The present study suggests a beneficial effect of cognition using a music-based exercise programme in a group of patients with moderate to severe dementia. Further studies are needed to confirm these findings.

No abstract

AIM The aim of this study was to examine the reliability and validity of the Dyskinesia Impairment Scale (DIS). The DIS consists of two subscales: dystonia and choreoathetosis. It measures both phenomena in dyskinetic cerebral palsy (CP).METHOD Twenty-five participants with dyskinetic CP (17 males; eight females; age range 5-22y; mean age 13y 6mo; SD 5y 4mo), recruited from special schools for children with motor disorders, were included. Exclusion criteria were changes in muscle relaxant medication within the previous 3 months, orthopaedic or neurosurgical interventions within the previous year, and spinal fusion. Interrater reliability was verified by two independent raters. For interrater reliability, intraclass correlation coefficients were assessed. Standard error of measurement, the minimal detectable difference, and Cronbach's alpha for internal consistency were determined. For concurrent validity of the DIS dystonia subscale, the Barry-Albright Dystonia Scale was administered. RESULTSThe intraclass correlation coefficient for the total DIS score and the two subscales ranged between 0.91 and 0.98 for interrater reliability. The reliability of the choreoathetosis subscale was found to be higher than that of the dystonia subscale. The standard error of the measurement and minimal detectable difference values were adequate. Cronbach's alpha values ranged from 0.89 to 0.93. Pearson's correlation between the dystonia subscale and Barry-Albright Dystonia Scale was 0.84 (p<0.001).INTERPRETATION Good to excellent reliability and validity were found for the DIS. The DIS may be promising for increasing insights into the natural history of dyskinetic CP and evaluating interventions. Future research on the responsiveness of the DIS is warranted.Cerebral palsy (CP) is worldwide the most common neuromotor disorder in children, with an incidence of 2 to 3 per 1000 live births.1,2 CP can be categorized into spastic, dyskinetic, and ataxic groups. Dyskinetic CP is further differentiated into dystonia and choreoathetosis. 1,3 Spastic CP is by far the most common type of CP, with a prevalence of approximately 80%, 4 and is followed by dyskinetic CP with a prevalence between 6.5% 5 and 14. 4%. 4 According to the Surveillance of Cerebral Palsy in Europe (SCPE), 6 dyskinetic CP is characterized by involuntary, uncontrolled, recurring, occasionally stereotyped movements, in which the primitive reflex patterns predominate and muscle tone varies. 6 The SCPE described dystonia in CP as dominated by abnormal postures that may give the impression of hypokinesia and muscle tone that is fluctuating (but with easily elicitable tone increase). Characteristics are involuntary movements, distorted voluntary movements, and abnormal postures due to sustained muscle contractions. Choreoathetosis in CP is dominated by hyperkinesia and tone fluctuation (but mainly decreased). Chorea refers to rapid, involuntary, jerky, often fragmented movements. Athetosis means slower, constantly changing, writhing, or contorting movements.6,7 These SCPE...

No abstract

Simulator-based driving training improved driving ability, especially for well educated and less disabled stroke patients. However, the findings of the study may have been modified as a result of the large number of dropouts and the possibility of some neurologic recovery unrelated to training.

Background and Purpose-Differences exist between European countries in the proportion of patients who die or become dependent after stroke. The aim of the present study was to identify differences in the use of time by stroke patients in 4 rehabilitation centers in 4 European countries. Methods-In each of the 4 centers, 60 randomly selected stroke patients were observed at 10-minute intervals using behavioral mapping. Observations took place on 30 weekdays selected at random, on equal numbers of morning, afternoon, and evening sessions. A logistic generalized estimating equation model with correction for differences in case mix and multiple testing was used for the analysis. Results-Overall time available from different professions was the highest in the United Kingdom, but patients in the United Kingdom spent on average only 1 hour per day in therapy. This was significantly less than patients in Belgium and Germany, who spent Ϸ2 hours, and patients in Switzerland who spent Ϸ3 hours per day in therapy. In all centers, patients spent less than half their time in interactions and Ͼ72% of the time in nontherapeutic activities. Conclusions-Important

Spasticity is considered an important neural contributor to muscle hypertonia in children with cerebral palsy (CP). It is most often treated with antispasticity medication, such as Botulinum Toxin-A. However, treatment response is highly variable. Part of this variability may be due to the inability of clinical tests to differentiate between the neural (e.g., spasticity) and nonneural (e.g., soft tissue properties) contributions to hypertonia, leading to the terms “spasticity” and “hypertonia” often being used interchangeably. Recent advancements in instrumented spasticity assessments offer objective measurement methods for distinction and quantification of hypertonia components. These methods can be applied in clinical settings and their results used to fine-tune and improve treatment. We reviewed current advancements and new insights with respect to quantifying spasticity and its contribution to muscle hypertonia in children with CP. First, we revisit what is known about spasticity in children with CP, including the various definitions and its pathophysiology. Second, we summarize the state of the art on instrumented spasticity assessment in CP and review the parameters developed to quantify the neural and nonneural components of hypertonia. Lastly, the impact these quantitative parameters have on clinical decision-making is considered and recommendations for future clinical and research investigations are discussed.

A short individualized exercise programme can improve functional balance in people aged 75 years and older. This improvement was maintained at least for one month but had worn off by one year.