 59. Ruff R. Acute illness myopathy. Neurology 1996; 46:600–601. 60. Bolton C, Young G, Zochodne D. The neurological complications of sepsis. Ann Neurol 1993; 33:94–100. 61. Wheeler, A, Bernard G. Treating patients with se vere sepsis. New Engl J Med 1999; 340:207–214. 62. Guttridge D, Mayo M, Madrid L, Wang C, Baldwin A. NF-kappaB-induced loss of myoD messenger RNA: possible role in muscle decay and cachexia. Science 2000; 289:2363–2365. 63. Zifko U. Long-term outcome of critical care illness polyneuropathy. Muscle Nerve 2000; 23 : S49–S52. 64. Spector S, Lemmer J, Koffman B, Fleisher T, Feuerstein IM, Hurley B, Dalakas M. Safety and efficacy of strength training in patients with sporadic inclusion body myositis. Muscle Nerve 1997; 20: 1242–1248. 65. Czerwinski S, Kurowski T, O’Neill T, Hickson R. Initiating regular exercise protects against muscle atrophy from glucocorticoids. J Appl Physiol 1987; 63: 1504–1510. 66. Kissel J, McDermott M, Mendell J, King W, Pandya S, Griggs R, Tawil R. Randomized, double-blinded, placebo-controlled trial of albuterol in facioscapulohumeral dystrophy. Neurology 2001; 57:1434–1440. 67. Lohi E-L, Lindberg C, Andersen O. Physical training effects in myasthenia gravis. Arch Phys Med Rehabil 1993; 74:1178–1180. 68. Mouradian M. Recent advances in the genetics and pathogenesis of Parkinson’s disease. Neurology 2002; 58:179–185. 69. Jankovic J. New and emerging therapies for Parkinson disease. Arch Neurol 1999; 56:785–790. 70. Zurn A, Widmer H, Aebischer P. Sustained delivery of GDNF: towards a treatment for Parkinson’s disease. Brain Res Rev 2001; 36:222–229. 71. Freed C, Greene P, Breeze R, Tsai W, DuMouchel W, Kao R, Dillon S, Winfield H, Culver S, Trojanowski J, Eidelberg D, Fahn S. Transplantation of embryonic dopamine neurons for severe Parkinson’s disease. N Engl J Med 2001; 344:710–719. 72. Saint-Cyr J, Trepanier L, Kumar R, Lozano A, Lang A. Neuropsychological consequences of chronic bilateral stimulation of the subthalamic nucleus in parkinson’s disease. Brain 2000; 123:2091–2108. Other Central and Peripheral Disorders 573 574 Rehabilitation of Specific Neurologic Disorders 73. Straits-Troster K, Fields J, Wilkinson S, Pahwa R, Lyons K, Koller W, Troster A. Health-related quality of life in Parkinson’s disease after pallidotomy and deep brain stimulation. Brain Cognit 2000; 42:399– 416. 74. Gibberd F, Page N, Spencer K, Kinnear E, Hawksworth J. Controlled trial of physiotherapy and occupational therapy for Parkinson’s disease. Br Med J 1981; 282:1196. 75. Tillerson JL, Cohen AD, Philhower J, Miller GW, Zigmond MJ, Schallert T. Forced limb-use effects on the behavioral and neurochemical effects of 6hydroxydopamine. J Neurosci 2001; 21:4427–4435. 76. Benecke R, Rothwell J, Dick J, Marsden C. Disturbance of sequential movements in patients with Parkinson’s disease. Brain 1987; 110:361–379. 77. Soliveri P, Brown R, Jahanshahi M, Marsden C. Effect of performance of a skilled motor task in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry 1992; 55:454–460. 78. Yekutiel M, Pinhasov A, Shahar G, Sroka H. A clinical trial of the re-education of movement in patients with Parkinson’s disease. Clin Rehabil 1991; 5:207– 214. 79. Riley D, Lang A, Blair R, Birnbaum A, Reid B. Frozen shoulder and other shoulder disturbances in parkinson’s disease. J Neurol Neurosurg Psychiatry 1989; 52:63–66. 80. Bowes S, Charlett A, Dobbs R, Lubel D, Mehta R, O’Neill C, Weller C, Hughes J, Dobbs S. Gait in relation to ageing and idiopathic Parkinsonism. Scand J Rehabil Med 1992; 24:157–160. 81. Comella C, Stebbins G, Brown-Toms N, Goetz C. Physical therapy and Parkinson’s disease: A controlled clinical trial. Neurology 1994; 44:376–378. 