Janis J. Daly, PhD, MS, Director, Cognitive and Motor Learning Laboratory; Associate Director, FES Center of Excellence, Louis Stokes Cleveland Department of Veterans Affairs Medical Center; Research Career Scientist, DVA, Washington, DC; Associate Professor, Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.

For those with persistent gait and upper limb deficits after stroke, it is difficult to obtain recovery of motor control and functional capability in response to standard care methods. Functional electrical stimulation (FES) is a promising intervention. Surface FES for wrist and hand muscles can result in improved impairment sufficient to produce important gains in functional capability. In addition, an FES gait training system with multiple channels and implanted electrodes has shown a statistically significant additive advantage for the recovery of coordinated gait components versus a comparable comprehensive gait training treatment without FES. Results were sufficiently robust to show important gains in quality of life.
Key words: stroke, functional electrical stimulation, neuromuscular electrical stimulation, functional neuromuscular stimulation, functional recovery, rehabilitation.

Angela K. Troyer, PhD, CPsych, Department of Psychology, Baycrest Centre for Geriatric Care, Toronto, ON.
Kelly J. Murphy, PhD, CPsych, Department of Psychology, Baycrest Centre for Geriatric Care, Toronto, ON.

Functional decline in dementia causes increased dependence on others and negatively impacts quality of life. Emerging evidence indicates that functional debility can be delayed or minimized by promoting an active lifestyle and using memory strategies. Older adults with active lifestyles maintain higher cognitive abilities and have reduced risks of developing dementia. Furthermore, individuals with dementia show improved cognitive and functional abilities following participation in physically and mentally stimulating activities. Memory strategy application can improve situation-specific memory performance in individuals with mild cognitive impairment and dementia, and has been shown to positively impact perceptions of well-being and functional ability in these individuals.
Key words: active lifestyle, dementia, memory intervention, mild cognitive impairment, rehabilitation.

Jerome D. Schein, PhD, Professor Emeritus, New York University, New York, NY, USA; Adjunct Professor, University of Alberta, Edmonton, AB.
Maurice H. Miller, PhD, Department of Speech-Language Pathology & Audiology Steinhardt School of Education, New York University, New York, NY, USA.

For persons whose hearing does not return in 60–90 days following idiopathic sudden sensorineural hearing loss (ISSNHL), audiologic rehabilitation should be provided. This article describes aspects of audiologic rehabilitation, including counselling, information about lifestyle changes, and techniques (such as amplification) for overcoming the communication handicap ISSNHL imposes. Advantages and limitations of various hearing aids are presented.
Key words: audiology, counselling, hearing aids, otology, rehabilitation, sensorineural, hearing loss.

Maurice H. Miller, PhD, Department of Speech-Language Pathology & Audiology/Steinhardt School of Education, New York University, New York, NY, USA.
Jerome D. Schein, PhD, Professor Emeritus, New York University, New York, NY, USA; Adjunct Professor, University of Alberta, Edmonton, AB.

Hearing loss that occurs instantaneously or over a period of a few days without immediately apparent cause is called Idiopathic Sudden Sensorineural Hearing Loss (ISSNHL). In part 1 of this series, the diagnosis and initial treatment of this condition are described in relation to most patients’ demands for active and aggressive intervention. Part 2 (to follow in the next issue) will address rehabilitation.
Key words: audiology, deafness, diagnosis, hearing aids, idiopathic, otology, rehabilitation, unilateral and bilateral hearing loss, sensorineural.

K.H.O. Deane, BSc, PhD and C.E. Clarke, BSc, MD, FRCP, Department of Neurosciences, The University of Birmingham and City Hospital, Birmingham, UK.

Many clinicians, therapists and patients support the use of rehabilitation in the treatment of Parkinson's disease. However, systematic reviews reveal a lack of conclusive evidence to support the use of common forms of rehabilitation therapy in this movement disorder. Lack of evidence of efficacy is not proof of lack of effect. Large pragmatic randomized controlled trials are required to determine the effectiveness and safety of rehabilitation therapies for people with Parkinson's disease.
Key words: Parkinson's disease, occupational therapy, physiotherapy, speech therapy, rehabilitation.

Doron Milstein, PhD, Hofstra University, Long Island, NY, USA.
Barbara E. Weinstein, PhD, Graduate School and University Center, CUNY, New York, NY, USA.

Hearing loss diminishes quality of life. The elderly rely on auditory input to maintain social contact and awareness of their environment, such that hearing loss in this age group can lead to isolation and withdrawal from the community. Most elderly individuals do not take advantage of available audiological services nor do they use hearing aids (HAs), the treatment of choice for their hearing loss. Modern HAs utilise digital technology and computer software to improve speech intelligibility. Current research reveals that HAs are effective in minimising the negative consequences of hearing loss in the daily functioning of the elderly. The availability of sophisticated technology allows for more efficient HA fitting, and allows the audiologist to spend more time counseling.
Key words: presbycusis, hearing aid technologies, rehabilitation, assistive listening devices.

Robert W Teasell, MD, FRCPC, Professor and Chair-Chief, Department of Physical Medicine & Rehabilitation, St Joseph's Health Care, London, University of Western Ontario, London, ON.

Timothy J Doherty, MD, PhD, FRCPC, Assistant Professor, Department of Physical Medicine and Rehabilitation, The University of Western Ontario, London, ON.

Defining Stroke Rehabilitation
Rehabilitation has been defined as an active process by which those disabled by injury or disease can realize their optimal physical, mental and social potential with integration into the most appropriate discharge environment. Comprehensive stroke rehabilitation programs are staffed by a full range of rehabilitation professionals--nurses, physical and occupational therapists, speech-language pathologists, psychologists, social workers, recreational therapists and physicians. An interdisciplinary team skilled in the care of stroke patients provides a comprehensive rehabilitation program for each patient. Brandstater and Basmajian,¹ and Roth et al.

Gail A. Eskes, PhD
Department of Psychology,
Queen Elizabeth II Health Sciences Centre Assistant Professor,
Psychiatry and Medicine (Neurology),
Adjunct Professor, Psychology,
Dalhousie University, Halifax, NS.

Beverly C. Butler, BSc
Department of Psychology,
Dalhousie University, Halifax, NS.

Introduction
Unilateral neglect is a cognitive and behavioural syndrome after brain damage that can have serious consequences for patient recovery, rehabilitation success and long-term reintegration to independent living. Outcome studies commonly identify neglect and related sequelae as significant predictors of poor outcome in stroke patients in terms of increased need for assistance in self-care activities and decreased quality of life.

Definition and Clinical Presentation
Unilateral neglect is most commonly defined as a failure to orient, report or respond to stimuli located in the space or body contralateral to a brain lesion (often due to stroke or brain injury), despite adequate sensorimotor ability to do so.¹ The neglect syndrome is fundamentally different from, although sometimes confused with, hemianopia, hemisensory loss or hemiplegia.