Clinical Characteristics of Voice, Speech, and Swallowing Disorders in Oromandibular Dystonia

2016 ◽  
Vol 59 (5) ◽  
pp. 940-949 ◽  
Author(s):  
Alexandre Kreisler ◽  
Anne-Caroline Verpraet ◽  
Solène Veit ◽  
Odile Pennel-Ployart ◽  
Hélène Béhal ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Clinical Characteristics ◽  
Rehabilitation Program ◽  
Swallowing Disorders ◽  
Oromandibular Dystonia ◽  
Matched Healthy Control ◽  
Voice Changes ◽  
Prominent Symptom ◽  
Healthy Control

Purpose To better define the clinical characteristics of idiopathic oromandibular dystonia, we studied voice, speech, and swallowing disorders and their impact on activities of daily living. Method Fourteen consecutive patients with idiopathic oromandibular dystonia and 14 matched, healthy control subjects were included in the study. Results Dysarthria was the most common disorder and its characteristics varied from one patient to another. However, we frequently observed a hyperkinetic, dysarthric profile characterized by imprecise consonants, a rough voice, changes in intensity, and hypernasality. Dysphagia appeared to be slightly less frequent and less disabling than dysarthria. Most patients had difficulty swallowing solids, and the oral phase was particularly problematic. Dysarthria and dysphagia affected activities of daily living in general and the psychological/emotional domain in particular. Conclusions The characteristics of dysarthria in oromandibular dystonia vary significantly from one patient to another due to differences in the set of affected muscles, so each patient should receive a personalized rehabilitation program. Dysarthria was the most prominent symptom, although spasmodic dysphonia was more frequent than expected. Further laboratory-based studies are needed to clarify the mechanisms and consequences of dysphagia in oromandibular dystonia.

scholarly journals Prevalence of epilepsy/seizures as a comorbidity of neurologic disorders in nursing homes

Neurology ◽  
2017 ◽  
Vol 88 (8) ◽  
pp. 750-757 ◽  
Author(s):  
Angela K. Birnbaum ◽  
Ilo E. Leppik ◽  
Kenneth Svensden ◽  
Lynn E. Eberly
Keyword(s):  
Nursing Home ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Clinical Characteristics ◽  
The United States ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Data Set ◽  
Neurologic Disorders ◽  
Comorbidity Burden

Objective:To determine the prevalence of epilepsy/seizure (epi/sz) comorbid with other neurologic disorders in elderly nursing home residents and to examine demographic and regional variability and associations with clinical characteristics.Methods:We studied 5 cross-sectional cohorts of all residents in any Medicare/Medicaid–certified nursing home in the United States on July 15 of each year from 2003 to 2007. Epi/sz was identified by ICD-9 codes (345.xx or 780.39) or check box (Minimum Data Set). Epi/sz prevalence was stable across all years, so only 2007 data were examined further. Logistic regression with generalized estimating equations was used to model cross-sectional prevalence of epi/sz as a function of demographics and neurologic comorbidities of interest, with adjustment for clinical characteristics, including cognitive status, comorbidity burden, medication burden, and activities of daily living.Results:Point prevalence of epi/sz in 2007 was 7.7% (n = 91,372 of N = 1,186,579) differing by geographical region, race/ethnicity, age group, and sex. Neurologic conditions having the highest association with epi/sz were brain tumor (epi/sz prevalence 23.4%–35.2%), head injury (17.9%), hemiplegia (17.7%), and stroke (13.7%). Epi/sz comorbid with stroke or dementia had a strong decreasing association with age (65–74 years had ≈3.8-times higher odds of epi/sz than 85+ years). Activities of daily living, comorbidity burden, and cognition scores were worse in persons with than without epi/sz.Conclusions:The prevalence of epi/sz in the elderly nursing home population is >7-fold higher compared to community-dwelling elderly and is 7 to 30 times higher among those with certain comorbid neurologic conditions. Demographics and clinical characteristics had weaker associations with epi/sz prevalence.

scholarly journals Association of Serum 25-Hydroxyvitamin D Deficiency with Risk of Incidence of Disability in Basic Activities of Daily Living in Adults >50 Years of Age