82. Formisano R, Pratesi I, Modarelli F, Bonifati V, Meco G. Rehabilitation and Parkinson’s disease. Scand J Rehabil Med 1992; 24:157–160. 83. Bagley S, Kelly B, Tunnicliffe N. The effect of visual cues on the gait of independently mobile Parkinson’s disease patients. Physiotherapy 1991; 77:415–420. 84. Lewis G, Byblow W, Walt S. Stride length regulation in Parkinson’s disease: The use of extrinsic, visual cues. Brain 2000; 123:2077–90. 85. Hanakawa T, Fukuyama H, Katsumi Y, Honda M, Shibasaki H. Enhanced lateral premotor activity during paradoxical gait in Parkinson’s disease. Ann Neurol 1999; 45:329–336. 86. Thaut M, McIntosh G, Rice R, Miller R, Rathbun J, Brault J. Rhythmic auditory stimulation in gait training for Parkinson’s disease patients. Mov Disord 1996; 11:193–200. 87. Patti F, Reggio A, Nicoletti F, Sellaroli T. Effects of rehabilitation therapy on Parkinson’s disability and functional independence. J Neurol Rehabil 1996; 10:223–231. 88. Miyai I, Fujimoto Y, Ueda Y, Yamamoto H, Nozaki S, Saito T, Kang J. Treadmill training with body weight support: Its effect on Parkinson’s disease. Arch Phys Med Rehabil 2000; 81:849–52. 89. Ziv I, Avraham M, Michaelov Y. Enhanced fatigue during motor performance in patients with Parkinson’s disease. Neurology 1998; 51:1583–1586. 90. Brooks D, Doder M. Depression in Parkinson’s disease. Curr Opin Neurol 2001; 14:465–470. 91. Rodriguez M, Siva A, Ward J, Kurland L, Stolp-Smith K, O’Brien P. Impairment, disability, and handicap in multiple sclerosis. Neurology 1994; 44:28–33. 92. Weinshenker B, Bass B, Rice G, Noseworthy J, Carriere W, Baskerville J, Ebers G. The natural history of multiple sclerosis: A geographically-based study. Brain 1989; 112:133–146. 93. Confavreux C, Vukusic S, Moreau T, Adeleine P. Relapses and progression of disability in multiple sclerosis. N Engl J Med 2000; 343:1430–1438. 94. Gulick E. Model confirmation of the MS-Related Symptom Checklist. Nurs Res 1989; 38:147–153. 95. Granger C, Cotter A, Hamilton B, Fiedler R, Hens M. Functional assessment scales: A study of persons with multiple sclerosis. Arch Phys Med Rehabil 1990; 71:870–875. 96. Rudick R, Miller D, Clough J, Gragg L, Farmer R. Quality of life in multiple sclerosis. Arch Neurol 1992; 49:1237–1242. 97. Vickrey B, Hays R, Harooni R, Myers L, Ellison G. A health-related quality of life measure for multiple sclerosis. Qual Life Res 1995; 4:187–206. 97a. Ford HL, Tennant G, Whalley A. Developing a disease-specific quality of life measure for people with MS. Clin Rehabil 2001; 15:247–258. 97b. Hobart JC, Lamping D, Fitzpatrick R. The Multi ple Sclerosis Impact Scale: A new patient-based out come measure. Brain 2001; 124:962–973. 98. Goodin D, Frohman E, Garmany G, Halper J, Likosky W, Lublin F, Silberberg D, Stuart W, van den Noort S. Disease modifying therapies in multi ple sclerosis. Neurology 2002; 58:169–178. 99. Reddy H, Narayanan S, Arnoutelis R, Jenkinson M, Antel J, Matthews P, Arnold D. Evidence for adaptive functional changes in the cerebral cortex with axonal injury from multiple sclerosis. Brain 2000; 123:2314–2320. 100. Lee M, Reddy H, Johansen-Berg H, Pendlebury S, Jenkinson M, Smith S, Palace J, Matthews P. The motor cortex shows adaptive functional changes to brain injury from multiple sclerosis. Ann Neurol 2000; 47:606–613. 101. Trapp B, Peterson J, Ransohoff R, Rubick R, Mork S, Bo L. Axonal transection in the lesions of multiple sclerosis. N Engl J Med 1998; 338:278–285. 102. Shakespeare D, Boffild M, Young C. Anti-spasticity agents for multiple sclerosis . The Cochrane Library, Issue 4: Oxford: Update Software, 2001. 103. Smith C, Birnbaum G, Carter J, Greenstein J, Lublin F. Tizanidine treatment of spasticity caused by multiple sclerosis. Neurology 1994; 44 :S34–S43. 