The current evidence base surrounding Bobath Concept (NDT) in adult neurorehabilitation: a scoping review update

Review question / Objective: This scoping review aimed to gain a clear understanding of the current evidence base surrounding neurological rehabilitation based on the Bobath Concept (NDT) in adult population, by analyzing the different types of evidence that address and inform practice in this field and the way the research has been conducted. The specific questions, in regards to the available international published and unpublished literature, are: • What types of research are being conducted about the Bobath concept in adult neurorehabilitation? • How Bobath concept in adult neurorehabilitation is being studied, defined, conceptualized and operationalized? • What are the main knowledge gaps about the research involving the Bobath concept in adult neurorehabilitation and the implications for rehabilitation science? Condition being studied: The Bobath Concept approach in adult neuroreabilitation.

Introduction of brain computer interface to neurologists

A brain-computer interface (BCI) is a technology that acquires and analyzes electrical signals from the brain to control external devices. BCI technologies can generally be used to control a computer cursor, limb orthosis, or word processing. This technology can also be used as a neurological rehabilitation tool for people with poor motor control. We reviewed historical attempts and methods toward predicting arm movements using brain waves. In addition, representative studies of minimally invasive and noninvasive BCI were summarized.

Magnetic Resonance Image Feature Analysis under Deep Learning in Diagnosis of Neurological Rehabilitation in Patients with Cerebrovascular Diseases

To explore the impact of magnetic resonance imaging (MRI) image features based on deep learning algorithms on the neurological rehabilitation of patients with cerebrovascular diseases, eighty patients with acute cerebrovascular disease were selected as the research objects. According to whether the patients were with vascular cognitive impairment (VCI), they were divided into VCI group (34 cases) and non-VCI group (46 cases). In addition, based on the convolutional neural network (CNN), a new multimodal CNN image segmentation algorithm was proposed. The algorithm was applied to the segmentation of MRI images of patients with vascular cognitive impairment (VCI) and compared with the segmentation results of CNN and fully CNN (FCN). As a result, the segmentation results of the three different algorithms showed that the Dice coefficient, accuracy, and recall of the multimodal CNN algorithm were 0.78 ± 0.24, 0.81 ± 0.28, and 0.88 ± 0.32, respectively, which were significantly increased compared to those of other two algorithms ( P < 0.05). The neurological evaluation results showed that the MMSE and MoCA scores of VCI patients were 15.4 and 14.6 ± 5.31, respectively, which were significantly lower than those of the non-VCI group ( P < 0.05). The TMT-a and TMT-b scores of VCI patients were 221.7 and 385.9, respectively, which were significantly higher than those of the non-VCI group ( P < 0.05). The FA and MD values of nerve function-related fibers shown in the MRI images of the VCI group were significantly different from those of the non-VCI group ( P < 0.05). Therefore, the neurological recovery process of VCI patients was affected by multiple neurocognitive-related fiber structures. To sum up, the multimodal CNN algorithm can sensitively and accurately reflect the degree of neurological impairment in patients with cerebrovascular disease and can be applied to disease diagnosis and neurological evaluation of VCI patients.

Effect of Comprehensive Nursing Intervention on Postpartum Psychological and Neurological Rehabilitation of Pregnant Patients with Encephalopathy

To explore the effect of comprehensive nursing intervention on postpartum psychological and neurological rehabilitation of pregnant patients with encephalopathy. 102 patients who were diagnosed as preeclampsia or eclampsia and confirmed as reversible posterior leukoencephalopathy syndrome (RPLS) by brain MRI from January 2015 to September 2019 in our hospital were collected. In research group (RG), patients (n=57) were treated with comprehensive nursing intervention mode, while patients (n=45) were treated with traditional nursing intervention mode in control group (CG). In the two groups, the psychological and neurological rehabilitation were observed before and after intervention. By examining the biochemical indexes in the two groups before and after the treatment, it was found that the biochemical indexes were significantly reduced after the intervention, but there was no significant difference in the indexes of lactate dehydrogenase (LDH) and uric acid (UA) between the two groups before and after the treatment. In the two groups, the psychological mood was compared by the rating scale. After the intervention, the anxiety and depression were relieved in the two groups, and the scores of the self-rating anxiety scale (SAS) and self-rating depression scale (SDS) of RG were lower than those of CG (P<0.05). After treatment and nursing, the neurological damage of RPLS in both groups was improved, but the residual rate of headache in RG was lower than that in CG (P<0.05). The incidence of maternal and infant adverse outcomes in RG was lower than that in CG (P<0.05). According to statistics, the patients’ nursing compliance and nursing satisfaction in RG were higher than those in CG (P<0.05). Comprehensive nursing intervention can significantly improve the adverse emotions of pregnant patients with encephalopathy and promote the rehabilitation of neurological function, so it has a high degree of nursing satisfaction.

