Hosted by;
International Biophilia Rehabilitation Academy and University of Sevilla
Co-Hosted by;
Romanian Society for NeuroRehabilitation (RoSneRa)
Medical Research Center, Polish Academy of Sciences, Warsaw, Poland
Research Center for Human Function Reacquisition by Engineering, Yokohama National University, Japan
Supported by;
Japanese Embassy in Spain
National Foundation, Japanese Society for Rehabilitation of Persons with Disabilities
Japanese National Foundation, Association for Technical Aids
Conference Chair;
Prof. José León-Carrión, Ph.D.
Center for Brain Injury Rehabilitation (CRECER), Seville, Spain
Vice Chair, International Brain Injury Association (IBIA)
The 11th IBRC Proceedings
Published September 12, 2014

View full abstract

DATE: 12-13 September 2014
Venue: Sevilla, Spain
University of Seville,
Center for Brain Injury Rehabilitation

View full abstract

It is my pleasure to invite you to attend the 11th INTERNATIONAL BIOPHILIA REHABILITATION CONFERENCE, organized by the International Biophilia Rehabilitation Academy and hosted by the University of Seville, Spain, on September 12th-13th, 2014.
The conference will focus on how to restructure rehabilitation medicine and assist patients in recovering functionality after brain injury, particularly in the aging population.
This meeting will provide an international platform for relevant rehabilitation designed to treat neuropsychological dysfunctions and disorders resulting from brain injury.
The ultimate goal is to further improve the care and welfare of an aging society and all those who suffer TBI.
We hope you will join us in the historic city of Seville and participate in advancing our knowledge of rehabilitation strategies.

View full abstract

The International Biophilia Rehabilitation Conference greets you for the 11th time. It has been 25 years since I made up my mind to establish an organization to study and restructure rehabilitation medicine designed to overcome physical disabilities, as opposed to accepting them as an inevitable part of the aging process. Japanese Biophilia Rehabilitation Conference holds 18 times.
I thought that our rehabilitation method would spread immediately when facts were shown, such as how many bedridden patients who had received our rehabilitation medical treatment were enabled to walk again. Although the development was shown in BIOPHILIA Vol. 1 in detail, the method was not enabled to socialize only by the fact being shown. The elucidation of a mechanism was called for. We began research for creating a mechanism to aid in the effect of the motivative exercise, which has been found to increase the effects on brain activity after research of many years.
IBRC 2014 has made the conference chair Prof. Jose Leon-Carrion, Ph.D., who is one of the leading authorities in the study of cerebral function research. It will be a memorable conference for our rehabilitation medical treatment which has been said to improve the field of cerebral function. This may also be said to be the final settlement of accounts of activity in recent years.
In order to contribute to future research on the therapeutic potential of affected parts, the produced nerve stem cells by the motivative exercise were drawn to the an inflammation part by the produced chemokine leading and RCT of the Takizawa method to the previous rehabilitation method and establishment of a technique of the rehabilitation medicine, we expect to join the many molecular genetics researchers, rehabilitation doctors, engineers, therapists, and administrative officials participating at this conference.
The matter worthy of special mention of IBRC 2014 is that our poster for the invitation was put up in the ISPRM Cancun convention by the request.

View full abstract

The International Biophilia Rehabilitation Conference (IBRC) has reached now to its 11th Edition - that will be held on the 12 and 13th of September, 2014, in Seville, Spain.The collaboration, started in 2011, of the Romanian Society for NeuroRehabilitation (RoSNeRa) - which is also a co-sponsor/ -organizer of this edition - with the International Biophilia Rehabilitation Academy (IBRA), has been consolidated, over time, including with the contribution of the President, together with some diligent colleagues, members of the RoSNeRa, to the development of the Biophilia Rehabilitation Journal.
As a consequence of the consolidation of our collaboration, the promotion of this event we have made, will hopefully result in an enhanced participation of Romanian colleagues at the IBRC 2014.
Through this new and hopefully very fruitful international academic joint event, we want, including with the contribution of the above mentioned Romanian scientific society - and of others which focus on Rehabilitation - to make a step forward in the Rehabilitation multidisciplinary collaborative research, at a global level, in order to better approach the needs of a population characterized, on one hand, by the growing number of persons with neural (mainly motor, cognitive/ communication, respectively sensorial) and/or some muscle-skeletal, severe disabilities and on the other, by continuous and accelerated demographic aging - i.e. with more elderly, that are prone to poli-pathology - in need, including for Rehabilitation and/or Assistive facilities/ technologies.
To be emphasized that our common endeavors to develop, at global level, Rehabilitation, are subsumed in the general very strong and important trend towards multimodal combating of disabilities, supported and boosted by the World Health Organization (WHO), together, mainly, with the International Society of Physical and Rehabilitation Medicine (ISPRM), the World Federation for NeuroRehabilitation (WFNR), the International Spinal Cord Society (ISCoS) and the World Bank: as it is known, on the 23rd of May 2014, the 67th World Health Assembly endorsed the “WHO global disability action plan 2014-2021: Better health for all people with disability” and, as it is determined within a very recent related press release of the ISPRM leadership: ”Disability and Rehabilitation is now a major area of the agenda of WHO”.
So, personally and on behalf of my Romanian colleagues who are actively working for the overall development and improvement of Rehabilitation, I wish a great success to the 11th IBRC, 2014.

View full abstract

As president of the Japanese Biophilia Rehabilitation Academy it is with outmost pleasure to inaugurate the 11th International Biophilia Rehabilitation Conference on Restructure Rehabilitation Medicine to be held this year at the Center for Brain Injury Rehabilitation of the University of Sevilla, Spain, during 12~13th September 2014.
This year’s theme is to restructure rehabilitation medicine and I am very proud to announce that along with our team of Japanese experts, we have an impressive line of extinguished speakers participating from around the world, such as Prof. Jose Leon Carrion from University of Seville, also the vice-chair of the International Brain Injury Association who will focus on how to restructure rehabilitation medicine, Prof. Mieczyslaw Pokorski director of the Medical Research Center, Polish Academy of Sciences and also director of the International Biophilia Rehabilitation Academy who will talk on the integration of the molecular genetics and engineering to accelerate to restructure rehabilitation medicine, Prof.Gelu Onose from University of Medicine and Pharmacy “Carol Davila”, and president of the Romanian Society for NeuroRehabilitation, Bucharest, Romania who will give us a presentation on neuroprotection in patients with subacute/subchronic conditions following severe central nervous system lesions with focus on traumatic, brain and spinal cord, injuries.

