ABSTRACT
Objective: To investigate the effect of using Vibration Sensory Analyzer-3000 (VSA-3000) in patients with impaired vibration sensation caused by central nervous system injury. Design: Prospective observational study. Setting: A university hospital for the research and clinical practice of rehabilitation. Subjects: Sixty patients (30 stroke and 30 spinal cord injury) were recruited, aged between 20 and 71 years old, under stable medication. Interventions: Not applicable. Main Measure: VSA-3000 threshold test, tuning fork test and somatosensory evoked potential (SSEP) measurement. Results: Test-retest reliability was determined based on data collected from 60 subjects, and the intraclass correlation coefficient (ICC) for vibration perception thresholds (VPTs) was in the "substantial" range. The kappa value between VSA-3000 and SSEP was 0.877, which was higher than that of tuning fork (κ = 0.732). VSA-3000 had good diagnostic accuracy with a sensitivity of 94.8%, specificity of 92.9%, and positive-predictive value of 93.8% and negative-predictive value of 94.0%, each value was higher than that of tuning fork. The area under the receiver operating characteristic curve (AUC) of VSA-3000 was 0.95 (95% CI: 0.91 to 0.98) and that of tuning fork was 0.89 (95% CI: 0.85 to 0.95), and there was a significant difference between the two values (P = 0.0216). The types of injury and age were the independent correlates of the VPTs. Conclusion: The present study provides preliminary evidence that VSA-3000 is a non-invasive and convenient quantitative testing instrument with good diagnostic accuracy, and it may be useful as a screening tool for assessing impaired vibration sensation caused by central nerve injury.
ABSTRACT
Coronavirus disease 2019 (COVID-19) has widely spread all over the world and the numbers of patients and deaths are increasing. According to the epidemiology, virology, and clinical practice, there are varying degrees of changes in patients, involving the human body structure and function and the activity and participation. Based on the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) and its biopsychosocial model of functioning, we use the WHO Family of International Classifications (WHO-FICs) framework to form an expert consensus on the COVID-19 rehabilitation program, focusing on the diagnosis and evaluation of disease and functioning, and service delivery of rehabilitation, and to establish a standard rehabilitation framework, terminology system, and evaluation and intervention systems based the WHO-FICs.
ABSTRACT
PURPOSE: To investigate the profiles of cognitive impairment through Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) in patients with chronic traumatic brain injury (TBI) or stroke and to evaluate the sensitivity of the two scales in patients with TBI. METHODS: In this cohort study, a total of 230 patients were evaluated, including TBI group (n = 103) and stroke group (n = 127). The cognitive functions of two groups were evaluated by designated specialists using MoCA (Beijing version) and MMSE (Chinese version). RESULTS: Comparedwith the patientswith stroke, the patientswith TBI received significantly lower score in orientation subtest and recall subtest in both tests.MoCA abnormal rates in the TBI group and stroke group were 94.17% and 86.61% respectively,whileMMSE abnormal rateswere 69.90% and 57.48%, respectively. In the TBI group, 87.10% patientswith normalMMSE score had abnormalMoCA score and in the stroke group, about 70.37% patients with normal MMSE score had abnormal MoCA score. The diagnostic consistency of two scales in the TBI group and the stroke group were 72% and 69%, respectively. CONCLUSION: In our rehabilitation center, patients with TBI may have more extensive and severe cognitive impairments than patients with stroke, prominently in orientation and recall domain. In screening post- TBI cognitive impairment, MoCA tends to be more sensitive than MMSE.
