scholarly journals Navigated Transcranial Magnetic Stimulation: A Biologically Based Assay of Lower Extremity Impairment and Gait Velocity

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Heather T. Peters ◽  
Kari Dunning ◽  
Samir Belagaje ◽  
Brett M. Kissela ◽  
Jun Ying ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Tibialis Anterior ◽  
Evoked Potential ◽  
Outcome Measurement ◽  
Motor Evoked Potential ◽  
Gait Velocity ◽  
Walk Test ◽  
Navigated Transcranial Magnetic Stimulation ◽  
10 Meter Walk Test ◽  
Difficulty Walking

Objectives. (a) To determine associations among motor evoked potential (MEP) amplitude, MEP latency, lower extremity (LE) impairment, and gait velocity and (b) determine the association between the presence of a detectable MEP signal with LE impairment and with gait velocity.Method. 35 subjects with chronic, stable LE hemiparesis were undergone TMS, the LE section of the Fugl-Meyer Impairment Scale (LE FM), and 10-meter walk test. We recorded presence, amplitude, and latency of MEPs in the affected tibialis anterior (TA) and soleus (SO).Results. MEP presence was associated with higher LEFM scores in both the TA and SO. MEP latency was larger in subjects with lower LEFM and difficulty walking.Conclusion. MEP latency appears to be an indicator of LE impairment and gait.Significance. Our results support the precept of using TMS, particularly MEP latency, as an adjunctive LE outcome measurement and prognostic technique.

scholarly journals Operant Up-Conditioning of the Tibialis Anterior Motor-Evoked Potential in Multiple Sclerosis: Feasibility Case Studies

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Aiko K. Thompson ◽  
Briana M. Favale ◽  
Jacqueline Velez ◽  
Patricia Falivena
Keyword(s):  
Multiple Sclerosis ◽  
Operant Conditioning ◽  
Tibialis Anterior ◽  
Evoked Potential ◽  
Maximum Voluntary Contraction ◽  
Motor Evoked Potential ◽  
Voluntary Contraction ◽  
Foot Drop ◽  
Immediate Feedback ◽  
Cord Injury

Damage to the corticospinal pathway often results in weak dorsiflexion of the ankle, thereby limiting the mobility of people with multiple sclerosis (MS). Thus, strengthening corticospinal connectivity may improve locomotion. Here, we investigated the feasibility of tibialis anterior (TA) motor-evoked potential (MEP) operant conditioning and whether it can enhance corticospinal excitability and alleviate locomotor problems in people with chronic stable MS. The protocol consisted of 6 baseline and 24 up-conditioning sessions over 10 weeks. In all sessions, TA MEPs were elicited at 10% above active threshold while the sitting subject provided 30–35% maximum voluntary contraction (MVC) level of TA background EMG. During baseline sessions, MEPs were simply measured. During conditioning trials of the conditioning sessions, the subject was encouraged to increase MEP and was given immediate feedback indicating whether MEP size was above a criterion. In 3/4 subjects, TA MEP increased 32–75%, MVC increased 28–52%, locomotor EMG modulation improved in multiple leg muscles, and foot drop became less severe. In one of them, MEP and MVC increases were maintained throughout 3 years of extensive follow-up sessions. These initial results support a therapeutic possibility of MEP operant conditioning for improving locomotion in people with MS or other CNS disorders, such as spinal cord injury and stroke.

S2-3. Intraoperative monitoring of lower extremity motor-evoked potential by direct cortical stimulation

2013 ◽  
Vol 124 (8) ◽  
pp. e20
Author(s):  
Masami Fujii ◽  
Yuichi Maruta ◽  
Hirochika Imoto ◽  
Hisaharu Goto ◽  
Michiyasu Suzuki
Keyword(s):  
Lower Extremity ◽  
Intraoperative Monitoring ◽  
Evoked Potential ◽  
Motor Evoked Potential ◽  
Cortical Stimulation ◽  
Direct Cortical Stimulation

10. Intraoperative motor evoked potential monitoring for predicting lower-extremity motor dysfunction

2010 ◽  
Vol 121 (7) ◽  
pp. e21
Author(s):  
Hirochika Imoto ◽  
Masami Fujii ◽  
Yuichi Maruta ◽  
Sadahiro Nomura ◽  
Hiroshi Yoneda ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Evoked Potential ◽  
Motor Evoked Potential ◽  
Motor Dysfunction ◽  
Evoked Potential Monitoring ◽  
Potential Monitoring

scholarly journals Dynamic balance recovery in chronic Acquired Brain Injury participants following a perturbation training

2021 ◽  
Author(s):  
Katherin Joubran ◽  
Simona Bar-Haim ◽  
Lior Shmuelof
Keyword(s):  
Brain Injury ◽  
Dynamic Balance ◽  
Balance Training ◽  
Acquired Brain Injury ◽  
Gait Velocity ◽  
Minimal Detectable Change ◽  
Walk Test ◽  
Perturbation Training ◽  
The Brain ◽  
10 Meter Walk Test

AbstractBackgroundAcquired Brain Injury (ABI) is defined as a damage to the brain that occurs after birth. Subjects post-ABI suffer from dynamic balance impairments that persist years after the injury.ObjectiveTo explore the effect of a perturbation method which is consisted of unexpected balance perturbations using Re-Step™ technology on the recovery of dynamic balance and gait velocity in chronic ABI participants.MethodsIn a clinical trial, 35 chronic ABI participants (stroke and traumatic brain injury) participated in 22 sessions of perturbation-training, twice a week for 3 months. Dynamic balance was assessed pre and post-training using Community Balance and Mobility Scale (CB&M). Gait velocity was also assessed in the stroke participants using the 10-meter walk test (10MWT).ResultsDynamic balance improved significantly post-training (p=0.001). This improvement was greater than the improvement that was observed in a sub-group that was tested twice before training (p=0.04). 16 participants (45.7%) out of 35 met or exceeded minimal detectable change (MDC) of the CB&M Scale. Self-paced velocity also improved significantly (p=0.02) but only 2 participants (9.5%) out of 21 exceeded the MDC of 10MWT post-stroke.ConclusionsUnexpected balance perturbation-training using Re-Step™ technology led to an improvement in dynamic balance and gait velocity in chronic ABI participants. The advantage of Re-Step™ technology training compared to conventional balance training should be further examined.

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