View full abstract

Those who are involved in medical treatment and rehabilitation often see someone who moves an arm, diagnosed as being impaired or paralyzed, with the other healthy hand. That is tantamount to a kind of PASSIVE EXERCISE by a physiotherapist, except that the beneficial effect of such movement would be enhanced. However, it is rather impossible to move a paralyzed leg by one’s healthy hand due to inconveniency and the sheer weight of a leg, i.e., the load would be too much.
The question arises of what effect is to be expected when the patient would be able to move his own paralyzed leg. That question has been the starting point of our cooperative research in medicine and engineering devoted to medical rehabilitation. A simple device has been designed in Japan to perform such moving of a paralyzed leg by the other healthy one. Since then, I have participated in this research and have been searching for the underlying physiological mechanisms of the beneficial effects. The effects of such self-training apparently consist of a boost to cerebral function due to enhancement in cortical blood flow.
Rehabilitation of a paralyzed patient with PASSIVE EXERCISE performed by a physiotherapist has been done for years. However, the nature of impairment basically persists basically unchanged. To improve the present state of rehabilitation by seeking the physiological underpinnings of a handicap we propose that molecular genetics could contribute to the automation of diagnosis or judgment of medical results obtained. That could be achieved by cooperative research efforts in the field of medical engineering in rehabilitation. We wish to continue such efforts towards the improvement in welfare of human beings with your attendance of today.

View full abstract

On behalf of Research Department of Japan Biophilia Rehabilitation Academy, it is a great pleasure to hold “the 11th International Biophilia Rehabilitation Conference (IBRC 2014)”.
The number of physical therapists, occupational therapists, and speech therapist has increased, but still the number is a shortage by the increase in elderly person.
According to United Nations statistics, the aging rate of 65 years or older in the developed countries has reached 15.9% in 2010. The Aging rate in Japan was the highest in the world with 23.0%, and the rate exceeded 25 % in 2013.
Moreover, they investigated the index of elderly of the 91 countries. The report says that the elderly population is increasing fastest in developing countries, and more than two-thirds of the elderly live there. Elderly people of the single life increase, too.
In order to solve these issues, research in the Biophilia Rehabilitation Academy is required. The rehabilitation we have studied and presented at our meeting will be expected. This best method will become worldwide soon.
My major is mechanical engineering and I will help rehabilitation using the assistive technology concerning nursing.
I wish a fruitful meeting and I’m looking forward to meet many friends and our meeting to succeed.

View full abstract

In the context of international exchange in Italy took place during the 10th IBRC, different topics were dealt with brilliantly and many projects have been started. Many opportunities for discussion have opened during the analysis of the proposals presented during the scientific and cultural exchange in the context of EBM.
Targets set for 2014 are the identification of shared rehabilitation protocols based on validated and universally recognized methodologies in a multi specialists collaboration perspective.
The 11th IBRC will outline the possibility of exploiting these international comparisons to create important guidelines in the world of rehabilitation and management of acute and chronic patients.
The certainty of a meeting full of prospects for the future as start from what was developed during the international event of 2013 which opened the way to new prospects, certainly useful for the scientific community, for health professionals and for patients who live states of weakness that managed together will lead to a significant increase of the homeostatic potentialities.

View full abstract

The brain ages, and human genetics and genomes are involved in cellular aging. Aging genetic expression is conditioned by interaction with the environment. Some genes have less expression after the age of 40: those with a major role in synaptic plasticity, vesicular transportation and mitochondrial function. Loss of white matter increases after the sixth decade. Experience produces functional changes that can improve nervous system functioning. However, cerebral-self regulation can deteriorate with age. As we get older, we get wiser. However, other factors have adverse effects in the long-run.
Three of the most common neurological diagnoses in the elderly are Alzheimer’s, Parkinson’s and stroke. The most common diagnosis within the dementias is Alzheimer’s, affecting between 35-50% of dementia cases; next is vascular dementia, which will be detected in 18 -13% of these cases.
The brain’s weight changes with age. As we age, our vision deteriorates. Deterioration in sense of smell may be due to a decrease in the speed of cognitive processes. Prospective memory undergoes general deterioration during the aging process. Studies report that implicit memory is more resistant to deterioration during normal aging, and that aging is related to physical activity, age and cognitive/motor functions.

View full abstract

How will the people all over the world overcome the super-aged society near future?
I have accepted this chief editor in order to realize the wish to stretch a hand to offer the resolution to age crisis and recognize that we should convert the target from an individual to the big mass.
We are going to spin the hope of human beings. I would like to ask more people the big encouragement and participation to our colleagues who get on a small ship and pull an oar toward a large wave called arrival of a super-aged society.
The statements above were the contents I contributed the greeting as the head of a member of editorial board in Japanese Biophilia Rehabilitation Academy establishment in 2002.
In 2000，I performed the study named “Surveillance study for Improvement in ADL and Independence for Advanced age Patients with Lower Limb Bone Fracture." by the Grant of Association for Technical Aids.
We had studied the methodized Autonomous Kinetic Rehabilitation named Takizawa Method with the support of the Geriatric Health Services Facilities for Elderly, Shonan no Oka. We could get the effective results in locomotion approved statistically by Prof. Ushizawa, Sanno University.
This research was also followed our article published in 1998.
Good points of this Method are not only useful for any elderly and anywhere to rebirth ADL training but also reasonable price, not expensive.
I could show you clearly that the Motivative Exercise is activating the cerebral function by head MRI and functional NIRS up to now.
It is my pleasure that I can publish this greeting in the 11th IBRA in Seville as one of the leaders of these researches in Japan.
We would advance cerebral function research, mechanism and effect research.
In order to spin the hope of human beings I am pleased if a new researcher participates us through this IBRC 2014.

