The impact of disease-modifying therapy ranges from cure to no impact with a wide range of intermediates. In cases where the intermediate group reaches a plateau after the acquisition of some muscle strength, it is necessary to set a functional level appropriate for increased motor power and establish a long-term exercise plan to maintain it. As the disease status stabilizes and the life span increases, early nonsurgical interventions are required, such as using a standing frame to prevent joint contracture, applying a spinal brace at the early stage of scoliosis, and maintaining sitting postures that exaggerate lumbar lordosis. In cases where scoliosis and hip displacement occur and progress even after conservative managements are implemented, early referral to surgery should be considered. Oromotor activity and swallowing function are influenced not only by the effects of disease-modifying drugs, but also by post-birth experience and training. Therefore, although the feeding tube cannot be removed, it is necessary to make efforts to simulate the infant feeding development while maintaining partial oral feeding. Since the application period of non-invasive ventilators has increased, it has become more important to prevent long-term complications such as facial abrasion, skin allergy, orthodontic deformities, and maxillary flattening caused by the interface. Dual ventilator mode or interface can also be utilized.
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Objective To examine the association between observer-assessed functional status and perceived recovery in the late phase after stroke. The study also aimed to determine whether observer-assessed functional improvements as a result of horse-riding therapy (H-RT) are related to enhanced perception of stroke recovery.
Methods This is a descriptive correlational study using data derived from a three-armed randomized controlled trial in which 123 individuals were enrolled, among whom 43 received H-RT for 12 weeks. The measures included the Modified Motor Assessment Scale, Berg Balance Scale, Timed Up and Go, timed 10-m walk, and perceived recovery from stroke indicated by item #9 in the Stroke Impact Scale (version 2.0). Spearman rank order correlation (rs) was used in the analyses.
Results There were moderate to strong positive or negative correlations between all four observer-assessed motor variables and participants’ ratings of perceived late-phase stroke recovery at trial entrance, ranging from rs=-0.49 to rs=0.54 (p<0.001). The results of the correlational analyses of variable changes showed that, after the end of the H-RT intervention, both self-selected and fast gait speed improvement were significantly correlated with increments in self-rated stroke recovery (rs=-0.41, p=0.01 and rs=-0.38, p=0.02, respectively).
Conclusion This study provided data supporting the association between individual ratings of self-perceived recovery after stroke and observer-assessed individual motor function. The results further demonstrate that enhancement in perceived stroke recovery after completing the intervention was associated with objectively measured gains in both self-selected and fast gait speed.
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Objective To investigate which outcome measurements are useful for detecting functional changes after therapeutic approach to delayed motor impairment in an animal model of Huntington's disease (HD). Method: R6/2 transgenic mice received intraventricular injections of adenoviral BDNF/noggin (AdB/N), AdBDNF, AdNull (n=15 each) at 4 weeks of age. Untreated R6/2s and wild-type mice were also recruited as controls. Motor performance was measured using rotarod analysis and locomotor activity test at regular intervals until preterminal age of 13 weeks. Results: On constant speed rotarod testing, AdB/N-treated R6/2s exhibited a delayed disease progression after post- operative 6 weeks. AdB/N also ameliorated general locomotor activity deficits. One min-rotarod analysis showed a delayed motor impairment in AdBDNF group at preterminal age compared with AdNull and untreated controls, which was not shown in 3 min and 5 min-rotarod. Accelerating rotarod paradigm was not superior to constant speed. Partial therapeutic effects on locomotor activities were detected in total 60 min-monitoring, but not in 30 min- or 10 min- monitoring. Conclusion: Appropriate behavioral testing and outcome measurements should be selected to detect the treatment effect to slow functional deterioration in HD. (J Korean Acad Rehab Med 2007; 31: 503-511)
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