A: Jaw opening-closing movements
Active jaw movements
Active neck exercises
Head-Neck extension on jaw opening (Mandible moves vertically downward);
B: Isometric strengthening exercises (Same as control group) C: Postural Advice and Home Exercise Program with Dairy (Same as control group)

A: Active neck exercises Active neck exercises Active jaw movements (Active Jaw movement will not be perform in this group) B: Isometric strengthening exercises C: Postural Advice and Home Exercise Program with Dairy i: Postural Advise ii: Home Exercise Program (unsupervised) iii: Home Dairy
Frequency and Duration of Treatment Non-specific Chronic Neck Pain (more than 3 months history of pain)
Initial Assessment (week 1) 60 minutes First treatment session (week1) 40 minutes
3 treatment sessions per week (week- 2) 40 minutes
3 treatment sessions per week (week- 3) 40 minutes
3 treatment sessions per week (week- 4) 40 minutes
3 treatment sessions per week (week- 5) 40 minutes
Last treatment session (week 6) 40 minutes
Final Assessment (week 6) 60 minutes

Neck Pain

PHYSIOTHERAPY

Jaw opening-closing movements Patient seated on a normal standard comfortable chair with proper back support and feet placed on the floor with no head support.
Active jaw movements The patient will then perform maximal Jaw opening-closing movements at a pace convenient for his/her for one minute. Three sets with two minutes rest in between will be ensured.
Active neck exercises While performing the above movements of jaws, the patient will actively perform active neck exercise (head-neck movements in sagittal plane- Extension- Flexion).
Head-Neck extension on jaw opening (Mandible moves vertically downward); and then from Head-Neck extension to natural flexion movement on jaw closing (Mandible moves vertically upward).

Jaw opening-closing movements

Active neck exercises:
Patient seated on a normal standard comfortable chair with proper back support and feet placed on the floor with no head support.
Note: For Active neck exercise (flexion and extension movements of neck), firstly the patient will perform maximal Jaw opening-closing movements at a pace convenient for his/her for 5 times in order to observe (eyeball observation) the neck extension and flexion as reference point for each individual.
Using this reference points, the patient will ask perform below mentioned active neck exercise.
Active neck exercises: The patient will then perform active neck exercise (flexion and extension of neck) at a pace convenient for his/her for one minute. Three sets with two minutes rest in between will be ensured.
Active jaw movement: While performing the above movements of neck, the patient will not perform any jaws movements.

Specific Active exercises

Isometric strengthening exercises For flexion the starting position will be upright head and neck. The patient will be asked to hold this position.
For extension the starting position will be upright head and neck. The patient will be asked to hold this position.
For rotation the starting position will be upright head and neck. The patient will be asked to hold this position.
• In all above movements ( flexion, extension & rotation) following method will be followed: Manual resistance will then be applied by the investigator by placing the hand on the patient's forehead, posterior part of the head and lateral part of the head with 6 second hold. 15 repetitions of this exercise will be performed. Three sets with one minute rest in between will be ensured.

Exercise Therapy

Postural Advice and Home Exercise Program with Dairy Postural advice and home exercise program. Postural Advise Maintain upright posture while sitting.
Avoid prolonged neck bending.
Avoid twisting movement of the neck.
Use a suitable pillow to maintain cervical spine.
Adjust computer screen at eye level.
Avoid constant use of mobile or similar device to prevent excessive strain over neck joints and muscles.
Carry light and even weight in both hands while shopping and other chores.•Stay hydrated.
Home Exercise Program (unsupervised) (3 times a day)
Forward flexion (Self Resisted), 6 sec hold, number of repetitions 15
Right side flexion (Self Resisted ), 6 sec hold, number of repetitions 15
Left side flexion (Self Resisted) x 6 sec hold,number of repetitions 15
Backward flexion (Self Resisted) x 6 sec hold, number of repetitions 15
Home Dairy A home dairy will be provided to maintain home exercise program record.