View full abstract

In recent years, rapid aging has become an important problem in many countries. With the aging of society, the number of stroke patients has increased year by year. Many stroke patients require rehabilitation in order to resume normal life. Although one physical therapist (PT) manages one patient in conventional rehabilitation, this system cannot be used to handle the rapidly increasing number of patients. Therefore, we proposed a system in which one PT manages many patients using certain devices, the so-called motivative exercise (Takizawa method). Motivative exercise is better suited as a rehabilitation system for the future. However, this system is currently unacceptable in Japan and other countries. One reason for the unpopularity of this system is a misinterpretation of motivative exercise: it is thought that many PTs will lose job opportunities because of this system. We believe that this misunderstanding results from misinterpretation of the business model of the Takizawa system.
During the stages of diagnosis and treatment in a general hospital, one doctor examines a large number of patients, and the hospital gains considerable income from the patients. However, in the current rehabilitation system, each hospital gains scanty income from patients, because one PT manages one stroke patient for a certain length of time. Therefore, in the current system, an economically disadvantaged hospital cannot hire more PTs. Since one PT manages many patients in motivative exercise, one PT can gain much higher income for the hospital; thus, the hospital can hire more PTs. We believe that a small hospital can hire a few PTs; therefore, motivative exercise would produce jobs for many PTs. We think that the current rehabilitation system would be rejuvenated by motivative exercise.
Although motivative exercise with devices is an advantageous business model for hospital management, we must show the availability of motivative exercise by rehabilitative efficacy, objectively with the rehabilitation score and brain function measurement. A traditional method for measuring rehabilitative efficacy is the rehabilitation score prepared by a PT; recent methods include brain function measurement by functional magnetic resonance imaging (fMRI) and near infrared spectroscopy (NIRS) with computer analysis. Currently, our team evaluates the efficacy of motivative exercise on the basis of the rehabilitation score and brain function measurement. Our research laboratory uses brain function measurement for the evaluation.
For measurement of the inner structure of the brain, fMRI examination is better than NIRS examination because of its superior resolution. However, fMRI examination cannot be performed when using some devices, since the patient may not move during examination and may not use some metal objects near the fMRI scanner. Therefore, NIRS is a better examination for evaluating the efficacy of rehabilitation. An NIRS image has lower resolution than that of an fMRI image, and only near-surface information is obtained through NIRS. We evaluated depth information of affected area on an NIRS image using approach of inverse problem in engineering, and measured the rehabilitative efficacy from the viewpoint of brain function recovery. Once the efficacy of the Takizawa method is proved on the basis of the rehabilitation score and brain function measurement, the Takizawa rehabilitation system will be widely used.
We hope that new researchers participate in our approach of providing important innovations in the field of the rehabilitation, through a workshop and research exchange in the 11th IBRC.

View full abstract

It is a contemporary reality the dialectic antagonism between the results of the general human progress (including in the health field, due to which, on one hand, survival ensuring, even in desperate situations, became frequently possible, but also connected to the significant and fast augmenting of the mean life duration: the alert ”demographic ageing” - a population process that generates more elderly, who’s bio-/medico-social characteristic is poli-pathology, with afferent disabilities) and its consequent elevation of the standards/ strivings for individual and/or collective improvements of the peoples’quality of life (QoL) and the - thus - anachronic co-existence of severe disabilities/ handicaps (providing ”veterans of the contemporary medicine”: an unfortunately, actual, inappropriate painful truth and global burden).
The complex modern management of patients with subacute/ subchronic conditions following severe CNS lesions, involves - in addition to neurosurgical intervention(s), if necessary - endeavors for: balanced pharmacological - and not only - stimulation of neuroprotection, neurotrophicity (and even, to some limited extent) of neuro-/synaptogenesis and respectively, modulation of neuroplasticity - all, together and in judicious synergy, with physical-kinesiological (including rehabilitation nursing) speech and/or cognitive-behavioral, therapies.
In this work, I first make an up-to-date general overview on the subject matter, detailing the path-physiological lesional mechanisms consequent to CNS injuries - including intimate targets for neuroprotection - and then, a synthetic presentation of mine and colleagues’ expertise, on neuroprotection, mainly based on four modern related: drugs and respectively, nutritional supplements.

View full abstract

Brain diseases such as Alzheimer’s Disease, Parkinson’s disease, and injury such as stroke have been considered to result in permanet loss of neurons with no possibility of cellular regeneration. This widely held belief has been challenged by evidence that certain brain areas retain the capability to generate new neurons in rodents and humans. The neuronal stem cells are found in hippocampus and cerebral cortex in human brains, suggesting the regenerative capacities in those areas of human brains. Recent studies also indicates that exposure to an enriched environment produces a significant increase in hippocampal neurogenesis in rodents. These regenerative capabilities of adult brains can be applied for the prevention of neurodegenerative diseases such as Alzheimer’s disease, or the rehabilitation after the brain injuries such as cerebral stroke. In this lecture, I will talk on the biology, physiology, pathology of neuronal stem cells in the contest with the clinical applications.

View full abstract

Our research proposes to challenge the established roles within our current civilization. We human beings have extended our survival to an advanced age amongst many countries. Therefore, the increase in elderly people means the increase in nonworking dependents. From nonworking dependents' increase viewpoint, it brings about economic stagnation and expansion of the social security expenditure that we wouldn’t enable to maintain. We would like to and must establish the new civilization, in which the increase in elderly people doesn’t mean a negative factor, by realizing the paradigm shifts within the rehabilitation medicine and thereby changing the meaning of the aging. The first paradigm shift, the theme of this year's conference of the International Biophilia Rehabilitation Academy (IBRC 2014), "To Restructure the Rehabilitation Medicine" was set by the conference chair and then promoted from each research domain in the posters for this conference. The author unifies those subjects and describes our academic activity, as well as research how the new civilization establishment has been enabled thus far.