104. Nance P, Sheremata W, Lynch S, Vollmer T, Hudson S, Francis G, O’Connor P, Cohen J, Schapiro R, Whitham R, Mass M, Lindsey J, Shellenberger K. Relationship of the antispasticity effect of tizanidine to plasma concentration in patients with multiple sclerosis. Arch Neurol 1997; 54:731–736. 105. Mattison P. Transcutaneous electrical nerve stimulation in the management of painful muscle spasm in multiple sclerosis. Clin Rehabil 1993; 7:45–48. 106. DeLuca J, Johnson S. Cognitive impairments in multiple sclerosis. NeuroRehabil 1993; 3 :9–16. 107. Beatty W, Goodkin D. Screening for cognitive impairment in multiple sclerosis. Arch Neurol 1990; 47:297–301. 108. Sullivan M, Weinshenker B, Mikail S, Bishop S. Screening for major depression in the early stages of MS. Can J Neurol Sci 1995; 22:228–231. 109. Traccis S, Rosati C, Monaco M. Successful treatment of acquired pendular elliptical nystagmus in multiple sclerosis with isoniazid and base-out prisms. Neurology 1990; 40:492–494. 110. Schwid S, Thornton C, Pandya S. Quantitative assessment of motor fatigue and strength in MS. Neu rology 1999; 53:743–750. 111. Krupp L, Elkins L. Fatigue and declines in cogni tive functioning in multiple sclerosis. Neurology 2000; 55:934–939. 112. Miller R, Green A, Moussavi R, Carson P, Weiner M. Excessive muscular fatigue in patients with spas tic paraparesis. Neurology 1990; 40:1271–1274. 113. Sheean G, Murray N, Rothwell J, Miller D, Thompson A. An electrophysiological study of the mechanism of fatigue in multiple sclerosis. Brain 1997; 120:299–315. 114. Bakshi R, Miletich R, Henschel K. Fatigue in mul tiple sclerosis: Cross-sectional correlation with brain MRI findings in 71 patients. Neurology 1999; 53:1151–1153. 115. Sheean G, Murray N, Rothwell J, Miller D, Thompson A. An open-labelled clinical and electrophysiological study of 3,4 diaminopyridine in the treatment of fatigue in multiple sclerosis. Brain 1998; 121:967– 975. 116. Roelcke U, Kappos L, Lechner-Scott J, Brunnschweiler H, Leenders K, Huber S, Ammann W, Plohmann A, Dellas S, Maguire R, Missimer JI, Radu E, Steck A. Reduced glucose metabolism in the frontal cortex and basal ganglia of multiple sclerosis patients with fatigue. Neurology 1997; 48:1566–1571. 117. Leocani L, Colombo B, Magnani G, et al. Fatigue in multiple sclerosis is associated with abnormal cortical activation to voluntary movement-EEG evidence. NeuroImage 2001; 13:1186–1192. 118. Kinkel R, Conway K, Copperman L, Forwell S, Hugos C. Fatigue and multiple sclerosis. Multiple Sclerosis Council for Clinical Practice Guidelines. Washington, D.C.: Paralysed Veterans of America, 1998. 119. Canadian MS Research Group. A randomized controlled trial of amantadine in fatigue associated with multiple sclerosis. Can J Neurol Sci 1987; 14:273– 278. 120. Weinshenker B, Penman M, Bass R, Ebers G, Rice G. A double-blind, randomized crossover trial of pemoline in fatigue associated with multiple sclerosis. Neurology 1992; 42:1468–1471. 121. Polman C, Bertelsmann F, van Loenen A, Koetsier J. 4-aminopyridine in the treatment of patients with MS. Arch Neurol 1994; 51:292–296. 122. Polman C, Bertelsmann F, de Waal R, van Dieman, Uitdehaag B, van Loenen A, Koetsier J. 4-aminopyridine is superior to 3,4-diaminopyridine in the treatment of patients with multiple sclerosis. Arch Neurol 1994; 51:1136–1139. 123. Bever C. The current status of studies of aminopyridines in patients with multiple sclerosis. Ann Neurol 1994; 36:S118–S121. 124. van Dieman H, Polman C, van Dongen T, van Loenen A, Nauta J, Taphoorn M, van Walbeek H, Koetsier J. The effect of 4-aminopyridine on clinical signs in multiple sclerosis. Ann Neurol 1992; 32:123– 130. 131. 132. 133. 137. 