Corridor and real-time 6-minute walk tests in healthy young adults: A randomized cross-over study.

Objective: Cardiopulmonary endurance is important for comfortably participating in activities of daily living. Exercise tests, such as the 6-minute walk test (6MWT), are commonly used to evaluate cardiopulmonary endurance. We investigated the effects of the Gait Real-Time Analysis Interactive Lab (GRAIL)- and corridor-based 6MWTs on functional performance. Methods: Thirty healthy men were randomly divided into two groups. Group A participants performed a corridor-based 6MWT, followed by a washout period (1 h). Subsequently, they performed the GRAIL-based 6MWT. Group B participants performed the tests in the reverse order of that performed by Group A participants. Results: The corridor-based 6MWT resulted in significantly higher 6MW distance and 6MW speed than the GRAIL-based 6MWT. No significant differences were observed between the two groups in any of the following secondary outcomes: systolic blood pressure, diastolic blood pressure, oxygen saturation, heart rate, dyspnea, and overall fatigue. A strong positive correlation was observed between the 6MW distance and 6MW speed. Conclusion: The corridor- and GRAIL-based 6MWT should not be used interchangeably.

Polarity-dependent cerebellar transcranial direct current stimulation modulates online functions of the alerting attention network.

OBJECTIVES: To investigate the modulatory effect of anodal, cathodal and sham cerebellar transcranial direct current stimulation (ctDCS) on the efficiency of the 3 attention networks namely alerting network, orienting network, and the network of executive control. METHODS: A sham-controlled, single-blind study. Experiments were performed at the neuroscience lab of Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia, between the months of January-July of 2018. Sixty-three healthy subjects were assessed for eligibility and a total of 60 subjects (30 males and 30 females) met the inclusion criteria. Subjects were randomly divided into 3 groups that received a single 20-minute session of 2 mA of anodal, cathodal or sham ctDCS while performing tasks. The tasks corresponded to the 3 attention networks-vigilance task assessed the alerting network, Posner's attention task assessed the orienting network and Flanker task assessed the network of executive control. The Edinburgh handedness inventory-short form determined the subjects' handedness. RESULTS: Analysis of variance (ANOVA) showed a highly significant polarity-independent group*task effect (p=0.003) for the vigilance task. Moreover, there was a significant polarity-independent group*task effect for valid cues (p=0.006). A polarity-dependent group*task effect was observed for invalid cues (p=0.011). CONCLUSION: Conclusion: Findings demonstrate that ctDCS modulates alerting attention and highlights a more profound effect of cerebellar modulation in attention tasks with higher cognitive load.

Reliability and validity of smartphone applications to measure the spinal range of motion: A systematic review.

Introduction: The objective of this study is to conduct a systematic review on the reliability and validity of various smartphone applications for spinal range of motion (ROM) measurements.Methods: Eleven studies were selected following an electronic search of PubMed, CINAHAL, Medline, Embase and SPORTDiscus. Quality appraisals of selected studies were conducted using a standardized appraisal tool.Results: Most studies demonstrated a good intra- and inter-rater reliability, as well as validity in more than 50% of joint movements. At the same time, relative reliability/validity outcomes (e.g. interclass correlation co-efficient) were stronger than absolute reliability/validity outcomes (e.g. mean differences, limits of agreement). Spinal rotation movement showed less reliability and validity when compared to other spinal movements.ConclusionsːResult of the study supports the use of smartphone applications for ROM measurements of spinal joints. However, we cannot advocate the most appropriate application for spinal ROM measurement or suggest which application is superior to all others. As clinicians have multiple options in selecting applications, it is recommended they use applications that have proven reliable and valid for that particular joint. Data from this study provides clinicians with evidence-based research on smartphone devices for measuring spinal joint ROM in clinical settings.

Effects of using assistive devices on the components of the modified instrumented timed up and go test in healthy subjects.

