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1.
Arch Phys Med Rehabil ; 104(10): 1588-1595, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37178950

RESUMO

OBJECTIVE: The objective of the study was to estimate the internal and external responsiveness of the Reaching Performance Scale for Stroke (RPSS) in individuals with stroke. DESIGN: Retrospective analysis of data from 4 randomized controlled trials. SETTING: Recruitment locations spanning rehabilitation centers and hospitals in Canada, Italy, Argentina, Peru, and Thailand. PARTICIPANTS: Data from 567 participants (acute to chronic stroke; N=567) were available. INTERVENTIONS: All 4 studies involved training using virtual reality for upper limb rehabilitation. MAIN OUTCOME MEASURES: RPSS and upper extremity Fugl-Meyer Assessment (FMA-UE) scores. Responsiveness was quantified for all data and across different stages of stroke. Internal responsiveness of the RPSS was quantified as effect-sizes calculated using post and preintervention change data. External responsiveness was quantified using orthogonal regressions between FMA-UE and RPSS scores. The area under the Receiver Operating Characteristic curve (AUC) was quantified based on the ability of RPSS scores to detect change above FMA-UE minimal clinically important different values across different stages of stroke. RESULTS: The RPSS had high internal responsiveness overall and across the acute or subacute and chronic stages of stroke. For external responsiveness, orthogonal regression analyses indicated that change in FMA-UE scores had positive moderate correlations with both RPSS Close and Far Target scores for all data and across the acute or subacute and chronic stages of stroke (0.6

Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Avaliação da Deficiência , Recuperação de Função Fisiológica , Estudos Retrospectivos , Extremidade Superior , Ensaios Clínicos Controlados Aleatórios como Assunto
2.
Appl Neuropsychol Adult ; : 1-8, 2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36628434

RESUMO

BACKGROUND: Cognitive deficits contribute to disability in Parkinson's disease (PD). Cognitive intra-individual variability (IIV) is associated with cognitive decline in age-related disorders, but IIV has not been related to functional ability in PD. We examined IIV in predicting functional ability in participants with PD. METHODS: De-identified National Alzheimer's Coordinating Center data (N = 1,228) from baseline and follow-up visits included participants with PD propensity score matched to control participants at baseline on age (M = 72), education (M = 15), and gender (28% female). PD symptom duration averaged 6 years. Outcome measures included the Functional Ability Questionnaire (FAQ), overall test battery mean (OTBM) of ten cognitive variables, IIV calculated as the standard deviation of cognitive data for each participant, Geriatric Depression Scale (GDS), and Unified PD Rating Scale gait and posture items. Baseline FAQ status in the PD group was predicted using logistic regression with age, education, cognition, GDS, and motor function as predictors. We compared baseline characteristics of PD participants with and without functional impairment at follow up. RESULTS: PD participants showed lower OTBM and greater IIV, GDS, and motor dysfunction than controls (p < .0001). Education, OTBM, IIV, GDS, and gait predicted functional status (77% overall classification; AUC = .84). PD participants with functional impairment at follow up showed significantly lower OTBM and greater IIV, GDS, and motor dysfunction at baseline (p < .001). CONCLUSION: IIV independently predicts functional status in participants with PD while controlling for other variables. PD participants with functional impairment at follow up showed greater IIV than those without functional impairment at follow up.

3.
Neurorehabil Neural Repair ; 37(2-3): 151-164, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36703562

RESUMO

BACKGROUND: A single bout of aerobic exercise (AE) can produce changes in neurophysiological and behavioral measures in healthy individuals and those with stroke. However, the effects of AE-priming effects on neuroplasticity markers and behavioral measures are unclear. OBJECTIVES: This systematic review aimed to examine the effects of AE on neuroplasticity measures, such as corticomotor excitability (CME), molecular markers, cortical activation, motor learning, and performance in stroke. METHODS: A literature search was performed in MEDLINE, CINAHL, Scopus, and PsycINFO databases. Randomized and non-randomized studies incorporating acute AE in stroke were selected. Two reviewers independently assessed the risk of bias and methodological rigor of the studies and extracted data on participant characteristics, exercise interventions, and neuroplasticity related outcomes. The quality of transcranial magnetic stimulation reported methods was assessed using a standardized checklist. RESULTS: A total of 16 studies were found suitable for inclusion. Our findings suggest mixed evidence for the effects of AE on CME, limited to no effects on intracortical inhibition and facilitation and some evidence for modulating brain derived neurotrophic factor levels, motor learning, and cortical activation. Exercise intensities in the moderate to vigorous range showed a trend towards better effects on neuroplasticity measures. CONCLUSION: It appears that choosing a moderate to vigorous exercise paradigm for at least 20 to 30 minutes may induce changes in some neuroplasticity parameters in stroke. However, these findings necessitate prudent consideration as the studies were diverse and had moderate methodological quality. There is a need for a consensus on an exercise priming paradigm and for good-quality, larger controlled studies.


