Influence of Impaired Upper Extremity Motor Function on Static Balance in People with Chronic Stroke.

BACKGROUND: Stroke is a leading cause of disability, especially due to an increased fall risk and postural instability. The objective of this study was to analyze the impact of motor impairment in the hemiparetic UE on static balance in standing, in subject with chronic stroke. METHODS: Seventy adults with chronic stroke, capable of independent standing and walking, participated in this cross-sectional study. The exclusion criteria included vestibular, cerebellar, or posterior cord lesions. The participants were classified based on their UE impairment using the Fugl-Meyer Assessment of Motor Recovery after Stroke (FMA-UE). A posturographic evaluation (mCTSIB) was performed in the standing position to analyze the center of pressure (COP) displacement in the mediolateral (ML) and anteroposterior (AP) axes and its mean speed with eyes open (OE) and closed (EC) on stable and unstable surfaces. RESULTS: A strong and significant correlation (r = -0.53; p < 0.001) was observed between the mediolateral (ML) center of pressure (COP) oscillation and the FMA-UE, which was particularly strong with eyes closed [r(EO) = 0.5; r(EC) = 0.54]. The results of the multiple linear regression analysis indicated that the ML oscillation is influenced significantly by the FMA-Motor, and specifically by the sections on UE, wrist, coordination/speed, and sensation. CONCLUSIONS: The hemiparetic UE motor capacity is strongly related to the ML COP oscillation during standing in individuals with chronic stroke, with a lower motor capacity associated with a greater instability. Understanding these relationships underpins the interventions to improve balance and reduce falls in people who have had a stroke.

Effects of the powerball® system on muscle strength, coordination, fatigue, functionality and quality of life in people with multiple sclerosis. A randomized clinical trial.

INTRODUCTION: Although clinical and functional impairments in the lower limbs have been extensively studied in patients with MS, the upper limb (UL) are also frequently affected. Clinical impairment of the UL in patients with MS is very common with muscle strength and hand dexterity as critical factors in maintaining functional activities that are the basis for independence and quality of life in people with MS. OBJECTIVE: To investigate the effects of a training protocol using the Powerball® system in combination with conventional physiotherapy on muscle strength, coordination, fatigue, functionality, and quality of life in persons with MS over an 8-week period. MATERIALS AND METHODS: A double-blind randomized controlled trial was conducted. The control group received conventional treatment, while the experimental group received additional UL training using the Powerball® system. Both groups received the same number of sessions and weeks of intervention. The following outcome measures were used: isometric grip and pinch strength, Box and Block Test (BBT), Nine Hole Peg Test (NHPT), Abilhand scale, Fatigue Severity Scale (FSS), Multiple Sclerosis Impact Scale (MSIS-29), and Likert satisfaction questionnaire for the experimental group. All measures were administered at baseline, after the treatment, and during a 3-week follow-up period. RESULTS: 25 patients completed the study (12 in the experimental and 13 in the control group). The experimental group showed significant improvements in coordination and manual dexterity of the more affected UL as measured by the BBT comparing pre- to post-treatment (p = 0.048) and pre-treatment to follow-up (p = 0.001), and on the less affected UP comparing pre-treatment to follow-up (p < 0.001) and post-treatment to follow-up (p = 0.034). The Likert-type satisfaction questionnaire obtained a mean score of 89.10 (± 8.54) out of 100 points. CONCLUSIONS: Upper limb treatment protocol using the Powerball® system, in combination with conventional physiotherapy for 8 weeks resulted in significant improvements in the intra-group analysis for UL coordination and manual dexterity in favor of the experimental group. The experimental group showed excellent satisfaction to the treatment.

Modularity Implications of an Overground Exoskeleton on Plantar Pressures, Strength, and Spasticity in Persons with Acquired Brain Injury.