138. Bever C, Young D, Anderson P, Krumholz A, Conway K, Leslie J, Eddington N, Plaisance K, Panitch H, Dhib-Jalbut S. The effects of 4-aminopyridine in multiple sclerosis patients. Neurology 1994; 44:1054– 1059. Smits R, Emmen H, Bertelsmann F, Kulig B, van Loenen A, Polman C. The effects of 4-aminopyridine on cognitive function in patients with multiple sclerosis. Neurology 1994; 44:1701–1705. Schwid S, Petrie M, McDermott M, Tierney D, Mason D, Goodman A. Quantitative assessment of sustained-release 4-aminopyridine for symptomatic treatment of multiple sclerosis. Neurology 1997; 48: 817–21. Kaji R, Happel L, Sumner A. Effect of digitalis on clinical symptoms and conduction variables in patients with multiple sclerosis. Ann Neurol 1990; 28: 582–584. Petajan J, Gappmaier E, White A, Spencer M, Mino L, Hicks R. Impact of aerobic training on fitness and quality of life in multiple sclerosis. Ann Neurol 1996; 39:432–441. Lord S, Wade D, Halligan P. A comparison of two physiotherapy treatment approaches to improve walking in multiple sclerosis: A pilot randomized controlled study. Clin Rehabil 1998; 12:477–486. Thompson A. The effectiveness of neurological rehabilitation in multiple sclerosis. J Rehabil Res Dev 2000; 37:455–461. Freeman J, Langdon D, Hobart J, Thompson A. The impact of inpatient rehabilitation on progressive multiple sclerosis. Ann Neurol 1997; 42:236–44. Freeman J, Langdon D, Hobart J, Thompson A. Inpatient rehabilitation in multiple sclerosis: Do the benefits carry over into the community? Neurology 1999; 52:50–56. Di Fabio R, Soderberg J, Choi T, Hansen C, Shapiro R. Extended outpatient rehabilitation: Its influence on symptom frequency, fatigue and functional status for persons with progressive multiple sclerosis. Arch Phys Med Rehabil 1998; 79:141–146. Lorig K, Sobel D, Stewart A, Brown B, Bandura A, Ritter P, Gonzalez V, Laurent D, Holman H. Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization. Med Care 1999; 37:5–14. Banja J, Jann B. Ethical issues in treating pediatric rehabilitation patients. NeuroRehabil 1993; 3 :44– 52. Kuban K, Leviton A. Cerebral palsy. N Eng J Med 1994; 330:188–195. Azaula M, Msall M, Buck G, Tremont M, Wilczenski F, Rogers B. Measuring functional status and family support in older school-aged children with cerebral palsy: Comparison of three instruments. Arch Phys Med Rehabil 2000; 81:307–311. Farmer S, Harrison L, Ingram D, Stephens J. Plasticity of central motor pathways in children with hemiplegic cerebral palsy. Neurology 1991; 41:1505– 1510. Eyre J, Tayulor J, Villagra F, Smith M, Miller S. Evidence of activity-dependent withdrawal of corticospinal projections during human development. Neurology 2001; 57:1543–1554. Palmer F, Shapiro B, Wachtel R, Allen M, Hiller J, Harryman S, Mosher B, Meinert C, Capute A. The Other Central and Peripheral Disorders 575 576 Rehabilitation of Specific Neurologic Disorders effects of physical therapy on cerebral palsy. N Eng J Med 1991; 318:803–808. 142. Mayo N. The effect of physical therapy for children with motor delay and cerebral palsy. Am J Phys Med Rehabil 1991; 70:258–267. 143. Colborne G, Wright V, Naumann S. Feedback of triceps surae EMG in gait of children with cerebral palsy: A controlled study. Arch Phys Med Rehabil 1994; 75:40–45. 144. Fernandez J, Pitetti K. Training of ambulatory individuals with cerebral palsy. Arch Phys Med Rehabil 1993; 74:468–472. 145. Schindl M, Forstner C, Kern H, Hesse S. Treadmill training with partial body weight support in nonambulatory patients with cerebral palsy. Arch Phys Med Rehabil 2000; 81:301–306. 146. Damiano D, Abel M. Functional outcomes of strength training in spastic cerebral palsy. Arch Phys Med Rehabil 1998; 79:119–125. 147. Tardeu C, Lespargot A, Tabary C, Bret M. For how long must the soleus muscle be stretched each day to prevent contracture? Dev Med Child Neurol 1988; 30:3–10. 