Stroke Rehabilitation Research Laboratory

West Orange, NJ, United States

Stroke Rehabilitation Research Laboratory

West Orange, NJ, United States

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Galletta E.E.,Montefiore Medical Center | Galletta E.E.,Stroke Rehabilitation Research Laboratory | Rao P.R.,American Speech Language Hearing Association | Rao P.R.,National Rehabilitation Hospital | Barrett A.M.,Stroke Rehabilitation Research Laboratory
Topics in Stroke Rehabilitation | Year: 2011

Aphasia researchers and clinicians share some basic beliefs about language recovery post stroke. Most agree there is a spontaneous recovery period and language recovery may be enhanced by participation in a behavioral therapy program. The application of biological interventions in the form of pharmaceutical treatments or brain stimulation is less well understood in the community of people who work with individuals having aphasia. The purpose of this article is to review the literature on electrical brain stimulation as an intervention to improve aphasia recovery. The article will emphasize emerging research on the use of transcranial magnetic stimulation (TMS) to accelerate stroke recovery. We will profile the current US Food and Drug Administration (FDA)-approved application to depression to introduce its potential for future application to other syndromes such as aphasia. © 2011 Thomas Land Publishers, Inc.


Barrett A.M.,Stroke Rehabilitation Research Laboratory | Goedert K.M.,Seton Hall University | Basso J.C.,Rutgers University
Nature Reviews Neurology | Year: 2012

Spatial neglect increases hospital morbidity and costs in around 50% of the 795,000 people per year in the USA who survive stroke, and an urgent need exists to reduce the care burden of this condition. However, effective acute treatment for neglect has been elusive. In this article, we review 48 studies of a treatment of intense neuroscience interest: prism adaptation training. Due to its effects on spatial motor 'aiming', prism adaptation training may act to reduce neglect-related disability. However, research failed, first, to suggest methods to identify the 50-75% of patients who respond to treatment; second, to measure short-term and long-term outcomes in both mechanism-specific and functionally valid ways; third, to confirm treatment utility during the critical first 8 weeks poststroke; and last, to base treatment protocols on systematic dose-response data. Thus, considerable investment in prism adaptation research has not yet touched the fundamentals needed for clinical implementation. We suggest improved standards and better spatial motor models for further research, so as to clarify when, how and for whom prism adaptation should be applied. © 2012 Macmillan Publishers Limited. All rights reserved.


Oh-Park M.,Rutgers University | Oh-Park M.,Kessler Institute for Rehabilitation | Oh-Park M.,Stroke Rehabilitation Research Laboratory | Hung C.,Rutgers University | And 5 more authors.
PM and R | Year: 2014

Objective: To examine whether stroke survivors with more severe spatial neglect duringtheir acute inpatient rehabilitation had poorer mobility after returning to their communities. Design: A prospective observational study. Setting: Acute inpatient rehabilitation and follow-up in the community. Participants: Thirty-one consecutive stroke survivors with right-brain damage (women, n= 15 [48.4%]), with the mean (standard deviation) age of 60 ± 11.5 years, were included in the study if they demonstrated spatial neglect within 2 months after stroke. Methods: Spatial neglect was assessed with the Behavioral Inattention Test (BIT) (range, 0-146 [a lower score indicates more severity]) and the Catherine Bergego Scale (range, 0-30 [a higher score indicates more severity]). A score of the Behavioral Inattention Test<129 or of the Catherine Bergego Scale >0 defined the presence of spatial neglect. Main Outcome Measurements: The outcome measure is community mobility, defined by the extent and frequency of traveling within the home and in the community, and is assessed with the University of Alabama at Birmingham Study of Aging Life-Space Assessment (range, 0-120 [a lower score indicates less mobile]). This measure was assessed after participants returned home≥6 months after stroke. The covariates were age, gender, functional independence at baseline; follow-up interval; and depressed mood, which may affect the relationship between spatial neglect and community mobility. Results: A lower Behavioral Inattention Test score was a significant predictor of a lower Life-Space Assessment score after controlling for all the covariates (β= 0.009 [95% confidence interval, 0.008-0.017]); P= .020). The proportion of participants unable to travel independently beyond their homes was 0%, 27.3%, and 72.7% for those with mild, moderate, and severe acute neglect, respectively (Catherine Bergego Scale range, 1-10, 11-20, and 21-30, respectively). Conclusions: Our result indicates that acute spatial neglect has a negative impact on regaining of functional mobility in the community. Specific screening and treatment of spatial neglect during acute stroke care may be necessary to improve long-term mobility recovery. © 2014 American Academy of Physical Medicine and Rehabilitation.


PubMed | Stroke Rehabilitation Research Laboratory
Type: Journal Article | Journal: Nature reviews. Neurology | Year: 2012

Spatial neglect increases hospital morbidity and costs in around 50% of the 795,000 people per year in the USA who survive stroke, and an urgent need exists to reduce the care burden of this condition. However, effective acute treatment for neglect has been elusive. In this article, we review 48 studies of a treatment of intense neuroscience interest: prism adaptation training. Due to its effects on spatial motor aiming, prism adaptation training may act to reduce neglect-related disability. However, research failed, first, to suggest methods to identify the 50-75% of patients who respond to treatment; second, to measure short-term and long-term outcomes in both mechanism-specific and functionally valid ways; third, to confirm treatment utility during the critical first 8 weeks poststroke; and last, to base treatment protocols on systematic dose-response data. Thus, considerable investment in prism adaptation research has not yet touched the fundamentals needed for clinical implementation. We suggest improved standards and better spatial motor models for further research, so as to clarify when, how and for whom prism adaptation should be applied.

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