Assuntos
Exercício Físico , Acidente Vascular Cerebral , Humanos , Exercício Físico/fisiologia , Estimulação Magnética Transcraniana , Plasticidade Neuronal/fisiologia , Biomarcadores
4.
Disabil Rehabil Assist Technol ; 17(1): 107-115, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32448005

RESUMO

INTRODUCTION: Virtual Reality (VR) based platforms are useful in enhancing post-stroke sub-optimal upper limb (UL) motor improvement. A variety of options are available from expensive highly customizable platforms to low cost turnkey solutions. Clinical outcomes primarily help assess the effects of VR-based platforms. These outcomes mainly quantify how much improvement has occurred. Very few outcomes characterize the type (i.e. how) of recovery. We categorized the types of VR-based platforms and outcome measures commonly used for post-stroke UL motor improvement. METHODS: We reviewed the published literature in English from 2000-2019. Different types of VR-based platforms were grouped into those available commercially and those developed by the various research groups. We initially classified outcomes from the retrieved studies under the appropriate International Classification of Functioning categories. Then, we divided the outcomes as those quantifying the type or extent of improvement. RESULTS: We found a total of 125 studies. Majority of the studies used commercially available platforms. A total of 42 different outcome measures were used. Seventeen different outcomes were used to assess body structure and functions as well as in activity limitations. Eight outcomes assessed the effects of contextual factors and participation restrictions. The Fugl Meyer Assessment, Wolf Motor Function Test and Stroke Impact Scale were most often used across the three categories. Of the 125 studies, 52 used outcomes characterizing the type of recovery. Although a smaller proportion, 24 studies included movement patterns outcomes. CONCLUSION: A standardized set of outcomes can promote better comparisons between studies using different VR-based platforms for post-stroke UL motor improvement.Implications for RehabilitationA wide variety of commercially available systems are present from expensive customizable systems to low-cost turnkey systems.The Fugl-Meyer Assessment and Wolf Motor Function Test along with the Stroke Impact Scale-Social Participation subscale were used most often across all studies as assessments of body structure and function, activity limitations and participation restriction.It is essential to include movement pattern outcomes addressing whether recovery of compensation occurs with the use of VR-based platforms.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Terapia de Exposição à Realidade Virtual , Realidade Virtual , Humanos , Recuperação de Função Fisiológica , Extremidade Superior
5.
PM R ; 14(3): 337-347, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-33675151

RESUMO

INTRODUCTION: Post-stroke upper limb motor improvement can be better quantified by describing movement patterns characterizing movement quality and use of compensations. Movement patterns can be described using both kinematic and clinical outcomes. One clinical outcome that assesses movement quality and compensations used for reaching a Close (18 points) and Far target (18 points) is the Reaching Performance Scale for Stroke (RPSS). OBJECTIVE: To estimate the pilot test-retest reliability and validity (concurrent, discriminant) of the RPSS in individuals with chronic stroke. DESIGN: Retrospective data analysis. SETTING: Research laboratory. PARTICIPANTS: Seventy-two individuals with upper limb hemiparesis ≥6 months prior to participation. INTERVENTION: Not applicable. MAIN OUTCOME MEASURE: RPSS Close and Far Target scores. Intraclass correlation coefficients (ICCs) helped assess pilot test-retest reliability on a subset of 14 participants. Concurrent validity was assessed for individual RPSS items with corresponding kinematic outcomes (trunk displacement, shoulder flexion, shoulder horizontal adduction, elbow extension, trajectory straightness) using Pearson correlations. We also ran multiple regression analyses with the RPSS total scores and used kinematic outcomes as the criterion standard. Logistic regression analyses estimated discriminant validity. We divided participants into two groups based on the Fugl-Meyer Assessment (FMA) scores (mild: ≥50/66; moderate-to-severe: ≤49/66). RESULTS: Test-retest reliability was excellent for Close (ICC = 0.98, 95% confidence interval [CI] 0.94-0.99) and Far targets (ICC = 0.98, 95% CI 0.95-0.99). Individual RPSS items for both targets were mildly to moderately correlated with corresponding kinematic values. A combination of trajectory straightness, elbow extension, and trunk displacement explained the majority of the variance in RPSS scores (47%) for both targets. The RPSS scores discriminated between individuals with mild and moderate-to-severe motor impairment for both Close (ExpB = 3.33, P < .001; 95% CI 1.70-6.52) and Far targets (ExpB = 2.59, P < .001, 95% CI 1.65-4.07). Cutoff points for transition between groups were 15.5 (Close target) and 14 (Far target). CONCLUSION: The RPSS is a valid clinical measure with excellent pilot results of test-retest reliability for assessing movement patterns and compensations used for reaching.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Extremidade Superior
6.
Neurorehabil Neural Repair ; 36(1): 17-37, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34766518