148. Brunstrom J, Bastian A, Wong M, Mink J. Motor benefit from levodopa in spastic quadriplegic cerebral palsy. Ann Neurol 2000; 47:662–665. 149. Albright A, Barron W, Fasick M, Barry M, Shultz B. Continuous intrathecal baclofen infusion for spasticity of cerebral origin. JAMA 1993; 270:2475–2477. 150. Molenaers G, Desloovere K, Eyssen M, Decat J, Jonkers I, De Cock P. Botulinum toxin type A treatment of cerebral palsy: An integrated approach. Europ J Neurol 1999; 6:S51–S57. 151. Abel M, Damiano D, Pannunzio M, Bush J. Muscle-tendon surgery in diplegic cerebral palsy: Functional and mechanical changes. J Pediatr Orthopaed 1999; 19:366–375. 152. Peacock W, Staudt L. Functional outcomes following selective posterior rhizotomy in children with cerebral palsy. J Neurosurg 1991; 74:380–385. 153. Buckon C, Thomas S, Pierce R, Piatt J Jr, Aiona M. Developmental skills of children with spastic diplegia: Functional and qualitative changes after selective dorsal rhizotomy. Arch Phys Med Rehabil 1997; 78:946–951. 154. Schwartz L, Engel J, Jensen M. Pain in persons with cerebral palsy. Arch Phys Med Rehabil 1999; 80: 1243–1246. 155. Beaty J, Canale S. Orthopedic aspects of myelomeningocele. J Bone Joint Surg 1990; 72A:626–630. 156. Mazur J, Shurtleff D, Menelaus M, Colliver J. Orthopedic management of high-level spinal bifida. J Bone Joint Surg 1989; 71A:56–61. 157. Tinetti M, Speechley M. Prevention of falls among the elderly. N Engl J Med 1989; 320:1055–1059. 158. Tinetti M, Williams C. Falls, injuries due to falls, and the risk of admission to a nursing home. N Engl J Med 1997; 337:1279–1284. 159. Koski K, Luukinen H, Laippala P, Kivela S. Risk fac tors for major injurious falls among the homedwelling elderly by functional abilities. Gerontology 1998; 44:232–238. 160. Guralnik J, Ferrucci L, Simonsick E, Salive M, Wallace R. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 1995; 332:556–561. 161. Rantanen T, Guralnik J, Foley D, Masaki K, Leveille S, Curb J, White L. Midlife hand grip strength as a predictor of old age disability. JAMA 1999; 281: 558–560. 162. Guttmann C, Benson R, Warfield S, Wei X, Anderson M, Hall C. White matter abnormalities in mobility-impaired older persons. Neurology 2000; 54: 1277–1283. 163. Kerber K, Enrietto J, Jacobson K, Baloh R. Disequilibrium in older people. Neurology 1998; 51:574–580. 164. Penninx B, Guralnik J, Ferucci L, Simonsick E, Deeg D, Wallace R. Depressive symptoms and physical decline in community-dwelling older persons. JAMA 1998; 279:1720–1726. 165. Thapa P, Gideon P, Cost T, Milam A, Ray W. An tidepressants and the risk of falls among nursing home residents. N Engl J Med 1998; 339:875–881. 166. Gehlsen G, Whaley M. Falls in the elderly: Part 1, Gait. Arch Phys Med Rehabil 1990; 71:735–738. 167. Kerrigan D, Lee L, Nieto T, Markman J, Collins J, Riley P. Kinetic alterations independent of walking speed in elderly fallers. Arch Phys Med Rehabil 2000; 81:730–735. 168. Rudman D, Feller A, Nagraj H, Gergans G, Lalitha P, Goldberg A, Schlenker R, Cohn L, Rudman I, Mattson D. Effects of human growth hormone in men over 60 years old. N Eng J Med 1990; 323:1–6. 169. Applegate W, Miller S, Graney M, Elam J, Burns R, Akins D. A randomized, controlled trial of a geriatric assessment unit in a community rehabilitation hospital. N Engl J Med 1990; 322:1572–1578. 170. Munin M, Rudy T, Glynn N, Crossett L, Rubash H. Early inpatient rehabilitation after elective hip and knee arthroplasty. JAMA 1998; 279:847–852. 171. Mulrow C, Gerety M, Kanten D, Cornell J, DeNino L, Chiodo L, Aguilar C, O’Neil M, Rosenberg J, Solis R. A randomized trial of physical rehabilitation for very frail nursing home residents. JAMA 1994; 271: 513–524. 172. Tinetti M, Baker D, McAvay G, Claus E, Garrett P, Gottschalk M, Koch M, Trainor K, Horwitz R. