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Journal of Neuroengineering and... Jun 2024This pilot study aimed to investigate the effects of REX exoskeleton rehabilitation robot training on the balance and lower limb function in patients with sub-acute... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
This pilot study aimed to investigate the effects of REX exoskeleton rehabilitation robot training on the balance and lower limb function in patients with sub-acute stroke.
METHODS
This was a pilot, single-blind, randomized controlled trial. Twenty-four patients with sub-acute stroke (with the course of disease ranging from 3 weeks to 3 months) were randomized into two groups, including a robot group and a control group. Patients in control group received upright bed rehabilitation (n = 12) and those in robot group received exoskeleton rehabilitation robot training (n = 12). The frequency of training in both groups was once a day (60 min each) for 5 days a week for a total of 4 weeks. Besides, the two groups were evaluated before, 2 weeks after and 4 weeks after the intervention, respectively. The primary assessment index was the Berg Balance Scale (BBS), whereas the secondary assessment indexes included the Fugl-Meyer Lower Extremity Motor Function Scale (FMA-LE), the Posture Assessment Scale for Stroke Patients (PASS), the Activities of Daily Living Scale (Modified Barthel Index, MBI), the Tecnobody Balance Tester, and lower extremity muscle surface electromyography (sEMG).
RESULTS
The robot group showed significant improvements (P < 0.05) in the primary efficacy index BBS, as well as the secondary efficacy indexes PASS, FMA-LE, MBI, Tecnobody Balance Tester, and sEMG of the lower limb muscles. Besides, there were a significant differences in BBS, PASS, static eye-opening area or dynamic stability limit evaluation indexes between the robotic and control groups (P < 0.05).
CONCLUSIONS
This is the first study to investigate the effectiveness of the REX exoskeleton rehabilitation robot in the rehabilitation of patients with stroke. According to our results, the REX exoskeleton rehabilitation robot demonstrated superior potential efficacy in promoting the early recovery of balance and motor functions in patients with sub-acute stroke. Future large-scale randomized controlled studies and follow-up assessments are needed to validate the current findings.
CLINICAL TRIALS REGISTRATION
URL: https://www.chictr.org.cn/index.html.Unique identifier: ChiCTR2300068398.
Topics: Humans; Stroke Rehabilitation; Male; Pilot Projects; Female; Exoskeleton Device; Middle Aged; Lower Extremity; Postural Balance; Single-Blind Method; Robotics; Aged; Adult; Stroke; Electromyography; Treatment Outcome; Recovery of Function
PubMed: 38851703
DOI: 10.1186/s12984-024-01391-0 -
Medicine Jun 2024Fall occurrences and the associated risk of injury are debilitating and major health concerns in the older population. Several interventions have been investigated and... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
BACKGROUND
Fall occurrences and the associated risk of injury are debilitating and major health concerns in the older population. Several interventions have been investigated and implemented to address the needs of balance impairments and to reduce the increased risk of falls. This study aimed to compare the effectiveness of the Otago exercise program (OEP) and gaze stability exercises (GSE) on balance and the risk of falls in older adults residing at an old age home facility.
METHODS
Thirty elderly participants were equally and randomly divided into 2 groups: Group OEP received the OEP, and group GSE received GSE for 8 weeks (thrice a week). In addition, both groups also performed core muscle-strengthening exercises. The outcome measures were the Berg balance scale (BBS) and the Fall efficacy scale-International (FES-I).
RESULTS
The interventions resulted in significant improvements (P < .001) in both outcome measures in both groups. The mean pretest BBS scores of groups OEP and GSE increased from 40.4 and 39.2 to the mean post-test scores of 48 and 45.2, respectively. Similarly, the mean pretest FES-I scores of groups OEP and GSE also improved from 39.47 and 40.4 to the mean post-test scores of 32.73 and 36.07. The between-group comparison showed greater improvement (P < .05) in OEP group in both variables.
CONCLUSIONS
OEP and GSE were found to be beneficial rehabilitation programs in improving balance and fear of falls in healthy older adults. However, the OEP was found to be a more effective intervention and may allow better balance and fall prevention improvements.
TRIAL REGISTRATION
The study has been registered in clinicaltrials.gov (ID: NCT05781776; on 23/03/2023).
Topics: Humans; Accidental Falls; Postural Balance; Male; Female; Aged; Exercise Therapy; Fear; Aged, 80 and over
PubMed: 38847714
DOI: 10.1097/MD.0000000000038345 -
Frontiers in Neuroinformatics 2024The brain is a complex dynamic system whose current state is inextricably coupled to awareness of past, current, and anticipated future threats and opportunities that...
