An??lisi i tractament d'un problema de lectura en un subjecte amb lesi?? cerebral. 'An??lisis y tratamiento de un problema de lectura en un sujeto con lesi??n cerebral'

Las dificultades para la lectura han recibido gran atenci??n en los ??ltimos a??os, especialmente la dislexia. Se establece una relaci??n en el art??culo entre las bases filos??ficas de una ciencia y sus aplicaciones. Se relata el tratamiento seguido, a partir del an??lisis conductual, y la contrastaci??n de hip??tesis desde la filosof??a del an??lisis conductual. Finalmente se concluye que el tratamiento no acaba al resolver el problema que imped??a iniciar el aprendizaje sino que se debe trabajar la comprensi??n lectora.

Tartamudez neurog??nica : un estudio

La publicaci??n recoge resumen en Ingl??s. El documento es una traducci??n de Ana Isabel Codesido Garc??a de la Facultad de Filolog??a de la Universidad de Santiago de Compostela

Evaluaci??n neuropsicol??gica del ni??o

Se plantea la elaboraci??n de una bater??a de evaluaci??n neuropsicol??gica destinada a la detecci??n de ni??os con problemas de aprendizaje o con lesi??n cerebral. Configurar el perfil neuropsicol??gico de los ni??os y, por tanto, analizar sus d??ficits y capacidades en las habilidades medidas, as?? como caracterizar subtipos neuropsicol??gicos diferenciados, para orientar la intervenci??n en los procesos en los que se muestren deficitarios. Este esquema permite realizar una apreciaci??n de conjunto de los puntos d??biles y fuertes del ni??o examinado, plantear estrategias de intervenci??n adecuadas y esquematizar las dimensiones. Tambi??n resulta ??til para organizar los datos e investigaci??n cl??nica con grupos de las diferentes patolog??as.

La problem??tica de la reeducaci??n del habla y del lenguaje en el paral??tico cerebral

Dar a conocer la problem??tica de la logopedia en el paral??tico cerebral, poco conocida en Espa??a, y observar las ventajas y desventajas de dos m??todos de reeducaci??n muy diferentes: el m??todo Bobath y el m??todo Tardieu, despu??s de experimentarlos. Reeducaci??n del habla y del lenguaje en el paral??tico cerebral. Realiza una descripci??n, basada en bibliograf??a y en la experiencia profesional en el campo, donde expone la problem??tica del habla y del lenguaje en el paral??tico cerebral y su reeducaci??n. Desarrolla ampliamente dos metodolog??as de reeducaci??n: Tardieu y Bobath y realiza un an??lisis comparativo de ellas, y una cr??tica, en diez aspectos relacionados con la alimentaci??n, el habla y el lenguaje. Bibliograf??a y experiencia profesional en el campo de la reeducaci??n. La par??lisis cerebral implica una lesi??n en el enc??falo. No es hereditaria e interfiere las capacidades motrices normales de donde se derivan los trastornos del habla y del lenguaje. La reeducaci??n de estos trastornos, junto al d??ficit mot??rico ha de realizarse de com??n acuerdo entre el fisioterapeuta y el logopeda. El m??todo Tardieu se basa en una rehabilitaci??n y reeducaci??n anal??tica a partir del estudio de diversos apartados y factores diferenciados entre s??, mientras que el Bobath se basa en una rehabilitaci??n y reeducaci??n global, a partir del estudio de niveles relacionados siempre entre s??. La ventaja de Bobath est?? en que tiene en cuenta la relaci??n entre el control motriz y la reeducaci??n del habla y del lenguaje, mientras que Tardieu tiene unos ejercicios pr??cticos que Bobath no considera.

Cessació de l'hàbit tabàquic en pacients afectats de malaltia vascular cerebral aguda

S'han estudiat 1003 pacients amb el diagnòstic de Malaltia Vascular Cerebral (MVC) aguda ingressats a la unitat de neurologia de l'Hospital Josep Trueta de Girona en el període de gener de 2005 a juliol de 2007. S'ha realitzat un estudi de cohorts prospectiu d'un any en 110 pacients que eren fumadors en el moment de l'ictus. Un elevat percentatge dels pacients afectats de MVC aguda presenten factors de risc vascular que es poden evitar com el consum de tabac o d'alcohol, i factors de risc vascular que cal controlar com la hipertensió, la dislipèmia, la diabetis o la cardiopatia. Només 4 de cada 10 pacients fumadors diagnosticats d'ictus havien abandonat l'hàbit un any després de presentar la MVC aguda. Les variables que millor prediuen la cessació tabàquica en aquests pacients són la localització de la lesió a l'ínsula cerebral i la intenció de deixar de fumar prèvia a l'ictus.

Intraaortic balloon pump counterpulsation and cerebral autoregulation : an observational study

The use of Intra-aortic counterpulsation is a well established supportive therapy for patients in cardiac failure or after cardiac surgery. Blood pressure variations induced by counterpulsation are transmitted to the cerebral arteries, challenging cerebral autoregulatory mechanisms in order to maintain a stable cerebral blood flow. This study aims to assess the effects on cerebral autoregulation and variability of cerebral blood flow due to intra-aortic balloon pump and inflation ratio weaning.