This study explored the effects of a modular overground exoskeleton on plantar pressure distribution in healthy individuals and individuals with Acquired Brain Injury (ABI). The research involved 21 participants, including ABI patients and healthy controls, who used a unique exoskeleton with adaptable modular configurations. The primary objective was to assess how these configurations, along with factors such as muscle strength and spasticity, influenced plantar pressure distribution. The results revealed significant differences in plantar pressures among participants, strongly influenced by the exoskeleton's modularity. Notably, significant distinctions were found between ABI patients and healthy individuals. Configurations with two modules led to increased pressure in the heel and central metatarsus regions, whereas configurations with four modules exhibited higher pressures in the metatarsus and hallux regions. Future research should focus on refining and customizing rehabilitation technologies to meet the diverse needs of ABI patients, enhancing their potential for functional recovery.

Transcranial Direct Current Stimulation in the Treatment of Gait Disturbance in Post-Stroke Patients: An Overview of Systematic Reviews.

INTRODUCTION: Transcranial direct current stimulation (tDCS) is a promising technique for brain modulation after a cerebrovascular accident (CVA). This treatment modality has been previously studied in the recovery of patients. The aim of this review is to analyse the evidence for the application of tDCS in the recovery of gait disturbance in stroke patients. METHODS: This review was conducted according to the recommendations of the PRISMA statement. Three different electronic databases were searched for relevant results: PubMed, Scopus, and Cochrane, from 2015 to January 2022. We included reviews and meta-analyses that only considered randomised controlled trials (RCTs) that investigated the effects of transcranial direct current stimulation, in combination or not with other physiotherapy treatments, compared to no treatment, usual care, or alternative treatment on gait recovery. Our primary outcomes of interest were walking speed, mobility, and endurance; secondary outcomes included motor function. RESULTS: Thirteen studies with a total of 195 RCTs were included. Data on population, outcome measures, protocols, and outcomes were extracted. The Amstar-2 scale and the GRADE system of certainty of evidence were used. Only one study received high certainty of evidence, 5 received low certainty of evidence, and 7 received critically low certainty of evidence. Moderate to low-quality evidence showed a beneficial effect of tDCS on gait parameters, but not significantly. CONCLUSIONS: Although the tDCS produces positive changes in gait recovery in spatio-temporal parameters such as mobility, endurance, strength, and motor function, there is insufficient evidence to recommend this treatment. Higher-quality studies with larger sample sizes are needed for stronger conclusions.

The efficacy of transcranial direct current stimulation on upper extremity motor function after stroke: A systematic review and comparative meta-analysis of different stimulation polarities.

BACKGROUND: The efficacy of transcranial direct current stimulation (tDCS) has been studied extensively. The cathodic (c-tDCS), anodic (a-tDCS), and bihemispheric stimulation have demonstrated efficacy in the management of the paretic upper extremity (UE) after stroke, but it has not been determined which stimulation polarity has, so far, shown the best results. OBJECTIVE: To evaluate the available evidence to determine which tDCS polarity has the best results in improving UE motor function after stroke. METHODS: PubMed, PEDro, Web of Science, EMBASE, and SCOPUS databases were searched. Different Medical Subject Headings (MeSH) terms were combined for the search strategy, to cover all studies that performed a comparison between different tDCS configurations focused on UE motor rehabilitation in people with lived experience of stroke. RESULTS: Fifteen studies remained for qualitative analysis and 12 for quantitative analysis. Non-significant differences with a 95% confidence interval (CI) were obtained for c-tDCS versus a-tDCS (g = 0.10, 95% CI = -0.13; 0.33, p = .39, N = 292), for a-tDCS versus bihemispheric (g = 0.02, 95% CI = -0.46; 0.42, p = .93, N = 81), and for c-tDCS versus bihemispheric (g = 0.09, 95% CI = -0.84; .66, p = .73, N = 100). No significant differences between the subgroups of the meta-analysis were found. CONCLUSIONS: The results of the present meta-analysis showed no evidence that a stimulation polarity is superior to the others in the rehabilitation of UE motor function after stroke. A non-significant improvement trend was observed toward c-tDCS compared to a-tDCS.

Kinematic Gait Analysis in People with Mild-Disability Multiple Sclerosis Using Statistical Parametric Mapping: A Cross-Sectional Study.

Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system. Gait abnormalities, such as altered joint kinematics, are common in people with MS (pwMS). Traditional clinical gait assessments may not detect subtle kinematic alterations, but advances in motion capture technology and analysis methods, such as statistical parametric mapping (SPM), offer more detailed assessments. The aim of this study was to compare the lower-limb joint kinematics during gait between pwMS and healthy controls using SPM analysis. Methods: A cross-sectional study was conducted involving pwMS and healthy controls. A three-dimensional motion capture system was used to obtain the kinematic parameters of the more affected lower limb (MALL) and less affected lower limb (LALL), which were compared using the SPM analysis. Results: The study included 10 pwMS with mild disability (EDSS ≤ 3) and 10 healthy controls. The results showed no differences in spatiotemporal parameters. However, significant differences were observed in the kinematics of the lower-limb joints using SPM. In pwMS, compared to healthy controls, there was a higher anterior pelvis tilt (MALL, p = 0.047), reduced pelvis elevation (MALL, p = 0.024; LALL, p = 0.044), reduced pelvis descent (MALL, p = 0.033; LALL, p = 0.022), reduced hip extension during pre-swing (MALL, p = 0.049), increased hip flexion during terminal swing (MALL, p = 0.046), reduced knee flexion (MALL, p = 0.04; LALL, p < 0.001), and reduced range of motion in ankle plantarflexion (MALL, p = 0.048). Conclusions: pwMS with mild disability exhibit specific kinematic abnormalities during gait. SPM analysis can detect alterations in the kinematic parameters of gait in pwMS with mild disability.

Muscle Coactivation Index during Walking in People with Multiple Sclerosis with Mild Disability, a Cross-Sectional Study.

BACKGROUND: Multiple sclerosis (MS) is a progressive neurodegenerative disease characterized by axonal degeneration and demyelination. Changes in gait, related to joint kinematics and kinetics, especially at the ankle and knee, have been observed in people with MS (pwMS). Muscle coactivation plays an important role in joint stabilization; however, excessive coactivation may interfere with gait. The aim of this study was to analyze the differences in muscle activation during gait in pwMS compared to healthy individuals. METHODS: A cross-sectional study was conducted involving pwMS and healthy controls. Surface electromyography was used to record muscle activity during gait. The main outcome measures were the coactivation index (CI) and the area under the curve (AUC), which were calculated for several pairs of lower extremity muscles. RESULTS: Nine pwMS and nine healthy controls were included. When comparing the MS group to the control group, the AUC was significantly higher in the lateral gastrocnemius (p = 0.023) and the CI for the lateral gastrocnemius-anterior tibialis (p = 0.022) and gluteus maximus-lateral gastrocnemius (p = 0.047). CONCLUSION: Mildly affected pwMS have altered muscle coactivation patterns during gait, especially in the most affected limb. The results highlight the importance of muscle coactivation in pwMS and its possible role in the early detection of gait abnormalities.

Reliability and agreement of the timed up and go test in children and teenagers with autism spectrum disorder.