The brain is a complex dynamic system whose current state is inextricably coupled to awareness of past, current, and anticipated future threats and opportunities that continually affect awareness and behavioral goals and decisions. Brain activity is driven on multiple time scales by an ever-evolving flow of sensory, proprioceptive, and idiothetic experience. Neuroimaging experiments seek to isolate and focus on some aspect of these complex dynamics to better understand how human experience, cognition, behavior, and health are supported by brain activity. Here we consider an event-related data modeling approach that seeks to parse experience and behavior into a set of time-delimited events. We distinguish between themselves, that unfold through time, and that record the experiment timeline latencies of event onset, offset, and any other event phase transitions. Precise descriptions of experiment events (sensory, motor, or other) allow participant experience and behavior to be interpreted in the context either of the event itself or of all or any experiment events. We discuss how events in neuroimaging experiments have been, are currently, and should best be identified and represented with emphasis on the importance of modeling both events and event context for meaningful interpretation of relationships between brain dynamics, experience, and behavior. We show how text annotation of time series neuroimaging data using the system of Hierarchical Event Descriptors (HED; https://www.hedtags.org) can more adequately model the roles of both events and their ever-evolving context than current data annotation practice and can thereby facilitate data analysis, meta-analysis, and mega-analysis. Finally, we discuss ways in which the HED system must continue to expand to serve the evolving needs of neuroimaging research.
PubMed: 38846339
DOI: 10.3389/fninf.2024.1292667 -
Cureus May 2024Anterior cruciate ligament (ACL) tears represent common occurrences in sports, particularly posing significant risks to young athletes. The diagnostic methods for ACL...
Nonsurgical Rehabilitation Perspectives for a Type I Salter-Harris Fracture With Lipohemarthrosis and Concomitant Grade II Anterior Cruciate Ligament (ACL) Tear in a Volleyball Athlete: A Case Report.
Anterior cruciate ligament (ACL) tears represent common occurrences in sports, particularly posing significant risks to young athletes. The diagnostic methods for ACL injury include magnetic resonance imaging (MRI), arthroscopy, and physical examination. Management of this injury can be done both operative and nonoperatively. Pediatric growth plate fractures are classified under the Salter-Harris classification. A 13-year-old male athlete sustained a knee injury during a volleyball match. While landing from a jump after a smash, the athlete directly landed on the ground on his right knee. After this, he reported discomfort and severe anterior knee pain. Due to immobility and pain, he was taken to the emergency unit. Upon radiographic examination, a Salter-Harris Classification Type I fracture was found, indicating epiphyseal slip and separation through the physis of the right proximal tibia medially. An MRI imaging was done to check the integrity of the ACL after the swelling had subsided post-15 days of injury. An MRI identified a bony contusion on the medial tibial plateau, extending to the physeal plate with a Grade II ACL tear. The concurrent occurrence of ACL injury and growth plate injury presents a significant concern. Hence, a referral for physical therapy rehabilitation was given. Our findings highlight the importance of prompt initiation of physical rehabilitation following such injuries. Where non-surgical rehabilitation strategies play a crucial role in managing these cases while focusing on restoring knee stability, promoting healing of the growth plate, and facilitating a safe return to sport. Tailored rehabilitation, including therapeutic exercises, neuromuscular training, and proprioceptive training, is essential for optimizing outcomes and preventing long-term complications. The case underscores the importance of a multidisciplinary approach in managing the complex knee injury of this young athlete.
PubMed: 38846221
DOI: 10.7759/cureus.59758 -
ENeuro Jun 2024In measurement, a reference frame is needed to compare the measured object to something already known. This raises the neuroscientific question of which reference frame...
