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Brazilian Journal of Physical Therapy 2023Individuals with Parkinson's disease present arm swing alterations that can adversely affect their locomotion. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Individuals with Parkinson's disease present arm swing alterations that can adversely affect their locomotion.
OBJECTIVE
To identify differences in arm swing asymmetry (ASA) between individuals with Parkinson's disease (PD) and healthy individuals and to investigate the relationship between ASA, temporal-spatial gait parameters, and disease progression.
METHODS
A literature search was conducted in PubMed, Scopus, ProQuest, Web of Science, and EBSCOhost up to February 2023. Cross-sectional studies evaluating parameters of arm swing (AS) and ASA were included. Methodological quality was assessed using the Critical Appraisal Checklist, and the quality of the evidence was measured with a modified Grading of Recommendations Assessment, Development, and Evaluation.
RESULTS
Fourteen studies were included in the systematic review (1130 participants). Irrespective of the medication phase (ON or OFF) and the type of walk test employed, the meta-analysis showed moderate-quality evidence that individuals with PD have increased ASA amplitude (SMD = 0.84; 95% CI: 0.69, 0.99; I²= 0%).Very low-quality evidence suggests higher ASA velocity (SMD=0.64; 95% CI: 0.24, 1.05; I²=59%) and lower AS amplitude on both the most affected (ES = -1.99, 95% CI: -3.04, -0.94, I: 91%) and the least affected sides (ES = -0.75, 95% CI: -1.05, -0.44; I²=66%). Meta-regression indicated that ASA is inversely related to disease duration (Z: -2.4892, P< 0.05) and motor symptoms progression (Z: -2.1336, P< 0.05).
CONCLUSIONS
Regardless of the medication phase and the type of walk test employed, individuals with PD exhibited greater ASA and decreased AS amplitude than healthy individuals. ASA decreases as the disease progresses and symptoms worsen.
Topics: Humans; Parkinson Disease; Walking; Arm; Cross-Sectional Studies; Biomechanical Phenomena; Gait
PubMed: 37980716
DOI: 10.1016/j.bjpt.2023.100559 -
Revue Medicale de Liege Feb 2023Affective instability is a common phenomenon in adults. It may be the expression of underlying organic or psychiatric conditions. This is a potentially disabling symptom...
Affective instability is a common phenomenon in adults. It may be the expression of underlying organic or psychiatric conditions. This is a potentially disabling symptom for the individual, which can cause psychological distress and even consequences in daily life functioning. This article is intended for any healthcare professional and aims to clarify the assessment and diagnostic approach to a patient with mood swings.
Topics: Adult; Humans; Mood Disorders; Affect
PubMed: 36799329
DOI: No ID Found -
Frontiers in Cellular Neuroscience 2021Bipolar disorder (BD) is a mood disorder that affects millions worldwide and is associated with severe mood swings between mania and depression. The mood stabilizers... (Review)
Review
Bipolar disorder (BD) is a mood disorder that affects millions worldwide and is associated with severe mood swings between mania and depression. The mood stabilizers valproate (VPA) and lithium (Li) are among the main drugs that are used to treat BD patients. However, these drugs are not effective for all patients and cause serious side effects. Therefore, better drugs are needed to treat BD patients. The main barrier to developing new drugs is the lack of knowledge about the therapeutic mechanism of currently available drugs. Several hypotheses have been proposed for the mechanism of action of mood stabilizers. However, it is still not known how they act to alleviate both mania and depression. The pathology of BD is characterized by mitochondrial dysfunction, oxidative stress, and abnormalities in calcium signaling. A deficiency in the unfolded protein response (UPR) pathway may be a shared mechanism that leads to these cellular dysfunctions. This is supported by reported abnormalities in the UPR pathway in lymphoblasts from BD patients. Additionally, studies have demonstrated that mood stabilizers alter the expression of several UPR target genes in mouse and human neuronal cells. In this review, we outline a new perspective wherein mood stabilizers exert their therapeutic mechanism by activating the UPR. Furthermore, we discuss UPR abnormalities in BD patients and suggest future research directions to resolve discrepancies in the literature.