INTRODUCTION: Evaluation of the changes in gait spatiotemporal parameters and functional mobility with using assistive devices (ADs) would provide useful information and mutual assistance when prescribing such ambulatory devices. This study aimed to investigate the spatiotemporal gait and functional mobility parameters in healthy adults when walking using different ADs. METHODS: A group of healthy subjects participated in the study. The instrumented modified Timed Up and Go test (iTUG) was used to investigate the impact of different types of ADs on spatiotemporal and functional mobility parameters. RESULTS: Subjects showed a significant difference in the gait task performance (P = .001) in stride velocity, stride length, and cadence when walking with and without ADs. A significant difference was also found in the performance of the turn-to-sit task (P = .001) in both velocity and duration when walking with and without ADs. The time to complete sit-to-stand was significantly slower when using a walker (98.3 ± 22.3°/sec, P = .004) and a cane (78.2 ± 21.9°/sec, P = .004) compared to walking without an AD (78.2 ± 21.8°/sec). No significant difference was found between walking with a cane group versus walking with a four-wheeled walker group (P = .94). CONCLUSION: ADs altered gait and functional mobility parameters differently in healthy subjects. Using a four-wheeled walker showed a tendency to increase stride velocity, cadence, stride length, and slow sit-to-stand velocity compared to using a cane. The findings highlight using more caution clinically when prescribing ADs and providing gait training.

Determinants of life satisfaction among stroke survivors 1 year post stroke.

ABSTRACT: Stroke is the major leading cause of death and severe long-term disability worldwide. The consequences of stroke, aside from diminished survival, have a significant impact on an individual's capability in maintaining self-autonomy and life satisfaction (LS). Thus, this study aimed to assess LS and other specific domains of LS in stroke survivors following their first-ever stroke, and to describe the relationship using socio-demographic and stroke-related variables.This study recruited 376 stroke survivors (244 men and 132 women, mean age: 57 years) 1 year following stroke. Data on participants' LS (measured using the Life Satisfaction Questionnaire [LiSat-11]), socio-demographics, and stroke-related variables were collected.Univariate analysis showed that LS and the 10 specific domains were not associated with the patients' gender or stroke type; however, age at onset, marital status, and vocational situation were significantly associated with some domains in LiSat-11 (Spearman's rho = 0.42-0.87; all P < 0.05). Logistic regression revealed that verbal and cognitive dysfunction were the most negative predictors of LS (odds ratio 4.1 and 3.7, respectively).LS is negatively affected in stroke survivors 1 year post onset. The results indicate that recovering social engagement is a positive predictor of higher LS in stroke survivors. More importantly, the findings revealed that cognitive and verbal dysfunctions were the most prominent negative predictors of the overall gross level of LS. Multidisciplinary rehabilitation for stroke survivors is therefore critical.

Effects of Green Brazilian Propolis Alcohol Extract on Nociceptive Pain Models in Rats.

Pain is one of the most common symptoms encountered in the medical practice. None of the management procedures used currently offer a complete relief for patients suffering from nociceptive pain. New treatment strategies for pain management are needed. Propolis has been used in traditional medicine to relieve various types of pain. The aim of the current study was to investigate the potential effects of the green Brazilian propolis alcohol extract in vivo on the nociceptive and inflammatory pain models in rats. Rats were distributed into three random groups (n = 6); Group I: control group received normal saline intraperitoneally (i.p.); Group II: treated with green Brazilian propolis alcohol extract (P50 mg/kg i.p.); Group III: treated with P100 mg/kg i.p. After sixty minutes, 50 µL of 5% formalin was injected subcutaneously into the dorsal surface of the right hind paw. The nociceptive response was identified by counting the number of flinches of the injected paw. The number of flinches was counted for the period of 0-5 min (early phase; neurogenic) and 10-60 min (late phase; inflammatory). Thermal hyperalgesia was assessed using three-paw withdrawal latency measurement with ten minutes intervals using a planter analgesic meter. Abdominal writhe (contraction) was induced by i.p. injection of acetic acid (1 mL of 2%). The results showed that green Brazilian propolis alcohol extract caused a significant inhibition of acetic acid-induced pain and significantly increased the pain threshold against infrared and formalin tests. The promising antinociceptive and anti-inflammatory properties of propolis and/or its active constituents as natural compounds in the present study indicates that it merits further studies in pain.