View full abstract

Purpose
Motivative exercise is easy, and can be carried out always and anywhere.
The functional improvement of the user by this introduction is already reported.
In this research, we aimed at investigating what kind of change happens to a patient through the continuation for one year after the fist introduction.
Subject and Method
The examinations were done for 12 outpatients of this hospital. All the members were doing research participation from last year. Two persons had ended hospital visit. This research is continuation from the research of the previous year, and has passed through examination of the ethical committee of this hospital. Cerebral function evaluations were done with the fNIRS examination by change of the oxyhemoglobin between the rest and task using Shimazu NIRS device and the analysis software following last year.
We performed activation comparison of the cerebral function of the motivative exercise of Knee joint flexural extension and ankle joints plantar flexion and the dorsiflexion. Furthermore, we performed comparison during same each exercise. One person could not evaluate but excepted.
We compared with the number of times of exercise between the 1^st and 2nd of the motivative exercise and passive exercise of Knee joint flexural extension and ankle joints plantar flexion and the dorsiflexion.
The number of times evaluation of movement compared the first time and the 2nd numerical value which the investigator counted the number of times of exercise, and recorded it at the time of a fNIRS examination.
We authorized the significant difference by SPSS15.0.
Result
Comparing change of the oxyhemoglobin of the motivative exercise and passive exercise, we verify the brain activated more in the Motivative exercise to affected. (P<0.05)
Comparing change of the first time evaluation and the second, we verify the 2nd evaluations had less change than first time evaluation. (P<0.05) In addition the significant difference was not seen by passive exercise of ankle joints plantar flexion and the dorsiflexion.
Comparing change of the number of times of exercises between the first time evaluation and the second, we verify the 2nd evaluations had more number of times of exercises. (P<0.05)
The threshold in motor cortex to activate movements might decrease by repeated active assisted exercise using Motivative exercise. These phenomenon are seemed to coincide motor adjustments.
Conclusion
We inferred that the number of elderly people in Japan have increased rapidly, over 25% in population. The degrees of care are aggravating worse and worse. The balance of Japanese long term care insurance has been in red already. To confront these facts, Motivative exercise could help to aging crisis. Between these researches, the degree of care was changeless in the space of a year and considered expression of the motivative exercise introduction result. The lower limbs muscular strength reinforcement seems to be presumed by the use for one year from findings.
Moreover, although my keynote lecture described the old result of research, we consider that we have realized a part of mechanism research which realizes the effect.

View full abstract

The nursing care insurance (NCI) rule defines the rehabilitation-related protocol needs of outpatients of the rehabilitation facility, such as 6 hours or more (one day), 3 hours or more (half a day), and 1 hours or more (short time). We will clarify the method corresponding to the demand of this nursing care insurance, and the rehabilitation result as affected by the change of the degree of care.

View full abstract

A devise NIRS (Near Infrared Spectroscopy) can measure brain activation with infrared light. That’s because NIRS is expected to various applied studies about brain measurement. However spatial resolution of NIRS is poor, which is disadvantage of NIRS. In order to overcome this disadvantage, we study for better analysis method of NIRS data. We define inverse problem about NIRS measurement and estimate brain activation position from observational result of NIRS measurement. As a result of considering the structure of the brain and performed numerical experiments by our method, it was found that estimation of the depth direction and local position is difficult but there is improvement potential about NIRS disadvantage.

View full abstract

Introduction
The rehabilitation effect by the bilateral exercise is clarified in foreign countries. The studies of bilateral exercise are not for lower extremities, but upper extremities to range over the related field of learning. This research evaluated the influence on the brain by the passive exercise, resistance exercise, active exercise, active assistive exercise and bilateral exercise such as motivative exercise at the convalescence rehabilitation hospital. The randomized controlled trial was enforced for the motivative exercise additional group with 6 subjects and non- additional group with 6 subjects at the time of the study. Since obtaining the results, we have reported the study.
Purpose
The purpose is to clarify the peculiarity of the cerebral function activation by comparing the passive exercise to the motivative exercise that is specified by the bilateral exercise with unaffected side exercise taking the lead in affected side exercise and to active it.
Subject and Method
The subjects were 9 cerebral infarction sequelae, 5 cerebral hemorrhage sequelae and 4 disuse syndromes including pneumonia. The subjects were 14 men and 4 women and age 60-88 (the average age 71.6 years old). The tests were done from 2010.9 to 2011.1.
We evaluated the patient’ body functions with the ROM of lower extremities, and ADL evaluation.
We evaluated the activation part of the brain at the exercise time of the passive exercise, resistance exercise, active exercise, active assistive exercise and motivative exercise with using the NIRS equipment, FOIRE-3000 by Shimadzu Corp.
Result
By many subjects, we understood that brain activity is broadly active by the motivative exercise than the passive exercise by a physiotherapist. We understood that brain activity was broadly active by the resistance exercise, active exercise and active assistive exercise than the passive exercise. And the motivative exercise was broadly active in brain activity than active exercise and active assistive exercise but the resistance exercise. There were no changes in the randomized controlled trial by the motivative exercise additional group and non- additional group. Therefore, there was no bad influence of the motivative exercise from RCT. Furthermore, there were many numbers of times to train of the motivative exercise more than others significantly.
Consideration
This research showed that the motivative exercise, the resistance exercise, active exercise and active assistive exercise look effective for brain activity active. From a result, it seems that it is important to examine the change in the rehabilitation medical treatment technique to the motivative exercise center from the passive exercise by a physiotherapist center.

View full abstract

Summary
The paper sustains a conceptual approach in the Neurorehabilitation of the patients with dystonia / dystonic syndrome, from the perspective of the International Classification of Functioning Disability and Health (ICFDH).
The author makes a succinct review of this rare pathological condition, from various points of view – clinic, etiopathogenic, epidemiologic, emphasizing the devastating effects upon activity, participation and the impacts on the quality of life – integrated in the general frame of ICFDH.
Based on the physiopathological aspects, the paper debates the therapeutic objectives and methods, stresses upon the lack of enough evidences based on randomized physical therapeutic protocols and controlled trials, to support a sustained physical rehabilitation program.
The paper emphasizes the importance of an individualized but comprehensive approach, inter- / multidisciplinary therapeutic protocols for the rational management of this rare, but severe human condition.

