The purpose of this study was to evaluate the effects of core strengthening combined with pelvic proprioceptive neuromuscular facilitation (PNF) on trunk impairment, balance, gait, and functional ability of chronic stroke patients. Twenty-three participants with chronic stroke were recruited and randomly allocated to one of the two groups: core strengthening combined with pelvic PNF (group 1, n=13), and pelvic PNF with trunk flexibility exercises (group 2, n=10). Intervention was given to both groups for 60 min per session 5 times per week for 4 weeks. Performance of both groups was evaluated on Trunk Impairment Scale, Tinetti Performance Oriented Mobility Assessment (Tinetti-POMA), Balance Evaluation Systems Test (Mini-BESTest), Wisconsin Gait Scale, and Barthel Activities of Daily Living Index prior to and after the completion of the intervention. The comparison between postintervention scores of Tinetti-POMA between group 1 (18.76±1.78) and group 2 (16.8±1.87) and Mini-BESTest group 1 (16.15±1.28) and group 2 (14.7±1.41) showed significant difference (P=0.018). The results indicated that core stabilisation combined with pelvic PNF was more effective for improving trunk impairment, balance and gait of chronic stroke patients.

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Both groups showed significant improvements, however inspiratory muscle training was seen to be more effective than deep breathing exercises for improving aerobic capacity, respiratory muscle strength and rate of perceived exertion in paraplegics.

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Objectives: The aims of this study were to assess the relationships of (1) clinical variables (age, level of injury, time since injury [TSI], and completeness of injury) and (2) psychological variables (stress and depression) with mental imagery ability in individuals with spinal cord injury. Study Design: This was a cross-sectional study. Participants with spinal cord injury (N = 130) were requested to fill the Kinesthetic and Visual Imagery Questionnaire and Vividness of Motor Imagery Questionnaire. They also completed the Perceived Stress Scale and Patient Health Questionnaire 9 for the assessment of stress and depression, respectively.Results: Mental imagery scores were found to be significantly low in cervical injuries ( P < 0.001) as compared with thoracic injuries ( P < 0.001). Furthermore, higher levels of spinal injuries resulted in lower mental imagery scores. Completeness of injury (according to Asia Impairment Scale) also had a significant relationship ( P < 0.001) with the mental imagery ability among spinal cord injury participants. Presence of stress ( P < 0.001) and depression ( P < 0.001) also associated with reduced efficiency of mental imagery in these individuals. Conclusions: Injury type and psychological factors were associated with mental imagery in SCI patients. Imagery-based interventions should be designed after consideration of identified factors yielding effect on their outcomes.

Background Pain of neuropathic origin in spinal cord injury (SCI) is unbearable and challenging to treat. Research studies conducted in the past have shown that mental imagery (MI) techniques have a significant impact on the reduction of symptoms of central neuropathic pain in people with SCI. Objectives The objective of this study was to evaluate the effect of MI training on pain intensity, neuropathic pain symptoms, and interference of pain with function in SCI. Methods A total of 42 SCI participants with central neuropathic pain (duration 6-12 months) were recruited and randomly allocated to MI or control groups. A MI training protocol was administered to MI group and for 30 min/d for 5 days. Outcome measures were assessed at baseline and at the end of 4 weeks. Results There was significant reduction in differences of mean [95% CI] scores of numeric rating scale (−2.1 [CI −2.78 to −1.41]; P < .001) between groups. Mean [95% CI] total scores of Neuropathic Pain Symptom Inventory declined in MI group as compared with control group (−4.52 [CI −5.86 to −3.18]; P < .001). Similarly, Brief Pain Inventory interference scale total dropped significantly ( P < .001) in MI group. Majority of participants in the MI group (55%) reported improvement in scores of Patients’ Global Impression of Change scale as compared with control group where most of the participants (52%) reported no change. Conclusions This study shows the effectiveness of the MI protocol developed as a rehabilitative approach in improving central neuropathic pain in SCI. Trial Registration. Clinical Trials Registry–India under Indian Council of Medical Research; CTRI/2018/07/014884. Registered July 16, 2018.

Objectives:One of the most common and disabling complications that affects individuals with spinal cord injury is spasticity. The purpose of this study is to compare the effect of agonist and antagonist electrical stimulations on triceps surae muscle spasticity in patients with spinal cord injury. Methods:A total of 30 subjects with spinal cord injury were considered for the study. They were divided into two groups randomly. Group 1 received agonist electrical stimulation (stimulation of triceps surae) and group 2 received antagonist electrical stimulation (stimulation of tibialis anterior) for 20 min, once daily, and 5 days per week for two weeks. To evaluate the therapeutic effect, modified Ashworth score, deep tendon reflex score and clonus score were tested before and after the treatment. Post treatment evaluation was made 24 h after the last treatment session.Results: Both the groups showed significant reductions in the modified Ashworth scores and deep tendon reflex scores after the intervention, but these reductions were not found in the clonus score. Also, there was no significant difference in the post intervention scores of modified Ashworth scale, deep tendon reflex and clonus score between the two groups.Discussion: This study provides evidence that both agonist electrical stimulation and antagonist electrical stimulations are equally effective in reducing spasticity in triceps surae muscle in patients with spinal cord injury.

A 55-year-old female presented at Department of Pañcakarma with diagnosis of progressive supranuclear palsy (PSP). For assessing disability, progressive supranuclear palsy rating scale (PSPRS) was used and balance was assessed by using Tetrax Interactive Balance System (IBS) posturography. Āyurvedic treatment was given along with Pañcakarma and balance exercises for 3 months. As part of Āyurvedic treatment, first Virecana karma was done with classical method and then Mātrā basti, Śirobasti, and other palliative treatment was given for 3 months. Amanatidine was not continued during Virecana karma but started thereafter. On comparison with pre-intervention scores, there was a significant improvement in the patient post-treatment. The features which mainly showed improvement were: Eye movements, spontaneous episodes of laughing, dysphagia, dysarthria, double vision, and neck rigidity. Balance showed significant improvement and there was a remarkable decrease in the postural sway. This case study may present new possibilities for treatment of neurodegenerative diseases by Āyurveda.