ASD patients include a variety of motor deficits; however, these issues have received less scientific attention than other ASD symptoms. Due to understanding and behavioral difficulties, it might be difficult to administer motor assessment measures to children and adolescents with ASD. To evaluate motor challenges in this population, including gait and dynamic balance issues, the timed up and go test (TUG) may be a simple, easy to apply, quick, and inexpensive tool. This test measures in seconds the time it takes for an individual to get up from a standard chair walk 3 m, turn around, walk back to the chair, and sit down again. The study purpose was to evaluate the inter- and intra-rater reliability of TUG test in children and teenagers with ASD. A total of 50 children and teenagers with ASD (43 boys and 7 girls) between 6 and 18 years were included. Reliability was verified by the intraclass correlation coefficient, standard error of measurement, and minimum detectable change. The agreement was analyzed by the Bland-Altman method. A good intra-rater reliability (ICC = 0.88; 95% CI = 0.79-0.93) and an excellent inter-rater reliability (ICC = 0,99; 95% CI = 0.98 to 0.99) were observed. Additionally, Bland-Altman plots demonstrated that there was no evidence of bias in either the replicates or between examiners. Furthermore, the limits of agreement (LOAs) between the testers and test replicates were close, indicating that there was little variation between measurements.       Conclusions: The test TUG showed strong intra- and inter-rater reliability values, low proportion of measurement errors, and lack of significant bias based on by test repetition in children and teenagers with ASD. These results could be clinically useful for assessing balance and the risk of falls in children and teenagers with ASD. However, the present study is not free of limitations, such as the use of a non-probabilistic sampling. What is Known: • People with ASD have a variety of motor deficits that have a prevalence rate almost as common as intellectual disability. In our knowledge, there are no studies that provide data on the reliability of the use of scales or assessment tests in children and adolescents with ASD to measure motor difficulties, such as gait and dynamic balance, in children and teenagers with ASD. • Timed up and go test (TUG) could be a possible tool to measure this motor skills. What is New: • The reliability and agreement of the Timed up and go test in 50 children and teenagers with autism spectrum disorder showed strong intra- and inter-rater reliability values, low proportion of measurement errors, and lack of significant bias based on by test repetition.

Reliability and Validity of the 10-Meter Walk Test (10MWT) in Adolescents and Young Adults with Down Syndrome.

People with Down syndrome (DS) have gait deficits because motor milestones are usually reached later. Decreased gait speed or reduced stride length are some of the main deficits. The main objective of the present work was to assess the reliability of the 10-Meter Walk Test (10MWT) in adolescents and young adults with DS. The objective has been to analyze the construct validity of the 10MWT with the Timed up and go (TUG) test. A total of 33 participants with DS were included. Reliability was verified by intraclass correlation coefficient (ICC). The agreement was analyzed by the Bland-Altman method. Finally, construct validity was evaluated through Pearson correlation coefficient. The 10MWT intra-rater and inter-rater reliability were good (ICC between 0.76 until 0.9) and excellent (ICC > 0.9), respectively. The minimal detectable change for intra-rater reliability was 0.188 m/s. Also, it has demonstrated moderate construct validity (r > 0.5) considering the TUG test. The 10MWT has shown high intra- and inter-rater reliability and validity in adolescent and adults with SD and a moderate construct validity between TUG test and 10MWT.

[Design and reliability study of a parental knowledge, attitude, and practice questionnaire on prevention and management of acute bronchiolitis of children under two years of age].

BACKGROUND: Acute bronchiolitis is the most common cause of hospitalization in the first year of life. Primary prevention and supportive care are key. Here, we aimed to design and assess the psychometric properties of a parent-focused questionnaire on prevention and management of acute bronchiolitis at home in children under two years of age. METHODOLOGY: For the design of the questionnaire, we conducted a literature search on prevention strategies and risk factors for bronchiolitis. An expert committee evaluated the content of the new questionnaire using the Content Validity Index and estimated the internal consistency reliability with Cronbach's alpha. RESULTS: A 26-item questionnaire divided into four dimensions (Risk factors, Signs and symptoms, Prevention, Care and pharmacological support) was created. The normalized score fell in the range between -50 and +50; a positive score was interpreted as presence of good knowledge, attitudes, and habits. Each of the 26 items obtained a Content Validity Index score > 0.80 and the global score was 0.90. The global internal consistency was a = 0.77, with differences between individual scores of the different dimensions of the questionnaire. CONCLUSION: The Parental knowledge, attitude, and practice questionnaire on prevention and management of acute bronchiolitis at home obtained an excellent Content Validity Index score by the expert committee and an acceptable internal consistency. Our questionnaire may reinforce the weak knowledge areas regarding the measures to apply.

Locomotor adaptation on a split-belt treadmill in adults with stroke: a systematic review.

