The Frequency Effect of the Motor Imagery Brain Computer Interface Training on Cortical Response in Healthy Subjects: A Randomized Clinical Trial of Functional Near-Infrared Spectroscopy Study.

Background: The motor imagery brain computer interface (MI-BCI) is now available in a commercial product for clinical rehabilitation. However, MI-BCI is still a relatively new technology for commercial rehabilitation application and there is limited prior work on the frequency effect. The MI-BCI has become a commercial product for clinical neurological rehabilitation, such as rehabilitation for upper limb motor dysfunction after stroke. However, the formulation of clinical rehabilitation programs for MI-BCI is lack of scientific and standardized guidance, especially limited prior work on the frequency effect. Therefore, this study aims at clarifying how frequency effects on MI-BCI training for the plasticity of the central nervous system. Methods: Sixteen young healthy subjects (aged 22.94 ± 3.86 years) were enrolled in this randomized clinical trial study. Subjects were randomly assigned to a high frequency group (HF group) and low frequency group (LF group). The HF group performed MI-BCI training once per day while the LF group performed once every other day. All subjects performed 10 sessions of MI-BCI training. functional near-infrared spectroscopy (fNIRS) measurement, Wolf Motor Function Test (WMFT) and brain computer interface (BCI) performance were assessed at baseline, mid-assessment (after completion of five BCI training sessions), and post-assessment (after completion of 10 BCI training sessions). Results: The results from the two-way ANOVA of beta values indicated that GROUP, TIME, and GROUP × TIME interaction of the right primary sensorimotor cortex had significant main effects [GROUP: F (1,14) = 7.251, P = 0.010; TIME: F (2,13) = 3.317, P = 0.046; GROUP × TIME: F (2,13) = 5.676, P = 0.007]. The degree of activation was affected by training frequency, evaluation time point and interaction. The activation of left primary sensory motor cortex was also affected by group (frequency) (P = 0.003). Moreover, the TIME variable was only significantly different in the HF group, in which the beta value of the mid-assessment was higher than that of both the baseline assessment (P = 0.027) and post-assessment (P = 0.001), respectively. Nevertheless, there was no significant difference in the results of WMFT between HF group and LF group. Conclusion: The major results showed that more cortical activation and better BCI performance were found in the HF group relative to the LF group. Moreover, the within-group results also showed more cortical activation after five sessions of BCI training and better BCI performance after 10 sessions in the HF group, but no similar effects were found in the LF group. This pilot study provided an essential reference for the formulation of clinical programs for MI-BCI training in improvement for upper limb dysfunction.

Synergistic Immediate Cortical Activation on Mirror Visual Feedback Combined With a Soft Robotic Bilateral Hand Rehabilitation System: A Functional Near Infrared Spectroscopy Study.

BACKGROUND: Mirror visual feedback (MVF) has been widely used in neurological rehabilitation. Due to the potential gain effect of the MVF combination therapy, the related mechanisms still need be further analyzed. METHODS: Our self-controlled study recruited 20 healthy subjects (age 22.150 ± 2.661 years) were asked to perform four different visual feedback tasks with simultaneous functional near infrared spectroscopy (fNIRS) monitoring. The right hand of the subjects was set as the active hand (performing active movement), and the left hand was set as the observation hand (static or performing passive movement under soft robotic bilateral hand rehabilitation system). The four VF tasks were designed as RVF Task (real visual feedback task), MVF task (mirror visual feedback task), BRM task (bilateral robotic movement task), and MVF + BRM task (Mirror visual feedback combined with bilateral robotic movement task). RESULTS: The beta value of the right pre-motor cortex (PMC) of MVF task was significantly higher than the RVF task (RVF task: -0.015 ± 0.029, MVF task: 0.011 ± 0.033, P = 0.033). The beta value right primary sensorimotor cortex (SM1) in MVF + BRM task was significantly higher than MVF task (MVF task: 0.006 ± 0.040, MVF + BRM task: 0.037 ± 0.036, P = 0.016). CONCLUSION: Our study used the synchronous fNIRS to compare the immediate hemodynamics cortical activation of four visual feedback tasks in healthy subjects. The results showed the synergistic gain effect on cortical activation from MVF combined with a soft robotic bilateral hand rehabilitation system for the first time, which could be used to guide the clinical application and the future studies.

A Study of Blended Learning Using the Smart Class Teaching Module on Psychosocial Dysfunction Course During the Training of Undergraduate Occupational Therapy Students in China.