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Eng J Med 1994; 331:821–827. 173. Clark F, Azen S, Zemke R, Jackson J, Carlson M, Mandel D, Hay J, Josephson K, Cherry B, Hessel C, Palmer J, Lipson L. Occupational therapy for independent-living older adult. JAMA 1997; 278:1321–1326. 174. Smith P. Pharmacology of the vestibular system. Curr Opin Neurol 2000; 13:31–37. 175. Eagger S, Luxon L, Davies R, Coelho A, Ron M. Psychiatric morbidity in patients with peripheral vestibular disorder. J Neurol Neurosurg Psychiatry 1992; 55:383–387. 176. Yardley L, Owen N, Nazareth I, Luxon L. Prevalence and presentation of dizziness in a general practice community sample of working age people. Br J Gen Pract 1998; 48:1131–1136. 177. Staab J. Diagnosis and treatment of psychologic symptoms and psychiatric disorders in patients with dizziness and imbalance. Otolaryngol Clin North Am 2000; 33:617–635. 178. Strupp M, Arbusow V, Maag K, Gall C, Brandt T. Vestibular exercises improve central vestibulospinal compensation after vestibular neuritis. Neurology 1998; 51:838–844. 179. Norre M. Rehabilitation treatments for vertigo and related syndromes. Crit Rev Phys Rehabil Med 1990; 2:101–120. 180. Froehling D, Silverstein M, Mohr D, Beatty C, Offord K, Ballard D. Benign positional vertigo: Incidence and prognosis in Olmsted County, Minnesota. Mayo Clin Proc 1991; 66:596–601. 181. Troost B, Patton J. Exercise therapy for positional vertigo. Neurology 1992; 42:1441–1444. 182. Brandt T, Steddin S, Daroff R. Therapy for benign paroxysmal positioning vertigo, revisited. Neurology 1994; 44:796–800. 183. Small G, Rabins P, Barry P, Buckholtz N, Dekosky S, Ferris S, Finkel S, Gwyther L, Khachaturian Z, Lebowitz B, McRae T, Morris J, Oakley F, Schneider L, Stremin J, Sunderland T, Teri L, Tune L. Diagnosis and treatment of Alzheimer disease and related disorders. JAMA 1997; 278:1363–1371. 184. Pomeroy V. The effect of physiotherapy input on mobility skills of elderly people with severe dementing illness. Clin Rehabil 1993; 7:163–170. 185. Eslinger P, Damasio A. Preserved motor learning in Alzheimer’s disease: Implications for anatomy and behavior. J Neurosci 1986; 6:3006–3009. 186. Dick M, Hsieh S, Dick-Muehlke C, Davis D, Cotman C. The variability of practice hypothesis in motor learning: Does it apply to Alzheimer’s disease? Brain Cogn 2000; 44:470–489. 187. Phillips C, Sloane P, Hawes C, Koch G, Han J, Spry K, Dunteman G, Williams R. Effects of residence in Alzheimer disease special care units on functional outcomes. JAMA 1997; 278:1340–1344. 188. Teri L, McCurry S, Buchner D, Logsdon R, LaCroix A, Kukull W, Barlow W, Larson E. Exercise and activity level in Alzheimer’s disease: A potential treatment focus. J Rehabil Res Dev 1998; 35:411–419. 189. Engel J. Etiology as a risk factor for medically refractory epilepsy: A case for early surgical intervention. Neurology 1998; 51:1243–1244. 190. Fraser R, Gumnit R, Dobkin B, Thorbecke R. Psy chosocial rehabilitation: A preand post-operative perspective. In: Engel J, ed. Surgical Treatment of the Epilepsies. New York: Raven Press, 1993. 190a. Rausch R. Epilepsy surgery within the temporal lobe and its short-term and long-term effects on memory. Curr Opin Neurol 2002; 15:185–189. 191. Birbeck G, Kim S, Hays R, Vickrey B. Quality of life measures in epilepsy: How well can they detect change over time? Neurology 2000; 54:1822–1827. 192. Jason L, Richman J, Rademaker A, Jordan K, Plioplys A, Taylor R, McCredy W, Huang C, Plioplys S. A community-based study of chronic fatigue syndrome. Arch Inten Med 1999; 159:2129–2137. 193. Natelson B. Chronic fatigue syndrome. JAMA 2001; 285:2557–2559. 194. Bou-Holaigah I, Rowe P, Kan J, Calkins H. The relationship between neurally mediated hypotension and the chronic fatigue syndrome. JAMA 1995; 274: 961–967. 