View full abstract

Summary
Study design:Retrospective analysis, focused on the early post acute evolution of 291 elderly ( >65 years) patients with CSCI, first time admitted in the Rehabilitation Clinic, during 2004-2013.
Methods: analysis of the medical files.
Results: There were 205 males and 86 females (ratio 2,4). Most of the patients (215 - 74%) were from rural regions, and 57% of the CSCI happened during agricultural activity; the etiology was dominated (79 %) by accidental falls - from the same level (22%), falls from height (from chariot 48%, from trees 5,5%), but also traffic accidents (21%). Vertebral lesions consisted in facet dislocation (bilateral in 32%, unilateral in 11% cases) or/and (associated) disk hernia (54%); about 37% patients had no radiological evidence of bone injury.
Conservative management was indicated in 106 subjects (36,4%) vs. operated (63,6%), with significant improvement of the neurological status in the surgical approached group, versus the non-operated (Fisher test, p < 0.01). Early admission in our department and specialized treatment favored a better neurological outcome, from totally paralisis (AIS type A+B) to incomplete lesions (AIS type C+D) (p=0.006).
Most of the patients 175 (60%) were discharged at home, whereas 63 (21,6%) were admitted in nursing home, aspect significantly correlated with the marital status vs. single (widow or divorced) ( p<0,01).
A low mortality rate (2%) and miscellaneous medical complications were noticed, mainly transient postural hypotension 192 subjects (65,9%), asymptomatic urinary tract infections 259 (89%), haematuria (42 14,4%), bronchopneumonia (11,3%), depression (58,7%), central pain (44%), mild decubitus ulcer 7 patients (2,4%).
Conclusions: CSCI at elderly has etiological and physiopathological particularities. Geriatric associated pathology and poor social conditions favored the incidence of CSCI. Comprehensive inter- / multidisciplinary therapeutic approach, early admission in the rehabilitation department after surgical stabilization, favored a better outcome and a low mortality rate.

View full abstract

Summary:
Peripheral repetitive magnetic stimulation (SMr) is a technique which involve two types of muscular stimulations: isotonic and isometric. The classic stimulation by exponential currents induce only isotonic muscular contraction.
Method:
The actual study evaluated by comparison two equal groups of patients, 32 patients per group, all of them with ischemic stroke not more than ten month later, who received a similar rehabilitation program based on kinetic-therapy, appropriate medication, the difference was the type of muscle stimulation placed at the same muscle for both groups of patients. The Group A received SMr on tibialis anterioris, and Group B rectangular current on the same muscle. The evaluation has mad at the first moment T1, and moment T2 six months later, after two period of rehabilitation therapy, each one of 15 days. The evaluation scale was: the test 6MWD (6 meter walking distance), Tinetti scale for walking and measures the polygon areas of stability in standing.
Results:
For Group A the test 6MWD increased with a percent of 38,5% at moment T2, and the polygon area of stability has reduced with 18,2%. For group B the result of 6MWD has increased with 18,3%, and polygon area of stability has reduced with 5,6%.
Conclusions:
SMr sustainably applied on key muscle groups has demonstrated and important role in early rehabilitation in neuromuscular disability.

View full abstract

Background and aims:
The study presents a new way of assessing the patient with spinal static disorder revealing the poor podal support and looks for a corresponding for the correlation between surface curvatures and podal support. The evaluation of this support can be an element of prophylaxis, evolution and therapy of scoliosis.
Our objectives are:
-the analysis of the plantar support during three admission in hospital (with and without Cheneau corset )
- establishing an appropriate therapeutic plan using the software of footscan Balance7 device
-adaptation of kinetic procedures based on the results of testing
Material and methods:
Our sudied group includes 86 patients with scoliosis ( 44 girls, 42 boys, ages between 5-18 years old) admitted in the Pediatric Neuropsychomotor Rehabilitation Center ”Dr.N .Robanescu”, Bucharest from begginning of 2013 (the study still continues with a extented number of patients). Patients were tested for plantar support with Footsacan 2 and 7 gait generation device and received physiotherapy (Klapp methods, Cotrell, Schroth), massage, respiratory gym , Cheneau corset.
Results:
The analysis of the plantar support shows that body weight in children with scoliosis is distributed unequal of lower limbs, focusing on the member of the primary curvature.
The plantar support of the evaluated patients is changed in orthostatic position (without a previous diagnosis of podal pathology) as a part of the clinical presentation of scoliosis.
The studied group shows plantar changes associated with column deviation.
The device emphasizes the improving of weight distribution problems and pressures in static and walking in patients who wear the Cheneau Corset.
Preliminary conclusions:
Evaluation of patients with scoliosis with Footsacan 2 and 7 gait generation device contributes to complete the kinetic treatment and provides a new perspective in the therapy of the scoliosis.

View full abstract

Impairment of one sense influences brain responses to other sensory inputs, further reorganizing brain function in a feedback manner. Prelingual deafness is a model of brain adaptation during sensory deprivation, which concerns not only sensory, but also cognitive domain, due to the use of visual communication skills such as sign language. This study seeks to determine the level of emotional intelligence, as based on the ability to discern emotions from facial expressions, quality of visual and mental attention, and non-verbal fluency in the prelingually deaf people as compared with the hearing counterparts. Participants were 29 prelingually deaf persons, with a hearing loss of >70 dB, communicating only in sign language, and 30 hearing persons. The age of all subjects ranged between 40-50 years. Psychometric tools consisted of the Emotional Intelligence Scale - Faces, the d2 Test of Attention, and the Figural Fluency Test. Since gender may bear on the psychological results, data also were broken down by gender in the analysis. The findings were that both deaf women and men defined significantly fewer emotions as known, compared with the hearing counterparts. That held true for emotions seen in both female and male faces. The deaf men were able to properly recognize a higher percentage of emotions associated with a definite face look, among the emotions they knew, compared with the hearing counterparts. That was not the case in the deaf women whose agility in face recognition was definitively worse. There were no appreciable differences in the attention and concentration indices between the deaf and hearing men, but deaf women’s total performance on attention was worse. On the positive side, the deaf women performed better than both deaf men and the normally hearing women in non-verbal fluency. Thus, the findings were mixed, with deaf adults being more agile in some psychocognitive domains compared with the hearing persons, and there were gender differences in the deaf persons. Thus, prelingual deafness, in general, does not impede cognitive functioning in adult age. There seems to be a plastic reorganization of brain networks to preserve the nature of detecting and executing of cognitive tasks, although there are task-specific variations. In particular, visuospatial coordination is enhanced in hearing impairment, compensating for the lack of auditory input.