RESUMO

BACKGROUND: Traumatic brain injury (TBI) is a leading cause of adult morbidity and mortality. Individuals with TBI have impairments in both cognitive and motor domains. Motor improvements post-TBI are attributable to adaptive neuroplasticity and motor learning. Majority of the studies focus on remediation of balance and mobility issues. There is limited understanding on the use of interventions for upper limb (UL) motor improvements in this population. OBJECTIVE: We examined the evidence regarding the effectiveness of different interventions to augment UL motor improvement after a TBI. METHODS: We systematically examined the evidence published in English from 1990-2020. The modified Downs and Black checklist helped assess study quality (total score: 28). Studies were classified as excellent: 24-28, good: 19-23, fair: 14-18, and poor: ≤13 in quality. Effect sizes helped quantify intervention effectiveness. RESULTS: Twenty-three studies were retrieved. Study quality was excellent (n = 1), good (n = 5) or fair (n = 17). Interventions used included strategies to decrease muscle tone (n = 6), constraint induced movement therapy (n = 4), virtual reality gaming (n = 5), non-invasive stimulation (n = 3), arm motor ability training (n = 1), stem cell transplant (n = 1), task-oriented training (n = 2), and feedback provision (n = 1). Motor impairment outcomes included Fugl-Meyer Assessment, Modified Ashworth Scale, and kinematic outcomes (error and movement straightness). Activity limitation outcomes included Wolf Motor Function Test and Motor Activity Log (MAL). Effect sizes for majority of the interventions ranged from medium (.5-.79) to large (≥.8). Only ten studies included retention testing. CONCLUSION: There is preliminary evidence that using some interventions may enhance UL motor improvement after a TBI. Answers to emergent questions can help select the most appropriate interventions in this population.


Assuntos
Lesões Encefálicas Traumáticas/fisiopatologia , Lesões Encefálicas Traumáticas/reabilitação , Reabilitação Neurológica , Avaliação de Resultados em Cuidados de Saúde , Extremidade Superior/fisiopatologia , Humanos
7.
F1000Res ; 11: 524, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36891251

RESUMO

Background: Action observation training (AOT) is used for lower limb (LL) stroke rehabilitation in subacute and chronic stages, but concise information regarding the types of activities to be used and the feasibility of administration in the acute stroke population is unknown. The aim of this study was to develop and validate videos of appropriate activities for LL AOT and test administrative feasibility in acute stroke.   Method: A video inventory of LL activities was created after a literature survey and expert scrutiny. Five stroke rehabilitation experts validated the videos per domains of relevance, comprehension, clarity, camera position and brightness. LL AOT was then tested on ten individuals with acute stroke for uncovering barriers for clinical use in a feasibility study. Participants watched the activities and attempted imitation of the same. Determination of administrative feasibility was undertaken via participant interviews.   Results: Suitable LL activities for stroke rehabilitation were identified. Content validation of videos led to improvements in selected activities and video quality. Expert scrutiny led to further video processing to include different perspectives of view and speeds of projected movements. Barriers identified included inability to imitate actions shown in videos and increased distractibility for some participants.    Conclusion: A video catalogue of LL activities was developed and validated. AOT was deemed safe and feasible for acute stroke rehabilitation and may be used in future research and clinical practice.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Extremidade Superior , Estudos de Viabilidade , Sobreviventes
8.
JMIR Serious Games ; 9(2): e23822, 2021 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-33825690