Online polarity-dependent effects of cerebellar transcranial direct current stimulation on motor speed and fine manual dexterity. A randomized controlled trial.

OBJECTIVES: To investigate the role of cerebellar transcranial direct current stimulation (ctDCS) in modulating cerebellar functions in the motor domains of fine motor dexterity and motor speed. Methods: A single-blind, randomized sham-controlled study was conducted between January and July 2018 at the neuroscience laboratory of Imam Abdulrahman Bin Faisal University. A total of 63 healthy participants were assessed for eligibility. Sixty subjects met the criteria of the study and were randomly divided into 3 groups that received anodal, cathodal or sham ctDCS. Subjects performed 2 motor tasks, The Grooved Pegboard test (GPT) assessed fine manual dexterity and the Finger Tapping Task (FTT) assessed motor speed. Subjects undertook the 2 tasks in a single intervention session while 20 minutes of 2mA ctDCS was administered online. The short form of the Edinburgh Handedness Inventory was used to assess handedness and both tasks were performed first with the dominant and then the non-dominant hand. The primary outcome measures included the time of completion of GPT for fine manual dexterity and the mean number of finger-taps for motor speed of each hand. Results: ANOVA revealed a highly significant polarity dependent Group*Task interaction (p less than 0.01) for FTT scores. ANOVA also revealed a non-significant Group*Task interaction for GPT scores.  Conclusion: Findings indicate that ctDCS has a modulatory effect on motor speed and could be a promising therapeutic intervention for treatment of neurological conditions with motor deficits.

Spinal direct current stimulation with locomotor training in chronic spinal cord injury.

Transcutaneous spinal direct current stimulation (tsDCS) is a non-invasive method of stimulating spinal circuits that can modulate and induce changes in corticospinal excitability (CE) in incomplete spinal cord injury (SCI). A double-blinded sham controlled study of 2 male patients (A and B) with SCI was carried out. Patient A received sham and cathodal tsDCS, while Patient B received sham and anodal tsDCS. Four baselines were recorded prior to each arm of stimulation. Outcomes were then measured post each arm of stimulation; 10-meter walk test, modified ashworth scale, berg balance scale, manual muscle testing, and spinal cord independence measure-III. Transcranial magnetic stimulation, assessed motor evoked potentials. Cathodal tsDCS increased the scores in few of the outcome measures and decreased others. Anodal stimulation increased scores in all measures. Motor evoked potentials increased in post-cathode and deteriorated in post-anode. In conclusion, tsDCS modulated gait parameters, spasticity, and CE in incomplete SCI.

Effects of transcranial direct current stimulation of primary motor cortex on cortical sensory deficits and hand dexterity in a patient with stroke: A case study.

Fine motor and manual dexterity deficits are the main causes of significant physical and psychosocial impairments in stroke survivors. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique used to modulate brain activity and improve clinical outcomes. This study was performed to investigate the efficacy of dual-hemispheric tDCS of the primary motor cortex (M1) in a patient with stroke exhibiting cortical sensation deficits. A double-blind, sham-controlled, single-case study was conducted. The patient underwent 30 sessions of sham tDCS followed by 30 real-stimulation sessions over both M1 cortices. Each session involved 20 minutes of 2-mA stimulation (current density, 0.08 mA/cm2; total charge density, 0.096 C/cm2). Functional measures were assessed using the Action Research Arm Test, grooved pegboard test, nine-hole peg test, and box and block test at several time points. Structural and diffusion tensor imaging data were acquired before (t0) and after (t1) stimulation. Slight improvements following sham tDCS were observed. However, following real stimulation, all results at all time points were clinically significant. Higher fractional anisotropy of the corticospinal tract and regional gray matter density were positively correlated with better recovery of fine motor skills. tDCS intervention induced functional improvement and structural changes in this patient with stroke.