This systematic review aimed to assess the efficacy of motor adaptation during walking on a split-belt treadmill (SBT) under different learning conditions in adults with stroke. We searched randomized clinical trials and case studies that used SBT under different learning conditions published between January 2011 and April 2022 in four databases: Pubmed, Scopus, Web of Science, and Brain-URJC. The following data were extracted: objectives, interventions, population, number of sessions, outcome measures, and results. The methodological quality of quantitative studies was evaluated using the Critical Review Form. We identified 79 studies, from which six met the criteria for this systematic review (four randomized clinical trials and two case series). The six selected studies included 156 patients with chronic stroke; 62.8% men, age 21-85 years. Walking on a SBT can generate artifacts in the gait pattern depending on the experimental conditions. Two series of cases and one trial reported that the dual motor task - the inclination of the slope of the SBT or the gradual change of speed - promotes the retention of the artifacts generated by the disturbances, resulting in the learning of a new motor pattern. However, combining physical exercise of different intensity and at different times with SBT, maximizing or minimizing errors, or including variable or constant speed disturbances do not seem to affect the locomotor adaptation process.

Kinesiology tape versus non-standardized tape in the treatment of balance in non-operated anterior cruciate ligament rupture patients: a randomized controlled trial.

PURPOSE/AIM: Anterior cruciate ligament injuries are the most common traumatic ligament injuries of the knee, which course with impaired balance. The aim of the present study was to analyse the effect of kinesiology tape on balance in subjects with non-operated anterior cruciate ligament rupture. MATERIALS AND METHODS: 36 subjects were randomly assigned to the kinesiology tape group (KT = 20) and the non-standardized tape group (NST = 16). Balance was assessed in the following 3 conditions: no bandage, immediately after application, and after four days of use. The outcome measures used were the Sensory Organisation Test (SOT), assessed by computerised dynamic Posturography (CDP), the modified star excursion balance test (mSEBT), the Spanish version of the KOOS and the Lysholm Knee Score. A 2-way repeated measures analysis of variance (ANOVA) was performed, with time as a within-subject factor and group as a between-subjects factor. Bonferroni correction was applied when the ANOVA was significant. RESULTS: ANOVA showed that there was no significant interaction between group and time for all outcome measures. However, a significant effect on the time factor was observed for: composite SOT score in both groups immediately after tape application; composite SOT after four days of use in the KT group; mSEBT in the KT group immediately after tape application. The KOOS improved in both groups after four days of tape use, while the Lysholm Knee Score improved only in the NST group. CONCLUSIONS: No differences were observed between the KT or NST groups in balance measurements.

Diseño y estudio de fiabilidad del cuestionario de conocimientos, aptitudes y prácticas de progenitores sobre prevención y abordaje de bronquiolitis aguda en población pediátrica menor de dos años / Design and reliability study of a parental knowledge, attitude, and practice questionnaire on prevention and management of acute bronchiolitis of children under two years of age

Fundamento: La bronquiolitis aguda es la causa más común de hospitalización en el primer año de vida. La prevención primaria y el cuidado de soporte son fundamentales. El objetivo de este estudio es crear un cuestionario para progenitores sobre la prevención y abordaje domiciliario de la bronquiolitis aguda, y estudiar sus propiedades psicométricas. Material y métodos: El diseño del cuestionario se basó en una búsqueda de la bibliografía sobre las estrategias de prevención y factores de riesgo de la bronquiolitis. Un comité de expertos evaluó su contenido mediante el índice de validez de contenido (IVC), y la consistencia interna (fiabilidad) se evaluó mediante alfa de Cronbach (α). Resultados: Se obtuvo un cuestionario de 26 ítems dividido en cuatro dimensiones (Factores de riesgo, Signos y síntomas, Prevención, Cuidados y soporte farmacológico) cuya puntuación normalizada oscila entre -50 y +50; se consideró existencia de buenos conocimientos, actitudes y hábitos si >0. El comité de expertos valoró todos los ítems con IVC >0,80, siendo el IVC global 0,90. La consistencia interna global fue α=0,77, con diferencias entre las puntuaciones individuales de las diferentes dimensiones del cuestionario. Conclusiones: El Cuestionario de conocimientos, aptitudes y prácticas para padres sobre prevención y abordaje domiciliario de la bronquiolitis aguda obtuvo una validez de contenido excelente tras la puntuación del comité de expertos, así como una consistencia interna aceptable. Puede ser una herramienta útil para reforzar aquellas medidas que los progenitores desconocen o no aplican.(AU)

