Re: Gschwind CR, Yeomans JL, Smith BJ. Upper limb surgery for severe spasticity after acquired brain injury improves ease of care. J Hand Surg Eur. 2019, 44: 898–904.

2019 ◽  
Vol 45 (3) ◽  
pp. 311-314
Author(s):  
Daisy Ryan ◽  
Marie Song ◽  
James K.-K. Chan
Keyword(s):  
Brain Injury ◽  
Upper Limb ◽  
Acquired Brain Injury ◽  
Severe Spasticity ◽  
Upper Limb Surgery

Upper limb surgery for severe spasticity after acquired brain injury improves ease of care

2019 ◽  
Vol 44 (9) ◽  
pp. 898-904 ◽  
Author(s):  
Claudia R. Gschwind ◽  
Jayne L. Yeomans ◽  
Belinda J. Smith
Keyword(s):  
Brain Injury ◽  
Upper Limb ◽  
Acquired Brain Injury ◽  
Upper Body ◽  
Level Of Evidence ◽  
Difficult Time ◽  
Severe Spasticity ◽  
Upper Limb Surgery ◽  
Limb Spasticity ◽  
Relevant Outcome Measure

For individuals with acquired brain injury and severe upper limb spasticity, personal care is often difficult, time-consuming and painful. Previous studies on outcomes after surgery for upper limb spasticity have focused on functional gain, pain, hygiene and appearance. We operated on 38 non-communicative patients (45 limbs, 535 procedures) with severe spasticity and a non-functional upper limb(s). The surgical goals were to provide opening of the fingers and thumb, wrist stability and, if required, to release muscles around the elbow and shoulder. We used the Carer Burden Score as a relevant outcome measure. Preoperatively and 3 months postoperatively, the carer rated the degree of difficulty in cleaning the palm, cutting the fingernails, cleaning the axilla and dressing the upper body on a 5-point Likert scale. Surgery significantly improved the ease of care, which has implications not only for the patient but also for carers and associated health costs. Level of evidence: IV

Potential contributing factors to upper limb associated reactions in people with acquired brain injury: an exploratory study

2021 ◽  
pp. 1-9
Author(s):  
Michelle B. Kahn ◽  
Ross A. Clark ◽  
Benjamin F. Mentiplay ◽  
Kelly J. Bower ◽  
John Olver ◽  
...  
Keyword(s):  
Brain Injury ◽  
Upper Limb ◽  
Exploratory Study ◽  
Acquired Brain Injury ◽  
Contributing Factors

The Accuracy of Subjective Assessment of Upper Limb Associated Reactions During Walking in People with Acquired Brain Injury

2021 ◽  
Vol 102 (10) ◽  
pp. e45-e46
Author(s):  
Michelle Kahn ◽  
Gavin Williams ◽  
Benjamin Mentiplay ◽  
Kelly Bower ◽  
John Olver ◽  
...  
Keyword(s):  
Brain Injury ◽  
Upper Limb ◽  
Acquired Brain Injury ◽  
Subjective Assessment

The reproducibility and responsiveness of subjective assessment of upper limb associated reactions in people with acquired brain injury during walking

2019 ◽  
Vol 34 (2) ◽  
pp. 252-262 ◽  
Author(s):  
Michelle B Kahn ◽  
Ross A Clark ◽  
Kelly J Bower ◽  
Benjamin F Mentiplay ◽  
Pua Yong Hao ◽  
...  
Keyword(s):  
Brain Injury ◽  
Upper Limb ◽  
Acquired Brain Injury ◽  
Elbow Flexion ◽  
Subjective Assessment ◽  
Flexion Angle ◽  
International Classification Of Functioning ◽  
Post Injury ◽  
Rehabilitation Centre ◽  
Injury Rehabilitation

Objective: The aim of this study is to determine inter-rater, test–retest and intra-rater reproducibility and responsiveness of subjective assessment of upper limb associated reactions in people with acquired brain injury using (1) the ‘Qualifiers Scale’ of the International Classification of Functioning, Disability and Health Framework, and (2) visually estimated elbow flexion angle during walking. Design: Observational study. Setting: A brain injury rehabilitation centre, Melbourne, Australia. Subjects: People with acquired brain injury and upper limb associated reactions and experienced neurological physiotherapists. Main measures: The Qualifiers Scale applied to individual upper limb joints and global associated reaction on a 5-point scale (0–4), a summed upper limb severity score and visually estimated elbow flexion angle. Results: A total of 42 people with acquired brain injury (mean age: 48.4 ± 16.5 years) were videoed walking at self-selected and fast speeds. A subset of 30 chronic brain injury participants (mean time post injury: 8.2 ± 9.3 years) were reassessed one week later for retest reproducibility. Three experienced neurological physiotherapists (mean experience: 22.7 ± 9.1 years) viewed these videos and subjectively rated the upper limb associated reactions. Strong-to-very strong test–retest, intra- and inter-rater reproducibility was found for elbow flexion angle (ICC > 0.86) and the Qualifiers Scale applied to global and individual upper limb joints (ICC > 0.60). Responsiveness of change from self-selected to fast walking speed (mean increase 0.46 m/s) was highest for elbow flexion angle (effect size = 0.83) and low-to-moderate for the Qualifiers Scale. Conclusion: Subjectively rated associated reactions during walking demonstrated strong reproducibility and moderate responsiveness to speed change. The Qualifiers Scale and elbow flexion angle can both subjectively quantify associated reactions during walking in a clinical setting.