Supportive Treatment

Insititute of Physical Medicine & Rehabilitation

The Effects Of Jaw Sensorimotor System In The Treatment Of Neck Pain And Dysfunction

Assessing the change in pain level:
The subject will be graphically or verbally portrayed a simple depiction consisting of a horizontal bar with labels ranging from '0' to '10' (a total of 11 integers)to rate his pain intensity.'0' would be considered as 'no pain'and '10' would indicate worst pain imaginable, whereas values 1 to 3 would indicate mild pain; 4 to 6 as moderate pain and 7 to 10 would indicate severe pain. NPRS has shown to have good sensitivity and it yields data that are best suited for statistical analysis.

Assessing the change in neck disability level:
The Neck Disability Scale is a reliable outcome measure to assess the treatment effectiveness for neck disability. It consists of 10 components.

Assessing the change in neck preconception error:
The concept adopted from Hallgren and co workers and it will be used as research instrument on baseline and final visits to find out any proprioceptive errors.
A Neutral Reference Point (NRP) will be used and asking patient to perform cervical spine range of motion (rotation, flexion and extension). Then measures any overshoot or undershoot of movement with regard to NRP using a cervical spine range of motion device.

Assessing the change in neck muscle endurance level:
Neck flexor muscle endurance test will be used to measure neck endurance in this study. It is a simple test and easy to apply. It is reliable test and achieved interrater reliability at moderate level among neck pain population.
Cervical extensor endurance test is a simple test for measurement neck extensor muscles endurance. It has good inter-rater reliability Kappa =0.800, Kappa SE= 0.109, 95% CL) and easy to administer. Losing of chin tuck position from neutral position of cervical spine is indicating of global weakness of neck muscles (weakness of superficial and deep neck extensor muscles) whist increasing of chin length with neck extension indicates a over activity of superficial extensor muscles and weakness of deep extensor muscles of cervical spine.

Saeed Akhter

principal investigator

University of Lahore

Patients receive stimulation in the VIM-nucleus of the thalamus

Patients receive stimulation in the posterior subthalamic area

Action Tremor

Deep Brain Stimulation

Annual eReport to the South-Eastern Norway Health Authority

Oslo University Hospital

A Controlled Comparison of Two DBS Targets for Upper Extremity Action Tremor

Deep Brain Stimulation in Disabling Action Tremor: A Randomized, Double-blind Study Comparing the Ventral Intermediate Nucleus (VIM) of the Thalamus and the Posterior Subthalamic Area (PSA) / Zona Incerta (The TREMORSTIM Study)

The difference in the change from baseline to the end of each of the two 3-month randomized cross-over periods, in tremor of the contralateral upper limb(s), as evaluated by items 5,6,10-14 and 16-21 in the Fahn-Tolosa-Marin (FTM)-score with VIM- versus PSA-stimulation.

2) The difference in the change from baseline to the end of each of the two 3-month cross-over periods in the items scoring tremor of face/tongue/voice/trunk/lower limb(s), with VIM- versus PSA-stimulation.

Change from baseline to 1-yr with stimulation at the most optimal of 4 electrode contacts of each patient (selected after the second randomization period) of the total FTM-score, tremor of the upper limb(s) (same items as above) and of the items scoring tremor in the face, tongue, voice, trunk, lower limb(s).

Change from baseline to 1-yr of Quality of Life in Essential Tremor (QUEST) scale, and Visual Analogue Scale of Global Disease Burden as assessed by the patient.

Frequency of serious adverse events (surgical complications and stimulation related side-effects), including eventual deterioration on neuropsychological testing , registered during the first year of stimulation.

Inger Marie Skogseid

Consultant, MDPhD

South-Eastern Norway Regional Health Authority

Randomized allocation of half the patients to be stimulated the first 3 months in the VIM-nucleus of the thalamus (VIM) and then 3 months in the posterior subthalamic area (PSA), and for the other half the first 3 months in the PSA and the next 3 months in the VIM

The doctor who assesses the primary outcome measures at 3 and 6 months and the participant are both unaware of which of the two targets is stimulated in the two randomization periods.

25 stroke patients between the ages of 18-80, stroke duration of less than 2 months and not more than 2 years whose MMSE scores equal or above the 25 will be included in this study. Oculus Rift and Leap motion will be used to create an immersive interactive environment. Modified Ashworth Scale (MAS), Functional independence scale, self-care questionnaire,Action Research Arm Test, Fugl meyer upper extremity motor evaluations will be applied just before the rehabilitation program, after the application and at the end of 6 weeks.

