Clinical Neurorehabilitation: Using Principles of Neurological Diagnosis, Prognosis, and Neuroplasticity in Assessment and Treatment Planning

2021 ◽  
Author(s):  
Douglas I. Katz ◽  
Brigid Dwyer
Keyword(s):  
Natural History ◽  
Treatment Planning ◽  
Functional Disability ◽  
Medical Rehabilitation ◽  
Neurological Dysfunction ◽  
Rehabilitation Team ◽  
Rehabilitative Treatment ◽  
Assessment And Treatment ◽  
Treatment Plans ◽  
Brain Reorganization

AbstractNeurorehabilitation aspires to restore a person to his or her fullest potential after incurring neurological dysfunction. In medical rehabilitation, diagnosis involves assessment of medical conditions and their effects on functioning. It is usually a team effort that involves an amalgam of diagnostic assessments by multiple disciplines, leading to a collection of rehabilitative treatment plans and goals. This article discusses a clinical neurological paradigm, using rigorous clinical assessment of neuropathological and clinical diagnosis, along with prognostication of natural history and recovery. In the context of the role of neuroplasticity in recovery, this paradigm can add significant value to rehabilitation team management and planning. It contributes to enhanced understanding of neurological impairments and syndromes as they relate to functional disability, aiding in targeting deficits and setting treatment goals. Rehabilitation strategies and goals should be informed by natural history and prognosis, and viewed in the framework of the stage of recovery. Prognostic formulations should suggest an emphasis on restorative versus compensatory strategies for functional problems. Treatment planning should be informed by evidence on how interventions modulate brain reorganization in promoting recovery. Strategies that promote adaptive neuroplasticity should be favored, especially with restorative efforts, and evidence supporting optimal techniques, timing, and dosing of rehabilitation should be considered in treatment planning.

scholarly journals Multicriterial CNN based beam generation for robotic radiosurgery of the prostate

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Stefan Gerlach ◽  
Christoph Fürweger ◽  
Theresa Hofmann ◽  
Alexander Schlaefer
Keyword(s):  
Deep Learning ◽  
Treatment Planning ◽  
Treatment Plan ◽  
Plan Quality ◽  
New Approach ◽  
Beam Generation ◽  
Radiological Features ◽  
Improve Treatment ◽  
Robotic Radiosurgery ◽  
Treatment Plans

AbstractAlthough robotic radiosurgery offers a flexible arrangement of treatment beams, generating treatment plans is computationally challenging and a time consuming process for the planner. Furthermore, different clinical goals have to be considered during planning and generally different sets of beams correspond to different clinical goals. Typically, candidate beams sampled from a randomized heuristic form the basis for treatment planning. We propose a new approach to generate candidate beams based on deep learning using radiological features as well as the desired constraints. We demonstrate that candidate beams generated for specific clinical goals can improve treatment plan quality. Furthermore, we compare two approaches to include information about constraints in the prediction. Our results show that CNN generated beams can improve treatment plan quality for different clinical goals, increasing coverage from 91.2 to 96.8% for 3,000 candidate beams on average. When including the clinical goal in the training, coverage is improved by 1.1% points.

The natural history of post-traumatic hypopituitarism: Implications for assessment and treatment

2005 ◽  
Vol 118 (12) ◽  
pp. 1416.e1-1416.e7 ◽  
Author(s):  
Amar Agha ◽  
Jack Phillips ◽  
Patrick O’Kelly ◽  
William Tormey ◽  
Christopher J. Thompson
Keyword(s):  
Natural History ◽  
Assessment And Treatment ◽  
History Of ◽  
Post Traumatic

Fiddly Fives: Management of Impacted Second Premolars

Dental Update ◽  
2021 ◽  
Vol 48 (5) ◽  
pp. 385-392
Author(s):  
Othman Hameed ◽  
Elizabeth Crawford ◽  
Nigel G Taylor
Keyword(s):  
Treatment Planning ◽  
Clinical Relevance ◽  
Treatment Options ◽  
Third Molar ◽  
Maxillary Canine ◽  
The Third ◽  
Topic Knowledge ◽  
Assessment And Treatment ◽  
General Dentists

Second premolars are the third most likely teeth to be affected by impaction after third molar and maxillary canine teeth. Although the presence of an impacted second premolar is relatively common, and is a situation that often presents to general dentists in practice, there is relatively little published regarding this topic. Knowledge of this condition is essential for all those involved with the management of these cases. This article explores the aetiology, assessment and treatment options available to manage this condition, using examples from cases treated within our department. CPD/Clinical Relevance: An understanding of the aetiology, assessment and various treatment options available to manage impacted second premolars will inform better treatment planning.

The natural history of intracranial venous angiomas

1991 ◽  
Vol 75 (5) ◽  
pp. 715-722 ◽  
Author(s):  
Timothy B. Garner ◽  
O. Del Curling ◽  
David L. Kelly ◽  
D. Wayne Laster
Keyword(s):  
Natural History ◽  
Imaging Techniques ◽  
Venous Drainage ◽  
Vascular Lesion ◽  
Neurological Dysfunction ◽  
Content Type ◽  
History Of ◽  
Clinical Records ◽  
Venous Angiomas ◽  
Fine Print

✓ Cerebral venous angiomas are congenital anomalies of the intracranial venous drainage. Many believe that they are associated with a high risk of hemorrhage and neurological dysfunction, but newer neurodiagnostic imaging techniques are showing not only that they are more common than previously known but also that many have no associated symptoms. In this retrospective study, the natural history of venous angiomas was examined in 100 patients (48 males and 52 females) with radiographically identifiable lesions treated over a 14-year period. Information on the natural history of the lesion was obtained from clinical records and follow-up data. Imaging studies included angiography, computerized tomography, and magnetic resonance imaging. Angioma locations were classified as frontal (42 cases), parietal (24 cases), occipital (4 cases), temporal (2 cases), basal or ventricular (11 cases), cerebellar (14 cases), or brain stem (3 cases); 47 lesions were on the left side. Headache as a presenting symptom was common (36 patients) and often led to other radiographic studies, but this appeared to be related to the vascular lesion in only four patients. Other possibly related complications were hemorrhage in one patient, seizures in five, and transient focal deficits in eight. Fifteen patients had no neurological signs or symptoms. The mean patient age at last contact was 45.3 years (range 3 to 94 years). All patients have been managed without surgery. It is concluded that significant complications secondary to venous angiomas are infrequent and that surgical resection of these lesions and of surrounding brain is rarely indicated.

Treatment Planning

2017 ◽  
pp. 91-110
Author(s):  
Alice Medalia ◽  
Tiffany Herlands ◽  
Alice Saperstein ◽  
Nadine Revheim
Keyword(s):  
Treatment Planning ◽  
Learning Style ◽  
Treatment Plan ◽  
Cognitive Remediation ◽  
Educational Approach ◽  
Frustration Tolerance ◽  
Case Examples ◽  
Time Treatment ◽  
Treatment Plans ◽  
Over Time

Chapter 6 describes how to use treatment plans to guide cognitive remediation sessions. Personalized treatment planning takes into account the multiple factors unique to each client that impact how they use cognition in everyday life. Neuropsychological Educational Approach to Remediation (NEAR) treatment plans address current cognitive deficits, the client’s need for structure, motivation and goals, learning style and barriers, endurance, frustration tolerance, approach to tasks, and task repertoire. The treatment plan should be updated periodically because each of these factors may change over time. Treatment plan components are reviewed, and case examples are provided.

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