scholarly journals Upper limb robotic assessment: Pilot study comparing velocity dependent resistance in individuals with acquired brain injury to healthy controls

2020 ◽  
Vol 7 ◽  
pp. 205566832092953
Author(s):  
Nitin Seth ◽  
Denise Johnson ◽  
Brian Allen ◽  
Hussein A Abdullah
Keyword(s):  
Brain Injury ◽  
Upper Limb ◽  
Sagittal Plane ◽  
Acquired Brain Injury ◽  
Rehabilitation Robotics ◽  
Healthy Controls ◽  
Clinical Scales ◽  
The Relationship ◽  
Further Development ◽  
Flexion And Extension

Introduction Assessment of velocity dependent resistance (VDR) can provide insights into spasticity in individuals with upper motor neuron syndrome. This study investigates the relationship between Modified Ashworth scores and a biomechanical based representation of VDR using a rehabilitation robot. Comparisons in VDR are made for the upper limb (UL) between individuals with acquired brain injury and healthy controls for the para-sagittal plane. Methods The system manipulates the individual’s limb through five flexion and extension motions at increasing speeds to obtain force profiles at different velocities. An approximation of VDR is calculated and analyzed statistically against clinical scales and tested for interactions. Results All individuals (aged 18–65), including healthy controls exhibited VDR greater than 0 (P < 0.05). MAS scores were found to be related to VDR (P < 0.05) with an interaction found between MAS Bicep and Tricep scores (P < 0.01). Considering this interaction, evidence of differences in VDR were found between several neighboring assessment score combinations. Conclusion The robot can detect and quantify VDR that captures information relevant to UL spasticity. Results suggests a better categorization of VDR is possible and supports further development of rehabilitation robotics for assisting spasticity assessment.

Co-located (multi-user) virtual rehabilitation of acquired brain injury: feasibility of the Resonance system for upper-limb training

2020 ◽  
Author(s):  
Jeffrey M. Rogers ◽  
Nick Mumford ◽  
Karen Caeyenberghs ◽  
Hannah Richards ◽  
Nienke Nuijen ◽  
...  
Keyword(s):  
Brain Injury ◽  
Upper Limb ◽  
Acquired Brain Injury ◽  
Resonance System ◽  
Virtual Rehabilitation

Prospective assessment of continuous intrathecal infusion of baclofen for spasticity caused by acquired brain injury: a preliminary report

1997 ◽  
Vol 87 (3) ◽  
pp. 415-419 ◽  
Author(s):  
Jay M. Meythaler ◽  
Anne McCary ◽  
Mark N. Hadley
Keyword(s):  
Brain Injury ◽  
Infusion Pump ◽  
Acquired Brain Injury ◽  
Intrathecal Baclofen ◽  
Intrathecal Administration ◽  
Content Type ◽  
Severe Spasticity ◽  
Prospective Assessment ◽  
Intrathecal Infusion ◽  
Fine Print

✓ Twelve consecutive patients with severe spasticity and hypertonia following acquired brain injury were treated with continuous intrathecal infusion of baclofen via an implanted, programmable infusion pump—catheter system for a minimum of 3 months. In every case intrathecal baclofen therapy resulted in a statistically significant reduction in upper- and lower-extremity tone, spasm frequency, and reflexes, contributing to improved functional abilities. There were no untoward side effects or complications associated with treatment. This preliminary assessment indicates that intrathecal administration of baclofen is effective in treating the disabling spasticity caused by acquired brain injury in selected patients.

Measuring task performance after acquired brain injury: Construct and concurrent validity of ‘Upper Limb Performance Analysis’

Brain Injury ◽  
2015 ◽  
Vol 29 (10) ◽  
pp. 1223-1231
Author(s):  
Hannah Louise Holman Barden ◽  
Ian James Baguley ◽  
Melissa Therese Nott ◽  
Robert Heard ◽  
Christine Chapparo
Keyword(s):  
Brain Injury ◽  
Performance Analysis ◽  
Task Performance ◽  
Upper Limb ◽  
Concurrent Validity ◽  
Acquired Brain Injury
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