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Budhdeo, S.

Publications and source records attributed to Budhdeo, S..

2 recordsLinked to original sources
bioRxiv2019

Physiotherapist confidence level in mobilising stroke patients after decompressive hemicraniectomy: are helmets useful?

IntroductionDecompressive hemicraniectomy is a lifesaving measure in malignant middle cerebral artery infarction; however, this leaves patients with a skull defect. There is variability of helmet use in this patient group across Britain. We aimed to examine whether (1) specialist physiotherapist were more confident mobilising a patient with hemiparesis and skull defect than a non-specialist physiotherapist (2) non-specialist and specialist physiotherapists would be more comfortable mobilising this patient with a helmet as opposed to without a helmet.\n\nMethodsWe carried out a cross-sectional online survey of specialist physiotherapists and non-specialist physiotherapists in Britain. Recruitment was through mailing lists. Physiotherapists were asked to rank their confidence level on a 5-point Likert scale of mobilising an example patient with and without a helmet. They were also asked about the number of additional therapists needed to safely mobilise the patient.\n\nFindings96 physiotherapists completed the survey; 44 were specialists and 52 were non-specialists. Specialist physiotherapists felt more comfortable mobilising patients (mean difference = 0.68, p < 0.001). Non-specialist physiotherapists felt significantly more comfortable mobilising patients with a helmet (mean difference = 0.96, p value < 0.001), as did specialist physiotherapists (mean difference = 0.68, p value < 0.001). There was no difference in confidence level arising from helmet use between the two groups (p = 0.72).\n\nConclusionsUse of helmets may allow specialist and non-specialist physiotherapists to feel more comfortable when mobilising stroke patients post-decompressive hemicraniectomy. Consideration should be made by hospitals and health systems for the provision of helmets this patient group, to maximise functional gains.

neuroscience↗
bioRxiv2019

Effects of healthy ageing on activation pattern within the brain during movement and motor imagery: an fMRI study.

IntroductionMotor imagery (MI) has potential as an intervention to improve performance in neurological disease affecting the motor system and to modulate brain computer interfaces (BCI). We hypothesized that the shared networks of MI and executed movement (EM) would be affected by age. Understanding these changes is important in application of MI in neurological disorders.\n\nMethodsUsing tensor-independent component analysis (TICA), we mapped the neural networks involved during MI and EM in 31 healthy volunteers (ages 20-72), who were recruited and screened for their ability to perform imagery. We used an fMRI block-design with MI & rest and EM & rest.\n\nResultsTICA defined 37 independent components (ICs). Eight remained after excluding ICs representing artifacts. These ICs accounted for 35% of variance. While all ICs had greater activation in EM than MI. Two ICs increased with greater age for EM only. These ICs contained a bilateral network of brain areas, including primary motor cortex and cerebellum.\n\nConclusionThis study demonstrates the prominence of shared cerebral networks between MI and EM. There are age-dependent changes to EM activation, while MI activation appeared age independent. This strengthens the rationale for using MI to access the motor networks independent of age.

neuroscience↗