195. Rowe P, Calkins H, DeBusk K, McKensie R, Anand R, Sharma G, Cuccherini B, Soto N, Hohman P, Snader S, Lucas K, Wolff M, Straus S. Fludrocortisone acetate to treat neurally mediated hypotension in chronic fatigue syndrome: A randomized controlled trial. JAMA 2001; 285:52–59. 196. Joyce E, Blumenthal S, Wessely S. Memory, attention, and executive function in chronic fatigue syndrome. J Neurol Neurosurg Psychiatry 1996; 60:495–503. 197. Whiting P, Bagnall A-M, Sowden A, Cornell J, Mulrow C, Ramirez G. Interventions for the treatment and management of chronic fatigue syndrome. JAMA 2001; 286:1360–1368. 198. d’Arminio Monforte A, Duca P, Vago L, Grassi M, Moroni M. Decreasing incidence of CNS AIDSdefining events associated with antiretroviral therapy. Neurology 2000; 54:1856–1859. 199. Kraft G, Freal J, Coryll J. Disability, disease duration and rehabilitation service needs in multiple sclerosis: Patient perspectives. Arch Phys Med Rehabil 1986; 67:164–178. Other Central and Peripheral Disorders 577 Index Page numbers followed by f and t indicate figures and tables, respectively. Accommodation, compensation through, 80 Acetylcholine, synaptic actions mediated by, 50 Acetylcholinesterase, functional neuroimaging, 185 Acquired immunodeficiency syndrome, 571 Action Research Arm Test, 282 Activa Tremor Control, 198 Activities of daily living measures, 290–94, 290t–293t after spinal cord injury, 473–75, 475t Acupuncture for pain management, 345 for stroke, 419–20 Adaptive aids for daily living, 233–34, 233t Adjustment scales, quality of life, 301, 301t Adolescents. See Children and adolescents Aerobic exercise in multiple sclerosis, 563 after traumatic brain injury, 521 Affective disorders management, 358, 360–63 after stroke, 434–36 Age differences functional neuroimaging, 161 walking speed, 252, 254t Aggression, after traumatic brain injury, 533 Aging. See Elderly persons Agitated Behavior Scale, 512 Agitation, after traumatic brain injury, 533, 534 AIDS, 571 Akinesia, in Parkinson’s disease, 557 Alien hand syndrome, 402 Allodynia, 338 Alzheimer’s disease concussion and, 537 measures of impairment, 276–77 rehabilitation, 570

Patients with the chronic fatigue syndrome often come to the attention of specialists in rehabilitation. A lot of sociopolitical baggage accompanies this diagnosis. Consumer groups and clinicians who believe in specific causes may villify those who do not. The prevalence of at least 6 months of new-onset fatigue unexplained by a medical diagnosis is 0.5% in American women and 0.3% in men.192 These persons report a lower functional status than matched patients with congestive heart failure.193 The syndrome may include fibromyalgia, depression, and an irritable bowel. Al though some reports have suggested abnormalities on MRI scans and by single photon emission tomography, these data have not held up in better-designed comparison studies. General conditioning exercises and energy conservation techniques may improve daily functioning in sedentary patients. The syndrome has been associated with neurally mediated hypotension in some instances, which can respond to sodium loading,194 but a randomized trial of fludrocortisone did not alter the course of the disease.195 Comorbid psychiatric conditions may relieve these symptoms, but may not alter the somatic complaints. Cognitive-behavioral therapy has helped some patients and antidepressant medications may lessen the cost of care within 6 months.193 Impaired working memory and attention on effortful tasks is common196 and may respond to cognitive remediation strategies. A systematic review of the literature concluded that graded exercise and cognitive behavioral therapy are the most promising interventions.197