PubMed: 34531727
DOI: 10.3389/fncel.2021.735622 -
Orthopaedic Surgery Sep 2022To determine whether unilateral chronic ankle instability (CAI) affects the kinematics of the uninjured contralateral ankle.
OBJECTIVE
To determine whether unilateral chronic ankle instability (CAI) affects the kinematics of the uninjured contralateral ankle.
METHODS
In this case-control study, 15 adult patients with unilateral CAI and 15 healthy controls were studied. Both the unstable and uninjured ankles in patients with unilateral CAI (CAI group, n = 15) were compared with that of healthy individuals (control group, n = 15). Applying body photo-reflective markers, the participant's motion during gait was measured. Biomechanical variables including overall ankle-toe angle, linear velocity, linear acceleration, angular velocity, angular acceleration, range of motion (RoM) in dorsiplantar flexion, and inversion-eversion at initial contact, loading response, mid-stance, terminal stance, pre-swing, and swing phase of the gait were measured.
RESULTS
In patients with CAI, the injured and uninjured ankles were significantly different regarding angle-toe angle, inversion-eversion RoM, dorsiplantar flexion in mid-stance, inversion-eversion at initial contact and terminal stance as well as the pre-swing and swing phases (p < 0.01). The uninjured ankles of patients showed lower ankle-toe velocity (p = 0.01) and acceleration (p = 0.01) compared to both the left and right ankles of the controls. In addition, the uninjured ankles of the patients showed decreased ankle dorsiflexion and increased inversion during initial contact, loading response, mid-stance, terminal stance, pre-swing, and swing compared to the control group (p < 0.017).
CONCLUSION
The results suggest that unilateral CAI can affect gait biomechanics in the contralateral uninjured ankle. Left unaddressed, unilateral CAI may lead to increased morbidity to the contralateral uninjured side. When surgery is not preferred for the management of unilateral CAI, rehabilitation protocols should focus on both sides.
Topics: Adult; Ankle; Ankle Joint; Biomechanical Phenomena; Case-Control Studies; Chronic Disease; Gait; Humans; Joint Instability
PubMed: 35852096
DOI: 10.1111/os.13307 -
Frontiers in Psychiatry 2022Psychiatric traits have been associated with intracerebral hemorrhage (ICH) in observational studies, although their causal relationships remain uncertain. We used...
BACKGROUND
Psychiatric traits have been associated with intracerebral hemorrhage (ICH) in observational studies, although their causal relationships remain uncertain. We used Mendelian randomization analyses to infer causality between psychiatric traits and ICH.
METHODS
We collected data from genome-wide association studies of ICH ( = 361,194) and eight psychiatric traits among Europeans, including mood swings ( = 451,619), major depressive disorder ( = 480,359), attention-deficit/hyperactivity disorder ( = 53,293), anxiety ( = 459,560), insomnia ( = 462,341), schizophrenia ( = 77,096), neuroticism ( = 374,323), and bipolar disorder ( = 51,710). We performed a series of bidirectional two-sample Mendelian randomization and related sensitivity analyses. A Bonferroni corrected threshold of < 0.00625 (0.05/8) was considered to be significant, and < 0.05 was considered suggestive of evidence for a potential association.
RESULTS
Mendelian randomization analyses revealed suggestive positive causality of mood swings on ICH (odds ratio = 1.006, 95% confidence interval = 1.001-1.012, = 0.046), and the result was consistent after sensitivity analysis. However, major depressive disorder ( = 0.415), attention-deficit/hyperactivity disorder ( = 0.456), anxiety ( = 0.664), insomnia ( = 0.699), schizophrenia ( = 0.799), neuroticism ( = 0.140), and bipolar disorder ( = 0.443) are not significantly associated with the incidence of ICH. In the reverse Mendelian randomization analyses, no causal effects of ICH on mood swings ( = 0.565), major depressive disorder ( = 0.630), attention-deficit/hyperactivity disorder ( = 0.346), anxiety ( = 0.266), insomnia ( = 0.102), schizophrenia ( = 0.463), neuroticism ( = 0.261), or bipolar disorder ( = 0.985) were found.
CONCLUSION
Our study revealed that mood swings are suggestively causal of ICH and increase the risk of ICH. These results suggest the clinical significance of controlling mood swings for ICH prevention.