Background: Acute bronchiolitis is the most common cause of hospitalization in the first year of life. Primary prevention and supportive care are key. Here, we aimed to design and assess the psychometric properties of a parent-focused questionnaire on prevention and management of acute bronchiolitis at home in children under two years of age. Methodology: For the design of the questionnaire, we conducted a literature search on prevention strategies and risk factors for bronchiolitis. An expert committee evaluated the content of the new questionnaire using the Content Validity Index and estimated the internal consistency reliability with Cronbach’s alpha. Results: A 26-item questionnaire divided into four dimensions (Risk factors, Signs and symptoms, Prevention, Care and pharmacological support) was created. The normalized score fell in the range between -50 and +50; a positive score was interpreted as presence of good knowledge, attitudes, and habits. Each of the 26 items obtained a Content Validity Index score > 0.80 and the global score was 0.90. The global internal consistency was α = 0.77, with differences between individual scores of the different dimensions of the questionnaire.Conclusion: The Parental knowledge, attitude, and practice questionnaire on prevention and management of acute bronchiolitis at home obtained an excellent Content Validity Index score by the expert committee and an acceptable internal consistency. Our questionnaire may reinforce the weak knowledge areas regarding the measures to apply.(AU)

Adaptación locomotora sobre pasarela rodante con correa dividida en personas con ictus: una revisión sistemática / Locomotor adaptation on a split-belt treadmill in adults with stroke: a systematic review

El objetivo de esta revisión fue evaluar la eficacia de la adaptación motora durante la marcha sobre cintas de marcha con correa dividida (CMCD) con diferentes condiciones de aprendizaje en personas con ictus. Se realizó una búsqueda de ensayos clínicos aleatorizados y estudios de casos en cuatro bases de datos (Pubmed, Scopus, Web of Science, Brain-URJC), publicados desde enero de 2011 hasta abril de 2022, que utilizasen CMCD bajo diferentes condiciones de aprendizaje. Se extrajeron datos sobre el objetivo, la intervención, la población, el número de sesiones, las medidas de resultados y los resultados obtenidos. Se valoró la calidad metodologica para estudios cuantitativos con la Critical Review Form.De los 79 estudios identificados, se incluyeron seis en la revisión, cuatro ensayos clínicos aleatorizados y dos series de casos. Incluyeron 156 personas con ictus crónico, 62,8% hombres, entre los 21-85 años de edad. La locomoción sobre CMCD puede generar artefactos en el patrón de marcha, según la condición experimental utilizada. Dos series de casos y un ensayo observaron que la doble tarea motora, la inclinación de la pendiente de la CMCD o el cambio gradual de velocidad, fomentarían la retención de los artefactos generados por las perturbaciones, redundando en el aprendizaje de un nuevo patrón motor.Sin embargo, incluir ejercicio físico de diferente intensidad y en diferentes momentos en combinación con CMCD, maximizar o minimizar los errores, o incluir perturbaciones variables o constantes de la velocidad, parecen no mostrar un efecto sobre el proceso de adaptación locomotora.(AU)

This systematic review aimed to assess the efficacy of motor adaptation during walking on a split-belt treadmill (SBT) under different learning conditions in adults with stroke. We searched randomized clinical trials and case studies that used SBT under different learning conditions published between January 2011 and April 2022 in four databases: Pubmed, Scopus, Web of Science, and Brain-URJC. The following data were extracted: objectives, interventions, population, number of sessions, outcome measures, and results. The methodological quality of quantitative studies was evaluated using the Critical Review Form. We identified 79 studies, from which six met the criteria for this systematic review (four randomized clinical trials and two case series). The six selected studies included 156 patients with chronic stroke; 62.8% men, age 21-85 years. Walking on a SBT can generate artifacts in the gait pattern depending on the experimental conditions. Two series of cases and one trial reported that the dual motor task - the inclination of the slope of the SBT or the gradual change of speed - promotes the retention of the artifacts generated by the disturbances, resulting in the learning of a new motor pattern. However, combining physical exercise of different intensity and at different times with SBT, maximizing or minimizing errors, or including variable or constant speed disturbances do not seem to affect the locomotor adaptation process.(AU)

