RESUMEN
OBJECTIVE Subjective improvement of patients who have undergone surgery for intracranial arachnoid cysts has justified surgical treatment. The current study aimed to evaluate the outcome of surgical treatment for arachnoid cysts using standardized interviews and assessments of neuropsychological function and balance. The relationship between arachnoid cyst location, postoperative improvement, and arachnoid cyst volume was also examined. METHODS The authors performed a prospective, population-based study. One hundred nine patients underwent neurological, neuropsychological, and physiotherapeutic examinations. The arachnoid cysts were considered symptomatic in 75 patients, 53 of whom agreed to undergo surgery. In 32 patients, results of the differential diagnosis revealed that the symptoms were due to a different underlying condition and were unrelated to an arachnoid cyst. Neuropsychological testing included target reaction time, Grooved Pegboard, Rey Auditory Verbal Learning, Rey Osterrieth complex figure, and Stroop tests. Balance tests included the extended Falls Efficacy Scale, Romberg, and sharpened Romberg with open and closed eyes. The tests were repeated 5 months postoperatively. Cyst volume was pre- and postoperatively measured using OsiriX software. RESULTS Patients who underwent surgery did not have results on balance and neuropsychological tests that were different from patients who declined or had symptoms unrelated to the arachnoid cyst. Patients with a temporal arachnoid cyst performed within the normal range on the neuropsychological tests. Seventy-seven percent of the patients who underwent surgery reported improvement, yet there were no differences in test results before and after surgery. Arachnoid cysts in the temporal region and posterior fossa did not influence the preoperative results of neuropsychological and motor tests. The arachnoid cyst volume decreased postoperatively (p < 0.0001), but there was no relationship between volume reduction and clinical improvement. CONCLUSIONS The results of this study speak against objectively verifiable improvement following surgical treatment in adults with intracranial arachnoid cysts.
Asunto(s)
Quistes Aracnoideos/terapia , Adolescente , Adulto , Anciano , Quistes Aracnoideos/diagnóstico , Quistes Aracnoideos/psicología , Femenino , Estudios de Seguimiento , Humanos , Espectroscopía de Resonancia Magnética , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Medición de Resultados Informados por el Paciente , Equilibrio Postural , Estudios Prospectivos , Cráneo , Resultado del Tratamiento , Adulto JovenRESUMEN
Objective We tried to translate the English version of the Falls Efficacy Scale,Swedish version [FES (S)] into Chinese and test the reliability and validity of the Chinese version of FES (S) in patients after stroke.Methods Totally 145 patients after stroke were recruited and were investigated by the Chinese version of FES (S).The result underwent analysis of reliability and validity.Results The internal consistency coefficient of the Chinese version of FES (S) were 0.896.The Cronbach's α coefficient of two dimensions,which were Activity of Daily Living Ability and Instrumental Activity of Daily Living,were 0.863 and 0.872.The split half coefficient was 0.653,test-retest reliability was 0.743.The content validity index(CVI)was calculated according to related formulas,which was 0.896～1.000,the average CVI of all items was 0.925,CVI of each item was above 0.8.Factor analysis got two factors,which explained 40.852％ of the total variance.Except for item 5,other items showed factor loading ＞0.4 for its common factor.Conclusions The Chinese version of FES (S) has been proved to be reliable and valid.It can be used as a valid tool for assessing stroke patients with risk for falls and self-confidence.
RESUMEN
OBJECTIVES: To test the effects of a new motor imagery practice approach, in which motor and motivational contents were integrated in order to improve gait in subjects with chronic poststroke hemiparesis. DESIGN: A half-crossover study composed of 2 phases. In phase 1, subjects were randomly assigned to receive either the experimental or the control treatment. In phase 2, the subjects who had initially received the control treatment "crossed over" to receive the experimental intervention. SETTING: The experimental and the control intervention were delivered in the subjects' homes; assessments were performed in a hospital laboratory. PARTICIPANTS: Community-dwelling individuals (N=23) with chronic poststroke hemiparesis whose gait was impaired. INTERVENTIONS: The experimental intervention, called integrated motor imagery practice, consisted of imagery scripts aimed at improving home and community walking as well as fall-related self-efficacy. The control treatment consisted of executed exercises to improve the function of the involved upper extremity. MAIN OUTCOME MEASURES: In-home walking, indoor and outdoor community ambulation, and fall-related self-efficacy. These were assessed before and after the intervention as well as at a 2-week follow-up. RESULTS: In-home walking was significantly improved after application of the experimental intervention (P≤.003), but not after the control treatment (P≤.68). Community ambulation did not improve. Fall-related self-efficacy was slightly improved by the integrated motor imagery intervention; however, the findings were not unequivocal. CONCLUSIONS: Home delivery of integrated motor imagery practice was feasible and exerted a positive effect on walking in the home. However, it was ineffective for improving gait in public domains. We speculate that the addition of physical practice to imagery practice may be essential for achieving that end.