In measurement, a reference frame is needed to compare the measured object to something already known. This raises the neuroscientific question of which reference frame is used by humans when exploring the environment. Previous studies suggested that, in touch, the body employed as measuring tool also serves as reference frame. Indeed, an artificial modification of the perceived dimensions of the body changes the tactile perception of external object dimensions. However, it is unknown if such a change in tactile perception would occur when the body schema is modified through the illusion of owning a limb altered in size. Therefore, employing a virtual hand illusion paradigm with an elongated forearm of different lengths, we systematically tested the subjective perception of distance between two points [tactile distance perception (TDP) task] on the corresponding real forearm following the illusion. Thus, the TDP task is used as a proxy to gauge changes in the body schema. Embodiment of the virtual arm was found significantly greater after the synchronous visuotactile stimulation condition compared with the asynchronous one, and the forearm elongation significantly increased the TDP. However, we did not find any link between the visuotactile-induced ownership over the elongated arm and TDP variation, suggesting that vision plays the main role in the modification of the body schema. Additionally, significant effect of elongation found on TDP but not on proprioception suggests that these are affected differently by body schema modifications. These findings confirm the body schema malleability and its role as a reference frame in touch.
Topics: Humans; Female; Male; Virtual Reality; Touch Perception; Young Adult; Adult; Illusions; Distance Perception; Proprioception; Body Image; Forearm
PubMed: 38844346
DOI: 10.1523/ENEURO.0244-23.2024 -
Clinics (Sao Paulo, Brazil) 2024This study aimed to compare different Body Mass Index (BMI) categories, body composition parameters, postural balance, and functional mobility among female students at a...
INTRODUCTION
This study aimed to compare different Body Mass Index (BMI) categories, body composition parameters, postural balance, and functional mobility among female students at a College of Applied Medical Sciences; and examine the relationship between BMI and body composition with postural balance and functional mobility among female students at the college of applied medical sciences.
MATERIALS AND METHODS
Female students, aged 18‒25 years old. They were subdivided into four groups according to their BMI category: underweight, normal, overweight, or obese, with n = 20 participants in each group. A Bioelectrical Impedance Human Body Analyzer (BIA) was used to assess the following body composition parameters: Fat Percentage (FATP), fat mass, muscle mass, and Total Body Water (TBW). A NeuroCom Balance Master was used to assess postural balance and functional mobility. A Timed Up and Go (TUG) test was employed to assess functional mobility. All data were analyzed using SPSS.
RESULTS
Participants' ages and heights were matched (p > 0.05). However, there were variables that were statistically significantly higher in terms of weight, BMI and body composition, including FATP, fat mass, muscle mass, and TBW (p = 0.000), among the obese group. Moreover, postural balance was lower among the obese group. There was a significant relationship between BMI and body composition variables in respect of postural balance but not in relation to functional mobility.
CONCLUSION
Postural instability but not functional mobility was related to higher BMI and body composition values among the study groups.
Topics: Humans; Female; Postural Balance; Body Composition; Cross-Sectional Studies; Body Mass Index; Young Adult; Adult; Adolescent; Obesity; Students; Overweight; Thinness; Electric Impedance; Reference Values
PubMed: 38843678
DOI: 10.1016/j.clinsp.2024.100401 -
Journal of Sports Science & Medicine Jun 2024To determine how lateral shuffling/lateral shuffle (LS) -induced fatigue affects ankle proprioception and countermovement jump (CMJ) performance. Eighteen male college...
To determine how lateral shuffling/lateral shuffle (LS) -induced fatigue affects ankle proprioception and countermovement jump (CMJ) performance. Eighteen male college athletes performed 6 modes of a repeated LS protocol with 2 distances (2.5 and 5 m) and 3 speeds (1.6, 1.8, and 2.0 m/s). After LS, ankle inversion proprioception (AIP) was measured using the active movement extent discrimination apparatus (AMEDA). CMJ, blood lactate (BLa), heart rate (HR) and rating of perceived exertion (RPE) were measured before and after LS. The number of changes of direction (CODs) in each protocol was recorded. LS-induced fatigue was evident in BLa, HR and RPE (all p < 0.05), increasing with shorter shuffle distance and faster speed. RM-ANOVA showed a significant distance main effect on both AIP (p < 0.01) and CMJ (p < 0.05), but the speed main effect was only significant for CMJ (p ≤ 0.001), not AIP (p = 0.87). CMJ performance was correlated with BLa, HR and RPE (r values range from -0.62 to -0.32, all p ≤ 0.001). AIP was only correlated with CODs (r = -0.251, p < 0.01). These results suggested that in LS, shorter distance, regardless of speed, was associated with worse AIP, whereas subsequent CMJ performance was affected by both LS distance and speed. Hence, AIP performance was not related to physiological fatigue, but CMJ performance was. Results imply that LS affects processing proprioceptive input and producing muscular output differently, and that these two aspects of neuromuscular control are affected by physiological fatigue to varying degrees. These findings have implications for injury prevention and performance enhancement.