Benchmarking of microbiome detection tools on RNA-seq synthetic databases according to diverse conditions.

Motivation: Here, we performed a benchmarking analysis of five tools for microbe sequence detection using transcriptomics data (Kraken2, MetaPhlAn2, PathSeq, DRAC and Pandora). We built a synthetic database mimicking real-world structure with tuned conditions accounting for microbe species prevalence, base calling quality and sequence length. Sensitivity and positive predictive value (PPV) parameters, as well as computational requirements, were used for tool ranking. Results: GATK PathSeq showed the highest sensitivity on average and across all scenarios considered. However, the main drawback of this tool was its slowness. Kraken2 was the fastest tool and displayed the second-best sensitivity, though with large variance depending on the species to be classified. There was no significant difference for the other three algorithms sensitivity. The sensitivity of MetaPhlAn2 and Pandora was affected by sequence number and DRAC by sequence quality and length. Results from this study support the use of Kraken2 for routine microbiome profiling based on its competitive sensitivity and runtime performance. Nonetheless, we strongly endorse to complement it by combining with MetaPhlAn2 for thorough taxonomic analyses. Availability and implementation: https://github.com/fjuradorueda/MIME/ and https://github.com/lola4/DRAC/. Supplementary information: Supplementary data are available at Bioinformatics Advances online.

STELO: A New Modular Robotic Gait Device for Acquired Brain Injury-Exploring Its Usability.

In recent years, the prevalence of acquired brain injury (ABI) has been on the rise, leading to impaired gait functionality in affected individuals. Traditional gait exoskeletons are typically rigid and bilateral and lack adaptability. To address this, the STELO, a pioneering modular gait-assistive device, was developed. This device can be externally configured with joint modules to cater to the diverse impairments of each patient, aiming to enhance adaptability and efficiency. This study aims to assess the safety and usability of the initial functional modular prototype, STELO, in a sample of 14 ABI-diagnosed participants. Adverse events, device adjustment assistance and time, and gait performance were evaluated during three sessions of device use. The results revealed that STELO was safe, with no serious adverse events reported. The need for assistance and time required for device adjustment decreased progressively over the sessions. Although there was no significant improvement in walking speed observed after three sessions of using STELO, participants and therapists reported satisfactory levels of comfort and usability in questionnaires. Overall, this study demonstrates that the STELO modular device offers a safe and adaptable solution for individuals with ABI, with positive user and therapist feedback.

The influence between gestational age and postural control, a systematic review.

The central nervous system (CNS) of preterm infants might have some peculiarities which distinguish it from that of full term infants. The difficulties associated with prematurity are the main cause of deaths all over the world during the new-born period after community-acquired pneumonia, and the second cause of deaths worldwide in children under five years old. Early recognition of signs indicating fragile postural control in premature infants can support understanding and help prevent and early intervention on possible future neuromotor dysfunctions in these subjects. The purpose of this paper is to determine if there is a qualitatively different development of postural control in premature infants without neurological involvement and infants born at term. We conducted a systematic review of longitudinal and cross-sectional case-control studies published between 2010 and March 2020 on this topic. The evaluation of parameters related to postural control was also included. The methodological quality of the selected works was evaluated using the CASPe critical reading programme for cases and controls. PRISMA guidelines for systematic reviews were followed for prematurity and postural control. 16 articles were included. The total sample amounted to 3,460 participants, of which 1,860 in the preterm group, and 1,600 in the control group. All the studies found show a poorer postural control by the group of children born preterm compared to the group of children born at term and one study indicating more limited postural control with higher prematurity. Regarding the methodological quality according to CASPe, those studies exceeding half of the total score were considered of adequate quality.