2020 ◽  
Vol 150 (11) ◽  
pp. 2977-2984
Author(s):  
Mariane M Luiz ◽  
Roberta Máximo ◽  
Dayane C Oliveira ◽  
Paula C Ramírez ◽  
Aline F de Souza ◽  
...  
Keyword(s):  
Vitamin D ◽  
Risk Factor ◽  
Activities Of Daily Living ◽  
Vitamin D Deficiency ◽  
Daily Living ◽  
Clinical Characteristics ◽  
Hydroxyvitamin D ◽  
Increased Risk ◽  
25 Hydroxyvitamin D

ABSTRACT Background Vitamin D deficiency compromises muscle function and is related to the etiology of several clinical conditions that can contribute to the development of disability. However, there are few epidemiological studies investigating the association between vitamin D deficiency and the incidence of disability. Objectives We aimed to assess whether vitamin D deficiency is associated with the incidence of disability in basic activities of daily living (BADL) and to verify whether there are sex differences in this association. Methods A 4-y follow-up study was conducted involving individuals aged 50 y or older who participated in ELSA (English Longitudinal Study of Ageing). The sample consisted of 4814 participants free of disability at baseline according to the modified Katz Index. Vitamin D was assessed by serum 25-hydroxyvitamin D [25(OH)D] concentrations and the participants were classified as sufficient (>50 nmol/L), insufficient (>30 to ≤50 nmol/L), or deficient (≤30 nmol/L). Sociodemographic, behavioral, and clinical characteristics were also investigated. BADL were re-evaluated after 2 and 4 y of follow-up. The report of any difficulty to perform ≥1 BADL was considered as an incident case of disability. Poisson models stratified by sex and controlled for sociodemographic, behavioral, and clinical characteristics were carried out. Results After 4-y follow-up, deficient serum 25(OH)D was a risk factor for the incidence of BADL disability in both women (IRR: 1.53; 95% CI: 1.16, 2.03) and men (IRR: 1.44; 95% CI: 1.02, 2.02). However, insufficient serum 25(OH)D was not a risk factor for the incidence of BADL disability in either men or women. Conclusions Independently of sex, deficient serum 25(OH)D concentrations were associated with increased risk of incidence of BADL disability in adults >50 y old and should be an additional target of clinical strategies to prevent disability in these populations.

scholarly journals Functional Assessment of Region-Specific Neglect: Are There Differential Behavioural Consequences of Peripersonal versus Extrapersonal Neglect?

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
T. C. W. Nijboer ◽  
A. F. ten Brink ◽  
M. Kouwenhoven ◽  
J. M. A. Visser-Meily
Keyword(s):  
Activities Of Daily Living ◽  
Functional Assessment ◽  
Daily Living ◽  
Inpatient Rehabilitation ◽  
Rehabilitation Program ◽  
Body Parts ◽  
Rehabilitation Center ◽  
Stroke Patients ◽  
Instrumental Activities ◽  
Processing Information

Background.Region-specific types of neglect (peripersonal and extrapersonal) have been dissociated, yet, differential behavioural consequences are unknown.Objective.The aim of the current study was to investigate behavioural consequences at the level of basic activities of daily living of region-specific neglect, using the Catherine Bergego Scale (CBS).Methods.118 stroke patients were screened within the first two weeks after admission to the rehabilitation center for inpatient rehabilitation.Results.Patients with peripersonal neglect and patients with neglect for both regions had significantly higher total score on the CBS compared to nonneglect patients. Total scores for patients with extrapersonal neglect were comparable to non-neglect patients. ADL impairments were found across activities (e.g., looking towards one side, forgetting body parts, colliding) for both patients with peripersonal neglect and patients with neglect for both regions. Patients with extrapersonal neglect were only impaired on the item on way finding.Conclusions.When diagnosing neglect, it is relevant to distinguish the type of region-specific neglect and, where needed, to adjust the rehabilitation program accordingly. As the CBS isnotdeveloped to typically measure ADL in extrapersonal neglect, it would be of importance to add other (instrumental) activities that heavily rely on processing information in farther space.

scholarly journals Impaired Performance on a Cognitively-Based Instrumental Activities of Daily Living Task, the 10-Item Weekly Calendar Planning Activity, in Individuals With Stroke Undergoing Acute Inpatient Rehabilitation

