CMIV Publications

Background Stroke now represents the condition with the highest need for physical rehabilitation worldwide, with only low or moderate-level evidence testing telerehabilitation compared to in-person care. We compared functional ambulation in subacute patients with stroke following telerehabilitation and matched in-person controls with no biopsychosocial differences at baseline.Methods We conducted a matched case-control study to compare functional ambulation between individuals with stroke following telerehabilitation and in-person rehabilitation, assessed using the Functional Ambulation Categories (FAC) and the Functional Independence Measure (TM) (FIM).Results The telerehabilitation group (n = 38) achieved significantly higher FAC gains (1.5 (1.3) vs 1.0 (1.0)) than the in-person rehabilitation group, with no differences in ambulation efficiency, in individuals: admitted to rehabilitation within 60 days after stroke onset; aged 49.8 (+/- 11.4) years at admission; 55.3% female sex; moderate stroke severity; 42.1% with 'good' motor FIM at baseline; mostly living with sentimental partner (73.7%); with 21.1% holding an university education degree.Conclusions The groups showed no significant differences in ambulation efficiency, though the telerehabilitation group achieved higher FAC gains. Our results suggest that home telerehabilitation can be considered a good alternative to in-person rehabilitation when addressing ambulation in patients with moderate stroke severity and whose home situation mostly includes a cohabiting partner.

BackgroundIn a population of light and heavy, nontreatment seeking drinkers, we recently showed that choice for alcohol versus a concurrently available snack reward was sensitive to the relative cost of alcohol. Here, we examined the neural substrates of alcohol choice using functional magnetic resonance imaging (MRI) in a new sample of light and heavy drinkers.MethodsParticipants were scanned during the Concurrent Alcohol Food Choice task, and collected points associated with the images of alcohol or snack rewards that they could redeem at the end of the experiment. As cost manipulation, point values were equal or varied so that they favored alcohol or the snack reward. Linear mixed-effects models were used for the analyses of behavioral and brain data.ResultsIn a replication of prior findings, alcohol choice was sensitive to the relative value of alcohol in both groups. Neural activations in, among others, orbitofrontal cortex and insula were associated to relative value during choice. In addition, we observed that choosing alcohol as opposed to snack engaged two separate sets of brain regions. We did not replicate our prior finding of increased choice preference for alcohol in heavy compared to light drinkers and found no between-group differences in brain activity.ConclusionsOverall, we replicated intact sensitivity to relative costs of alcohol in heavy drinkers and found its associated brain activity regions involved in value and salience attribution. Alcohol choice engaged regions involved in value-based behavior while snack preference elicited activity in areas linked to externally oriented attention. The failure to replicate the between-group differences may be due to the artificial MRI environment or observed differences in personality traits.