RESUMO

BACKGROUND: Increasing evidence supports the use of virtual reality systems to improve upper limb motor functions in individuals with cerebral palsy. While virtual reality offers the possibility to include key components to promote motor learning, it remains unclear if and how motor learning principles are incorporated into the development of rehabilitation interventions using virtual reality. OBJECTIVE: The objective of this study was to determine the extent to which motor learning principles are integrated into virtual reality interventions targeting upper limb function in individuals with cerebral palsy. METHODS: A systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search was performed in 10 databases using a combination of keywords related to cerebral palsy, virtual reality, video games, and rehabilitation. Studies were divided into 2 categories: commercial video game platforms and devices and custom virtual reality systems. Study quality was assessed using the modified Downs and Black checklist. RESULTS: The initial search yielded 1497 publications. A total of 26 studies from 30 publications were included, with most studies classified as "fair" according to the modified Downs and Black checklist. The majority of studies provided enhanced feedback and variable practice and used functionally relevant and motivating virtual tasks. The dosage varied greatly (total training time ranged from 300 to 3360 minutes), with only 6 studies reporting the number of movement repetitions per session. The difficulty progression and the assessment of skills retention and transfer were poorly incorporated, especially for the commercial video games. CONCLUSIONS: Motor learning principles should be better integrated into the development of future virtual reality systems for optimal upper limb motor recovery in individuals with cerebral palsy. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42020151982; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020151982.

9.
Hum Genome Var ; 7(1): 40, 2020 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-33298903

RESUMO

A palindrome in DNA is like a palindrome in language, but when read backwards, it is a complement of the forward sequence; effectively, the two halves of a sequence complement each other from its midpoint like in a double strand of DNA. Palindromes are distributed throughout the human genome and play significant roles in gene expression and regulation. Palindromic mutations are linked to many human diseases, such as neuronal disorders, mental retardation, and various cancers. In this work, we computed and analyzed the palindromic sequences in the human genome and studied their conservation in personal genomes using 1000 Genomes data. We found that ~30% of the palindromes exhibit variation, some of which are caused by rare variants. The analysis of disease/trait-associated single-nucleotide polymorphisms in palindromic regions showed that disease-associated risk variants are 14 times more likely to be present in palindromic regions than in other regions. The catalog of palindromes in the reference genome and 1000 Genomes is being made available here with details on their variations in each individual genome to serve as a resource for future and retrospective whole-genome studies identifying statistically significant palindrome variations associated with diseases or traits and their roles in disease mechanisms.

10.
Clin Neurophysiol ; 131(9): 2067-2078, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32682234

RESUMO

OBJECTIVES: The corticospinal system (CS) regulates muscle activation through shifts in muscle-level tonic stretch-reflex thresholds (TSRT). This ability is impaired in stroke and contributes to sensorimotor impairments such as spasticity. We determined the role of CS in elbow flexor activity regulation in healthy and post-stroke subjects. We also determined whether CS modulation deficits were related to sensorimotor impairment intensity in post-stroke individuals. METHODS: Seventeen healthy (59.8 ± 12.2 yr) and 27 stroke subjects (58.7 ± 10.1 yr) had transcranial magnetic stimulation (TMS) applied over the primary motor cortex (M1) flexor representation to elicit motor-evoked potentials (MEPs) in elbow flexors in different angular positions. In a subset of post-stroke subjects (n = 12), flexor TSRTs were measured in passive and active conditions, and TSRT modulation was determined. RESULTS: Position-related MEP amplitude modulation was similar in healthy and mild stroke subjects, while subjects with more severe stroke exhibited less consistent modulation. MEP modulation in stroke was related to clinical upper limb motor impairment, spasticity, and the ability to modulate TSRTs between passive and active elbow movements. CONCLUSIONS: CS output was closely related to TSRT modulation. Impairments in TSRT regulation may underlie motor deficits in moderate-to-severe post-stroke individuals. SIGNIFICANCE: Translation of these neurophysiological findings to clinical applications may enhance post-stroke motor recovery.


