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Dementia is an eurodegenerative disorder, which causes significant disability, especially among the elderly population worldwide. The affected person shows a progressive cognitive decline, which interferes with the independence in performing the activities of daily living. Other than the cognitive domain, the patient tends to have neuropsychiatric, behavioral, sensorimotor, speech, and language-related issues. It is expected that the global burden of the disease will rise with more people entering the geriatric age group. By 2050 close, to 140 million people will be living with one or the other type of dementia. Alzheimer’s disease contributes to more than 60% of cases worldwide, followed by vascular dementia. Pharmacotherapy has a limited role to play in the treatment, and at present, no drug is available, which can halt or reverse the progress of the disease. World Health Organization has mandated rehabilitation as a core recommendation in the global action plan on the public health response to dementia. Rehabilitation services are widely recognized as a practical framework to maximize independence and community participation in dementia care. The rehabilitation program is customized to achieve the desired goals, as each person has different experiences, preferences, motivations, strengths, and requirements based on type, course, and severity of the illness. It is an interdisciplinary-team approach with the involvement of several health care professionals. This article reviews the existing literature and outlines the effective rehabilitation strategies concisely in dementia care.

Objective To observe the effect of overground gait training with ‘Mobility Assisted Robotic System-MARS’ on gait parameters in patients with stroke Patients & Methods: This prospective pre-post study was conducted in a tertiary teaching research hospital with 25 stroke patients with age ranging between 18–65 years. Patients fulfilling the inclusion criteria were divided in 2 groups based on the duration of stroke (≤ 6 months-sub-acute stroke & > 6 months-chronic stroke) and provided overground gait training with MARS robot for 12 sessions over a period of 2–3 weeks. Primary outcome measures were; 10-Meter walk test, 6-minutes’ walk test-6MWT and Timed up & Go-TUG tests. Secondary outcome measures were Functional Ambulation Category-FAC, Modified Rankin Scale-MRS and Scandinavian Stroke Scale-SSS. Results No adverse events were reported. Twelve patients in sub-acute stroke group and 13 patients in chronic stroke group were provided gait training for a period of maximum 1 hour per session. All primary and secondary outcome measures showed significant improvement in gait parameters at the end of the training (p < 0.05) barring 10-Meter walk test in sub-acute stroke group (p = 0.255). Chronic stroke group showed significant minimum clinically important difference-MCID difference in endurance (6MWT) at the end of the training and both groups showed better ‘minimal detectable change-MDC’ in balance (TUG) at the end of the training. Conclusions Overground gait training with MARS Robot is safe and efficacious. Patients showed significant improvement in walking speed, endurance, balance and independence at the end of the training. Clinical Trial Registry : National Clinical Trial Registry of India (CTRI/2021/08/035695)

A thorough history and examination in rehabilitation settings are paramount. We present a case of spinal cord injury with quadriparesis with severe axial stiffness and increasing spasticity not responding to high doses of medication. Only after repeated inquiry, patient gave history of symptoms suggestive of ankylosing spondylitis (AS). Initiating treatment for AS resulted in decreased stiffness and spasticity and improved functional outcome in the patient.

Objective To observe the effect of overground gait training with ‘Mobility Assisted Robotic System-MARS’ on gait parameters in patients with stroke. Patients & methods This prospective pre-post study was conducted in a tertiary teaching research hospital with 29 adult stroke patients, with age up to 65 years. Patients fulfilling the inclusion criteria were divided in 2 groups based on the duration of stroke (≤ 6 months-sub-acute & > 6 months-chronic stroke) and provided overground gait training with MARS robot for 12 sessions (1 h/session) over a period of 2–3 weeks. Primary outcome measures were; 10-Meter walk test-10MWT, 6-min’ walk test-6MWT and Timed up & Go-TUG tests. Secondary outcome measures were Functional Ambulation Category-FAC, Modified Rankin Scale-MRS and Scandinavian Stroke Scale-SSS. Results No adverse events were reported. Twenty-five patients who were able to perform 10-MWT at the beginning of study were included in the final analysis with 12 in sub-acute and 13 in chronic stroke group. All primary and secondary outcome measures showed significant improvement in gait parameters at the end of the training (p < 0.05) barring 10-Meter walk test in sub-acute stroke group (p = 0.255). Chronic stroke group showed significant minimum clinically important difference-MCID difference in endurance (6MWT) at the end of the training and both groups showed better ‘minimal detectable change-MDC’ in balance (TUG) at the end of the training. Conclusions Patients in both the groups showed significant improvement in walking speed, endurance, balance and independence at the end of the training with overground gait training with MARS Robot. Clinical trial registry National Clinical Trial Registry of India (CTRI/2021/08/035695,16/08/2021).

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