BACKGROUND Online blended learning, also known as "smart classes", has benefits when compared with traditional teaching methods that use books and lectures. This study aimed to compare the use of the Smart Class teaching module with traditional teaching on the topic of psychosocial dysfunction during the training of undergraduate occupational therapy (OT) students in China. MATERIAL AND METHODS We recruited Grade 2017 OT students as the Smart Class teaching module group and Grade 2016 OT students as the Traditional Class teaching module group to participate in the study. The objective evaluation (assignment score, practical exam score, written exam score, and final score) and subjective evaluation (data from student questionnaires and information from interviews with the lead teacher and assistant teachers) were performed in both groups. RESULTS No significant difference was found in the final scores (P=0.874) and students' questionnaire results between the 2 groups. However, data from the student questionnaires and teacher interviews indicated a preference for combining the Smart Class teaching module and the Traditional Class teaching module. CONCLUSIONS The advantage of the Smart Class teaching module is that it can effectively integrate excellent teaching resources across geographical restrictions and it is conducive to promoting independent learning for students and all-around supervision for teaching. The Smart Class teaching module was comparable to traditional teaching methods for the training of undergraduate OT students in China, but was preferred by the students.

Motor Dual-Tasks for Gait Analysis and Evaluation in Post-Stroke Patients.

Eighteen stroke patients were recruited for this study involving the evaluation of cognition and walking ability and multitask gait analysis. Multitask gait analysis consisted of a single walking task (Task 0), a simple motor dual-task (water-holding, Task 1), and a complex motor dual-task (crossing obstacles, Task 2). The task of crossing obstacles was considered to be equivalent to the combination of a simple walking task and a complex motor task as it involved more nervous system, skeletal movement, and cognitive resources. To eliminate heterogeneity in the results of the gait analysis of the stroke patients, the dual-task gait cost values were calculated for various kinematic parameters. The major differences were observed in the proximal joint angles, especially in the angles of the trunk, pelvis, and hip joints, which were significantly larger in the dual motor tasks than in the single walking task. This research protocol aims to provide a basis for the clinical diagnosis of gait function and an in-depth study of motor control in stroke patients with motor control deficits through the analyses of dual-motor walking tasks.

The Smart Class Teaching Module for Rehabilitation Medicine English Education in China.

BACKGROUND Learning medical English is particularly challenging for non-native English-speaking medical students. The Smart Class teaching module is a new online teaching module for rehabilitation-related medical English, the efficacy of which has yet to be established in the literature. Gender differences should also not be ignored in our study, taking into account the proven performance differences between males and females in language learning. MATERIAL AND METHODS First-year physiotherapy students in Grade 2018 and Grade 2019 at Guangzhou Medical University were recruited to participate in this study. Grade 2019, as the experimental group, completed the Smart Class teaching module, while Grade 2018, as the control group, completed the Traditional Class teaching module. The efficacy of both modules was assessed objectively using the students' medical English exam scores and subjectively using the students' responses to a questionnaire. RESULTS In total, 242 questionnaires were distributed, and 210 valid questionnaires were returned, of which 119 were from the Smart Class teaching module group and 91 were from the Traditional Class teaching module group. There was no statistically significant difference between the medical English exam scores of the 2 groups (P=0.324). However, the subjective assessment revealed that the students experienced a significantly greater burden from the workload in the Smart Class teaching module group (P<0.001). CONCLUSIONS We found both the Smart Class teaching module and the Traditional Class teaching module achieved similar teaching outcomes. Therefore, the former represents a viable alternative teaching option for situations where traditional class teaching is not possible.

The change of synovial fluid proteome in rabbit surgery-induced model of knee osteoarthritis.

The aims of this study were to explore the change of synovial fluid (SF) proteome in a knee osteoarthritis (KOA) rabbit model, and to provide a new target for the treatment of knee osteoarthritis at the proteomic level. Sixteen New Zealand rabbits were randomly and equally divided into two groups. Group A rabbits were subjected to right anterior cruciate ligament transection (ACLT), while group B rabbits were subjected to sham ACLT. Six weeks later, the proteomes of knee joint SF from group A and B rabbits were analyzed using a label-free quantitative proteomic analysis method. We extracted 944 relevant items from GO BlastGO2 for the 23 proteins differentially expressed between the two groups. The final annotation results were 23 protein sequences annotated by 462 GO items. According to the KEGG gene database of rabbit protein sequences, as well as annotation of the KO numbers of homologous/similar proteins to the relevant 64 KEGG pathways, we extracted the sequences of 16 significantly differently expressed proteins among the relevant 64 KEGG messages/metabolism pathways. These included adiponectin, pyruvate kinase, bisphosphoglycerate mutase, HtpG/heat shock proteins, hemoglobin subunit alpha-1 2, VCP (CDC48), 14-3-3 protein beta/theta/zeta, and ferritin heavy chain, whose levels were decreased in group A. The other proteins were fibrinogen alpha/beta/gamma chain, carboxylesterase 2, paraoxonase/arylesterase 1, apolipoprotein A-I, immunoglobulin heavy chain, and transferrin, whose levels were increased in group B. The identified differentially expressed proteins indicate the change of SF proteomic expression in KOA and may provide protein targets for treating this condition.