Assuntos
Potencial Evocado Motor/fisiologia , Córtex Motor/fisiopatologia , Tratos Piramidais/fisiopatologia , Reflexo de Estiramento/fisiologia , Acidente Vascular Cerebral/fisiopatologia , Idoso , Eletroencefalografia , Eletromiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estimulação Magnética Transcraniana
12.
Neurorehabil Neural Repair ; 34(3): 210-221, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31976815

RESUMO

Background. Kinematic abundance permits using different movement patterns for task completion. Individuals poststroke may take advantage of abundance by using compensatory trunk displacement to overcome upper limb (UL) movement deficits. However, movement adaptation in tasks requiring specific intersegment coordination may remain limited. Objective. We tested movement adaptation in both arms of individuals with chronic stroke (n = 16) and nondominant arms of controls (n = 12) using 2 no-vision reaching tasks involving trunk movement (40 trials/arm). Methods. In the "stationary hand task" (SHT), subjects maintained the hand motionless over a target while leaning the trunk forward. In the "reaching hand task" (RHT), subjects reached to the target while leaning forward. For both tasks, trunk movement was unexpectedly blocked in 40% of trials to assess the influence of trunk movement on adaptive arm positioning or reaching. UL sensorimotor impairment, activity, and sitting balance were assessed in the stroke group. The primary outcome measure for SHT was gain (g), defined as the extent to which trunk displacement contributing to hand motion was offset by appropriate changes in UL movements (g = 1: complete compensation) and endpoint deviation for RHT. Results. Individuals poststroke had lower gains and greater endpoint deviation using the more-affected compared with less-affected UL and controls. Those with less sensorimotor impairment, greater activity levels, and better sitting balance had higher gains and smaller endpoint deviations. Lower gains were associated with diminished UL adaptability. Conclusions. Tests of condition-specific adaptability of interjoint coordination may be used to measure UL adaptability and changes in adaptability with treatment.


Assuntos
Adaptação Fisiológica/fisiologia , Mãos/fisiopatologia , Atividade Motora/fisiologia , Paresia/fisiopatologia , Desempenho Psicomotor/fisiologia , Córtex Sensório-Motor/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Tronco/fisiopatologia , Adulto , Idoso , Fenômenos Biomecânicos/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paresia/etiologia , Acidente Vascular Cerebral/complicações
13.
Arch Physiother ; 9: 12, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31754461

RESUMO

BACKGROUND: The lateral epicondyle is a common site for chronic tendinosis (i.e. lateral epicondylitis), a condition characterized by overuse and degeneration of a tendon due to repeated microtrauma. This leads to pain and functional limitations. There is a growing interest in non-surgical forms of treatment for this condition including provision of corticosteroid injections and regenerative injection therapy (provision of autologous blood and platelet rich plasma injections). OBJECTIVE: We compared the effectiveness of corticosteroids with regenerative injection therapy for the treatment of lateral epicondylitis. METHODS: We systematically reviewed randomized controlled trials published in English language from 2008 to 2018. Databases used included PEDro, Scopus, PubMed, and CINAHL. Nine articles met our selection criteria. The PEDRo scale scores helped assess study quality. Cochrane risk of bias criteria helped assess bias. We analyzed results focusing on pain and function using meta-analyses. RESULTS: Six out of 9 studies had low risk of bias. There were no short-term (1 and 2 month) differences in pain scores between the corticosteroid and regenerative injection groups. Participants receiving regenerative injections demonstrated greater long-term improvements lasting for a period of ≈2 years. CONCLUSION: Regenerative injections provision results in greater long-term pain relief and improved function for people with lateral epicondylitis.

14.
J Allied Health ; 48(3): 220-225, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31487362

RESUMO

Homelessness is a national epidemic and individuals experiencing homelessness have decreased access to healthcare services. At the same time, physical therapy (PT) educational programs are required to teach students about cultural competence, pro-bono service, and advocacy for underserved populations. Having PT students provide pro-bono services to this population in a supervised environment is a mutually beneficial scenario for the patients, students, and the PT program. AIMS: The study objective was to evaluate whether participating in a student-run free clinic (SRFC) at a homeless shelter could change PT students' attitudes towards individuals experiencing homelessness. METHODS: Forty DPT students completed the Health Professionals' Attitude Toward the Homeless Inventory (HPATHI) with 19 volunteering (experimental group) to participate in the SRFC. The HPATHI was administered again immediately following participation in the SRFC to assess if their attitudes had changed. RESULTS: Baseline scores differed between the control and experimental group (p=0.03). However, post-scores of the experimental group did not differ compared to pre-scores. The subsequent analysis estimated differences on 4 of 19 questions, specifically within the personal advocacy and social advocacy subscales. CONCLUSIONS: Overall, PT students' attitudes did not change significantly after one session of volunteering at an SRFC in a homeless shelter. However, small changes were seen in personal and social advocacy subscales of the HPATHI.