View full abstract

Aging is an inevitable process and is characterized by a reduction in general homeostatic adaptation to metabolic requirements and by several modifications including the progressive loss of muscle mass, strength, and a reduction of oxidative capacity. Aging is correlated with a reduction in cell oxygen supply and a parallel decrease in oxygen demand by tissues. During aging, reactive oxygen species (ROS) are generated, which have detrimental effects on structural and functional components of membranes. ROS are generated under hypoxic conditions and the accumulation of free radicals during life reduces the ability of tissues to remove them. Moreover, during aging the oxidative capacity decreases in parallel with the reduction in total mitochondrion volume. With increasing age, human skeletal muscles, progressively, reduce in volume, mainly due to a reduced number of motor units and muscle fibers.A consistent feature of age is limb muscle atrophy and the loss of peak force and power. Similarly sarcopenia is the physiological age-related reduction of muscle mass and strength. The multifactorial etiology underlying this process involves: changes in muscle metabolism and in endocrine system, alteration of nutritional, mitochondrial and genetic factors as well as a decrease in the number of motor neurons. It is well know that during aging brain plasticity is preserved and it is clear that plasticity is induced in the mature central nervous system by environmental input. The physiological changes which follows the time course, can be delayed by lifestyles. Brain plasticity during aging is the result of the neurochemical, physiological and behavioural changes in elderly and is the base to find new ideas that could improve our quality of life.

View full abstract

We examined the effect of a neurocognitive rehabilitation method in a young patient with upper limb impairment after cerebral hemorrhage.The "Perfetti" Neurocognitive Rehabilitation considers rehabilitation as a process of relearning, so every moment is necessary to use the parameters of the movement (spatiality, temporality) that do not fall into the so-called neuromotor methods. It proposes the learning of movements, through cognitive exercises. In the context of therapeutic exercise, the patient is encouraged to solve the "problem" related to movement through the use of "perceptive hypothesis". The method is based on the recovery of learning, on the conception of the body as a receptorial surface and the idea that the movement represents a phenomenon of knowledge. The patient made neurocognitive therapeutic exercise associated with high intensity focused acoustic waves to optimize muscle tone and hydrokinesitherapy at the frequency of 3 sessions per week for 6 months. The assessment was performed at the beginning (T0), mid (T1) and the end (T2) of the rehabilitation program, through: Multi Joint System; R.O.M. goniometric examination of the upper limb; Myometry; Fugl-Meyer Scale for the functional evaluation of the hemiplegic upper limb; Ashworth scale for spasticity. At the end of the rehabilitation program, we found improvement in upper limb proprioception; decrease in muscle tone at myometry in the upper limb flexors; increase in passive ROM of the shoulder; increase in the The Fugl-Meyer score; decrease in the Ashworth scale score.The proposed rehabilitation program is effective in improving the functional ability of the person with severe spasticity of the upper limb and functional deficit in the outcome of cerebral hemorrhage. The integration of functional neurocognitive rehabilitation in the treatment program is able to promote not only the recovery of the movement, understood as recovery of the articular range, but also the cognitive processes, perception, attention and the ability to solve problems through the stimulation of neuroplasticity.

View full abstract

Aim of the study is to analyze the effect of mechano-sound vibrations at a frequency of 120 Hz on limited areas of the spastic muscles through the searching for specific "key points," specific areas that, if properly stimulated, allow a reduction in the tone of the entire muscle. We evaluated and treated a sample group of 10 patients with spasticity; aged between 63 and 70 years. All subjects were assessed by: Ashworth Scale, passive R.O.M.; assessment of active motility, Bahkta Test, Surface EMG. Treatment with focused acoustic waves at 120 Hz was performed twice a week for 8 weeks with distal-proximal stimulation. After 8 weeks of treatment patients are underwent injection of botulinum toxin into the most dysfunctional muscles. We found a mean reduction in the level of spasticity on the Ashworth scale; increase of ROM passive extension of the wrist, knee flexion and ankle dorsiflexion; increase in muscle strength in the hemiplegic side; increase in the mean score on Bahkta The electromyographic analysis showed a significant reduction of the minimum value (uV) of the basal tone of all the treated muscles. The results show the validity of the application of focused acoustic waves in the treatment of spasticity. The "experimentally" identified key points are all situated in close proximity to fascial structures, connective tissue, tendons and ligaments. This is in line with the location of type III and IV "interstitial" mechanoreceptors, involved in the clasp-knife phenomenon. The use of focused acoustic waves, associated with specific stretching and muscle strengthening, can therefore be regarded as a good method for preparation to the next phase of treatment, such as for example preparing the tissue to inoculation of botulinum toxin, and then to prolong and potentiate the effect in the months after inoculation.

View full abstract

Background and aims:
The paper assess the quality of life of the families with a disabled child who have addressed to our rehabilitation center. Knowing the quality of life of these families helps us to assess families’ need for suport and services and to find together proper therapeutically solutions.
Our aims are:
To evaluate the life quality of families faced with disability
To find together proper therapeutically solutions
Material and methods:
Our study group included 60 families with a disabled child, evaluated between 2011-2013 in National Pediatric Rehabilitation Center “Dr.Nicolae Robanescu”, Bucharest . The used methods were: observation, clinical interview with children and parents, FQOLS (Family Quality Life Survey) 2006.
Results:
Regarding the family structure, 12 families include also the grandparents (extended family), 44 are biparental families (nuclear families) and 4 mono parental families. The most involved members of the family are the parents (in 30 families), 80 % of them being the mothers (mothers feel themselves in general overcharged). Family health is important for all the families and for most of them (50 families) the major obstacle in treatment is the delayed time before admission as they have great expectations from the treatment. Regarding the financial income most of the families have a medium one (52 families) and the financial wellbeing is important to them. Our study revealed that the relationships into the family are also disturbed when a child is diagnosed with a disability.
Conclusions:
When a child is diagnosed with a disability the whole life of the family is changed. The mechanisms of coping, psychological support and counselling, psychiatric referral where it is needed, besides the other therapeutic interventions (physical therapy, occupational therapy) play an important role in improving the life quality of families with a disabled child. Our local communities through medical, educational and social services, public awareness activities regarding the needs of the family may contribute to improve the life quality of these families.