PubMed: 36684013
DOI: 10.3389/fpsyt.2022.1049432 -
Frontiers in Bioengineering and... 2021Fall-induced injuries can stem from a disruption in the postural control system and place a financial burden on the healthcare system. Most gait research focused on...
Fall-induced injuries can stem from a disruption in the postural control system and place a financial burden on the healthcare system. Most gait research focused on lower extremities and neglected the contribution of arm swing, which have been shown to affect the movement of the center of mass when walking. This study evaluated the effect of arm swing on postural control and stability during regular and rocky surface walking. Fifteen healthy young adults (age = 23.4 ± 2.8) walked on these two surfaces with three arm motions (normal, held, and active) using the CAREN Extended-System (Motek Medical, Amsterdam, NL). Mean, standard deviation and maximal values of trunk linear and angular velocity were calculated in all three axes. Moreover, step length, time and width mean and coefficient of variation as well as margin of stability mean and standard deviation were calculated. Active arm swing increased trunk linear and angular velocity variability and peak values compared to normal and held arm conditions. Active arm swing also increased participants' step length and step time, as well as the variability of margin of stability. Similarly, rocky surface walking increased trunk kinematics variability and peak values compared to regular surface walking. Furthermore, rocky surface increased the average step width while reducing the average step time. Though this surface type increased the coefficient of variation of all spatiotemporal parameters, rocky surface also led to increased margin of stability mean and variation. The spatiotemporal adaptations showed the use of "cautious" gait to mitigate the destabilizing effects of both the active arm swing and rocky surface walking and, ultimately, maintain dynamic stability.
PubMed: 34926413
DOI: 10.3389/fbioe.2021.645581 -
Journal of Sports Science & Medicine Sep 2022In the last decades, indoor volleyball has experienced significant rule changes and a high player specialization in both sexes. Different spike attack arm swing...
In the last decades, indoor volleyball has experienced significant rule changes and a high player specialization in both sexes. Different spike attack arm swing techniques have developed which might affect performance and risk of injury. While a variety of arm swing techniques was already shown in world class beach volleyball players, it is unclear if this is also true for world class indoor volleyball. Therefore, the purpose of this study was to assess the spike attack arm swing techniques of Olympic volleyball winners and finalists (1984-2021) and to investigate possible differences between sex, playing position, scoring system, and compared to beach volleyball. Eighty-two male (M) and 85 female (F) players were assessed from video recordings from ten competitions. Five different arm swing techniques in the cocking phase (Straight, Bow-and-arrow high, Bow-and-arrow low, Snap, Circular) were classified by two experts. The most frequent technique for both sexes was the Circular (M = 40.2%; F = 38.8%), followed by Snap (M = 28.0%; F = 23.5%), Bow-and-arrow low (M = 20.7%; F = 21.2%), Bow-and-arrow high (M = 7.3% F = 11.8%), and Straight (M = 3.7%; F = 4.7%). Bow-and-arrow high and Straight techniques were significantly less used than other techniques in both sexes. There were no significant differences (p > 0.05) in arm swing techniques between sexes, playing positions, and scoring system but significant differences (p < 0.001) to beach volleyball. Although most volleyball textbooks only describe the Bow-and-arrow techniques, most of the world class indoor volleyball players used Circular and Snap arm swing techniques. Reasons for that could be the implicit knowledge of players (and coaches) regarding increased performance (ball speed) and injury prevention. Based on these results we suggest to critically revise arm swing technique training especially for young players and players with shoulder problems.
Topics: Arm; Female; Humans; Male; Shoulder; Video Recording; Volleyball
PubMed: 36157399
DOI: 10.52082/jssm.2022.465 -
Journal of Affective Disorders Jun 2024Mood swings is linked to a higher risk of cardiovascular diseases (CVDs). However, the causal relationships between them remain unknown.
BACKGROUND
Mood swings is linked to a higher risk of cardiovascular diseases (CVDs). However, the causal relationships between them remain unknown.
METHODS
We conducted this Mendelian randomization (MR) analysis to evaluate the causal associations between mood swings (n = 373,733) and 5 CVDs, including CAD, MI, HF, AF, and stroke using summary data of large-scale genome-wide association studies (GWAS). FinnGen datasets validated the results. Various MR approaches, sensitivity analyses, multivariable MR (MVMR), and two-step MR mediation analyses were applied.