Assuntos
Atitude do Pessoal de Saúde , Pessoas Mal Alojadas , Especialidade de Fisioterapia , Clínica Dirigida por Estudantes , Adulto , Feminino , Humanos , Masculino , Projetos Piloto , Estudantes de Ciências da Saúde , Inquéritos e Questionários , Adulto Jovem
16.
PM R ; 10(11): 1261-1270, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30503233

RESUMO

BACKGROUND: Efforts to augment post-stroke upper limb (UL) motor improvement include the use of newer interventions such as noninvasive brain stimulation (NIBS) and task practice in virtual reality environments (VEs). Despite increasing interest in using a combination of these 2 interventions, the effectiveness of this combination to enhance UL motor improvement outcomes has not been examined. OBJECTIVE: To evaluate the effectiveness of a combination of NIBS and task practice in a VE to augment post-stroke UL motor improvement. METHODS: We conducted a systematic search of the published literature using standard methodology. The Down and Black checklist and the Physiotherapy Evidence Database Research Organization Scale were used to assess study quality. We compared changes in UL impairment and activity levels between active stimulation and sham or other interventions using standardized mean differences and derived a summary effect size. RESULTS: We retrieved 5 studies that examined the role of a combination of NIBS and task practice in a VE to optimize UL motor improvement. These 5 studies included 3 randomized controlled trials, 1 cross-sectional study, and 1 crossover study. There was level 1a evidence that the combination was beneficial in subacute stroke. There was level 1b evidence that provision of real stimulation was not superior to sham stimulation in chronic stroke. Effect sizes favoring the combination were moderate for improvements in UL impairment and small for activity levels. CONCLUSIONS: Preliminary evidence supports the effectiveness of this combination in subacute stroke. Emergent questions need to be addressed to derive maximum benefit of this combination to augment post-stroke UL motor improvement. LEVEL OF EVIDENCE: I.


Assuntos
Atividade Motora/fisiologia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/fisiopatologia , Extremidade Superior/fisiopatologia , Realidade Virtual , Humanos , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/complicações
17.
J Neurophysiol ; 119(1): 5-20, 2018 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-28904099

RESUMO

Previous motor learning studies based on adapting movements of the hemiparetic arm in stroke subjects have not accounted for spasticity occurring in specific joint ranges (spasticity zones), resulting in equivocal conclusions about learning capacity. We compared the ability of participants with stroke to rapidly adapt elbow extension movements to changing external load conditions outside and inside spasticity zones. Participants with stroke ( n = 12, aged 57.8 ± 9.6 yr) and healthy age-matched controls ( n = 8, 63.5 ± 9.1 yr) made rapid 40°-50° horizontal elbow extension movements from an initial (3°) to a final (6°) target. Sixteen blocks (6-10 trials/block) consisting of alternating loaded (30% maximal voluntary contraction) and nonloaded trials were made in one (controls) or two sessions (stroke; 1 wk apart). For the stroke group, the tonic stretch reflex threshold angle at which elbow flexors began to be activated during passive elbow extension was used to identify the beginning of the spasticity zone. The task was repeated in joint ranges that did or did not include the spasticity zone. Error correction strategies were identified by the angular positions before correction and compared between groups and sessions. Changes in load condition from no load to load and vice versa resulted in undershoot and overshoot errors, respectively. Stroke subjects corrected errors in 1-4 trials compared with 1-2 trials in controls. When movements did not include the spasticity zone, there was an immediate decrease in the number of trials needed to restore accuracy, suggesting that the capacity to learn may be preserved after stroke but masked by the presence of spasticity. NEW & NOTEWORTHY When arm movements were made outside, instead of inside, the range affected by spasticity, there was an immediate decrease in the number of trials needed to restore accuracy in response to a change in the external load. This suggests that motor learning processes may be preserved in patients with stroke but masked by the presence of spasticity in specific joint ranges. This has important implications for designing rehabilitation interventions predicated on motor learning principles.