View full abstract

Continuity of Life is a novel concept that can be defined as the degree to which an adverse event or process (such as acquired brain injury) has interrupted the continuity of an individual’s life with regard to his or her activities, hopes and plans. This perceived degree of interruption is assessed within a number of life domains such as access to material possessions and earnings; personal physical and mental health; relationships with family members and friends; work, studies and professional career; leisure and recreation; rights, duties and responsibilities; and personal beliefs and/or religious faith. The Continuity of Life Interview (COLI) is a related assessment tool developed and evaluated by consumers, clinicians and academics experienced in rehabilitation and recovery. The COLI is aimed at assessing an individual’s perception of illness- or injury-related disruption of, or interference with, relevant life areas and global life quality regarding present state and plans for the future. The instrument is a semi-structured interview schedule which has been evaluated for its feasibility (i.e. duration of the interview, comprehensibility of the main questions and other procedural, textual and rating issues), inter-rater and test-retest reliability. The Continuity of Life concept and instrument are currently being evaluated in a study which aims to implement and evaluate an 8-week mindfulness program, combined with psychoeducation for people with an acquired brain injury and their carers, who attend the State Head Injury Unit at Sir Charles Gairdner Hospital in Perth, Australia. The specific objective of this study is to determine the effectiveness of the mindfulness program in improving quality and continuity of life in patients with acquired brain injury.

View full abstract

We made a population-based study in subjects with chronic stroke, undergoing home rehabilitation, to assess the overall psychological and physical outcome, increase in residual abilities, nutritional intake and social reintegration. 41 patients undergoing home rehabilitation at a frequency of 2 sessions per week for 40 days a year were assessed by FIM, Mini Mental State Examination, Stroke Impact Scale, Tinetti Balance Scale, Hamilton Depression Scale, Ashworth Scale, Motricity Index, 10-Meter Walking Test, 6-Minutes Walking Test, 5 Repetitions Sit-To-Stand Test. The home rehabilitation treatment consisted of: passive mobilization of the limbs, postural changes, exercise relearning of motor tasks by executing specific tasks congruent with the residual abilities, assisted gait in gravitary environment, education for self-repeating of the re-learned motor task, training of the caregiver. Patients were evaluated at T0 (beginning of the rehabilitation program), T1 (4 months after twice a week therapy), T2 (one year follow-up). The results showed a statistically significant improvement only in the treatment period and a decrease of results after 16 months from the initial assessment. This applies to all parameters taken into account, except for the emotional factor, assessed with the Hamilton Depression Scale, the only parameter statistically significantly improved one year after the first assessment; In fact, it was found an improvement in mood during the whole measurement period; that, in line with what is stated in literature may be indicative of the importance and necessity of adequate family and social relationships in the management of patients with stroke in chronic phase. The pilot study described is still under further enrollment in order to collect a larger series.

View full abstract

In this paper, we introduce kinetic analysis method whose motion images are acquired in rehabilitation training scenes. The rehabilitation trainings with kinetic analysis enable home trainings for improving and maintaining motility functions, which are needed by elderly humans. Our engineered approach is explained and results are shown by analyzing human motions in walking training scenes. In the future, we aim to incorporate with the training and evaluation programs which physical therapists are proposing.

View full abstract

Introduction: Rehabilitation is a complex activity, both medical and social, that involves professional education for the patient, family and medical personnel. This activity seeks to restore full functionality for patients, in order to ensure an almost normal life. Our goal was to measure the interest and assesment of resident doctors in Rehabilitation Medicine on their speciality and also on their social and educational life.
Material and methods: We have applied and validated the original “Dundee Ready Education Environment Measure (DREEM)” test in English, for the first time for residents. The DREEM test, implying questions and answers with multiple coefficients, was filled in anonymously. A total of 28 resident doctors have participated at the test, the results being distributed by year of practice.
Results:All Cronbach alpha correlation coefficients are significant (>0.7) except the 5^th category. As regards theinter-item correlations (internal consistency) for each category, on our sample, the test has a very good overall reliability, but we have found some questions that are not significant for the final results. The test has its own interpretation guide, with four final possible results, in the range from 0 to 200 points. In our case, the total average score was 150.4 points, which places us on the borderline between the 3^rd and 4^th category: 101-150 points / 151-200 points (between „More positive than negative” and “Excellent”).
Discussions:The test showed that the residents have approved the courses and the clinical part comprising practical works. They showed interest in treatment methodologies, as well as in the idea of associating theoretical and practical training, considering it necessary for their future profession. The DREEM test showed that the assessment and treatment of various pathologies approached through medical rehabilitation perspective is a matter of interest to all the resident doctors from all years of practice.
Conclusions: Periodic testing of resident’s perception proves particularly useful for identifying the deficiencies, which may arise during the teaching process. This can be a significant instrument to continuously respond to the raised common issues, solving them efficiently. As a student-teacher partnership, modern training cannot ignore the practical needs of resident doctors, that are in the need of permanently improving their skills, by combining theoretical training with specialized courses and practical work, all necessary for their profession.

View full abstract

Japan is known as the country with the greatest longevity in its population. However, a lot of bedridden people are included in this. It is important that we live longer be active and happy, without becoming bedridden. What is needed is to reduce the incidence of such as cerebrovascular incidents, events of the cardiovascular system, and cancer. We hope to enlighten everyone that diet, exercise and the relief of stress can prevent diseases, when people don’t have some illness. I’d like to introduce our approach in this presentation. Further more, I will show that there are anti-aging effects of Japanese hot springs. Japan is a country famous for having many hot springs. We also have the custom of bathtub bathing. This has positive effects on wellness such as by the improvement of circulation, relaxation of sympathetic nerves, and the rejuvenation of the skin condition.