2021 ◽  
Vol 12 ◽  
Author(s):  
Abhishek Jaywant ◽  
Catherine Arora ◽  
Alexis Lussier ◽  
Joan Toglia
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Cognitive Strategies ◽  
Inpatient Rehabilitation ◽  
Screening Tools ◽  
Weekly Schedule ◽  
Stroke Patients ◽  
Planning Activity ◽  
Instrumental Activities ◽  
Healthy Control

Performance-based, functionally relevant, and standardized measures of cognitive-instrumental activities of daily living (C-IADL) can complement neuropsychological tests of cognitive impairment and provide valuable clinical information to inform rehabilitation planning. Existing measures have been validated in the outpatient setting. Here, we sought to evaluate a 10-item, short-form of a C-IADL measure, Weekly Calendar Planning Activity (WCPA-10), in inpatients with stroke undergoing acute rehabilitation. The specific goal was to determine if the WCPA-10 could differentiate between stroke patients undergoing acute inpatient rehabilitation and healthy control individuals. We also explored whether the WCPA-10 would identify C-IADL limitations in stroke patients screened as having intact cognition. Seventy-seven stroke inpatients undergoing rehabilitation and 77 healthy control participants completed the WCPA-10, which involves entering a list of simulated, fictional appointments into a weekly schedule while keeping track of and adhering to multiple task rules and ignoring built-in obstacles and distractions. Compared to the control group, stroke patients had significantly worse accuracy, made more errors, used fewer cognitive strategies, followed fewer rules, took more time to complete the task, and were less efficient. 83% of stroke patients were less accurate than predicted by their age, and 64% used less strategies than their age prediction. Among 28 participants who screened as having “normal” cognitive function on the Montreal Cognitive Assessment, the majority had deficits on the WCPA-10. Our results provide initial support for use of a brief C-IADL assessment, WCPA-10, for individuals with stroke undergoing inpatient rehabilitation. They indicate that stroke patients have deficits in C-IADL accuracy, efficiency, and strategy use at this stage of stroke recovery. Results highlight the need to use performance based, functional cognitive assessments, even for those who perform well on cognitive screening tools.

scholarly journals Robot-Assisted Therapy and Constraint-Induced Movement Therapy for Motor Recovery in Stroke: Results From a Randomized Clinical Trial

2021 ◽  
Vol 15 ◽  
Author(s):  
Thais Tavares Terranova ◽  
Marcel Simis ◽  
Artur César Aquino Santos ◽  
Fábio Marcon Alfieri ◽  
Marta Imamura ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Activities Of Daily Living ◽  
Randomized Clinical Trial ◽  
Upper Limb ◽  
Daily Living ◽  
Movement Therapy ◽  
Rehabilitation Program ◽  
Motor Recovery ◽  
Robot Assisted ◽  
Constraint Induced Movement Therapy

Background: Stroke is one of the leading causes of adult disability, and up to 80% of stroke survivors undergo upper extremity motor dysfunction. Constraint-Induced Movement Therapy (CIMT) and Robot-Assisted Therapy (RT) are used for upper limb stroke rehabilitation. Although CIMT and RT are different techniques, both are beneficial; however, their results must be compared. The objective is to establish the difference between RT and CIMT after a rehabilitation program for chronic stroke patients.Method: This is a randomized clinical trial, registered at ClinicalTrials.gov (ID number NCT02700061), in which patients with stroke received sessions of RT or CIMT protocol, combined with a conventional rehabilitation program for 12 weeks. The primary outcome was measured by Wolf Motor Function Test (WMFT) and Fugl-Meyer Assessment—Upper Limb (FMA-UL). Activities of daily living were also assessed.Results: Fifty one patients with mild to moderate upper limb impairment were enrolled in this trial, 25 women and 26 men, mean age of 60,02 years old (SD 14,48), with 6 to 36 months after stroke onset. Function significantly improved regardless of the treatment group. However, no statistical difference was found between both groups as p-values of the median change of function measured by WMFT and FMA were 0.293 and 0.187, respectively.Conclusion: This study showed that Robotic Therapy (RT) was not different from Constraint-Induced Movement Therapy (CIMT) regardless of the analyzed variables. There was an overall upper limb function, motor recovery, functionality, and activities of daily living improvement regardless of the interventions. At last, the combination of both techniques should be considered in future studies.

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