Assuntos
Aprendizagem , Movimento , Acidente Vascular Cerebral/fisiopatologia , Idoso , Estudos de Casos e Controles , Cotovelo/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espasticidade Muscular/fisiopatologia , Músculo Esquelético/fisiopatologia
18.
IEEE/ACM Trans Comput Biol Bioinform ; 15(4): 1239-1246, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-26672046

RESUMO

One of the goals of relation extraction is to identify protein-protein interactions (PPIs) in biomedical literature. Current systems are capturing binary relations and also the direction and type of an interaction. Besides assisting in the curation PPIs into databases, there has been little real-world application of these algorithms. We describe UPSITE, a text mining tool for extracting evidence in support of a hypothesized interaction. Given a predicted PPI, UPSITE uses a binary relation detector to check whether a PPI is found in abstracts in PubMed. If it is not found, UPSITE retrieves documents relevant to each of the two proteins separately, and extracts contextual information about biological events surrounding each protein, and calculates semantic similarity of the two proteins to provide evidential support for the predicted PPI. In evaluations, relation extraction achieved an Fscore of 0.88 on the HPRD50 corpus, and semantic similarity measured with angular distance was found to be statistically significant. With the development of PPI prediction algorithms, the burden of interpreting the validity and relevance of novel PPIs is on biologists. We suggest that presenting annotations of the two proteins in a PPI side-by-side and a score that quantifies their similarity lessens this burden to some extent.


Assuntos
Mineração de Dados/métodos , Processamento de Linguagem Natural , Mapeamento de Interação de Proteínas/métodos , Algoritmos , Bases de Dados de Proteínas , Humanos , Mapas de Interação de Proteínas/genética , Mapas de Interação de Proteínas/fisiologia , Proteínas/genética , Proteínas/metabolismo , Proteínas/fisiologia , Semântica
19.
Exp Brain Res ; 236(2): 381-398, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29164285

RESUMO

This study addresses the question of how posture and movement are oriented with respect to the direction of gravity. It is suggested that neural control levels coordinate spatial thresholds at which multiple muscles begin to be activated to specify a referent body orientation (RO) at which muscle activity is minimized. Under the influence of gravity, the body is deflected from the RO to an actual orientation (AO) until the emerging muscle activity and forces begin to balance gravitational forces and maintain body stability. We assumed that (1) during quiet standing on differently tilted surfaces, the same RO and thus AO can be maintained by adjusting activation thresholds of ankle muscles according to the surface tilt angle; (2) intentional forward body leaning results from monotonic ramp-and-hold shifts in the RO; (3) rhythmic oscillation of the RO about the ankle joints during standing results in body swaying. At certain sway phases, the AO and RO may transiently overlap, resulting in minima in the activity of multiple muscles across the body. EMG kinematic patterns of the 3 tasks were recorded and explained based on the RO concept that implies that these patterns emerge due to referent control without being pre-programmed. We also confirmed the predicted occurrence of minima in the activity of multiple muscles at specific body configurations during swaying. Results re-affirm previous rejections of model-based computational theories of motor control. The role of different descending systems in the referent control of posture and movement in the gravitational field is considered.


Assuntos
Gravitação , Movimento/fisiologia , Orientação/fisiologia , Postura/fisiologia , Adulto , Análise de Variância , Eletromiografia , Potencial Evocado Motor/fisiologia , Feminino , Humanos , Masculino , Músculo Esquelético/fisiologia , Adulto Jovem
20.
Data (Basel) ; 2(4)2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30498741

RESUMO

Bio-molecular reagents like antibodies required in experimental biology are expensive and their effectiveness, among other things, is critical to the success of the experiment. Although such resources are sometimes donated by one investigator to another through personal communication between the two, there is no previous study to our knowledge on the extent of such donations, nor a central platform that directs resource seekers to donors. In this paper, we describe, to our knowledge, a first attempt at building a web-portal titled Antibody Exchange (or more general 'Bio-Resource Exchange') that attempts to bridge this gap between resource seekers and donors in the domain of experimental biology. Users on this portal can request for or donate antibodies, cell-lines and DNA Constructs. This resource could also serve as a crowd-sourced database of resources for experimental biology. Further, we also studied the extent of antibody donations by mining the acknowledgement sections of scientific articles. Specifically, we extracted the name of the donor, his/her affiliation and the name of the antibody for every donation by parsing the acknowledgements sections of articles. To extract annotations at this level, we adopted two approaches - a rule based algorithm and a bootstrapped pattern learning algorithm. The algorithms extracted donor names, affiliations and antibody names with average accuracies of 57% and 62% respectively. We also created a dataset of 50 expert-annotated acknowledgements sections that will serve as a gold standard dataset to evaluate extraction algorithms in the future.

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