View full abstract

Objective To assess the impact of socio-demographic and co-morbidity factors, and quantified depressive symptoms on disability in inpatients.
Method Observational cross-sectional study including a number of 80 elderly (16 males, 64 females; mean age 72.48 years; standard deviation 9.95 years) admitted in the Geriatrics Division between May-July, 2012. We used the: Functional Independence Measure (FIM), Geriatric Depression Scale (GDS) and an array of socio-demographic and poli-pathology parameters, respectively. Statistical analysis included Somers’D for ordinal variables, linear bivariate correlations, general linear model analysis, ANOVA and Kruskal-Wallis, tests.
Results FIM scores were negatively correlated with age (R=-0.301; 95%c.i.-0.439--0.163 p=0.007); GDS score had a negative impact on FIM (R=-0.322; 95%c.i.-0.324-0.052 p=0.004). A general linear model, including other variables (education, living conditions, provenance, gender, matrimonial state) as factors, found living conditions (p=0.027) and the combination of matrimonial state and gender (p=0.004) to significantly influencing the FIM score. ANOVA showed significant differences in FIM scores stratified by the number of chronic diseases (p=0.035).
Discussion and conclusions Our study objectifies the negative impact of depression on functional status; interestingly, education had no influence on FIM scores; living conditions and combination of matrimonial state and gender had an important related impact: patients with living spouses showed significant better functional scores than divorced/ widowers; the number of chronic diseases also affected FIM scores: lower in patients with significant poli-pathology. These findings must be considered when designing geriatric rehabilitation programs within home skilled cares.

View full abstract

Alzheimer’s Disease is is the most common form of dementia. There is no cure for the disease, which worsens as it progresses, and eventually leads to death. In the early stages, the most common symptom is difficulty in remembering recent events, known as short term memory loss. This short term memory loss is caused by the neuronal loss in hippocampus. The cause and progression of the disease are not well understood; it is associated with plaques and tangles in the brain. Current treatments only help with the symptoms of the disease. There are no available treatments that stop or reverse the progression of the disease. Mental stimulation, exercise, and a balanced diet have been suggested as ways to delay cognitive symptoms in healthy older individuals, but there is no conclusive evidence supporting an effect.
Coconut oil contains middle chain triglyceride (MCT), which is specifically metabolized into ketone bodies in the liver. The ketone body is another energy resource for the brain, which would be used in starvation or extensive exercises when glucose is depleted. I will show a case history of early onset Alzheimer’s disease with a significant improvement of cognitve decline after the intake of coconut oil that was precisely written in the best seller book “Alzheimer's Disease: What If There Was a Cure”, by Mary Newport, MD. I recently published the recipie book with coconut oil for the patients with Alzheimer’s disease in Japan. I also show in this lecture how to use the coconut oil in daily diet in order to prevent and improve cognitive functions.

View full abstract

Background:Neuroprotection, as a therapeutic strategy for patients under recovery after TBI, is not universally accepted, consequently is not widely. Throughout these two studies we comparatively assess neurorestorative, including neurorehabilitative, outcomes obtained with or without Cerebrolysin®.
Scope and study design:This was a retrospective case-control study that was approved by the bioethics commission of the Bagdasar-Arseni Teaching Emergency Hospital, Bucharest, Romania. The aim of the study was to comparatively assess neurorestorative, including neu¬rorehabilitative, outcomes obtained with or without Cerebrolysin®.
Materials and methods:Nineteen cases treated with Cerebrolysin versus 28 who did not receive this drug were included in this study. First we studied 47 patients with TBI all in subacute state, admitted between January 2005 and December 2010, than 120 patients with different states since TBI admitted in the same period 2005-2010, which receive (studied lot) or not (control lot) neuroprotection.
Results:Cerebrolysin used for short period, only in subacute state, is not statistical significant in improving psycho–cognitive and functional parameters we evaluated ( FIM, GOS, Rankin, number of days untill the functional knee extension recovery, KE, untill walk between parallels bars, WPB, cane assisted walk CW, etc, totally 9 parameters). Neuroprotection with Cerebrolysin used during the next steps of rehabilitation admission, increase significant statistically functional benefit of the patient (difference FIM upon discharge – FIM upon admission 48: 25.08, p value being p<0,001), hastensneuro-psycho-motor performances (patients block knee faster 8:10, p<0,001, WPB faster 8>12, p<0,001, CW faster 7:13, p<0,001) and is dose dependent (difference FIM dis. -FIM adm is statistically significant only with patients treated with 20 ml Cerebrolysin/ day, average 53,17, p=0,047).
Discussion and conclusion:The clinical/functional evolution, comparatively evaluated in the studied inpatients, suggest that Cerebrolysin, correctly indicated and administered, may perhaps contribute to some improvement of post-TBI patients’overall neurorestorative/rehabilitative outcome, used not only in post acute state after TBI, but also during the next phases of rehabilitation.

View full abstract

Background and aims:
The goal of our paper is to present the Pediatric Neuropsychomotor Rehabilitation Center „Dr. N. Robanescu”, Bucharest which is the reference center in the field in Romania.
Therapeutic success in saving the lives of children with diseases occurred at birth, meningoencephalitis, stroke after cerebral malformations , vertebromedular and craniocerebral trauma and the need of rehabilitation therapy in congenital malformations of the limbs and spine P(cifoscoliosis), posttraumatic disorders of the limbs, sequelae after cardiopulmonary arrest in surgery for cardiac congenital malformations and the others, has generated the appearance of care units for children with chronic disorders, so that they wouldn’t be excluded by the society they should be inserted in.
Methods:
Accommodation in hospital and care method meet European standards and protocols as it could be seen in images during therapy. Adequate equipped therapeutic compartments with highly qualified staff make us one national reference center.
Results:
The results are comparable to those in the literature and depends on the whole team ( with country specific differences). Therapeutic team and the family find together the optimal ways in which to ensure a better quality of life for children with disabilities.
Conclusion :
We follow the global developments in the field trying to adapt them to our socio-economic conditions. Hospitalization of these chronical ill children meets certain operating standards; they need a welcoming environment in which there is an interaction between health, educational and social factors , so they do not perceive neuromotor rehabilitation as any ”hospital’s aggression”

View full abstract