Background: Balance impairment and lack of postural orientation are serious problems in patients with repetitive mild traumatic brain injury (mTBI). Objective: To investigate whether anodal transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) can improve balance control and gait in repetitive mTBI rat models. Methods: In this prospective animal study, 65 repetitive mTBI rats were randomly assigned to two groups: the tDCS group and the control group. To create repetitive mTBI model rats, we induced mTBI in the rats for 3 consecutive days. The tDCS group received one session of anodal tDCS over the M1 area 24 h after the third induced mTBI, while the control group did not receive tDCS treatment. Motor-evoked potential (MEP), foot-fault test, and rotarod test were evaluated before mTBI, before tDCS and after tDCS. The Mann–Whitney U test and Wilcoxon signed rank test were used to assess the effects of variables between the two groups. Results: Anodal tDCS over the M1 area significantly improved the amplitude of MEP in the tDCS group (p = 0.041). In addition, rotarod duration was significantly increased in the tDCS group (p = 0.001). The foot-fault ratio was slightly lower in the tDCS group, however, this was not statistically significant. Conclusion: Anodal tDCS at the M1 area could significantly improve the amplitude of MEP and balance function in a repetitive mTBI rat model. We expect that anodal tDCS would have the potential to improve balance in patients with repetitive mTBI.

Balance impairment could occur due to weakness of the core muscles in stroke patients.To investigate the association between functional ability, including trunk balance and core muscle thickness us...

To investigate the predictive value of enhanced-magnetic resonance imaging (MRI) and fluoroscopic factors regarding the effects of transforaminal epidural steroid injections (TFESIs) in low back pain (LBP) patients with lumbosacral radiating pain. A total of 51 patients who had LBP with radiating pain were recruited between January 2011 and December 2012. The patient data were classified into the two groups 'favorable group' and 'non-favorable group' after 2 weeks of follow-up results. The favorable group was defined as those with a 50%, or more, reduction of pain severity according to the visual analogue scale (VAS) for back or leg pain. The clinical and radiological data were collected for univariate and multivariate analyses to determine the predictors of the effectiveness of TFESIs between the two groups. According to the back or the leg favorable-VAS group, the univariate analysis revealed that the corticosteroid approach for the enhanced nerve root, the proportion of the proximal flow, and the contrast dispersion of epidurography are respectively statistically significant relative to the other factors. Lastly, the multiple logistic regression analysis showed a significant association between the corticosteroid approach and the enhanced nerve root in the favorable VAS group. Among the variables, MRI showed that the corticosteroid approach for the enhanced target root is the most important prognostic factor in the predicting of the clinical parameters of the favorable TFESIs group.

Background: Balance and memory deficits are common in patients with repetitive mild traumatic brain injury (mTBI). Objective: To investigate the combined effects of amantadine and transcranial direct current stimulation (tDCS) on balance and memory in repetitive mTBI rat models. Methods: In this prospective animal study, 40 repetitive mTBI rats were randomly assigned to four groups: tDCS, amantadine, combination of amantadine and anodal tDCS, and control. The tDCS group received four sessions of anodal tDCS for four consecutive days. The amantadine group received four intraperitoneal injections of amantadine for four consecutive days. The combination group received four intraperitoneal injections of amantadine and anodal tDCS for four consecutive days. Motor-evoked potential (MEP), rotarod test, and novel object test results were evaluated before mTBI, before treatment, and after treatment. Results: All groups showed significant improvements in the rotarod and novel object tests, particularly the combination group. The combination group showed a significant improvements in duration (p < 0.01) and maximal speed in the rotarod test (p < 0.01), as well as an improvement in novel object ratio (p = 0.05) and MEP amplitude (p = 0.05) after treatment. The combination group exhibited a significant increase in novel object ratio compared to the tDCS group (p = 0.04). The GFAP integral intensity of the left motor cortex and hippocampus was the lowest in the combination group. Conclusion: Combination treatment with amantadine and tDCS had positive effects on balance and memory recovery after repetitive mTBI in rats. Therefore, we expect that the combination of amantadine and tDCS may be a treatment option for patients with repetitive mTBIs.

Han SJ, et al. Ann Rehabil Med. 2015 Dec;39(6):888-896. http://dx.doi.org/10.5535/arm.2015.39.6.888

To determine the optimal frequency of physical therapy (PT) in young children with cerebral palsy (CP). Twenty-three children (mean age, 47.30 ± 31.95 months) with CP who had undergone both low- and high-frequency PT in an outpatient rehabilitation clinic were analyzed retrospectively. The Gross Motor Function Measure-88 (GMFM-88) score was assessed before and after low- and high-frequency PT. The high-frequency PT group showed statistically significant improvements of GMFM-88 compared to the low-frequency PT group. In the high-frequency PT group, the improvement in total GMFM-88 scores was greater in children below 36 months of age than in children above 36 months of age. Moreover, the ambulatory group showed greater improvement compared to the non-ambulatory group during high-frequency PT. High-frequency PT might benefit gross motor function in children with CP up to 36 months of age. High-frequency PT resulted in improved standing and gait function in the ambulatory group.