25 stroke patients between the ages of 18-80, stroke duration of less than 2 months and not more than 2 years whose MMSE scores equal or above the 25 will be included in this study. Oculus Rift a will be used to create an immersive visual environment.Patient will be watching the premade scenarios without interaction. Modified Ashworth Scale (MAS), Functional independence scale, self-care questionnaire, Action Research Arm Test, Fugl meyer upper extremity motor evaluations will be applied just before the rehabilitation program, after the application and at the end of 6 weeks.

Stroke

Rehabilitation

Patients will use virtual reality d4evice to play task oriented games like bowling, arrow shooting and home activity simulations which focuses upper extremity abduction, flexion and rotation movements. Each session will be a total of 45 minutes divided to 3 15 minute games. Sessions will held for 6 weeks each monday, wednesday and friday at same time for each patient.
In addition to the virtual reality treatment program conventional rehabilitation therapies including neurodevelopmental facilitation techniques, physiotherapy, and occupational therapy and, where necessary, speech therapy will be applied according to the needs of the patient.

Intervention

The control group will be included in the virtual reality program only focusing on visual scenes without upper extremity interaction. Bobath therapy, walking exercises, upper extremity active exercises, proprioceptive neuromuscular facial techniques will be applied to the control group for 6 weeks.

Control

Abant Izzet Baysal University

Effect of Immersive Virtual Reality Usage on Upper Extremity Function in Stroke Patients

Effect of Immersive Virtual Reality Usage on Upper Extremity Function in Stroke Patients: A Prospective, Double Blinded, Randomized Controlled Clinical Trial

Evaluates and measures recovery in post-stroke hemiplegic patients. Motor Test requires Tennis ball, A small spherical shaped container, A tool to administer reflex tests, Enough space is needed for a patient to move around freely, if possible space should be a quiet

Measures the level of a patient's disability and indicates how much assistance is needed for the individual to carry out activities of daily living

Purpose of PASS is to demonstrate independence, adequacy, and safety are rated on four-point scales.

Assesses upper limb functioning using observational methods. Focuses on grip, grasp and pinch motions of hand

After publication of article all outcomes will be open to others researches with an excel data sheet. Researchers can contact corresponding researcher with his contact mail and request data.

Patients' information and contact will be obtaioned from neurologist and willing participant's gender, age and stroke onset data will be processed with a random number generator. Patients will divide into two groups as intervention and control with a normal distrubution of gender, age and stroke onset.

Both group will recevie conventional stroke rehabilitation. Intervention group will receive a Oculus Rift+Leap motion tracking supported upper extremity activities and control group will receive a sham virtual reality on focusing visual scenes without interaction.
Outcomes will be recorded by physical therapist using SPSS and groups would not be specified with letter. Statistical analysis will be conducted by another researcher who does not aware of groups given numbers on SPSS.

Patients with discrepancy in stroke symptom onset based on the diagnosis of the first neurologist who evaluated the patient at emergency room and the next day after admission

Ischemic Stroke

Dong-Wha Kang

Certainty Of Stroke Symptom Onset Study

Observational Study on the Certainty of Stroke Symptom Onset

The onset time assessed at emergency departement by a neurologist will be compared to the onset time assessed next day after admission by a different neurologist.

The subjective uncertainty of the stroke symptom onset will be analyzed based on numerical scale from 1 to 5.
Factors influencing the uncertainty will be investigated. Demographic factors, risk factors, stroke subtype, symptoms of stroke will be compared between patients with different certainty to stroke symptom onset

Demographic factors, risk factors, stroke subtype, symptoms of stroke will be compared between patients with and without discrepancy on symptom onset of stroke diagnosed by two different neurologists

dysarthria/headache

The Effects Of Jaw Sensorimotor System In The Treatment Of Neck Pain And Dysfunction

A Controlled Comparison of Two DBS Targets for Upper Extremity Action Tremor

Effect of Immersive Virtual Reality Usage on Upper Extremity Function in Stroke Patients

Certainty Of Stroke Symptom Onset Study

科学に裏打ちされた最も完全な薬草データベース