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La Clinica Terapeutica 2020Apraxia affects 20% of the right brain-damaged patients and 50% of the left brain-damaged patients. This disorder of motor programming reduces patients' independence and... (Meta-Analysis)
Meta-Analysis
Apraxia affects 20% of the right brain-damaged patients and 50% of the left brain-damaged patients. This disorder of motor programming reduces patients' independence and there are few guidelines on the rehabilitative treatment in the physiotherapy and speech therapy field.The aim of this study was to assess which therapeutic interventions are the most effective in stroke patients with apraxia in considering the mentioned purviews. Four databases were systematically searched in order to detect all available studies investigating the physical and speech rehabilitation of patients. The literature research produced five studies including 168 patients for the physiotherapy and 50 for speech therapy fields; two were eligible for meta-analysis. Quality was rated with Jadad, PEDro scale and Cochrane Risk Of Bias Tool. Both for physiotherapy and speech therapy fields, the RCTs interventions obtained statistically significant results for outcomes of interest. Despite this, it is still not possible to determine the best approach due to the low number of patients involved, the lack of maintenance of the results at follow up and the timing of the revaluation period being very short to confirm the efficacy of treatments.
Topics: Apraxias; Humans; Physical Therapy Modalities; Speech Therapy; Stroke
PubMed: 32901792
DOI: 10.7417/CT.2020.2257 -
Cortex; a Journal Devoted To the Study... Aug 2020To investigate the literature for frequencies, profiles and neural correlates of limb and face apraxias in frontotemporal dementia (FTD). (Review)
Review
PURPOSE
To investigate the literature for frequencies, profiles and neural correlates of limb and face apraxias in frontotemporal dementia (FTD).
METHOD
The search conducted in Ovid Medline, PsycINFO and Scopus yielded 487 non-duplicate records, and 43 were included in the final analysis.
RESULTS
Apraxias are evident in diverse forms in all clinical variants of FTD within the first four years of the disease. Face apraxia and productive limb apraxia co-occur in the behavioural and nonfluent variants. The logopenic variant resembles Alzheimer's disease in terms of pronounced parietal limb apraxia and absence of face apraxia. The semantic variant exhibits conceptual praxis deficits together with relatively preserved imitation skills. Concerning the genetic variants of FTD, productive limb apraxia is common among carriers of the progranulin gene mutation, and subtle gestural alterations have been documented among carriers of the chromosome 9 open reading frame 72 gene mutation before the expected disease onset. The data on neural correlations suggest that the breakdown of praxis results from bilateral cortical and subcortical damage in FTD and that Alzheimer-type pathology of the cerebrospinal fluid increases the severity of limb apraxia in all of the variants. Face apraxia correlates with degeneration of the medial and superior frontal cortices.
CONCLUSIONS
Each of the clinical variants of FTD exhibits a characteristic profile of apraxias that may support early differentiation between the variants and from Alzheimer's disease. However, the screening procedures developed for stroke populations seem insufficient, and a multifaceted assessment tool is needed. Although valid and practical tests already exist for dementia populations, a concise selection of test items that covers all of the critical domains is called for.
Topics: Alzheimer Disease; Apraxias; Frontotemporal Dementia; Heterozygote; Humans; Neuropsychological Tests; Pick Disease of the Brain
PubMed: 32418629
DOI: 10.1016/j.cortex.2020.03.023 -
Revista de Neurologia Mar 2020Freezing of gait (FOG) is one of the most severe symptoms associated with Parkinson's disease (PD). Physiotherapy treatment could be an effective strategy for treating... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Freezing of gait (FOG) is one of the most severe symptoms associated with Parkinson's disease (PD). Physiotherapy treatment could be an effective strategy for treating FOG, but no systematic review has been carried out in this regard.
AIM
To identify the characteristics, methodological quality, and main outcomes of the studies that have analyzed the effects of physiotherapy interventions in FOG up to date, by performing a systematic review and a meta-analysis.
PATIENTS AND METHODS
Four electronic databases were searched in order to find randomized controlled trials that provided information regarding the effects of any kind of physiotherapy treatment on FOG. The methodological quality of the included investigations was assessed by means of the PEDro scale.
RESULTS
Twelve studies were identified for inclusion into the qualitative analysis, with four randomized controlled trials included in the final meta-analysis. The quality of the trials was generally good. Those physiotherapy modalities including cues were more effective for treating FOG than traditional physiotherapy approaches. The meta-analysis indicated that physiotherapy interventions had a significantly greater impact on FOG than control comparisons.
CONCLUSIONS
Physiotherapy treatment, especially those modalities including visual and auditory cueing, should be prescribed to PD patients with FOG. Future studies including PD patients with cognitive impairment and FOG objective measurement tools are need to complete the existing scientific evidence.
Topics: Data Accuracy; Gait Apraxia; Humans; Parkinson Disease; Physical Therapy Modalities; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 32100276
DOI: 10.33588/rn.7005.2019417 -
Current Pain and Headache Reports Jan 2020Although visual and somatosensory disturbances are the most common migraine aura (MA) symptoms, patients can also experience other symptoms during their MA. The aim of...
PURPOSE OF THE REVIEW
Although visual and somatosensory disturbances are the most common migraine aura (MA) symptoms, patients can also experience other symptoms during their MA. The aim of this review is to provide an overview of studies that report symptoms of dysphasia and other higher cortical dysfunctions (HCDs) during MA, as well as to determine the frequency of HCDs.
RECENT FINDINGS
Five studies met the inclusion criteria, corresponding to 697 patients overall. The most frequently reported HCDs were those of the language group (range 10-53%). The occurrence of visual HCDs was noted in 12-40 patients, somatosensory HCDs in 12-20%, and memory disturbances in 10-22% of the patients during MAs. MA is associated with a wide range of neurological symptoms, including symptoms of HCD. A better strategy for investigation of the HCD symptoms is needed to correctly stratify patients thus allowing meaningful studies of aura pathophysiology.
Topics: Aphasia; Apraxias; Cerebral Cortex; Humans; Memory Disorders; Migraine with Aura; Somatosensory Disorders
PubMed: 31981018
DOI: 10.1007/s11916-020-0836-3