Cold-water immersion decreases cerebral oxygenation but improves recovery after intermittent-sprint exercise in the heat

This study examined the effects of post-exercise cooling on recovery of neuromuscular, physiological, and cerebral hemodynamic responses after intermittent-sprint exercise in the heat. Nine participants underwent three post-exercise recovery trials, including a control (CONT), mixed-method cooling (MIX), and cold-water immersion (10 °C; CWI). Voluntary force and activation were assessed simultaneously with cerebral oxygenation (near-infrared spectroscopy) pre- and post-exercise, post-intervention, and 1-h and 24-h post-exercise. Measures of heart rate, core temperature, skin temperature, muscle damage, and inflammation were also collected. Both cooling interventions reduced heart rate, core, and skin temperature post-intervention (P < 0.05). CWI hastened the recovery of voluntary force by 12.7 ± 11.7% (mean ± SD) and 16.3 ± 10.5% 1-h post-exercise compared to MIX and CONT, respectively (P < 0.01). Voluntary force remained elevated by 16.1 ± 20.5% 24-h post-exercise after CWI compared to CONT (P < 0.05). Central activation was increased post-intervention and 1-h post-exercise with CWI compared to CONT (P < 0.05), without differences between conditions 24-h post-exercise (P > 0.05). CWI reduced cerebral oxygenation compared to MIX and CONT post-intervention (P < 0.01). Furthermore, cooling interventions reduced cortisol 1-h post-exercise (P < 0.01), although only CWI blunted creatine kinase 24-h post-exercise compared to CONT (P < 0.05). Accordingly, improvements in neuromuscular recovery after post-exercise cooling appear to be disassociated with cerebral oxygenation, rather reflecting reductions in thermoregulatory demands to sustain force production.

Cerebral cortex activation mapping upon electrical muscle stimulation by 32-channel time-domain functional near-infrared spectroscopy

The application of different EMS current thresholds on muscle activates not only the muscle but also peripheral sensory axons that send proprioceptive and pain signals to the cerebral cortex. A 32-channel time-domain fNIRS instrument was employed to map regional cortical activities under varied EMS current intensities applied on the right wrist extensor muscle. Eight healthy volunteers underwent four EMS at different current thresholds based on their individual maximal tolerated intensity (MTI), i.e., 10 % < 50 % < 100 % < over 100 % MTI. Time courses of the absolute oxygenated and deoxygenated hemoglobin concentrations primarily over the bilateral sensorimotor cortical (SMC) regions were extrapolated, and cortical activation maps were determined by general linear model using the NIRS-SPM software. The stimulation-induced wrist extension paradigm significantly increased activation of the contralateral SMC region according to the EMS intensities, while the ipsilateral SMC region showed no significant changes. This could be due in part to a nociceptive response to the higher EMS current intensities and result also from increased sensorimotor integration in these cortical regions.

Validity of accelerometry in ambulatory children and adolescents with cerebral palsy

To evaluate the validity of the ActiGraph accelerometer for the measurement of physical activity intensity in children and adolescents with cerebral palsy (CP) using oxygen uptake (VO 2) as the criterion measure. Thirty children and adolescents with CP (mean age 12.6 ± 2.0 years) wore an ActiGraph 7164 and a Cosmed K4b 2 portable indirect calorimeter during four activities; quiet sitting, comfortable paced walking, brisk paced walking and fast paced walking. VO 2 was converted to METs and activity energy expenditure and classiWed as sedentary, light or moderate-to-vigorous intensity according to the conventions for children. Mean ActiGraph counts min -1 were classiWed as sedentary, light or moderate-to-vigorous (MVPA) intensity using four diVerent sets of cut-points. VO 2 and counts min¡1 increased signiWcantly with increases in walking speed (P < 0.001). Receiver operating characteristic (ROC) curve analysis indicated that, of the four sets of cut-points evaluated, the Evenson et al. (J Sports Sci 26(14):1557-1565, 2008) cut-points had the highest classiWcation accuracy for sedentary (92%) and MVPA (91%), as well as the second highest classiWcation accuracy for light intensity physical activity (67%). A ROC curve analysis of data from our participants yielded a CP-speciWc cut-point for MVPA that was lower than the Evenson cut-point (2,012 vs. 2,296 counts min¡1), however, the diVerence in classiWcation accuracy was not statistically signiWcant 94% (95% CI = 88.2-97.7%) vs. 91% (95% CI = 83.5-96.5%). In conclusion, among children and adolescents with CP, the ActiGraph is able to diVerentiate between diVerent intensities of walking. The use of the Evenson cut-points will permit the estimation of time spent in MVPA and allows comparisons to be made between activity measured in typically developing adolescents and adolescents with CP. © 2011 Springer-Verlag.