RESULTS
The MR analysis revealed significant causal effects of mood swings on CAD (OR = 1.45, 95 % CI 1.24-1.71; P = 5.52e-6), MI (OR = 1.60, 95 % CI 1.32-1.95; P = 1.77e-6), HF (OR = 1.42, 95 % CI 1.18-1.71; P = 2.32e-4), and stroke (OR = 1.48, 95 % CI 1.19-1.83; P = 3.46e-4), excluding AF (P = 0.16). In the reverse MR analysis, no causal relationships were observed. The results were reproducible using FinnGen data. In the MVMR analysis, the causal effects of mood swings on CAD, MI, HF and stroke still remain significant after adjusting potential confounding factors including BMI, smoking and T2DM, but not for LDL and hypertension. Further mediation analysis indicated hypertension may mediate the causal pathways from mood swings to CAD (18.11 %, 95 % CI: 8.83 %-27.39 %), MI (16.40 %, 95 % CI: 7.93 %-24.87 %), HF (13.06 %, 95 % CI: 6.25 %-19.86 %), and stroke (18.04 %, 95 % CI: 8.73 %-27.34 %).
CONCLUSION
Mood swings has a significant causal impact on the development of CAD, MI, HF, and stroke, partly mediated by hypertension.
Topics: Humans; Cardiovascular Diseases; Mendelian Randomization Analysis; Genome-Wide Association Study; Hypertension; Stroke
PubMed: 38518854
DOI: 10.1016/j.jad.2024.03.076 -
Research Square Jun 2023Although most individuals recover from coronavirus disease 2019 (COVID-19) within a few weeks, some people continue to experience a wide range of symptoms known as...
BACKGROUND
Although most individuals recover from coronavirus disease 2019 (COVID-19) within a few weeks, some people continue to experience a wide range of symptoms known as post-acute sequelae of SARS-CoV-2 (PASC) or long COVID. Majority of patients with PASC develop neurological disorders like brain fog, fatigue, mood swings, sleep disorders, loss of smell and test among others collectively called neuro-PASC. While the people living with HIV (PWH) do not have a higher risk of developing severe disease and mortality/morbidity due to COVID-19. As a large section of PWH suffered from HIV-associated neurocognitive disorders (HAND), it is essential to understand the impact of neuro-PASC on people with HAND. In pursuit of this, we infected HIV/SARS-CoV-2 alone or together in primary human astrocytes and pericytes and performed proteomics to understand the impact of co-infection in the central nervous system.
METHODS
Primary human astrocytes and pericytes were infected with SARS-CoV-2 or HIV or HIV + SARS-CoV-2. The concentration of HIV and SARS-CoV-2 genomic RNA in the culture supernatant was quantified using reverse transcriptase quantitative real time polymerase chain reaction (RT-qPCR). This was followed by a quantitative proteomics analysis of mock, HIV, SARS-CoV-2, and HIV + SARS-CoV-2 infected astrocytes and pericytes to understand the impact of the virus in CNS cell types.
RESULTS
Both healthy and HIV-infected astrocytes and pericytes support abortive/low level of SARS-CoV-2 replication. In both mono-infected and co-infected cells, we observe a modest increase in the expression of SARS-CoV-2 host cell entry factors (ACE2, TMPRSS2, NRP1, and TRIM28) and inflammatory mediators (IL-6, TNF-α, IL-1β and IL-18). Quantitative proteomic analysis has identified uniquely regulated pathways in mock vs SARS-CoV-2, mock vs HIV + SARS-CoV-2, and HIV vs HIV + SARS-CoV-2 infected astrocytes and pericytes. The gene set enrichment analysis revealed that the top ten enriched pathways are linked to several neurodegenerative disorders, including Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis.
CONCLUSIONS
Our study emphasizes the significance of long-term monitoring of patients co-infected with HIV and SARS-CoV-2 to detect and understand the development of neurological abnormalities. By unraveling the molecular mechanisms involved, we can identify potential targets for future therapeutic interventions.
PubMed: 37398206
DOI: 10.21203/rs.3.rs-3031591/v1