International Journal of Neurorehabilitation

Background: Foot pain is a non-specific complaint among individuals who stand for extended periods of time. Prefabricated inserts have been effective for increasing balance and managing pain. One manufacturer has developed a line of general inserts for that purpose. The purpose of this study was to examine the effectiveness of a commercially available orthotic insert on balance, pain, and plantar foot pressures as well as to determine if enhancing balance may decrease pain.
Methods: Twenty-three subjects with at least 6 months non-specific foot pain participated and were issued a commercially available orthotic insert after screening. The Sensory Organization Test composite score was used to assess balance on the NeuroCom® Balance Manager SMART EquiTest. Foot Function Index (FFI) and Numeric Pain Rating Scale (NPRS) were used to assess pain. GAITRite was utilized to assess plantar foot pressures.
Results: Foot pain was decreased after one week with use of the commercially available orthotic insert. Increased balance scores were noted between day 1 without inserts and after day 7 of insert wear and also between day 1 with inserts and day 7. Decreases in pain were noted between pre balance testing without inserts (day 1) and after day 7 as well as immediately after balance testing with inserts (day 1) and day 7. Among the females, right lateromedial foot pressures increased from day 1 without inserts and immediately after the addition of inserts. An inverse relationship was observed between the NPRS and the composite balance scores after 1 week of insert wear.
Conclusions: Results indicate that a commercially available orthotic insert may be effective in managing foot pain and increasing balance after one week. Additionally, inserts appear to shift the right foot pressures from the predominately medial aspect of the foot to the lateral aspect of the foot for females but not males.

Objective: To assess the efficacy of phenol block of the obturator nerve in treating severe adductor spasticity.
Design: A prospective pilot study.
Setting: Outpatient rehabilitation clinics.
Participants: We recruited 5 participants with severe adductor spasticity. Four were persons with multiple sclerosis and one was a person with adult cerebral palsy. All participants were women and had an average age of 60.4 years; four participants had bilateral severe adductor spasticity and one had unilateral severe adductor spasticity.
Interventions: A total of 9 phenol blocks of the obturator nerve were performed. Five were performed with ultrasound guidance, followed by localization of the obturator nerve by peripheral nerve stimulator. Four were performed using anatomic landmark and peripheral nerve stimulator for localization.
Outcome Measures: The primary outcome measure was the Modified Ashworth Scale score of the hip adductor at 1 month after the obturator nerve block. The secondary outcomes measures include Modified Ashworth Scale (MAS) score of the hip adductors at 6 months, distance between the right and left medial femur condyles in supine with hip extended to neutral, Disability Assessment Scale (DAS) score, Goal Attainment Scale (GAS) score, Spasticity Numeric Rating Scale score and Subjects’ and Physician Global Impression of Changes scores.
Results: There was statistically significant decrease in the MAS score at 1-month compared to baseline (2.43 vs. 4; P=0.001). There was no statistically significant difference in the secondary outcomes. There were no reported adverse effects of procedure.
Conclusion: This study suggests that phenol block of the obturator nerve is effective in treating severe adductor spasticity. We recommend a larger study with more participants and longer follow up period to allow further assessment of the efficacy of the phenol block of the obturator nerve in treating severe adductor spasticity.

Background: Spinal cord injury (SCI) refers to spinal cord damage arising from trauma, disease or degeneration. At present, there is still no treatment for any paraplegia resulting from SCI. We have previously shown that very low intensity, low frequency, electromagnetic field treatment (VLIFE) promotes neuronal plasticity after stroke and as a result, improves clinical recovery.
Objective: In this paper we studied an innovative electromagnetic field treatment for SCI in an animal model.
Methods: SCI was caused to 20 rats by hemi crush. The animals were divided into three groups, 7 animals were not treated, two groups received VLIFE treatment for two months, 7 rats received 15.72 Hz, and 6 rats received a dedicated treatment of 26 Hz. Clinical evaluation was performed weekly, and imaging assessment monthly.
Results: Clinical performance assessed by a locomotor test, show significant clinical improvement of the neurological function following treatment with VLIFE (p < 0.05). Imaging results after two months of treatment, by MRI including DTI analysis, show that the non-treated (sham) spinal cord has not recovered, while in the treated animal the fibers of the spinal cord were preserved and rewired. VLIFE treatment has major benefits on injured spinal cord: preservation of the spinal cord from further degradation caused by the edema and internal cord scars, and rewiring of the spinal cord resulting with rehabilitation and improved clinical performance.
Conclusions: Low intensity low frequency electromagnetic field treatment may be beneficial for rehabilitation from SCI, human clinical trials are planned.

Background: In the last decades a special attention has been focused on the role of disturbed immune balance in the behavioral co-morbidities of tumor patients. The prognostic significance of malignant tumor-induced imbalance in the innate immune system is well known. The innate system uses a limited number of Pattern Recognition Receptors (PRR) to recognize conserved Pathogenic Associated Molecular Pattern (PAMP) structures expressed by microbes but not by host. Growing experiences suggest that the improvement of tumor induced disturbance of immune balance by using standardized plant PAMP like preparations goes often together with a better quality of life (QoL).

Methods: In this study tumor patients were treated with standardized plant immunomodulators (mistletoe lectin and arabinoxylan) which were shown to activate the type-1 natural immune cells against cancer. After at least a therapy for six months the patients were asked about their QoL using questionnaires.

Results: The following answers were received from the 35 patients: Decrease of pains: 17%, improvement of anxiety: 40%, Increase of physical activity: 71%, Improvement of appetite: 66%, Improvement of sleep: 40%, improvement of digestion: 43%, decrease of side effects during oncotherapy: 71%, beneficial judgement of the progress of disease based on clinical findings: 46%. As shown, the most important effects were the improvement of physical activity and decrease of side effects during conventional oncotherapy.

Conclusion: Present results may support the relationship between tumor induced disturbance of immune balance and the tumor induced behavioral co-morbidities. Further clinical investigations are necessary to proof this hypothesis.

To investigate the effect of physical therapy on F-wave characteristics in a patient with cerebrovascular disease, we tested the relationship between F-wave waveforms and the recovery of voluntary movement on the affected side. We measured F-waves of affected thenar muscles after stimulating the affected median nerve at the wrist in a left hemiplegia patient (female, 60 years old) with cerebrovascular disease. We analysed the F/M amplitude ratio and Fwave waveform values from 30 trials.

F-wave waveform values were determined as follows. We calculated the correlation coefficient of each waveform and defined identifying F-waves as those with a correlation coefficient greater than 0.9. We determined the number of different wave forms from the number of identifying waveforms. F-waves were tested three times at 9, 52, and 70 months from sideration. The patient underwent physical therapy twice a week, with each session lasting 20 min. The F/M amplitude ratio gradually decreased and the number of F-wave waveform types gradually increased. Muscle tonus and voluntary movements of the affected arm gradually improved with physical therapy. In this patient with cerebrovascular disease, F-wave waveform values in her affected arm gradually increased as muscle tonus and voluntary movements of the arm improved.