The Use of Portable Devices for the Instrumental Assessment of Balance in Patients with Chronic Stroke: A Systematic Review.

BACKGROUND: Improving balance remains a challenge in stroke rehabilitation. The technological development has allowed the design of more accessible and user-friendly systems for assessing postural control. OBJECTIVES: The aim of this review was to analyze portable devices for the instrumental assessment of balance in patients with chronic stroke. METHODS: PRISMA guidelines were used to carry out the systematic review. The literature search was restricted to articles written in English or Spanish published from 2013 to December 2022 in Pubmed, Web of Science, Scopus, PEDro, and CINAHL. Of the 309 search results, 229 unique references were reviewed after duplicates were removed. The PEDro scale was applied to evaluate the methodological quality of the included papers, and the degree of evidence and level of recommendation were determined through the Oxford Centre for Evidence-Based Medicine. RESULTS: A total of seven articles reporting on five different balance testing devices were included in this systematic review; they regarded BIORescue, a smartphone application, and the Biodex-BioSway Balance System for the evaluation of standing balance, and SwayStar Balance and Xsens ForceShoes™ for the evaluation of dynamic balance during walking. CONCLUSIONS: The use of portable devices that assess balance in adult patients with chronic stroke is scarce.

Arm-swing kinematics in Parkinson's disease: A systematic review and meta-analysis.

BACKGROUND: Parkinson's disease (PD) causes postural instability and gait abnormalities that may be associated with an arm swing reduction. OBJECTIVE: To conduct systematic review and meta-analysis to determine the kinematic patterns of arm-swing during gait in people with PD METHODS: A computer literature search of the PubMed, EMBASE, WOS, PEDro, SCOPUS and SciELO databases was conducted. Terms related to PD and arm-swing were combined to find studies that performed a free walking evaluation of the arm-swing of PD patients on or off medication compared to healthy controls. After a standardized evaluation by three examiners, fifteen articles met inclusion criteria. Random effects meta-analysis models were utilized to quantify (1) the arm-swing range of motion (RoM); (2) the arm-swing amplitude; (3) the arm-swing velocity; and (4) the arm-swing asymmetry. RESULTS: On average, arm-swing RoM (7.07°), amplitude (0.8 cm), and velocity (0.31 m/s) were significantly decreased in PD compared to healthy controls. Healthy subjects had significantly more symmetrical arm-swing (8.16%) than people with PD. Effect sizes were moderate-large. CONCLUSIONS: People with PD have significant differences in RoM, amplitude, velocity, and asymmetry of arm-swing during gait compared to the healthy control group. Medication phase does not significantly influence arm-swing characteristics. Further studies will be needed to determine whether different disease characteristics influence the biomechanics of arm-swing during gait.

Multisensory stimulation to promote feeding and psychomotor development in preterm infants: A systematic review.

BACKGROUND: Sensory stimulation is an intervention that, through peripheral stimuli, can facilitate brain organization, due to neuronal plasticity and cortical reorganization. The objective of this study was to evaluate the evidence about the effects of a multisensory stimulation program, applied on preterm infants, compared to any intervention or standard care, to improve feeding behaviour, and psychomotor development. METHODS: The data sources included Medline (pubmed, EBSCO), Scopus and Web Of Science. The studies were randomized clinical trials published between 2015 and 2021 that analyzed multisensory stimulation interventions in preterm infants born less than 37 weeks of pregnancy. RESULTS: Nine articles were identified, involving 545 preterm infants between 25 and 37 weeks of pregnancy. The studies applied different combinations of sensory stimulation. These interventions were related to a better time to achieve full oral feeding and higher consumption of human milk at discharge, better psychomotor development and visual function. All studies scored 6 or higher on the PEDro scale meaning good quality. CONCLUSION: Multisensory stimulation in preterm infants may improve feeding, psychomotor development, and visual function.