Topics: Humans; Male; Proprioception; Young Adult; Heart Rate; Muscle Fatigue; Ankle; Athletic Performance; Lactic Acid; Plyometric Exercise; Physical Exertion
PubMed: 38841636
DOI: 10.52082/jssm.2024.418 -
Frontiers in Veterinary Science 2024Intramedullary cord tumors present diagnostic and therapeutic challenges. Furthermore, spinal cord tumors can move across compartments, making antemortem diagnosis...
Case report: Magnetic resonance imaging features with postoperative improvement of atypical cervical glioma characterized by predominant extramedullary distribution in a dog.
INTRODUCTION
Intramedullary cord tumors present diagnostic and therapeutic challenges. Furthermore, spinal cord tumors can move across compartments, making antemortem diagnosis difficult, even with advanced imaging. This report presents a rare case of a cranial cervical spinal glioma, confirmed by surgical histopathology, with postoperative improvement in a dog.
CASE DESCRIPTION
A 9-year-old female Maltese dog presented with kyphotic posture, progressive left hemiparesis, and decreased appetite. Neurological examination revealed neck pain and decreased proprioception in the left limbs along with intact deep pain perception. Two days later, the patient developed non-ambulatory tetraparesis. Magnetic resonance imaging (MRI) revealed an ovoid, well-defined mass with homogeneously marked contrast enhancement in the second cervical spinal cord that severely compressed the spinal cord. This mass was heterogeneously hyperintense on T2-weighted images and iso-to-hypointense on T1-weighted images, showing an appearance resembling the "golf-tee" and "dural tail" signs. The MRI findings suggested an intradural extramedullary tumor. Intraoperatively, a well-demarcated mass which was locally adherent to the spinal meninges was removed. Both histopathological and genomic tumor tests were indicative of a glioma. Approximately 2 weeks postoperatively, the patient's neurological signs returned to normal.
CONCLUSION
This case report describes an atypical cervical glioma with complicated MR characteristics in a dog, where MRI helped guide surgical intervention.
PubMed: 38840642
DOI: 10.3389/fvets.2024.1400139 -
Aging Clinical and Experimental Research Jun 2024Conducted physically, supervised group-based falls prevention exercise programs have demonstrated effectiveness in reducing the risk of falls among older adults. In this... (Randomized Controlled Trial)
Randomized Controlled Trial
UNLABELLED
Conducted physically, supervised group-based falls prevention exercise programs have demonstrated effectiveness in reducing the risk of falls among older adults. In this study, we aimed to assess the acceptability, feasibility, and effectiveness of a virtual supervised group-based falls prevention exercise program (WE-SURF™) for community-dwelling older adults at risk of falls.
METHOD
A preliminary study utilizing virtual discussions was conducted to assess the acceptability of the program among six older adults. Effectiveness was evaluated in a randomized controlled feasibility study design, comprising 52 participants (mean age: 66.54; SD: 5.16), divided into experimental (n = 26) and control (n = 26) groups. The experimental group engaged in a 6-month WE-SURF™ program, while the control group received standard care along with a fall's prevention education session. Feasibility of the intervention was measured using attendance records, engagement rates from recorded videos, dropouts, attrition reasons, and adverse events.
RESULTS
Preliminary findings suggested that WE-SURF™ was acceptable, with further refinements. The study revealed significant intervention effects on timed up and go (TUG) (η2p:0.08; p < 0.05), single leg stance (SLS) (η2p:0.10; p < 0.05), and lower limb muscle strength (η2p:0.09; p < 0.05) tests. No adverse events occurred during the program sessions, and both attendance and engagement rates were high (> 80% and 8/10, respectively) with minimal dropouts (4%). The WE-SURF™ program demonstrated effectiveness in reducing the risk of falls while enhancing muscle strength and balance.
CONCLUSION
In conclusion, WE-SURF™ was demonstrated to be an acceptable, feasible, and effective virtual supervised group-based exercise program for fall prevention in community-dwelling older adults at risk of falls. With positive outcomes and favourable participant engagement, WE-SURF™ holds the potential for wider implementation. Further research and scaling-up efforts are recommended to explore its broader applicability. (Registration number: ACTRN 12621001620819).
Topics: Humans; Accidental Falls; Aged; Female; Male; Feasibility Studies; Exercise Therapy; Middle Aged; Postural Balance; Independent Living
PubMed: 38836944
DOI: 10.1007/s40520-024-02759-x