Assessment of the functional state of the brain by neuroenergy mapping as a way to optimize neurological rehabilitation

Neurological rehabilitation of patients with brain injuries is a complex interdisciplinary system aimed at restoring and producing compensatory mechanisms, as well as psychological and social readaptation of patients. An important issue is a personalized rehabilitation program for each individual patient. One method that can help solve this problem is neuroenergy mapping.

Pressure ulcers microbiota dynamics and wound evolution

Bacterial species and their role in delaying the healing of pressure ulcers (PU) in spinal cord injury (SCI) patients have not been well described. This pilot study aimed to characterise the evolution of the cutaneous microbiota of PU in SCI cohort. Twenty-four patients with SCI from a French neurological rehabilitation centre were prospectively included. PU tissue biopsies were performed at baseline (D0) and 28 days (D28) and analysed using 16S rRNA gene-based sequencing analysis of the V3–V4 region. At D0, if the overall relative abundance of genus highlighted a large proportion of Staphylococcus, Anaerococcus and Finegoldia had a significantly higher relative abundance in wounds that stagnated or worsened in comparison with those improved at D28 (3.74% vs 0.05%; p = 0.015 and 11.02% versus 0.16%; p = 0.023, respectively). At D28, Proteus and Morganella genera were only present in stagnated or worsened wounds with respectively 0.02% (p = 0.003) and 0.01% (p = 0.02). Moreover, Proteus, Morganella, Anaerococcus and Peptoniphilus were associated within the same cluster, co-isolated from biopsies that had a poor evolution. This pathogroup could be a marker of wound degradation and Proteus could represent a promising target in PU management.

Neurological rehabilitation for a patient with chronic Rasmussen encephalitis: a case report

ABSTRACT Rasmussen encephalitis is a rare disease consisting of a chronic, slowly progressive inflammatory reaction of brain tissues. The objective of this study was to describe the case of an 18-year-old female patient, studying on the fourth grade of elementary school, and right-handed, who underwent left hemispherectomy in a neurological rehabilitation program. Her seizures began at 10 years of age and were unresponsive to drug treatment, with functional repercussions. She underwent hemispherectomy in March 2019, with 7 years of ongoing disease, and was admitted for the rehabilitation program with a multidisciplinary team in June 2020. The quality-of-life questionnaire (WHOQOL-BREF) was applied as a comparison measure before and after the rehabilitation program, along with measures of participation on the program activities. Despite the patient’s short time in a rehabilitation program, data show the importance of an interdisciplinary intervention through the establishment of specific and contextualized objectives in chronic patients.

Stroke Rehabilitation in Nigeria: Challenges and Opportunities

Stroke rehabilitation offers opportunity for people with impairments and disabilities secondary to stroke. In this regard, there are many advances particularly in the developed countries. Whereas, in the developing countries such as Nigeria there are still many challenges such as lack of guidelines to guide clinicians and other stakeholders, dearth of the neurological rehabilitation professionals, inadequate training of the existing rehabilitation professionals, poor infrastructure, and lack of policies for stroke rehabilitation. However, there are also opportunities as well such as increased national and global focus on non-communicable diseases, partnership with stakeholders in national and global health, leveraging on democratic governance, leveraging on Sustainable Development Goals (SDGs), and leveraging on the systems through which communities deal with stroke. When these opportunities are harnessed, they can help to improve stroke rehabilitation in the country. Additionally, tackling the challenges headlong can help to improve stroke rehabilitation in Nigeria.